Journal of palliative medicine
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The Charter of the Rights of the Dying Child was formulated as a professional guide for caring the child in the final stages. The study examines the nurses' degree of agreement with the Charter's principles and their perception of the implementation of those principles in hospital. ⋯ This study highlights the value of the Charter of the Rights of the Dying Child as a reference guideline for nurses working in pediatric hospitals. Better training is important to improve the nurse's communication skills and the pediatric palliative care should be offered to all families that have a child with incurable disease mostly in the end of life.
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Automating conversation analysis in the natural clinical setting is essential to scale serious illness communication research to samples that are large enough for traditional epidemiological studies. Our objective is to automate the identification of pauses in conversations because these are important linguistic targets for evaluating dynamics of speaker involvement and turn-taking, listening and human connection, or distraction and disengagement. ⋯ ML is a valid method for automatically identifying Conversational Pauses in the natural acoustic setting of inpatient serious illness conversations.
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Observational Study
Discrepancies between Reasons of Palliative Care Team Consultation and Palliative Care Team Activities.
Palliative care team (PCT) is a common type of palliative care services. However, distress in cancer patients may be underestimated by hospital staff. Reasons for PCT consultation may be inconsistent with patients' actual needs. ⋯ Delirium and the need for family and decision-making support were underrecognized by hospital staff. PCT intervention for CRF and depression was often withheld because of very late referral. Appropriate timing of PCT consultations is important. Providing educational opportunities for hospital staff to comprehensively assess patient's multidimensional distress is needed.
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Review
Voluntarily Stopping Eating and Drinking: A Practical Approach for Long-Term Care Facilities.
Some residents of long-term care (LTC) facilities with lethal or serious chronic illnesses may express a wish to hasten their death by voluntarily stopping eating and drinking (VSED). LTC facility clinicians, administrators, and staff must balance resident safety, moral objections to hastened death, and other concerns with resident rights to autonomy, self-determination, and bodily integrity. Initially, requests for hastened death, including VSED must be treated as opportunities to uncover underlying concerns. ⋯ In addition, an independent second opinion from a consultant with palliative care and/or hospice expertise is indicated to help determine the most appropriate response. When VSED is the only acceptable option to relieve suffering of residents with severe chronic and lethal illnesses, facilitating VSED requests honors resident-centered care. The author offers practice suggestions and a checklist for LTC facilities and staff caring for residents requesting and undergoing VSED.
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Although timely palliative care is recommended for patients with advanced cancer, referrals to palliative care services are often late. ⋯ A longer disease course and referral for symptom management were associated with earlier referral, whereas overall symptom burden was higher for late referrals. Further research is required on combining symptom screening with timely referral to improve symptom management in advanced cancer.