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Cultural conceptualizations of hospice palliative care: More similarities than differences.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The role of culture is significant in hospice palliative care (HPC). While mainstream HPC has been well described in many Western countries, there is no conceptual clarity regarding the meaning of HPC among minority cultures and ethnicities. In this article we describe and critically appraise the findings of a literature synthesis of 15 qualitative studies regarding the conceptualization of HPC among culturally diverse populations. Three primary themes emerged regarding HPC. They highlight: (i) that HPC should attend to the physical, psychosocial and spiritual aspects of death and dying; (ii) that the ideal HPC provide...
Source: Palliative Medicine - November 12, 2009 Category: Palliative Care Authors: Bosma H, Apland L, Kazanjian A Tags: Palliat Med Source Type: journals

Can you hear me now? The experience of a deaf family member surrounding the death of loved ones.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians. PMID: 19910395 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - November 12, 2009 Category: Palliative Care Authors: Kehl KA, Gartner CM Tags: Palliat Med Source Type: journals

The intravenous to oral relative milligram potency ratio of morphine during chronic dosing in cancer pain.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Morphine (M) is the opioid analgesic of choice for severe cancer pain. The IV to PO M equipotent switch ratio (CR) is controversial. We designed this prospective observational cohort to confirm the efficacy and safety of M IV to PO CR of 1:3. Consecutive cancer patients admitted to an inpatient palliative medicine unit were screened for inclusion. Pain was managed by palliative medicine specialists. They were blinded to the patient data collected, and the calculated CR. The switch was considered successful if the following criteria were met: (1) Pain adequately controlled: pain rated as none or mild (2) Number of RD le...
Source: Palliative Medicine - November 12, 2009 Category: Palliative Care Authors: Lasheen W, Walsh D, Mahmoud F, Sarhill N, Rivera N, Davis M, Lagman R, Legrand S Tags: Palliat Med Source Type: journals

Oncologist patient-centered communication with patients with advanced cancer: Exploring whether race or socioeconomic status matter.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19910397 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - November 12, 2009 Category: Palliative Care Authors: Pollak K, Alexander SC, Grambow SC, Tulsky JA Tags: Palliat Med Source Type: journals

Evaluation of quality-of-life measures for use in palliative care: A systematic review.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Many measurement instruments were identified, but most had not yet been adequately evaluated. The evaluation of existing instruments with good content validity should have priority over the development of new instruments. PMID: 19843620 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - October 19, 2009 Category: Palliative Care Authors: Albers G, Echteld MA, de Vet HC, Onwuteaka-Philipsen BD, van der Linden MH, Deliens L Tags: Palliat Med Source Type: journals

Creating social work competencies for practice in hospice palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes and critically appraises the findings of a literature synthesis of 15 qualitative studies regarding the conceptualization of HPC among culturally diverse populations. Three primary themes emerged regarding HPC. They highlight i) that HPC should attend to the physical, psychosocial and spiritual aspects of death and dying; ii) that the ideal HPC provider demonstrates excellent knowledge and expertise about end of life care, and is respectful, genuine and compassionate; and (iii), that HPC should include a range of resources that alleviate the potential burdens associated with end of life care. The syn...
Source: Palliative Medicine - October 19, 2009 Category: Palliative Care Authors: Bosma H, Johnston M, Cadell S, Wainwright W, Abernethy N, Feron A, Kelley ML, Nelson F Tags: Palliat Med Source Type: journals

The pragmatic use of apomorphine at the end of life.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Parkinson's Disease (PD) is an irreversible degenerative neurological disorder with no known cure. Apomorphine is a potent short-acting D1/D2 dopamine agonist administered sub-cutaneously that is used in the treatment of PD. Optimising PD medication is an important aspect of end of life care. There are no previously reported cases of apomorphine providing symptom relief in terminal care of PD patients. This case highlights its potential benefits for symptom control at the end of life. PMID: 19837701 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - October 15, 2009 Category: Palliative Care Authors: Dewhurst F, Lee M, Wood B Tags: Palliat Med Source Type: journals

Costs associated with resource utilization during the palliative phase of care: a Canadian perspective.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Such results provide a comprehensive picture of costs related to palliative care in Canada, by specifying the cost sharing between the PHCS, the family, and NFPO. PMID: 19837702 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - October 15, 2009 Category: Palliative Care Authors: Dumont S, Jacobs P, Fassbender K, Anderson D, Turcotte V, Harel F Tags: Palliat Med Source Type: journals

