Palliative medicine
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Palliative medicine · Apr 2013
Revisiting the Palliative Performance Scale: change in scores during disease trajectory predicts survival.
The Palliative Performance Scale (PPS) on admission is a predictor of survival. However, it is not highly discriminating for mid-range scores. 'PPS Change' between two time points considers the disease trajectory, and may improve the scale's utility. ⋯ The magnitude of change in PPS score during the disease trajectory is associated with one's survival and is a potentially useful prognostication tool. Further research is needed to extend on our work.
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Palliative medicine · Apr 2013
Randomized Controlled Trial'It makes me feel that I'm still relevant': a qualitative study of the views of nursing home residents on dignity therapy and taking part in a phase II randomised controlled trial of a palliative care psychotherapy.
Trials of dignity therapy (a palliative care psychotherapy) have shown self-reported benefits for participants from taking part, although more so in intervention than control groups. However, the sources of these benefits are unknown. ⋯ Dignity therapy is likely to be beneficial to some care home residents, albeit the small minority who have the desire and the capacity to engage in such an intervention. Whether or not dignity therapy helps distressed residents, and the most effective way of screening for those who might benefit from it, need to be determined.
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Palliative medicine · Apr 2013
Patient perspectives on participation in the ENABLE II randomized controlled trial of a concurrent oncology palliative care intervention: benefits and burdens.
ENABLE (Educate, Nurture, Advise Before Life Ends) II was one of the first randomized controlled trials (RCTs) examining the effects of a concurrent oncology palliative care intervention on quality of life, mood, and symptom control for advanced cancer patients and their caregivers. However, little is known about how participants experience early palliative care and the benefits and burdens of participating in a palliative care clinical trial. ⋯ The benefits of the intervention and the positive aspects of trial participation outweighed trial "burdens". This study raises additional important questions relevant to future trial design and intervention development: when should a palliative care intervention be initiated and what aspects of self-care and healthy living should be offered in addition to palliative content for advanced cancer patients when they are feeling well?
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Palliative medicine · Apr 2013
Hospice experiences and approaches to support and assess family caregivers in managing medications for home hospice patients: a providers survey.
Hospice providers need to ensure that informal, unpaid caregivers can safely manage medications to alleviate pain and distressing symptoms in patients near the end of life. ⋯ Supporting caregivers in medication management is considered important, yet challenging, to hospice providers. Additional resources may be needed to help providers consistently and effectively teach, support, and assess caregivers' medication management.