Palliative medicine
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Palliative medicine · Jul 2006
End-of-life care in community hospitals: the perceptions of bereaved family members.
The perceptions of bereaved family members were obtained to evaluate the nature and quality of end-of-life care in community hospitals. ⋯ The results of this study have implications for UK government initiatives, such as the National Framework for Older People, and the Department of Health's 'Keeping the NHS Local'.
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Palliative medicine · Jul 2006
Multicenter StudyHospital doctors' attitudes towards palliative care in Germany.
Experts from different areas strongly criticize the current level of palliative care in Germany, both inpatient and home care services. Apart from the experts' opinions, little is known in this context about the perspectives of hospital doctors working in different disciplines, such as surgery, internal medicine, gynaecology or anaesthesia. These doctors presumably treat many incurably ill patients with palliative care needs, but they usually have very little experience in palliative medicine. ⋯ Main needs for improvement were seen in the psychosocial support services and in the co-operation with outpatient services. In [corrected] the hospital physicians' view, palliative nursing care was of a higher standard than medical aspects [corrected] of care [corrected] The physicians showed great interest in improving their knowledge of [corrected] palliative care and in new specialist palliative care services. The conclusions were that three main strategies for improvement should be embarked on: (1) the establishment of integrated care systems to overcome financial and structural barriers between in- and outpatient care; (2) the establishment of further specialist palliative care services (eg, hospital-based palliative care teams); and (3) better education in palliative medicine.
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Palliative medicine · Jul 2006
The last two days of life of nursing home patients--a nationwide study on causes of death and burdensome symptoms in The Netherlands.
The aim of this study was to identify the direct causes of death and to evaluate the presence of burdensome symptoms in the last two days of life of terminally ill nursing home (NH) patients. ⋯ In practice, it appears that, for many patients, the last days of life are spent unconscious or conscious with one or more burdensome symptom(s), which suggests the potential for improvement of symptom management.
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Palliative care has been challenged to share its message with a wider audience, and for many years it has been articulating an approach that is suitable for all patients. However, it is not clear how widely this message has been accepted. As part of a study into end-of-life care for heart failure, we conducted seven focus groups with doctors in general practice, palliative medicine, cardiology, geriatrics and general medicine. ⋯ Palliative care was welcomed as providing permission to fail, whilst representing a dilemma between quantity and quality of life for the interviewees. Our work suggests that specialist palliative care has been partially successful in getting their message across, and poor understanding or receptivity are not major barriers to implementing palliative care. Educational or other interventions to implement change in palliative care need to acknowledge the complex interaction of factors influencing physicians' behaviour.
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Palliative medicine · Jul 2006
Grief support provided to caregivers of palliative care patients in Spain.
Grief support for relatives of patients in palliative care is recognized as a fundamental practice within palliative medicine. The aim of this research was to determine the nature and extent of grief support programs offered to relatives of patients in palliative care in Spain. A postal survey was carried out among members of the Spanish Society of Palliative Care. ⋯ Results show that 88.6% of the services include grief support, that mainly emotional and one-to-one care is provided (92.4 and 89.9%, respectively), and that the number of psychologists and social workers in each team is limited. The risk factors most commonly taken into account by professionals are: absence of family support (36.92%) and the bereaved's case history (21.54%); while the most widely used diagnostic criteria for complicated bereavement are blame and depression (12.5 and 11.36%). In conclusion, it can be seen that bereavement services are not completely consolidated in Spain and there is a need for a greater variety of intervention strategies.