Palliative medicine
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Palliative medicine · Jan 2015
PREDICT: a diagnostic accuracy study of a tool for predicting mortality within one year: who should have an advance healthcare directive?
CARING is a screening tool developed to identify patients who have a high likelihood of death in 1 year. ⋯ PREDICT was successfully applied to the Australian healthcare system with findings similar to the original CARING study conducted in the United States. This tool could improve end-of-life care by identifying who should have advance care planning or an advance healthcare directive.
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Palliative medicine · Jan 2015
Awareness of dementia by family carers of nursing home residents dying with dementia: a post-death study.
High-quality palliative care for people with dementia should be patient-centered, family-focused, and include well-informed and shared decision-making, as affirmed in a recent white paper on dementia from the European Association for Palliative Care. ⋯ Family carers are often unaware that their relative has dementia, that is, in one-fourth of cases of dementia and one-fifth of advanced dementia, posing considerable challenges for optimal care provision and end-of-life decision-making. Considering that family carers of residents who develop dementia later after admission to a nursing home are less likely to be aware, there is room for improving communication strategies toward family carers of nursing home residents.
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Palliative medicine · Jan 2015
ReviewEffectiveness of complex interventions focused on quality-of-life assessment to improve palliative care patients' outcomes: a systematic review.
One of the most crucial palliative care challenges is in determining how patient' needs are defined and assessed. Assessing quality of life has been defined as a priority in palliative care, and it has become a central concept in palliative care practice. ⋯ Effectiveness of interventions focused on quality-of-life assessment is moderate. Additional studies should explore the complexity of the real palliative care world more accurately and understand the effects of independent variables included in complex palliative care interventions.
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Palliative medicine · Jan 2015
Multicenter StudyEvaluation of measurement equivalence of the Family Satisfaction with the End-of-Life Care in an ethnically diverse cohort: tests of differential item functioning.
The Family Satisfaction with End-of-Life Care is an internationally used measure of satisfaction with cancer care. However, the Family Satisfaction with End-of-Life Care has not been studied for equivalence of item endorsement across different socio-demographic groups using differential item functioning. ⋯ Differential item functioning was observed primarily for race and education. No differential item functioning of high magnitude was observed for any item, and the overall impact of differential item functioning was negligible. One item, satisfaction with "the patient's pain relief," might be singled out for further study, given that this item was both hypothesized and observed to show differential item functioning for race and education.
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Palliative medicine · Jan 2015
Using continuous sedation until death for cancer patients: a qualitative interview study of physicians' and nurses' practice in three European countries.
Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. ⋯ This qualitative analysis suggests that there is systematic variation in end-of-life care sedation practice and its conceptualization in the United Kingdom, Belgium and the Netherlands.