Articles: palliative-care.
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Background: Little is known about the aggressiveness of cancer care at the end of life (ACCEoL) for children with cancer in countries where palliative care (PC) is scarce. Objective: The aim of this study was to determine the frequency and time trends of ACCEoL in the pediatric population in a Western European country. Setting/Subjects: We conducted a retrospective cohort study analyzing children between 0 and 17 years who died of cancer in public hospitals in Portugal, from January 2010 to December 2015. ⋯ The prevalence of ACCEoL remained stable over the period. Conclusions: In our cohort about 9 out of 10 children with cancer experienced at least one indicator of ACCEoL, a rate higher than in countries with well-developed PC services. There is a need to improve the care in the last months of life for children with cancer.
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Background: Altered cognitive function due to delirium changes the threshold or tolerance of symptoms. The impacts of delirium motor subtypes on symptoms remain unknown. Objectives: Determining whether delirium motor subtypes are associated with the severity of physical symptoms in a palliative care setting. ⋯ However, patients with hypoactive delirium did not have higher odds of developing severe symptoms. Patients without delirium at T1, who developed hyperactive or mixed delirium, had a higher severity of both pain and dyspnea than those who were delirium-free (OR, 95% CI; 1.60, 1.08-2.37, and 1.86, 1.27-2.72, respectively) at T2. Conclusion: Hyperactive delirium is associated with the intensity of pain and dyspnea in patients receiving palliative care.
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J Pain Symptom Manage · Dec 2024
ReviewLanguage justice as health equity in palliative care: A scoping review.
Communication is the foundation of optimal healthcare provision. Linguistic diversity is a reality in palliative care settings. ⋯ To provide equitable care reflecting language justice, investigators and clinicians should include interpreters, patients, and families as integral team members. The increase in number of interventional studies suggests evidence of the value interpreters add to the palliative care team. Collaborating with linguistically diverse stakeholders reflects language justice and holds promise for ensuring optimal communication.
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Background: Recent research indicates that psychedelic-assisted therapy (PAT) may be a safe and effective treatment for several psychiatric disorders, including those experienced by people with serious physical illness. Understanding health care workers' (HCWs') attitudes and knowledge about the clinical application of psychedelics for patients with serious illness is important in progressing research and identifying factors to consider in potential future implementation of PAT. Aim: The aim of this systematic review was to synthesize quantitative, qualitative, and mixed methods studies that explored HCWs' attitudes and knowledge about the role of psychedelics in treating psychological distress in patients with serious illness. ⋯ Five themes were developed: Polarized views about PAT for patients with serious illness; attitudes often informed by PAT research knowledge and heuristic methods; stronger evidence base needed to increase HCWs' confidence and support implementation of PAT; barriers may hinder PAT's potential integration into existing care models; and team-based approach and clinical education are essential to facilitate PAT. Conclusion: Although support for PAT varied, most HCWs perceived potential benefits in treating refractory distress, desired education about PAT, and called for further research to develop a stronger evidence base. Limitations of the review and included studies are discussed, along with implications of the findings and recommendations for future research.