Draining malignant ascites at home with tunnelled catheters: complications and costs

European Journal of Palliative Care
2015 22(6) pp 266-273

Damian Mullan, Nabil Kibriya, Hadeel Hassan, Arun Jacob and Hans-Ulrich Laasch

Recurrent malignant ascites can be managed at home using tunnelled intraperitoneal catheters. The authors have conducted a study to determine the safety, efficacy and complications of tunnelled paracentesis performed at home, as well as the potential cost savings compared with conventional drainage in hospital.

Available in print in Arthur Rank House Library, Brookfields Hospital

Venting gastrostomy at home for symptomatic management of bowel obstruction in advanced/recurrent ovarian malignancy: a case series

Journal of Palliative Medicine, Aug 2015, vol. 18, no. 8, p. 722-728

DeEulis, Timothy G, Yennurajalingam, Sriram

In this case series, the authors describe supportive care outcomes in ovarian cancer patients with malignant bowel obstruction receiving the effects of VG in a community setting. Their results suggest that VG may be beneficial in controlling nausea and vomiting in ovarian cancer patients with MBO and that VG placement with concurrent evacuation of large-volume ascites was associated with minimal complications. 

Patient and caregiver opinions of motivational interviewing techniques in role-played palliative care conversations: a pilot study

Journal of Pain and Symptom Management, Jul 2015, vol. 50, no. 1, p. 91-98 

Pollak, Kathryn I, Jones, Jacqueline, Lum, Hillary D, De La Cruz, Scott, Felton, Susanne, Gill, Arvin, Kutner, Jean S

The aim of this pilot study was to describe how patients and caregivers perceived MI techniques in palliative care role-play encounters. Qualitative analyses revealed that participants independently identified the following helpful communication elements that are consistent with core MI techniques: reflection and validation of values, support of autonomy and flexibility, and open questions acting as catalysts for discussion. Participants rated the MI-trained physician slightly higher on the perceived empathy scale. The authors conclude that the use of MI techniques shows promise for improving palliative care discussions.

Fulltext available in Journal of Pain and Symptom Management

Available in print in Arthur Rank House Library, Brookfields Hospital

Spiritual care: which is the best assessment tool for palliative settings?

International journal of palliative nursing, Sep 2015, vol. 21, no. 9, p. 430-438

Blaber, Michael, Jone, June, Willis, Derek

This paper analyses the benefits and drawbacks of using spiritual history-taking tools, considering four of the most widely used tools-FICA, FAITH, SPIRITual and HOPE. The authors conclude that spiritual history-taking tools do have an important role in identifying the spiritual needs of patients at the end of life, with the 'HOPE' tool most comprehensively addressing the spirituality themes identified as important within the healthcare literature.

Fulltext available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Experiences of hospice inpatient nurses in supporting children before the death of a parent.

International journal of palliative nursing, Sep 2015, vol. 21, no. 9, p. 453-459

Clipsham, Laura, Islam, Zoebia, Faull, Christina

This study provides an insight into how nurses identify the support needs of children, the barriers and facilitators to providing support and the impact on the nurses of their involvement in supporting the children.  The authors conclude that formal training and readily available resources help nurses working with children.

Fulltext available in International Journal of Palliative Nursing

Available in pront in Arthur Rank House Library, Brookfields Hospital

Evidence-based guidelines for pressure ulcer management at the end of life

International journal of palliative nursing, May 2015, vol. 21, no. 5, p. 225-232

Langemo, Diane, Haesler, Emily, Naylor, Wayne, Tippett, Aletha, Young, Trudie

This article discusses patient and risk assessment, prevention and care for pressure ulcers for the palliative care patient and the recommendations given in the palliative care section of the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline 

Fulltext  available International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Hospice nurses' views on single nurse administration of controlled drugs

International journal of palliative nursing, Jul 2015, vol. 21, no. 7, p. 319-327

Taylor, Vanessa, Middleton-Green, Laura, Carding, Sally, Perkins, Paul

The aim of this study was to explore the views and experiences of nurses who had implemented single nurse dispensing and administration of controlled drugs (SNAD). Overall the nurses felt that SNAD benefited patients and families because it minimised interruptions and enabled them to respond more quickly to requests from patients. However, concerns were raised about competence in drug calculations and the impact of inexperience or tiredness.

