Palliative medicine
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Palliative medicine · Dec 2023
A grounded theory of interdependence between specialist and generalist palliative care teams across healthcare settings.
Individuals with palliative care needs face increased risk of discontinuity of care as they navigate between healthcare settings, locations and practitioners which can result in poor outcomes. Little is known about interactions that occur between specialist and generalist palliative care teams as patients are transition from hospital to community-based care after hospitalisation. ⋯ Teams need to explicitly consider and agree their mode of functioning, and enact changes to enhance knowledge of the team, intentional communication and valuing other teams' contributions. Future research is needed to test or expand this theory across a range of cultures and contexts.
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Palliative medicine · Dec 2023
'Thank goodness you're here'. Exploring the impact on patients, family carers and staff of enhanced 7-day specialist palliative care services: A mixed methods study.
Healthcare usage patterns change for people with life limiting illness as death approaches, with increasing use of out-of-hours services. How best to provide care out of hours is unclear. ⋯ Enhanced seven-day services provide high quality integrated palliative care, with positive experiences for patients, carers and staff.
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Palliative medicine · Dec 2023
Family carer experiences of hospice care at home: Qualitative findings from a mixed methods realist evaluation.
Hospice-at-home aims to enable patients approaching end-of-life to die at home and support their carers. A wide range of different service models exists but synthesised evidence on how best to support family carers to provide sustainable end-of-life care at home is limited. ⋯ Carers in hospice-at-home services identified care to be of a higher quality than generic community services. Hospice staff were perceived as having 'time to care', communicated well and were comfortable with dying and death. Hands-on care was particularly valued in the period close to death.
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Palliative medicine · Dec 2023
Health care professional recruitment of patients and family carers to palliative care randomised controlled trials: A qualitative multiple case study.
Trial participant recruitment is an interactional process between health care professionals, patients and carers. Little is known about how clinicians carry out this role in palliative care trials and the reasons why they do or do not recruit participants. ⋯ Those planning trials need to ensure that trial recruiters, depending on their experience and trial characteristics, have access to training and support to address the 'emotional labour' of recruitment. The type of training required requires further research.
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Palliative medicine · Dec 2023
Observational StudyThe financial costs of anticipatory prescribing: A retrospective observational study of prescribed, administered and wasted medications using community clinical records.
The prescribing of injectable end-of-life anticipatory medications ahead of possible need is recommended best practice. The financial costs of these medications have been little studied. ⋯ The costs of prescribed and unused anticipatory medications were higher than previously reported but remain modest. Usage of prescriptions was lower than previously documented. There may be scope to reduce the quantity of vials that are routinely prescribed without adversely affecting care; further research is needed to investigate this possibility.