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Latest & greatest articles for palliative care
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on palliative care or other clinical topics then use Trip today.
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Improving the quality of palliativecare for ambulatory patients with lung cancer. Most patients with advanced lung cancer currently receive much of their health care, including chemotherapy, as outpatients. Patients have to deal with the complex and time consuming logistics of ambulatory cancer care. At the same time, members of staff often waste considerable time and energy in organisational aspects of care that could be better used in direct interaction with patients.Quality improvement (...) study using direct observation and run and flow charts, and focus group meetings with patients and families regarding perceptions of the clinic and with staff regarding satisfaction with working conditions.Thoracic oncology outpatient clinic at a Norwegian university hospital where patients receive chemotherapy and complementary palliative care.Waiting time and time wasted during consultations; calmer working situation at the clinic; satisfaction among patients.Rescheduled patients' appointments
Palliativecare in the final days of life: "they were expecting it at any time". Providing care to actively dying patients presents unique challenges for the clinician. Patients in their final days require careful symptom management. Families need support and coaching as death approaches. Care does not end with the death of the patient but continues through death pronouncement, family notification of the death, discussion of autopsy, and immediate bereavement support. Skills (...) in these and related areas are discussed in the context of one man's death, as illuminated by comments made after death by his daughter and his physician. This case also highlights the often differing perspectives of families and clinicians as they work to deal with a patient's death. A goal of mastering the palliative skills necessary to competently care for an actively dying patient is to enable a patient to die peacefully and relatively free of discomfort. Achieving such competency should also help to relieve
Systematic review of specialist palliative day-care for adults with cancer Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
A systematic review of the scientific evidence for the efficacy of a palliativecare approach in advanced dementia A systematic review of the scientific evidence for the efficacy of a palliativecare approach in advanced dementia A systematic review of the scientific evidence for the efficacy of a palliativecare approach in advanced dementia Sampson E L, Ritchie C W, Lai R, Raven P W, Blanchard M R CRD summary This review assessed the efficacy of palliativecare models in patients (...) with dementia. The authors concluded that there is currently little evidence on which to base any conclusions. Given the limited evidence identified, the authors' cautious conclusions are likely to be reliable. Authors' objectives To assess the efficacy of a palliativecare model in patients with dementia. Searching MEDLINE, EMBASE, PsycINFO, CINAHL, the British Nursing Index, AMED, Web of Science and SIGLE were searched from inception to October 2003. The third quarter of the Cochrane Database
Does palliativecare improve outcomes for patients with HIV/AIDS: a systematic review of the evidence Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Palliativecare in sub-Saharan Africa. Control of pain and symptoms and terminal care are necessary for quality HIV and cancer care in sub-Saharan Africa. However, what constitutes feasible, accessible, and effective palliativecare, and how to develop such services, remains to be resolved. Africa-specific palliativecare includes components that carry resource implications. Home and community-based care has been largely successful, but community capacity and the resources and clinical (...) supervision necessary to sustain quality care are lacking. Coverage and referrals must be primary concerns. Simple lay and professional protocols have been developed, but opioid availability remains a major constraint. Areas of good practice, and areas where further success may be achieved include: attention to community needs and capacity; explicit frameworks for service development and palliative-care integration throughout the disease course (including antiretroviral provision); further education
PalliativeCarePalliativeCare | The King's Fund Main navigation Health and care services Leadership, systems and organisations Patients, people and society Policy, finance and performance Search term Apply PalliativeCare: Perspectives for dying people This content relates to the following topics: Share this content Authors Jenni Burt Cathy Shipman Julia Addington-Hall Patrick White Publication details ISBN 978 1 85717 500 4 Pages 12 Palliativecare – care for people in their final stages (...) of life – is gaining increasing recognition, but for it to be extended to all communities, primary care trusts (PCTs) need to be able to commission these services more effectively. Drawing on a two-year research project carried out by , funded by The King's Fund, this publication examines palliativecare provision in London, looking at how and why services vary between . It explores the views of key health professionals on current services and on each others' roles, featuring the voices of GPs
What do patients receiving palliativecare for cancer and their families want to be told? A Canadian and Australian qualitative study. To obtain feedback from patients receiving palliativecare and their relatives from various ethnic backgrounds about their experiences of the disclosure process and their satisfaction with information sharing during the illness.A qualitative study with semistructured single interviews.Perth, Western Australia, and Winnipeg, Manitoba, Canada.72 participants (...) registered with palliativecare: 21 patient-family dyads in Perth and 14 dyads and 2 patients in Winnipeg.Participants described their experiences in great detail. The analysis indicates that in information sharing the process is as important as the content. The timing, management, and delivery of information and perceived attitude of practitioners were critical to the process. This applied to information interactions at all stages of the illness. Main content areas mentioned related to prognosis
Palliativecare for patients with heart failure. Heart failure accounts for more hospitalizations among Medicare beneficiaries than any other condition. Its symptoms, including shortness of breath, fatigue, and edema, can be frightening and diminish quality of life. Although treatment advances have allowed patients to live longer with a better quality of life, heart failure remains a leading cause of death in the United States. Half of heart failure patients die within 5 years of diagnosis (...) , including symptom management and discussing advance directives, prognosis, and hospice care. By combining optimal medical management with palliativecare, physicians can best care for heart failure patients and their families.
