Palliative medicine
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Palliative medicine · Jul 2024
Case ReportsBispectral Index monitoring of palliative sedation for home withdrawal of tracheostomy ventilation: A case report.
Tracheostomy ventilation in motor neurone disease is an uncommon life-sustaining treatment. Best practice is having a plan for ventilation withdrawal, but the literature to guide practice is limited. Case reports have documented standard doses of opioids and benzodiazepines used for sedation in such cases. ⋯ More research using an objective measure of sedation is required, as clinical assessment of sedation in this context is compromised.
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Palliative medicine · Jul 2024
ReviewA systematic review on the impact of financial insecurity on the physical and psychological well-being for people living with terminal illness.
People living with terminal illness are at higher risk of experiencing financial insecurity. The variance in definitions of financial insecurity, in addition to its impact on the well-being of this population has not yet been systematically analysed. ⋯ People living with terminal illness require support with their financial situation to ensure their well-being is not negatively impacted by financial insecurity.
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Palliative medicine · Jul 2024
Views of patients with progressive illness and carers about the role of digital advance care planning systems to record and share information: A qualitative study.
Digital approaches are being explored internationally to support the elicitation, documentation and sharing of advance care planning information. However, the views and experiences of patients and carers are little understood, impeding the development and impact of digital approaches to strengthen palliative and end-of-life care. ⋯ Lived experiences of information sharing influenced trust and confidence in digital advance care planning systems. Despite scepticism about the extent that care can be delivered in line with their preferences, patients and carers acknowledge digital systems could facilitate care through contemporaneous and accurately documented wishes and preferences. There remains a need to determine how independent patient and public-facing advance care planning resources might be integrated with existing digital health record systems.
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Palliative medicine · Jul 2024
Observational StudyThe cost of providing care by family and friends (informal care) in the last year of life: A population observational study.
Little is known about replacement costs of care provided by informal carers during the last year of life for people dying of cancer and non-cancer diseases. ⋯ We provide a first adult general population estimate for replacement informal care costs in the last year of life of £41,000 per carer per decedent and highlight characteristics associated with greater costs. This presents a major challenge for future universal care coverage as the pool of people providing informal care diminish with an ageing population.
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Palliative medicine · Jul 2024
Psychological health in Palliative Care: Thematic analysis of a psychiatrist's and an art therapist's clinical reflexive journals.
Patients receiving palliative care often face psychological distress, which can be challenging for clinicians to manage. Therefore, reflexive and visual journaling can be used as powerful techniques for clinician selfreflection and personal development. These journals are a form of practice wisdom, providing insights into psychological health in palliative care. ⋯ Good psychological health in palliative care extends beyond psychopathology and is influenced by the cardinal elements of being human, value systems and systemic elements in the therapeutic environment.