586 results match your criteria BMC Palliative Care [Journal]


Advance care planning in dementia: recommendations for healthcare professionals.

BMC Palliat Care 2018 Jun 21;17(1):88. Epub 2018 Jun 21.

End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium.

Background: Advance care planning (ACP) is a continuous, dynamic process of reflection and dialogue between an individual, those close to them and their healthcare professionals, concerning the individual's preferences and values concerning future treatment and care, including end-of-life care. Despite universal recognition of the importance of ACP for people with dementia, who gradually lose their ability to make informed decisions themselves, ACP still only happens infrequently, and evidence-based recommendations on when and how to perform this complex process are lacking. We aimed to develop evidence-based clinical recommendations to guide professionals across settings in the practical application of ACP in dementia care. Read More

View Article
June 2018
1 Read

The interaction of socioeconomic status with place of death: a qualitative analysis of physician experiences.

BMC Palliat Care 2018 Jun 20;17(1):87. Epub 2018 Jun 20.

The Temmy Latner Centre for Palliative Care, Sinai Health System, 60 Murray Street, 4th Floor, Box 13, Toronto, ON, M5T 3L9, Canada.

Background: Home is a preferred place of death for many people; however, access to a home death may not be equitable. The impact of socioeconomic status on one's ability to die at home has been documented, yet there remains little literature exploring mechanisms that contribute to this disparity. By exploring the experiences and insights of physicians who provide end-of-life care in the home, this study aims to identify the factors perceived to influence patients' likelihood of home death and describe the mechanisms by which they interact with socioeconomic status. Read More

View Article

Chemotherapy and palliative care near end-of life: examining the appropriateness at a cancer institute for colorectal cancer patients.

BMC Palliat Care 2018 Jun 19;17(1):86. Epub 2018 Jun 19.

Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.

Background: Appropriate cessation of chemotherapy and timely referral of patients to hospice services are crucial for the quality of care near death. We investigated the quality of care in our Cancer Institute in very advanced metastatic colorectal cancer patients treated in real life.

Patients And Methods: We performed a retrospective analysis of electronic medical data of patients with metastatic colorectal cancer who were candidates for chemotherapy during the study period (1 January 2007-30 June 2014) and died before 31 December 2014. Read More

View Article
June 2018
1 Read

Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care.

BMC Palliat Care 2018 Jun 11;17(1):85. Epub 2018 Jun 11.

Department of Social and Welfare Studies (ISV), Faculty of Health Sciences, Linköping University, 581 83, Linköping, Sweden.

Background: The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention.

Methods: Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Read More

View Article

Residential aged care residents and components of end of life care in an Australian hospital.

BMC Palliat Care 2018 Jun 9;17(1):84. Epub 2018 Jun 9.

Northern Adelaide Palliative Service, Modbury Hospital, 41-69 Smart Rd, Modbury, South Australia, 5092, Australia.

Background: With ageing of Australians, the numbers of residential aged care (RAC) residents is rising. This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care. The aim was to study a sample of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required. Read More

View Article

The degree of social difficulties experienced by cancer patients and their spouses.

BMC Palliat Care 2018 Jun 8;17(1):83. Epub 2018 Jun 8.

Department of Medical Oncology, Kanazawa Medical University, Ishikawa, Japan.

Background: Although recent studies have increasingly reported physical and psychological problems associated with cancer and its treatment, social problems of cancer patients and their families have not been sufficiently elucidated. The present study aimed to identify cancer-associated social problems from the perspectives of both patients and their spouses and to compare and analyze differences in their problems.

Methods: This was a cross-sectional internet-based study. Read More

View Article

Introducing PALETTE: an iterative method for conducting a literature search for a review in palliative care.

BMC Palliat Care 2018 Jun 2;17(1):82. Epub 2018 Jun 2.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, 3508, GA, Utrecht, Netherlands.

