Journal of palliative medicine
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The intensive care unit (ICU) experience has been reported to cause adverse health effects in families during and after the ICU stay. The objective of this study was to evaluate health-related quality of life (HRQOL) in relatives of patients 90 days after ICU discharge or death. ⋯ The SF-36 showed evidence of impaired mental health in relatives of ICU patients 90 days after discharge. Better end-of-life care, psychiatric support after the ICU experience, and better conflict prevention and resolution are potential targets for improvement.
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Multicenter Study
The influence of age on the likelihood of receiving end-of-life care consistent with patient treatment preferences.
Age differences may help to explain discrepancies in medical care received by cancer patients near death. ⋯ Likelihood of a patient's treatment preference being consistent with care differ by age and treatment preferences. Older patients preferring life-prolonging therapies are less likely to receive them than younger patients; middle-aged patients who want to avoid life-prolonging care are more likely to do so than younger patients. Both findings have implications for patients' quality-of-death, indicating a need for further research.
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Randomized Controlled Trial Multicenter Study
Methodological challenges in conducting a multi-site randomized clinical trial of massage therapy in hospice.
Researchers conducting multi-site studies of interventions for end-of-life symptom management face significant challenges with respect to obtaining an adequate sample and training and retaining on-site study teams. The purpose of this paper is to describe the strategies and responses to these challenges in a multi-site randomized clinical trial (RCT) of the efficacy of massage therapy for decreasing pain among patients with advanced cancer in palliative care/hospice settings. ⋯ Three key qualities characterized successful on-site study teams: (1) organizational commitment; (2) strong leadership from on-site study coordinators; and (3) effective lines of communication between the on-site study coordinators and both their teams and the university-based research team. Issues of recruitment, retention and training should be accounted for in hospice-based research study design and budgeting.
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Multicenter Study
"If God wanted me yesterday, I wouldn't be here today": religious and spiritual themes in patients' experiences of advanced cancer.
This study sought to inductively derive core themes of religion and/or spirituality (R/S) active in patients' experiences of advanced cancer to inform the development of spiritual care interventions in the terminally ill cancer setting. ⋯ R/S plays a variety of important and inter-related roles for most advanced cancer patients. Future research is needed to determine how spiritual care can incorporate these five themes and address R/S concerns.
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The objective of this study was to establish screening criteria for constipation in palliative care and, subsequently, to determine data for diagnostic suspicion of constipation in a palliative care population. Also we investigate the incidence of fecal impaction in the same sample of palliative care patients. ⋯ The screening for constipation in palliative care should be performed exploring subjective symptoms and other objective signs. A diagnosis of suspected constipation was found in almost half of the palliative care patients studied. A VNS of constipation did not produce good predictive values for the detection of constipation in our sample.