Palliative care for severely affected patients with multiple sclerosis: when and why? Results of a delphi survey of health care professionals

Journal of Palliative Medicine, October 2014, vol./is. 17/10(1128-36)Strupp J, Romotzky V, Galushko M, Golla H, Voltz R

The objective was to use a Delphi survey to analyse when and why specialised palliative care integration would be beneficial via examining health care professionals' attitudes.  The results identify specific areas in which palliative care will likely prove to be a valuable asset in the treatment course of MS.

Breathlessness, functional status, distress, and palliative care needs over time in patients with advanced chronic obstructive pulmonary disease or lung cancer: a cohort study

Journal of Pain & Symptom Management, October 2014, vol./is. 48/4(569-581.e1)Weingaertner V, Scheve C, Gerdes V, Schwarz-Eywill M, Prenzel R, Bausewein C, Higginson IJ, Voltz R, Herich L, Simon ST, PAALiativ Project, PAALiativ Project

The objective of this paper is to describe and compare the courses of refractory breathlessness, functional status, distress, and PC needs in patients with advanced chronic obstructive pulmonary disease (COPD) or lung cancer (LC) over time. The authors conclude that the PC needs of patients with advanced COPD are comparable with LC patients, and breathlessness severity and distress are even higher. 

Available in print in Arthur Rank House Library, Brookfields Hospital

Learning, development, and support needs of community palliative care clinical nurse specialists

International Journal of Palliative Nursing, September 2014, vol./is. 20/9(425-33)

Whittaker E, Kernohan WG, McLaughlin D

The aim of this study was to explore what learning, development, and support PC-CNSs in one hospice need to enable them to fulfil all components of their role: clinical practice, education, research, and leadership and management.  They identified that both organisational culture and individuals themselves influenced the learning and development support available. Working relationships and stability within teams affected how supported individuals felt and had implications for managers in meeting the needs of staff while balancing the needs of the service.

Full text available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Neuropathic pain in people with cancer (part 1): incidence, manifestation, and assessment

International Journal of Palliative Nursing, September 2014, vol./is. 20/9(442-7)

Taverner T

Nurses are well placed to identify patients with possible signs and symptoms of neuropathic pain. Part 1 of this paper provides an overview of neuropathic cancer pain incidence, manifestation, and assessment; part 2 will address management.

Full text available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Psychosocial, educational and communicative interventions for patients with cachexia and their family carers

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(334-8)

Reid J

Full text available in Current Opinion in Supportive and Palliative Care

Indications and practice of artificial hydration for terminally ill cancer patients

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(358-63)

Nakajima N, Satake N, Nakaho T

The purpose of this review is to update medical professionals on the role of artificial hydration in terminally ill cancer patients and to highlight recent research.

Full text available in Current Opinion in Supportive and Palliative Care

Role of corticosteroids for fatigue in advanced incurable cancer: is it a 'wonder drug' or 'deal with the devil'

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(346-51)

Yennurajalingam S, Bruera E

This review summarizes recent literature on the impact of corticosteroids on fatigue, its related symptoms, and the role of 'corticosteroid rotation' in improving the corticosteroid-related side-effects.  The two recently published artilces found confirm the short-term benefits for the symptomatic treatment of cancer-related fatigue and anorexia cachexia in advanced incurable cancer. Long-term use of corticosteroids is not recommended at this time because of the risk of debilitating side-effects and no evidence of its long-term benefits. Recent studies also suggest the possible role of corticosteroid rotation or switching similar to opioid rotation for improvement of these side-effects.

Full text available in Current Opinion in Supportive and Palliative Care

End-of-life matters in chronic heart failure patients

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(364-70)
Sobanski P, Jaarsma T, Krajnik M

The purpose of this review is to provide an update on current end-of-life issues specific to heart failure patients, including a proposed new model of end-of-life trajectories which takes into account the influence of comorbidities on the prognosis of heart failure and advance care planning for patients with implanted cardiac devices which has been shown to be unsatisfactory. A recent strategy for managing implantable cardioverter defibrillators in patients approaching death is presented.

Full text available in Current Opinion in Supportive and Palliative Care

Cancer-related insomnia

American Journal of Hospice & Palliative Medicine, November 2014, vol./is. 31/7(777-85)

Induru RR, Walsh D.

