Articles: palliative-care.
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Intensive care medicine · Nov 2024
Practice GuidelineEuropean Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.
The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented. ⋯ Methods for enhancing family-centeredness of care include structured family conferences and culturally sensitive interventions. Conflict-management protocols and strategies to prevent burnout among healthcare professionals are also considered. The work done to develop these guidelines highlights many areas requiring further research.
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J Pain Symptom Manage · Nov 2024
Race and Socio-Economic Status Impact Withdrawal of Treatment in Young Traumatic Brain Injury.
Withdrawal of life-sustaining therapies (WDLST) in young individuals with traumatic brain injury (TBI) is an overwhelming situation often made more stressful by socioeconomic factors that shape health outcomes. Identifying these factors is crucial to developing equitable and goal-concordant care for patients and families. ⋯ The decision for WDLST in young patients with severe TBI may be influenced by cultural and socioeconomic factors in addition to clinical considerations.
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J Pain Symptom Manage · Nov 2024
Quality of Care in the Last Two Years of Life for Children with Complex Chronic Conditions.
Limited data exists about care received by children with complex chronic conditions (CCCs) in the final years of their disease and end-of-life (EOL). ⋯ In this study, children with CCCs met 69% of quality measures and received high-intensity healthcare in the last two years of life.
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High-functioning palliative care teams are essential to high-quality care for individuals with serious illness and their families. Such teams are flexible and adapt to change. However, recent high turnover and understaffing, compounded by a pandemic, challenge even the most resilient and adaptable teams. ⋯ Leaders may find caring for seriously ill patients professionally satisfying, even as aspects of their leadership role cause them significant distress. For this reason, we share some lessons learned in leading evolving palliative care teams of varying composition, practice settings, and degrees of maturation. We hope these strategies equip palliative care leaders to build stronger, even more cohesive teams in times of change and uncertainty.