What progress has been made towards implementing national guidance on end of life care? A national survey of UK general practices.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objectives of this study were to establish the extent to which UK primary care has adopted recommended practices on supportive and palliative care of adults with cancer, and to relate this to participation in national initiatives. We conducted a cross-sectional postal questionnaire survey of a random sample of UK general practices. In total, 60.0% of practices (2096 of 3495) responded to the survey: 61.5% reported involvement with the Gold Standards Framework (GSF); 24.4% with the Liverpool or other End of Life Care Pathway; 12.3%, with the Preferred Place of Care (PPC) initiative; and 8.4% with Advance Care Planning (...
Source: Palliative Medicine - October 15, 2009 Category: Palliative Care Authors: Hughes PM, Bath PA, Ahmed N, Noble B Tags: Palliat Med Source Type: journals

Preliminary report of the integration of a palliative care team into an intensive care unit.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nearly half of Americans who die in hospitals spend time in the intensive care unit (ICU) in the last 3 days of life. Minority patients who die in the ICU are less likely to formalize advance directives and surviving family members report lower satisfaction with the provision of information and sensitivity to their cultural traditions at the end-of-life. This is a descriptive report of a convenience sample of 157 consecutive patients served by a palliative care team which was integrated into the operations of an ICU at Montefiore Medical Center in the Bronx, New York, from August 2005 until August 2007. The team includ...
Source: Palliative Medicine - October 12, 2009 Category: Palliative Care Authors: O'Mahony S, McHenry J, Blank AE, Snow D, Karakas SE, Santoro G, Selwyn P, Kvetan V Tags: Palliat Med Source Type: journals

Depression assessment and classification in palliative cancer patients: a systematic literature review.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this study was to review the literature on depression in palliative cancer care in order to identify which assessment methods and classification systems have been used in studies of depression. Extensive electronic database searches in PubMed, CancerLit, CINAHL, PsychINFO, EMBASE and AgeLine as well as hand search were carried out. In the 202 included papers, 106 different assessment methods were used. Sixty-five of these were only used once. All together, the Hospital Anxiety and Depression Scale (HADS) was the most commonly used assessment method. However, there were regional differences and while the HA...
Source: Palliative Medicine - October 12, 2009 Category: Palliative Care Authors: Wasteson E, Brenne E, Higginson IJ, Hotopf M, Lloyd-Williams M, Kaasa S, Loge JH Tags: Palliat Med Source Type: journals

Collaborating or co-existing: a survey of attitudes of medical oncologists toward specialist palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study is the first to specifically investigate the views of Australian medical oncologists toward collaboration with specialist palliative care. While positive attitudes have been expressed, identified barriers to collaboration need attention. PMID: 19825895 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - October 12, 2009 Category: Palliative Care Authors: Ward AM, Agar M, Koczwara B Tags: Palliat Med Source Type: journals

Intranasal alfentanil for severe intractable angina in inoperable coronary artery disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe a case study where intranasal alfentanil provided rapid relief of symptoms preventing repeated hospital admissions. PMID: 19825896 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - October 12, 2009 Category: Palliative Care Authors: Osborn H, Jefferson M Tags: Palliat Med Source Type: journals

Living with advanced chronic obstructive pulmonary disease: patients concerns regarding death and dying.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study explores the experiences of patients with COPD, particularly fears surrounding death and dying. Semi-structured interviews were conducted with 21 patients with moderate or severe COPD. Findings revealed that patient understanding of COPD was poor, most patients were unaware of the progressive nature of the condition, and few were aware they could die of COPD. Despite this, patients often expressed concerns that their condition might deteriorate. Patients had particular concerns regarding the manner of their death; the overriding fear was dying of breathlessness or suffocation. None of the patients' had discussed...
Source: Palliative Medicine - October 12, 2009 Category: Palliative Care Authors: Gardiner C, Gott M, Small N, Payne S, Seamark D, Barnes S, Halpin D, Ruse C Tags: Palliat Med Source Type: journals

