Journal of palliative medicine
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Comparative Study
Training Pediatric Fellows in Palliative Care: A Pilot Comparison of Simulation Training and Didactic Education.
Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills. ⋯ This simulation-based curriculum is an effective method for improving PC comfort, education, and consults. More frequent practice is likely needed to lead to sustained improvements in communication competence.
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Comparative Study
Supportive Cardiology: Moving Palliative Care Upstream for Patients Living with Advanced Heart Failure.
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL). ⋯ A PC team was embedded into our institution's existing HF team. Findings show that integration of an embedded model of PC delivery for patients living with advanced HF led to overwhelming positive patient and family feedback while providing timely advance care planning discussions that may be associated with beneficial patient, family, and system outcomes. These outcomes can be used to inform public policy and speak to a cost-effective patient and family-centered approach for providing care to individuals and families living with advanced HF.
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Comparative Study
Factors Associated with the Efficacy of Trigger Point Injection in Advanced Cancer Patients.
Few studies have reported the efficacy of trigger point injection (TPI) to myofascial trigger points (MTrPs) in advanced cancer patients. Factors that are associated with TPI efficacy have not yet been elucidated. ⋯ The TPI efficacy is likely high when advanced cancer patients have fewer MTrPs together with cancer pain at areas other than the lower back or hip. MTrPs in advanced cancer patients are more commonly observed together with cancer pain rather than independently. Healthcare providers should recognize the relationship between MTrP and cancer pain and proactively perform physical examinations to detect MTrPs for potential TPI.
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More children are living with serious illness. However, survival and complexity of illnesses have not been described. ⋯ Results provide important information on the complexity of disease processes for children referred to palliative care, types of illnesses referred, survival, and pain levels. Results reflect earlier referral to palliative care for most children and highlight the medical complexity especially for children with congenital and genetic diagnoses.
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Comparative Study
Symptom Prevalence and the Negative Emotional States in End-Stage Renal Disease Patients with or without Renal Replacement Therapy: A Cross-Sectional Analysis.
Limited comparative data are available on the symptom severity and burden of dialyzed versus nondialyzed end-stage renal disease (ESRD) patients and their association with negative emotional states. ⋯ There was no difference in the prevalence of symptom burden and severity, irrespective of the type of treatment. Psychological disturbances were associated with higher symptom burden and severity and, therefore, should be screened thoroughly to achieve optimal ESRD management.