Fulltext available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

The role of airflow for the relief of chronic refractory breathlessness

Current Opinion in Supportive and Palliative Care, Sep 2015, vol. 9, no. 3, p. 206-211

Swan, Flavia, Booth, Sara

The authors conclude that there is sufficient review evidence available to suggest that airflow from the hand-held fan or medical air can provide clinically relevant and discernible relief of chronic refractory breathlessness at rest in patients with advanced diseases. Emerging evidence indicates that airflow from the hand-held fan may also have an important role with exertion-induced breathlessness.

Fulltext available in Current Opinion in Supportive and Palliative Care

NICE issues draft guideline on end of life care

July 2015

This guideline applies to all adults who are potentially entering the last days of their lives in any setting that is covered by NHS services.  It covers recognising dying, communication and shared decision-making and only the clinical aspects of symptom management.

The draft guideline is open for comments until Wednesday 9 September 2015.

You can read the consultation documents here

Social media and palliative medicine: a retrospective 2-year analysis of global Twitter data to evaluate the use of technology to communicate about issues at the end of life

BMJ supportive & palliative care, June 2015  5(2):207-12
Nwosu AC;  Debattista M;  Rooney C;  Mason S.

The scope and breadth of the use of Twitter to discuss end-of-life care has not previously been reported. The authors' aim was to determine the frequency, sentiment and trend of Twitter 'tweets' containing palliative care-related identifiers (hashtags) and/or phrases sent by users over a 2-year period.  They found that a lot of discussion about palliative care is taking place on Twitter, and the majority of this is positive. Social media presents a novel opportunity for engagement and ongoing dialogue with public and professional groups. 

• Fulltext available in BMJ Supportive and Palliative Care
• • Available in print in Arthur Rank House Library, Brookfields Hospital

Is the use of negative pressure wound therapy for a malignant wound legitimate in a palliative context? "The concept of NPWT ad vitam": a case series

Palliative medicine, May 2015, vol. 29, no. 5, p. 470-473 

Riot, Samuel, de Bonnecaze, Guillaume, Garrido, Ignacio, Ferron, Gwenaël, Grolleau, Jean-Louis, Chaput, Benoit

The use of negative pressure wound therapy is usually not recommended for the management of malignant wounds that are often malodorous, highly exuding, and painful.  It is, however, an effective procedure for maintaining a good quality of life in certain palliative situations.  The authors report their experiences with five patients for whom manufacturers and health authorities contraindicated the use of negative pressure wound therapy because of its potential to encourage tumor growth, although it was considered to be beneficial for all of these patients.

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

Outcomes of lung transplant candidates referred for co-management by palliative care: a retrospective case series

Palliative Medicine, May 2015, vol. 29, no. 5, p. 429-435

Colman, Rebecca, Singer, Lianne G, Barua, Reeta, Downar, James

Lung transplant candidates are rarely referred for palliative care consultation until they are deemed ineligible for transplant.  In this article, the authors review the characteristics, interventions, and outcomes of lung transplant candidates referred for co-management by palliative care, to determine whether they safely received opioids and went on to transplantation.  They conclude that palliative care and opioids in particular can be safely provided without compromising eligibility for transplantation. 

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

 

Fixed-dose subcutaneous methylnaltrexone in patients with advanced illness and opioid-induced constipation: results of a randomized, placebo-controlled study and open-label extension

Journal of palliative medicine, Jul 2015, vol. 18, no. 7, p. 593-600 

Bull, Janet, Wellman, Charles V, Israel, Robert J, Barrett, Andrew C, Paterson, Craig, Forbes, William P

The study objective was to assess safety and efficacy of fixed-dose MNTX in two phase 4 trials. The authors report that fixed-dose MNTX administered in the RCT and in a follow-up open label extension study demonstrated robust efficacy and was well tolerated in treating OIC in patients with advanced illness.