Room for improvement? A quality of life assessment in patients with malignant bowel obstruction.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This prospective study followed 35 patients admitted to hospital with malignant bowel obstruction (MBO) to evaluate quality of life (QOL). Subjects completed the Edmonton Symptom Assessment Scale (ESAS) and Rotterdam Symptom Checklist (RSCL) at recruitment, and at one week, one month and three months.The highest ranked ESAS scores at recruitment (which was generally 18-36 hours post admission to hospital) included loss of appetite (median=7.5), fatigue (6.5) and overall well-being (6.0). The total ESAS score improved by 7.5, 11.5 and 11.0 points respectively at one week, one month and three months (p<0.05, p<0.01...
Source: Palliative Medicine - September 30, 2009 Category: Palliative Care Authors: Selby D, Wright F, Stilos K, Daines P, Moravan V, Gill A, Chakraborty A Tags: Palliat Med Source Type: journals

Quantifying the impact of standardized assessment and symptom management tools on symptoms associated with cancer-induced anorexia cachexia syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this study was to quantify the impact of standardized assessment and management tools on patient symptom scores in cancer-induced anorexia cachexia syndrome (ACS) using a within-group study design. Baseline assessments included the Patient Generated Subjective Global Assessment (PG-SGA) tool and an amended Symptoms and Concerns Checklist (SCC). Symptom management strategies, written for this project, were instigated. Follow-up SCC scores were collected at 2 and 4 weeks. Forty out of 79 patients referred were recruited; 29/79 (36.7%) were too unwell or had died prior to consent. At baseline, the PG-SGA tool...
Source: Palliative Medicine - September 30, 2009 Category: Palliative Care Authors: Hawkins C, Waterfield K, Hildreth AJ, Kirkpatrick G, Andrew IM Tags: Palliat Med Source Type: journals

French general practitioners vary in their attitudes toward treating terminally ill patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The purpose of this study is to analyze French general practitioners' attitudes toward prescribing opiate painkillers for dying patients and compare them with their attitudes toward making frequent home visits. One hundred and fifteen general practitioners indicated the acceptability of prescribing opiates in 48 scenarios of terminal cancer patients with different levels of age, gender, stated pain, request for painkillers, and signs of depression; 103 of them also indicated the acceptability of making frequent home visits in the same 48 scenarios. The responses were analyzed using analysis of variance and cluster anal...
Source: Palliative Medicine - September 30, 2009 Category: Palliative Care Authors: Mas C, Albaret MC, Sorum P, Mullet E Tags: Palliat Med Source Type: journals

Bereavement needs assessment in specialist palliative care: a review of the literature.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bereavement needs assessment for specialist palliative care services has been highlighted as important by NICE guidance on palliative care for adults with cancer. Identifying and implementing appropriate bereavement measurement tools has remained a challenge. This paper identifies and reviews bereavement measurement tools to determine their suitability for use within bereavement services and hospice settings. Cochrane, MEDLINE, PsycINFO and CINAHL, electronic databases were searched, yielding 486 papers. From fifty-nine full text papers appraised, 10 measurement tools were analysed in detail. Some tools had been tested...
Source: Palliative Medicine - September 16, 2009 Category: Palliative Care Authors: Agnew A, Manktelow R, Taylor BJ, Jones L Tags: Palliat Med Source Type: journals

Governance in changing times: the experiences of hospice trustees in the United Kingdom.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hospice trustees are volunteers who are vital to the governance and management of independent, charitable hospices, yet little is known about their roles and concerns. This paper presents some findings from a qualitative study which explored the views and perspectives of hospice trustees in the UK. Twenty hospice trustees took part in semi-structured telephone interviews, which were analysed using an iterative thematic approach. Nine themes emerged from the analysis, and were grouped into two major categories. One theme, 'becoming a trustee', is presented in this paper to illustrate trustees' concerns about the challen...
Source: Palliative Medicine - September 16, 2009 Category: Palliative Care Authors: Turner M, Payne S Tags: Palliat Med Source Type: journals

Adverse events arising from a palliative care survey.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article explores the nature of the adverse responses to the survey. The majority of complaints were received from family members rather than from patients. Complaints described dissatisfaction with the topic, little warning about the study and felt it to be inappropriate for their family member's level of health. Survey instruments used to determine attitudes and needs in relation to end-of-life patient care are likely to elicit adverse responses that should be reported in a similar way to other investigational studies. Also arising from adverse responses and the complaint process, is the impact of criticism on study ...
Source: Palliative Medicine - July 30, 2009 Category: Palliative Care Authors: Braithwaite M, Philip J, Finlayson F, Tranberg H, Gold M, Kotsimbos T, Wilson J Tags: Palliat Med Source Type: journals

