Current opinion in supportive and palliative care
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Curr Opin Support Palliat Care · Mar 2013
ReviewIdentifying treatment burden as an important concept for end of life care in those with advanced heart failure.
The concept of treatment burden is receiving increasing attention and this review seeks to show that treatment burden is an important issue for end-of-life care in those with advanced heart failure. ⋯ Treatment burden has the potential to be an important barometer of quality of care from the patient perspective in advanced heart failure.
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Curr Opin Support Palliat Care · Mar 2013
ReviewEnd-of-life care in adults with congenital heart disease: now is the time to act.
There are increasing numbers of adults with congenital heart disease (CHD) and these patients remain at long-term risk of complications and premature death. This review focuses on the changing picture of adult CHD with more complex patients surviving, the challenges of balancing life-prolonging intervention, the barriers to discussing the end-of-life (EOL) issues and draws on the experience of other specialities in managing young patients. ⋯ These patients require an early and proactive approach to EOL discussions, and the unique needs of young patients should be recognized. Further research is needed to develop local and national guidelines for the palliative care approach in these patients.
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Curr Opin Support Palliat Care · Mar 2013
ReviewEvidence-based approach to manage persistent wound-related pain.
Pain is a significant concern in people with chronic wounds. A systematized approach is recommended for the management of wound-associated pain with the objectives to address pain relief, increase function, and restore overall quality of life. ⋯ Pain is a complex biopsychosocial phenomenon that requires multiple pharmacological and nonpharmacological management approach.
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Curr Opin Support Palliat Care · Mar 2013
Review Case ReportsSelf-care and communication issues at the end of life of recipients of a left-ventricular assist device as destination therapy.
The purpose of this review is to provide an overview of self- care and communication issues at the end of life of patients with left-ventricular assist devices (LVADs) for destination therapy, based on recent research on end-of-life communication in other diseases. ⋯ Healthcare professionals treating patients before and after LVAD implantation need to take an active role in end-of-life discussions and be able to communicate information regarding expected complications, quality of life and prognosis to the patients and caregivers. Research is needed addressing optimal ways and timing of communication with LVAD patients and families.
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Curr Opin Support Palliat Care · Mar 2013
ReviewThe management of wound-related procedural pain (volitional incident pain) in advanced illness.
The prevention and treatment of wound-related procedural pain is one of the greatest areas of unmet need within wound management. Also referred to as 'Volitional Incident Pain', it is the most prevalent subtype of breakthrough pain experienced by patients afflicted with wounds. Novel formulations of existing analgesics are now available to address this challenge. ⋯ Novel formulations of fentanyl citrate, delivered through an array of noninvasive routes, allow for rapid-onset and short-acting effects that better match the onset and duration of wound-related procedural pain.