BMJ supportive & palliative care
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BMJ Support Palliat Care · Mar 2017
Skills, expertise and role of Australian emergency clinicians in caring for people with advanced cancer.
To explore the views of Australian emergency department (ED) clinicians about their skills, role and expertise in caring for people with advanced cancer. ⋯ ED clinicians in Australia, particularly those who have received palliative care education, feel comfortable and adequately skilled in managing people with advanced cancer presenting to EDs, and most find it rewarding. The importance of palliative care education to emergency clinicians' training should be recognised.
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BMJ Support Palliat Care · Mar 2017
Place of care: from referral to specialist palliative care until death.
While there are many poorly standardised studies focusing on place of death, there are limited data on place(s) of care during the final stages of disease. ⋯ A significant number of patients received specialist palliative care across multiple care settings. Late referral is associated with a single domain of care. General practitioner involvement supports patient care and death at home. Place of care and ease of transfer between care settings may be better indicators of the quality of care we provide.
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BMJ Support Palliat Care · Mar 2017
Increasing inpatient hospice use versus patient preferences in the USA: are patients able to die in the setting of their choice?
Growth in hospice utilisation has been accompanied by an increase in the proportion of hospice patients who die in an inpatient hospice setting rather than at home. ⋯ Although more patients are dying while receiving inpatient care, these changes in site of death seem to reflect changing patient preferences. The net effect is that patients in this sample were more likely to die in the setting of their choice in 2012 than they were in 2008.
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BMJ Support Palliat Care · Mar 2017
The online use of Violence and Journey metaphors by patients with cancer, as compared with health professionals: a mixed methods study.
To compare the frequencies with which patients with cancer and health professionals use Violence and Journey metaphors when writing online; and to investigate the use of these metaphors by patients with cancer, in view of critiques of war-related metaphors for cancer and the adoption of the notion of the 'cancer journey' in UK policy documents. ⋯ Violence metaphors are not by default negative and Journey metaphors are not by default a positive means of conceptualising cancer. A blanket rejection of Violence metaphors and an uncritical promotion of Journey metaphors would deprive patients of the positive functions of the former and ignore the potential pitfalls of the latter. Instead, greater awareness of the function (empowering or disempowering) of patients' metaphor use can lead to more effective communication about the experience of cancer.
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BMJ Support Palliat Care · Dec 2016
Medical students writing on death, dying and palliative care: a qualitative analysis of reflective essays.
Medical students and doctors are becoming better prepared to care for patients with palliative care needs and support patients at the end of life. This preparation needs to start at medical school. ⋯ Reflective essays give insights into the way students learn about death, dying and palliative care and how it affects them personally as well as the preparation that is needed to be better equipped to deal with these kinds of experiences. Analysis of the essays enabled the proposal of new strategies to help make them more effective learning tools and to optimise students' learning from a palliative care attachment.