The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Feb 2014
A comparison of support needs between rural and urban family caregivers providing palliative care.
The present study examined the support needs for urban and rural family caregivers of a palliative family member using a cross-sectional telephone survey in northeastern Ontario, Canada (n = 140; 70 urban, 70 rural). Support needs identified as most important by both the groups were informational. ⋯ Rural and urban caregivers perceived care for care recipients as accessible (mean accessibility score 1.9, standard deviation [SD] = 0.09 and 1.7, SD = 0.7, respectively, P = .20); the majority indicated that when needed, services were easily and quickly obtained. Although there are similarities in the formal care experiences, rural caregivers experience greater unmet needs in receiving support for instrumental activities.
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Am J Hosp Palliat Care · Feb 2014
Case ReportsUse of intravenous fentanyl against morphine tolerance in breakthrough cancer pain: a case series and literature review.
Palliative care physicians are accustomed to using transdermal fentanyl patch for cancer pain control but not so familiar with its intravenous administration. Historically, fentanyl has been used to treat breakthrough pain because it is a very potent analgesic with a rapid onset and short duration of action. ⋯ Therefore, sequential opioid trials may be a reasonable approach in patients with poor analgesic effect after dose escalation. Here, we present 2 morphine-tolerant patients with cancer in whom the intravenous fentanyl was effectively used for their refractory breakthrough pain.
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Am J Hosp Palliat Care · Feb 2014
Case ReportsThe use of pentobarbital in cases of severe delirium: a case series.
Delirium is a common syndrome present at the end of life and causes significant distress for patients and families. Sleep disruption is a common precipitating factor for delirium and restoration of sleep may be instrumental in attenuating symptoms. ⋯ Pentobarbital has been shown to reduce the time to sleep onset, decrease the number of body movements during sleep and spontaneous awakenings and increase the total sleep time. Pentobarbital may provide an additional treatment option for patients whose delirium is refractory to standard management approaches.
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Am J Hosp Palliat Care · Feb 2014
The experiences of suffering of palliative care patients in malaysia: a thematic analysis.
A qualitative study was conducted with semi-structured interviews to explore the experiences of suffering in 20 adult palliative care inpatients of University Malaya Medical Centre. The results were thematically analyzed. ⋯ An existential-experiential model of suffering was conceptualized from the analysis. This model may inform the development of interventions in the prevention and management of suffering.
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Am J Hosp Palliat Care · Feb 2014
Integrating massage therapy within the palliative care of veterans with advanced illnesses: an outcome study.
To describe the integration of massage therapy into a palliative care service and to examine the relationship between massage and symptoms in patients with advanced illnesses. ⋯ Massage is a useful tool for improving symptom management and reducing suffering in palliative care patients.