820 results match your criteria BMJ Support Palliat Care[Journal]


Blood transfusions: time for a change in practice?

Authors:
Elizabeth Brown

BMJ Support Palliat Care 2019 Apr 16. Epub 2019 Apr 16.

Saint Michaels Hospice, Harrogate HG2 8QL, UK

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2019-0017
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http://dx.doi.org/10.1136/bmjspcare-2019-001779DOI Listing
April 2019
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Psycho-oncology care in breast cancer centres: a nationwide survey.

BMJ Support Palliat Care 2019 Apr 13. Epub 2019 Apr 13.

Center for Integrated Oncology (CIO), Bonn, Germany.

Objective: To describe psycho-oncological care structures and processes in German breast cancer centres from the perspective of the centre administration.

Methods: The findings are based on a postal survey of a representative random sample of surgical sites of certified breast cancer centres in Germany. Data were collected in 2013 and 2014. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001704DOI Listing

Guide to every death and a little life.

Authors:
Kacper Niburski

BMJ Support Palliat Care 2019 Apr 13. Epub 2019 Apr 13.

Medicine, McGill University, Montreal, Québec H3A 0G4, Canada

The following is a narrativised story of my experience rotating in palliative care. It is lively. Read More

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http://dx.doi.org/10.1136/bmjspcare-2019-001825DOI Listing

Home parenteral nutrition during palliative care: little benefit.

BMJ Support Palliat Care 2019 Apr 11. Epub 2019 Apr 11.

Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0017
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http://dx.doi.org/10.1136/bmjspcare-2018-001736DOI Listing
April 2019
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iValidate: a communication-based clinical intervention in life-limiting illness.

BMJ Support Palliat Care 2019 Apr 11. Epub 2019 Apr 11.

ICU, Barwon Health, Geelong, Victoria, Australia.

Objectives: Report the implementation, user evaluation and key outcome measures of an educational intervention-the iValidate educational programme-designed to improve engagement in shared decision-making by health professionals caring for patients with life-limiting illness (LLI).

Design: Prospective, descriptive, cohort study.

Participants: Health professionals working in acute care settings caring for patients with an LLI. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001669DOI Listing
April 2019
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Advance care planning and place of death, hospitalisation and actual place of death in lung, heart and cancer disease: a randomised controlled trial.

BMJ Support Palliat Care 2019 Apr 11. Epub 2019 Apr 11.

The Palliative Care Team, Oncology Department, Aarhus University Hospital, Aarhus, Denmark.

Objectives: Advance care planning (ACP) can be a way to meet patients' end-of-life preferences and enhance awareness of end-of-life care. Thereby it may affect actual place of death (APOD) and decrease the rate of hospitalisations. The aim was to investigate if ACP among terminally ill patients with lung, heart and cancer diseases effects fulfilment of preferred place of death (PPOD), amount of time spent in hospital and APOD. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001677DOI Listing
April 2019
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Efficacy of low-dose and/or adjuvant methadone in palliative medicine.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Saint Francis Hospice Blanchardstown, Dublin, Ireland.

Objectives: To summarise the current body of published evidence on the use of low-dose and/or adjuvant methadone in the palliative care setting.

Methods: The authors searched multiple databases (PubMED, SCORPUS, EMBASE and the Cochrane library) for relevant articles using the terms 'methadone', 'palliative', 'low dose' and 'adjuvant'. The review was restricted to articles published between 2003 and 2018. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001695DOI Listing
April 2019
6 Reads

Spiritual care provided by nursing home physicians: a nationwide survey.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

End of Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.

Objective: To examine perceptions and experiences regarding providing spiritual care at the end of life of elderly care physicians practising in nursing homes in the Netherlands, and factors associated with spiritual care provision.

Methods: A cross-sectional survey was sent to a representative sample of 642 elderly care physicians requesting information about their last patient who died and the spiritual care they provided. We compared their general perception of spiritual care with spiritual and other items abstracted from the literature and variables associated with the physicians' provision of spiritual care. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001756DOI Listing

Neutropenic diets to prevent cancer infections: updated systematic review and meta-analysis.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Division of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona, USA.

Introduction: Multiple studies have questioned the benefit of neutropenic diets in decreasing infections in patients with cancer, but recent surveys showed that such diets are still prescribed. In this study, we sought to evaluate the effectiveness of neutropenic diet in decreasing infection and mortality in neutropenic patients with cancer with neutropenia. This review is an update of a previously published systematic review. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0017
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http://dx.doi.org/10.1136/bmjspcare-2018-001742DOI Listing
April 2019
21 Reads

Tai Chi for heart attack survivors: qualitative insights.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Miriam Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.

