Journal of palliative medicine
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Randomized Controlled Trial
A randomized controlled trial of a goals-of-care video for elderly patients admitted to skilled nursing facilities.
To determine the impact of a video on preferences for the primary goal of care. ⋯ Subjects admitted to SNFs who viewed a video were more likely than those exposed to a verbal narrative to opt for comfort. Concordance between a preference for comfort and a DNR order was low. These findings suggest a need to improve ascertainment of patients' preferences.
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Fatigue is a multidimensional phenomenon that has different meanings according to different societal and cultural settings. This study aims to decipher fatigue in Taiwanese patients with cancer. ⋯ The meaning of fatigue is mainly associated with physical factors among these patients. Education of complexities in fatigue in tandem with psychosocial and spiritual care may help alleviate this symptom, and promote quality of life.
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Children with life-threatening illnesses have unique physical and psychosocial needs that pediatric palliative care programs can address. Integrated programs strive to address these needs from the point of diagnosis through death, if needed, at the same time that curative care is provided. To better understand the variation in these needs, we assessed the health status and health-related quality of life (HRQOL) of children enrolled in an integrated pediatric palliative care program. ⋯ Children with life-threatening illnesses in our sample had a high level of morbidity compared with those found in other HUI studies of children with acute or chronic health conditions. Not only do our results highlight severely impaired HRQOL, they also demonstrate the wide variety of health states and needs for children in integrated palliative care programs. This information can help develop strategies to encourage more providers to participate in integrated pediatric palliative care programs.
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Despite broad support for palliative and end-of-life care training in medical schools, required clinical palliative care and end-of-life experiences are rare. In this study, we assess the impact of a required palliative care educational intervention on medical students' palliative care pain knowledge and end-of-life attitudes. ⋯ A modest, required palliative care curriculum can yield improvements in medical student knowledge and attitudes. However, expansion of the experiential component and palliative care skills training and assessment are needed for students to have more meaningful outcomes and to ultimately contribute to better patient outcomes.