Development of the Carers' Alert Thermometer (CAT) to identify family carers struggling with caring for someone dying at home: a mixed method consensus study

BMC palliative care, Jan 2015, vol. 14, p. 22

Knighting, Katherine, O'Brien, Mary R, Roe, Brenda, Gandy, Rob, Lloyd-Williams, Mari, Nolan, Mike, Jack, Barbara A

The aim of the study was to explore what professionals and carers of patients with cancer and advanced progressive illness, in their last year of life, find burdensome and to develop an alert system for use by non-specialist staff to help avoid crisis situations for the carer and avoidable hospital admissions.  The resultant CAT is an evidence-based alert thermometer consisting of 10 questions, guidance on the possible actions for each alert and space for an action plan to be jointly agreed by the assessor and carer.

Fulltext available in BMC Palliative Care

 

: 'I want to feel at home': establishing what aspects of environmental design are important to people with dementia nearing the end of life

BMC palliative care, Jan 2015, vol. 14, p. 26

Fleming, Richard, Kelly, Fiona, Stillfried, Gillian

Using a combination of focus groups and a Delphi survey, this study explored the views of people with dementia, family carers and professionals on what aspects of the physical environment would be important to support a good quality of life to the very end.

fulltext available BMC Palliative Care

Existential concerns about death: a qualitative study of dying patients in a Danish hospice

American Journal of Hospice & Palliative Medicine, June 2015  32(4):427-36

Moestrup L;  Hansen HP.

Research suggests that addressing dying patients' existential concerns can improve their quality of life. Here, the authors aimed to illuminate dying patients' existential concerns about the impending death through a descriptive analysis of semi-structured interviews with 17 patients in Danish hospices. The main findings demonstrated how the patients faced the imminent death without being anxious of death but sorrowful about leaving life.

Symptom management of bone metastasis at end of life

Journal of Hospice and Palliative Nursing, Jun 2015, vol. 17, no. 3, p. 183-186

Coyne, Paul Ensom

Through the use of a case narrative, this article demonstrates the complexity of palliative care as it relates to the pain management of bone metastasis at end of life from both the pharmacological and psychosocial perspectives. Treatment interventions for pain in each of these domains is explored, illustrating that metastatic bone pain at end of life is a multifaceted experience that requires a multimodal approach to care.

Barriers to research in palliative care: A systematic literature review

Progress in Palliative Care, 01 April 2015, vol./is. 23/2(75-84)

Blum, David, Inauen, Roman, Binswanger, Jacqueline, Strasser, Florian

The most often mentioned barriers to palliative care research are ethical concerns of performing research in a vulnerable population and issues of trial conduct due to difficulties obtaining informed consent or high attrition rates.  Possible strategies to overcome the barriers include international collaborative efforts and improving study designs to tailor them specifically to the PC population.

Available in print in Arthur Rank House Library, Brookfields Hospital

Ethics in palliative care

Progress in Palliative Care, 01 June 2015, vol./is. 23/3

This is a special issue exploring ethical issues.  It includes the following:

• Moral luck and the question of autonomy, choice and control in end of life decision making
• Decision-making capacity at the end of life
• Ethical dilemmas of surrogate decision making
• When mediation fails: identifying and working with inappropriate surrogate decision makers
• Palliative sedation: controversies and challenges
• CPR and hospice: incompatible goals, irreconcilable differences

Available in print in Arthur Rank House library, Brookfields Hospital

The Medicalization of Bereavement: (Ab)normal Grief in the DSM-5

Death Studies, 01 July 2015, vol./is. 39/6(347-352)

Bandini, Julia

This article first considers the removal of the bereavement exclusion from the criteria for the diagnosis of major depression DSM-5.  It then examines the consequences of this medicalization of grief, including overdiagnosis and overtreatment, a potential expanded market for pharmaceutical companies, and the loss of traditional and cultural methods of adapting to the loss of a loved one.