Objectives: Cardiac rehabilitation (CR) programmes are standard of care for patients following a coronary event. While such exercise-based secondary prevention programme do offer benefits, they are used by less than 30% of eligible patients and attrition within these programmes is high. This project is a nested qualitative assessment of a pilot programme considering Tai Chi (TC) as an alternative to CR. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001685DOI Listing
April 2019
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PROgnostic Model for Advanced Cancer (PRO-MAC).

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore.

Objective: To develop and validate a simple prognostic tool for early prediction of survival of patients with advanced cancer in a tertiary care setting.

Design: Prospective cohort study with 2 years' follow-up.

Setting: Single tertiary teaching hospital in Singapore. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001702DOI Listing
April 2019
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Reiki therapy for pain, anxiety and quality of life.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Clinical Geriatric, Centre Hospitalier Universitaire de Limoges, Limoges, France.

The use of complementary and alternative therapies is growing year after year, and Reiki therapy takes a place of choice. Reiki therapy, classed as a biofield energy therapy, raises the question of validity when applied to patients, especially in palliative care. The purpose of this review is to highlight the effects of Reiki therapy on pain, anxiety/depression and quality of life of patients, specifically in palliative care. Read More

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http://dx.doi.org/10.1136/bmjspcare-2019-001775DOI Listing
April 2019
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Community paramedics treat high acuity conditions in the home: a prospective observational study.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Health Solutions, Northwell Health, New Hyde Park, New York, USA.

Objectives: As the US population ages and healthcare reimbursement shifts, identifying new patient-centred, cost-effective models to address acute medical needs will become increasingly important. This study examined whether community paramedics can evaluate and treat, under the direction of a credentialed physician, high acuity medical conditions in the home within an advanced illness management (AIM) practice.

Methods: A prospective observational study of an urban/suburban community paramedicine (CP) programme, with responses initiated based on AIM-practice protocols and triaged prior to dispatch using the Advanced Medical Priority Dispatch System (AMPDS). Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001746DOI Listing
April 2019
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Prevalence of depression in patients with cancer in Iran: a systematic review and meta-analysis.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Department of Biology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.

Introduction: It is generally accepted that depression, affecting the quality of life, is a serious and common complication in patients with cancer. Given that there is no integrated study on this topic in Iran, the present study sought to investigate the prevalence of depression in patients with cancer by a systematic review and meta-analysis.

Methods: To meet the study objectives, all English and Persian papers published from 2000 to January 2018 were systematically collected and the data were extracted for analysis. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001724DOI Listing

Morphine infusor pump switch to oral methadone.

BMJ Support Palliat Care 2019 Apr 3. Epub 2019 Apr 3.

Palliative Care, Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.

Between 2014 and 2017, four patients with widespread cancer were referred to a home palliative care team from a hospital in Oviedo (Spain) with subcutaneous elastomeric infusion pump containing 180-260 mg/day of morphine for previously uncontrolled pain. 3-4 rotations were performed over 5-11 days, gradually substituting morphine for oral methadone (three times a day) to minimise the risks of rapid conversion, with a highly variable final subcutaneous morphine:oral methadone ratio (5:1 to 17:1), guided by the absence of pain, and to enhance the patient's functional capacity avoiding device dependence. The final methadone dose varied between 15 and 39 mg/day. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001760DOI Listing

Preferences for a good death: a cross-sectional survey in advanced cancer patients.

BMJ Support Palliat Care 2019 Apr 3. Epub 2019 Apr 3.

Humanities Teaching and Research Section, School of Nursing, Peking University, Beijing, China.

Objective: The aim of this study was to describe preferences for a good death among Chinese patients with advanced cancer and then to explore factors contributing to their preferences including patient demographics and disease variables.

Methods: A convenience sample of 275 patients with advanced cancer was recruited from a tertiary cancer hospital in Beijing, China, between February and December 2017. A Chinese version of the Good Death Inventory (GDI) was used to measure patients' preferences for dying and death. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001750DOI Listing

Requested withdrawal of mechanical ventilation in six patients with motor neuron disease.

BMJ Support Palliat Care 2019 Apr 3. Epub 2019 Apr 3.

Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Objectives: Mechanical ventilation (MV) has been shown to improve survival and quality of life in motor neuron disease (MND). However, during the progression of MND, there may come a point when MV is no longer felt appropriate. Association of Palliative Medicine Guidelines have been recently published to help clinicians withdraw MV at the request of patients with MND in a safe and compassionate manner to ensure that symptoms of distress and dyspnoea are minimised. Read More

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http://dx.doi.org/10.1136/bmjspcare-2017-001464DOI Listing
April 2019
4 Reads

Factors influencing palliative care in advanced dementia: a systematic review.

BMJ Support Palliat Care 2019 Apr 3. Epub 2019 Apr 3.

Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK.

Background: Dementia is a progressive neurodegenerative life-limiting disease. The international literature indicates that patients with advanced dementia can benefit from palliative care (PC) provided during the end-of-life phase. However, evidence indicates that currently many fail to access such provision despite the increased recognition of their palliative needs. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001692DOI Listing

Delirium management by palliative medicine specialists: a survey from the association for palliative medicine of Great Britain and Ireland.

BMJ Support Palliat Care 2019 Mar 4. Epub 2019 Mar 4.

Division of Palliative Care, Bruyère Research Institute; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Objectives: Delirium is common in palliative care settings. Management includes detection, treatment of cause(s), non-pharmacological interventions and family support; strategies which are supported with varying levels of evidence. Emerging evidence suggests that antipsychotic use should be minimised in managing mild to moderate severity delirium, but the integration of this evidence into clinical practice is unknown. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001586DOI Listing
March 2019
60 Reads

Impact of medical assistance in dying (MAiD) on family caregivers.

BMJ Support Palliat Care 2019 Mar 1. Epub 2019 Mar 1.

Supportive Care, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada

Medical assistance in dying (MAiD) is a globally polarising topic which often sparks debate surrounding the ethical and moral dilemmas that arise with a life-ending intervention. To gain a better understanding of this intervention, it is important to explore the experience of those most intimately affected by MAiD. Family caregivers of those with a terminal illness are the backbone of the healthcare and support team, often providing a substantial amount of informal care while at the same time coping with their own distress and anticipatory grief. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001686DOI Listing
March 2019
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Palliative care and imaging utilisation for patients with cancer.

BMJ Support Palliat Care 2019 Mar 1. Epub 2019 Mar 1.

Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.

Objective: This observational study explores the association between palliative care (PC) involvement and high-cost imaging utilisation for patients with cancer patients during the last 3 months of life.

Methods: Adult patients with cancer who died between 1 January 2012 and 31 May 2015 were identified. Referral to PC, intensity of PC service use, and non-emergent oncological imaging utilisation were determined. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001572DOI Listing

Effect of creative writing on mood in patients with cancer.

BMJ Support Palliat Care 2019 Mar 1. Epub 2019 Mar 1.

Medicine, Penn State Cancer Institute, Hershey, Pennsylvania, USA

Objective: To determine the feasibility of conducting creative writing workshops (CWW) for patients with cancer to promote improvement in mood.

Method: We piloted a prospective study to determine the feasibility of conducting CWW over a 4-week period. Patients were randomised 2:1 to either an intervention arm (IA) or to standard of care (SOC). Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0017
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http://dx.doi.org/10.1136/bmjspcare-2018-001710DOI Listing
March 2019
14 Reads

Haematologists and palliative care: a multicentric qualitative study.

BMJ Support Palliat Care 2019 Feb 26. Epub 2019 Feb 26.

Palliative Care, Hospices Civils de Lyon, Lyon, France.

Objectives: Early palliative care leads to meaningful improvements in physical and psychosocial symptoms, as well as quality of life, in patients with advanced cancer. Patients with haematological malignancies, despite a high level of distress, continue to have less access to palliative care services. The aim of this study was to identify haematologists' perceptions of palliative care, as well as barriers to patient referral. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001714DOI Listing
February 2019
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Resilience in inpatient palliative care nursing: a qualitative systematic review.

BMJ Support Palliat Care 2019 Feb 26. Epub 2019 Feb 26.

Faculty of Health and Medicine, Lancaster University, Lancaster, UK.

Background: Nurses in inpatient palliative care are frequently exposed to death and dying in addition to common stressors found in other nursing practice. Resilience may mitigate against stress but remains ill-defined and under-researched in the specialist palliative care setting.

