Palliative medicine
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Palliative medicine · Jul 2015
Use of nasal fentanyl for cancer pain: A pharmacoepidemiological study.
Breakthrough pain affects 40%-90% of patients with cancer pain. Nasal fentanyl is one of the recommended treatments, particularly if the breakthrough pain is of rapid onset. ⋯ The use of nasal fentanyl was surprisingly low. There is a need for clinical research addressing the use of nasal fentanyl without a long-acting opioid for background pain and the use of nasal fentanyl together with another short-acting opioid.
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Palliative medicine · Jul 2015
ReviewA scoping review of bereavement risk assessment measures: Implications for palliative care.
Palliative care standards and policies recommend that bereavement support be provided to family caregivers, yet uncertainty surrounds whether support currently offered by palliative care services throughout developed countries meets caregiver needs. The public health model of bereavement support, which aligns bereavement support needs with intervention, may address this gap between policy and practice. ⋯ This review is an important preliminary step in improving the assessment of bereavement risk and, consequently, better bereavement outcomes for palliative care family caregivers.
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Palliative medicine · Jul 2015
Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study.
Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels. Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients. However, studies barely included lung cancer patients. ⋯ The Mindfulness-Based Stress Reduction training seemed to be feasible for patients with lung cancer and their partners. A randomized controlled trial is needed to examine the effectiveness of Mindfulness-Based Stress Reduction in reducing psychological distress in lung cancer patients and partners.
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Palliative medicine · Jul 2015
Observational StudyTherapeutic futility in cancer patients at the time of palliative care transition: An analysis with a modified version of the Medication Appropriateness Index.
Palliative Care professionals are often confronted with therapeutic futility, consisting in inappropriate strategies that do not add any advantage to the patient and may actually increase adverse events. Scientific literature concerning this issue is lacking. This article is one of the first to study therapeutic futility specifically at the time of transition to the palliative care setting. ⋯ This article tried to evaluate the main causes of therapeutic futility at the palliative care transition. The principal causes of inappropriateness were absence of clinical indication, clinically significant drug-disease/comorbidity interactions, and incorrect dosage/posology.
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Palliative medicine · Jul 2015
ReviewInterventions for bereaved parents following a child's death: A systematic review.
A child's death is one of the most stressful events that parents and siblings may experience. Interventions for bereaved families following a child's death have been examined over the last several decades. However, there is little high-quality evidence to support any rationale for determining optimal interventions for bereaved parents and siblings. ⋯ Very little evidence of sufficient quality is available to confirm the effects of intervention measures on bereaved parents and siblings following a child's death. Well-designed randomized controlled trials are needed to improve our understanding of the efficacy and implementation of interventions targeting bereaved parents and siblings.