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Latest & greatest articles for palliative care
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on palliative care or other clinical topics then use Trip today.
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What do patients receiving palliativecare for cancer and their families want to be told? A Canadian and Australian qualitative study. To obtain feedback from patients receiving palliativecare and their relatives from various ethnic backgrounds about their experiences of the disclosure process and their satisfaction with information sharing during the illness.A qualitative study with semistructured single interviews.Perth, Western Australia, and Winnipeg, Manitoba, Canada.72 participants (...) registered with palliativecare: 21 patient-family dyads in Perth and 14 dyads and 2 patients in Winnipeg.Participants described their experiences in great detail. The analysis indicates that in information sharing the process is as important as the content. The timing, management, and delivery of information and perceived attitude of practitioners were critical to the process. This applied to information interactions at all stages of the illness. Main content areas mentioned related to prognosis
Palliativecare for patients with heart failure. Heart failure accounts for more hospitalizations among Medicare beneficiaries than any other condition. Its symptoms, including shortness of breath, fatigue, and edema, can be frightening and diminish quality of life. Although treatment advances have allowed patients to live longer with a better quality of life, heart failure remains a leading cause of death in the United States. Half of heart failure patients die within 5 years of diagnosis (...) , including symptom management and discussing advance directives, prognosis, and hospice care. By combining optimal medical management with palliativecare, physicians can best care for heart failure patients and their families.
Improving supportive and palliativecare for adults with cancer Guidance on Cancer Services Improving Supportive and PalliativeCare for Adults with Cancer The Manual National Institute for Clinical Excellence NHSImproving Supportive and PalliativeCare for Adults with Cancer Cancer service guidance supports the implementation of The NHS Cancer Plan for England, 1 and the NHS Plan for Wales Improving Health in Wales. 2 The service guidance programme was initiated in 1995 to follow on from (...) and consultation with stakeholders. The recommendations are based on the research evidence that addresses clinical effectiveness and service delivery. While cost impact has been calculated for the main recommendations, formal cost-effectiveness studies have not been performed.Guidance on Cancer Services Improving Supportive and PalliativeCare for Adults with Cancer The Manual Contents Executive summary 3 Introduction A. Aim of this Guidance 15 B. Rationale for developing the Guidance 15 - Burden of cancer 15
What are the palliativecare needs of older people and how might they be met? WHO/Europe | What are the palliativecare needs of older people and how might they be met? S Français Deutsch Pусский M search Databases Interactive atlases Evidence resources European health report Our flagship report maps health trends, charts progress towards achieving health goals and provides an advance base for health policy Resources Social media Events Organization Governance Partners Networks Jobs (...) and internships What are the palliativecare needs of older people and how might they be met? What are the palliativecare needs of older people and how might they be met? Download Summary The issue Ageing populations are characteristic of many countries. The pattern of disease at the end of life is changing and more people are living with serious chronic circulatory and respiratory diseases as well as with cancer. More people will need help at the end of life, in a social context of changing family structure
Overcoming the false dichotomy of curative vs palliativecare for late-stage HIV/AIDS: "let me live the way I want to live, until I can't". Recent advances in human immunodeficiency virus (HIV) therapy have significantly reduced HIV-related mortality in the developed world, but mortality rates have plateaued, and AIDS remains a leading cause of serious illness and death for young adults. The chronic nature of the HIV disease course and the increasing burden of cumulative HIV-related morbidity (...) into a manageable chronic disease, yet at the same time has resulted in a more narrow focus and a de facto separation between disease-specific "curative" and symptom-specific "palliative" care for patients with HIV/AIDS. As patients survive longer in the latter stages of progressive HIV disease, they may in fact have increasing need for comprehensive symptom management as well as wide-ranging need for psychosocial, family, and care planning support. In the HAART era, the false dichotomy of curative vs
