Journal of palliative medicine
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It is unclear if physiologic measures are useful for assessing dyspnea. We examined the association among the subjective rating of dyspnea according to patients with advanced cancer, caregivers and nurses, and various physiologic measures. ⋯ Patients' level of dyspnea was weakly associated with physiologic measures. Caregivers' perception may be a useful surrogate for dyspnea assessment.
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Comparative Study
Assessing the financial impact of an inpatient acute palliative care unit in a tertiary care teaching hospital.
Evidence suggests palliative care consult services yield cost improvements; few studies have examined the impact of an inpatient palliative care unit on hospital costs. ⋯ Cost avoidance is realized when patients transfer to an APCU even when conservative pre-APCU cost measures are used and when patients with varying diagnoses and discharge outcomes are included. This study demonstrates a replicable methodology for estimating the financial impact of an APCU.
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Safe patient handling (SPH) and positioning is a worldwide health care issue in both developed and developing countries. It is important for all caregivers and patients but especially for palliative care and oncology patients. While there is a wide breadth of curriculum available in developed countries, little information is available about how to teach SPH and positioning in a developing country where resources are very limited. ⋯ Current barriers toward future development of SPH in Nepal are defined and discussed. The SPH curriculums that have been created are provided and specific recommendations are outlined. There is a dearth of research to guide SPH education in developing countries. SPH change requires long-term support and curriculums that are culturally sensitive and contextually appropriate.
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Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure. ⋯ The addition of methadone was associated with improved pain control for patients with moderate to severe pain on another opioid and appears to offer a safe, well-tolerated and practical alternative in this situation.