Palliative medicine
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Palliative medicine · Sep 2020
A drive for structure: A longitudinal qualitative study of the implementation of the Carer Support Needs Assessment Tool (CSNAT) intervention during hospital discharge at end of life.
Informal carers are essential in enabling discharge home from hospital at end of life and supporting palliative patients at home, but are often ill-prepared for the role. Carers' support needs are rarely considered at discharge. If carers are less able to cope with home care, patient care may suffer and readmission may become more likely. ⋯ Structure and focus may facilitate implementation, but the dominance of outcomes measurement and performance metrics in health systems may powerfully frame perceptions of the intervention and implementation decisions. There is uncertainty over who is best-placed or responsible for supporting carers around hospital discharge, and challenges in connecting with carers prior to discharge.
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Palliative medicine · Sep 2020
ReviewThe palliative care needs of adults with intellectual disabilities and their access to palliative care services: A systematic review.
There is evidence that people with intellectual disabilities experience healthcare inequalities, including access to specialist palliative care, but to date, there has not been a systematic review of empirical evidence. ⋯ This review highlights the specific problems in providing equitable palliative care for adults with intellectual disabilities, but there is a lack of research into strategies to improve practice. This should be prioritised using methods that include people with intellectual disabilities and families.
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Palliative medicine · Sep 2020
The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review.
Access to community palliative care 'out-of-hours' - defined as care provided after the normal hours of work - is advocated globally. Healthcare assistants, who provide care under the direction of a qualified professional, are increasingly employed to help deliver such care, yet there is a little understanding regarding their role, responsibilities or contribution. ⋯ This review highlighted a dearth of evidence relating to the healthcare assistant role in out-of-hours palliative care. Limited evidence suggests they play a role, but that it is hidden and undervalued. Such invisibility will have a significant impact on the planning and delivery of out-of-hours palliative care. Future research is needed on role development for the benefit of patients and caregivers.
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Palliative medicine · Sep 2020
A case series of suprascapular nerve block (with an historical comparator) for shoulder pain in motor neurone disease.
Shoulder pain is a distressing but under-reported and poorly managed symptom in people with motor neurone disease. ⋯ Suprascapular nerve block is a safe, effective therapy for patients with chronic shoulder pain.
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Palliative medicine · Sep 2020
Meta AnalysisComparison of end-of-life care in people with chronic obstructive pulmonary disease or lung cancer: A systematic review.
Palliative care has been widely implemented in clinical practice for patients with cancer but is not routinely provided to people with chronic obstructive pulmonary disease. ⋯ People with chronic obstructive pulmonary disease receive less palliative measures at the end of life compared to people with lung cancer, despite a relatively similar symptom profile.