Articles: palliative-care.
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J. Natl. Cancer Inst. · Feb 2003
Randomized Controlled Trial Multicenter Study Clinical TrialSingle- versus multiple-fraction radiotherapy in patients with painful bone metastases: cost-utility analysis based on a randomized trial.
Radiotherapy is an effective palliative treatment for cancer patients with painful bone metastases. Although single- and multiple-fraction radiotherapy are thought to provide equal palliation, which treatment schedule provides better value for the money is unknown. We compared quality-adjusted life expectancy (the overall valuation of the health of the patients) and societal costs for patients receiving either single- or multiple-fraction radiotherapy. ⋯ Compared with multiple-fraction radiotherapy, single-fraction radiotherapy provides equal palliation and quality of life and has lower medical and societal costs, at least in The Netherlands. Therefore, single-fraction radiotherapy should be considered as the palliative treatment of choice for cancer patients with painful bone metastases.
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Br J Community Nurs · Feb 2003
Multicenter StudyDistrict nurses' experiences and perceptions of cancer patient referrals.
Traditionally palliative care of cancer patients has been seen as an important and defining aspect of district nursing. Care of the dying patient has been used to describe the ability and scope of the district nursing service to holistically provide for patient need. However health and social service changes in the last decade have refocused the district nurse's role away from holistic delivery to more specialized care. ⋯ We conducted a study to explore district nurses' perceptions and experiences of referral of cancer patients to gain insight into these referral processes. We interviewed 20 nurses from three primary care trusts to explore the referral process of cancer patients to the district nursing service from the district nurses' point of view. The nurses expressed concerns regarding completeness, accuracy and appropriateness of referral and suggested improvements that could be made.
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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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To elicit ratings of quality and satisfaction with care from medical inpatients, especially those near the end of life. ⋯ Patients with do-not-resuscitate orders who were treated by a house-staff service gave the lowest ratings of physician quality and satisfaction. Only private patients who were not depressed were highly satisfied with their nursing care. Further study is required to better understand these findings and whether they are amenable to quality improvement.