Objective: The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001693DOI Listing
February 2019

Virtual reality videos used in undergraduate palliative and oncology medical teaching: results of a pilot study.

BMJ Support Palliat Care 2019 Feb 26. Epub 2019 Feb 26.

Media and Technology, Velindre Cancer Centre, Cardiff, UK.

Background: Virtual reality (VR) immersive environments have been shown to be effective in medical teaching. Our university hospital received funding from our deanery, Health Education in Wales, to film teaching videos with a 360-degree camera.

Aims: To evaluate whether VR is an effective and acceptable teaching environment. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001720DOI Listing
February 2019
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Advance care planning for home health staff: a systematic review.

BMJ Support Palliat Care 2019 Feb 26. Epub 2019 Feb 26.

University Library Service, Cardiff University, Cardiff, UK.

Background: Advance care planning (ACP) is a process where patients express their wishes regarding their future healthcare. Its importance has been increasingly recognised in the past decade. As increasing numbers of elderly people are living in care homes, the aim of this review was to identify the most effective ACP interventions to train/educate all levels of healthcare professionals working in care homes. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001680DOI Listing
February 2019

Palliative medicine physicians: doomed to burn?

BMJ Support Palliat Care 2019 Mar;9(1):45-46

Psychology Unit of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy.

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http://dx.doi.org/10.1136/bmjspcare-2018-001731DOI Listing

Conversion of other opioids to methadone: a retrospective comparison of two methods.

BMJ Support Palliat Care 2019 Feb 16. Epub 2019 Feb 16.

Department of Supportive and Palliative Care, Mater Health Services, Brisbane, Queensland, Australia

Context: A rapid method of methadone conversion known as the Perth Protocol is commonly used in Australian palliative care units. There has been no follow-up or validation of this method and no comparison between different methods of conversion.

Objectives: The primary objective of this study was to test the hypothesis that the achieved doses of methadone are independent of the conversion method (rapid vs slower). Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001645DOI Listing
February 2019
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Palliative care quality measures: an exploratory study.

BMJ Support Palliat Care 2019 Feb 14. Epub 2019 Feb 14.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Igiene ospedaliera, Roma, Italy.

Objectives: The aim of this study was to investigate how palliative care service structures and processes correlate with their outputs and outcomes, measuring the latter respectively in terms of intensity of care and death at home.

Methods: The Veneto Regional Health Authorities collected a set of 37 quality indicators for the year 2016, covering the following five dimensions: service integration, service structure, accessibility, professional processes and organisational processes. Their validity was assessed by a panel of 29 palliative care experts. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001679DOI Listing
February 2019

Palliative medicine and hospital readmissions in end-stage liver disease.

BMJ Support Palliat Care 2019 Feb 13. Epub 2019 Feb 13.

Division of Gastroenterology, Department of Medicine, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada.

Background: Patients with end-stage liver disease (ESLD) have a reduced life expectancy and a significant symptom burden. Our aim is to determine if inpatient palliative care (PC) referral for patients with ESLD is associated with decreased hospital readmission rates.

Methods: The 2013 US Nationwide Readmission Database (NRD) was used for the current analysis. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001635DOI Listing
February 2019

Primary palliative care research: opportunities and challenges.

BMJ Support Palliat Care 2019 Feb 12. Epub 2019 Feb 12.

Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Introduction: Primary care has a central role in palliative and end of life care: 45.6% of deaths in England and Wales occur under the care of primary care teams at home or in care homes. The Community Care Pathways at the End of Life (CAPE) study investigated primary care provided for patients in the final 6 months of life. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001653DOI Listing
February 2019

Advance care plans in dementia: user-centred design.

BMJ Support Palliat Care 2019 Feb 8. Epub 2019 Feb 8.

Health and Life Sciences, School of Nursing and Midwifery, The Gateway, De Montfort University, Leicester, UK.

Objectives: Historically, dementia has not been recognised as a life-limiting condition or one that may benefit from a palliative approach to its care. There are many challenges in providing palliative and end-of-life care to this group of people, some of which may be reduced through advance care planning (ACP) to support people with dementia to have a greater influence on their care at end of life. ACP has been defined as a process of discussing and recording of wishes, values and preferences for future care and treatment held between an individual, family members and their care provider(s) that takes effect when the person loses capacity. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001700DOI Listing
February 2019

Short Graphic Values History Tool for decision making during serious illness.

