What influences attitudes towards clinically assisted hydration in the care of dying patients? A review of the literature

BMJ Supportive and Palliative Care 2015;5:3 223-231

Miriam J Gent, Sarah Fradsham, Graham M Whyte, Catriona R Mayland

The aim of the review is to describe the attitudes and knowledge of patients, families, healthcare professionals and the general public regarding clinically assisted hydration (CAH) in the care of dying patients. Developing international evidence suggests that cultural norms and ethical principles of a family, population or healthcare environment influence attitudes towards CAH, particularly where CAH has symbolic meaning; representing care, hope and trust. However, there is surprisingly little robust evidence regarding dying patients, or the wider general public's views, on the perceived value of CAH in the last days and hours of life.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Associations between oral complications and days to death in palliative care patients

Supportive Care in Cancer, January 2016, vol./is. 24/1(157-161)

Matsuo K., Watanabe R., Kanamori D., Nakagawa K., Fujii W., Urasaki Y., Murai M., Mori N., Higashiguchi T.

Adverse oral symptoms gradually appear in advanced cancer patients as the disease progresses. We retrospectively investigated the associations between the incidence of oral problems and the days to death (DTD) in patients receiving palliative care.  From their findings, the authors suggest that, during palliative care, oral complications appear more frequently when the DTD period is shorter. These symptoms may be useful indicators when deciding on the proper timing of intensive oral care intervention to decrease oral problems and pain in terminally ill patients.

Malignancy associated hypercalcaemia-responsiveness to IV bisphosphonates and prognosis in a palliative population

Supportive Care in Cancer, April 2016, vol./is. 24/4(1771-1777)

Mallik S., Mallik G., Macabulos S.T., Dorigo A.

The goals of this study were to determine the reversibility of hypercalcaemia amongst patients whose underlying malignancy is not being treated and assess whether correction results in improvement in symptoms attributable to hypercalcaemia, while identifying risk factors that can predict responsiveness.  The authors found that a reduction in calcium level was associated with a significantly prolonged survival, as well as symptomatic improvement, irrespective of whether normocalcaemia was achieved. 

Evaluating the effects of mindfulness-based interventions for informal palliative caregivers: a systematic literature review

Palliative Medicine, Feb 2016, vol. 30, no. 2, p. 117-131Jaffray, Linda, Bridgman, Heather, Stephens, Miranda, Skinner, Timothy

Mindfulness-based interventions may have application in the setting of palliative caregiving. The aim of this review is to describe, evaluate and synthesise the peer-reviewed literature on the effects of mindfulness-based interventions for informal palliative caregivers. Results suggest that mindfulness-based interventions are feasible and acceptable to offer to this group and may provide benefit, particularly in terms of reducing depression and caregiver burden and increasing quality of life. However, effects were not as robust as findings in the wider mindfulness intervention literature. 

Euthanasia and physician-assisted suicide: a white paper from the European Association for Palliative Care.

Palliative Medicine, Feb 2016, vol. 30, no. 2, p. 104-116

Radbruch, Lukas, Leget, Carlo, Bahr, Patrick, Müller-Busch, Christof, Ellershaw, John, de Conno, Franco, Vanden Berghe, Paul, board members of the EAPC

This white paper aims to provide an ethical framework for palliative care professionals on euthanasia and physician-assisted suicide. It also aims to provide an overview on the available evidence as well as a discourse of ethical principles related to these issues. Following a consensus process which sought comments and opinion from experts and nationals organisations this final version was adopted as an official position paper of the European Association for Palliative Care in April 2015.

To access this article click here

Implementation of a pilot telehealth programme in community palliative care: A qualitative study of clinicians' perspectives

Palliative Medicine, Apr 2016, vol. 30, no. 4, p. 409-417

Collier, Aileen, Morgan, Deidre D, Swetenham, Kate, To, Timothy Hm, Currow, David C, Tieman, Jennifer J

The aim of this study was to explore clinicians' perspectives on and experiences of the utilisation of a pilot telehealth model and its integration into a specialist community palliative care programme. The study was conducted in a metropolitan specialist palliative care service in South Australia. Introducing this technology challenged the team to critically explore aspects of current service provision.  