Coping flexibility, forward focus and trauma focus in older widows and widowers

Bereavement Care, 01 April 2015, vol./is. 34/1(17-23)

Knowles, Lindsey M, O'Connor, Mary-Frances

The primary aim of the present study was to assess whether trauma focus and forward focus coping strategies, and using strategies from both flexibly, would predict grief severity. Results showed that greater forward focus and coping flexibility predicted lower grief severity, and also predicted lower yearning, loneliness, and perceived stress. 

Available in print in Arthur Rank House Library, Brookfields Hospital 

Palliative care outcome measures resource pack launched

May 2015

The Cicely Saunders Institute and Hospice UK have joined forces to launch a new Palliative Care Outcome Measures Resource Pack. “Outcome measures are essential if hospices are to better understand – and be able to demonstrate to others – the positive difference they make for patients and families.” The packs are intended to help hospices and other palliative care teams learn more about outcome measures, and start to introduce a shared set of outcome measures into clinical practice.

Follow this link for the web article

New Macmillan toolkit for health and social care staff on discussing care plans

A new resource designed to help healthcare professionals discuss future care plans with patients, has been released by Macmillan Cancer Support.

The toolkit is aimed at generalists caring for people with progressive illnesses and those reaching the end stage of their lives. It covers a range of topics, and includes video clips and web links to assist professionals with their learning.

New free online training resource on Advance Care Planning

A new, free training resource is available to support healthcare professionals, carers, families and patients to prepare for the end of life by making advance care plans.

The training, which consists of 10 online modules, was produced by Kent Community Health NHS Foundation Trust and Canterbury Christ Church University and hospices in Kent.

'The Road Ahead': NCPC launches official strategy for 2015-18

NCPC has published its official strategy for 2015-18.

The new strategy has been agreed by NCPC's Board of Trustees and affirms its vision for palliative and end of life care, demonstrates how it can play an important role in shaping the future, and sets out the areas in which it will work to achieve these goals.

In the three years to March 2018 The Road Ahead will shape all NCPC's activities, including its work leading the Dying Matters Coalition.

The road ahead - National Council for Palliative Care Strategy 2015-2018

Published May 2015

The new strategy has been agreed by the NCPC's Board of Trustees and affirms their vision for palliative and end of life care over the next three years, demonstrates the role they can play in shaping the future and sets out the areas in which they will work to achieve these goals.

The strategy identifies four priority areas of work:

• Changing attitudes
• Changing behaviour
• Improving care and support
• Improving evidence and intelligence

Follow this link for the strategy

Tax help: a guide to taxation at bereavement (booklet)

Produced by Tax Help for Older People, this booklet is a checklist and reminder about things to do about tax at bereavement.  It is aimed at those where the personal representative of the person who has died is the surviving spouse or close family member.  Rather than being an exhaustive account of the entire tax system, it provides sufficient guidance on the common issues that need to be addressed when someone dies.

Download a copy of the guide here

Advance care planning in a UK hospice: the experiences of trained volunteers

European Journal of Palliative Care, May/June 2015, 22(3)144-51
Penny Jones, Kate Heaps, Carla Rattigan and Di Marks-Maran

In 2013, Greenwich & Bexley Community Hospice launched an ACP project to enable hard-to-reach people with life-limiting illness in the London borough of Greenwich, and their carers, to develop an advance care plan. The hospice aimed to recruit and train up to 45 volunteers to support a minimum of 225 people with life-limiting illness. An evaluation of the volunteers’ experiences was commissioned after the project’s first year of operation. This article discusses the development of the project and the findings of the evaluation, starting with a
brief literature review of ACP.

