Articles: palliative-care.
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Palliative medicine · Feb 2024
Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study.
The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability. ⋯ This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.
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Background: It is commonly thought that most deaths in developed countries take place in hospital. Death place is a palliative care quality indicator. Objectives: To determine the use of Canadian hospitals by patients who died in hospital during the 2019-2020 year and any additional hospital utilization occurring over their last 365 days of life. ⋯ Conclusions: This study confirms a continuing shift of death and dying out of hospital in Canada. Most deaths and end-of-life care preceding death take place outside of hospitals now. Enhanced community-based services are recommended to support optimal dying processes outside of hospitals and also help more dying people avoid hospital deaths.
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Palliative care clinicians enhance the illness experiences of patients and their families through building therapeutic relationships. Many psychological concepts underlie a clinician's approach to a specific patient. ⋯ As we all (both clinicians and patients) bring our own histories and unique biographies to the work of palliative care, a more explicit focus on the psychological aspects of this work can enhance our own experience and efficacy as providers. With a thoughtful focus on the psychological aspects of how we engage with patients, palliative care clinicians can offer a more meaningful therapeutic encounter.
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Toxic work culture contributes to healthcare worker burnout and attrition, but little is known about how healthcare organizations can systematically create and promote a culture of civility and collegiality. ⋯ Analysis of positive feedback from a mortality review survey provided meaningful insights into a health system's culture of teamwork and values related to civility and collegiality when providing end-of-life care. Systematic collection and sharing of positive feedback is feasible and has the potential to promote positive culture change and improve healthcare worker well-being.