Palliative medicine
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Palliative medicine · Feb 2016
ReviewAssisting the bereaved: A systematic review of the evidence for grief counselling.
Supporting people after bereavement is a priority area for many health services. Investment in bereavement care must be supported by a rigorous evidence-base. ⋯ Grief counselling interventions require a strong rationale for design, and a systematic approach to development and evaluation. Descriptive research efforts should inform this process, focusing on homogeneity in sample, identification of risk factors for complicated grief and the impact of extraneous factors on intervention effects. Interventions should include comparisons to usual care, as well as replication to confirm positive findings.
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Palliative medicine · Feb 2016
ReviewA systematic review and thematic synthesis of quality of life in the informal carers of cancer patients with cachexia.
Informal carers of cancer patients with cachexia face additional challenges to those encountered by informal carers in general because of the central role food and eating play in everyday life. Patient weight loss and anorexia, core features of cancer cachexia, are frequent causes of distress in caregivers. Identification of quality of life issues can inform the development of interventions for both caregivers and patients and facilitate communication with healthcare professionals. ⋯ The complexity of caring for a cancer patient with cachexia translates into a range of problems and experiences for informal carers. By addressing the impact of caring for a patient with cancer cachexia on carers, both caregiver and patient quality of life may improve.
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Palliative medicine · Feb 2016
ReviewEuthanasia and physician-assisted suicide: A white paper from the European Association for Palliative Care.
In recognition of the ongoing discussion on euthanasia and physician-assisted suicide, the Board of Directors of the European Association for Palliative Care commissioned this white paper from the palliative care perspective. ⋯ The European Association for Palliative Care feels that it is important to contribute to informed public debates on these issues. Complete consensus seems to be unachievable due to incompatible normative frameworks that clash.
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Palliative medicine · Feb 2016
ReviewEvaluating the effects of mindfulness-based interventions for informal palliative caregivers: A systematic literature review.
There is a need to identify proactive, evidence-based interventions to support informal palliative caregivers. Mindfulness-based interventions, evidenced in the literature as providing physical and mental health benefits for diverse populations, may have application in the setting of palliative caregiving. ⋯ This is the first systematic literature review on this topic. Results suggest both feasibility and potential benefit. Further qualitative research is required to explore the outcomes identified by informal caregivers themselves as the reduced magnitude of effect may suggest that we are not measuring the right outcomes in this context. This would inform more sensitive outcome measures for future intervention studies and guide the development and application of mindfulness-based models in this area.
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Palliative medicine · Feb 2016
Palliative care and other physicians' knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: Survey results.
To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning in their jurisdiction of practice. This includes the use of advance directives/living wills and substitute decision-makers who can legally consent to or refuse treatment if there is no valid advance directive. ⋯ A high level of knowledge of the law is essential to ensure that patients' wishes and decisions, expressed through Advance Care Planning, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or cessation of treatment.