Palliative medicine
-
Palliative medicine · Feb 2018
Randomized Controlled TrialUsing intuition or a formal palliative care needs assessment screening process in general practice to predict death within 12 months: A randomised controlled trial.
Population ageing will lead to more deaths with an uncertain trajectory. Identifying patients at risk of dying could facilitate more effective care planning. ⋯ Screening tool was better at predicting actual death than intuition, but with a higher false positive rate. Both were similarly effective at screening the whole cohort for death. Screening for possible death is not the best option for initiating end-of-life planning: recognising increased burden of illness might be a better trigger.
-
Palliative medicine · Oct 2017
Randomized Controlled Trial Comparative StudyRandomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer: The Danish Palliative Care Trial.
Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. ⋯ We did not observe beneficial or harmful effects of early specialist palliative care, but important beneficial effects cannot be excluded.
-
Palliative medicine · Jun 2017
Randomized Controlled TrialFeasibility of assessing patients' acceptable pain in a randomized controlled trial on a patient pain education program.
For patients with cancer-related pain, the numeric rating scale is the most frequently used instrument to measure pain intensity. In the literature, it has been suggested to interpret patient-reported ratings of pain in relation to the pain intensity which is acceptable to the individual patient. ⋯ Measurement of acceptable pain intensity is feasible. Patients with additional pain treatment became more critical and accepted less pain. More research is needed before we can use acceptable pain intensity as a reference for the interpretation of pain ratings.
-
Palliative medicine · Feb 2017
Randomized Controlled TrialStandardized patient simulation versus didactic teaching alone for improving residents' communication skills when discussing goals of care and resuscitation: A randomized controlled trial.
Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care. ⋯ Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose.
-
Palliative medicine · Jan 2017
Randomized Controlled TrialExperiences of patients and caregivers with early palliative care: A qualitative study.
Early palliative care improves quality of life and satisfaction with care and is increasingly endorsed for patients with advanced cancer. However, little is known about the experience of receiving early palliative care from a patient and caregiver perspective. ⋯ The elements of care described by participants may be used to develop, support and refine models of early palliative care for patients with cancer.