Background: In the rapidly developing specialty of palliative care, literature reviews have become increasingly important to inform and improve the field. When applying widely used methods for literature reviews developed for intervention studies onto palliative care, challenges are encountered such as the heterogeneity of palliative care in practice (wide range of domains in patient characteristics, stages of illness and stakeholders), the explorative character of review questions, and the poorly defined keywords and concepts. To overcome the challenges and to provide guidance for researchers to conduct a literature search for a review in palliative care, Palliative cAre Literature rEview iTeraTive mEthod (PALLETE), a pragmatic framework, was developed. Read More

View Article
June 2018
2 Reads

Prevalence and characteristics of breakthrough cancer pain in an outpatient clinic in a Catalan teaching hospital: incorporation of the Edmonton Classification System for Cancer pain into the diagnostic algorithm.

BMC Palliat Care 2018 May 28;17(1):81. Epub 2018 May 28.

Faculty of Nursing and Phisiotherapy, Universitat de Lleida, Montserrat Roig 2, 25198, Lleida, Spain.

Background: Breakthrough cancer pain (BTcP) is defined according to its principal characteristics: high intensity, short time interval between onset and peak intensity, short duration, potential recurrence over 24 h and non-responsiveness to standard analgesic regimes. The Edmonton Classification System for Cancer Pain (ECS-CP) is a classification tool that evaluates different dimensions of pain. The aim of this study was to measure prevalence and the main characteristics of BTcP in a sample of advanced cancer patients and to explore the complexity observed when ECS-CP is incorporated into BTcP diagnostics algorithm. Read More

View Article

Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs.

BMC Palliat Care 2018 May 24;17(1):79. Epub 2018 May 24.

Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands.

Background: Advance Care Planning (ACP) and its documentation, accessible to healthcare professionals regardless of where patients are staying, can improve palliative care. ACP is usually performed by trained facilitators. However, ACP conversations would be more tailored to a patient's specific situation if held by a patient's clinical healthcare team. Read More

View Article

Place of death in patients with dementia and the association with comorbidities: a retrospective population-based observational study in Germany.

BMC Palliat Care 2018 May 24;17(1):80. Epub 2018 May 24.

Department of Palliative Medicine, Munich University Hospital, Ludwig-Maximilians- University Munich, Munich, Germany.

Background: Due to increasing life expectancy, more and more older people are suffering from dementia and comorbidities. To date, little information is available on place of death for dementia patients in Germany. In addition, the association of place of death and comorbidities is unknown. Read More

View Article
May 2018
3 Reads

Whose job? The staffing of advance care planning support in twelve international healthcare organizations: a qualitative interview study.

BMC Palliat Care 2018 May 24;17(1):78. Epub 2018 May 24.

Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science (LSE), Houghton Street, London, WC2A 2AE, UK.

Background: ACP involving a facilitated conversation with a health or care professional is more effective than document completion alone. In policy, there is an expectation that health and care professionals will provide ACP support, commonly within their existing roles. However, the potential contributions of different professionals are outlined only broadly in policy and guidance. Read More

View Article

Building Bridges, Paediatric Palliative Care in Belgium: A secondary data analysis of annual paediatric liaison team reports from 2010 to 2014.

BMC Palliat Care 2018 May 22;17(1):77. Epub 2018 May 22.

Institute of Health and Society- Institut de recherche Santé et Société (IRSS), Université catholique de Louvain, 30, Clos Chapelle-aux-Champs, Boite 1.30.13, B-1200, Brussels, Belgium.

Background: Although continuity of care in paediatric palliative care (PPC) is considered to be an essential element of quality of care, it's implementation is challenging. In Belgium, five paediatric liaison teams (PLTs) deliver palliative care. A Royal Decree issued in 2010 provides the legal framework that defines the PLTs' missions, as ensuring continuity of curative and palliative care between the hospital and home for children diagnosed with life-limiting conditions. Read More

View Article

Formal procedure to facilitate the decision to withhold or withdraw life-sustaining interventions in a neonatal intensive care unit: a seven-year retrospective study.

BMC Palliat Care 2018 May 17;17(1):76. Epub 2018 May 17.

Department of Neonatology, Hospital Nord, Assistance-Publique des Hôpitaux de Marseille, 13015, Marseille, France.

Background: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. Read More

View Article

Use of hospital palliative care according to the place of death and disease one year before death in 2013: a French national observational study.

