Articles: palliative-care.
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Depression can be quite common in the palliative care population. The estimated prevalence ranges from 24% to 70%. Depression in this population leads to a decreased quality of life and may lead to a desire for an earlier death. ⋯ There is evidence to indicate that methylphenidate and antidepressants can provide a therapeutic benefit for palliative care patients with depressive symptoms. This benefit may be enhanced when these medications are used in combination. The use of music therapy or future-focused psychotherapy may also be beneficial in the treatment of depression.
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Background: Standardized referral criteria can aid in identifying patients who would benefit from palliative care consultation. Little is known, however, on palliative care team members' perceptions of these criteria. Objective: Describe palliative care programs' reasons for referral criteria implementation and their perception of the benefits or disadvantages of its use. ⋯ Late referrals (64.2%) were the most commonly cited reason for referral criteria implementation. The majority (77.4%) felt that referral criteria lead to positive outcomes, including earlier referrals for palliative care-appropriate patients (71.7%). Increases in staff workload and inappropriate referrals were identified as disadvantages of referral criteria use.* Conclusion: Palliative care program members identified both benefits and disadvantages of referral criteria use, but felt they had mostly productive results. *Correction added on March 18, 2021 after first online publication of December 18, 2020: In the Results section of the abstract, the third sentence was changed from "Increases in clinical volume and inappropriate referrals were identified as disadvantages of referral criteria use." to "Increases in staff workload and inappropriate referrals were identified as disadvantages of referral criteria use."
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Support Care Cancer · May 2021
Effects of meaning in life and individual characteristics on dignity in patients with advanced cancer in China: a cross-sectional study.
This study was conducted to evaluate the effects of meaning in life and individual characteristics on dignity in patients with advanced cancer. ⋯ Self-perceived dignity is significantly negatively associated with meaning in life, age, inpatient status, and performance status. The early recognition of risk factors for the loss of dignity and interventions to enhance meaning in life may prevent the loss of dignity in patients with advanced cancer.
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Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative condition managed with a multidisciplinary approach. Palliative care is important for this approach, but there is a lack of recommendations for the role and involvement of palliative medicine (PM) specialists in multidisciplinary ALS care. ⋯ Our study when compared with other study results having a similar aim showed that there is a variability in the practice of palliative care specialists in ALS clinics. Having evidence-based guidelines will help in the management of ALS patients more effectively.
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J Pain Symptom Manage · May 2021
Observational StudySelection Bias in Observational Studies of Palliative Care: Lessons Learned.
Palliative care (PC) programs are typically evaluated using observational data, raising concerns about selection bias. ⋯ This case study demonstrates that selection of comparison groups impacts the magnitude of measured and unmeasured confounding, which may change effect estimates. The substantial impact of confounding on effect estimates in this study raises concerns about the evaluation of novel serious illness care models in the absence of randomization. We present key lessons learned for improving future evaluations of PC using observational study designs.