Articles: palliative-care.
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Randomized Controlled Trial
Integrated care at home reduces unnecessary hospitalizations of community-dwelling frail older adults: a prospective controlled trial.
Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. ⋯ Integrated care that included a home visiting multidisciplinary geriatric team significantly reduced unnecessary hospitalizations, emergency room visits and allowed more patients to die at home. It is an effective tool to improve coordination and access to care for frail and dependent older adults.
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J Pain Symptom Manage · Feb 2017
Randomized Controlled TrialDignity Therapy and Life Review for Palliative Care Patients: A Randomised Controlled Trial.
Dignity therapy (DT) is a psychotherapeutic intervention with increasing evidence of acceptability and utility in palliative care settings. ⋯ This study provides initial evidence that the specific process of legacy creation is able to positively affect sense of generativity, meaning, and acceptance near end of life. High acceptability and satisfaction rates for both DT and LR and positive impacts on families/carers of DT participants provide additional support for clinical utility of these interventions. Further evaluation of specific mechanisms of change post-intervention is required given DT's uncertain efficacy on other primary outcomes.
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Critical care medicine · Feb 2017
Randomized Controlled TrialA Randomized Trial of Palliative Care Discussions Linked to an Automated Early Warning System Alert.
To determine whether an Early Warning System could identify patients wishing to focus on palliative care measures. ⋯ This study suggests that automated Early Warning System alerts can identify patients potentially benefitting from directed palliative care discussions and reduce the number of ICU transfers.
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JAMA internal medicine · Jan 2017
Randomized Controlled Trial Multicenter StudyEfficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative Care: A Randomized Clinical Trial.
Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. ⋯ In patients receiving palliative care, individualized management of delirium precipitants and supportive strategies result in lower scores and shorter duration of target distressing delirium symptoms than when risperidone or haloperidol are added.
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J Pain Symptom Manage · Jan 2017
Randomized Controlled TrialCoping in Patients with Incurable Lung and Gastrointestinal Cancers: A Validation Study of the Brief COPE.
Patients with incurable cancer engage in several coping styles to manage the impact of cancer and its treatment. The Brief COPE is a widely used measure intended to capture multiple and distinct types of coping. The Brief COPE has not been validated among patients with incurable cancer. ⋯ The selected subscales of the Brief COPE are appropriate measures of coping among individuals newly diagnosed with incurable lung and gastrointestinal cancers.