Palliative medicine
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Palliative medicine · Sep 2019
Family members' experiences of assisted dying: A systematic literature review with thematic synthesis.
Families' experiences of assisted dying are under-investigated and families are rarely considered in clinical guidelines concerning assisted dying. ⋯ Our data confirm that families across all jurisdictions are involved in assisted suicide decision and enactment. Family needs are under-researched, and clinical guidelines should incorporate recommendations about how to consider family needs and how to provide them with evidence-based tailored interventions.
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Palliative medicine · Sep 2019
Do published patient decision aids for end-of-life care address patients' decision-making needs? A systematic review and critical appraisal.
Many decisions are made by patients in their last months of life, creating complex decision-making needs for these individuals. Identifying whether currently existing patient decision aids address the full range of these patient decision-making needs will better inform end-of-life decision support in clinical practice. ⋯ Patient decision-making needs are broad and varied. Currently developed patient decision aids are insufficiently addressing patient decision-making needs. Improving future end-of-life patient decision aid content through five key suggestions could improve patient-focused decision-making support at the end of life.
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Palliative medicine · Sep 2019
Multi-disciplinary palliative care is effective in people with symptomatic heart failure: A systematic review and narrative synthesis.
Despite recommendations, people with heart failure have poor access to palliative care. ⋯ Overall, the results support the use of multi-disciplinary palliative care in people with advanced heart failure but trials do not identify who would benefit most from specialist palliative referral. There are no sufficiently robust multi-centre evaluation phase trials to provide generalisable findings. Use of common population, intervention and outcomes in future research would allow meta-analysis.
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Palliative medicine · Sep 2019
Inclusion, characteristics and outcomes of people requiring palliative care in studies of non-pharmacological interventions for delirium: A systematic review.
Delirium is common, distressing, serious and under-researched in specialist palliative care settings. ⋯ Non-pharmacological delirium interventions have frequently excluded and under-characterised people requiring palliative care and infrequently reported their outcomes.
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Palliative medicine · Sep 2019
What socio-economic factors determine place of death for people with life-limiting illness? A systematic review and appraisal of methodological rigour.
Socio-economic factors play important roles in place of death. However, up-to-date knowledge on socio-economic determinants for place of death is warranted including analysis of collinearity between socio-economic determinants. ⋯ Inequalities concerning place of death were found, and attention towards socio-economic inequality concerning place of death is necessary, especially in patients with a poor financial status, patients living in deprived and metropolitan areas and patients who are employed. Furthermore, we found a low degree of assessment for collinearity and adjustment of socio-economic variables. These issues should be considered in planning of future studies of socio-economic determinants for place of death.