Palliative medicine
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Clinical experience suggests that screening for delirium on admission to a hospice is often omitted but early recognition and detection can improve outcome for these patients. In a series of audits we have evidenced low use of the recommended screening tool provided within the admission proforma of two hospices. In some circumstances this omission is appropriate to the clinical situation, however the results show this is not always the case. These results have highlighted implications for future work exploring the barriers to routine cognitive screening on admission to an inpatient unit.
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Palliative medicine · Apr 2012
Randomized Controlled TrialA brief guided self-help intervention for psychological distress in palliative care patients: a randomised controlled trial.
Previous findings implicated rumination (recurrent dwelling on abstract concerns) in elevated psychological distress in palliative patients. We hypothesised that reducing rumination may be important in addressing psychological distress in palliative care. ⋯ The findings suggest that a brief guided self-help intervention based on concreteness training can be effective in addressing anxiety in palliative care.
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Palliative medicine · Apr 2012
Comparative StudyAre we heading in the same direction? European and African doctors' and nurses' views and experiences regarding outcome measurement in palliative care.
To examine and compare doctors' and nurses' views and experiences regarding outcome measurement in palliative care, including patient-reported outcome measures (PROMs). ⋯ Overall these respondents shared similar views and experiences, and both were influenced by similar factors. Multidisciplinary outcome measurement education and training is feasible and required. Multidimensional and brief PROMs that include physical and psychological domains need to be prioritized, and access to freely available, validated and translated tools is needed to ensure cross-national comparisons and coordination of international research.
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Palliative medicine · Apr 2012
Is patient autonomy a critical determinant of quality of life in Korea? End-of-life decision making from the perspective of the patient.
We aimed to investigate the current practice of the involvement in decision making from the perspectives of terminal cancer patients, and to explore its possible associations with quality of life and quality of death in Korea. ⋯ in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual's ability, preference, need, and culture.
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Palliative medicine · Apr 2012
'That's part of everybody's job': the perspectives of health care staff in England and New Zealand on the meaning and remit of palliative care.
the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how this policy is enacted on the ground. ⋯ these data indicate that, within England and New Zealand, the policy rhetoric of universal palliative care provision is not being straightforwardly translated into service delivery and individual clinical practice. Further research is required to explore and evaluate different models of organization and service provision that empower 'generalists' to provide palliative care, without resulting in deskilling. Finally, definitional clarity at an academic/policy level is also needed.