Journal of palliative medicine
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More children are living with serious illness. However, survival and complexity of illnesses have not been described. ⋯ Results provide important information on the complexity of disease processes for children referred to palliative care, types of illnesses referred, survival, and pain levels. Results reflect earlier referral to palliative care for most children and highlight the medical complexity especially for children with congenital and genetic diagnoses.
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Comparative Study
Symptom Prevalence and the Negative Emotional States in End-Stage Renal Disease Patients with or without Renal Replacement Therapy: A Cross-Sectional Analysis.
Limited comparative data are available on the symptom severity and burden of dialyzed versus nondialyzed end-stage renal disease (ESRD) patients and their association with negative emotional states. ⋯ There was no difference in the prevalence of symptom burden and severity, irrespective of the type of treatment. Psychological disturbances were associated with higher symptom burden and severity and, therefore, should be screened thoroughly to achieve optimal ESRD management.
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Use of palliative care has increased substantially as the population ages and as evidence for its benefits grows. However, there is limited information regarding which care activities are necessary for delivering high-quality, interdisciplinary, community-based palliative care. ⋯ The delivery of palliative care is interdisciplinary and involves numerous discrete tasks and activities. Understanding the components of a community-based palliative care model is the first step to designing incentives to encourage its spread.
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Optimal management of chronic medications for patients with life-limiting illness is uncertain. Medication deprescribing may improve outcomes in this population, but patient concerns regarding deprescribing are unclear. ⋯ Few participants expressed concerns about discontinuing statins; many perceived potential benefits. Cardiovascular disease patients perceived greater potential positive impact from statin discontinuation.
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Research indicates that bereavement services reduce distress and support adjustment in the bereaved, particularly those experiencing significant levels of depression or grief. However, the service use of bereaved individuals and whether utilization differs among those experiencing depression and complicated grief currently remain unclear. Research is needed to clarify the preferences of the bereaved, including specific bereaved subgroups. ⋯ Findings indicate a difference in the projected service use of the bereaved experiencing depression and/or complicated grief. Follow-up screenings 6-12 months post-bereavement are recommended to identify those in need of formal psychosocial support.