An overview of the assessment and management of insomnia in cancer patients is presented.

Persistent hiccups in advanced neuro-oncology patients: findings from a descriptive phenomenological study

Journal of Hospice and Palliative Nursing, Oct 2014, vol/iss 16/7(396-401)

Palese, Alvisa, Condolo, Giulio, Dobrina, Raffaella, Skrap, Miran

According to the patients' experience, living with persistent hiccups was characterized by 3 main themes: (a) resignation to its unpredictable nature; (b) despair that there is nothing worse than hiccups; and (c) learning to control the pauses. In trying to interrupt hiccups, patients learn to control their pauses, lengthening the interval between 1 spasm and the next, thereby achieving an acceptable level of symptom discomfort.

Identification and validation of premortem purge: a delphi study

Journal of Hospice and Palliative Nursing, Oct 2014, vol/iss 16/7 (430-437)

Schreiber, Tanya P., Bennett, Marsha J.

Anecdotal accounts offered by nurses suggest that some individuals in the final phase of dying experience a sudden, unexpected surge of energy and enhanced mental clarity, varying in intensity and duration. The Delphi method was used to systematically collect observations, opinions, and perceptions of the phenomenon, labeled premortem surge (PS).

Integrative review of dignity in end-of-life care

Palliative Medicine, July 2014, vol./is. 28/7(931-940)

Guo Q., Jacelon C.S

The aim of this review was to synthesize the meaning of dying with dignity and to identify common aspects of dignity in end-of-life care. 

Full text available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

Self-injury in youths who lost a parent to cancer: nationwide study of the impact of family-related and health-care-related factors

Psycho-Oncology, September 2014, vol./is. 23/9(989-97)

Bylund Grenklo T, Kreicbergs U, Valdimarsdottir UA, Nyberg T, Steineck G, Furst CJ

Self-injury, a manifestation of severe psychological distress, is increased in cancer-bereaved youths. The results of this study involving 622 youths (aged 18-26) who had lost a parent between the ages of 13 and 16 suggest that poor family cohesion before and after the loss of a parent to cancer is associated with an increased risk of self-injury in teenage children.

The volume of hydration in terminally ill cancer patients with hydration-related symptoms: a prospective study

Journal of Palliative Medicine, September 2014, vol./is. 17/9(1037-41)

Nakajima N, Takahashi Y, Ishitani K

This study aimed to clarify the effects of reducing the volume of artificial hydration, based on the Japanese guideline, in terminally ill cancer patients with hydration-related symptoms on the alleviation of various symptoms and QOL.  The results suggest that hydration-related symptoms were significantly improved after performing guideline-based AHT.

Insomnia among patients with advanced disease during admission in a Palliative Care Unit: a prospective observational study on its frequency and association with psychological, physical and environmental factors

BMC Palliative Care, 2014, vol./is. 13/(40)

Renom-Guiteras A, Planas J, Farriols C, Mojal S, Miralles R, Silvent MA, Ruiz-Ripoll AI

The authors conclude that insomnia was highly frequent and seemed to be influenced by several physical, psychological and environmental factors. They suggest that within the multimodal management of insomnia, the assessment of nocturnal rumination may be of particular interest, irrespective of emotional distress. 

Full text available in BMC Palliative Care

Exploring hope and healing in patients living with advanced non-small cell lung cancer

Oncology Nursing Forum, 01 September 2014, vol./is. 41/5(497-508)

Eustache, Chloe, Jibb, Emily, Grossman, Mary

The authors used an interpretive qualitative study design involving 12 patients. Four main themes were identified: (a) the morass of shattered hope, (b) tentative steps toward a new hope paradigm, (c) reframing hope within the context of a life-threatening illness, and (d) strengthening the link between hope and wellness. They highlight the importance of understanding the fluctuating nature of hope in patients with advanced lung cancer to foster it, therefore promoting healing.

Available in print in Arthur Rank House Library, Brookfields Hospital

How to conduct research in an independent hospice: practical tips and advice

European Journal of Palliative Care, 2014, Vol/iss 21/5 (236-9)

Paul Perkins, Rebecca Day, Julie Hapeshi, Lorraine Dixon and Rudo Nyakuhwa

Hospices, as centres of excellence, have a duty to drive and initiate research if they are to provide high-quality palliative care but they do face a number of challenges. In this paper, the authors use their experience at Sue Ryder to provide some insight into how independent hospices can become active in conducting research.

