Palliative medicine
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Palliative medicine · Jan 2021
Education needed to improve antimicrobial use during end-of-life care of older adults with advanced cancer: A cross-sectional survey.
Antimicrobial use during end-of-life care of older adults with advanced cancer is prevalent. Factors influencing the decision to prescribe antimicrobials during end-of-life care are not well defined. ⋯ Although the initiation of additional intravenous antimicrobials was viewed as escalation of care, antimicrobials were not routinely discussed during advance care planning. Educational interventions that promote recognition of antimicrobial-associated adverse events, incorporate antimicrobial use into advance care plans, and offer communication simulation training around the role of antimicrobials during end-of-life care are warranted.
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Palliative medicine · Jan 2021
Randomized Controlled TrialPerspectives of bereaved partners of lung cancer patients on the role of mindfulness in dying and grieving: A qualitative study.
Mindfulness-Based Stress Reduction (MBSR) has been shown to reduce psychological distress in cancer patients but not their partners. Whether MBSR can support patients and partners in coping with the dying and grieving process is less well examined. ⋯ The present study showed that MBSR can facilitate lung cancer patients and their partners in accepting the forthcoming death and openly communicating about this, which can support a peaceful death and healthy grieving process.
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Palliative medicine · Jan 2021
Randomized Controlled TrialDo family meetings for hospitalised palliative care patients improve outcomes and reduce health care costs? A cluster randomised trial.
Family meetings facilitate the exploration of issues and goals of care however, there has been minimal research to determine the benefits and cost implications. ⋯ Family meetings may be helpful in reducing family caregiver distress and enhancing their preparedness for the caregiving role and it appears they may be conducted without increased hospital health utilisation impacts; although opportunity costs need to be considered in order to routinely offer these as a standardised intervention. Additional health economic examination is also advocated to comprehensively understand the cost-benefit implications.
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Palliative medicine · Jan 2021
Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review.
The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. ⋯ Seven tools were identified which showed different and limited levels of validity in the context of palliative care and chronic heart failure.
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Palliative medicine · Jan 2021
'My wife is my doctor at home': A qualitative study exploring the challenges of home-based palliative care in a resource-poor setting.
Family caregiving is common globally, but when a family member needs palliative and end-of-life care, this requires knowledge and expertise in dealing with symptoms, medication, and treatment side effects. Caring for a family member with advanced prostate cancer in the home presents practical and emotional challenges, especially in resource-poor contexts, where there are increasing palliative cases without adequate palliative care institutions. ⋯ Home-based care is promoted as an ideal and cost-effective model of care, particularly in Westernised palliative care models. However, in resource-poor contexts, there are significant challenges associated with the implementation of this model. This study revealed the scale of challenges family caregivers, who lack basic training on aspects of caring, face in providing home care unsupported by healthcare professionals.