Journal of palliative medicine
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Introduction: The needs of patients living with malignant neoplasm, and those of their families and care partners, require a multidimensional and interdisciplinary approach. By systematically assessing these needs with validated tools, healthcare professionals can identify and monitor therapeutic objectives, interventions, and results. Objective: At the Catalan Institute of Oncology (ICO), we set out to update the ICO Toolkit-a set of instruments for assessing the physical, emotional, and social needs of palliative care patients. ⋯ Results: The final 19 instruments selected for the ICO Toolkit-2 achieved a degree of consensus of 90%-100%. Conclusions: The updated ICO Toolkit-2 facilitates a multidimensional, systematic, objective, and measurable assessment of the needs of malignant neoplasm patients throughout their cancer journey. Uptake of the new toolkit could improve the care and support provided to patients and their families and care partners.
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The literature available on the topic of education programs for noncancer patients' informal caregivers (ICs) is heterogeneous and fragmented in the setting of palliative care (PC). We conducted a scoping review (ScR) to map the literature on educational programs for ICs in home-based PC, considering the available reviews, qualitative studies, observational studies, studies of validation of measurement tools, uncontrolled trials, nonrandomized controlled trials, and feasibility studies. This ScR included 21 eligible records by searching PubMed, Web of Science, Embase, Scopus, and CINAHL databases. ⋯ ICs can improve their knowledge, confidence, and attitudes toward PC. The literature summary might render the assistance more accessible to ICs to improve the quality of caregiving and nursing care linked to patient and caregiver outcomes. However, robust studies (e.g., randomized controlled trials) are still required to identify and establish the efficacy of each described intervention and, therefore, offer tailored approaches considering the diverse diseases and social and cultural characteristics of patients and ICs.
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Background: Palliative care (PC) is essential to improve quality of life for individuals with life-limiting acute neurological conditions, particularly in resource-limited settings. In Latin America and the Caribbean (LAC), there is limited health care professional training and education on PC. Objective: We reviewed the peer-reviewed literature discussing end-of-life care, withdrawal of life-sustaining treatments (WOLST), and PC in the acute inpatient setting. ⋯ Our review found that several articles highlight the limitations of PC usage in LAC and inadequate access to treatments, including gastrostomy and tracheostomy tube placement. Conclusions: Our review demonstrates a need to improve PC knowledge and access to end-of-life care resources. Regional educational efforts are needed to improve PC knowledge among health care providers who care for patients with acute neurological conditions in LAC.
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Introduction: It is a common practice in Ontario to prescribe patients with advanced life-limiting illness a Symptom Response Kit (SRK), an emergency medication and medical supply kit, to manage distressing symptoms in the community toward the end of life (EOL). These are hugely beneficial to patients; however, the medications included have high risk profiles, and there is no uniform procedure in place for the return or disposal of SRKs. This narrative review aims to identify what happens to unused SRKs when no longer needed. ⋯ There is no consensus on SRK terminology and no studies evaluating the return or safe disposal of SRKs in the community when no longer needed. Future work should establish safety regulations, disposal monitoring, supervision of use, and terminology standardization. OHAH organizations provincially are conducting innovative work in this area.
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Objective: To systematically review studies presenting quantitative data on the experiences of patients and providers engaged in VSED. Background: Voluntarily stopping eating and drinking (VSED) to purposefully accelerate the end of life is uncommon but likely accounts for thousands of deaths per year. A single systematic review of literature was published in 2014. ⋯ Little research to guide best practice is available, particularly in the United States. Caregivers and health care providers generally indicate support however, extensive preparation and caregiver assistance make the practice challenging. Practitioners express a need for training.