BMC Palliat Care 2018 May 16;17(1):75. Epub 2018 May 16.

National sickness insurance fund, 26-50, avenue du Professeur André Lemierre, 75986, Paris cedex 20, France.

Background: Only limited data are available concerning the diseases managed before death and hospital palliative care (HPC) use according to place of death in France. We therefore conducted an observational study based on administrative health data in a large population to identify the diseases treated one year before death in 2013, the place of stay with or without hospital palliative care, and the place of death.

Methods: French health insurance general scheme beneficiaries were identified in the National Health data Information System (Snds) with a selection of information. Read More

View Article
May 2018
3 Reads

Feasibility, acceptability and adaption of dignity therapy: a mixed methods study achieving 360° feedback.

BMC Palliat Care 2018 May 10;17(1):73. Epub 2018 May 10.

Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.

Background: Dignity Therapy (DT) is a short-term intervention to reduce psychological suffering in end-of-life care. Its strength lies in evidenced-based development and investigation. The aim of the present study is to investigate the feasibility of DT at German palliative care units (PCU), as well as the acceptability and adaption of a German version of the DT question protocol (DTQP). Read More

View Article

The availability and effectiveness of tools supporting shared decision making in metastatic breast cancer care: a review.

BMC Palliat Care 2018 May 11;17(1):74. Epub 2018 May 11.

NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500BN, Utrecht, The Netherlands.

Background: Shared decision-making (SDM) in the management of metastatic breast cancer care is associated with positive patient outcomes. In daily clinical practice, however, SDM is not fully integrated yet. Initiatives to improve the implementation of SDM would be helpful. Read More

View Article

Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: a comprehensive review.

BMC Palliat Care 2018 May 8;17(1):72. Epub 2018 May 8.

Western Australian Centre for Rural Health (WACRH), School of Population and Global Health, The University of Western Australia, Geraldton, WA, 6530, Australia.

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern.

Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples' preferences, needs, opportunities and barriers to palliative care. Read More

View Article

How do professionals assess the quality of life of children with advanced cancer receiving palliative care, and what are their recommendations for improvement?

BMC Palliat Care 2018 May 8;17(1):71. Epub 2018 May 8.

Centre de Psycho-Oncologie, CHU Sainte-Justine, Montréal, QC, H3T 1C5, Canada.

Background: It is known that information regarding the quality of life of a patient is central to pediatric palliative care. This information allows professionals to adapt the care and support provided to children and their families. Previous studies have documented the major areas to be investigated in order to assess the quality of life, although it is not yet known what operational criteria or piece of information should be used in the context of pediatric palliative care. Read More

View Article

Benchmarking time to initiation of end-of-life homecare nursing: a population-based cancer cohort study in regions across Canada.

BMC Palliat Care 2018 May 4;17(1):70. Epub 2018 May 4.

Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.

Background: Several studies have demonstrated the benefits of early initiation of end-of-life care, particularly homecare nursing services. However, there is little research on variations in the timing of when end-of-life homecare nursing is initiated and no established benchmarks.

Methods: This is a retrospective cohort study of patients with a cancer-confirmed cause of death between 2004 and 2009, from three Canadian provinces (British Columbia, Nova Scotia, and Ontario). Read More

View Article

Comparing unplanned and potentially planned home deaths: a population-based cross-sectional study.

BMC Palliat Care 2018 May 2;17(1):69. Epub 2018 May 2.

Research Group for General Practice, Department of Global Public Health and Primary Care, University of Bergen, PO box 7804, N-5018, Bergen, Norway.

Background: There is little research on number of planned home deaths. We need information about factors associated with home deaths, but also differences between planned and unplanned home deaths to improve end-of-life-care at home and make home deaths a feasible alternative. Our aim was to investigate factors associated with home deaths, estimate number of potentially planned home deaths, and differences in individual characteristics between people with and without a potentially planned home death. Read More

View Article

Exploring end-of-life interaction in dyads of parents and adult children: a protocol for a mixed-methods study.

BMC Palliat Care 2018 Apr 27;17(1):68. Epub 2018 Apr 27.

Institute for General Practice, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany.