BMJ Support Palliat Care 2019 Feb 6. Epub 2019 Feb 6.

Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada.

Objectives: To develop and validate a values clarification tool, the Short Graphic Values History Tool (GVHT), designed to support person-centred decision making during serious illness.

Methods: The development phase included input from experts and laypersons and assessed acceptability with patients/family members. In the validation phase, we recruited additional participants into a before-after study. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001698DOI Listing
February 2019
3 Reads

Symptom burden in malignant and non-malignant disease on admission to a palliative care unit.

BMJ Support Palliat Care 2019 Feb 4. Epub 2019 Feb 4.

Department of Palliative Care, The Royal Melbourne Hospital, Parkville, Victoria, Australia.

Background: There is increasing recognition that patients with non-malignant diseases have comparable physical and psychosocial symptom burden to patients with cancer. There is currently limited data directly comparing symptom burden between these patient groups.

Objective: To investigate differences in symptom burden between patients with malignant and non-malignant conditions admitted to a palliative care unit (PCU). Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001560DOI Listing
February 2019

Healing experience for family caregivers after an intensive care unit death.

BMJ Support Palliat Care 2019 Feb 4. Epub 2019 Feb 4.

Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.

Objectives: Family caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.

Methods: Semi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001561DOI Listing
February 2019
1 Read

Assisted ventilation in motor neurone disease during inpatient palliative care: barriers and utilisation.

BMJ Support Palliat Care 2019 Feb 2. Epub 2019 Feb 2.

Palliative Medicine, Velindre Cancer Centre, Cardiff, UK.

Objectives: An increasing number of patients with motor neuron disease (MND) in the UK and Ireland use assisted ventilation, and a small proportion of these use long-term tracheostomy ventilation (TV).1 2 NICE guidelines recommend that patients with MND should routinely receive specialist palliative care input.3 The aim was to establish the extent to which hospices and specialist palliative care units (SPCUs) in the UK and Ireland currently manage patients with MND using assisted ventilation especially TV and to identify any associated barriers. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001672DOI Listing
February 2019
1 Read

Advance care planning for the severely ill in the hospital: a randomized trial.

BMJ Support Palliat Care 2019 Jan 21. Epub 2019 Jan 21.

Palliative Care Physician, Palliative Care Unit, University Hospital Zürich, Zürich, Switzerland.

Objectives: To investigate the impact of advance care planning (ACP) including decision aids for severely ill medical inpatients.

Methods: Single-centre randomised controlled trial at a Swiss university hospital. Patients were randomly assigned (1:1) to receive an extra consultation with the hospital social service or a consultation with in-house facilitators trained according to an internationally established ACP programme. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2017-0014
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http://dx.doi.org/10.1136/bmjspcare-2017-001489DOI Listing
January 2019
13 Reads

Simple and powerful: a consultant and governance-led bereavement service.

BMJ Support Palliat Care 2019 Jan 10. Epub 2019 Jan 10.

Medway NHS Foundation Trust, Gillingham, UK.

Background: Following bereavement, families can be left with unanswered questions or issues of concern. We piloted a bereavement service model which was consultant and governance-led with the aim to reduce complaints, reduce litigation, reduce coroners' inquests and support families.

Methods: Following the death of a patient, the next of kin was sent an invitation. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001661DOI Listing
January 2019

Place of death in a small island state: a death certificate population study.

BMJ Support Palliat Care 2019 Jan 18. Epub 2019 Jan 18.

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

Objectives: Low/middle-income countries, particularly Small Island Developing States, face many challenges including providing good palliative care and choice in place of care and death, but evidence of the circumstances of dying to inform policy is often lacking. This study explores where people die in Trinidad and Tobago and examines and describes the factors associated with place of death.

Methods: A population-level analysis of routinely collected death certificate and supplementary health data where the unit of analysis was the recorded death. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001631DOI Listing
January 2019
12 Reads

Living longer and living better: breast cancer endocrine therapy.

BMJ Support Palliat Care 2019 Jan 18. Epub 2019 Jan 18.

Department of Medical Oncology, Centro Hospitalar Universitário do Algarve, Faro, Portugal.

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001666DOI Listing
January 2019
7 Reads

Subcutaneous dexmedetomidine for baclofen withdrawal during palliative sedation.

BMJ Support Palliat Care 2019 Jan 12. Epub 2019 Jan 12.

