Palliative medicine
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Palliative medicine · Mar 2008
Multicenter StudyDeath rattle: its impact on staff and volunteers in palliative care.
Hospice staff and volunteers frequently hear the sound of death rattle and offer explanations and reassurance to relatives and other patients. This paper describes our study into the impact of hearing the sound of death rattle on hospice staff and volunteers, part of our wider investigation into death rattle. ⋯ Death rattle has a negative impact on staff and volunteers who work with dying patients. This effect may influence their decision to intervene when death rattle occurs. Doctors and nurses need to consider why, when and how they intervene and the consequences of that intervention.
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Palliative medicine · Jan 2008
Multicenter StudyPreferences for location of death of seriously ill hospitalized patients: perspectives from Canadian patients and their family caregivers.
Previous studies involving palliative patients suggest a preference for dying at home. The purpose of this paper is to examine, prospectively, patient and family caregiver preferences for, and congruence with, location of death for hospitalized patients with cancer and end-stage medical conditions. Questionnaires were administered to 440 eligible in-patients and 160 family caregivers in five hospitals across Canada. ⋯ The results suggest that only half of all patients and family caregivers report a preference for a home death. Furthermore, half of the patient/family caregiver dyads disagree on preferred location of death. If one of the primary goals of end of life care is to enhance the quality of life of dying patients and their family caregivers, policies directed towards ensuring that patients die in their location of choice ought to be a priority and resources should be allocated to promote the development of excellent care, not only in the home, but also within our institutional settings.
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Palliative medicine · Dec 2007
Multicenter StudyFlecainide for the treatment of chronic neuropathic pain: a Phase II trial.
Management of neuropathic pain is challenging. Medications that interfere with sodium channel transport, such as lidocaine, mexilitene and flecainide, are promising as analgesics. ⋯ Flecainide produced a 30% response rate. Response in this study was defined to be highly relevant and clinically significant reduction in pain. The drug merits study in a randomized placebo-controlled trial.
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Palliative medicine · Dec 2007
Multicenter StudyOfficial certification of doctors working in palliative medicine in Europe: data from an EAPC study in 52 European countries.
There is an increasing move to recognize palliative medicine as an area of certificated specialization. Drawing on a survey of palliative care provision in the World Health Organization European region, an overview of palliative care specialization and accreditation practices was presented. Within an international survey to key experts in palliative care carried out in 2005, conducted in 52 countries, a question about the certification for palliative care professionals was included. ⋯ Across countries there is disparity in the certification criteria followed and considerable variability in the demands that are made in order to achieve certification. Further studies are needed to focus in depth on palliative medicine certification and accreditation across Europe. Establishing uniform approaches to certification for palliative medicine in different European countries will contribute to wider take-up of specialty status and the improved recognition of palliative care as a discipline.
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Palliative medicine · Oct 2007
Multicenter StudyHaving a difficult time leaving: experiences and attitudes of nurses with palliative sedation.
Palliative sedation is an important topic of medical and ethical debates. Although nurses often participate in its use, little is known about their attitudes and experiences. ⋯ The struggles that nurses in this study cohort experienced indicate the need for further study and may suggest the need for more nursing education and discussion about ethical aspects of palliative sedation.