Background: A considerable number of terminally-ill adult children are outlived by at least one parent and receive palliative care prior to their death. At the same time, adult children continue to be confronted with their parents' terminal illnesses and end-of-life situations. The current study explores the specifics of dyadic interaction at the end of life between a) adult children suffering from a life-threatening disease and their parents, and b) terminally ill parents and their adult children. Read More

View Article

Palliative care for homeless people: a systematic review of the concerns, care needs and preferences, and the barriers and facilitators for providing palliative care.

BMC Palliat Care 2018 Apr 24;17(1):67. Epub 2018 Apr 24.

Amsterdam Public Health Research Institute (APH), Department of Public and Occupational Health, Expertise Centre for Palliative Care, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.

Background: Homeless people often suffer from complex and chronic comorbidities, have high rates of morbidity and die at much younger ages than the general population. Due to a complex combination of physical, psychosocial and addiction problems at the end of life, they often have limited access to palliative care. Both the homeless and healthcare providers experience a lot of barriers. Read More

View Article

The Japan hospice and palliative evaluation study 4: a cross-sectional questionnaire survey.

BMC Palliat Care 2018 Apr 20;17(1):66. Epub 2018 Apr 20.

Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

Background: Constant evaluation is important for maintaining and improving the quality of end-of-life care. We therefore conduct the fourth Japan Hospice and Palliative Evaluation Study (J-HOPE4) as a continuous evaluation study. In this present paper, we describe the design of J-HOPE4. Read More

View Article
April 2018
1 Read

Self-competence in death work among health and social care workers: a region-wide survey in Hong Kong.

BMC Palliat Care 2018 Apr 20;17(1):65. Epub 2018 Apr 20.

CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong.

Background: According to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates. Read More

View Article
April 2018
1 Read

Adding a second surprise question triggers general practitioners to increase the thoroughness of palliative care planning: results of a pilot RCT with cage vignettes.

BMC Palliat Care 2018 Apr 19;17(1):64. Epub 2018 Apr 19.

Department of Anesthesiology, Pain and Palliative Medicine, Radboud university medical center, Postbox 9101, internal code 549, 6500, HB, Nijmegen, the Netherlands.

Background: In our aging society, palliative care should be a standard component of health care. However, currently it is only provided to a small proportion of patients, mostly to those with cancer, and restricted to the terminal phase. Many general practitioners (GPs) say that one of their most significant challenges is to assess the right moment to start anticipatory palliative care. Read More

View Article
April 2018
1 Read

Comfort in palliative sedation (Compas): a transdisciplinary mixed method study protocol for linking objective assessments to subjective experiences.

BMC Palliat Care 2018 Apr 18;17(1):62. Epub 2018 Apr 18.

Mental Health and Wellbeing research group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium.

Background: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Read More

View Article
April 2018
1 Read

Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study.

BMC Palliat Care 2018 Apr 18;17(1):63. Epub 2018 Apr 18.

Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia.

Background: Self-care practice within the palliative care workforce is often discussed, yet seemingly under-researched. While palliative care professionals are required to implement and maintain effective self-care strategies, there appears little evidence to guide them. Moreover, there is an apparent need to clarify the meaning of self-care in palliative care practice. Read More

View Article
April 2018
1 Read

Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

BMC Palliat Care 2018 Apr 17;17(1):61. Epub 2018 Apr 17.

Netherlands Institute for Health Services Research (NIVEL), P.O Box 1568, 3500 BN, Utrecht, The Netherlands.

Background: In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Read More

View Article
April 2018
1 Read

Symptom management, nutrition and hydration at end-of-life: a qualitative exploration of patients', carers' and health professionals' experiences and further research questions.

BMC Palliat Care 2018 Apr 16;17(1):60. Epub 2018 Apr 16.

Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.

Background: Symptom management is an essential aspect of palliative and end-of-life care, but evidence suggests that patients' symptoms may not always be relieved, causing significant harm to patients and magnifying their relatives' distress. A growing body of evidence focuses on symptom management at the end-of-life, but research funding for palliative care remains disproportionately low. It is therefore crucial that research funding is targeted at areas of importance to patients and relatives. Read More

View Article
April 2018
1 Read

Community readiness and momentum: identifying and including community-driven variables in a mixed-method rural palliative care service siting model.