Hôpital de la Cité-de-la-Santé, Laval, QC H7M 3L9, Canada

Sudden cessation of baclofen can produce a withdrawal syndrome even if it was previously orally administered. We present the case of a man who exhibited signs of baclofen withdrawal syndrome during palliative sedation. Attempts were made to induce muscle relaxation with ever-increasing doses of benzodiazepine. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001715DOI Listing
January 2019
2 Reads

Healthcare professionals' moral distress in adult palliative care: a systematic review.

BMJ Support Palliat Care 2019 Jan 12. Epub 2019 Jan 12.

Psychology Unit of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.

Objectives: Palliative care providers may be exposed to numerous detrimental psychological and existential challenges. Ethical issues in the healthcare arena are subject to continual debate, being fuelled with ongoing medical, technological and legal advancements. This work aims to systematically review studies addressing the moral distress experienced by healthcare professionals who provide adult palliative care. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001674DOI Listing
January 2019

Resistance to respiratory depression in 'opioid induced hyper-algesia': a hidden clinical danger.

Authors:
Marie Joseph

BMJ Support Palliat Care 2019 Jan 12. Epub 2019 Jan 12.

St Raphael's Hospice, Sutton SM3 9DX, UK

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http://dx.doi.org/10.1136/bmjspcare-2018-001678DOI Listing
January 2019
1 Read

Unusual case of transdermal fentanyl in cachexia.

BMJ Support Palliat Care 2019 Jan 5. Epub 2019 Jan 5.

Palliative Medicine, Manchester University NHS Foundation Trust, Manchester, UK.

Fentanyl has a low molecular weight and is lipophilic making it suitable for transdermal administration. However, multiple factors appear to lead to interindividual variation in absorption via this route. Here we describe an unusual case where a patient was found to have twelve 100 μg/hour fentanyl patches in situ which she was using as background analgesia. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001652DOI Listing
January 2019

Ethical issues in nursing home palliative care: a cross-national survey.

BMJ Support Palliat Care 2018 Dec 18. Epub 2018 Dec 18.

School of Nursing and Midwifery, Queen's University, Belfast, UK.

Objectives: With an increased dependency on nursing homes to provide care to the ageing population, it is likely that ethical issues will also increase. This study aimed to identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada, and pilot the Ethical issues in Palliative Care for Nursing Homes (EPiCNH) instrument in Canada.

Methods: A cross-sectional survey design was used. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001643DOI Listing
December 2018

Behind the wheel safety in palliative care: a literature review.

BMJ Support Palliat Care 2018 Dec 6. Epub 2018 Dec 6.

Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Brixton, London, UK.

Background: Driving is a complex activity that requires physical abilities and adequate executive and cognitive functioning. There is concern among specialist palliative care services about patients continuing to drive despite having progressive incurable illnesses, comorbidities and medications to manage their symptoms.

Objectives: To determine the quality of literature available about driving that would apply to palliative care patients, specifically in relation to road test or simulated driving scores and neurocognitive testing. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001639DOI Listing
December 2018
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Utility of the Seattle Heart Failure Model for palliative care referral in advanced ambulatory heart failure.

BMJ Support Palliat Care 2018 Dec 6. Epub 2018 Dec 6.

Division of Cardiology, Toronto General Hospital - University Health Network, Toronto, Ontario, Canada.

Background: Physicians face uncertainty when predicting death in heart failure (HF) leading to underutilisation of palliative care. To facilitate decision-making, we assessed the Seattle Heart Failure Model (SHFM) as a referral tool by evaluating its performance in predicting 1-year event-free survival from death, heart transplant (HTx), and ventricular assist device (VAD) implantation.

Methods: We retrospectively reviewed the charts of consecutive patients with advanced ambulatory HF with New York Heart Association Class III/IV HF and a left ventricular ejection fraction of ≤40% from 2000 to 2016. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001626DOI Listing
December 2018
4 Reads

The liminal space palliative care volunteers occupy and their roles within it: a qualitative study.

BMJ Support Palliat Care 2018 Dec 7. Epub 2018 Dec 7.

End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.

Objectives: Volunteers have an important place in palliative care (PC), positively influencing quality of care for seriously ill people and those close to them and providing a link to the community. However, it is not well understood where volunteers fit into PC provision or how to support them adequately. We therefore chose to describe volunteer roles across care settings through the perspective of those closely involved in the care of terminally ill people. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001632DOI Listing
December 2018
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