Articles: palliative-care.
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Randomized Controlled Trial
The minimal clinically important difference of the Richmond Agitation-Sedation Scale in patients with cancer with agitated delirium.
The Richmond Agitation-Sedation Scale (RASS) is commonly used to assess psychomotor activity; however, to the authors' knowledge, its minimal clinically important difference (MCID) has not been determined to date. The objective of the current study was to identify the MCID for RASS using 2 anchor-based approaches. ⋯ For patients with persistent restlessness/agitation, a reduction of ≥4 points in RASS was considered to be the MCID for both nurses and caregivers. These preliminary findings may have implications for sample size calculation and the interpretation of treatment effect in future delirium trials. Cancer 2018;124:2246-52. © 2018 American Cancer Society.
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Am J Hosp Palliat Care · May 2018
Randomized Controlled TrialA Descriptive Analysis of End-of-Life Conversations With Long-Term Glioblastoma Survivors.
Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. ⋯ Patients with GBM had multiple goals/priorities with potential treatment implications, but documentation showed SI conversations occurred relatively late and infrequently reflected patient goals/priorities.
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Palliative medicine · Apr 2018
Randomized Controlled TrialDifferential effects of early palliative care based on the age and sex of patients with advanced cancer from a randomized controlled trial.
Early palliative care interventions enhance patient outcomes, including quality of life, mood, and coping, but it remains unclear whether certain subgroups of patients are more likely to benefit from early palliative care. We explored whether age and sex moderate the improved outcomes seen with early palliative care. ⋯ Age and sex moderate the effects of early palliative care for patients with advanced lung cancer. Early palliative care may need to be tailored to individuals' unique sociodemographic and clinical characteristics.
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J Pain Symptom Manage · Apr 2018
Randomized Controlled TrialA Novel Screening Method to Identify Late-Stage Dementia Patients for Palliative Care Research and Practice.
Investigators need novel methods for timely identification of patients with serious illness to test or implement new palliative care models. ⋯ A novel method using an EHR phenotype plus brief medical record review is effective to identify hospitalized patients with late-stage dementia. In health care systems with similar clinical data warehouses, this method may be applied to serious illness populations to improve enrollment in clinical trials of palliative care or to facilitate access to palliative care services.
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Palliative medicine · Apr 2018
Randomized Controlled TrialThe 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer.
People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. ⋯ In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.