Latest & greatest articles for palliative care

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Top results for palliative care

101. Researching children's perspectives in pediatric palliative care: A systematic review and meta-summary of qualitative research. (Abstract)

Researching children's perspectives in pediatric palliative care: A systematic review and meta-summary of qualitative research. Qualitative research is pivotal in gaining understanding of individuals' experiences in pediatric palliative care. In the past few decades, the number of qualitative studies on pediatric palliative care has increased slightly, as has interest in qualitative research in this area. Nonetheless, a limited number of such studies have included the first-person perspective (...) of children. The aim of this article is to understand the contribution of previous qualitative research on pediatric palliative care that included the voices of children.A systematic review of qualitative studies and a meta-summary were conducted. MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and ERIC were searched without limitations on publication date or language. Eligible articles were qualitative research articles in which the participants were children ranging in age from 3 to 18 years.ResultWe retrieved

2019 Palliative & supportive care

102. Electronic palliative care coordination systems (EPaCCS): a systematic review. (Full text)

Electronic palliative care coordination systems (EPaCCS): a systematic review. To systematically search, evaluate and report the state of the science of electronic palliative care coordination systems (EPaCCS).We searched CINAHL, MEDLINE, Embase, the Cochrane Library and grey literature for articles evaluating or discussing electronic systems to facilitate sharing of information about advance care plans. Two independent review authors screened full-text articles for inclusion, assessed quality

2019 BMJ Supportive & Palliative Care PubMed abstract

103. Aromatherapy, massage and reflexology: A systematic review and thematic synthesis of the perspectives from people with palliative care needs. (Full text)

Aromatherapy, massage and reflexology: A systematic review and thematic synthesis of the perspectives from people with palliative care needs. Effectiveness evidence of complementary therapies in people with advanced disease is uncertain, and yet people are still keen to engage in complementary therapy. Insights into people's experiences of complementary therapy in palliative care, the perceived benefits, and how they want it delivered, can inform clinical guidelines and suggest ways to test (...) therapies more appropriately in future evaluations.Explore in people with advanced disease (1) the experiences and perceptions of benefits and harms of aromatherapy, massage, and reflexology and (2) how they would like these therapies delivered.A systematic review and thematic synthesis of qualitative studies. Database search terms were related to palliative care, aromatherapy, reflexology and massage. Citations and full texts were reviewed independently against predefined inclusion criteria. Studies

2019 Palliative medicine PubMed abstract

104. Palliative care for people with dementia living at home: A systematic review of interventions. (Full text)

Palliative care for people with dementia living at home: A systematic review of interventions. The European Association for Palliative Care White Paper defined optimal palliative care in dementia based on evidence and expert consensus. Yet, we know little on how to achieve this for people with dementia living and dying at home.To examine evidence on home palliative care interventions in dementia, in terms of their effectiveness on end-of-life care outcomes, factors influencing implementation (...) , the extent to which they address the European Association for Palliative Care palliative care domains and evidence gaps.A systematic review of home palliative care interventions in dementia.The review adhered to the PRISMA guidelines and the protocol was registered with PROSPERO (CRD42018093607). We searched four electronic databases up to April 2018 (PubMed, Scopus, Cochrane library and CINAHL) and conducted lateral searches.We retrieved eight relevant studies, none of which was of high quality

2019 Palliative medicine PubMed abstract

105. Drug use beyond the licence in palliative care: A systematic review and narrative synthesis. (Abstract)

Drug use beyond the licence in palliative care: A systematic review and narrative synthesis. Drug use beyond the licence (off-label use, off-label drug use) is a common practice in palliative care and respective recommendations can often be identified in the literature. It is both risky and offers opportunities at the same time and, therefore, requires special attention in clinical practice.To determine the prevalence of off-label drug use in palliative care and to identify, evaluate (...) was performed.Eight studies met the inclusion criteria. Due to the variety in study designs and settings, no meta-analysis or meaningful statistical analysis was possible and a narrative synthesis of the data was performed. Frequency of off-label drug use ranged from 14.5% to 35%. Up to 97% of palliative care units did not have any policy or guidance on handling off-label drug use. About 20% of prescribers never obtain consent in the context of off-label use.Off-label use is common in palliative care with up

2019 Palliative medicine

106. Pressure ulcers in patients receiving palliative care: A systematic review. (Abstract)

Pressure ulcers in patients receiving palliative care: A systematic review. Pressure ulcers are associated with significant morbidity and mortality as well as high cost to the health service. Although often linked with inadequate care, in some patients, they may be unavoidable.This systematic review aims to quantify the prevalence and incidence of pressure ulcers in patients receiving palliative care and identify the risk factors for pressure ulcer development in these patients as well (...) and exclusion criteria.Overall pressure ulcer prevalence and incidence were found to be 12.4% and 11.7%, respectively. The most frequently identified risk factors were decreased mobility, increased age, high Waterlow score and long duration of stay.The prevalence of pressure ulcers is higher in patients receiving palliative care than the general population. While this should not be an excuse for poor care, it does not necessarily mean that inadequate care has been provided. Skin failure, as with other organ

