Palliative medicine
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Palliative medicine · Mar 2017
Doctors' reports about palliative systemic treatment: A medical record study.
Decisions about palliative systemic treatment are key elements of palliative and end-of-life care. Such decisions must often be made in complex, clinical situations. ⋯ Medical records provide insight into the decision-making process about palliative systemic treatment. The content and detail of doctors' notes, however, widely varies especially concerning their palliative systemic treatment considerations. Registries that aim to measure the quality of (end-of-life) care must be aware of this outcome. Future research should further explore how medical records can best assist in evaluating the quality of the decision-making process in the patient's final stage of life.
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Palliative medicine · Mar 2017
Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study.
Gathering clinical evidence data on patients' palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread. ⋯ Implementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.
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Palliative medicine · Mar 2017
Comparative StudyProcess and impact of an advance care planning intervention evaluated by bereaved surrogate decision-makers of dialysis patients.
Few studies have examined the process and impact of an advance care planning intervention experienced by surrogate decision-makers of dialysis patients. ⋯ Our data may help explain the beneficial effects of SPIRIT on surrogates, but future trials should include data on control surrogates' perspectives.