Articles: palliative-care.
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J Pain Symptom Manage · Jun 2023
ReviewDEVELOPMENT AND VALIDATION A TOOL TO ASSESS THE STRUCTURAL QUALITY OF PALLIATIVE CARE SERVICES.
The current gap in access to palliative care requires the expansion of palliative care services worldwide. There is little information about the structural components required by palliative care services to provide adequate end-of-life care. No specific tools have been developed to assess the structural quality of these services. ⋯ The SQPCS-21 tool to assess structural quality of palliative care services, has good content and construct validity and its application provides information about institutions at the individual and aggregated level. This tool can provide guidance to monitor the structural quality of palliative care worldwide.
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Observational Study
Chlorpromazine's Potential Role in Palliating Distressing Symptoms Associated with Hyperactive Delirium in Patients at End of Life.
Background: The hyperactive subtype of delirium is characterized by agitation, restlessness, delusions, and/or hallucinations, which commonly present near end of life (EoL). Symptom relief often requires the use of medications, such as chlorpromazine (CPZ), to reduce patient distress by inducing proportional sedation. Objective: The purpose of this study was to evaluate CPZ's potential role in managing the distress of hyperactive delirium in patients receiving EoL care. ⋯ Results: Sustained improvement in symptoms of delirium was seen in 80% of patients as identified in the palliative psychiatrist's progress notes. Meanwhile, 75% of patient's improvement was reported in nursing-driven Delirium Observation Screening Scale. Conclusion: This study elucidates that at doses of ∼100 mg/day, CPZ is potentially an effective medication for patients with advanced cancer, experiencing hyperactive delirium in their final week of life.
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J Pain Symptom Manage · Jun 2023
Review Meta AnalysisPalliative Care Interventions Effects on Psychological Distress: A Systematic Review & Meta-Analysis.
Managing psychological distress is an objective of palliative care. No meta-analysis has evaluated whether palliative care reduces psychological distress. ⋯ Psychological distress is not likely to be reduced in the context of a typical palliative care intervention. The systemic exclusion of patients with common mental health conditions in more than 1/3 of the studies raises ethical questions about the goals of palliative care RCTS and could perpetuate inequalities.
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Palliative medicine · Jun 2023
Randomized Controlled TrialThe effect of an integrated palliative care intervention on quality of life and acute healthcare use in patients with COPD: Results of the COMPASSION cluster randomized controlled trial.
COPD causes high morbidity and mortality, emphasizing the need for palliative care. ⋯ We found no evidence that palliative care improves quality of life in patients with COPD. However, it can potentially reduce acute healthcare use. The consequences of the COVID-19 pandemic led to suboptimal implementation and insufficient power, and may have affected some of our findings.