Journal of palliative medicine
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Humor frequently occurs in palliative care environments; however, the acceptability of humor, particularly between patients and health care providers has not been previously examined. ⋯ The vast majority of participants found humorous interactions with their health care providers acceptable and appropriate, and this may indicate a opportunity for enhanced and more effective end-of-life care in the future.
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Loved ones of a patient with an incurable disease will accompany the patient to the end of life. Health care professionals must discuss difficult matters with loved ones and be sure that they really understand the seriousness of the patient's disease. The study explore how the professionals do when they explore the grounds on which they make their assessment of loved ones' insight into a patient's fatal disease. ⋯ Ways to communicate with loved ones are crucial when making an assessment. The different ways loved ones use hope and other strategies made it problematic for the professionals to use these as indicators of state of mind in this matter. Training in conversation skills could be one way to support professionals when discussing and managing these difficult situations.
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Anorexia is a significant problem in patients approaching the end of life, for which corticosteroids are widely prescribed. It is not clear which regimen is the most safe and effective for this indication. ⋯ Corticosteroids are beneficial in treating anorexia in palliative care patients with malignancies; however there is no evidence for their use in anorexia due to end-stage nonmalignant disease. There is insufficient evidence to recommend any particular corticosteroid drug over another, or to recommend a dosing regimen.
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Patients with severe chronic obstructive pulmonary disease (COPD) experience substantial symptom burden, psychological and social morbidity. The experience of this illness has an impact beyond the patient. ⋯ The impact of caring borne by family carers is substantial and life changing. Health professionals may assist carers in their role through acknowledgement, facilitating recognition of the changes that have occurred (and their implications), and enabling creative adaptive responses for carers. Such assistance is likely to enhance the ability of carers to continue in this demanding role.
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Randomized Controlled Trial Comparative Study
Association between Physician Trainee Self-Assessments in Discussing Religion and Spirituality and Their Patients' Reports.
Effective physician communication at the end-of-life is a cornerstone to providing patient-centered palliative care. Educational programs in physician communication often rely on self-assessments of physician knowledge and attitudes and seldom provide patients' reports. Thus, it is unclear whether physician self-assessments are associated with patient perspectives. ⋯ Physician trainee self-assessments may be a valid surrogate for patient ratings of quality with respect to religious/spiritual communication. This specific domain of physician-patient communication should receive further investigation as our finding contrasts with reports of more general measures of physician-patient end-of-life communication.