Journal of palliative medicine
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Depression affects a quarter of palliative patients and is associated with reduced quality of life. Screening for psychological problems at key points in the patients' pathway is recommended but there is no consensus as to how to do this. ⋯ The screening question was shown to have acceptable sensitivity and specificity in a small sample of community palliative care patients. It is likely to be most useful to accurately identify those who are not depressed and identify those patients who need a more in-depth assessment of their mood.
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Given the important role caregivers play in palliative care planning and decision making, anxiety and depression in caregivers of terminally ill cancer patients and their impact on the caregivers' evaluation of the patients' physical and psychological symptom burden were analyzed. ⋯ Integrative palliative care should offer psychooncological care for the caregivers on a routine basis to avoid misleading perspectives possibly influencing end-of-life treatment decisions.
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Moral distress is a pervasive reality of palliative care practice. An existing framework for understanding it has been proposed as a way to begin to address moral distress's detrimental effects on clinicians. ⋯ Application of the proposed framework to a clinical case provides opportunities for understanding mechanisms of response that may be amenable to intervention and for suggesting appropriate alternative strategies and practices. A full understanding of the process can help to mitigate or to avoid the progression of distress and concurrently to appraise the situation that leads to moral distress or moral outrage.