The American journal of hospice & palliative care
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Reports of family satisfaction with pediatric palliative care have been limited. This knowledge is critical for both program development and furthering understanding of needs. ⋯ Respondents reported that the Rainbow Kids team had provided emotional support, helped with decision making and communication, and that their children's symptoms were managed. Furthermore, parent respondents expressed high levels of satisfaction with services from the Rainbow Kids team.
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Am J Hosp Palliat Care · May 2013
Evaluation of end-of-life cancer care in the ICU: perceptions of the bereaved family in Japan.
The purpose of this study was to investigate the evaluation of end-of-life care from bereaved family of cancer patients who had died in intensive care units in Japan. Cross-sectional anonymous questionnaire surveys were conducted on community dwelling individuals aged 40-79 who were randomly sampled from census tracts. End-of-life care was assessed using the Good Death Inventory and Care Evaluation Scale. ⋯ The result showed that bereaved family of cancer patients evaluated lower than the non-cancer patients for "The doctors dealt promptly with discomforting symptoms of the patients' (p=0.009), 'The nurses had adequate knowledge and skills' (p=0.016), 'Admission (use) was possible when necessary without waiting' (p=0.008) , Consideration was given to the health of the family (P=0.039) and Physical and psychological comfort (p=0.03). Overall, it can be presumed that the cancer patients' bereaved family evaluated about symptoms management and doctors and nurses skills was low. There is a need to improve for end-of-life care of cancer patients and to conduct further research to explore quality-improvement interventions to bereaved family of cancer in intensive care unit.
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Am J Hosp Palliat Care · May 2013
Why do palliative care patients present to the emergency department? Avoidable or unavoidable?
Presentations by patients with advanced illness to the Emergency Department (ED) towards the end-of-life can be distressing for both patients and caregivers. With an understanding of why patients present, interventions to avoid these presentations close to the end-of-life may be possible. ⋯ Many ED presentations by palliative care patients may be avoidable. Appropriate sharing of information to on-call doctors, creating confidence in carers and providing extra practical supports is necessary. A comprehensive, coordinated specialist palliative care approach across community and acute services may help ensure patients are not sent to the ED inappropriately.
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Itch/pruritus can be very distressing in palliative care population and often is difficult to treat. Conventional antihistamines lack efficacy. Cutaneous and central pathogenesis of itch is extremely complex and unclear, making its treatment challenging. ⋯ Gabapentin impedes transmitting nociceptive sensations to brain, thus also suppressing pruritus. Gabapentin is safe and found to be effective in uremic pruritus, cancer/hematologic causes, opiod-induced itch, brachioradial pruritis, burns pruritus, and pruritus of unknown origin. Further research is required in this area to establish whether gabapentin is consistently effective.
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Am J Hosp Palliat Care · Mar 2013
Variation in the incidence of agitated delirium during the day in a palliative care unit: a preliminary report.
In the literature regarding delirium and agitation in palliative care, there are references of their worsening as the hours of the day flows from afternoon on, with an inversion of the awake-sleep cycle. We studied the frequency of the use of our protocol for the control of agitation. ⋯ The reverse situation occurs in all other hours of the day. The chi-square goodness of fit test proves that the differences are statistically significant (P < .001).