Journal of palliative medicine
-
Despite the fact that many cancer patients worldwide die in general hospitals, there are few reports of the analysis of delirium in terminally ill cancer patients in this setting. ⋯ Our study indicates that male sex, T-bil, antibiotic therapy, NSAID therapy, and hematological malignancy are significant predictors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital setting.
-
End-of-life care has become a priority in medical education internationally. A previous study of hospice patients and staff regarding medical students teaching in a hospice showed positive responses from patients and hospice staff. However concern was expressed by some staff regarding medical students' welfare, contributing to gatekeeping by professionals. Studies have shown that medical students feel underprepared to care for the dying by the time they qualify. ⋯ We would encourage staff to not be overprotective but to support students to take every opportunity to meet with patients in a hospice.
-
The intensity and persistence of treatment-related symptoms among breast cancer survivors is incompletely understood. ⋯ Given their severity, persistence, and association with emotional burden, treatment-related symptoms among breast cancer survivors (BCS) merit greater attention toward clinical management, patient education, and longitudinal study.
-
Depression affects a quarter of palliative patients and is associated with reduced quality of life. Screening for psychological problems at key points in the patients' pathway is recommended but there is no consensus as to how to do this. ⋯ The screening question was shown to have acceptable sensitivity and specificity in a small sample of community palliative care patients. It is likely to be most useful to accurately identify those who are not depressed and identify those patients who need a more in-depth assessment of their mood.
-
Moral distress is a pervasive reality of palliative care practice. An existing framework for understanding it has been proposed as a way to begin to address moral distress's detrimental effects on clinicians. ⋯ Application of the proposed framework to a clinical case provides opportunities for understanding mechanisms of response that may be amenable to intervention and for suggesting appropriate alternative strategies and practices. A full understanding of the process can help to mitigate or to avoid the progression of distress and concurrently to appraise the situation that leads to moral distress or moral outrage.