A good death in Uganda: survey of needs for palliativecare for terminally ill people in urban areas. To identify the palliativecare needs of terminally ill people in Uganda.Descriptive cross sectional study.Home care programmes in and around Kampala that look after terminally ill people in their homes.173 terminally ill patients registered with the home care programmes.Most of the participants had either HIV/AIDS or cancer or both; 145 were aged under 50 years, and 107 were women. Three main (...) needs were identified: the control or relief of pain and other symptoms; counselling; and financial assistance for basic needs such as food, shelter, and school fees for their children. The preferred site of care was the home, though all these people lived in urban areas with access to healthcare services within 5 km of their homes.A "good death" in a developing country occurs when the dying person is being cared for at home, is free from pain or other distressing symptoms, feels no stigma
Is there evidence that palliativecare teams alter end-of-life experiences of patients and their caregivers? Is there evidence that palliativecare teams alter end-of-life experiences of patients and their caregivers? Is there evidence that palliativecare teams alter end-of-life experiences of patients and their caregivers? Higginson I J, Finlay I G, Goodwin D M, Hood K, Edwards A G, Cook A, Douglas H R, Normand C E CRD summary This review evaluated the effectiveness of palliativecare (...) and hospice care teams compared with conventional care. The authors found only a small positive effect on patient outcomes. The authors used a quantitative synthesis despite the presence of clinical and statistical heterogeneity, so the results should be interpreted with caution. Authors' objectives To evaluate the effectiveness of palliativecare and hospice care teams (PCHCT). Searching MEDLINE, CINAHL, Cancerlit, PsycINFO, EMBASE, PallCare Index, the Cochrane EPOC Register of trials, SIGLE, ASSIA
Doctors' perceptions of palliativecare for heart failure: focus group study. To identify doctors' perceptions of the need for palliativecare for heart failure and barriers to change.Qualitative study with focus groups.North west England.General practitioners and consultants in cardiology, geriatrics, palliativecare, and general medicine.Doctors supported the development of palliativecare for patients with heart failure with the general practitioner as a central figure. They were reluctant (...) to endorse expansion of specialist palliativecare services. Barriers to developing approaches to palliativecare in heart failure related to three main areas: the organisation of health care, the unpredictable course of heart failure, and the doctors' understanding of roles. The health system was thought to work against provision of holistic care, exacerbated by issues of professional rivalry and control. The priorities identified for the future were developing the role of the nurse, better community
Dignity-conserving care--a new model for palliativecare: helping the patient feel valued. The basic tenets of palliativecare may be summarized as the goal of helping patients to die with dignity. The term "dignity" provides an overarching framework that may guide the physician, patient, and family in defining the objectives and therapeutic considerations fundamental to end-of-life care. Dignity-conserving care is care that may conserve or bolster the dignity of dying patients. Using segments (...) of interviews with a patient with advanced lung cancer, his wife, and his palliativecare physician, this article illustrates and explores various aspects of dignity-conserving care and the model on which it is based. Dignity-conserving care offers an approach that clinicians can use to explicitly target the maintenance of dignity as a therapeutic objective and as a principle of bedside care for patients nearing death.
Secondary and tertiary palliativecare in US hospitals. Palliativecare services provide secondary and tertiary levels of palliativecare, the interdisciplinary care of patients in which the goal is comfort and quality of life. Primary palliativecare refers to the basic skills and competencies required of all physicians and other health care professionals. Secondary palliativecare refers to the specialist clinicians and organizations that provide consultation and specialty care. Tertiary (...) palliativecare refers to the academic medical centers where specialist knowledge for the most complex cases is practiced, researched, and taught. The case of Reverend J, a man with advanced cancer admitted to an acute palliativecare unit in a teaching hospital, illustrates the use of secondary and tertiary clinical palliativecare services in hospitals and health care systems.