Available in print in Arthur Rank House Library, Brookfields Hospital

End-of-life care for cystic fibrosis patients

European Journal of Palliative Care, 2015, 22(2)74-77; 22(3)136-140
Julia Nightingale and Irfan Shafiq

From lung transplantation to advance care planning, from symptom control to place of death, Julia Nightingale and Irfan Shafiq review the key issues arising for respiratory physicians when caring for patients suffering from cystic fibrosis. This paper is published in two parts

Available in print in Arthur Rank House Library, Brookfields Hospital

A palliative care outreach programme for patients with respiratory disease

European Journal of Palliative Care, May/June 2015, 22 (3) 126-9

Lisa Makey and Andrew Hiskett

Keech Hospice Care initiated an outreach programme aimed at helping patients with chronic lung disease to access palliative care. Lisa Makey and Andrew Hiskett show how it has improved patients’ quality of life and reduced their fear of engaging with hospices. Although this programme focused on respiratory disease, the results indicate that the management of any non-malignant condition could be optimised by the introduction of similar programmes.

Available in print in Arthur Rank House Library, Brookfields Hospital

Detecting pain or distress in people with dementia: an appraisal of two strategies

European Journal of Palliative Care, May/June 2015, 22 (3) 110-113

Jenny T van der Steen, Claud Regnard, Ladislav Volicer, Nele J A Van den Noortgate and Elizabeth L Sampson

What is the best approach to recognise pain or distress in people with dementia who cannot express themselves verbally? Jenny T van der Steen, et al have critically appraised two assessment tools: the pain tool PAINAD and the distress documentation tool DisDAT.

Available in print in Arthur Rank House Library, Brookfields Hospital

Advance care planning in people with early cognitive impairment

BMJ Supportive and Palliative Care, March 2015, 5(1) 63-69
Kenny Cheong, Paul Fisher, Jenny Goh, Lynette Ng, Hui Mien Koh, Philip Yap

This study aims to explore the perspectives of patients with early cognitive impairment(ECI) regarding ACP, and in particular, understand their reasons for resistance.  It was found that a large proportion of patients with ECI decline ACP discussions and the reasons are influenced by personal values, coping behaviours and socio-cultural norms. These findings have important implications for practice.

Fulltext available in BMJ Supportive and Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

Predicting palliative care needs and mortality in end stage renal disease: use of an at-risk register

BMJ Supportive and Palliative Care, March 2015, 5(1) 19-25
Kennedy Feyi, Sarah Klinger, Georgina Pharro, Liz Mcnally, Ajith James, Kate Gretton, Michael K Almond

This research used the GSF `surprise question' to formulate a list of patients predicted to die within 1 year with end stage renal failure. The authors conclude that these patients can be accurately identified by a multi-disciplinary team using the surprise trigger question with a relatively high sensitivity and specificity. The accurate identification of patients with reduced life expectancy allows appropriate end of life care planning to begin in keeping with patients' wishes and within published guidelines.

Fulltext available in BMJ Supportive and Palliative Care
Available in print in Arthur Rank House Library, Brookfields Hospital

Cancer survivors' perceived need for supportive care and their attitude towards self-management and eHealth

Supportive Care in Cancer, June 2015, 23(6):1679-88

Jansen F; van Uden-Kraan CF; van Zwieten V; Witte BI; Verdonck-de Leeuw IM.

The authors conclude that the perceived need for supportive care including healthy lifestyle programs was high, and in general, cancer survivors had a positive attitude towards self-management and eHealth. Need and attitude were associated with sociodemographic and clinical variables and quality of life. Therefore, a tailored approach seems to be warranted to improve and innovate supportive care targeting cancer survivors.

Fulltext available in Supportive Care in Cancer

Log in using your Athens account details or contact the library where we can download it for you.

Pharmacological options for the management of refractory cancer pain-what is the evidence?

Supportive Care in Cancer, May 2015,  23(5):1473-81 

Afsharimani B;  Kindl K;  Good P;  Hardy J.

The management of patients with refractory pain remains a challenge. The evidence of benefit for many of the agents used is weak, and each additional agent increases the risk of adverse events. Evidence-based guidelines cannot, therefore, be developed at present. New approaches are recommended including targeted opioid therapy, multimodal analgesia, a goal-oriented approach to pain management and increasing use of the multidisciplinary team and support services.

