Palliative medicine
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Palliative medicine · Jan 2022
Meta AnalysisNavigating the caregiving abyss: A metasynthesis of how family caregivers manage end-of-life care for older adults at home.
Demographic changes (global aging, decreased fertility, increased home deaths) will present a critical need for end-of-life family caregivers of older adults at home. In order to support these family caregivers, we need to better understand their experiences, struggles, and needs. ⋯ Family caregivers of older adults at the end of life navigate a variety of challenges. The findings provide a conceptual framework to help guide the development of education, interventions, and health policy to meet family caregivers' needs in providing quality end-of-life care.
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Palliative medicine · Jan 2022
ReviewPractice review: Evidence-based and effective management of fatigue in patients with advanced cancer.
Fatigue affects most patients living with advanced cancer and is a symptom that healthcare professionals can find difficult to manage. ⋯ We recommend regular assessment, review and acknowledgement of the impact of fatigue. Exercise and energy conservation should be considered. Pharmacological interventions are not endorsed as a routine approach. Many interventions currently recommended by guidelines are not supported by a robust evidence base and further research on their efficacy is required.
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Palliative medicine · Jan 2022
ReviewAdaptation and continuous learning: integrative review of coping strategies of palliative care professionals.
Coping is essential to manage palliative care professionals' challenges. The focus has been on the effects of coping mechanism; however, little is known about coping itself in palliative care. ⋯ The model showed a process of adaptation and learning to persevere in palliative care. It changes over time under factors and strategies, and evolves in a personal and professional transformation, parallel to the working life. It would be worth assessing coping in healthcare professionals who chose to leave palliative care and to investigate the reasons they did so and their coping mechanisms.
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Palliative medicine · Jan 2022
Multicenter StudyEffect of continuous deep sedation on survival in the last days of life of cancer patients: A multicenter prospective cohort study.
Continuous deep sedation is ethically controversial with respect to whether it shortens a patient's life. ⋯ Continuous deep sedation with careful dose adjustment was not associated with shorter survival in the last days of life in patients with advanced cancer.
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Palliative medicine · Jan 2022
Pain assessment tools in paediatric palliative care: A systematic review of psychometric properties and recommendations for clinical practice.
Assessing pain in infants, children and young people with life-limiting conditions remains a challenge due to diverse patient conditions, types of pain and often a reduced ability or inability of patients to communicate verbally. ⋯ Balancing aspects of feasibility and psychometric properties, the FPS-R is recommended for self-assessment, and the FLACC scale/FLACC Revised and PPP are the recommended observational tools in their respective age groups.