Journal of palliative medicine
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Advance directives are an important but underutilized resource. Reasons for this underutilization need to be determined. ⋯ Having been asked about advance directives by medical staff, legal staff, or family and friends increases the likelihood that patients will possess an advance directive. Those with prior experience with end-of-life decision-making are more likely to possess an advance directive. Family structure and health care utilization also impacts possession of advance directives.
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Our aim was to investigate the feasibility of completing an exercise program in patients with advanced cancer and to obtain preliminary data of its impact on physical and quality of life (QoL) outcomes. ⋯ These preliminary results show that physical exercise in patients with advanced cancer is feasible. A significant impact was observed on physical and QoL outcomes. These findings need to be confirmed with a larger-scale, randomized controlled trial.
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Patients severely affected by multiple sclerosis (MS) present with complex symptoms and needs requiring an interdisciplinary care approach. ⋯ Our results clearly identified specific areas in which palliative care will likely prove to be a valuable asset in the treatment course of MS. This information should serve clinicians, indicating when to consider palliative care services and help further reduce or eliminate uncertainty about how palliative care can be integrated in the course of MS.
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Many heart failure (HF) patients experience high symptom burden, but palliative care (PC) services have been used infrequently in this population. ⋯ Currently, only a fraction of HF patients who are at high risk for morbidity and mortality receive PC services. Additional research is needed to identify factors associated with PC referral that can be prospectively identified, and to develop better prediction models to identify HF patients who may benefit from PC referral.