Palliative medicine
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Palliative medicine · Dec 2013
Review Meta Analysis'Best practice' in developing and evaluating palliative and end-of-life care services: a meta-synthesis of research methods for the MORECare project.
Improved and cost-effective palliative and end-of-life care is an international policy imperative. Developments are impeded by a weak and often inconsistent evidence base. ⋯ The complexity of delivering and evaluating palliative and end-of-life care services requires the accumulation of knowledge from multiple sources to understand the active components of an intervention to deliver patient benefit and examine the evaluation methods to detect change and reveal processes prior to a definitive trial. The implementation of evidence into practice should form a continuum throughout the evaluation stages to reveal understanding on the process of intervention delivery, the context and the intended outcome(s).
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Palliative medicine · Dec 2013
ReviewPalliative care research: lessons learned by our team over the last 25 years.
In the last 25 years, palliative care has made major progress as an interdisciplinary specialty that addresses quality-of-life issues for patients with life-limiting illnesses and their families. Research by numerous investigators has contributed to our increasing body of knowledge to support an evidence-based practice. ⋯ We conclude by sharing some of what we learned about the processes, pearls, and pitfalls of palliative care research.
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Palliative medicine · Dec 2013
ReviewBreathlessness--current and emerging mechanisms, measurement and management: a discussion from an European Association of Palliative Care workshop.
A pre-conference workshop at the 2012 European Association of Palliative Care meeting discussed the current scientific and clinical aspects of breathlessness. ⋯ Ensuring optimal delivery of interventions for breathlessness, whose design is underpinned by improving the understanding in the aetiology and maintenance of breathlessness, is the subject of ongoing controlled clinical trials.
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Palliative medicine · Dec 2013
MORECare research methods guidance development: recommendations for ethical issues in palliative and end-of-life care research.
There is little guidance on the particular ethical concerns that research raises with a palliative care population. ⋯ The culture surrounding palliative care research needs to change by fostering collaborative approaches between all those involved in the research process. Changes to the legal framework governing the research process are required to enhance the ethical conduct of research in palliative care. The recommendations are relevant to all areas of research involving vulnerable adults.
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Palliative medicine · Dec 2013
Research on psychological and social factors in palliative care: an invited commentary.
Psychosocial factors are a major determinant of well-being in patients with advanced disease. However, the development of valid and reliable measures of meaningful and relevant outcomes and randomized controlled trials to assess the impact of novel interventions are relatively recent accomplishments. ⋯ Psychosocial research in palliative care has grown in rigor and volume over the past several decades, and a variety of novel interventions have been developed and evaluated. However, the findings from this research have only begun to have an impact on clinical practice in palliative care.