Journal of palliative medicine
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Background: Recent research indicates that psychedelic-assisted therapy (PAT) may be a safe and effective treatment for several psychiatric disorders, including those experienced by people with serious physical illness. Understanding health care workers' (HCWs') attitudes and knowledge about the clinical application of psychedelics for patients with serious illness is important in progressing research and identifying factors to consider in potential future implementation of PAT. Aim: The aim of this systematic review was to synthesize quantitative, qualitative, and mixed methods studies that explored HCWs' attitudes and knowledge about the role of psychedelics in treating psychological distress in patients with serious illness. ⋯ Five themes were developed: Polarized views about PAT for patients with serious illness; attitudes often informed by PAT research knowledge and heuristic methods; stronger evidence base needed to increase HCWs' confidence and support implementation of PAT; barriers may hinder PAT's potential integration into existing care models; and team-based approach and clinical education are essential to facilitate PAT. Conclusion: Although support for PAT varied, most HCWs perceived potential benefits in treating refractory distress, desired education about PAT, and called for further research to develop a stronger evidence base. Limitations of the review and included studies are discussed, along with implications of the findings and recommendations for future research.
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Background: Caregivers are engaging in recreational travel with the neuro-oncology patients they care for, yet there is little scientific research on this phenomenon. Aim: The purpose of this study is to examine the experiences of recreational travel among caregiver-patient with brain cancer dyads from the perspective of the caregivers. Specifically, we examined (1) context (i.e., why and when) of recreational travel, (2) the caregiver's travel preparations, and (3) the impact of the travel on caregivers. ⋯ Caregivers most often described the emotional impact of travel, which was often complex and bittersweet. Conclusions: Travel with a patient with brain cancer may be an important goal for caregivers and could help create meaning and memories, but can also present challenges. Early and clear communication from the care team can play a role in supporting meaningful trips.
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Background: Inpatient hospices (IHs) can alleviate distress and address economic burdens on patients with terminal cancer. However, there have been inconsistent findings regarding IHs in terms of cost savings and medication use. Objective: We aimed to examine cost savings associated with IHs, according to the timing of first hospitalization before death, and analyze their use of medication, among Korean patients with terminal lung cancer. ⋯ IHs used 2.103 times more opioid analgesics (95% CI: 1.980-2.233, p < 0.001). They also used more antiemetics, delirium medications, and antianxiety agents, as well as fewer antidepressive agents, systemic steroids, diuretics, total parenteral nutrition, and antibiotics (all p < 0.05). Conclusions: Patients with terminal lung cancer in IHs in Korea were more likely to receive symptom-oriented medications and experienced reduced hospitalization costs only during the 30 days preceding death.
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Background: Since 2011, extended care paramedics in South Australia have collaborated with palliative care services to deliver successful palliative and end of life care. However, a gap in paramedic training was identified with a growing number of patients opting for home palliation, prompting the development of a 2021 education program by the South Australian Ambulance Service in partnership with Program of Experience in the Palliative Approach, to equip paramedics with enhanced skills and resources for effective palliative care in the community. Aim: To qualitatively evaluate the effectiveness of the education program provided to paramedics by exploring their subjective experience in providing palliative care within the community following the education program. ⋯ This was crucial for complying with a patient's wishes of not wanting to leave their own familiar surrounding at the end of their life. Palliative care education was shown to improve paramedic knowledge and skills. Specific knowledge gaps were highlighted by the participants to better manage palliative care patients in the community.