Articles: palliative-care.
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Randomized Controlled Trial Comparative Study
Anxiety and Depressive Symptoms Among Two Seriously Medically Ill Populations and Their Family Caregivers: A Comparison and Clinical Implications.
Anxiety and depression are common among patients with acute illness and their families. In oncology, psychosocial services addressing these symptoms are increasingly part of regular practice. Less is known about psychiatric distress among patients with acute neurological injury (ANI) and their family caregivers. To highlight this inequity in psychosocial intervention across medical services, we compared anxiety and depressive symptomatology shortly following diagnosis among patients facing incurable cancer or ANI and their family caregivers. ⋯ This is the first cross-comparison of psychiatric distress in patients and family caregivers affected by two distinct, life-threatening illnesses early in the illness trajectory. Findings support the priority of addressing psychiatric distress among patients with ANI and their family caregivers, as has been emphasized in the psychosocial oncology field.
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Palliative medicine · Oct 2017
Randomized Controlled Trial Comparative StudyRandomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer: The Danish Palliative Care Trial.
Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. ⋯ We did not observe beneficial or harmful effects of early specialist palliative care, but important beneficial effects cannot be excluded.
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J Pain Symptom Manage · Oct 2017
Randomized Controlled TrialDignity Therapy and Life Review for Palliative Care Patients: A Qualitative Study.
Dignity therapy (DT) is a psychotherapeutic intervention whose aim was to bolster the sense of purpose, meaning, and sense of dignity in patients with terminal disease. ⋯ This study provides further insight into what palliative care patients consider to be most important and meaningful to them when taking part in DT and LR. Creating legacy documents is likely to result in session content that is different in several key areas compared with LR, even when controlling for interview questions, therapist influences, and session length. Consideration of the above is essential in optimizing psychotherapeutic outcomes near end of life.
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Randomized Controlled Trial Comparative Study
Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial.
The use of benzodiazepines to control agitation in delirium in the last days of life is controversial. ⋯ In this preliminary trial of hospitalized patients with agitated delirium in the setting of advanced cancer, the addition of lorazepam to haloperidol compared with haloperidol alone resulted in a significantly greater reduction in agitation at 8 hours. Further research is needed to assess generalizability and adverse effects.
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J Pain Symptom Manage · Sep 2017
Randomized Controlled TrialLevel of Care Preferences among Nursing Home Residents with Advanced Dementia.
Delivering goal-directed care is a hallmark of high-quality palliative care, but requires an understanding of preferences. ⋯ Most proxies select comfort as the preferred level of care for NH residents with advanced dementia. Discussions regarding prognosis, as well as inquiry about goals of care, are modifiable factors that may promote a preference for comfort care in this population.