BMC Palliat Care 2018 Apr 6;17(1):59. Epub 2018 Apr 6.

School of Geography & Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4M1, Canada.

Background: Health service administrators make decisions regarding how to best use limited resources to have the most significant impact. Service siting models are tools that can help in this capacity. Here we build on our own mixed-method service siting model focused on identifying rural Canadian communities most in need of and ready for palliative care service enhancement through incorporating new community-driven insights. Read More

View Article
April 2018
1 Read

Health service utilisation during the last year of life: a prospective, longitudinal study of the pathways of patients with chronic kidney disease stages 3-5.

BMC Palliat Care 2018 Apr 5;17(1):57. Epub 2018 Apr 5.

Faculty of Health, Queensland University of Technology, Brisbane, Australia.

Background: Chronic kidney disease (CKD) is a growing global problem affecting around 10% of many countries' populations. Providing appropriate palliative care services (PCS) to those with advanced kidney disease is becoming paramount. Palliative/supportive care alongside usual CKD clinical treatment is gaining acceptance in nephrology services although the collaboration with and use of PCS is not consistent. Read More

View Article
April 2018
1 Read

Redefining diagnosis-related groups (DRGs) for palliative care - a cross-sectional study in two German centres.

BMC Palliat Care 2018 Apr 5;17(1):58. Epub 2018 Apr 5.

Munich University Hospital, Department of Palliative Medicine, Ludwig-Maiximilians-Universitaet Munich, Marchioninistr. 15, 81377, Munich, Germany.

Background: Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. Read More

View Article
April 2018
1 Read

Exploring attitudes toward physician-assisted death in patients with life-limiting illnesses with varying experiences of palliative care: a pilot study.

BMC Palliat Care 2018 Apr 4;17(1):56. Epub 2018 Apr 4.

Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Canada.

Background: On February 6th, 2015, the Supreme Court of Canada ruled that competent adults suffering intolerably from a grievous and irremediable medical condition have the right to the assistance of a physician in ending their own lives, an act known as physician-assisted death, and later defined as medical assistance in dying, allowing for provision by a physician or a nurse practitioner. As of June 6th, 2016, this is no longer illegal across Canada. There is strong support amongst the general population for physician-assisted death, however there is no recent data on the attitudes of terminally ill patients. Read More

View Article
April 2018
1 Read

Striving for a balance between leading and following the patient and family - nurses' strategies to facilitate the transition from life-prolonging care to palliative care: an interview study.

BMC Palliat Care 2018 Apr 3;17(1):55. Epub 2018 Apr 3.

Örebro University Hospital, Örebro, Sweden.

Background: The transition from life-prolonging to palliative care (PC) can be challenging often characterized by psychical, physiological, social and existential changes. Knowledge of how to support the patient and family in this specific care phase is lacking, and this area needs to be further explored. The aim of this study was to investigate strategies that registered nurses (RNs) use to ease the transition from life-prolonging care to PC for patients with incurable disease. Read More

View Article
April 2018
1 Read

A review of paper-based advance care planning aids.

BMC Palliat Care 2018 Mar 27;17(1):54. Epub 2018 Mar 27.

Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA.

Background: Advance care planning (ACP) aids can help prepare patients, family members, and physicians for in-the-moment medical decision-making. We wished to describe the content and approach of paper-based ACP aids in order to characterize existing aids and inform the development of a new ACP aid.

Methods: Paper-based ACP aids were identified through an environmental scan and screened for eligibility. Read More

View Article
March 2018
1 Read

Palliative care for people with schizophrenia: a qualitative study of an under-serviced group in need.

BMC Palliat Care 2018 Mar 27;17(1):53. Epub 2018 Mar 27.

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia.

Background: People with schizophrenia are at risk of receiving poorer end of life care than other patients. They are often undertreated, avoid treatment and are about half as likely to access palliative care. There are limited options for end of life care for this under-serviced group in need. Read More

View Article
March 2018
2 Reads

Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol.

BMC Palliat Care 2018 Mar 22;17(1):52. Epub 2018 Mar 22.

