Palliative medicine
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Palliative medicine · Jan 2015
Multicenter StudyPalliative Care Phase: inter-rater reliability and acceptability in a national study.
The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. ⋯ Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.
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Palliative medicine · Jan 2015
ReviewEffectiveness of complex interventions focused on quality-of-life assessment to improve palliative care patients' outcomes: a systematic review.
One of the most crucial palliative care challenges is in determining how patient' needs are defined and assessed. Assessing quality of life has been defined as a priority in palliative care, and it has become a central concept in palliative care practice. ⋯ Effectiveness of interventions focused on quality-of-life assessment is moderate. Additional studies should explore the complexity of the real palliative care world more accurately and understand the effects of independent variables included in complex palliative care interventions.
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Palliative medicine · Jan 2015
Quality indicators for palliative care services: mixed-method study testing for face validity, feasibility, discriminative power and usefulness.
In the absence of a standardized, comprehensive and valid set of quality indicators for palliative care, we developed one for palliative care services in Belgium. ⋯ Based on the results, minor adjustments were made to individual indicators, to the measurement tools and to the procedure used; the quality indicators are now ready for further evaluation and use across palliative care services in Belgium. As soon as these indicators are being used systematically, it will be possible to demonstrate and compare quality at the national and international levels and to evaluate improvement initiatives.
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Palliative medicine · Jan 2015
Awareness of dementia by family carers of nursing home residents dying with dementia: a post-death study.
High-quality palliative care for people with dementia should be patient-centered, family-focused, and include well-informed and shared decision-making, as affirmed in a recent white paper on dementia from the European Association for Palliative Care. ⋯ Family carers are often unaware that their relative has dementia, that is, in one-fourth of cases of dementia and one-fifth of advanced dementia, posing considerable challenges for optimal care provision and end-of-life decision-making. Considering that family carers of residents who develop dementia later after admission to a nursing home are less likely to be aware, there is room for improving communication strategies toward family carers of nursing home residents.
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Palliative medicine · Jan 2015
PREDICT: a diagnostic accuracy study of a tool for predicting mortality within one year: who should have an advance healthcare directive?
CARING is a screening tool developed to identify patients who have a high likelihood of death in 1 year. ⋯ PREDICT was successfully applied to the Australian healthcare system with findings similar to the original CARING study conducted in the United States. This tool could improve end-of-life care by identifying who should have advance care planning or an advance healthcare directive.