Barriers to advance care planning in chronic obstructive pulmonary disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The English End of Life Care Strategy promises that all patients with advanced, life limiting illness will have the opportunity to participate in Advance Care Planning (ACP). For patients with Chronic Obstructive Pulmonary Disease (COPD), the barriers to this being achieved in practice are under-explored. Five focus groups were held with a total of 39 health care professionals involved in the care of patients with COPD. Participants reported that discussions relating to ACP are very rarely initiated with patients with COPD and identified the following barriers: inadequate information provision about the likely course o...
Source: Palliative Medicine - July 30, 2009 Category: Palliative Care Authors: Gott M, Gardiner C, Small N, Payne S, Seamark D, Barnes S, Halpin D, Ruse C Tags: Palliat Med Source Type: journals

The palliative care knowledge test: reliability and validity of an instrument to measure palliative care knowledge among health professionals.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study used psychometric methods such as item response theory and intraclass correlation coefficients. Ultimately, 20 items in 5 domains including 'philosophy', 'pain', 'dyspnoea', 'psychiatric problems" and 'gastrointestinal problems' were selected. For these items, the intraclass correlation was 0.88 overall and 0.61-0.82 in each domain; the Kuder-Richardson formula 20 in internal consistency was 0.81. Validity and reliability of the instrument were established. This tool is designed to evaluate a wider range of palliative care knowledge than currently available assessments and can be used for general physicians and ...
Source: Palliative Medicine - July 30, 2009 Category: Palliative Care Authors: Nakazawa Y, Miyashita M, Morita T, Umeda M, Oyagi Y, Ogasawara T Tags: Palliat Med Source Type: journals

Modafinil for attentional and psychomotor dysfunction in advanced cancer: a double-blind, randomised, cross-over trial.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cognitive impairment seems to be highly prevalent in patients with advanced cancer. Modafinil, a novel vigilance and wake-promoting agent, may be an alternative treatment. We wanted to investigate this treatment on attentional and psychomotor dysfunction in cancer patients. 28 cancer patients with a tiredness score of 50 mm or more on a scale of 0 to 10 (0 = no tiredness, 10 = worst possible tiredness) and Karnofsky Performance Status 40-70 were included. All medications were kept stable during the trial despite short acting opioids for breakthrough pain. On day 1 the patients were randomly assigned to receive 200 mg M...
Source: Palliative Medicine - July 30, 2009 Category: Palliative Care Authors: Lundorff L, Jønsson B, Sjøgren P Tags: Palliat Med Source Type: journals

Can ketamine prescribed for pain cause damage to the urinary tract?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Presentation of three palliative care patients who were given ketamine as an analgesic and subsequently developed significant and debilitating urological symptoms. In one patient there was resolution of symptoms following cessation of ketamine, but some symptoms persisted until death in the other two. Possible mechanisms for damage to the urothelium by ketamine are suggested. PMID: 19648225 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - July 30, 2009 Category: Palliative Care Authors: Storr T, Quibell R Tags: Palliat Med Source Type: journals

Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article explores perceptions of service users and key stakeholders of palliative care services about problems encountered in journeys between care settings during end-of-life care. This article draws on data from interviews with stakeholders (n = 44), patients (n = 16), carers (n = 19) and bereaved carers (n = 20); and focus groups (n = 9) with specialist nurses. Data were gathered in three areas of the United Kingdom. Data were analysed using a framework approach. Transport problems between care settings emerged as a key theme. Four particular problems were identified: (1) urgent need for transport due to patients' r...
Source: Palliative Medicine - July 29, 2009 Category: Palliative Care Authors: Ingleton C, Payne S, Sargeant A, Seymour J Tags: Palliat Med Source Type: journals

Reliability and validity of Japanese version of the McGill Quality of Life Questionnaire assessed by application in palliative care wards.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The McGill Quality of Life Questionnaire (MQOL), which consists of 16 items constructing physical, psychological, existential and support subscales and one item of overall quality of life (QOL), has been developed to assess QOL of terminal cancer patients. To examine if MQOL Japanese version (MQOL-J) is applicable, it was administered to 83 terminal cancer patients in palliative care wards several days after admission and then 7 to 10 days after the first interview. Cronbach's alpha coefficient for four subscales was 0.584-0.860. Sixteen items were classified into four factors by factor analysis, similar to the origina...
Source: Palliative Medicine - July 29, 2009 Category: Palliative Care Authors: Tsujikawa M, Yokoyama K, Urakawa K, Onishi K Tags: Palliat Med Source Type: journals

