Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2011
A rapid two-stage screening protocol for palliative care in the emergency department: a quality improvement initiative.
A rapid two-stage screening protocol was developed to improve referral for palliative care needs among frail elderly in the emergency department (ED). ⋯ The project shows unmet needs among elderly ED patients, and the feasibility of rapid screening and referral using a quality improvement approach. At its peak, the project accounted for half the referrals to the palliative care consultation service.
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J Pain Symptom Manage · Nov 2011
Review Meta AnalysisWhat palliative care-related problems do patients experience at HIV diagnosis? A systematic review of the evidence.
Palliative care is an essential element of HIV care throughout the disease trajectory, but there is a lack of information to guide clinical care at HIV diagnosis. ⋯ People who have recently been diagnosed with HIV have multidimensional palliative care-related problems. HIV care and support services need to assess and manage problems using integrated palliative care, with referral for complex problems. Patient centeredness must be a principle of HIV clinical research.
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Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress. ⋯ Severity of anxiety symptoms did not differ between the study sites, suggesting that anxiety may differ from depression and desire for hastened death in the course that it takes over the duration of terminal cancer.
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J Pain Symptom Manage · Nov 2011
Process and outcomes of euthanasia requests under the belgian act on euthanasia: a nationwide survey.
Since 2002, the administration of a lethal drug by a physician at the explicit request of the patient has been legal in Belgium. The incidence of euthanasia in Belgium has been studied, but the process and outcomes of euthanasia requests have not been investigated. ⋯ Under the Belgian Act on Euthanasia, about half of the requests are granted. Factors related to the reason for the request, position of the attending physician toward the request, and advice from the second physician influence whether a request is granted or not.
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J Pain Symptom Manage · Nov 2011
A model for increasing palliative care in the intensive care unit: enhancing interprofessional consultation rates and communication.
Only a minority of patients who die in the medical intensive care unit (MICU) receive palliative care services. At the South Texas Veterans Health Care System Audie L. Murphy Hospital, only 5% of patients who died in the MICU from May to August 2010 received a palliative care consultation. ⋯ Daily pre-rounds between the palliative care and MICU teams increased palliative care services for MICU patients at risk for poor outcomes, who may benefit from a palliative care consultation.