Do hospital-based palliative teams improve care for patients or families at the end of life? Do hospital-based palliative teams improve care for patients or families at the end of life? Do hospital-based palliative teams improve care for patients or families at the end of life? Higginson I J, Finlay I, Goodwin D M, Cook A M, Hood K, Edwards A G, Douglas H R, Norman C E Authors' objectives To assess the effectiveness of hospital-based palliativecare on the process and outcomes of care (...) for patients and families at the end of life. Searching The databases searched were: MEDLINE from 1977 to 1999; CINAHL from 1982 to 1998; Cancerlit from 1983 to 1999; PsycINFO from 1979 to 1999; EMBASE from 1979 to 1999; PallCare Index (1998); and the Cochrane EPOC Register of trials. The keywords were 'palliative', 'hospice', 'terminal care', 'terminally ill', 'dying', 'end-of-life' and associated terms. These were combined with 'effective', 'evaluate', 'random', 'methods', 'economics', 'statistics
Does truth telling improve psychological distress of palliativecare patients: a systematic review Does truth telling improve psychological distress of palliativecare patients: a systematic review Does truth telling improve psychological distress of palliativecare patients: a systematic review Leliopoulo C, Wilkinson S M, Fellowes D Authors' objectives To identify and review studies that measured whether telling the truth has a positive or negative effect on the patients' psychological (...) distress, and to draw conclusions as to whether truth disclosure is beneficial or not in reducing psychological distress in palliativecare patients. Searching The following databases were searched: MEDLINE from 1966 to December 2001; EMBASE from 1980 to March 2001; PsycINFO from 1966 to April 2001; CINAHL from 1982 to March 2001; Best Evidence from 1991 to January/February 2001; SIGLE from 1980 to January 2001; and the Cochrane Database of Systematic Reviews (Issue 1, 2001). The search terms used
A palliative-care intervention and death at home: a cluster randomised trial. The Palliative Medicine Unit at University Hospital of Trondheim, Norway, started an intervention programme that aims to enable patients to spend more time at home and die there if they prefer. Close cooperation was needed with the community health-care professionals, who acted as the principal formal caregivers, and a multidisciplinary consultant team coordinated the care. We did a cluster randomised trial to assess (...) controls died at home (54 [25%] vs 26 [15%], p<0.05). The time spent at home was not significantly increased, although intervention patients spent a smaller proportion of time in nursing homes in the last month of life than did controls (7.2 vs 14.6%, p<0.05). Hospital use was similar in the two groups.The palliative-care intervention enabled more patients to die at home. More resources for care in the home (palliativecare training and staff) and an increased focus on use of nursing homes would
The impact of different models of specialist palliativecare on patients' quality of life: a systematic literature review The impact of different models of specialist palliativecare on patients' quality of life: a systematic literature review The impact of different models of specialist palliativecare on patients' quality of life: a systematic literature review Salisbury C, Bosanquet N, Wilkinson E K, Franks P J, Kite S, Lorentzon M, Naysmith A Authors' objectives To assess the impact (...) of different models of specialist palliativecare on the quality of life of patients. Searching Electronic searches were conducted of the following databases in 1997 for articles published since 1978: MEDLINE, EMBASE, Index of Scientific and Technical Proceedings, the Cochrane Library, SIGLE, NHS Project Research System, Health Planning and Administration, Cancerlit and DHSS data. EMBASE, MEDLINE and the Cochrane Library searches were updated to June 1998. Details of the search strategy were given
Patient and carer preference for, and satisfaction with, specialist models of palliativecare: a systematic literature review Patient and carer preference for, and satisfaction with, specialist models of palliativecare: a systematic literature review Patient and carer preference for, and satisfaction with, specialist models of palliativecare: a systematic literature review Wilkinson E K, Salisbury C, Bosanquet N, Franks P J, Kite S, Lorentzon M, Naysmith A Authors' objectives To examine (...) the impact of specialist models of palliativecare on consumer satisfaction, opinion and preference. Searching Electronic searches of the following databases were carried out (1978-June 1998): MEDLINE; EMBASE; Index of scientific and technical proceedings; the Cochrane Library; SIGLE (Index of grey literature); NHS Project Research System. Details of the search strategies were provided. The following journals were handsearched (June 1992-June 1996): the Hospice Journal; Palliative Medicine; Journal