Reporting end-of-life practice: can we trust doctors to be honest?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19643952 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - July 29, 2009 Category: Palliative Care Authors: Draper H, Ives J, Pall H, Smith S, Damery S, Wilson S Tags: Palliat Med Source Type: journals

Nurses' attitudes towards end-of-life decisions in medical practice: a nationwide study in Flanders, Belgium.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, nurses accept a wide variety of ELDs being practiced with terminally ill patients. PMID: 19605604 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - July 14, 2009 Category: Palliative Care Authors: Inghelbrecht E, Bilsen J, Mortier F, Deliens L Tags: Palliat Med Source Type: journals

Prioritising drugs for single patient (n-of-1) trials in palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many of the drugs prescribed commonly to palliative care patients have potentially significant side-effects and are of unproven benefit. The acquisition of evidence to support the prescribing of these drugs has been very slow. Single patient trials (SPTs) (also known as n-of-1 trials) offer a potential means of obtaining the evidence necessary to support or refute the use of several of the drugs and interventions whose use is currently based on physician experience or anecdote alone. A list of SPTs considered "most urgent", for commonly employed treatments and for the most common and most troublesome symptoms in pallia...
Source: Palliative Medicine - July 14, 2009 Category: Palliative Care Authors: Nikles J, Mitchell G, Walters J, Hardy J, Good P, Rowett D, Shelby-James T, Currow D Tags: Palliat Med Source Type: journals

Clinical findings and recommendations made during home visits by a palliative care specialist physician.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Little has been reported regarding the nature of home visits by palliative care specialist physicians to assist in the management of complex cases. We determined the characteristics, actionable clinical findings and recommendations made during consecutive home visits conducted by a specialist physician for patients registered with a community palliative care service. Patient demographic information and clinical records were reviewed. Ninety-one patients received a total of 104 home and residential facility visits. Median patient age was 59 (Q1-Q3, 43-72). Ten children (under the age of 14) received a total of 15 visits...
Source: Palliative Medicine - July 5, 2009 Category: Palliative Care Authors: Bush SH, Wearne HJ, Reilly PE, Chacko R, Palmer JL Tags: Palliat Med Source Type: journals

Suffering and healing--our core business.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19528137 [PubMed - in process] (Source: Palliative Medicine)
Source: Palliative Medicine - June 28, 2009 Category: Palliative Care Authors: George R Tags: Palliat Med Source Type: journals

An evaluation of the implementation of a programme to improve end-of-life care in nursing homes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Gold Standards Framework in Care Homes programme aims to improve the quality of end-of-life care for residents. The impact of introducing phase 2 of the programme to homes in England was evaluated. A pre-post survey design was adopted, focusing on indicators identified as markers of good end-of-life care. The 95 homes in phase 2 of the programme were invited to participate in the evaluation. Homes completed a baseline survey of care provision and an audit of the five most recent resident deaths. The survey and audit were repeated post programme completion. Forty-nine homes returned completed pre- and post-surveys, ...
Source: Palliative Medicine - June 3, 2009 Category: Palliative Care Authors: Badger F, Clifford C, Hewison A, Thomas K Tags: Palliat Med Source Type: journals

The use of artificial nutrition among cancer patients enrolled in palliative home care services.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion the results suggest that, contrary to existing guidelines, HPN is used to supplement oral intake, and not only for patients with a non-functioning gastrointestinal tract. PMID: 19477887 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - June 3, 2009 Category: Palliative Care Authors: Orrevall Y, Tishelman C, Permert J, Cederholm T Tags: Palliat Med Source Type: journals

Methodological review: measured and reported congruence between preferred and actual place of death.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We examined methods of measuring and reporting congruence to highlight variations impairing cross-study comparisons. Medline, PsychInfo, CINAHL, and Web of Science were systematically searched for clinical research studies examining patient preference and congruence as an outcome. Data were extracted into a matrix, including purpose, reported congruence, and method for eliciting preference. Studies were graded for quality. Using tables of preferred versus actual places of death, an overall congruence (total met preferences out of total preferences) and a kappa statistic of agreement were determined for each study. Twelve s...
Source: Palliative Medicine - June 3, 2009 Category: Palliative Care Authors: Bell C, Somogyi-Zalud E, Masaki K Tags: Palliat Med Source Type: journals