Department of Health and Care Sciences, Linnaeus University, SE-392 81, Kalmar, Sweden.

Background: The demography of the world is changing as the population is ageing. Because of this change to a higher proportion of older people, the WHO has called for improved palliative care for older persons. A large number of all deaths in the industrialised world occur while older people are living in nursing homes and therefore a key question becomes how the principles of palliative care can be implemented in that context. Read More

View Article
March 2018
3 Reads

Using motivational interviewing to facilitate death talk in end-of-life care: an ethical analysis.

BMC Palliat Care 2018 Mar 21;17(1):51. Epub 2018 Mar 21.

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

Background: Morbidity arising from unprepared bereavement is a problem that affects close personal relations of individuals at the end-of-life. The bereavement studies literature demonstrates that a lack of preparedness for a loved one's death is a risk factor for secondary psychological morbidity among survivors. Short awareness time of death negatively correlates to preparedness for bereavement. Read More

View Article
March 2018
2 Reads

Partnering with families to promote nutrition in cancer care: feasibility and acceptability of the PIcNIC intervention.

BMC Palliat Care 2018 Mar 20;17(1):50. Epub 2018 Mar 20.

National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Cost, Australia.

Background: Malnutrition is frequent in patients with cancer, particularly those in advanced stages of the disease. The aim of the present study was to test the feasibility of a family-centred nutritional intervention, based on the Family Systems theory and past research.

Methods: This was a single-arm trial assessing feasibility (eligibility, recruitment and retention rates); acceptability by patients, family caregivers and health professionals; intervention fidelity, and energy/protein intake (in one site only). Read More

View Article
March 2018
4 Reads

Developing and testing a nursing home end -of -life care chart audit tool.

BMC Palliat Care 2018 Mar 15;17(1):49. Epub 2018 Mar 15.

Winnipeg Regional Health Authority, 4th floor, 650 Main St, Winnipeg, MB, R3B 1E2, Canada.

Background: Nursing home (NH) administrators need tools to measure the effectiveness of care delivered at the end of life so that they have objective data on which to evaluate current practices, and identify areas of resident care in need of improvement.

Methods: A three-phase mixed methods study was used to develop and test an empirically derived chart audit tool aimed at assessing the care delivered along the entire dying trajectory.

Results: The Auditing Care at the End of Life (ACE) instrument contains 27 questions captured across 6 domains, which are indicative of quality end-of-life care for nursing home residents. Read More

View Article
March 2018
1 Read

Palliative sedation in Germany: factors and treatment practices associated with different sedation rate estimates in palliative and hospice care services.

BMC Palliat Care 2018 Mar 13;17(1):48. Epub 2018 Mar 13.

Department of Palliative Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Background: Clinical practice of Palliative Sedation (PS) varies between institutions worldwide and sometimes includes problematic practices. Little available research points at different definitions and frameworks which may contribute to uncertainty of healthcare professionals in the application of PS. This analysis investigates what demographic factors and characteristics of treatment practices differ between institutions with high versus low sedation rates estimates in Palliative and Hospice Care in Germany. Read More

View Article
March 2018
1 Read

Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the 'PACE Steps to Success' intervention in seven countries.

BMC Palliat Care 2018 Mar 12;17(1):47. Epub 2018 Mar 12.

Department of Family Medicine and Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.

Background: Several studies have highlighted the need for improvement in palliative care delivered to older people long-term care facilities. However, the available evidence on how to improve palliative care in these settings is weak, especially in Europe. We describe the protocol of the PACE trial aimed to 1) evaluate the effectiveness and cost-effectiveness of the 'PACE Steps to Success' palliative care intervention for older people in long-term care facilities, and 2) assess the implementation process and identify facilitators and barriers for implementation in different countries. Read More

View Article
March 2018
2 Reads

Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

BMC Palliat Care 2018 Mar 12;17(1):46. Epub 2018 Mar 12.

Division of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.

Background: For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. Read More

View Article
March 2018
1 Read

Analysis of factors delaying the surgical treatment of patients with neurological deficits in the course of spinal metastatic disease.