Full text available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

How can you prove that you are delivering good care? Monitoring the quality of palliative care using quality indicators

European Journal of Palliative Care, 2014, Vol/iss 21/5 (228-31)

Joachim Cohen and Kathleen Leemans

Measuring the quality of palliative care in a systematic and valid manner, so that the results can be used to improve care where necessary, remains a challenge. In this article, the authors argue that quality indicators specifically designed for palliative care can address this challenge and illustrate this using an indicator set recently developed in Belgium.

Full text available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

A survey about patients transferred from a specialist palliative care unit to an acute hospital setting

European Journal of Palliative Care, 2014, Vol/iss 21/5 (219-21)

Trisha Castanheira and Bethany Wright

Increasingly in both malignant and non-malignant disease, palliative care is being offered alongside active therapy so the interface between acute and specialist palliative care services is likely to be less clear-cut.  In this article the authors ask if hospice patients benefit from transfers to the acute hospital and consider how to achieve a balance between curative and palliative care?  They present and discuss the results of a survey conducted at Birmingham St Mary’s Hospice looking at patient transfers to the acute hospital.

Full text available in European Journal of Palliative Care
Available in print in Arthur Rank House Library, Brookfields Hospital

Is religion harmful or beneficial at the end of life?

European Journal of Palliative Care,  2014, Vol/iss  21/4 (188-92)

Nimisha Panchmatia

Nimisha Panchmatia has reviewed the literature in an attempt to understand the role and impact – whether positive or negative – of religion and spirituality for patients nearing the end of life.

Full text available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hoapital

Developing a complex intervention to improve advance care planning for care home residents

European Journal of Palliative Care,  2014, Vol/iss  21/4 (173-6)

Tamsin McGlinchey, Stephen Mason, Philip Saltmarsh, Maureen Gambles, Gerard Corcoran, Rebecca Bancroft and John E Ellershaw

This paper describes phase1 of a project set up in the North-West of England to develop, implement and evaluate a complex intervention aimed at improving the planning of future care for care home residents with and without mental capacity.

Full text available in European Journal of Palliative Care

Available in print in the Arthur Rank House Library, Brookfields Hospital

Wake up, sleep is important! Managing sleep disturbance in patients with advanced cancer

European Journal of Palliative Care,  2014, Vol/iss  21/4 (162-5)

Gunnhild Jakobsen, Anne Kari Knudsen and Pål Klepstad

Sleep disturbance is a relatively common, but often neglected, problem in advanced cancer and should be considered as a separate issue which needs specific assessment and treatment. The authors explain how to screen for sleep disturbance in cancer patients and outline the available management options.

Full text available in European Journal of Palliative Care

Available in print in the Arthur Rank House Library, Brookfields Hospital

What a wish to die can mean: reasons, meanings and functions of wishes to die, reported from 30 qualitative case studies of terminally ill cancer patients in palliative care

BMC Palliative Care, 2014, vol./is. 13/(38)
Ohnsorge K; Gudat H; Rehmann-Sutter C

The objective of this study is to explore the different possible motivations and explanations of patients who express or experience a WTD.The distinction between reasons, meanings and functions allows for a more detailed understanding of the motivation for the WTD statements of cancer patients in palliative care situations. Better understanding is crucial to support patients and their relatives in end-of-life care and decision making. 

Full text available from BMC Palliative Care at ProQuest

Care of breathlessness in a hospice patient with advanced lung cancer

End of Life Journal, 2014, Vol/iss 4/2
Gemma Hodge

This article explores the available evidence regarding best practice in the assessment and management of dyspnoea in patients with advanced lung cancer receiving palliative care and reflects on the care of a woman with advanced lung cancer admitted to a hospice and who had an acute episode of dyspnoea.

Full text available in End of Life Journal

Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme

BMJ Supportive and Palliative Care 2014;Vol/iss 4/3 (313-321)
Karen Detering, William Silvester, Charlie Corke, Sharyn Milnes, Rachael Fullam, Virginia Lewis, Jodie Renton

The authors report the results of the evaluation of an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training. They conclude that the programme significantly improved the doctors’ self-reported confidence in discussing advance care planning, improved their scores on the patient e-simulation exercise and was rated highly by the majority of participants.

