Palliative medicine
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Palliative medicine · Jul 2017
ReviewA metasynthesis study of family caregivers' transition experiences caring for community-dwelling persons with advanced cancer at the end of life.
Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. ⋯ The findings provide a framework to guide the development of supportive programs and future research.
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Palliative medicine · Jul 2017
Palliative care for Parkinson's disease: Patient and carer's perspectives explored through qualitative interview.
Palliative care is recommended for non-malignant illnesses, including Parkinson's disease. However, past research with healthcare workers highlights unmet palliative needs in this population and referral rates to Specialist Palliative Care are low. Some healthcare workers perceive a 'fear' in their patients about introducing palliative care. However, less is known about the views of people with Parkinson's disease and their carers about palliative care. ⋯ A holistic palliative care approach could address the complex physical and psychosocial symptoms experienced by people with Parkinson's disease and their carers, and people with Parkinson's disease and their carers are open to palliative care. Further research needs to explore how palliative care can be introduced into the routine care for people with Parkinson's disease.
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Palliative medicine · Jul 2017
Development of a caregiver-reported measure to support systematic assessment of people with dementia in long-term care: The Integrated Palliative care Outcome Scale for Dementia.
Symptom burden is common for long-term care residents with dementia which if untreated compromises quality of life. Measurement tools can support assessment of symptoms and problems but are not widely used in long-term care settings. We developed the Integrated Palliative care Outcome Scale for Dementia derived from the Palliative care Outcome Scale, Palliative care Outcome Scale-Symptom and Integrated Palliative care Outcome Scale. ⋯ Integrated Palliative care Outcome Scale for Dementia is a comprehensive and acceptable caregiver-reported measure to detect symptoms and problems in dementia. It is suitable for caregiver staff without professional training as it has been refined and tailored to maximise caregiver expertise, ready for further psychometric testing.
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Palliative medicine · Jul 2017
Review Meta AnalysisDying in the hospital setting: A meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important.
Despite most expected deaths occurring in hospital, optimal end-of-life care is not available for all in this setting. ⋯ Consumer narratives help to provide a clearer direction as to what is important for hospital end-of-life care. Systems are needed to enable optimal end-of-life care, in accordance with consumer priorities, and embedded into routine hospital care.
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Palliative medicine · Jul 2017
Case ReportsPalliative long-term abdominal drains in refractory ascites due to end-stage liver disease: A case series.
Ascites, the commonest complication of cirrhosis, leads to frequent hospitalisations. Refractory ascites confers a median survival of 6 months without liver transplantation. In many, the management remains palliative (large-volume paracentesis). Despite calls for improvement, palliative and end-of-life care is not yet integrated into end-stage liver disease. Long-term abdominal drains are a palliative strategy in malignant ascites, but not end-stage liver disease. ⋯ Palliative and end-of-life care needs in end-stage liver disease remain under-addressed. Our data suggest that long-term abdominal drains may be a safe and effective palliative intervention in end-stage liver disease. Prospective randomised controlled trials comparing large-volume paracentesis versus long-term abdominal drains in refractory ascites secondary to end-stage liver disease are warranted.