Palliative & supportive care
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Palliat Support Care · Apr 2015
"It is the 'starting over' part that is so hard": Using an online group to support hospice bereavement.
Although hospice agencies are required to provide informal caregivers (family or friends of the patient) with formal bereavement support when their loved one passes, most bereavement interventions lack standardization and remain untested. We employed the Dual Processing Model of Bereavement as a theoretical framework for assessing the potential of a secret Facebook group for bereaved hospice caregivers. ⋯ This pilot study provides insight into the use of a secret Facebook group to facilitate bereavement support to caregivers. Findings highlight the promise of Facebook for hospice bereavement support. Providers and researchers are encouraged to explore the positive outcomes associated with bereavement support.
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Palliat Support Care · Apr 2015
Case ReportsThe need for a multidisciplinary approach to pain management in advanced cancer: A clinical case.
Advanced cancer patients are often affected by multiple complex symptoms brought about by persistent nociceptive stimuli and intense psychosocial distress. One such complex symptom, cancer pain, has continued to pose a challenge in medical management even though the concept of total pain was described several years ago by Cicely Saunders. Oftentimes, the application of a multidisciplinary approach is delayed after numerous opioid dose escalations and invasive procedures have been performed. The case presented here highlights the importance of timely multidisciplinary intervention and the use of an acute palliative care unit, which resulted in adequate pain control after multiple medical and invasive procedures that caused toxicities.
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Palliat Support Care · Apr 2015
Effectiveness of multidisciplinary team conference on decision-making surrounding the application of continuous deep sedation for terminally ill cancer patients.
Continuous deep sedation (CDS) is a way to reduce conscious experience of symptoms of severe suffering in terminally ill cancer patients. However, there is wide variation in the frequency of its reported. So we conducted a retrospective analysis to assess the prevalence and features of CDS in our palliative care unit (PCU). ⋯ Our results indicate that the prevalence of CDS will be decreased when it is carried out solely for appropriate indications. Continuity of teamwork, good coordination, exchange of information, and communication between the various care providers are essential. A lack of any of these may lead to inadequate assessment, information discrepancies, and unrest.
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Palliat Support Care · Apr 2015
The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer.
The purpose of this study was to determine the effect of acupressure applied to the pericardium 6 (P6 or neiguan) acupuncture point on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. ⋯ The efficacy of applying acupressure was demonstrated. We determined that applying acupressure at the P6 point is effective in decreasing chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. Further research with more subjects is needed.
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Palliat Support Care · Apr 2015
Case ReportsA palliative care intervention for pain refractory to a percutaneous cordotomy.
Intrathecal analgesia and radiofrequency techniques for tumor ablation are employed for palliation of symptoms. These interventions are efficacious in a select number of patients for controlling pain and improving quality of life. Careful selection of an appropriate candidate must be performed to prevent needless, invasive, and costly interventions, as interventional pain management alone will not treat total pain in cancer patients. We describe here a patient who experienced intractable pain and unsuccessfully underwent cordotomy but responded to the interdisciplinary (IDT) palliative care approach in an acute palliative care unit (APCU). ⋯ An APCU approach involving an IDT alleviated the need for invasive interventions by diagnosing and treating the psychosocial, emotional, and spiritual distress contributing to the patient's total pain expression. Successful management must be reflective of rigorous assessment of the physical, psychological, spiritual, social, and practical aspects before consideration of more invasive treatments.