Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2023
ReviewDEVELOPMENT AND VALIDATION A TOOL TO ASSESS THE STRUCTURAL QUALITY OF PALLIATIVE CARE SERVICES.
The current gap in access to palliative care requires the expansion of palliative care services worldwide. There is little information about the structural components required by palliative care services to provide adequate end-of-life care. No specific tools have been developed to assess the structural quality of these services. ⋯ The SQPCS-21 tool to assess structural quality of palliative care services, has good content and construct validity and its application provides information about institutions at the individual and aggregated level. This tool can provide guidance to monitor the structural quality of palliative care worldwide.
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J Pain Symptom Manage · Jun 2023
Shared Decision Making in the Geriatric Surgery Verification Program: Assessing Baseline Performance.
As part of the launch of the Geriatric Surgery Verification program in 2019, the American College of Surgeons issued care standards for older patients, including requirements for preoperative documentation of patients' goals. Hospital performance on these standards prior to the Geriatric Surgery Verification program is unknown. ⋯ Before GSV program implementation, clinicians for two major operations almost never met the GSV standard for preoperative discussion of patient goals. Interdisciplinary teams will need to adjust clinical practice to meet best-practice communication standards for older patients.
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J Pain Symptom Manage · Jun 2023
Observational StudyVisualizing how to use antipsychotics for agitated delirium in the last days of life.
How physicians use antipsychotics for agitated delirium in the last days of life varies markedly, which could hamper the quality of care. ⋯ The algorithm-based treatment could be feasible, effective, and safe. Visualizing how palliative care specialists provide pharmacological management could be beneficial for nonspecialist clinicians, and clinical, educational, and research implications warrant further empirical testing.
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J Pain Symptom Manage · Jun 2023
From Hospital to Home: Referrals to pediatric hospice and home-based palliative care.
Hospital-based pediatric palliative care (PPC) may help optimize referrals to community-based hospice and home-based palliative care (HBPC) for children with serious illness, yet little is known about their referral practices. ⋯ Despite demographic eligibility, a minority of patients seen by a hospital-based PPC team received referrals for hospice or HBPC. Children discharged from an ICU and those with neurologic conditions may be at higher risk of missing referrals best aligned with their needs. Future research should identify and address causes of referral misalignment. Advocacy for programs adaptable to patients' changing needs may also be needed.
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J Pain Symptom Manage · Jun 2023
Palliative Care Needs of Physically Frail Community-Dwelling Older Adults with Heart Failure.
Physical frailty is emerging as a potential "trigger" for palliative care (PC) consultation, but the PC needs of physically frail persons with heart failure (HF) in the outpatient setting have not been well described. ⋯ Physically frail people with HF have higher unmet PC needs than those who are nonfrail. Implementing PC needs and frailty assessments may help identify vulnerable patients with unmet needs requiring further assessment and follow-up.