BMJ supportive & palliative care
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BMJ Support Palliat Care · Mar 2016
Multicenter Study'My body's falling apart.' Understanding the experiences of patients with advanced multimorbidity to improve care: serial interviews with patients and carers.
Multimorbidity is increasingly common in the last year of life, and associated with frequent hospital admissions. The epidemiology is well described, but patient perspectives are less understood. We report the experiences and perceptions of people with advanced multimorbidity to inform improvements in palliative and end-of-life care. ⋯ Patients with advanced multimorbidity received less care than their illness burden would appear to merit. Some people did restrict their interactions with care providers to preserve autonomy, but many had a limited understanding of their multiple conditions, medications and available services, and found accessing support impersonal and challenging. Greater awareness of the needs associated with advanced multimorbidity and the coping strategies adopted by these patients and carers is necessary, together with more straightforward access to appropriate care.
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BMJ Support Palliat Care · Mar 2016
Randomized Controlled TrialComparison of respiratory health-related quality of life in patients with intractable breathlessness due to advanced cancer or advanced COPD.
Breathlessness is common in patients with advanced cancer and almost universal in advanced chronic obstructive pulmonary disease (COPD), but studies suggest their experiences of breathlessness vary. This report builds on these studies by providing quantitative evidence of differences in respiratory health-related quality of life (HRQoL) between these groups. Further, it explores the validity of the Chronic Respiratory Questionnaire (CRQ) in patients with cancer. ⋯ Patients with breathlessness due to advanced COPD have worse respiratory HRQoL than those with advanced cancer. This may result from greater burden of breathlessness in COPD due to condition longevity, lesser burden of breathlessness in cancer due to its episodic nature, or variance in palliative referral thresholds by disease group. Our results suggest that greater access to palliative care is needed in advanced COPD, and that formal psychometric testing of the CRQ may be warranted in cancer.
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BMJ Support Palliat Care · Mar 2016
Does palliative care education matter to medical students? The experience of attending an undergraduate course in palliative care.
Palliative care (PC) education has become a priority in many European countries where PC is quickly developing. There remains, however, a lack of information on acceptability and medical students' experiences in PC education. This kind of information is important because it could encourage universities to adapt their curricula appropriately to the demographic and societal necessity. ⋯ The subject of PC turns out to be very important to students, who almost unanimously evaluated their experience positively and highlighted the benefits of attending a PC course. Students especially reported being surprised by the humane and holistic features of the course, and they found that what they learned in the course is applicable to all patients and prepares them to work better as doctors. Participants recommend the course for all undergraduate students as a core component of the curricula.