Palliative medicine
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Palliative medicine · Mar 2015
ReviewHospital-based bereavement services following the death of a child: a mixed study review.
There has been a breadth of research on the grief experience of parents following the death of a child. However, the role and impact of hospital-based bereaved services remain unclear. ⋯ There is a role for transitional hospital-based services/interventions for families in the lead up to and following the death of a child. Further mixed method research is required to inform best practice bereavement care guidelines in the perinatal, neonatal, and pediatric hospital settings.
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Palliative medicine · Mar 2015
Multicenter StudyA survey of clinician attitudes and self-reported practices regarding end-of-life care in heart failure.
As heart failure often follows an unpredictable clinical trajectory, there has been an impetus to promote iterative patient-provider discussions regarding prognosis and preferences for end-of-life care. ⋯ Clinicians vary in their views and approaches to end-of-life discussions and care. Some lack confidence and most are interested in further skills acquisition.
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Palliative medicine · Mar 2015
Inviting parents to take part in paediatric palliative care research: a mixed-methods examination of selection bias.
Recruitment to paediatric palliative care research is challenging, with high rates of non-invitation of eligible families by clinicians. The impact on sample characteristics is unknown. ⋯ We found evidence of selective invitation practices that could bias research findings. Non-invitation and selection bias should be considered, assessed and reported in palliative care studies.
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Palliative medicine · Mar 2015
Impact of a clinical pathway on end-of-life care following stroke: a mixed methods study.
Death after stroke is common, but little is known about end-of-life care processes in acute stroke units. ⋯ Distressing stroke-related clinical problems dominated relatives' concerns rather than use of the end-of-life care pathway. At times, relatives felt primarily responsible for key aspects of decision-making. Relatives often felt unprepared for a prolonged dying process after stroke, particularly where patients had persistent major swallowing difficulties.
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Palliative medicine · Mar 2015
Case ReportsA case report of dexmedetomidine used to treat intractable pain and delirium in a tertiary palliative care unit.
This case report describes an end-stage cancer patient with intractable neuropathic pain and delirium who was successfully managed during the last 3 weeks of her life with a continuous subcutaneous infusion of dexmedetomidine. ⋯ Dexmedetomidine is a potentially useful medication for the targeted treatment of intractable pain and delirium in the tertiary palliative care environment. Future research is required to compare dexmedetomidine infusion to standard treatment with midazolam infusion for treatment of intractable symptoms in the palliative care environment.