End-of-life decisions in the UK: a response to van der Heide and colleagues.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19494056 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - June 3, 2009 Category: Palliative Care Authors: Seale C Tags: Palliat Med Source Type: journals

Ratings of symptoms and comfort in dementia patients at the end of life: comparison of nurses and families.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
After-death reporting by proxies on end-of-life outcomes is used in research and can also be used to target institutions directly to improve practice. We compared the scores of family caregivers and nurses on two End-of-Life in Dementia Scales (EOLD) scales: Symptom Management (SM; range 0-45) over the last 3 months of life and Comfort Assessment in Dying (CAD; range 14-42). Higher scores represent better outcomes. Four Dutch nursing homes retrospectively enrolled 48 decedents with dementia. Total mean scores for family caregivers and nurses were 28.7 (SD 9.6) versus 25.2 (SD 12.7) for the SM and 31.7 (SD 5.5) versus 3...
Source: Palliative Medicine - June 1, 2009 Category: Palliative Care Authors: van der Steen JT, Gijsberts MJ, Knol DL, Deliens L, Muller MT Tags: Palliat Med Source Type: journals

Key stakeholders' experiences and views of the NHS End of Life Care Programme: findings from a national evaluation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reports on the qualitative interview component of a national evaluation of the NHS End of Life Care Programme. It describes and discusses the views and experiences of 37 stakeholders of the Programme in relation to its development and implementation, impact and sustainability. The sample comprises individuals holding different roles in, and contrasting views and experiences of the Programme, and from various locations in England. Overall, the aims, approach and impact of the Programme were described positively, although concerns about achieving sustainability were widespread. The extent of support for the Prog...
Source: Palliative Medicine - June 1, 2009 Category: Palliative Care Authors: Kennedy S, Seymour J, Almack K, Cox K Tags: Palliat Med Source Type: journals

End-of-life decisions in the United Kingdom.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19477884 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 28, 2009 Category: Palliative Care Authors: van der Heide A, Onwuteaka-Philipsen B, Deliens L, van Delden J, van der Maas P Tags: Palliat Med Source Type: journals

End-of-life care in hospital: a descriptive study of all inpatient deaths in 1 year.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objectives of this study are to ascertain how many patients who died in a district general hospital in England might have been able to be cared for at home, to obtain the cost of each inpatient stay, to make an estimate of the maximum resource implications of care packages for these patients, and to calculate the savings in hospital admissions that could be used for the development of community services. These objectives are dependant on full implementation of the End of Life Strategy. A descriptive study of all inpatient deaths in one year in a district general hospital in the south west of England was conducted. Data...
Source: Palliative Medicine - May 28, 2009 Category: Palliative Care Authors: Abel J, Rich A, Griffin T, Purdy S Tags: Palliat Med Source Type: journals

On dying and human suffering.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will explain that the experience of dying benefits from being situated and analysed in a broader context of cultural experience, as suggested by the theory and study of human suffering. Conversely, the theory and methods involved in studies of human suffering can gain from a mortal view of vulnerability, grief, social ambiguity and identity changes characteristic of experiences at the end of life. PMID: 19477888 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 28, 2009 Category: Palliative Care Authors: Kellehear A Tags: Palliat Med Source Type: journals

Physician factors associated with outpatient palliative care referral.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care progr...
Source: Palliative Medicine - May 21, 2009 Category: Palliative Care Authors: Ahluwalia S, Fried T Tags: Palliat Med Source Type: journals

Are end-of-life patient education materials readable?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although established guidelines for developing low-literacy patient education materials are available, poorly designed material continue to be disseminated. We evaluated the readability and layout of English-language end-of-life patient education materials available on the Internet. Internet websites of five national palliative care organizations were searched to identify patient education materials for review. A convenience sample of 15 patient education materials per palliative care organization (n = 75) was downloaded and printed. The Simplified Measure of Gobbledygook (SMOG) was used to calculate the reading grade ...
Source: Palliative Medicine - May 21, 2009 Category: Palliative Care Authors: Ache K, Wallace L Tags: Palliat Med Source Type: journals

