Palliative medicine
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Palliative medicine · Jan 2022
Opioid-sparing effects of ketorolac in palliative care patients receiving opioids for chronic cancer-related pain: A systematic literature review.
Standard of care in treatment of cancer-related pain involves opioids in combination with non-steroidal anti-inflammatory drugs (NSAID). Ketorolac, a NSAID, has demonstrated opioid-sparing effects in other clinical settings. ⋯ Given the heterogeneity of the data, adequately powered, randomised controlled trials are required to establish any opioid-sparing effect of ketorolac. For patients not responding to conventional pain management, ketorolac may have a role in treatment augmentation.
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Palliative medicine · Jan 2022
Resilience in advanced cancer caregiving. A systematic review and meta-synthesis.
Close relatives provide much of the care to people with cancer. As resilience can shield family caregivers from mental health problems, there has been a burgeoning interest in resilience-promoting interventions. However, the evidence necessary for the development of these interventions is scant and unsynthesized. ⋯ This review and theoretical synthesis reveal key elements of resilience in the process of cancer caregiving, including influencing factors and outcomes. Implications and avenues for further research are discussed.
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Palliative medicine · Dec 2021
Timely short-term specialized palliative care service intervention for older people with frailty and their family carers in primary care: Development and modelling of the frailty+ intervention using theory of change.
Palliative care is advocated for older people with frailty and multimorbidity in the community. However, how to best deliver it is unclear. ⋯ The Theory of Change approach allowed us to identify multiple intervention components targeting different stakeholders to achieve the desired outcomes. It also facilitated a detailed description of the intervention which aims to increase replicability and effective comparisons with other interventions.
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Palliative medicine · Dec 2021
End of life care for people with severe mental illness: Mixed methods systematic review and thematic synthesis (the MENLOC study).
Parity of esteem means that end-of-life care for people with severe mental illness should be of equal quality to that experienced by all. ⋯ Implications for services and practice reflect evidence in which there is a high degree of confidence. Partnership should be developed across the mental health and end-of-life systems, and ways found to support people to die where they choose. Staff caring for people with severe mental illness at the end-of-life need education, support and supervision. End-of-life care for people with severe mental illness requires a team approach, including advocacy. Proactive physical health care for people with severe mental illness is needed to tackle problems of delayed diagnosis.
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Palliative medicine · Dec 2021
Asian patients' perspectives on advance care planning: A mixed-method systematic review and conceptual framework.
Asian healthcare professionals hold that patients' families play an essential role in advance care planning. ⋯ The essential first step to engaging patients in advance care planning is to educate them on it and on their diseases. Asian patients' various beliefs about advance care planning should be accommodated, especially their preferences regarding their role in it, its timing, and its documentation.