The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Dec 2015
The preference of place of death and its predictors among terminally ill patients with cancer and their caregivers in China.
To describe the preference of place of death among Chinese patients with cancer and their caregivers and to identify factors associated with the preference. ⋯ This study described information about the preference of place of death and its potential predictive factors in terminally ill patients with cancer in mainland of China.
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Am J Hosp Palliat Care · Dec 2015
Ketamine PCA for Treatment of End-of-Life Neuropathic Pain in Pediatrics.
Control of neuropathic pain (NP) for children at end of life is challenging. Ketamine improves control of NP, but its use in children is not well described. We describe a retrospective case review of 14 children with terminal prognoses treated with ketamine patient-controlled analgesia (PCA) for management of opioid-refractory NP at the end of life. ⋯ Benzodiazepines limited neuropsychiatric side effects. Ketamine treatment arrested dose escalation of opioids in 64% of patients, and 79% were discharged to home hospice. Ketamine PCA is an effective, well-tolerated therapy for opioid-refractory NP in pediatric end-of-life care.
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Am J Hosp Palliat Care · Nov 2015
Palliative Care in the Intensive Care Unit: Are Residents Well Trained to Provide Optimal Care to Critically ill Patients?
Palliative care (PC) and end-of-life (EOL) care are gaining importance in the management of critically ill patients in the ICU. Residents form a significant work force in the ICU and most often are the only group that provides round the clock coverage. ⋯ Teaching should focus on overcoming the identified barriers especially communication with patients and their families. More studies are needed to identify the best method to teach Palliative care in the ICU.
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Am J Hosp Palliat Care · Nov 2015
Timing of Palliative Care Consultations and Recommendations: Understanding the Variability.
Palliative care consultation teams (PCCTs) provide care that enhances quality of life. The effectiveness of PCCTs depends, however, on their timely utilization by other providers. The goal of this study was to examine the timing of palliative care consultation requests and responses at a single Veteran Affairs Medical Center. ⋯ In logistic regressions, timing variables were not significant predictors of whether consultation recommendations were made or implemented. There is substantial variability in when patients receive a palliative care consultation. Many patients receive palliative care within the first week of hospitalization and their final month of life.
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Am J Hosp Palliat Care · Nov 2015
Attitudes Toward and Experiences in End-of-life Care Education in the Intensive Care Unit: A Survey of Resident Physicians.
Resident physicians provide the most physician care to intensive care unit (ICU) patients. The body of literature about residents' palliative and end-of-life care (PC/EOLC) experiences in the ICU is limited. To our knowledge, this is the first study to assess resident physicians in multiple specialties regarding PC/EOLC in the ICU. ⋯ Residents reported moderate comfort in dealing with end-of-life (EOL) issues and felt somewhat prepared to care for critically ill patients at the EOL. Feedback should be provided to residents regarding their PC/EOLC skills, and education should be tailored to residents rotating in the ICU.