Palliative & supportive care
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Palliat Support Care · Oct 2015
Quality of life changes and intensive care preferences in terminal cancer patients.
There is scarce research on the short-term fluctuations in end-of-life (EoL) care planning for seriously ill patients. The aim of our study was to investigate the stability of preferences regarding treatment in an intensive care unit (ICU) and identify the factors associated with changes in preferences in terms of quality of life (QoL). ⋯ The attitudes of terminally ill cancer patients regarding ICU care at the end of life were not stable over time, and changes in their QoL were associated with a tendency to change their preferences about ICU care. Attention should thus be paid to patients' QoL changes to improve medical decision making with regard to EoL care.
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Palliat Support Care · Oct 2015
Depression means different things: A qualitative study of psychiatrists' conceptualization of depression in the palliative care setting.
Medical practitioners conceptualize depression in different ways, which adds to the challenges of its diagnosis and treatment, as well as research in the palliative care setting. Psychiatric assessment is often considered the "gold standard" for diagnosis, therefore how psychiatrists conceptualize depression in this setting is pertinent. Our study aimed to investigate this issue. ⋯ Psychiatrists did not subscribe to a unitary model of depression but understood it as a heterogeneous concept comprised of depressive illness and other less clearly defined depressive presentations. Given the influence of psychiatric opinion in the area of depression, these findings may serve as a platform for further discussions to refine the concepts of depression in the palliative care setting, which in turn may improve diagnostic and treatment outcomes.
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Palliat Support Care · Oct 2015
Reliability and validity of the Head and Neck Cancer Inventory (HNCI) in Japanese patients.
This project evaluated the psychometric properties of a translated version of the Head and Neck Cancer Inventory (HNCI) for use with Japanese patients. The HNCI is a measure for assessing the quality of life (QoL) of head and neck cancer patients and survivors. The present study was aimed at investigating the reliability and validity of this translated instrument. ⋯ The reliability and validity of the Japanese HNCI were evaluated. Although its classification is different from the original U.S. version, the Japanese HNCI is a self-administered questionnaire that can assess quality of life (QoL) in patients with head and neck cancer.
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Palliat Support Care · Oct 2015
Case ReportsThe "do-not-resuscitate" order in palliative surgery: Ethical issues and a review on policy in Hong Kong.
A do-not-resuscitate (DNR) order, or "advance directive," is commonly seen in the cases of palliative patients who express a wish to withhold specific resuscitative therapies in the event of a cardiac arrest. With recent technological advances, there are increasing numbers of palliative patients who undergo surgical interventions to treat their symptoms and discomfort. ⋯ The present article describes a case and the ethical issues involved and gives some practical suggestions for those facing similar problems. We also review the latest DNR policy in Hong Kong.
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Palliat Support Care · Oct 2015
The process of palliative sedation as viewed by physicians and nurses working in palliative care in Brazil.
Our aim was to describe the process of palliative sedation from the point of view of physicians and nurses working in palliative care in Brazil. ⋯ The opinion of the physicians and nurses who participated in this study converged with the principal national and international guidelines on palliative sedation. However, even though it is a therapy that has been adopted in palliative care, it remains a controversial practice.