Liverpool care pathway carers survey.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19460832 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 21, 2009 Category: Palliative Care Authors: Mullick A, Beynon T, Colvin M, Morris M, Shepherd L, Cave L, Lowell J, Asmall N, Carey I Tags: Palliat Med Source Type: journals

End-of-life decisions in the United Kingdom involving medical practitioners and legalisation of euthanasia or physician-assisted suicide: survey of doctors' attitudes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19460833 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 21, 2009 Category: Palliative Care Authors: Grogan E, Beattie R, Campbell C, George R, Harlow T, Macgregor B, Oliver D, Thorns A, Noble B Tags: Palliat Med Source Type: journals

An integrated model of provision of palliative care to patients with cystic fibrosis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report our experience of the terminal care of 40 patients with CF with regard to the circumstances of death, lung transplantation status, specific symptoms and provision of palliative treatments. The transition from disease modifying treatments to palliative care was particularly complex. Patients had a high level of symptoms requiring palliation and most died in hospital. Palliative care is a crucial component of a CF service and requires the specialist skills of both the CF and palliative care teams. PMID: 19460834 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 21, 2009 Category: Palliative Care Authors: Bourke S, Doe S, Gascoigne A, Heslop K, Fields M, Reynolds D, Mannix K Tags: Palliat Med Source Type: journals

Improving training in spiritual care: a qualitative study exploring patient perceptions of professional educational requirements.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study provides 'palliative patient' perspectives to strengthen recommended models of spiritual care delivery. It shows that user opinions on training can be helpful not only in deciding objectives but also how to achieve them. PMID: 19443521 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 14, 2009 Category: Palliative Care Authors: Yardley S, Walshe C, Parr A Tags: Palliat Med Source Type: journals

What do patients with brain metastases from non-small cell lung cancer want from their treatment?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Brain metastases are a common complication of non-small cell lung cancer (NSCLC). Prognosis is poor and the effectiveness of whole brain radiotherapy (WBRT) is uncertain for patients with moderate performance status. Studies on WBRT effectiveness have thus far used outcome measures, such as survival, performance status and cognitive function. The aim of this study was to study what patients with recently diagnosed brain metastases from NSCLC want from their treatment. We carried out semistructured interviews with nine patients with brain metastases from NSCLC, for whom the benefit of WBRT is uncertain. Interpretative p...
Source: Palliative Medicine - May 14, 2009 Category: Palliative Care Authors: Dorman S, Hayes J, Pease N Tags: Palliat Med Source Type: journals

UK doctors' attitudes to the legalisation of assisted suicide.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19443523 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - May 14, 2009 Category: Palliative Care Authors: Lee W, Price A, Rayner L, Hotopf M Tags: Palliat Med Source Type: journals

'They're part of the team': participant evaluation of the ACTIVE intervention.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study used participant feedback to qualitatively evaluate an intervention (Assessing Caregivers for Team Intervention through Videophone Encounters [ACTIVE]) that used videophone technology to include patients and/or their family caregivers in hospice interdisciplinary team meetings. Data were generated during individual interviews with hospice staff members and family caregivers who participated in ACTIVE intervention. Modified grounded theory procedures served as the primary analysis strategy. Results indicated that ACTIVE intervention enhanced team functioning in terms of context, structure, processes and outcomes....
Source: Palliative Medicine - May 14, 2009 Category: Palliative Care Authors: Oliver D, Washington K, Wittenberg-Lyles E, Demiris G, Porock D Tags: Palliat Med Source Type: journals

Symptoms and problems in a nationally representative sample of advanced cancer patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Little is known about the need for palliative care among advanced cancer patients who are not in specialist palliative care. The purpose was to identify prevalence and predictors of symptoms and problems in a nationally representative sample of Danish advanced cancer patients. Patients with cancer stage 3 or 4 from 54 hospital departments (n = 1630) received the EORTC QLQ-C30 questionnaire. Mean scores were calculated according to the scoring manual and in addition a 'symptom/problem' and a 'severe symptom/problem' was defined and calculated. Multiple logistic regression was used to identify predictors. In total, 977 (...
Source: Palliative Medicine - May 14, 2009 Category: Palliative Care Authors: Johnsen A, Petersen M, Pedersen L, Groenvold M Tags: Palliat Med Source Type: journals