Fulltext available in  Supportive Care in Cancer

Log in using your Athens account details or contact the library where we can download the article for you

Spirituality in palliative and supportive care (special issue)

Palliative & Supportive Care, February 2015, 13 (1)

This special issue focuses on spirituality and, among others, includes the following articles:

• Meaning of life in patients with cancer
• Mindfulness in informal caregivers of palliative patients
• Do spiritual patients want spiritual interventions
• The role of Chaplains in end of life decision-making
• Guidelines for conducting a spiritual assessment

Fulltext available in Palliative & Supportive Care

This links to the contents page.  To access the articles you will need your Athens account details or contact the library where they can be downloaded for you.

Verbalized desire for death or euthanasia in advanced cancer patients receiving palliative care

Palliative & Supportive Care, April 2015, 13(2):295-303

Guell E;  Ramos A;  Zertuche T;  Pascual A.

The authors found that although the single most common reason for a desire for death or desire for euthansia comment was pain or physical suffering, most of the reasons given were nonphysical.   They conclude that emotional and spiritual issues should be identified and effectively addressed when responding to a desire for death statement in terminally ill cancer patients.

Fulltext available in Palliative & Supportive Care

Log in using your Athens account details or contact the library where it can be downloaded for you

A communication training perspective on AND versus DNR directives

Palliative & Supportive Care, April 2015, 13(2):385-7

Levin TT;  Coyle N.

An alternative, "Allow Natural Death" (AND), has been proposed as a better way of framing end of life discussions.   The authors contrast the advantages and disadvantages of the term AND from the communication training perspective and suggest that AND-framing language replace DNR as a better way to facilitate meaningful end-of-life communication. One well-designed, randomized, controlled simulation study supports this practice. We also consider the communication implications of "natural" versus "unnatural" death.

Fulltext available in Palliative and Supportive Care

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The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer

Palliative and Supportive Care, April 2015, 13(2):275-84
Genc F;  Tan M.

The purpose of this study was to determine the effect of acupressure applied to the pericardium 6 (P6 or neiguan) acupuncture point on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer.  The authors conclude that the efficacy of applying acupressure was demonstrated but that further research is needed.

Fulltext available in Palliative and Supportive Care 

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Management of radiotherapy-induced skin reactions

International journal of palliative nursing, Apr 2015, vol. 21, no. 4, p. 187-192

Trueman, Ellen

Radiotherapy is frequently used for palliation of disease-related symptoms and complications but treatment-related side-effects do occur, with an acute skin reaction being one of the most common. This article describes how the use of a recognised assessment tool and evidence-based guidelines can facilitate consistent, high-quality care in the management of radiotherapy-induced skin reactions.

Fulltext available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Last offices: nurses' experiences of the process and their views about involving significant others

International journal of palliative nursing, Apr 2015, vol. 21, no. 4, p. 173-178

Martin, Susan, Bristowe, Katherine

The aim of the study was to explore nurses' experiences of carrying out last offices, in hospice inpatient and community settings, and their views on involving the person's significant others in the process. 

Fulltext available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Integrated end-of-life care services – the Greenwich Care Partnership

European Journal of Palliative Care, March/April 2015, vol/iss 22/2, p84-89
Kate Heaps and Di Marks-Maran

There is often insufficient support in the community to enable people to die at home. The authors describe an integrated care project established in 2011 in the London borough of Greenwich, which enables more patients, and their carers, to receive appropriate care and support in their homes at the end of life.

Fulltext available in European Journal of Palliative Care
Available in print in Arthur Rank House, Brookfields Hospital

End-of-life care for cystic fibrosis patients – part 1

European Journal of Palliative Care, March/April 2015, vol/iss 22/2, p74-77

Julia Nightingale and Irfan Shafiq

From lung transplantation to advance care planning, from symptom control to place of death, this paper reviews the key issues arising when caring for patients suffering from cystic fibrosis.

