Palliative medicine
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Palliative medicine · Oct 2022
The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review.
Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent. ⋯ Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment 'success' that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population.
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Palliative medicine · Oct 2022
ReviewHow best to capture the impact of complementary therapies in palliative care: A systematic review to identify and assess the appropriateness and validity of multi-domain tools.
Complementary therapies are widely used in palliative care settings. Qualitative research found that people with advanced disease report a range of physical and psychological benefits from complementary therapies, however evidence of their effectiveness from clinical trials is inconclusive. This may be because trials are limited by use of inappropriate outcome measures. ⋯ Of the tools identified, 'Functional Assessment of Cancer Therapy - General' appears to be the most suitable alternative tool against COMSIN criteria, for trials of massage, reflexology and aromatherapy in palliative care. Further tool validation is required before firm recommendations can be made. Co-development of a core outcome set could ensure relevant domains are assessed.
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Palliative medicine · Oct 2022
Observational StudyCancer pain: Results of a prospective study on prognostic indicators of pain intensity including pain syndromes assessment.
Pain is a prevalent symptom in patients with advanced cancer. Recognition of prognostic factors associated with pain intensity, could help provide better assessment, leading to better pain management. ⋯ The recognition of specific pain syndromes may help to better classify cancer pain.
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Palliative medicine · Oct 2022
'Mum, I think we might ring the ambulance, okay?' A qualitative exploration of bereaved family members' experiences of emergency ambulance care at the end of life.
In the context of a sudden or unexpected event, people with a life-limiting illness and their family caregivers may be dependent on emergency ambulance services. ⋯ The generalist palliative care provided by emergency ambulance personnel is a vital service for patients in the last year of life, and their caregivers. This must be acknowledged in palliative care policy and supported with training, specialist consultation and adequate resources.
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Palliative medicine · Oct 2022
Is the use of palliative care services increasing? A comparison of current versus historical palliative care access using health service datasets for patients with cancer.
Mature evidence exists supporting the integration of palliative care in cancer care, but translation of evidence into practice is less well understood. ⋯ Despite established benefits of early palliative care, the important task of translation of this evidence into practice remains.