Palliative medicine
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Palliative medicine · Jan 2013
ReviewThe use of observational scales to monitor symptom control and depth of sedation in patients requiring palliative sedation: a systematic review.
Palliative sedation is the intentional lowering of consciousness of a patient in the last phase of life to relieve suffering from refractory symptoms such as pain, delirium and dyspnoea. ⋯ A minority of studies reported the use of observational scales to monitor the effect of palliative sedation. Future studies should be focused on establishing proper instruments, most adequate frequency and timing of assessment, and interdisciplinary evaluation of sedation depth and symptom control for palliative sedation.
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Palliative medicine · Jan 2013
ReviewWhy do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying.
Assisted dying is legal in four European countries and three American states. Elsewhere, particularly in more affluent or mainly Protestant countries, it remains controversial. Dominant headlines feature professional (medical, legal, religious) arguments versus celebrity campaigners; ordinary people are less clearly represented. ⋯ Our review sheds light on ordinary people's perspectives about assisted dying, when they are ill or disabled. Unbearable suffering is a key construct, and common factors are revealed that lead people to ask for help to die. The consistency of international views indicates a mandate for legislative and medical systems worldwide to listen and understand this.
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Palliative medicine · Jan 2013
A new model for breaking bad news to people with intellectual disabilities.
To develop a model for breaking bad news that meets the needs of people with intellectual disabilities (IDs). ⋯ Patients who have IDs do not easily process verbal information in a clinical setting. The new model for breaking bad news to people with IDs needs to be tested in practice using robust outcome measures. The model's relevance to wider patient groups should also be evaluated.
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Palliative medicine · Jan 2013
The association between in-patient death, utilization of hospital resources and availability of palliative home care for cancer patients.
The impact of palliative home care programs on in-patient admissions and deaths has not been appropriately established. ⋯ Our findings suggest that a PHCT is associated with reduced in-patient deaths and overall hospitalization over the last two months of life.
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Palliative medicine · Jan 2013
Extent of palliative care need in the acute hospital setting: a survey of two acute hospitals in the UK.
In common with international health policy, The End of Life Care Strategy for England has highlighted the delivery of high quality palliative care in the acute hospital setting as an area of priority. ⋯ The results reveal that according to the GSF prognostic guide, over a third of hospital in-patients meet the criteria for palliative care need. Consensus between medical staff, nursing staff and the GSF was poor regarding the identification of patients with palliative care needs. This has significant implications for patient care, and draws into question the utility of the GSF in the hospital setting.