Articles: palliative-care.
-
J Pain Symptom Manage · May 2022
A novel scale to assess palliative care patient experience of feeling heard and understood.
Patient experience of palliative care serves as an important indicator of quality and patient-centeredness. ⋯ This novel multi-item Feeling Heard and Understood scale can be used to measure and improve ambulatory palliative care patient experience.
-
Background: Oncologists and palliative specialists prescribe opioids for millions of cancer patients despite limited research on effective screening and mitigation strategies to reduce risk of opioid-related harm in that population. Objective: To evaluate the efficacy of a novel opioid risk stratification process for predicting significant aberrant behaviors (SABs) related to prescribed opioid medications. Design and Setting/Subjects: This is a prospective, longitudinal study of 319 consecutive patients referred to an outpatient palliative care clinic between 2010 and 2012, a period during which prescription opioid-related deaths began to increase in the United States. ⋯ Five risk factors significantly enhanced our risk model: age 18 to 45 years, job instability, history of bipolar diagnosis, history of substance abuse, and theft. Conclusion: Our risk stratification process provides a useful model for predicting those at greatest risk of future aberrant behaviors and most in need of comanagement. We recommend additional studies to test our proposed streamlined risk stratification tool.
-
Palliative medicine · May 2022
ReviewDeath doulas as supportive companions in end-of-life care: A scoping review.
Death doulas have gained greater attention recently by offering psychosocial, spiritual and other non-clinical support for patients with time-limiting diseases, including their families, with the potential to complement existing end-of-life care services. However, their roles, scope of practice and care impact remain poorly understood. ⋯ Death doulas can augment existing end-of-life care services by providing holistic and personalised care services at home or hospital settings. Their roles are still evolving and remain mostly unregulated, with little evidence about their impact. There is a need for more rigorous studies to explore healthcare professionals' views about this role and examine the clinical outcomes among dying persons and their families.
-
J Pain Symptom Manage · May 2022
A race-conscious approach toward research on racial inequities in palliative care.
Racial inequities in palliative and end-of-life care have been well-documented for many years. This inequity is long-standing and resistant to many intervention efforts. ⋯ Public Health Critical Race Praxis (PHCRP) offers researchers new routes of inquiry to broaden the scope of research priorities in palliative care and improving racial outcomes through a novel conceptual framework and methodology. PHCRP, based off critical race theory (CRT), contains 10 principles within four foci to guide researchers toward a more race conscious approach for the generation of research questions, research processes, and development of interventions targeting racial inequities.
-
Therapeutic presence is one of the fundamental skills that palliative care providers have to offer. The COVID-19 pandemic has created many barriers to connection that impact the way providers practice. This narrative piece about a remote cross-country palliative care encounter offers reflections on creating therapeutic presence amidst the current pandemic.