Palliative medicine
-
Palliative medicine · Jan 2010
Room for improvement? A quality-of-life assessment in patients with malignant bowel obstruction.
This prospective study followed 35 patients admitted to hospital with malignant bowel obstruction (MBO) to evaluate quality of life (QOL). Subjects completed the Edmonton Symptom Assessment Scale (ESAS) and Rotterdam Symptom Checklist (RSCL) at recruitment, and at one week, one month and three months. The highest ranked ESAS scores at recruitment (which was generally 18-36 hours post admission to hospital) included loss of appetite (median=7.5), fatigue (6.5) and overall well-being (6.0). ⋯ Psychological functioning appeared to be worsening by three months and at no time did activity level improve significantly. The overall QOL score was extremely poor at baseline (6.0 median) improving to 3.3 at one month (median fall=1.0, p<0.05) and 3.4 at three months. Further work should address the lack of improvement in activity and apparent deterioration in psychological functioning after one month.
-
Palliative medicine · Jan 2010
Can you hear me now? The experience of a deaf family member surrounding the death of loved ones.
Individuals who are Deaf face challenges both similar and unique from those faced by hearing individuals when a family member is dying. This study was guided by the question, ''What are the challenges faced by a Deaf family member when a loved one is dying?'' ⋯ These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians.
-
Palliative medicine · Dec 2009
Collaborating or co-existing: a survey of attitudes of medical oncologists toward specialist palliative care.
Patients with advanced cancer often have complex care needs requiring collaboration between medical oncology and palliative care providers. Little is known about how effective and acceptable such collaboration is to medical oncologists. Attitudes of Australian medical oncologists toward collaboration with specialist palliative care services were investigated using a Web-based survey. ⋯ Suggestions for improvement in collaboration focused around four areas - improved resources, improved multidisciplinary links, mutual respect and understanding, and consistency in service provision. This study is the first to specifically investigate the views of Australian medical oncologists toward collaboration with specialist palliative care. While positive attitudes have been expressed, identified barriers to collaboration need attention.
-
Palliative medicine · Dec 2009
Multicenter StudyCosts associated with resource utilization during the palliative phase of care: a Canadian perspective.
This study aimed to evaluate prospectively the resource utilization and related costs during the palliative phase of care in five regions across Canada. ⋯ Such results provide a comprehensive picture of costs related to palliative care in Canada, by specifying the cost sharing between the PHCS, the family, and NFPO.
-
Palliative medicine · Dec 2009
Randomized Controlled TrialModafinil for attentional and psychomotor dysfunction in advanced cancer: a double-blind, randomised, cross-over trial.
Cognitive impairment seems to be highly prevalent in patients with advanced cancer. Modafinil, a novel vigilance and wake-promoting agent, may be an alternative treatment. We wanted to investigate this treatment on attentional and psychomotor dysfunction in cancer patients. 28 cancer patients with a tiredness score of 50 mm or more on a scale of 0 to 10 (0=no tiredness, 10=worst possible tiredness) and Karnofsky Performance Status 40-70 were included. ⋯ On ESAS, depression and drowsiness also improved statistically significantly (p-values=<0.001 and 0.038, respectively). Modafinil in a single dose regimen was significantly superior to placebo regarding two cognitive tests of psychomotor speed and attention. Furthermore subjective scores of depression and drowsiness were significantly improved by modafinil.