Palliative medicine
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Palliative medicine · Sep 2021
Professionals', patients' and families' views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process.
In combination with non-pharmacological interventions, opioids may safely reduce chronic breathlessness in patients with severe illness. However, implementation in clinical practice varies. ⋯ There are significant barriers and enablers to the use of opioids for the symptomatic reduction of chronic breathlessness based on the knowledge, views and attitudes of clinicians, patients and families. Clinicians' interactions with patients and their families strongly influences adherence with opioid treatment regimens for chronic breathlessness. Clinicians', patients' and families' knowledge about the delicate balance between benefits and risks is generally poor. Education for all, but particularly clinicians, is likely to be a necessary (but insufficient) factor for improving implementation in practice.
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Palliative medicine · Sep 2021
Randomized Controlled TrialComparing the effect of a consult model versus an integrated palliative care and medical oncology co-rounding model on health care utilization in an acute hospital - an open-label stepped-wedge cluster-randomized trial.
The benefit of specialist palliative care for cancer inpatients is established, but the best method to deliver specialist palliative care is unknown. ⋯ The co-rounding model was associated with a shorter hospital length of stay. Readmissions within 30 days and access to specialist palliative care were similar.
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Palliative medicine · Sep 2021
Nationwide evaluation of palliative care (Q-PAC study) provided by specialized palliative care teams using quality indicators : Large variations in quality of care.
Although a number of quality indicators for palliative care have been implemented worldwide, evidence regarding the performance of palliative care teams is scarce. ⋯ The large risk-adjusted variation found across the quality indicator scores suggest that repeated and standardized quality improvement evaluations can allow teams to benchmark themselves to each other to identify areas of their palliative care delivery that need improvement.
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Palliative medicine · Sep 2021
What does effective end-of-life care at home for children look like? A qualitative interview study exploring the perspectives of bereaved parents.
End-of-life care for children with life-shortening conditions is provided in a range of settings including hospital, hospice and home. What home-based, end-of-life care should entail or what best practice might look like is not widely reported, particularly from the perspective of parents who experienced the death of a child at home. ⋯ Parents with experience of caring for a dying child at home offer valuable input to future the policy and practice surrounding effective home-based, end-of-life care for children. New models of care or service developments should consider the key components and attributes for effective home-based end-of-life identified by bereaved parents in this study.
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Palliative medicine · Sep 2021
Case ReportsShoulder pain in a patient with renal cell carcinoma? Suprascapular neuropathy caused by bone metastasis of renal cell carcinoma: A case report.
Pain management is crucial in palliative care for patients with advanced cancer. Here, we report a case of shoulder pain in a patient with renal cell carcinoma. ⋯ More research is expected on development of an early surveillance model, barriers to cancer pain management, communication from patients' perspectives.