Articles: palliative-care.
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J Pain Symptom Manage · Nov 2011
Review Meta AnalysisWhat palliative care-related problems do patients experience at HIV diagnosis? A systematic review of the evidence.
Palliative care is an essential element of HIV care throughout the disease trajectory, but there is a lack of information to guide clinical care at HIV diagnosis. ⋯ People who have recently been diagnosed with HIV have multidimensional palliative care-related problems. HIV care and support services need to assess and manage problems using integrated palliative care, with referral for complex problems. Patient centeredness must be a principle of HIV clinical research.
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Gastrointest. Endosc. · Aug 2011
Meta Analysis Comparative StudyMeta-analysis of randomized trials comparing the patency of covered and uncovered self-expandable metal stents for palliation of distal malignant bile duct obstruction.
Self-expandable metal stents (SEMSs) are used for palliation of malignant biliary obstruction. ⋯ CSEMSs have a significantly longer duration of patency compared with USEMSs in patients with distal malignant biliary obstruction. Stent dysfunction occurs at a similar rate, although there is a trend toward later obstruction with CSEMSs.
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J Pain Symptom Manage · May 2011
Review Meta AnalysisEffectiveness of knowledge translation interventions to improve cancer pain management.
Cancer pain is prevalent, yet patients do not receive best care despite widely available evidence. Although national cancer control policies call for education, effectiveness of such programs is unclear and best practices are not well defined. ⋯ Trials that used a higher dose of KT intervention (characterized by extensive follow-up, comprehensive educational program, and higher resource allocation) were significantly more likely to have positive results than trials that did not use this approach. Further attention to methodological issues to improve educational interventions and research to clarify factors that lead to better pain control are urgently needed.
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J Pain Symptom Manage · Apr 2011
Review Meta AnalysisPalliative sedation in patients with advanced cancer followed at home: a systematic review.
Patients with advanced cancer who are near the end of life may experience intolerable suffering refractory to targeted palliative therapies. Palliative sedation (PS) is considered to be an effective treatment modality for these refractory symptoms when aggressive efforts fail to provide relief. ⋯ PS at home seems to be a feasible treatment option among selected patients and makes a potentially important contribution to improving care for those who choose to die at home. Although the existing studies provide only low-quality evidence, the decision to use PS does not seem to anticipate patients' death. More homogeneous prospective studies on a large number of patients should confirm this observation.
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J Pain Symptom Manage · Apr 2011
Review Meta AnalysisThe measurement of spirituality in palliative care and the content of tools validated cross-culturally: a systematic review.
Despite the need to assess spiritual outcomes in palliative care, little is known about the properties of the tools currently used to do so. In addition, measures of spirituality have been criticized in the literature for cultural bias, and it is unclear which tools have been validated cross-culturally. ⋯ The nine tools identified in this review are those that have currently been validated in cross-cultural palliative care populations and, subject to appraisal of their psychometric properties, may be suitable for cross-cultural research.