2019 Palliative medicine

107. Barriers and facilitators to implementation of cancer treatment and palliative care strategies in low- and middle-income countries: systematic review. (Full text)

Barriers and facilitators to implementation of cancer treatment and palliative care strategies in low- and middle-income countries: systematic review. To appraise improvement strategies adopted by low- and middle-income countries to increase access to cancer treatments and palliative care; and identify the facilitators and barriers to implementation.A systematic review was conducted and reported in accordance with PRISMA statement. MEDLINE, CINAHL, and the Cochrane Library databases were (...) searched. Bias was assessed using the Standards for Quality Improvement Reporting Excellence, and evidence graded using the Australian National Health and Medical Research Council system.Of 3069 articles identified, 18 studied were included. These studies involved less than a tenth (n = 12, 8.6%) of all low- and middle-income countries. Most were case reports (58%), and the majority focused on palliative care (n = 11, 61%). Facilitators included: stakeholder engagement, financial support, supportive

2019 International journal of public health PubMed abstract

108. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. (Abstract)

Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. The oligometastatic paradigm suggests that some patients with a limited number of metastases might be cured if all lesions are eradicated. Evidence from randomised controlled trials to support this paradigm is scarce. We aimed to assess the effect of stereotactic ablative radiotherapy (SABR) on survival, oncological (...) ), we randomly assigned patients (1:2) to receive either palliative standard of care treatments alone (control group), or standard of care plus SABR to all metastatic lesions (SABR group), using a computer-generated randomisation list with permuted blocks of nine. Neither patients nor physicians were masked to treatment allocation. The primary endpoint was overall survival. We used a randomised phase 2 screening design with a two-sided α of 0·20 (wherein p<0·20 designates a positive trial). All

2019 Lancet Controlled trial quality: predicted high

109. Factors influencing palliative care in advanced dementia: a systematic review. (Full text)

Factors influencing palliative care in advanced dementia: a systematic review. 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.To investigate the factors influencing provision of PC (...) professionals and patients-related barriers and facilitators in provision of PC for people with advanced dementia from perspective of stakeholders across different care settings. The most commonly reported barriers are lack of skills and training opportunities of the staff specific to PC in dementia, lack of awareness that dementia is a terminal illness and a palliative condition, pain and symptoms assessment/management difficulties, discontinuity of care for patients with dementia and lack of coordination

2019 BMJ Supportive & Palliative Care PubMed abstract

110. A systematic review of palliative care tools and interventions for people with severe mental illness. (Full text)

A systematic review of palliative care tools and interventions for people with severe mental illness. Increasing attention to palliative care for the general population has led to the development of various evidence-based or consensus-based tools and interventions. However, specific tools and interventions are needed for people with severe mental illness (SMI) who have a life-threatening illness. The aim of this systematic review is to summarize the scientific evidence on tools (...) and interventions in palliative care for this group.Systematic searches were done in the PubMed, Cochrane Library, CINAHL, PsycINFO and Embase databases, supplemented by reference tracking, searches on the internet with free text terms, and consultations with experts to identify relevant literature. Empirical studies with qualitative, quantitative or mixed-methods designs concerning tools and interventions for use in palliative care for people with SMI were included. Methodological quality was assessed using

2019 BMC Psychiatry PubMed abstract

111. Would You Refer This Patient With Cancer to a Palliative Care Specialist?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. (Abstract)

Would You Refer This Patient With Cancer to a Palliative Care Specialist?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. In 2016, the American Society of Clinical Oncology published a guideline recommending that all patients with advanced cancer be referred to palliative care providers. This recommendation was based on a series of trials showing that palliative care, when added to standard oncology treatment, improves outcomes, including quality of life. Here, 2 oncologists (...) , 1 of whom is also a palliative care specialist, debate the guideline and discuss how best to care for a 71-year-old woman with metastatic neuroendocrine carcinoma who has a short life expectancy but feels well and has no symptoms related to her cancer or chemotherapy.

2019 Annals of Internal Medicine

112. Patient reported outcomes for cancer patients receiving immunotherapy: opportunities for palliative care - A Systematic Review. (Abstract)

Patient reported outcomes for cancer patients receiving immunotherapy: opportunities for palliative care - A Systematic Review. Immune checkpoint inhibitors (ICIs) are increasingly used to treat a variety of cancers, but comparatively little is known about patient-reported outcomes (PROs) and health-related quality of life (HRQoL) among patients receiving these novel therapies.We performed a systematic review to examine PROs and HRQoL among cancer patients receiving ICIs as compared to other

2019 Journal of pain and symptom management

113. A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia. (Full text)

A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia. A challenge for commissioners and providers of end-of-life care in dementia is to translate recommendations for good or effective care into quality indicators that inform service development and evaluation.To identify and critically evaluate quality indicators for end-of-life care in dementia.We found 8657 references, after de-duplication. In all, 19 publications (...) describing 10 new and 3 updated sets of indicators were included in this review. Ultimately, 246 individual indicators were identified as being relevant to dementia end-of-life care and mapped against EAPC guidelines.We systematically derived and assessed a set of quality indicators using a robust framework that provides clear definitions of aspects of palliative care, which are dementia specific, and strengthens the theoretical underpinning of new complex interventions in end-of-life care in dementia.

