BMJ supportive & palliative care
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BMJ Support Palliat Care · Dec 2011
Patients with pancreatic cancer and relatives talk about preferred place of death and what influenced their preferences: a qualitative study.
To explore reasons why people with pancreatic cancer, who are reaching the end of their lives, say they wish to die at home or elsewhere, and why preferences may change. ⋯ The National Health Service End of Life Care Strategy for England seeks to meet the needs of people who are dying and promotes better support for home deaths. More information is needed about why patients hold different views about place of care and place of death, why patients' preferences change and what importance patients attach to place of death. Health professionals should bear this in mind if the subject is raised during advance care planning.
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BMJ Support Palliat Care · Dec 2011
Randomized Controlled TrialA novel approach to enhancing hope in patients with advanced cancer: a randomised phase II trial of dignity therapy.
To assess the ability of dignity therapy to reduce distress in advanced cancer patients. ⋯ The effects of dignity therapy on people with advanced cancer are encouraging. Further investigation is warranted focusing on distressed patients and those earlier in the palliative care trajectory.
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BMJ Support Palliat Care · Dec 2011
Increased mortality in parents bereaved in the first year of their child's life.
To identify the relative risk (RR) of mortality in bereaved parents compared with non-bereaved counterparts. ⋯ Bereaved parents who experience stillbirth or infant death have markedly increased mortality compared with non-bereaved parents, up to 25 years (mean) after the death of their child. However, the RR reduces over time.
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BMJ Support Palliat Care · Dec 2011
Effectiveness of a multidisciplinary consultation team for cancer pain and palliative care in a large university hospital in The Netherlands.
Multidisciplinary palliative care teams (PCTs) are increasingly employed for cancer patients. However, relatively few studies have prospectively assessed the clinical effectiveness of inpatient PCTs. Our aim was to evaluate the effectiveness of a multidisciplinary PCT for hospitalised cancer patients in a large university hospital in The Netherlands. ⋯ The authors conclude that a multidisciplinary PCT for clinical cancer patients may have a positive effect on pain, on ESAS symptoms and on duration of hospitalisation.
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BMJ Support Palliat Care · Dec 2011
How is agitation and restlessness managed in the last 24 h of life in patients whose care is supported by the Liverpool care pathway for the dying patient?
Guidance regarding the patient centred management of agitation and restlessness reinforces the importance of considering underlying causes, non-pharmacological approaches to treatment and judicious use of medications titrated to patient need. In contrast, recent reports in the literature suggest that the practice of continuous deep sedation until death is prevalent in the UK. ⋯ Only 51% of patients received medication to alleviate agitation and restlessness in the last 24 h of life. Median doses were low in comparison to doses recommended for continuous deep sedation, suggesting that there is no 'blanket' policy for continuous deep sedation at the end of life for patients whose care is supported by the LCP.