Palliative medicine
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Palliative medicine · Jul 2017
Palliative care for Parkinson's disease: Patient and carer's perspectives explored through qualitative interview.
Palliative care is recommended for non-malignant illnesses, including Parkinson's disease. However, past research with healthcare workers highlights unmet palliative needs in this population and referral rates to Specialist Palliative Care are low. Some healthcare workers perceive a 'fear' in their patients about introducing palliative care. However, less is known about the views of people with Parkinson's disease and their carers about palliative care. ⋯ A holistic palliative care approach could address the complex physical and psychosocial symptoms experienced by people with Parkinson's disease and their carers, and people with Parkinson's disease and their carers are open to palliative care. Further research needs to explore how palliative care can be introduced into the routine care for people with Parkinson's disease.
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Palliative medicine · Jul 2017
Review Meta AnalysisDying in the hospital setting: A meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important.
Despite most expected deaths occurring in hospital, optimal end-of-life care is not available for all in this setting. ⋯ Consumer narratives help to provide a clearer direction as to what is important for hospital end-of-life care. Systems are needed to enable optimal end-of-life care, in accordance with consumer priorities, and embedded into routine hospital care.
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Palliative medicine · Jul 2017
ReviewA metasynthesis study of family caregivers' transition experiences caring for community-dwelling persons with advanced cancer at the end of life.
Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. ⋯ The findings provide a framework to guide the development of supportive programs and future research.
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Palliative medicine · Jul 2017
Case ReportsPalliative long-term abdominal drains in refractory ascites due to end-stage liver disease: A case series.
Ascites, the commonest complication of cirrhosis, leads to frequent hospitalisations. Refractory ascites confers a median survival of 6 months without liver transplantation. In many, the management remains palliative (large-volume paracentesis). Despite calls for improvement, palliative and end-of-life care is not yet integrated into end-stage liver disease. Long-term abdominal drains are a palliative strategy in malignant ascites, but not end-stage liver disease. ⋯ Palliative and end-of-life care needs in end-stage liver disease remain under-addressed. Our data suggest that long-term abdominal drains may be a safe and effective palliative intervention in end-stage liver disease. Prospective randomised controlled trials comparing large-volume paracentesis versus long-term abdominal drains in refractory ascites secondary to end-stage liver disease are warranted.
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Palliative medicine · Jul 2017
Shared decision making about palliative chemotherapy: A qualitative observation of talk about patients' preferences.
Particularly at the end of life, treatment decisions should be shared and incorporate patients' preferences. This study examines elaboration and preference construction. ⋯ Elaboration and joint preference construction is not standard practice in consultations on palliative chemotherapy. Oncologists may benefit from realising this and training skills that support this key step of shared decision making. Also, repeated shared decision making throughout the course of palliative chemotherapy should be stimulated.