Palliative & supportive care
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Palliat Support Care · Jun 2007
ReviewA review of methylnaltrexone, a peripheral opioid receptor antagonist, and its role in opioid-induced constipation.
Opioid medications are frequently used in pain and palliative care patients with malignancy to manage symptoms such as pain and dyspnea. However, opiates are associated with various side effects. Constipation is a particularly problematic and common side effect of opioid pharmacology. Opioid antagonists have been studied in the management of opioid-induced constipation. Methylnaltrexone (MNTX) is a peripheral opioid antagonist currently under clinical investigation. It offers the potential to reverse undesirable side effects without reversing analgesia. ⋯ Larger clinical trials of MNTX are still necessary to support its use as a standard for treatment of opioid-induced constipation.
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Palliat Support Care · Jun 2007
Randomized Controlled TrialImproving the quality of life of geriatric cancer patients with a structured multidisciplinary intervention: a randomized controlled trial.
To examine the potential impact of elderly age on response to participation in a structured, multidisciplinary quality-of-life (QOL) intervention for patients with advanced cancer undergoing radiation therapy. ⋯ Our results demonstrate that geriatric patients with advanced cancer undergoing radiation therapy will benefit from participation in a structured multidisciplinary QOL intervention. Therefore, geriatric individuals should not be excluded from participating in a cancer QOL intervention, and, in fact, elderly age may be an indicator of strong response to a QOL intervention. Future research should further explore this finding.
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Palliat Support Care · Mar 2007
Crying: a force to balance emotions among cancer patients in palliative home care.
Crying is a common but seldom studied phenomenon in palliative care. The aim of this study was to explore the significance of patients crying in a palliative care context. ⋯ Professionals need to understand the different levels of crying. In such situations sometimes comforting the patient may not be the best solution, as some may need privacy.
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Palliat Support Care · Mar 2007
Factors relating to terminally ill cancer patients' willingness to continue living at home during the early phase of home care after discharge from clinical cancer centers in Japan.
To assess the willingness of Japanese terminally ill cancer patients to continue living at home during the early phase of home care after discharge from a Clinical Cancer Center (CCC) in Japan, and to identify factors relating to their willingness to continue living at home. ⋯ At about 10 days after discharge, 64 patients (88%) wished to continue living at home. A hierarchical logistic regression analysis was performed on the data. It was found that the fewer the medical treatments undergone (OR = 0.20, 95% CI: 0.05-0.72), the higher the patients' perception that their condition was consistent with care at home (OR = 2.77, 95% CI: 1.08-8.62) and with their functional well-being (OR = 1.45, 95% CI: 1.08-2.17). In addition, the higher the caregivers' satisfaction with life (OR = 2.37, 95% CI: 1.15-5.77), the more willing patients tended to be to continue living at home. SIGNIFICANT OF RESULTS: The willingness of Japanese terminally ill cancer patients to continue living at home appears to be affected by caregiver status. This indicates a need for discharging facilities to monitor the state of home assistance and to investigate the nature of assistance required for continuing home care.
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Palliat Support Care · Mar 2007
Caregiving at the end of life: perspectives from spousal caregivers and care recipients.
The purpose of this study is to examine the perspectives of both the spousal caregiver and care recipient on the caregiving experience in home-based palliative care. ⋯ Health care and social service professionals need to recognize and understand both caregiver and care recipient perspectives if they are to successfully meet the needs of both members of the dyad.