Palliative medicine
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Palliative medicine · Dec 2012
Out-of-hours medical care for terminally ill patients: A survey of availability and preferences of general practitioners.
Continuity of care is one of the core values of good medical care for terminally ill patients. The availability of one's own general practitioner (GP) out of hours is regarded as important for personal continuity. Few data are available about the extent of out-of-hours care given by GPs to their terminally ill patients. ⋯ The reported out-of-hours availability of GPs for terminally ill patients is still high. GPs' perception of their duty of care might change in the next generations, and the increasing number of salaried GPs, living far from their practice, might threaten out-of-hours availability for terminally ill patients. GPs' perception of their duty of care might change in the next generations, and the increasing number of salaried GPs living far from their practice might threaten out-of-hours availability for terminally ill patients.
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Palliative medicine · Dec 2012
Qualitative evaluation of a problem-solving intervention for informal hospice caregivers.
Informal hospice caregivers may experience compromised well-being as a result of significant stress. Although quite limited, problem-solving interventions with this population have garnered empirical support for improved caregiver well-being. ⋯ The study findings provide much needed depth to the field's understanding of problem-solving interventions for informal hospice caregivers and can be used to enhance existing support services.
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Palliative medicine · Oct 2012
Randomized Controlled TrialPain and distress in advanced dementia: choosing the right tools for the job.
There is a concern that pain is under-recognized in dementia. However, there may be other causes of distress. We wished to evaluate the utility of a distress tool and a pain tool. ⋯ Both tools are useful. However, the pain tool also picks up distress, which is not caused by pain. It could potentially lead to false ascriptions of pain. The distress tool picks up a broader array of signs, which may be useful both in practice and in research.
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Palliative medicine · Oct 2012
Assessing quality of care for the dying: the development and initial validation of a postal self-completion questionnaire for bereaved relatives.
Evaluating 'quality of care for the dying' from the patients' perspective has practical and ethical difficulties: an alternative is to use bereaved relatives' views as 'proxy' measures. Currently, within the United Kingdom, there is no validated instrument which specifically examines quality of care in the last days of life or the impact of the Liverpool Care Pathway (LCP) for the Dying Patient. ⋯ ECHO-D is the first instrument specifically to assess 'quality of care for the dying', focussing on the last days of life, and has direct links with the use of the LCP Programme.