Palliative medicine
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Palliative medicine · Feb 2013
Multivariate analysis of countries' government and health-care system influences on opioid availability for cancer pain relief and palliative care: more than a function of human development.
Many international governmental and nongovernmental organizations regard unrelieved cancer pain as a significant global public health problem. Although opioids such as morphine are considered essential medicines in the provision of palliative care and for treating cancer pain, especially when the pain is severe, low- and middle-income countries often lack such medications. ⋯ Study findings demonstrate that a limited number of predictor variables characterizing a country's government and health-care system infrastructure can explain its opioid consumption level, with the greatest influence being very high Human Development Index. However, Human Development Index is not the most policy-relevant factor, and this finding should be reconciled against the reality that many countries with low or medium Human Development Index have succeeded in creating and sustaining a health-care system to strengthen cancer pain care and palliative care, including through the appropriate use of essential prescription opioids.
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Palliative medicine · Feb 2013
Congruence between preferred and actual place of care and death among Danish cancer patients.
Meeting patient's preferences is an important outcome in palliative care. No Scandinavian study has reported systematically collected preferences from patients regarding place of care (POC) and place of death (POD). The extent of possible incongruence between patients' preferences and reality remains unknown. ⋯ Regular discussions with patients on this subject are needed. Social and professional support is of importance in meeting patients' preferences. Larger scaled studies and research focusing on meeting patients' preferences are needed.
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Palliative medicine · Feb 2013
Understanding Compassion Satisfaction, Compassion Fatigue and Burnout: a survey of the hospice palliative care workforce.
Despite the increasingly crucial role of the healthcare workforce and volunteers working in hospice and palliative care (HPC), very little is known about factors that promote or limit the positive outcomes associated with practicing compassion. ⋯ Our results indicate a significant negative correlation between Compassion Satisfaction and Burnout (r = -0.531, p < 0.001) and between Compassion Satisfaction and Compassion Fatigue (r = -0.208, p < 0.001), and a significant positive correlation between Burnout and Compassion Fatigue (r = 0.532, p < 0.001). Variations in self-reported levels of the above constructs were noted by key practice characteristics. Levels of all three constructs are significantly, but differentially, affected by type of service provided, principal institution, practice status and professional affiliation. Results indicate that health care systems could increase the prevalence of Compassion Satisfaction through both policy and institutional level programs to support HPC professionals in their jurisdictions.
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Palliative medicine · Feb 2013
Resource utilization and cost analyses of home-based palliative care service provision: the Niagara West End-of-Life Shared-Care Project.
Increasing emphasis is being placed on the economics of health care service delivery - including home-based palliative care. ⋯ While higher than expenditures previously reported for a cancer-only population in an urban Ontario setting, the costs were still within the parameters of the US Medicare Hospice Benefits, on a par with the per diem funding assigned for long-term care homes and lower than both average alternate level of care and hospital costs within the Province of Ontario. The study results may assist service planners in the appropriate allocation of resources and service packaging to meet the complex needs of palliative care populations.
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Palliative medicine · Feb 2013
Awareness of incurable cancer status and health-related quality of life among advanced cancer patients: a prospective cohort study.
Many patients near death report an interest in knowing their prognoses. Patients' awareness of disease status may lead to more appropriate care and maintained or improved quality of life. However, it is not known whether advanced cancer patients' awareness of disease status is associated with patients' quality of life. ⋯ Our findings demonstrate the importance of patients' awareness of disease status to HRQOL.