Journal of palliative medicine
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Multicenter Study
Preparedness for the death of a loved one and mental health in bereaved caregivers of patients with dementia: findings from the REACH study.
Although it has been suggested that family and friends who are prepared for the death of a loved one have less distress, the relationship between preparedness and bereavement mental health is inconclusive. ⋯ Despite providing high-intensity care, often for years, many bereaved caregivers perceived themselves as unprepared for the death. These caregivers had more depression, anxiety, and complicated grief symptoms. Future work should be directed to confirming these findings and determining how best to intervene with high-risk caregivers.
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Randomized Controlled Trial Multicenter Study
Duloxetine versus routine care in the long-term management of diabetic peripheral neuropathic pain.
Duloxetine hydrochloride is a dual reuptake inhibitor of both serotonin and norepinephrine. In the present open-label study, the safety of duloxetine at a fixed-dose of 60 mg twice daily (BID) for up to 52 weeks was evaluated and compared to routine care in the therapy of patients diagnosed with diabetic peripheral neuropathic pain (DPNP). ⋯ In this study, duloxetine was safe and well tolerated compared to routine care in the long-term management of patients with DPNP.
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Multicenter Study
Initial assessment of a new instrument to measure quality of life at the end of life.
We conducted this study to pilot a new multidimensional instrument to assess the quality of life at the end of life. ⋯ We have developed a new instrument to measure the quality of life at the end of life that assesses empirically derived domains that are of demonstrated importance to dying patients, is acceptable to a seriously ill population, and exhibits excellent psychometric properties. Some items related to completion and preparation represent particularly new contributions to quality-of-life measurement.
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To describe the palliative care needs of dying nursing home residents during the last 3 months of life. ⋯ Dying nursing home residents need improved emotional and spiritual care, help with personal cleanliness, and treatment for pain. Efforts to improve end-of-life care in nursing homes should combine traditional palliative care services with increased attention to emotional symptoms and personal care services.
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Multicenter Study
End-of-life care education in internal medicine residency programs: an interinstitutional study.
Integrating end-of-life care (EOL) education into medical residency programs requires knowledge of what programs currently teach and what residents learn. ⋯ Existing internal medicine residency education lacks training in critical EOL care domains. Residency programs need additional training for residents and teaching faculty in EOL content and skills, with assessment practices that demonstrate competencies have been acquired. Program directors perceive institutional support for making these changes.