Journal of palliative medicine
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Background: Since 2011, extended care paramedics in South Australia have collaborated with palliative care services to deliver successful palliative and end of life care. However, a gap in paramedic training was identified with a growing number of patients opting for home palliation, prompting the development of a 2021 education program by the South Australian Ambulance Service in partnership with Program of Experience in the Palliative Approach, to equip paramedics with enhanced skills and resources for effective palliative care in the community. Aim: To qualitatively evaluate the effectiveness of the education program provided to paramedics by exploring their subjective experience in providing palliative care within the community following the education program. ⋯ This was crucial for complying with a patient's wishes of not wanting to leave their own familiar surrounding at the end of their life. Palliative care education was shown to improve paramedic knowledge and skills. Specific knowledge gaps were highlighted by the participants to better manage palliative care patients in the community.
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Background: The majority of hospice patients are over the age of 65, and the majority of hospice deaths occur in private homes. As a hospice patient's disease progresses, death becomes imminent and family and friends gather around to say good-bye. These private vigils are the culmination of the hospice experience and reflect both the strengths and the challenges surrounding hospice care. ⋯ Co-coding of stories and validation of findings by hospice nurses and physicians assure the trustworthiness of the data. Results: Hospice staff share narratives related to family and caregiver burden, challenges with symptom management, frustrations with staffing shortages, and administrative burdens surrounding the experience of death vigils. Conclusions: The family and hospice clinician's experiences with the final act of dying at home are sometimes challenged by the intermittent nature of home care during the final days.
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Background: Patients with cancer use the internet to inform medical decision making. Objective: To examine the content of ChatGPT responses to a hypothetical patient question about decision making in advanced cancer. Design: We developed a medical advice-seeking vignette in English about a patient with metastatic melanoma. ⋯ When vignettes referenced the daughter's opinion on the hospice recommendation, approximately one third of responses also referenced this, stating the importance of talking to her about treatment preferences and values. Conclusion: ChatGPT responses to questions about advanced cancer decision making can be heterogeneous based on demographic and clinical characteristics. Findings underscore the possible impact of this heterogeneity on treatment decision making in patients with cancer.
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Randomized Controlled Trial
Impact of Baduanjin Qigong Exercise on Fatigue in Patients with Lung Cancer: A Randomized Controlled Trial.
Background: Patients report fatigue as the most distressing symptom associated with cancer and treatment. Baduanjin has beneficial effects on reducing fatigue. However, no relevant randomized controlled trials comparing the effects of Baduanjin exercise with routine exercise in patients with lung cancer and fatigue have been reported. ⋯ Results: A total of 73 patients were analyzed. After the intervention, patients in the Baduanjin group experienced significant improvement in fatigue and pain (p < 0.05), while no significant difference in Edmonton Symptom Assessment System items were observed among patients in the exercise group. Conclusion: Our study showed that Baduanjin was a better exercise than routine activity in relieving their fatigue.