Available in print in Arthur Rank House Library, Brookfields Hospital

Complex decongestive lymphatic therapy with or without vodder ii manual lymph drainage in more severe chronic postmastectomy upper limb lymphedema: a randomized noninferiority prospective study

Journal of Pain and Symptom Management, Dec 2015, vol. 50, no. 6, p. 750-757

Gradalski, Tomasz, Ochalek, Katarzyna, Kurpiewska, Joanna

The purpose of this study was to compare the reduction in edema volume in more advanced (≥20% limb volume difference) postmastectomy arm lymphedema achieved by compression bandaging (CB) and physical exercises vs. the same management augmented by an additional 30 minutes of MLD (Vodder II method). A decrease of limb volume (15.6% in the CB group and 13.8% in the CDT group), edema volume (47.2% and 47.4%, respectively), and limb-related volume change (14.7% and 12.5%) during the intensive phase were observed. This improvement remained constant in both groups after six months of maintenance therapy. The health-related quality of life similarly showed improvement in both groups, with a high level of treatment satisfaction. These results indicate that parallel (immediate and delayed) results may be obtained by CDT without the use of Vodder MLD and CB may be an essential part of lymphedema management. 

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Pilot study of a brief behavioral intervention for dyspnea in patients with advanced lung cancer

Journal of Pain and Symptom Management, Dec 2015, vol. 50, no. 6, p. 854-860

Greer, Joseph A, MacDonald, James J, Vaughn, Jeanne, Viscosi, Elene, Traeger, Lara, McDonnell, Theresa, Pirl, William F, Temel, Jennifer S

This pilot study examined the feasibility and utility of delivering a brief behavioral intervention for dyspnea in patients with lung cancer. The manualized intervention consisted of two sessions in which nurse practitioners taught participants breathing and relaxation techniques within the infusion clinic and encouraged home practice. In this sample patients reported improvements in dyspnea, QOL, and mood.

Available in print in Arthur Rank House Library, Brookfields Hospital

Patient-controlled therapy of breathlessness in palliative care: a new therapeutic concept for opioid administration?

Journal of pain and symptom management, Mar 2016, vol. 51, no. 3, p. 581-588

Schmitz, Andrea, Schulz, Christian, Friebel, Uta, Hohlfeld, Thomas, Bausewein, Claudia

Often, severity of breathlessness increases quickly, calling for rapid symptom control.  The aim of this pilot study was to investigate whether intravenous opioid PCT can be an effective therapeutic method to reduce breathlessness in patients with advanced disease. Secondary aims were to study its feasibility and acceptance in patients with refractory breathlessness.  The authors conclude that opioid PCT is a feasible and acceptable therapeutic method to reduce refractory breathlessness in palliative care patients. 

Nurses' resilience and nurturance of the self

International Journal of Palliative Nursing, Oct 2015, vol. 21, no. 10, p. 504-510

Shimoinaba, Kaori, O'Connor, Margaret, Lee, Susan, Kissane, David

The purpose of this study was to explore the nature of nurses' resilience and the way it is developed. Self-nurturing was evident as the way nurses developed resilience, which included knowledge of self, coping adaptively, valuing care and accepting limitations. However, none had educational pathways to build greater resilience. Integrating support and education to foster nurses' resilience is important to enable self-protection, as well as the provision of high quality care.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Rapid discharge from hospital in the last days of life: an evaluation of key issues and the discharge sister role

International Journal of Palliative Nursing, Dec 2015, vol. 21, no. 12, p. 588-595

Jones, Susan, Hamilton, Sharon, Nicholson, Alex

This study explored the issues surrounding rapid discharge from hospital in the final days of life, and evaluated the contribution of a discharge sister role. A qualitative design was used, incorporating focus groups and interviews with key stakeholders. A total of 75 staff and 7 carers participated. Rapid discharge is challenging and requires high levels of skill. The discharge sister navigated complex organisational systems to facilitate rapid discharge for those who might otherwise have died in hospital.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

The use of corticosteroids in reducing cancer-related fatigue: assessing the evidence for clinical practice

International Journal of Palliative Nursing, Jan 2016, vol. 22, no. 1, p. 5-9

Begley, Sarah, Rose, Kevin, O'Connor, Margaret

A widely used strategy to treat fatigue in palliative care is the use of corticosteroids but, despite being frequently prescribed, evidence of their effectiveness is ambiguous. This paper used a systematic approach to explore literature to determine evidence about whether the use of corticosteroids improves levels of cancer-related fatigue in people with advanced cancer.  The four included studies all reported improvements in patient-reported fatigue as a result of taking corticosteroids, although the quality of results varied and only a few were deemed to have statistically significant results. While there is some evidence that corticosteroids can improve cancer-related fatigue, more rigorous research is required.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Short break and emergency respite care: what options for young people with life-limiting conditions?

