Palliative medicine
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Palliative medicine · Jul 2014
Case report of exocrine pancreatic insufficiency in two palliative care patients.
This case report describes two patients with advanced disease who were found to have exocrine pancreatic insufficiency. There have been no prior case reports of exocrine pancreatic insufficiency in patients with advanced malignant disease in the palliative care setting. The instigation of diagnostic tests for exocrine pancreatic insufficiency might be delayed or omitted in light of the plausible explanations for symptoms of gastrointestinal disturbance in patients with progressive life-limiting illness, making clinical vigilance about this condition important, since the identification and treatment of exocrine pancreatic insufficiency could improve quality of life. ⋯ Identification of exocrine pancreatic insufficiency and the instigation of pancreatic enzyme replacement therapy can, even in the late stages of illness, contribute significantly to symptom control of gastrointestinal disturbance and may allow patients to be cared for in their preferred environment.
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Palliative medicine · Jul 2014
End-of-life care in general practice: A cross-sectional, retrospective survey of 'cancer', 'organ failure' and 'old-age/dementia' patients.
End-of-life care is often provided in primary care settings. ⋯ The results highlight the need to integrate palliative care with optimal disease management in primary practice and to initiate advance care planning early in the chronic disease trajectory to enable all patients to live as well as possible with progressive illness and die with dignity and comfort.
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Palliative medicine · Jul 2014
Terminal cancer patients' and their primary caregivers' attitudes toward hospice/palliative care and their effects on actual utilization: A prospective cohort study.
Previous studies on hospice/palliative care indicated that patients' socio-demographic factors, disease status, and availability of health-care resources were associated with hospice/palliative care utilization. However, the impact of family caregivers on hospice/palliative care utilization has not been thoroughly investigated. ⋯ Promoting awareness of prognosis and to improve communication between doctors and families is important for facilitating the use of hospice/palliative care.
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Paediatric palliative care is still often introduced late in the illness trajectory of children with life-limiting diseases. Translating palliative care into practice continues to be a challenge. ⋯ According to this second step of psychometric testing of the Paediatric Palliative Screening Scale, the strongest and most urgent necessity indicators for a palliative care approach are life expectancy and child/family preferences. These results are somewhat discrepant with results from the previous validation of the instrument as well as previous research findings.