BMJ supportive & palliative care
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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.
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BMJ Support Palliat Care · Mar 2012
Intention, procedure, outcome and personhood in palliative sedation and euthanasia.
Palliative sedation at the end of life has become an important last-resort treatment strategy for managing refractory symptoms as well as a topic of controversy within palliative care. Furthermore, palliative sedation is prominent in the public debate about the possible legalisation of voluntary assisted dying (physician-assisted suicide and euthanasia). This article attempts to demonstrate that palliative sedation is fundamentally different from euthanasia when it comes to intention, procedure, outcome and the status of the person. ⋯ However, only the latter intentionally ends life and also has this as its goal. There is the danger that deep sedation could bring death forward in time due to particular side effects of the treatment. Still that would, if it happens, not be intended, and accordingly is defensible in view of the doctrine of double effect.