International Journal of Palliative Nursing, Feb 2016, vol. 22, no. 2, p. 57-65

Mitchell, Tracy K, Knighting, Katherine, O'Brien, Mary R, Jack, Barbara A

Service providers face difficult decisions about how best to develop services for the increasing numbers of young people with life-limiting conditions who require palliative care.  The purpose of this two-phase evaluation study was to explore alternative short break and emergency respite care options to children's hospice care. There were few, or no, alternatives when children's hospice care was not available that can meet the need of young people with life-limiting conditions, creating anxiety for children's hospice users and those leaving the service as a result of reaching transition age or through no longer meeting the children's hospice eligibility criteria. 

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Palliative care for people with dementia: a literature review

International Journal of Palliative Nursing, Feb 2016, vol. 22, no. 2, p. 76-81

Lillyman, Sue, Bruce, Mary

This literature review has identified several key themes in relation to the person dying with dementia including: diagnosis of the dying phase, appropriate timing of referral to specialist palliative care services; ethical decisions in relation to medication and nutrition; the environment; undertreatment especially, for pain relief; over and burdensome treatment interventions; carer involvement; collaborative working and advance decision making.

Available in print in Arthur Rank House Library, Brookfields Hospital

Conservative care of the elderly ckd patient: a practical guide

Advances in Chronic Kidney Disease, Jan 2016, vol. 23, no. 1, p. 51-56 

Raghavan, Divya, Holley, Jean L

Palliative or supportive care should be routine for conservatively managed CKD patients. Decision-making about dialysis or conservative management requires patients and families be given information on prognosis, quality of life on dialysis, and options for supportive care. Advance care planning is the process by which these issues can be explored. Patients with ESRD have a high symptom burden, which needs to be addressed in any treatment plan. Common symptoms include pain, fatigue, insomnia, pruritus, anorexia, and nausea. Recommendations for management are discussed in the article. 

Fulltext available in Advances in Chronic Kidney Disease

Walls, wisdom, worries, and wishes: engaging communities in discussion about death, dying, loss, and care using café conversation

Progress in Palliative Care, 2016, vol./is. 24/1(9-14)

McLoughlin, K., McGilloway, S., Lloyd, R., O'Connor, M., Rhatigan, J., Shanahan, M., Richardson, M., Keevey, A.

This paper reflects on the adaptation of the World Café concept to engage with members of the public in Compassionate Communities Café Conversation.  This paper outlines the preparation, presentation, and pilot evaluation of the Compassionate Communities Café Conversation experience in two towns in the Mid-West of Ireland. The experience and findings suggest that this approach offers a potentially very useful framework for use by others as part of a health promoting approach to palliative care.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

The palliative care needs of people severely affected by neurodegenerative disorders: a qualitative study

Progress in Palliative Care, 2015, vol./is. 23/6(331-342)

Veronese, S., Gallo, G., Valle, A., Cugno, C., Chiò, A., Calvo, A., Rivoiro, C., Oliver, D. J.

The particular needs of people with advanced and progressive neurological disease are not well known. A qualitative approach was used, interviewing people with advanced amyotrophic lateral sclerosis/motor neurone disease (ALS/MND), multiple sclerosis (MS), Parkinson's disease (PD), and multiple systems atrophy (MSA) and their family carers to ascertain their particular needs. Focus groups of health and social care professionals allowed a professional view of the needs. People with progressive disease have many, difficult and distressing symptoms: physical, including pain, movement issues, swallowing and speech problems, psychological, feelings of being abandoned and of anxiety and depression, social, of isolation, of being a burden and of financial issues, and spiritual, of loss of hope and the meaning of life as they approach death.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

"Sometimes we can't fix things": a qualitative study of health care professionals' perceptions of end of life care for patients with heart failure

BMC Palliative Care, January 2016, vol./is. 15/1(no pagination)

Glogowska M., Simmonds R., McLachlan S., Cramer H., Sanders T., Johnson R., Kadam U.T., Lasserson D.S., Purdy S.

