Articles: palliative-care.
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Palliative medicine · Dec 2024
Palliative and end-of-life care for patients with pleural mesothelioma: A cohort study.
Pleural mesothelioma is a rare and incurable cancer, with complex physical and psychological symptoms. Despite recent advances in treatment, prognosis remains poor (average 8-15 months) with a lack of research on palliative and end-of-life care. ⋯ Patients with pleural mesothelioma have unplanned admissions to hospital towards the end of life, with possible inequalities; they receive late advance care planning and face challenges unique to their disease. It is important that patients receive high quality palliative end-of-life care through accessing specialist palliative care or have guidance/signposting to other potential sources of support.
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Palliative medicine · Dec 2024
Associations between physicians' personal preferences for end-of-life decisions and their own clinical practice: PROPEL survey study in Europe, North America, and Australia.
Physicians have significant influence on end-of-life decisions. Therefore, it is important to understand the connection between physicians' personal end-of-life care preferences and clinical practice, and whether there is congruence between what they prefer for themselves and for patients. ⋯ Physicians consider their own preferences when providing care and their preferences impact the recommendations they make to patients. Incongruence exists between what physicians prefer for themselves and what they prefer for patients.
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Introduction: There is limited understanding of critical care (CC) and specialist palliative care (SPC) professionals' perceptions regarding the role and utility of SPC for patients on extracorporeal membrane oxygenation (ECMO). Methods: An 18-item survey was distributed via convenience sampling and snowballing strategies to CC and SPC attendings working with veno-venous ECMO patients. Results: A total of 75 surveys were completed. ⋯ Responses varied on the appropriateness of discussing SPC with patients/families prognosis (81% SPC vs. 47% CC, p < 0.05), end-of-life preferences (100% vs. 62%, p < 0.05), goals of care (95% vs. 58%, p < 0.05), and code status (76% vs. 43%, p < 0.05). Conclusion: Most respondents indicated that psychosocial support and multidisciplinary team collaborations were within the SPC scope. CC professionals were less likely to indicate that discussion of the care trajectory with patients/families was within SPC scope.
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Background: The debate over legalizing medical assistance in dying (assisted dying) is ongoing, also in Nordic countries such as Sweden where assisted dying is illegal. A 2020 survey by the Swedish Medical Association highlighted varied perspectives, with 41% of physicians supporting and 34% opposing legalization. Professionals in palliative care were more negative toward it. ⋯ The open-ended questions revealed thoughts regarding the complexity of the issue and the need for further discussion and education. Conclusion: In Sweden, where euthanasia and physician-assisted suicide is illegal, more than one-third of palliative care professionals were in favor of legalizing these practices while one-fourth were undecided, these proportions differed markedly between professions. Further, we uncovered a significant need for further discussion and education.
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Patients with end-of-life care (EoLC) needs present to the emergency departments (ED) frequently and at times, it can be difficult to provide a high standard of care. Within the Irish setting, there is limited literature on the provision of EoLC in EDs and this study, therefore, aimed to evaluate the perceptions of emergency medicine (EM) clinicians regarding the provision of EoLC in EDs in Ireland. ⋯ EM clinicians agree that they are comfortable breaking bad news and discussing EoLC with patients and families, but disagree that adequate resources and infrastructure are in place to provide a high standard of EoLC in Irish EDs. Challenges exist centred on training and infrastructure and addressing these may lead to enhanced EoLC in the future.