Palliative medicine
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Palliative medicine · Jul 2022
Meta AnalysisHow effective is virtual reality technology in palliative care? A systematic review and meta-analysis.
The efficacy of virtual reality for people living with a terminal illness is unclear. ⋯ Virtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research.
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Palliative medicine · Jul 2022
Randomized Controlled TrialAcceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial.
Fatigue often interferes with functioning in patients with advanced cancer, resulting in increased family caregiver burden. Acceptance and commitment therapy, a promising intervention for cancer-related suffering, has rarely been applied to dyads coping with advanced cancer. ⋯ Acceptance and commitment therapy showed strong feasibility, acceptability, and promise and warrants further testing.
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Palliative medicine · Jul 2022
Medical communication and decision-making about assisted hydration in the last days of life: A qualitative study of doctors experienced with end of life care.
The impact of assisted hydration on symptoms and survival at the end of life is unclear. Little is known about optimal strategies for communicating and decision-making about this ethically complex topic. Hydration near end of life is known to be an important topic for family members, but conversations about assisted hydration occur infrequently despite guidance suggesting these should occur with all dying people. ⋯ Proactive, routine discussion with dying people about hydration-related issues is indicated in all cases. There is room for debate regarding the limits of shared decision-making and the benefits of routine discussion of assisted hydration with all dying people. Clinicians have to navigate multiple barriers as they strive to provide individualised care.
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Palliative medicine · Jul 2022
Randomized Controlled TrialEffects of a theory-based advance care planning intervention for nursing homes: A cluster randomized controlled trial.
Uptake of advance care planning in routine nursing home care is low. Through extensive literature review, theoretical development, and stakeholder involvement, we developed the ACP+ intervention. ⋯ The ACP+ intervention for nursing homes improved care staff's self-efficacy but not their knowledge concerning advance care planning. Considering the comprehensive and multi-component approach used, these effects were smaller than expected. Reasons for this may be related to the chosen follow-up period, outcomes and measurements, or to the intervention itself and its implementation.
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Palliative medicine · Jul 2022
Health care professionals' perceptions of factors influencing the process of identifying patients for serious illness conversations: A qualitative study.
The Serious Illness Care Programme enables patients to receive care that is in accordance with their priorities. However, despite clarity about palliative care needs, many barriers to and difficulties in identifying patients for serious illness conversations remain. ⋯ The process of identifying patients for serious illness conversations is complex and may not be captured only by generic tools such as the surprise question. It is crucial to address existential and ethical obstacles that can hinder the identification of patients for serious illness conversations.