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Palliative & Supportive Care Feb 2015
Topics: Humans; Palliative Care; Spirituality
PubMed: 25664449
DOI: 10.1017/S1478951515000255 -
Canadian Family Physician Medecin de... Sep 2017To outline symptom management in, as well as offer a home-based protocol for, patients with advanced heart failure (HF). (Review)
Review
OBJECTIVE
To outline symptom management in, as well as offer a home-based protocol for, patients with advanced heart failure (HF).
SOURCES OF INFORMATION
The terms and were searched in PubMed and relevant databases. All articles were reviewed. The specific medical management protocol was developed by the "HeartFull" collaborative team at the Temmy Latner Centre for Palliative Care in Toronto, Ont.
MAIN MESSAGE
Educating patients about advanced HF and helping them understand their illness and illness trajectory can foster end-of-life discussions. Home-based care of patients with advanced HF that includes optimizing diuresis can lead to improved symptom management. It is also hoped that it can reduce both patient and health care system burden and result in greater health-related quality of life for patients with advanced HF.
CONCLUSION
This article provides an overview of how to manage common symptoms in patients with advanced HF. The home diuresis protocol with guidelines for oral and intravenous diuretic therapy is available at .
Topics: Diuretics; Female; Heart Failure; Home Care Services; Humans; Male; Palliative Care; Patient Education as Topic; Quality of Life; Terminal Care
PubMed: 28904030
DOI: No ID Found -
PloS One 2020Palliative care is an essential part of medical practice but it remains limited, inaccessible, or even absent in low and middle income countries.
BACKGROUND
Palliative care is an essential part of medical practice but it remains limited, inaccessible, or even absent in low and middle income countries.
OBJECTIVES
To evaluate the general knowledge, attitudes, and practices of Mozambican physicians on palliative care.
METHODS
A cross-sectional observational study was conducted between August 2018 and January 2019 in the 3 main hospitals of Mozambique, in addition to the only hospital with a standalone palliative care service. Data was collected from a self-administered survey directed to physicians in services with oncology patients.
RESULTS
Two hundred and seven out of 306 physicians surveyed answered the questionnaire. The median physician age was 38 years. Fifty-five percent were males, and 49.8% residents. The most common medical specialty was surgery with 26.1%. Eighty percent of physicians answered that palliative care should be provided to patients when no curative treatments are available; 87% believed that early integration of palliative care can improve patients' quality of life; 73% regularly inform patients of a cancer diagnosis; 60% prefer to inform the diagnosis and prognosis to the family/caregivers. Fifty percent knew what a "do-not-resuscitate" order is, and 51% knew what palliative sedation is. Only 25% of the participants answered correctly all questions on palliative care general knowledge, and only 24% of the participants knew all answers about euthanasia.
CONCLUSIONS
Mozambican physicians in the main hospitals of Mozambique have cursory knowledge about palliative care. Paternalism and the family-centered model are the most prevalent. More interventions and training of professionals are needed to improve palliative care knowledge and practice in the country.
Topics: Adult; Aged; Attitude of Health Personnel; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Mozambique; Palliative Care; Surveys and Questionnaires
PubMed: 32833987
DOI: 10.1371/journal.pone.0238023 -
JCO Global Oncology Jan 2023Palliative care in Sarawak is mainly provided by health care professionals with limited formal training in palliative care. Therefore, in 2020, collaborative work...
PURPOSE
Palliative care in Sarawak is mainly provided by health care professionals with limited formal training in palliative care. Therefore, in 2020, collaborative work between Sarawak General Hospital, University Malaysia Sarawak, and ASCO began. This study reports on the outcome of this collaboration.
METHODS
The collaboration was initiated with the first ASCO Palliative Care e-course, Train the Trainer program, International Development and Education Award-Palliative Care and translation of ASCO Palliative Care Interdisciplinary Curriculum resources.
RESULTS
This collaboration has resulted in the change of practice of palliative care among the oncology team of Sarawak General Hospital.
CONCLUSION
It encourages more timely palliative care referrals to ensure that patients with complex physical, psychosocial, and spiritual needs have the necessary input and support from the palliative care team throughout the course of patients' illnesses.
Topics: Humans; Palliative Care; Medical Oncology; Curriculum; Health Personnel
PubMed: 36630666
DOI: 10.1200/GO.22.00351 -
Journal of Clinical Oncology : Official... Sep 2014Radiotherapy is a successful, time-efficient, well-tolerated, and cost-effective intervention that is crucial for the appropriate delivery of palliative oncology care.... (Review)
Review
Radiotherapy is a successful, time-efficient, well-tolerated, and cost-effective intervention that is crucial for the appropriate delivery of palliative oncology care. The distinction between curative and palliative goals is blurred in many patients with cancer, requiring that treatments be chosen on the basis of factors related to the patient (ie, poor performance status, advanced age, significant weight loss, severe comorbid disease), the cancer (ie, metastatic disease, aggressive histology), or the treatment (ie, poor response to systemic therapy, previous radiotherapy). Goals may include symptom relief at the site of primary tumor or from metastatic lesions. Attention to a patient's discomfort and transportation limitations requires hypofractionated courses, when feasible. Innovative approaches include rapid response palliative care clinics as well as the formation of palliative radiotherapy specialty services in academic centers. Guidelines are providing better definitions of appropriate palliative radiotherapy interventions, and bone metastases fractionation has become the first radiotherapy quality measure accepted by the National Quality Forum. Further advances in the palliative radiation oncology subspecialty will require integration of education and training between the radiotherapy and palliative care specialties.