Full text available in BMJ Supportive and Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

Diagnosing dying: an integrative literature review

BMJ Supportive and Palliative Care 2014;Vol/iss 4/2, (263-270)

Catriona Kennedy; Patricia Brooks-Young; Carol Brunton Gray; Phil Larkin;  Michael Connolly; Bodil Wilde-Larsson; Maria Larsson; Tracy Smith; Susie Chater

The aim of this review was to examine the evidence as to how patients are judged by clinicians as being in the final hours or days of life.The findings support the explicit recognition of ‘uncertainty in diagnosing dying’ and the need to work with and within this concept. Clinical decision making needs to allow for recovery where that potential exists, but equally there is the need to avoid futile interventions

Full text  available in BMJ Supportive and Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

Developing a service for patients with very severe chronic obstructive pulmonary disease (COPD) within resources

BMJ Supportive and Palliative Care 2014; Vol/iss 4/2 (196-201)
Jason Boland, Janet Owen, Rachel Ainscough, Hazim Mahdi

The aim of this service development was to improve local service provision in Barnsley, within the currently available resources, for patients with very severe COPD, to improve patient identification and symptom management, increase advance care planning and the numbers of patients dying in their preferred place, and increase patient and carer support and satisfaction. 

Full text available in BMJ_Supportive_and_Palliative_Care
Available in print in Arthur Rank House Library, Brookfields Hospital

Resuscitation decisions for patients dying in the community: A qualitative interview study of general practitioner perspectives

Palliative Medicine, September 2014, vol./is. 28/8(1053-61)

Miller S, Dorman S

The aim was to investigate how General Practitioners think and feel about making and communicating Do Not Attempt Cardiopulmonary Resuscitation decisions for patients dying in the community. Resuscitation decisions are important in facilitating a peaceful death, but can be difficult for general practitioners to discuss. The authors suggest that GPs might benefit from clearer guidance on when an attempt at resuscitation is unlikely to be successful, especially in non-malignant disease. Team discussions including Gold Standards Framework meetings can give confidence and support in making difficult end-of-life decisions.

Available in print in Arthur Rank House Library, Brookfields Hospital

Palliative sedation therapy: a systematic literature review and critical appraisal of available guidance on indication and decision making

Journal of Palliative Medicine, May 2014, vol./is. 17/5(601-11)

Schildmann E, Schildmann J

Following a review and critical appraisal, the authors found that the guidelines differ considerably on aspects of indication and decision making about PST which are relevant from a clinical as well as ethical perspective. The comparison and critical appraisal can serve as a starting point for the improvement of future PST policies. 

Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: a phase II randomized controlled trial

Journal of Palliative Medicine, June 2014, vol./is. 17/6(688-95)

Juliao M, Oliveira F, Nunes B, Vaz Carneiro A, Barbosa A

Eighty participants were included in this study and followed for 30 days. The authors conclude that dignity therapy resulted in a beneficial effect on depression and anxiety symptoms in end-of-life care. The therapeutic benefit was sustained over a 30-day period. 

Palliative use of noninvasive ventilation: navigating murky waters

Journal of Palliative Medicine, June 2014, vol./is. 17/6(657-61)

Quill CM, Quill TE

The authors describe the use of NPPV in four patients with advanced disease and preexisting treatment-limiting directives. They discuss some of the ethical dilemmas and unintended consequences that may accompany the use of NPPV in such circumstances and review the benefits and burdens of palliative NPPV.  They conclude with a summary of principles that can be used as a guide to decision making regarding palliative NPPV.

Delirium in palliative and end of life care

Journal of Pain & Symptom Management, August 2014, vol./is. 48/2

This is a themed issue of the journal with a range of articles relating to delirium.  Titles include:

• Clinical practice guidelines for delirium management: potential application in palliative care
• Treating an established episode of delirium in palliative care: expert opinion and review of the current evidence base with recommendations for future development
• End-of-life delirium: issues regarding recognition, optimal management, and the role of sedation in the dying phase
• Practical assessment of delirium in palliative care
• A relational ethical approach to end-of-life delirium

Available in print in Arthur Rank House Library, Brookfields Hospital

The implications of mandatory do not attempt cardiopulmonary resuscitation discussions

International Journal of Palliative Nursing, July 2014, vol./is. 20/7(323-5)

Berry PA

A discussion on the recent Court of Appeal judgement in the case of Tracey vs Cambridge University Hospital HNS Foundation Trust relating to the failure to consult on the placement of a DNACPR notice in the patient's medical record.

