Palliative medicine
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Palliative medicine · Jul 2020
Randomized Controlled TrialEconomic evaluation of a combined screening and stepped-care treatment program targeting psychological distress in patients with metastatic colorectal cancer: A cluster randomized controlled trial.
Psychological distress is highly prevalent among patients with metastatic colorectal cancer. ⋯ The intervention is dominant over usual care, primarily due to lower costs in the intervention group. However, there were no statistically significant differences in clinical effects and the uptake of the intervention was quite low. Therefore, widespread implementation cannot be recommended.
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Palliative medicine · Jun 2020
Randomized Controlled TrialHow short is too short? A randomised controlled trial evaluating short-term existential behavioural therapy for informal caregivers of palliative patients.
Informal caregivers of palliative patients show higher levels of depression and distress compared with the general population. Fegg's (2013) existential behavioural therapy was shortened to two individual 1-h sessions (short-term existential behavioural therapy). ⋯ Inclusion rate was tripled compared with a previously evaluated longer EBT group intervention. By shortening the intervention, inclusion rate was traded for effectiveness and the intervention could not impact caregivers' psychological state. Early integration of sEBT and combination of individual and group setting and further study of the optimal length for caregiver interventions are suggested.
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Palliative medicine · May 2020
Randomized Controlled TrialReducing time in acute hospitals: A stepped-wedge randomised control trial of a specialist palliative care intervention in residential care homes.
Care home residents are frequently transferred to hospital, rather than provided with appropriate and timely specialist care in the care home. ⋯ The model of care significantly reduces hospitalisations through provision of outreach by specialist palliative care clinicians. The data offer substantial evidence for Specialist Palliative Care Needs Rounds to reduce hospitalisations in older people approaching end of life, living in care homes.
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Palliative medicine · Mar 2020
Randomized Controlled TrialExamining key sociodemographic characteristics of adolescents and young adults with cancer: A post hoc analysis of the Promoting Resilience in Stress Management randomized clinical trial.
The "Promoting Resilience in Stress Management" intervention is a skills-based, early palliative care intervention with demonstrated efficacy in adolescents and young adults with cancer. ⋯ The "Promoting Resilience in Stress Management" intervention demonstrated a positive effect for the majority of outcomes regardless of sex, age, and race. It may not be as helpful for adolescents and young adults living in disadvantaged neighborhoods. Future studies must confirm its generalizability and integrate opportunities for improvement by targeting individual needs.
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Palliative medicine · Jan 2020
Randomized Controlled TrialOnline training improves medical students' ability to recognise when a person is dying: The ORaClES randomised controlled trial.
Recognising dying is a key clinical skill for doctors, yet there is little training. ⋯ The online training resource proved effective in altering the decision-making of medical students to agree more with expert decision-making.