Palliative medicine
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Palliative medicine · Oct 2022
'You can't feel what we feel': Multifaceted dyspnoea invisibility in advanced chronic obstructive pulmonary disease examined through interpretative phenomenological analysis.
More than a symptom, dyspnoea is an existential experience shaping the lives of those afflicted, particularly when its persistence despite maximal pathophysiological treatments makes it pervasive. It is, however, insufficiently appreciated by concerned people themselves, family members, healthcare professionals and the public (dyspnoea invisibility), limiting access to appropriate care and support. ⋯ The study confirmed that dyspnoea invisibility is a reality for people with advanced chronic obstructive pulmonary disease. It shows dyspnoea invisibility to be a multifaceted burden. Future research should aim at identifying individual and collective measures to overcome dyspnoea invisibility.
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Palliative medicine · Oct 2022
A feasibility study of a decision aid to support family carers of people with severe dementia or those towards the end-of-life.
Advance care planning in dementia does not always happen. As dementia progresses, decisions are often left for family carers to make with professionals. ⋯ We met the success criteria demonstrating this study was feasible and acceptable to carers. Future research should test the effectiveness of the decision aid in a full scale evaluation.
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Palliative medicine · Oct 2022
ReviewHow best to capture the impact of complementary therapies in palliative care: A systematic review to identify and assess the appropriateness and validity of multi-domain tools.
Complementary therapies are widely used in palliative care settings. Qualitative research found that people with advanced disease report a range of physical and psychological benefits from complementary therapies, however evidence of their effectiveness from clinical trials is inconclusive. This may be because trials are limited by use of inappropriate outcome measures. ⋯ Of the tools identified, 'Functional Assessment of Cancer Therapy - General' appears to be the most suitable alternative tool against COMSIN criteria, for trials of massage, reflexology and aromatherapy in palliative care. Further tool validation is required before firm recommendations can be made. Co-development of a core outcome set could ensure relevant domains are assessed.
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Palliative medicine · Oct 2022
Is the use of palliative care services increasing? A comparison of current versus historical palliative care access using health service datasets for patients with cancer.
Mature evidence exists supporting the integration of palliative care in cancer care, but translation of evidence into practice is less well understood. ⋯ Despite established benefits of early palliative care, the important task of translation of this evidence into practice remains.
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Palliative medicine · Oct 2022
Evaluating a partnership model of hospice enabled dementia care: A three-phased monitoring, focus group and interview study.
People with dementia and their caregivers often lack equitable access to hospice care which is a concern internationally. Domains of best practice in palliative care for this population exist and hospices are urged to become dementia friendly. ⋯ Positive outcomes resulted from this best practice model; achievement of preferred place of care and death at home, dual benefits of therapies for patients and families and partnership in cross working and learning between services. Replication of this model should be considered internationally.