Articles: palliative-care.
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Randomized Controlled Trial Clinical Trial
Does hospital at home for palliative care facilitate death at home? Randomised controlled trial.
To evaluate the impact on place of death of a hospital at home service for palliative care. ⋯ In a locality with good provision of standard community care we could not show that hospital at home allowed more patients to die at home, although neither does the study refute this. Problems relating to recruitment, attrition, and the vulnerability of the patient group make randomised controlled trials in palliative care difficult. While these difficulties have to be recognised they are not insurmountable with the appropriate resourcing and setting.
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To gather information about healthcare providers' beliefs regarding pain and its treatment in children with cognitive impairment. ⋯ The presence of cognitive impairment appeared to influence provider decisions regarding the appropriateness of specific pain assessment and treatment methods requiring skills on the part of the child. Overall, healthcare provider views regarding analgesia and sedation were similar for all children, regardless of impairment. Whether these beliefs are consistent with clinical practice is yet to be documented.
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Eur J Cardiothorac Surg · Dec 1999
Comparative StudyMesothelioma--VATS biopsy and lung mobilization improves diagnosis and palliation.
Mesothelioma is an increasingly frequent malignancy in which diagnosis is often delayed and disease diagnosed at an advanced stage. Earlier diagnosis and therapeutic intervention that can control recurrent pleural effusion may improve outlook and survival. ⋯ VATs provides adequate tissue for histological diagnosis where other methods fail. At the same operative sitting it provides a therapeutic intervention that allows drainage of effusion cytoreductive pleurectomy and lung mobilization in a significant number of cases. Where the pleural space can be closed this results in significantly fewer hospital admissions and appears to improve quality of life and length of survival. The price is a longer hospital stay due to prolonged air leak.
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This study was a retrospective examination of adolescents' use of non-pharmacologic methods to manage menstrual discomfort. ⋯ It is possible that some methods are used because they have a physiologic impact on pain (e.g. heat), whereas others (e.g., distraction) provide a sense of comfort and control. Further research is necessary to examine the determinants of why and when certain management strategies are used by adolescents.
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To identify and synthesize evidence from studies examining the quality of care of dying patients in both specialist and general practitioner care. ⋯ There is limited evidence of improvements in the care of selected cancer patients, and a dearth of evidence concerning patients dying from other, more common causes. The methods of research used to date are of limited current utility and new methods are required.