Journal of palliative medicine
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Introduction: Palliative care (PC) is essential for improving the quality of life for individuals with serious illnesses, yet access to PC services remains limited, particularly in low- and middle-income countries (LMICs). This study aimed to assess the impact of a one-day PC training initiative for health care professionals in Uganda. Methods: Participants' pre- and post-course self-assessments, qualitative feedback, and satisfaction surveys were analyzed. ⋯ Course satisfaction was high. Conclusion: This study underscores the importance of investing in PC education to address the growing demand for PC in LMICs. The positive impact observed highlights the potential of such initiatives to bridge the gap in access to PC services and improve outcomes for patients facing life-threatening illnesses.
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Introduction: There is limited understanding of critical care (CC) and specialist palliative care (SPC) professionals' perceptions regarding the role and utility of SPC for patients on extracorporeal membrane oxygenation (ECMO). Methods: An 18-item survey was distributed via convenience sampling and snowballing strategies to CC and SPC attendings working with veno-venous ECMO patients. Results: A total of 75 surveys were completed. ⋯ Responses varied on the appropriateness of discussing SPC with patients/families prognosis (81% SPC vs. 47% CC, p < 0.05), end-of-life preferences (100% vs. 62%, p < 0.05), goals of care (95% vs. 58%, p < 0.05), and code status (76% vs. 43%, p < 0.05). Conclusion: Most respondents indicated that psychosocial support and multidisciplinary team collaborations were within the SPC scope. CC professionals were less likely to indicate that discussion of the care trajectory with patients/families was within SPC scope.
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Background: Historically, there have been perceptions that engagement with palliative care (PC) services may preclude potentially curative but high-risk operations. As such, we sought to investigate the relationship between specialty PC consultation and the care trajectory of surgical patients. We hypothesized that PC consultation would be associated with increased frequency of nonoperative treatments being chosen among surgical inpatients. ⋯ There was no association between PC involvement with surgical decision making and odds of discharge to hospice (OR 0.42 [0.18, 1.51]) nor death during admission (OR 0.66 [0.21, 2.10]). Conclusions: We found that specialty PC involvement in surgical decision making does not preclude the pursuit of disease-directed surgical treatment. Contrary to our hypothesis, our single institutional data demonstrate that early PC consultation can be synergistic with surgical disease management and does not preclude elevated-risk operative care.