Palliative medicine
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Palliative care aims to improve quality of life by relieving physical, emotional, and spiritual suffering. Health system planning can be informed by evaluating cost and effectiveness of health care delivery, including palliative care. ⋯ Applicability and generalizability of evidence is uncertain due to small sample sizes, short duration, and limited modeling of costs and effects. Further economic evaluations with larger sample sizes are needed, inclusive of the diversity and complexity of palliative care populations and using patient-centered outcomes.
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Palliative medicine · Jan 2020
Comparative StudyEffect of caregiving at end of life on grief, quality of life and general health: A prospective, longitudinal, comparative study.
Determining the effect of caregiving and bereavement remains a challenge. To date, no study has employed a comparison group to investigate caregivers' grief, quality of life and general health in relation to non-caregivers. ⋯ It took 9-10 months for the caregivers' grief, general health and quality of life to correspond to the comparison group. These findings present an opportunity for palliative care research and practice to consider how best to support the majority of caregivers without grief complications so that their pre- and post-death support needs are realised.
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Palliative medicine · Jan 2020
Randomized Controlled TrialOnline training improves medical students' ability to recognise when a person is dying: The ORaClES randomised controlled trial.
Recognising dying is a key clinical skill for doctors, yet there is little training. ⋯ The online training resource proved effective in altering the decision-making of medical students to agree more with expert decision-making.
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Palliative medicine · Jan 2020
Understanding what works, why and in what circumstances in hospice at home services for end-of-life care: Applying a realist logic of analysis to a systematically searched literature review.
We have undertaken a systematically searched literature review using a realist logic of analysis to help synthesise the diverse range of literature available on hospice at home services. ⋯ Our literature review showed how it was possible to develop a coherent framework and test it against 34 published papers and abstracts. Central to this review was theory building, and as further evidence emerges, our programme theories can be refined and tested against any new empirical evidence.
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Palliative medicine · Jan 2020
End-of-life care and place of death in adults with serious mental illness: A systematic review and narrative synthesis.
People with serious mental illness have greater mortality risk than the general population. They experience health care inequalities throughout life; it is not clear if this persists to end of life. ⋯ The evidence was sparse and heterogeneous, demonstrating variability in patterns and reporting of health care use and with little consensus on where people with serious mental illness are likely to die. Given that people with serious mental illness have increased mortality risk, this gap in the knowledge around end-of-life care outcomes is concerning; this area of research needs further development.