Journal of palliative medicine
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Background: Cardiogenic shock (CS) is one of the leading causes of death in patients with myocardial infarction, myocarditis, and congestive heart failure. The utilization patterns of specialist palliative care (PC) consultation in these patients are currently unknown. Objectives: To determine the utilization of PC in patients with CS and the overall comorbidities of that population. ⋯ Furthermore, the patients who received PC had significantly higher odds of death than those who did not (adjusted odds ratio = 6, p < 0.0001). Conclusion: Despite high mortality rates, specialist PC is not routinely involved in the care of those who die with CS, although does appear to be utilized among those most likely to die. This suggests preferential utilization of specialist PC for terminal patients; however, further research will be helpful to better understand current consult practices and increase PC utilization for this highly morbid population.
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Objectives: The field of pediatric palliative care (PPC) has grown in the last few years because of increased awareness of the unique requirements of children at the terminal stage. In this study, we aimed to analyze the willingness and confidence of adult palliative care physicians in Saudi Arabia who provide palliative care services to children in need. Methods: This study employed a cross-sectional design to collect data from a large sample of palliative care physicians in Saudi Arabia. ⋯ In addition, they are less comfortable managing pain and symptoms than interacting with families of palliative children. Conclusions: In Saudi Arabia, palliative care physicians are eager to offer PPC; however, they need requisite resources and training. In addition, we found that palliative care physicians and their patients would benefit from further support and assistance from a PPC team.
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Background: Despite long-standing recognition that providers should discuss DNR (do-not-resuscitate) orders prior to surgery, there is evidence that perioperative code status discussions are frequently of limited quality. Limited attention has been paid to patient perspectives. Objective: Determine the scope of literature on management of perioperative DNR orders from the patient perspective. ⋯ We highlight themes, analyze limitations of existing evidence, and outline implications for future research. Conclusions: There has been relatively little attention to the patient's perspective, preferences, and expectations regarding perioperative code status decisions. Careful investigation is necessary to inform patient-centerted approaches to communication and decision making regarding perioperative use of life-sustaining therapies.
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Background: Palliative care (PC) in rural aged care facilities faces significant challenges, including late referrals and insufficient staff training, leading to a risk of suboptimal end-of-life care. Objectives: The aim of the project was to develop and implement an evidence-based Palliative Care Assessment Toolkit (PCAT) to improve PC in rural aged care facilities and evaluate its impact on care delivery and staff practices. Design: The study employed a mixed-methods design across three phases: codesign of the toolkit, implementation, and evaluation (using pre- and post-data). ⋯ Staff feedback indicated increased confidence in delivering PC. Conclusions: The PCAT improved the delivery of PC in rural aged care settings, enhancing both resident outcomes and staff practices. Further research is recommended to validate these findings across various settings and to explore the long-term sustainability and cost-effectiveness of such interventions.