Available in print in Arthur Rank House Library, Brookfields Hospital

'Cancer changes everything!' Exploring the lived experiences of women with metastatic breast cancer

International Journal of Palliative Nursing, July 2014, vol./is. 20/7(334-42)

Krigel S, Myers J, Befort C, Krebill H, Klemp J

The aim of this study was to further explore the lived experiences of women with metastatic breast cancer (MBC), to inform the development of interventions to enhance survivorship care for women with advanced disease. 

Full text available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Breathlessness in motor neurone disease: a review of the current strategies and gaps in the evidence

Current Opinion in Supportive & Palliative Care, September 2014, vol./is. 8/3(213-7)

Allcroft P

Palliative care teams are increasingly becoming involved in the complex care of these patients at an earlier stage in their illness. Assessment of breathlessness and its successful management improves the QoL of patients with MND and may minimize hospitalisation.

Full text available in Current Opinion in Supportive and Palliative Care

Preparedness planning before mechanical circulatory support: a "how-to" guide for palliative medicine clinicians

Journal of Pain & Symptom Management, May 2014, vol./is. 47/5(926-935.e6)

Swetz KM, Kamal AH, Matlock DD, Dose AM, Borkenhagen LS, Kimeu AK, Dunlay SM, Feely MA

Previous literature has suggested that palliative medicine providers are well poised to assist cardiologists, cardiothoracic surgeons, and the multidisciplinary cardiovascular team with promotion of informed consent and initial and iterative discussions regarding goals of care. Here, the authors outline several key aspects of preparedness planning and detail strategies for engaging patients who are receiving mechanical circulatory support in the process. 

Full text available from Elsevier in Journal of Pain and Symptom Management

Available in print in Arthur Rank House Library, Brookfields Hospital

Care strategy for death rattle in terminally ill cancer patients and their family members: recommendations from a cross-sectional nationwide survey of bereaved family members' perceptions

Journal of Pain & Symptom Management, July 2014, vol./is. 48/1(2-12)

Shimizu Y, Miyashita M, Morita T, Sato K, Tsuneto S, Shima Y

The authors aimed to clarify death rattle-related emotional distress levels among family members and their perceptions of the need for death rattle care improvement and explore the factors influencing both these issues. 

Full text available from Elsevier in Journal of Pain and Symptom Management

Available in print in Arthur Rank House Library, Brookfields Hospital

The challenges of providing palliative care for people with intellectual disabilities: a literature review

International Journal of Palliative Nursing, June 2014, vol./is. 20/6(279-84)

Dunkley S, Sales R

This literature review explores the challenges of providing palliative care for people with intellectual disability,  highlighting the need for ongoing staff development focusing on staff confidence, collaborative working between professionals, and the empowerment of people with intellectual disability to be involved in decisions about their end-of-life care. 

Full text available from EBSCO in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Current assessment and treatment strategies of dysphagia in head and neck cancer patients: a systematic review of the 2012/13 literature

Current Opinion in Supportive & Palliative Care, June 2014, vol./is. 8/2(152-63)

Kraaijenga SA, van der Molen L, van den Brekel MW, Hilgers FJ 

This review focuses on the rapidly growing literature published during the past 2 years about the current assessment and treatment strategies of dysphagia in HNC patients. 

Full text available from Ovid in Current Opinion in Supportive and Palliative Care

"It's alright to ask for help": findings from a qualitative study exploring the information and support needs of family carers at the end of life

BMC Palliative Care, 2014, vol./is. 13/(22)

Harrop E, Byrne A, Nelson A

Results from four focus groups with Clinical Nurse Specialists, healthcare assistants, former and current carers at a hospice in the UK, suggest three domains which could underpin the development of educational or information based resources for carers: developing knowledge and competence; facilitating preparedness; supporting role recognition and confidence building.

Full text available from Proquest in BMC Palliative Care

Full text available from BioMedCentral in BMC Palliative Care