Palliative medicine
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Palliative medicine · Jun 2019
Perinatal Palliative Care: A qualitative study evaluating the perspectives of pregnancy counselors.
A prenatal diagnosis of a life-limiting disease raises complex ethical, emotional, and medical issues. Studies suggest that 40%-85% of parents decide to continue the pregnancy if given the option of Perinatal Palliative Care. However, structured Perinatal Palliative Care programs are missing in many European countries. In Germany, parents have the right to free psychosocial support from pregnancy counseling services after the prenatal diagnosis of a life-limiting disease. ⋯ A structured Perinatal Palliative Care program is considered as necessary by the pregnancy counselors. Future research should focus on (1) needs reported by concerned parents; (2) attitude and role of all healthcare providers involved; (3) strategies to include stakeholders in the development of Perinatal Palliative Care networks; and (4) outcome parameters for evaluation of Perinatal Palliative Care frameworks.
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Palliative medicine · Jun 2019
Case ReportsShould we include monitors to improve assessment of awareness and pain in unconscious palliatively sedated patients? A case report.
Awareness and pain during palliative sedation is typically assessed by observational scales, but the use of such scales has been put into question. ⋯ This case demonstrates the feasibility and potential advantages of using monitoring devices to objectify assessments of pain and discomfort in palliatively sedated patients.
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Palliative medicine · Jun 2019
Drug use beyond the licence in palliative care: A systematic review and narrative synthesis.
Drug use beyond the licence (off-label use, off-label drug use) is a common practice in palliative care and respective recommendations can often be identified in the literature. It is both risky and offers opportunities at the same time and, therefore, requires special attention in clinical practice. ⋯ Off-label use is common in palliative care with up to one-third of prescriptions affected. Challenges are often related to obtaining informed consent. Little is known about the decision-making process. More information and guidance for the prescribers are needed to enable safe handling of drugs outside their licence in palliative care.
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Palliative medicine · Jun 2019
Meta AnalysisAirflow relieves chronic breathlessness in people with advanced disease: An exploratory systematic review and meta-analyses.
Chronic breathlessness is a neglected symptom of advanced diseases. ⋯ Airflow appears to offer meaningful relief of chronic breathlessness and should be considered as an adjunct treatment in the management of breathlessness.