Palliative medicine
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Palliative medicine · Dec 2024
Review Meta AnalysisThe ideal path to a good death: An international meta-synthesis of rural residents' perspectives.
Rural areas frequently encounter restricted access to healthcare and end-of-life services. Given current pressing realities, understanding their unique perspectives on what constitutes a good death is essential. Existing research has largely overlooked the voices of rural residents. ⋯ The essential characteristics of a rural good death align with previous interpretations. However, distinct aspects emerge: communities play a significant role, characterized by reciprocal relationships; the role of medicine is less emphasized; and "rurality" deeply shapes residents' expectations of a good death. The pathway to a good death presented in this article is aspirational, requiring collaborative efforts to make it a tangible reality.
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Palliative medicine · Dec 2024
ReviewPharmacological treatment of pain, dyspnea, death rattle, fever, nausea, and vomiting in the last days of life in older people: A systematic review.
Evidence based guidelines for treatment of physical symptoms during the last days of life in older people are not available. ⋯ Limited evidence exists to guide the pharmacological treatment of pain, dyspnea, death rattle, fever, nausea, and vomiting in the last days of life of older people. Other than the use of opioids for treatment of pain and dyspnea and prophylactic administration of hyoscine butylbromide to decrease the likelihood of developing death rattle, no specific recommendations can be formulated for use in clinical practice. This demonstrates the challenging nature of research in the last days of life of older people, despite its pressing need.
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Palliative medicine · Dec 2024
ReviewFostering nurse-patient relationships in palliative care: An integrative review with narrative synthesis.
Nurse-patient relationships are an integral component of person-centred palliative care. Greater understanding of how nurse-patient relationships are fostered and perceived by patients and nurses can be used to inform nursing practice. ⋯ Nurses and patients are invested in the nurse-patient relationship, benefitting when it is positive, therapeutic and both parties are valued partners in the care. Key elements of fostering the nurse-patient relationship in palliative care were revealed, however, the dominance of the nurses' perspectives signifies that the nature and impact of these relationships may not be well understood.
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Palliative medicine · Dec 2024
ReviewPractice review: Pharmacological management of severe chronic breathlessness in adults with advanced life-limiting diseases.
Severe and refractory chronic breathlessness is a common and burdensome symptom in patients with advanced life-limiting disease. Its clinical management is challenging because of the lack of effective interventions. ⋯ Management of breathlessness remains challenging with only few pharmacological options with limited and partially conflicting evidence. Therefore, pharmacological treatment should be reserved for patients with advanced disease under monitoring of side effects, after optimisation of the underlying condition and use of evidence-based non-pharmacological interventions as first-line treatment.