Journal of palliative medicine
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Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making. ⋯ Serial PPS assessments are feasible and predicted functional decline in cancer and noncancer patients in this sample. Cancer patients exhibited higher initial functional scores but both cancer and noncancer patients declined in functionality along hospitalization. Earlier deaths occurred in the terminal PPS category than in the transitional PPS category.
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While the importance of pediatric palliative care (PPC) for children with life-threatening illness is increasingly recognized, little is known about physicians' attitudes toward palliative care for children with heart disease. ⋯ There are significant differences between pediatric cardiologists and PPC physicians in perception of palliative care involvement and perceived barriers to PPC consultation. An intervention that targets communication and exchange of expertise between PPC and pediatric cardiology could improve care for children with heart disease.
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Case Reports
Treating Tobacco Use in Patients with Incurable Malignancies: Should We Even Start the Conversation?
Clinical practice guidelines recommend that all medical providers address tobacco use with patients, as the long-term health benefits of becoming tobacco free are well documented. What happens, though, when a patient has an incurable malignancy and, therefore, will not reap the long-term benefits? Clinical Consideration: Our case study encourages providers to consider the relevance of tobacco use treatment for those with incurable diseases. ⋯ Although long-term benefits will not provide realistic motivation, other equally important rewards (e.g., decreased shortness of breath), a sense of accomplishment shared by patients and family, and the ability to exert control over a behavior can be equally motivating for some patients.