Home About us Contact
|
Home About us Contact | ||
|
|
||
Palliative Medicine (palliative + medicine)
Selected AbstractsDelirium: Acute Confusional States in Palliative MedicineEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2005KAREN QUINN No abstract is available for this article. [source] Oncology for Palliative Medicine, 2nd editionJOURNAL OF ADVANCED NURSING, Issue 2 2004Anne McQueen No abstract is available for this article. [source] Integrating Palliative Medicine into the Care of Persons with Advanced Dementia: Identifying Appropriate Medication UseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2008Holly M. Holmes MD OBJECTIVES: To evaluate the feasibility of developing consensus recommendations for appropriate prescribing for patients with advanced dementia using a new conceptual framework and to determine the frequency of inappropriate medication use based on these recommendations in a small sample of patients with advanced dementia. DESIGN: Medication data were obtained using chart review. Recommendations for appropriate prescribing were achieved using a modified Delphi consensus panel. SETTING: Three long-term care facilities. PARTICIPANTS: Thirty-four patients with advanced dementia enrolled in the Palliative Excellence in Alzheimer Care Efforts Program were selected to evaluate medication use. Twelve geriatricians at the University of Chicago participated in the modified Delphi consensus panel. MEASUREMENTS: Prescription and over-the-counter medications were recorded for the 34 patients. Following the modified Delphi process, medications were characterized into one of four categories for use in palliative care patients with advanced dementia: never appropriate, rarely appropriate, sometimes appropriate, or always appropriate. RESULTS: Patients were taking an average of 6.5 medications at enrollment. Six patients were taking 10 or more medications daily. Consensus was reached ranking the appropriateness of 69 of 81 medication classes for patients with advanced dementia. Overall, 5% of the 221 medications prescribed at enrollment were considered to be never appropriate, and 10 of 34 patients (29%) had been taking a medication considered to be never appropriate. CONCLUSION: Based on these preliminary findings, consensus criteria for prescribing in advanced dementia are needed to decrease polypharmacy and reduce the use of medications that are of minimal benefit or high risk. [source] Palliative Ultrasound for Home Care Hospice PatientsACADEMIC EMERGENCY MEDICINE, Issue 3 2010Peter J. Mariani MD Abstract The evolving relationship between emergency and palliative medicine is expected to benefit patients of each. Two collaborative care encounters involving home hospice patients are discussed. Portable bedside ultrasound was performed in the home to diagnose ascites and to guide palliative paracentesis. Specific interventions and outcomes are reported. The interface of emergency and palliative care and the use of paracentesis in cancer palliation are briefly reviewed. It is concluded that home-performed ultrasound and ultrasound-guided procedures are promising palliative modalities for care at the end of life. ACADEMIC EMERGENCY MEDICINE 2010; 17:293,296 © 2010 by the Society for Academic Emergency Medicine [source] Acceptability of common screening methods used to detect distress and related mood disorders,preferences of cancer specialists and non-specialistsPSYCHO-ONCOLOGY, Issue 3 2008Alex J. Mitchell Abstract A new questionnaire of clinicians' attitudes and practices in relation to screening for mood disorder was distributed to 300 cancer professionals (specialists and non-specialists) working across the UK. From 226 (75.3%) health professionals working in cancer care who responded, approximately two-thirds always or regularly attempted to detect mood disorder during consultations but a substantial minority relied on patients spontaneously mentioning an emotional issue. The highest rate of routine questioning was performed by clinicians working in palliative medicine (76.3%) as well as nurse specialists working in all areas (72%). Despite these relatively high rates of enquiry, 10% or less of all specialists used a validated questionnaire, most preferring to rely on their own clinical skills or recalling the two simple questions of the short Patient Health Questionnaire (PHQ2). Staff suggested that ideal screening practice was to use one, two or three simple questions or a short validated questionnaire but not to refer to a specialist for a diagnosis. The main barrier to successful screening was lack of time but insufficient training and low confidence were also influential. Once distress was detected, 90% of nurses but only 40% of doctors were prepared to give distressed patients as much time as they needed. Predictors of clinicians' willingness to use more advanced screening methods were length of follow-up appointments and time clinicians were prepared to spend detecting distress. We suggest that future field studies of screening tools should also measure the issue of acceptability. Copyright © 2007 John Wiley & Sons, Ltd. [source] Palliative care in the hinterlands: A description of existing services and doctors' attitudesAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2005Glenn J. Pereira Abstract Objective:,To describe palliative care services as they exist in the hinterlands (towns away from regional centres) of Midwest New South Wales, including an estimation of the numbers of cases treated by local doctors, and the service they provide to their patients. Generalist doctors' attitudes to palliative care are also explored, as this information is lacking in the literature but is important for service provision. Design:,Descriptive survey. Setting:,Rural primary care and district hospitals. Participants:,Generalist doctors in hinterland areas. Results:,In total, 38% (19/50) of surveys were returned. ,Visiting rights' to the district hospital were held by 78.9% of local doctors, and patients are admitted under the care of their own doctor for symptom control and terminal care, 94.1% and 76.5% of the time, respectively. All doctors surveyed perform home visits for terminally ill patients, and 68.4% make themselves routinely available after hours. Doctors surveyed estimated that they managed a mean of 8.4 deaths due to chronic illness in the past 12 months. Most (78.9%) said that they would continue to manage dying patients even if they had a choice, and they feel between moderately and very satisfied that they provide quality care. However, only 21.1% considered their undergraduate training in palliative medicine to be adequate, and all said that they would refer to a specialist service if it were available. Conclusions:,Generalist rural doctors not only treat many dying patients, but also provide a continuity of care that is rarely seen in other settings. Proposals of models for ,rural' palliative care should, therefore, take this unique setting into account. One such suggestion is given in this article. [source] | ||||||||||