BMJ supportive & palliative care
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BMJ Support Palliat Care · Mar 2012
Where do patients known to a community palliative care service die?
The majority of people would prefer to die at home and National Health Service policy aims to support this concept. This service evaluation compared the preferred and actual place of death of patients known to a specialist community palliative care service. ⋯ The perceived lack of social support for patients dying at home is a significant trigger for admission to a hospice. The provision of sitters to support patients dying at home may ensure people achieve their preference. Commissioners consider preferred place of care to be a marker of quality, but clinical events that precipitate admission are often outside the influence of the palliative care team.
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BMJ Support Palliat Care · Mar 2012
ReviewPalliative medicine and smartphones: an opportunity for innovation?
The use of smartphones and their software applications (apps) provides health professionals with opportunities to integrate technology into clinical practice. Increasing numbers of work-related apps are available to health professionals, especially in certain specialties such as orthopaedics. However, so far the availability of apps specific to palliative medicine is limited. ⋯ There is a lack of palliative medicine specific resources for smartphones and no studies have been published which examine the potential benefits of mobile technology for learning, clinical practice and professional development. This provides an opportunity for further research and development. Academic institutions could work with technological developers to improve access to, and dissemination of, key information for practice. Considered development of mobile technology has the potential to improve patient care, data sharing and education within the palliative medicine specialty.
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BMJ Support Palliat Care · Mar 2012
Observational StudyHas there been any progress in improving the quality of hospitalised death? Replication of a US chart audit study.
To describe the experience of dying in a US tertiary academic medical centre and to compare this experience with a historical decedent sample. ⋯ Less invasive EOL care was observed in decedents who received a PCC. Ongoing monitoring of EOL care is critically important for hospital quality improvement programmes.
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BMJ Support Palliat Care · Mar 2012
Comparative StudyWhich questions of two commonly used multidimensional palliative care patient reported outcome measures are most useful? Results from the European and African PRISMA survey.
To evaluate the views of clinicians and researchers on their use of outcome measures and which questions are most important in palliative and end-of-life care. ⋯ In palliative care, outcome measures often used in clinical practice are also often used in research. Questions relating to pain, symptoms, emotional needs and family concerns are consistently considered the most useful and important in palliative patient reported outcome measures (PROMs).
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BMJ Support Palliat Care · Mar 2012
Public opinion on preferences and priorities for end-of-life care in sub-Saharan Africa: piloting a novel method of street surveying.
There is a great need for end-of-life care in Africa due to the high incidence of life-threatening illness. However, little is known about the views of the African public on end-of-life care. Therefore, the authors piloted a street survey in Nairobi (Kenya), where adult pedestrians were randomly interviewed about local preferences and priorities for end-of-life care. ⋯ All 17 had experienced the death of a close relative in the last 5 years. Methodological and implementation lessons have been learnt and the results of the pilot suggest street surveying is a feasible and acceptable method to examine public opinion on end-of-life care in Africa, provided people are able to freely decline to respond and safety measures are in place for interviewer. This novel pilot offers a new opportunity for health research in Africa.