Fulltext available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

Young adult palliative care: challenges and opportunities

American Journal of Hospice and Palliative Medicine, Feb 2015, vol. 32, no. 1, p. 101-111

Clark, Jennifer K., Fasciano, Karen

This review examines the current data pertinent to young adult palliative care and discusses the challenges and opportunities where palliative medicine can enhance the care provided to this growing and vulnerable population. 

  

Difficulties in caring for a patient with cancer at the end of life at home and complicated grief

American Journal of Hospice and Palliative Medicine, Mar 2015, vol. 32, no. 2, p. 173-177

Ando, Michiyo, Ninosaka, Yasuyoshi, Okamura, Kazuhisa, Ishi, Yoko

This study aimed to investigate difficulties in caring for a patient with cancer at the end of life at home and to examine relationships between difficulties with care and complicated grief.  The results suggest that the condition of the patient, the view of the caregiver on home care, and the absence of other support are important factors contributing to difficulties of family caregivers, and that these difficulties may lead to complicated grief.

A mixed-methods qualitative research study to develop a complex intervention for weight loss and anorexia in advanced cancer: the Family Approach to Weight and Eating

Palliative medicine, Feb 2015, vol. 29, no. 2, p. 164-176

Hopkinson, Jane B, Richardson, Alison

A mixed-methods process informed by the Medical Research Council's guidelines for developing a complex intervention was used to develop a psychosocial intervention for patients with incurable cancer and weight loss or poor appetite and their family caregivers and then to test for its feasibility, acceptability and perceived benefit. 15 of the patient/caregiver dyads reported benefits of the Family Approach to Weight and Eating. The intervention should now be tested in a pilot trial and the effect on emotional health outcomes in patients and their family caregivers evaluated.

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital
 

Breaking bad news about transitions to dying: a qualitative exploration of the role of the District Nurse

Palliative Medicine, Feb 2015, vol. 29, no. 2, p. 138-146

Griffiths, Jane, Ewing, Gail, Wilson, Charlotte, Connolly, Michael, Grande, Gunn

Patients and families need to know the patient is approaching the dying phase, yet evidence suggests breaking bad news about the patient's transition to dying rarely happens. The authors suggest that while District Nurses are ideally placed to carry out this work, it is complex and they are unprepared for it. They conclude that DNs urgently need carefully tailored training in this aspect of their work, to enable them to provide optimal end of life care. 

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

The management of secondary lower limb lymphoedema in cancer patients: a systematic review

Palliative Medicine, Feb 2015, vol. 29, no. 2, p. 112-119

Leung, Elaine Y L, Tirlapur, Seema A, Meads, Catherine

The authors evaluate the available evidence for the treatment of secondary lower limb lymphoedema in patients with malignancies.

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

The prevention and management of pressure ulcers: summary of updated NICE guidance

Journal of Wound Care, Apr 2015, vol. 24, no. 4, p. 179-184

Cooper, L, Vellodi, C, Stansby, G, Avital, L

Conducting research interviews with bereaved family carers: when do we ask?

Journal of Palliative Medicine, Mar 2015, vol. 18, no. 3, p. 241-245

Bentley, Brenda, O'Connor, Moira

The aim of this study was to explore the insights of bereaved family carers about the most appropriate time to be involved in a research interview about the end of life and death of their family member.  The findings indicate that interviews with the bereaved may be most fruitful for researchers and beneficial to family carers when they are allowed to make the choice about timing for themselves, beginning weeks after the death of their family member.

Intravenous lidocaine for cancer pain without electrocardiographic monitoring: a retrospective review

Journal of Palliative Medicine, Apr 2015, vol. 18, no. 4, p. 373-377

Peixoto, Renata D'Alpino, Hawley, Pippa

The belief that cardiac monitoring is required for safe administration of intravenous lidocaine is a barrier to access in the palliative care setting.  The authors argue that their protocol of infusional lidocaine can be beneficial to patients with cancer with severe opioid-refractory pain, and can safely be administered with close observation and vital sign monitoring, without ECG monitoring.  They conclude this treatment could be delivered in palliative care units, hospices, or even patients' homes, providing suitable nursing supervision can be provided.