Treatment of locally advanced pancreatic carcinoma in Sweden: a health economic comparison of palliative treatment with best supportive care versus palliative treatment with gemcitabine in combination with best supportive care Treatment of locally advanced pancreatic carcinoma in Sweden: a health economic comparison of palliative treatment with best supportive care versus palliative treatment with gemcitabine in combination with best supportive care Treatment of locally advanced pancreatic (...) carcinoma in Sweden: a health economic comparison of palliative treatment with best supportive care versus palliative treatment with gemcitabine in combination with best supportive care Ragnarson-Tennvall G, Wilking N Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study
Are some palliativecare delivery systems more effective and efficient than others: a systematic review of comparative studies Are some palliativecare delivery systems more effective and efficient than others: a systematic review of comparative studies Are some palliativecare delivery systems more effective and efficient than others: a systematic review of comparative studies Critchley P, Jadad A R, Taniguchi A, Woods A, Stevens R, Reyno L, Whelan T J Authors' objectives To assess (...) the effectiveness of different models of palliativecare delivery systems. Searching The following sources were searched to March 1997: MEDLINE (from 1966), HealthSTAR (from 1975), CINAHL (from 1982), Cancerlit (from 1982), and the Cochrane Library (Issue 2, 1997). Search strategies, which were adapted for all databases, included the terms 'palliat', 'hospice', 'terminally ill', 'end stage disease' and 'delivery of health care'. In addition, the reference lists of available texts and retrieved articles were
Does hospital at home for palliativecare facilitate death at home? Randomised controlled trial. To evaluate the impact on place of death of a hospital at home service for palliative care.Pragmatic randomised controlled trial.Former Cambridge health district.229 patients referred to the hospital at home service; 43 randomised to control group (standard care), 186 randomised to hospital at home.Hospital at home versus standard care.Place of death.Twenty five (58%) control patients died at home (...) characteristics of the patients admitted to the service. The study attained less statistical power than initially planned.In a locality with good provision of standard community care we could not show that hospital at home allowed more patients to die at home, although neither does the study refute this. Problems relating to recruitment, attrition, and the vulnerability of the patient group make randomised controlled trials in palliativecare difficult. While these difficulties have to be recognised
Do specialist palliativecare teams improve outcomes for cancer patients: a systematic literature review Do specialist palliativecare teams improve outcomes for cancer patients: a systematic literature review Do specialist palliativecare teams improve outcomes for cancer patients: a systematic literature review Hearn J, Higginson I J Authors' objectives To determine whether there is any evidence that the management of patents with advanced cancer by coordinated or multiprofessional teams (...) , which provide specialist palliativecare, improves the quality of care of these patients and their families. Searching The following databases were searched: MEDLINE from 1980 to 1996; PsycINFO from 1984 to 1996; CINAHL from 1982 to 1996; and BIDS, EMBASE, Social SciSearch and IBSS, from 1992 to 1996. The search terms were provided in the paper. Palliative Medicine, Journal of PalliativeCare and Progress in PalliativeCare were handsearched from their first issues to the end of 1996. Two Internet
Bus rounds for palliativecare education in the community Bus rounds for palliativecare education in the community Bus rounds for palliativecare education in the community Bruera E, Selmser P, Pereira J, Brenneis C Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study (...) and the conclusions drawn. Health technology Bus rounds for palliativecare education. Type of intervention Education of palliativecare specialists, family doctors and medical students. Economic study type Cost-effectiveness analysis. Study population Physicians and nurse palliativecare consultants, family doctors, medical students. Setting Community. The economic study was carried out in Alberta, Canada. Dates to which data relate Effectiveness and resource use data related to the period February 1996