Topics: Humans; Neoplasms; Palliative Care
PubMed: 25113773
DOI: 10.1200/JCO.2014.55.1143 -
Chinese Clinical Oncology Dec 2019Patients with incurable cancer face lots of problems before they expire. Complications resulting from cancer or its treatment are a significant determinant of the... (Review)
Review
Patients with incurable cancer face lots of problems before they expire. Complications resulting from cancer or its treatment are a significant determinant of the quality of life of cancer patients. It is of outmost importance to make use of all treatment options in order to improve their survival and quality of life. Nowadays, available are a number of Interventional Radiology procedures that are minimally invasive, can be performed under local anesthesia or conscious sedation and are indispensable in helping patient through the cancer disease process. These techniques can be broadly classified into drainage of fluid collections, decompression and relief of obstruction, pain and tumor burden reduction, vascular and gastrointestinal tract access as well as hemostasis. The purpose of this article is to describe the basic concepts of minimally invasive techniques applied as palliative care therapies in the cancer patients. Controversies concerning techniques and products and the need for patient-centered tailored approaches will be discussed.
Topics: Humans; Neoplasms; Palliative Care
PubMed: 31865715
DOI: 10.21037/cco.2019.12.01 -
Heart Failure Reviews Sep 2017Heart failure (HF) is a chronic and progressive illness, which affects a growing number of adults, and is associated with a high morbidity and mortality, as well as... (Review)
Review
Heart failure (HF) is a chronic and progressive illness, which affects a growing number of adults, and is associated with a high morbidity and mortality, as well as significant physical and psychological symptom burden on both patients with HF and their families. Palliative care is the multidisciplinary specialty focused on optimizing quality of life and reducing suffering for patients and families facing serious illness, regardless of prognosis. Palliative care can be delivered as (1) specialist palliative care in which a palliative care specialist with subspecialty palliative care training consults or co-manages patients to address palliative needs alongside clinicians who manage the underlying illness or (2) as primary palliative care in which the primary clinician (such as the internist, cardiologist, cardiology nurse, or HF specialist) caring for the patient with HF provides the essential palliative domains. In this paper, we describe the key domains of primary palliative care for patients with HF and offer some specific ways in which primary palliative care and specialist palliative care can be offered in this population. Although there is little research on HF primary palliative care, primary palliative care in HF offers a key opportunity to ensure that this population receives high-quality palliative care in spite of the growing numbers of patients with HF as well as the limited number of specialist palliative care providers.
Topics: Heart Failure; Humans; Palliative Care; Primary Health Care; Prognosis; Quality of Life
PubMed: 28281018
DOI: 10.1007/s10741-017-9604-9 -
Annali Dell'Istituto Superiore Di Sanita 2016In recent years the emergence of new types of patient, clinical situations, technological frontiers and "health" objectives have changed considerably the needs of ill... (Review)
Review
INTRODUCTION
In recent years the emergence of new types of patient, clinical situations, technological frontiers and "health" objectives have changed considerably the needs of ill children, this also concerns pediatric palliative care (PPC). In Italy, despite the introduction of legislation (Law 38/2010) stipulating the right of children and families to access appropriate services for pain control and pediatric palliative care, the availability of these services is still limited.
AIM
The aim of this study is to highlight, through a review of the existing data and published literature, the critical issues that obstacle the planning and development of PPC services in Italy.
RESULTS
Four main areas identified were: socio-cultural setting; types of patients and nature of diseases requiring PPC; training for PPC providers; regulatory and political issues.
CONCLUSIONS
This type of analysis can provide the rational for advancing proposals and developing supportive, corrective and implementation strategies.
Topics: Adolescent; Adult; Child; Child, Preschool; Culture; Humans; Italy; Pain Management; Palliative Care; Patient Comfort; Pediatrics
PubMed: 27999228
DOI: 10.4415/ANN_16_04_16 -
CMAJ : Canadian Medical Association... Dec 2019
Topics: Adolescent; Cooking; Family; Female; Humans; Intensive Care Units, Pediatric; Multiple Organ Failure; Palliative Care
PubMed: 31844023
DOI: 10.1503/cmaj.190464 -
Journal of Perinatology : Official... Dec 2015Technological advances have increased our ability to detect a life-threatening, life-limiting or lethal problem early in pregnancy, leaving parents months to anticipate... (Review)
Review
Technological advances have increased our ability to detect a life-threatening, life-limiting or lethal problem early in pregnancy, leaving parents months to anticipate a death or a prematurely born infant. Babies can also be born with unanticipated problems that could lead to death. In either scenario, perinatal palliative care should be offered as a strategy for family support. Since the preponderance of professional training focuses on saving lives, many health professionals are uncomfortable with palliative care. This article's purpose is to define best practices for the provision of family-centered perinatal and neonatal palliative care and provision of support to bereaved families experiencing anticipated and unanticipated life-limiting conditions or death of their infant. An overview of core concepts and values is presented, followed by intervention strategies to promote an integrated family-centered approach to palliative and bereavement care. The concluding section presents evidence-based recommendations.
Topics: Adult; Attitude of Health Personnel; Bereavement; Emotional Intelligence; Female; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Male; Palliative Care; Parents; Perinatal Care; Pregnancy; Professional-Family Relations; Social Support
PubMed: 26597801
DOI: 10.1038/jp.2015.145