Palliative medicine
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Palliative medicine · May 2020
Randomized Controlled TrialReducing time in acute hospitals: A stepped-wedge randomised control trial of a specialist palliative care intervention in residential care homes.
Care home residents are frequently transferred to hospital, rather than provided with appropriate and timely specialist care in the care home. ⋯ The model of care significantly reduces hospitalisations through provision of outreach by specialist palliative care clinicians. The data offer substantial evidence for Specialist Palliative Care Needs Rounds to reduce hospitalisations in older people approaching end of life, living in care homes.
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Palliative medicine · May 2020
Healthcare providers' views and experiences of non-specialist palliative care in hospitals: A qualitative systematic review and thematic synthesis.
Healthcare providers working in hospitals are frequently exposed to patients with palliative care needs. For most patients, these reflect non-specialist rather than specialist palliative care needs. Embedding palliative care principles early in patients' disease trajectories within acute care delivery in hospitals, however, is a challenge. How to best understand the experiences of those providing non-specialist palliative care in hospitals has not been systematically assessed. ⋯ Non-specialist palliative care in hospitals is operationalised as care in the last weeks and days of life. The organisation of acute care, inter-disciplinary working practices, clinician attitudes, poor communication structures and lack of education and training in palliative care principles exacerbates poor implementation of this care earlier for patients in hospitals.
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Palliative medicine · May 2020
'It's not what they were expecting': A systematic review and narrative synthesis of the role and experience of the hospital palliative care volunteer.
Volunteers make a major contribution to palliative care but little is known specifically about hospital palliative care volunteers. ⋯ Hospital palliative care volunteers face unique challenges in supporting terminally ill patients. Volunteer support in hospital settings is possible and appropriate, if sufficient support is available to mitigate the challenges associated with complex, high-acuity care.
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Palliative medicine · May 2020
Feasibility and acceptability of a culturally adapted advance care planning intervention for people living with advanced cancer and their families: A mixed methods study.
Increasing evidence shows that advance care planning is effective in improving outcomes. However, its applicability and acceptability outside Western cultures remain unknown. Examination of relevant cultural adaptations is required prior to wider adoption. ⋯ Implementing a culturally adapted advance care planning intervention in an inpatient hospital setting in Taiwan is possible. The participants reported the intervention to be acceptable. However, careful attention to the conceptual underpinning using local primary data is imperative for its success.
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Palliative medicine · May 2020
Case series of introducing palliative care consultation in psychiatry.
The significance of palliative care consultation in psychiatry is unclear. ⋯ Future research should focus on reasons for reservations about palliative care in psychiatry, include more patients with severe persistent mental illness and assess the value of palliative care consultation in resolving this problem.