Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2011
Measuring comprehensive outcomes in palliative care: validation of the Korean version of the Good Death Inventory.
No systematic or comprehensive attempts have yet been made to assess quality of death as an indicator of palliative care outcomes in Korea, and no validated instruments exist for the assessment of a good death in Koreans. ⋯ The Korean version of the GDI is a reliable and valid measure of the comprehensive outcomes of palliative care from the perspective of bereaved Korean family members.
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J Pain Symptom Manage · Oct 2011
Clinician accuracy when estimating survival duration: the role of the patient's performance status and time-based prognostic categories.
Although shown to be an independent predictor of actual survival (AS) duration, previous reports have identified significant inaccuracy in clinician estimates of survival (CES). ⋯ In a patient population referred for specialist palliative care consultation with diverse diagnoses and a wide range of CES, time-based categorization of survival estimates along with PPS and possibly gender could be used to inform the CES process for individual patients. Intentionally incorporating these objective elements into what has historically been the subjective process of CES may lead to improvements in accuracy.
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J Pain Symptom Manage · Oct 2011
Advance care planning in Belgium and The Netherlands: a nationwide retrospective study via sentinel networks of general practitioners.
Advance care planning (ACP) is an important part of patient-centered palliative care. There have been few nationwide studies of ACP, especially in Europe. ⋯ In these countries, ACP is done with approximately one-third of the studied terminally ill patient population. Most agreements are made only verbally, and care also is often planned with family only. ACP relates strongly both to patient factors and to health care measures performed at the very end of life.
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J Pain Symptom Manage · Oct 2011
The PRISMA Symposium 3: lessons from beyond Europe. why invest in research and service development in palliative care? An Australian perspective.
Hospice and palliative care services need to be able to compete with finite health care resources. To compete for such funding, the sector needs to continuously improve the evidence base that demonstrates improved outcomes, or else funding will continue to be at the level of a "social good" rather than as services that deliver improved health outcomes. Three questions need to be answered for policy makers and health funders: 1) Why invest health care spending in hospice and palliative care?, 2) Why invest research monies in hospice and palliative care clinical research and health service development?, and 3) How can emerging evidence be more effectively implemented to improve patient outcomes? No single measure captures the net benefit of hospice and palliative care services. ⋯ Benchmarking and service development strategies can deliver improved patient outcomes. With routine point-of-care data collection and feedback loops to individual services, patient-valued outcomes and resourcing can be improved in hospice and palliative care. Public-good investments in hospice and palliative care research are vital to building the evidence base for improving the quality of care offered.
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J Pain Symptom Manage · Oct 2011
The PRISMA Symposium 2: lessons from beyond Europe. reflections on the evolution of palliative care research and policy in Canada.
In Canada, the aging population with a rising incidence of chronic diseases-and thus more complex care needs-is putting significant pressure on the health care system, long-term care system, and family caregivers. Ten years ago, the Government of Canada appointed Canada's first Minister with Special Responsibility for Palliative Care. During that time, the federal government developed significant public policy goals for palliative care, including the Canadian Strategy on Palliative and End-of-Life Care. ⋯ In 2007, the Secretariat within the federal government supporting the Canadian strategy was defunded and disbanded. Four years later, progress in improving palliative care for Canadians has slowed. This article reviews some of the successes of palliative care policy and research in Canada and outlines several lessons to be learned for other jurisdictions developing public policy for palliative care.