Articles: palliative-care.
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J Pain Symptom Manage · Dec 2024
Case ReportsPalliative Care Consults for Clinician Distress: Part of the Job?
Clinician distress is common in serious illness care. Palliative specialists are often consulted for cases involving significant distress among primary teams. ⋯ This article uses three composite cases to illustrate types of clinician distress and examine the benefits and risks of palliative specialist involvement. We conclude with a discussion of potential impacts of palliative care consults for clinician distress on the field of palliative care and consider next steps in critically important efforts to support and sustain the entire workforce-both palliative specialists and nonspecialists alike-when caring for patients with serious illness and their family caregivers.
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J Pain Symptom Manage · Dec 2024
Death anxiety in patients with advanced cancer and their family caregivers.
Death anxiety is associated with fears of suffering and uncertainty at the end of life. It is also relevant to patients' family caregivers, who can experience fears about the patients' death and dying. ⋯ The results indicate that death anxiety is a common, clinically significant problem in patients with advanced cancer and their family caregivers, emphasizing the need for targeted psychological support.
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Many patients who could benefit from palliative care (PC) do not access it because of the timing and tenor of the introduction provided by their specialist. A barrier to improving specialists' (from disciplines other than PC) engagement with PC services may be an inadequate understanding of how those specialists view PC. As part of a larger project to develop public messaging for advance care planning, PC, and hospice, we conducted a qualitative market research study aimed at identifying the "deep metaphors" held by specialists about PC to provide an empirical foundation for more effective outreach and messaging. ⋯ The interviews were videorecorded and transcribed and were analyzed along with images brought by participants using a variation of the constant comparative method. The themes included: Having to tell patients the "right" information and path; Not allowing myself to make mistakes; Depending on algorithms so I can give my patients the best care; Putting the patient in charge can challenge clinical algorithms; Observing that PC seems to lack an objectively "right" decision; Consulting PC invites subjectivity best contained at the end of the algorithm. These themes can inform strategies for outreach and messaging to other serious illness specialist clinicians to lower reluctance to consult PC, increasing patient access.
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Review
Lived experiences of end-of-life care at home in the UK: a scoping review of qualitative research.
Home is the preferred place of care and death for most people with advanced illness. ⋯ There is limited published evidence exploring the lived experiences of end-of-life care at home and this constrains the extent to which community services can be evidence informed in their design and delivery. More research is needed to examine the first-hand experiences of people who are dying at home, particularly for those with non-cancer conditions and where specialist services are not involved.