Articles: palliative-care.
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Background: Many seriously ill patients in need of palliative care (PC) globally never receive it, partly due to a lack of well-trained providers. Objectives: We analyzed feedback from international participants in a U. S.-based PC training course: "Palliative Care Education and Practice" to identify elements of the course that would meet the needs of international learners. ⋯ Results: Key barriers to PC practice change included lack of awareness of PC among local providers, challenges navigating institutional leaders, and a lack of trained providers. Participants requested an increased focus on topics such as resiliency, leadership, and pediatric PC. Conclusions: To address the needs of international learners, PC courses should consider offering a specific track for international participants, as well as an increased focus on topics such as resiliency, leadership development, and pediatric PC.
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Internal medicine journal · Nov 2021
The burden of diagnostic investigations at the end of life for people with COPD.
Chronic obstructive pulmonary disease (COPD) is an incurable, chronic condition that leads to significant morbidity and mortality, with most patients dying in hospital. While diagnostic tests are important for actively managing patients during hospital admissions, the balance between benefit and harm should always be considered. This is particularly important when patients reach the end of life, when the focus is to reduce burdensome interventions. ⋯ There were missed opportunities to reduce the burden of diagnostic tests and focus on comfort at the end of life. Increased physician education regarding communication and end-of-life care, including recognising active dying may address these issues.
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Background: There are racial/ethnic disparities in hospice use and end-of-life (EOL) care outcomes in the United States. Although the use of community health workers (CHWs) and patient navigators (PNs) has been suggested as a means of reducing them, CHW/PNs' attitudes toward a palliative care philosophy remain unknown. The purpose of this study was to examine how personal attributes affect a CHW/PN's attitude toward EOL care. ⋯ Eighty percent strongly agreed or agreed with being open to discussing death with a dying patient. Higher self-efficacy scores were associated with more favorable attitudes toward hospice (r = 0.306, p = 0.016). Conclusions: CHWs/PNs have an overall favorable attitude toward the palliative care philosophy and may be inclined to providing EOL care.
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J Pain Symptom Manage · Nov 2021
Clinical relevance and prognostic value of inflammatory biomarkers: a prospective study in terminal cancer patients receiving palliative care.
Inflammatory biomarkers have prognostic value in cancer patients, but the feasibility of their use with terminal cancer patients and the related cutoff points are poorly explored. ⋯ The inflammatory biomarkers analyzed are independent predictive factors for death within 90 days in terminal cancer patients. CAR appears to be the most useful parameter for predicting survival in these patients.
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Background: With support from the Radcliffe Institute for Advanced Study at Harvard University, we convened researchers representing palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapies. We aimed to define priorities and envision an agenda for future research on psychedelic-assisted therapies in patients with serious illness. Over two days in January 2020, participants engaged in an iterative series of reflective exercises that elicited their attitude and perspectives on scientific opportunities for this research. ⋯ Additionally, participants suggested epistemological limitations of the medical model to understand the potential value and therapeutic use of psychedelics. Conclusions: Medicine and society are witnessing a resurgence of interest in the effects and applications of psychedelic-assisted therapies in a wide range of settings. This article suggests key opportunities for research in psychedelic-assisted therapies for those affected by serious illness.