Studies show that patients with advanced heart failure may have a poor understanding of their condition and its outcome and, therefore, miss opportunities to discuss their wishes for EoL care and preferred place of death. We aimed to explore the perceptions and experiences of health care professionals (HCPs) working with patients with heart failure around EoL care. These key professionals can help co-ordinate care and support in the terminal phase of the condition. Links between heart failure teams and specialist palliative care services appear to benefit patients, and further sharing of expertise between teams is recommended.

Fulltext available from National Library of Medicine in BMC Palliative Care

The use of aromasticks to help with sleep problems: A patient experience survey

Complementary therapies in clinical practice, Feb 2016, vol. 22, p. 51-58

Dyer, Jeannie, Cleary, Lise, McNeill, Sara, Ragsdale-Lowe, Maxine, Osland, Caroline

Essential oils may be inhaled by means of an aromastick (a personal inhaler device containing essential oils) as a means of improving sleep. Sixty-five aromasticks were given out over a 13 week period. 94% of patients reported that they did use their aromastick to help them sleep and 92% reported that they would continue to do so. An improvement of at least one point on a Likert scale measuring sleep quality was shown by 64% of patients following the use of an aromastick.

Fulltext available in Complementary Therapies in Clinical Practice

Effect of progressive relaxation exercises on fatigue and sleep quality in patients with chronic obstructive lung disease (COPD)

Complementary therapies in clinical practice, Nov 2015, vol. 21, no. 4, p. 277-281

Akgün Şahin, Zümrüt, Dayapoğlu, Nuray

This research was conducted to investigate the effect of Progressive Muscle Relaxation Technique on fatigue and sleep quality in patients with COPD.  It was determined that PMRT decreased patients' fatigue level and improved their sleep quality.  Progressive relaxation exercises programs represent effective therapeutic intervention approaches for relieving COPD-associated fatigue and sleep quality. 

Fulltext available in Complementary Therapies in Clinical Practice

What does end stage in neuromuscular diseases mean? Key approach-based transitions

Current opinion in supportive and palliative care, Dec 2015, vol. 9, no. 4, p. 361-368

Tripodoro, Vilma Adriana, De Vito, Eduardo Luis

The purpose of this article is to revise the definition of end stage in the setting of neuromuscular disease (NMD), to understand the implications for the patient, family and healthcare team, and to address the obstacles involved in the lack of definition.  Better end-stage NMD definitions should help to identify the goals of care, but a broad range in time and intensity of deterioration make a valid definition difficult. This article emphasizes the relevance of an integrated approach through the whole trajectories of NMD patients considering key transitions.

Unexpected death in palliative care: what to expect when you are not expecting

Current opinion in supportive and palliative care, Dec 2015, vol. 9, no. 4, p. 369-374

Hui, David

When death occurs suddenly and earlier than anticipated, it is considered as an unexpected death. In this article, the author discusses when death is expected and unexpected, and reviews the frequency, impact, causes, and approach to unexpected death in the palliative care setting. Unexpected death has significant impact on care, including unrealized dreams and unfinished business among patients, a sense of uneasiness and complicated bereavement among caregivers, and uncertainty in decision making among healthcare providers. 

Living with advanced cancer and an uncertain disease trajectory: an emerging patient population in palliative care?

BMJ Support Palliat Care 2015; vol/is 5/4, p 352-357
Elizabeth A Lobb, Judith Lacey, John Kearsley, Winston Liauw, Lesley White and Annmarie Hosie

Participants in this study represent an emerging cancer patient population who are receiving palliative therapies. Our study suggests that a flexible model of care is needed to support the needs of people who may still be receiving some form of chemotherapy and/or radiotherapy, and remain well. This model may need to take more of an intermittent approach, that is, as required for specific symptom management, rather than patients being linked continuously to a palliative care service for long periods of time.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Defining the palliative care patient: its challenges and implications for service delivery

BMJ Support Palliat Care 2015; vol/is 5/4, p 46-52

Helen Mitchell, Simon Noble, Ilora Finlay and Annmarie Nelson

Within the UK, general practitioners (GPs) are required to maintain a register of palliative patients under their care. We explored GPs' views of what defines a palliative care patient in the context of identifying clinical service needs.  Achieving health policy targets which require identification of palliative patients will continue to be a challenge until a workable and reliable definition of the term ‘palliative’ is agreed upon.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities

BMJ Support Palliat Care 2015 December, vol/is 5/5, p 531-7
Dorry McLaughlin, Owen Barr, Sonja McIlfatrick and Roy McConkey

Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training.