 

Efficacy and safety of gabapentin for uremic pruritus and restless legs syndrome in conservatively managed patients with chronic kidney disease

Journal of Pain and Symptom Management, Apr 2015, vol. 49, no. 4, p. 782-789

Cheikh Hassan, Hicham I, Brennan, Frank, Collett, Gemma, Josland, Elizabeth A, Brown, Mark A

The authors of this study conclude that gabapentin is a viable treatment for conservatively managed CKD and ESKD patients with pruritus and/or RLS, but side effects are common. Gabapentin should be used with caution although higher doses do not appear to be a factor associated with side effects.

Fulltext available in Journal of Pain and Symptom Management

Available in print in Arthur Rank House Library, Brookfields Hospital

Bed care for patients in palliative settings: considering risks to caregivers and bed surfaces

International Journal of Palliative Nursing, Feb 2015, vol. 21, no. 2, p. 66-70

Fragala, Guy

When moving and positioning patients in bed, health professionals face an occupational risk of injury. The turning and positioning (TAP) system is a new method of moving patients in bed, that evidence has shown to reduce the risk of injury to caregivers. Providing the correct bed surface is another aspect of bed care essential to the comfort of the palliative patient, and to aid wound prevention and treatment. This article provides an overview and discussion of these two aspects of bed care for palliative patients.

Fulltext available in International Journal of Palliative Nursing

Availablein print in Arthur Rank House Library, Brookfields Hospital

The unmet palliative care needs of those dying with dementia

International Journal of Palliative Nursing, Mar 2015, vol. 21, no. 3, p. 126-133

Dempsey, Laura, Dowling, Maura, Larkin, Philip, Murphy, Kathy

The literature suggests that people with end-stage dementia are still not receiving adequate or appropriate end of life care. Difficulty diagnosing dementia, a stigma surrounding the disease, lack of education of the dementia disease process and the ability to identify complications encountered at end-stage dementia by health-care providers, families and carers are some of the factors preventing those with dementia receiving effective EoLC.

Full text available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Development of a questionnaire to measure the key attributes of the community palliative care specialist nurse role

International Journal of Palliative Nursing, Feb 2015, vol. 21, no. 2, p. 87-95

Cameron, Dee, Johnston, Bridget

Since the role of specialist nurses is considered one of the least understood or valued developments in nursing, specialist nurses must demonstrate their contribution to quality, person-centred health care. The Quality Measure for Palliative Nursing is unique since it aims to measure the quality of care provided by community palliative care specialist nurses, and could also be used to measure patient satisfaction with the quality of care provided.

Fulltext available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Continuous subcutaneous infusion in palliative care: a review of current practice

International Journal of Palliative Nursing, Feb 2015, vol. 21, no. 2, p. 60-64

Thomas, Tabitha, Barclay, Stephen

Syringe drivers are widely used in palliative care, and this article reviews the challenges and outstanding questions associated with their use. Misperceptions among the lay public and some health professionals can be addressed by sensitive communication with patients and families and clear thinking in clinical teams concerning the drugs and doses used, particularly in non-malignant disease. Good levels of knowledge concerning syringe driver use has been found among GPs and community nurses, although this is not the case in some nursing home teams. The advantages of newer devices, safety and efficacy of drug combinations, selection of diluent, and management of site reactions are discussed.

Full Text:

Fulltext in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Care of the human spirit and the role of dignity therapy: a systematic review of dignity therapy research

BMC palliative care, Jan 2015, vol. 14, p. 8

Fitchett, George, Emanuel, Linda, Handzo, George, Boyken, Lara, Wilkie, Diana J

Dignity Therapy (DT), an intervention for people facing serious illness, focuses on dignity conservation tasks such as settling relationships, sharing words of love, and preparing a legacy document for loved ones. The authors found that although patients reported high levels of satisfaction and benefits for themselves and their families, the effects on physical and emotional symptoms were inconsistent.  They point to three areas for future research on DT.