Journal of palliative medicine
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There are very few reports about end-stage renal disease (ESRD) patients with breast pains in the medical literature, posing a difficulty to understand their pathophysiology. ⋯ Morbidity-mortality with calciphylaxis and chronic hypotension related tissue changes is high, and the breast lesions in ESRD patients require aggressive treatment for underlying inadequate oxygen delivery to these peripheral tissues.
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Health system restructuring coupled with the preference of patients to be cared for at home has altered the setting for the provision of palliative care. Accordingly, there has been emphasis on the provision of home-based palliative care by multidisciplinary teams of health care providers. Evidence suggests that these teams are better able to identify and deal with the needs of patients and their family members. Currently there is a lack of literature examining the predictors of palliative care service use for various professional service categories. ⋯ These findings will help case managers, health administrators, and policy decision makers better allocate human resources to palliative patients.
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Current evidence indicates that patients with hematological malignancies are less likely to receive input from specialist palliative care services compared to those with solid tumors. ⋯ Over recent years, collaboration between hematology and palliative care has resulted in increased referral numbers, with potentially positive results for patients.
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The place of death is of considerable interest now, yet few studies have determined public preferences for place of end-of-life (EOL) care or final days of life. ⋯ These findings suggest homes are the preferred EOL place now for the majority of Albertans, if not other citizens, while at the same time suggesting that marital and living arrangement realities temper EOL place choices and possibilities, with widows best realizing the need for assistance from others when dying. The widespread preference for home-based EOL care indicates public health interventions are needed to promote good home deaths.
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Palliative care in Thailand was not well established in the past, but it is better supported by many organizations at present. Despite the change in the situation, the availability of essential drugs for palliative care has not been well studied. ⋯ LH and PH have better overall nonopioid and opioid medication availability than CH and GH.