Available in print in Arthur Rank Hospice Library, Brookfields Hospital

Prognostic factors of 30-day mortality after palliative procedures in patients with malignant pleural effusion

Annals of surgical oncology, Nov 2015, vol. 22, no. 12, p. 4083-4088 

Abrao, Fernando Conrado, de Abreu, Igor Renato Louro Bruno, Fogarolli, Mariana, Caxeiro, Giovanna, Bezerra, Camila Borges Saes, de Cerqueira Cesar, Fernanda Prado, Rocha, Poline Spitti, Younes, Riad Naim

The aim of this study was to identify predictors of 30-day mortality in patients with malignant pleural effusion (MPE) who need pleural palliative procedures. The authors identified four factors that are easily recognized in daily practice and can help select patients with low life expectancy, therefore preventing invasive procedures and hospitalizations for this subgroup of patients.

Internet-based exposure and behavioral activation for complicated grief and rumination: a randomized controlled trial

Behavior therapy, Nov 2015, vol. 46, no. 6, p. 729-748

Eisma, Maarten C, Boelen, Paul A, van den Bout, Jan, Stroebe, Wolfgang, Schut, Henk A W, Lancee, Jaap, Stroebe, Margaret S

This study examined the effectiveness and feasibility of therapist-guided internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination. 

Fulltext available from Elsevier in Behavior Therapy

Palliative care in patients with ovarian cancer and bowel obstruction

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, Nov 2015, vol. 23, no. 11, p. 3157-3163

Daniele, Alberto, Ferrero, A, Fuso, L, Mineccia, M, Porcellana, V, Vassallo, D, Biglia, N, Menato, G

Malignant bowel obstruction (MBO) is usually a pre-terminal event in patients with ovarian cancer. The authors analyzed medical and surgical procedures, performance status, nutritional status, cachexia, and their prognostic value in this group of patients. Cachexia, low performance status, and poor nutritional status were significant predictors of worse survival after MBO, independent of the treatment. The authors conclude that surgery has to be considered in patients without serious contraindications; otherwise, a medical protocol, including antisecretory drugs, is the standard of care in frail patients. 

Symptom management and end-of-life care in amyotrophic lateral sclerosis

Neurologic clinics, Nov 2015, vol. 33, no. 4, p. 889-908

Jackson, Carlayne E, McVey, April L, Rudnicki, Stacy, Dimachkie, Mazen M, Barohn, Richard J

The number of available symptomatic treatments has markedly enhanced the care of patients with amyotrophic lateral sclerosis (ALS). Once thought to be untreatable, patients with ALS today clearly benefit from multidisciplinary care. Unfortunately, there are few randomized controlled trials of medications or interventions addressing symptom management. In this review, the authors provide the level of evidence, when available, for each intervention that is currently considered standard of care by consensus opinion. 

Fulltext available from Elsevier in Neurologic Clinics

Tools to assess pain or lack of comfort in dementia: a content analysis

Journal of pain and symptom management, Nov 2015, vol. 50, no. 5, p. 659-675

van der Steen, Jenny T, Sampson, Elizabeth L, Van den Block, Lieve, Lord, Kathryn, Vankova, Hana, Pautex, Sophie, Vandervoort, An, Radbruch, Lukas, Shvartzman, Pesach, Sacchi, Valentina, de Vet, Henrica C W, Van Den Noortgate, Nele J A.

The authors aim was to map and compare items in tools that assess pain and the broader notion of discomfort or comfort in people with severe dementia or at the end of life.

Fulltext available from Elsevier in Journal of Pain and Symptom Management

Available in print in Arthur Rank House Library, Brookfields Hospital

Palliative care of urologic patients at end of life

Clinics in geriatric medicine, Nov 2015, vol. 31, no. 4, p. 667-678

Sinclair, Christian T, Kalender-Rich, Jessica L, Griebling, Tomas L, Porter-Williamson, Karin

This article focuses on the issues facing patients with advanced and terminal urologic illness, from the framework of care planning based on defining patient-specific and family-specific goals of care, to palliative management strategies for common symptoms and syndromes that these patients and their families experience. It also discusses the management of common urologic issues that may arise in the course of care for all patients at the end of life, as well as the impact of these conditions on caregivers 

Fulltext available from Elsevier in Clinics in Geriatric Medicine

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