Authors:
Grzegorz Guzik

BMC Palliat Care 2018 Mar 7;17(1):44. Epub 2018 Mar 7.

Orthopedic Oncology Department, Specialist Hospital in Brzozów- Podkarpacki Oncology Center, ul. Dworska 77a, 38-420, Korczyna, Polska, Poland.

Background: Thoracic spine cancer metastases is frequently the cause of neurological deficits. Despite the availability of diagnostics, delays in treatment are still quite common. The aim of this work is to analyze the reasons for delayed diagnostics and treatment, in patients with neurological deficits in the course of metastatic spine disease. Read More

View Article
March 2018
4 Reads

Aligning policy objectives and payment design in palliative care.

Authors:
Stephen Duckett

BMC Palliat Care 2018 Mar 7;17(1):42. Epub 2018 Mar 7.

Health Program, Grattan Institute, 8 Malvina Place, Carlton, VIC, 3053, Australia.

Background: Payment models for palliative care vary across nations, with few adopting contemporary payments designs that apply to other parts of the health system.

Aim: To propose optimal payment arrangements for palliative care.

Approach: Review of relevant literature on funding mechanisms in health care generally and palliative care in particular. Read More

View Article
March 2018
1 Read

Effects of a new medical insurance payment system for hospice patients in palliative care programs in Korea.

BMC Palliat Care 2018 Mar 7;17(1):45. Epub 2018 Mar 7.

Department of Family Medicine, Pusan National University Hospital, Busan, 602-739, South Korea.

Background: This study investigates the effects of a new medical insurance payment system for hospice patients in palliative care programs and analyzes length of survival (LoS) determinants.

Method: At the Pusan National University Hospital hospice center, between January 2015 and April 2016, 276 patients were hospitalized with several diagnosed types of terminal stage cancer. This study separated patients into two groups, "old" and "new," by admission date, considering the new system has been applied from July 15, 2015. Read More

View Article
March 2018
7 Reads

Palliative care in the emergency department: an educational investigation and intervention.

BMC Palliat Care 2018 Mar 7;17(1):43. Epub 2018 Mar 7.

Department of Emergency Medicine, Carolinas Medical Center, Carolinas Healthcare System, 1000 Blythe Blvd., 3rd Floor MEB, Charlotte, NC, 28203, USA.

Background: To investigate the value of a novel simulation-based palliative care educational intervention within an emergency medicine (EM) residency curriculum.

Methods: A palliative care scenario was designed and implemented in the simulation program at an urban academic emergency department (ED) with a 3-year EM residency program. EM residents attended one of eight high-fidelity simulation sessions, in groups of 5-6. Read More

View Article
March 2018
2 Reads

Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis.

BMC Palliat Care 2018 Mar 7;17(1):41. Epub 2018 Mar 7.

Department of Community Health Sciences, University of Calgary, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.

Background: The aim of palliative care is to improve the quality of life of patients and families through the prevention and relief of suffering. Frequently, patients may choose to receive palliative care in the home. The objective of this paper is to summarize the quality and primary outcomes measured within the palliative care in the home literature. Read More

View Article
March 2018
3 Reads

Development and validation of the quality care questionnaire -palliative care (QCQ-PC): patient-reported assessment of quality of palliative care.

BMC Palliat Care 2018 Mar 5;17(1):40. Epub 2018 Mar 5.

Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea.

Background: In this study, we aimed to develop and validate an instrument that could be used by patients with cancer to evaluate their quality of palliative care.

Methods: Development of the questionnaire followed the four-phase process: item generation and reduction, construction, pilot testing, and field testing. Based on the literature, we constructed a list of items for the quality of palliative care from 104 quality care issues divided into 14 subscales. Read More

View Article
March 2018
4 Reads

"Never at ease" - family carers within integrated palliative care: a multinational, mixed method study.

BMC Palliat Care 2018 Mar 1;17(1):39. Epub 2018 Mar 1.

Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.

Background: Family carers manage a wide range of responsibilities in the lives and care of patients receiving palliative care. They fulfil multiple roles and perform activities within different settings. This has immediate consequences on family carers' every-day lives. Read More

View Article
March 2018
1 Read