2019 Palliative medicine PubMed abstract

114. The effects of aromatherapy massage on improvement of anxiety among patients receiving palliative care: A systematic review of randomized controlled trials. (Full text)

The effects of aromatherapy massage on improvement of anxiety among patients receiving palliative care: A systematic review of randomized controlled trials. Anxiety in patients receiving palliative care is a noteworthy concern because it may affect their quality of life. Aromatherapy has been widely utilized to improve anxiety among patients receiving palliative care.To investigate the effectiveness of anxiety improvement in patients receiving palliative care by comparing the intervention group (...) of anxiety improvement among patients receiving palliative care.

2019 Medicine PubMed abstract

115. Thromboprophylaxis for inpatients with advanced cancer in palliative care settings: A systematic review and narrative synthesis. (Abstract)

Thromboprophylaxis for inpatients with advanced cancer in palliative care settings: A systematic review and narrative synthesis. Patients with advanced cancer have an elevated risk of venous thromboembolism. Increasingly, patients are admitted to palliative care settings for brief admissions, with greater numbers of discharges (vs deaths) reported internationally. There is limited guidance around the use of thromboprophylaxis or incidence of venous thromboembolism for these patients.The aim (...) of this study was to review the use of thromboprophylaxis as well as incidence of venous thromboembolism and bleeding in palliative care units or residential hospices for patients with advanced cancer.A systematic review using Cochrane methods.Medline, Embase and the Cochrane Library were searched up to 28 September 2018 along with a grey literature search; the reference lists of selected papers were hand-searched. Inclusion criteria were original papers assessing thromboprophylaxis use in palliative care

2019 Palliative medicine

116. Resilience in inpatient palliative care nursing: a qualitative systematic review. (Full text)

Resilience in inpatient palliative care nursing: a qualitative systematic review. 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.The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses.A thematic synthesis (...) , and construct a sense of meaning or purpose. Future research could explore how nurses understand resilience and how it could be enhanced in the palliative care inpatient setting. With resilience, nurses may remain in the profession longer and improve the quality of care when they do.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

2019 BMJ Supportive & Palliative Care PubMed abstract

117. What is the evidence that people with frailty have needs for palliative care at the end of life? A systematic review and narrative synthesis. (Full text)

What is the evidence that people with frailty have needs for palliative care at the end of life? A systematic review and narrative synthesis. The number of older people living and dying with frailty is rising, but our understanding of their end-of-life care needs is limited.To synthesise evidence on the end-of-life care needs of people with frailty.Systematic review of literature and narrative synthesis. Protocol registered prospectively with PROSPERO (CRD42016049506).Fourteen electronic (...) for reduced intervention, but these preferences were not always observed at critical phases of care.People with frailty have varied physical and psychosocial needs at the end of life that may benefit from palliative care. Frailty services should be tailored to patient and family needs and preferences at the end of life.

2019 Palliative medicine PubMed abstract

118. Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial (Full text)

Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial Malignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.We performed a multicentre, randomised, parallel group controlled trial comparing (...) early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia. Participants had newly diagnosed MPM; main carers were additionally recruited.review by SPC within 3 weeks of allocation and every 4 weeks throughout the study. HRQoL was assessed at baseline and every 4 weeks with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30.change in EORTC C30 Global Health Status 12 weeks after

2019 EvidenceUpdates PubMed abstract

119. Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. (Abstract)

Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. 30648926 2019 12 03 2019 12 03 1477-030X 33 3 2019 03 Palliative medicine Palliat Med Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. 332-345 10.1177/0269216318818011 Warth Marco M 0000-0003-3277-5516 1 Institute of Medical Psychology, Center for Psychosocial Medicine (...) Hubert J HJ 2 Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany. Ditzen Beate B 1 Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany. eng Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review 2019 01 16 England Palliat Med 8704926 0269-2163 IM Hospice and Palliative Care Nursing methods Humans Palliative Care psychology

2019 Palliative medicine

120. Healthcare professionals' moral distress in adult palliative care: a systematic review. (Abstract)

Healthcare professionals' moral distress in adult palliative care: a systematic review. 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.A (...) literature search was performed on PubMed, Scopus, Web of Science and PsycINFO databases, searching for the terms 'moral distress' AND 'palliative care'. The review process has followed the international PRISMA statement guidelines.The initial search identified 248 papers and 10 of them were considered eligible. Four main areas were identified: (1) personal factors, (2) patients and caregivers, (3) colleagues and superiors and (4) environment and organisation. Managing emotions of self and others

2019 BMJ Supportive & Palliative Care