Palliative medicine
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Palliative medicine · Sep 2020
A case series of suprascapular nerve block (with an historical comparator) for shoulder pain in motor neurone disease.
Shoulder pain is a distressing but under-reported and poorly managed symptom in people with motor neurone disease. ⋯ Suprascapular nerve block is a safe, effective therapy for patients with chronic shoulder pain.
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Palliative medicine · Sep 2020
ReviewThe palliative care needs of adults with intellectual disabilities and their access to palliative care services: A systematic review.
There is evidence that people with intellectual disabilities experience healthcare inequalities, including access to specialist palliative care, but to date, there has not been a systematic review of empirical evidence. ⋯ This review highlights the specific problems in providing equitable palliative care for adults with intellectual disabilities, but there is a lack of research into strategies to improve practice. This should be prioritised using methods that include people with intellectual disabilities and families.
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Palliative medicine · Sep 2020
The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review.
Access to community palliative care 'out-of-hours' - defined as care provided after the normal hours of work - is advocated globally. Healthcare assistants, who provide care under the direction of a qualified professional, are increasingly employed to help deliver such care, yet there is a little understanding regarding their role, responsibilities or contribution. ⋯ This review highlighted a dearth of evidence relating to the healthcare assistant role in out-of-hours palliative care. Limited evidence suggests they play a role, but that it is hidden and undervalued. Such invisibility will have a significant impact on the planning and delivery of out-of-hours palliative care. Future research is needed on role development for the benefit of patients and caregivers.
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Palliative medicine · Sep 2020
'Take more laxatives was their answer to everything': A qualitative exploration of the patient, carer and healthcare professional experience of constipation in specialist palliative care.
Constipation is a major problem for many older adults, more so for those who are receiving specialist palliative care. However, limited research reports the subjective experiences of constipation, despite evidenced differences between the healthcare professional and patient/carer perspective. ⋯ Assessment and management of constipation may not yet reflect the holistic palliative care model. A focus on the pharmacological management may result in lifestyle modifications being underutilised. Healthcare professionals also need to be open to initiate communication on bowel care and consider non-pharmacological approaches. It is important that patients and families are supported in self-care management, alongside standardised guidelines for practice and for healthcare professionals to facilitate this.
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Palliative medicine · Sep 2020
Randomized Controlled TrialA randomised phase II trial testing the acceptability and feasibility of a narrative approach to public health communication to increase community engagement with palliative care.
Communities have limited understanding of palliative care, creating barriers to informed choice around consideration of a full range of care options in the event of serious illness. Few empirically tested interventions are available to educate community about palliative care, and ultimately improve timely access to these services. ⋯ This study provides preliminary data to inform a future, longitudinal trial evaluating effectiveness and ultimately other evidence-based, public health approaches to improve community engagement with palliative care. Further studies are required to confirm the generalisability of findings to a broader representative sample and other settings including internationally.