Journal of palliative medicine
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Palliative care programs are rapidly evolving in acute care facilities. Increased and earlier access has been advocated for patients with life-threatening illnesses. Existing programs would need major growth to accommodate the increased utilization. ⋯ We will discuss various metrics including symptom outcomes, quality of end-of-life care, program growth, and financial issues. Despite the growing evidence to support early palliative care involvement, referral to palliative care remains heterogeneous and delayed. To address this issue, we will discuss various conceptual models and practical recommendations to optimize palliative care access.
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Children admitted to pediatric intensive care units (PICUs) face potentially life limiting conditions. The toll on heath care professionals caring for these children is significant and often overlooked. There is a potential need for increased staff support, and facilitated peer support sessions could be an effective management tool, but few studies specifically evaluate this multidisciplinary population. The purpose of this pilot study is to evaluate the current rates of grief and burnout among health care professionals in our PICU, and explore facilitated support sessions as a method of reducing grief perceptions and burnout among providers. ⋯ While facilitated peer support did not reduce grief and burnout scores among our PICU interdisciplinary staff, many factors could have affected results, including small sample size, potentially different participants across sessions, timing of sessions, and the timing of administration of posttest instruments. Additionally, even though not statistically significant, the area of personal growth showed a trend toward improvement, indicating an area for further research.
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Amyotrophic lateral sclerosis (ALS) is a fatal, neurological disease, which can potentially impact mental health as well as the adaptation process of people who are affected. Most of the results available are cross-sectional. The aim of this study was to study the evolution of coping strategies, Quality of Life (QoL), and mental health in a sample of ALS patients. ⋯ This study, the first to evaluate psychosocial aspects of ALS over time, underlines the importance of global, multidisciplinary, and adapted care.
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To assess the impact, retention, and magnitude of effect of a required didactic and experiential palliative care curriculum on third-year medical students' knowledge, confidence, and concerns about end-of-life care, over time and in comparison to benchmark data from a national study of internal medicine residents and faculty. ⋯ We conclude that required structured didactic and experiential palliative care during the clinical clerkship year of medical student education shows significant and largely sustained effects indicating students are better prepared than a national sample of residents and attending physicians.
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A retrospective chart review of terminal patients with cancer with agitation and their risk factors.
Agitated delirium is often observed in terminal patients with cancer. To clarify the risk factors for agitated delirium in terminal patients with cancer, we conducted a retrospective chart review of 126 patients with cancer who died at a university hospital in 2008. ⋯ It is necessary to consider risk factors in order to categorize terminal patients with cancer into high- and low-risk groups and undertake possible counter-measures.