Palliative medicine
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Palliative medicine · Jun 2007
Multicenter StudyDoes the agreement of patient and physician assessments of health related quality of life in palliative care depend on patient characteristics?
Using physician assessments of patients' health related quality of life may improve the feasibility of studies in palliative care. However, poor agreement between patients and physicians has been found. We investigated whether subgroups of patients with good agreement existed. ⋯ Based on our findings physician assessments cannot be recommended as a substitute for patient self-assessment for any subgroups of palliative care patients.
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Palliative medicine · Jun 2007
Comparative StudyAre anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients.
Anxiety and depressed mood are common symptoms in hospitalized advanced cancer patients. It is often presumed that anxiety and depression affect the occurrence and experience of physical symptoms. ⋯ The relationship between anxiety, depressed mood and the presence and intensity of physical symptoms in hospitalized advanced cancer patients is very limited.
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Palliative medicine · Jun 2007
Prescribing by specialist nurses in cancer and palliative care: results of a national survey.
This study investigates Macmillan nurses' views on nurse prescribing in cancer and palliative care and explores perceived motivators and barriers to training for and the implementation of this extended nursing role. ⋯ A clear lack of enthusiasm amongst specialist nurses in cancer and palliative care to undertake prescribing training was identified. It is noteworthy that half of the Macmillan nurses trained as extended formulary independent nurse prescribers were not prescribing. Since government targets for nurse prescribing are not yet being met, these findings raise important questions concerning whether extended nurse prescribing is likely to be a successful initiative in cancer and palliative care.
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Palliative medicine · Jun 2007
The challenge of patients' unmet palliative care needs in the final stages of chronic illness.
There is consensus in the literature that the end of life care for patients with chronic illness is suboptimal, but research on the specific needs of this population is limited. ⋯ Patients dying from chronic illness in this study had many concerns and unmet clinical needs. Care teams were frustrated by the lack of resources available to them and admitted they were ill-equipped to provide for the individual's holistic needs. Some clinicians described difficulty in talking openly with the patient and family regarding the palliative nature of their treatment. An earlier and more effective implementation of the palliative care approach is necessary if the needs of patients in the final stages of chronic illness are to be adequately addressed.
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Palliative medicine · Jun 2007
Implementing a resuscitation policy for patients at the end of life in an acute hospital setting: qualitative study.
To explore attitudes and experiences of doctors and nurses regarding cardiopulmonary resuscitation for patients with end stage illness in an acute hospital. ⋯ The findings indicate a need for ongoing staff support and training in applying resuscitation policy to decisions for patients with end stage illness in an acute hospital. They support suggestions that reviews of local resuscitation policy and of national guidelines should be undertaken with openness and honesty regarding the goals, opportunities and difficulties involved in trying to deliver good end of life care in local settings.