Palliative medicine
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Palliative medicine · Dec 2012
ReviewUsing observation as a data collection method to help understand patient and professional roles and actions in palliative care settings.
Observational research methods are important for understanding people's actions, roles and behaviour. However, these techniques are underused generally in healthcare research, including research in the palliative care field. ⋯ Qualitative observational data collection methods can contribute to theoretical and conceptual development and the explanation of social processes in palliative care. In particular this contribution to understanding care structures and processes should improve understanding of patients' experiences of their care journey and thus impact on care outcomes.
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Palliative medicine · Dec 2012
Designing and conducting randomized controlled trials in palliative care: A summary of discussions from the 2010 clinical research forum of the Australian Palliative Care Clinical Studies Collaborative.
Rigorous clinical research in palliative care is challenging but achievable. Trial participants are likely to have deteriorating performance status, co-morbidities and progressive disease. It is difficult to recruit patients, and attrition unrelated to the intervention being trialled is high. ⋯ All active Australian researchers in palliative care were invited to present their current research and address three specific questions: (1) What has worked well? (2) What didn't work well? and (3) How should the research be done differently next time? Fourteen studies were presented, including six double-blind, randomized, controlled, multi-site trials run by the PaCCSC. Key recommendations are reported, including guidance on design; methodologies; and strategies for maximizing recruitment and retention. These recommendations will help to inform future trial design and conduct in palliative care.
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Palliative medicine · Dec 2012
Case ReportsTopical application of a beclometasone steroid inhaler for treatment of stoma inflammation.
We describe two cases of peristomal inflammation which resulted in pain, poor adhesion of the stoma bag and faecal leaking. The inflammation did not respond to regular cleaning and barrier film sprays, but dramatically improved with the application of a beclometasone dry powder aerosol inhaler sprayed onto the inflamed skin around the stoma site. A steroid inhaler was used to decrease the peristomal inflammation without affecting the adhesion of the stoma bag which could be caused by creams.
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Palliative medicine · Dec 2012
Out-of-hours medical care for terminally ill patients: A survey of availability and preferences of general practitioners.
Continuity of care is one of the core values of good medical care for terminally ill patients. The availability of one's own general practitioner (GP) out of hours is regarded as important for personal continuity. Few data are available about the extent of out-of-hours care given by GPs to their terminally ill patients. ⋯ The reported out-of-hours availability of GPs for terminally ill patients is still high. GPs' perception of their duty of care might change in the next generations, and the increasing number of salaried GPs, living far from their practice, might threaten out-of-hours availability for terminally ill patients. GPs' perception of their duty of care might change in the next generations, and the increasing number of salaried GPs living far from their practice might threaten out-of-hours availability for terminally ill patients.
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Palliative medicine · Dec 2012
ReviewEstablishing hospice care for prison populations: An integrative review assessing the UK and USA perspective.
models of care based on the hospice model have delivered effective support to dying people since their inception. Over the last 20 years this form of care has also been introduced into the prison system (mainly in the United States) to afford terminally ill inmates the right to die with dignity. ⋯ the provision of palliative care for the increasing prison population remains under-researched globally, with a notable lack of evidence from the United Kingdom.