Palliative medicine
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Palliative medicine · Jun 2012
Experiences of dying, death and bereavement in motor neurone disease: a qualitative study.
to explore the experiences of people with Motor Neurone Disease (MND), current and bereaved carers in the final stages of the disease and bereavement period. ⋯ this study has identified a number of issues people with MND and their carers face in the final stages of the illness, indicating some ways in which health, social and palliative care services could be improved or co-operate more effectively in order to better meet their needs.
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Palliative medicine · Jun 2012
Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: perceptions of health and social services professionals.
Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the challenges of end-of-life care services to homeless illicit drug users based on data collected during a national study on end-of-life care services delivery to homeless persons in Canada. ⋯ First, barriers preventing homeless illicit drug users from accessing end-of-life care services, such as competing priorities (e.g. withdrawal management), lack of trust in healthcare providers and discrimination. Second, challenges to end-of-life care services delivery to this population in health and social care settings, including non-disclosure of illicit drug use, pain and symptom management, interruptions in care, and lack of experience with addictions. The authors identify a need for increased research on the role of harm reduction in end-of-life care settings to address these challenges.
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Palliative medicine · Jun 2012
Place of death related to demographic factors for hospice patients in Wellington, Aotearoa New Zealand.
Because socioeconomic and cultural factors contribute to where one dies, it is important to document place of death determinants in diverse societies. ⋯ Age, economics, diagnosis, ethnicity, marital status, and whether one enters a hospice service for (at least in part) respite were all associated to a certain extent with where one dies. These findings contribute to the growing evidence linking various factors, especially ethnic groups, with place of death.
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Clinical experience suggests that screening for delirium on admission to a hospice is often omitted but early recognition and detection can improve outcome for these patients. In a series of audits we have evidenced low use of the recommended screening tool provided within the admission proforma of two hospices. In some circumstances this omission is appropriate to the clinical situation, however the results show this is not always the case. These results have highlighted implications for future work exploring the barriers to routine cognitive screening on admission to an inpatient unit.
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Palliative medicine · Apr 2012
Randomized Controlled TrialA brief guided self-help intervention for psychological distress in palliative care patients: a randomised controlled trial.
Previous findings implicated rumination (recurrent dwelling on abstract concerns) in elevated psychological distress in palliative patients. We hypothesised that reducing rumination may be important in addressing psychological distress in palliative care. ⋯ The findings suggest that a brief guided self-help intervention based on concreteness training can be effective in addressing anxiety in palliative care.