What are the palliativecare needs of older people and how might they be met? WHO/Europe | What are the palliativecare needs of older people and how might they be met? S Français Deutsch Pусский M search Databases Interactive atlases Evidence resources European health report Our flagship report maps health trends, charts progress towards achieving health goals and provides an advance base for health policy Resources Social media Events Organization Governance Partners Networks Jobs (...) and internships What are the palliativecare needs of older people and how might they be met? What are the palliativecare needs of older people and how might they be met? Download Summary The issue Ageing populations are characteristic of many countries. The pattern of disease at the end of life is changing and more people are living with serious chronic circulatory and respiratory diseases as well as with cancer. More people will need help at the end of life, in a social context of changing family structure
Improving supportive and palliativecare for adults with cancer Guidance on Cancer Services Improving Supportive and PalliativeCare for Adults with Cancer The Manual National Institute for Clinical Excellence NHSImproving Supportive and PalliativeCare for Adults with Cancer Cancer service guidance supports the implementation of The NHS Cancer Plan for England, 1 and the NHS Plan for Wales Improving Health in Wales. 2 The service guidance programme was initiated in 1995 to follow on from (...) and consultation with stakeholders. The recommendations are based on the research evidence that addresses clinical effectiveness and service delivery. While cost impact has been calculated for the main recommendations, formal cost-effectiveness studies have not been performed.Guidance on Cancer Services Improving Supportive and PalliativeCare for Adults with Cancer The Manual Contents Executive summary 3 Introduction A. Aim of this Guidance 15 B. Rationale for developing the Guidance 15 - Burden of cancer 15
Drug therapy for anxiety in palliativecare. Anxiety is common among patients with advanced disease. It can be a natural response to impending death, but may also result from an underlying anxiety disorder, pain, or other untreated or poorly managed symptoms.The primary objective of this review was to identify and evaluate studies examining medications used to treat patients suffering from anxiety during the terminal phases of disease.We searched the following sources: MEDLINE (1966 to July (...) the criteria for inclusion in this review. Two of these studies assessed the effectiveness of alprazolam in patients with a diagnosis of cancer, but who would not be considered in the end-stage of life.No data were available to enable an assessment to be made of the effectiveness of drugs to treat anxiety in palliativecare patients.There remains insufficient evidence to draw a conclusion about the effectiveness of pharmacotherapy for anxiety in terminally ill patients. To date no studies were found
Overcoming the false dichotomy of curative vs palliativecare for late-stage HIV/AIDS: "let me live the way I want to live, until I can't". Recent advances in human immunodeficiency virus (HIV) therapy have significantly reduced HIV-related mortality in the developed world, but mortality rates have plateaued, and AIDS remains a leading cause of serious illness and death for young adults. The chronic nature of the HIV disease course and the increasing burden of cumulative HIV-related morbidity (...) into a manageable chronic disease, yet at the same time has resulted in a more narrow focus and a de facto separation between disease-specific "curative" and symptom-specific "palliative" care for patients with HIV/AIDS. As patients survive longer in the latter stages of progressive HIV disease, they may in fact have increasing need for comprehensive symptom management as well as wide-ranging need for psychosocial, family, and care planning support. In the HAART era, the false dichotomy of curative vs
A good death in Uganda: survey of needs for palliativecare for terminally ill people in urban areas. To identify the palliativecare needs of terminally ill people in Uganda.Descriptive cross sectional study.Home care programmes in and around Kampala that look after terminally ill people in their homes.173 terminally ill patients registered with the home care programmes.Most of the participants had either HIV/AIDS or cancer or both; 145 were aged under 50 years, and 107 were women. Three main (...) needs were identified: the control or relief of pain and other symptoms; counselling; and financial assistance for basic needs such as food, shelter, and school fees for their children. The preferred site of care was the home, though all these people lived in urban areas with access to healthcare services within 5 km of their homes.A "good death" in a developing country occurs when the dying person is being cared for at home, is free from pain or other distressing symptoms, feels no stigma
Is there evidence that palliativecare teams alter end-of-life experiences of patients and their caregivers? Is there evidence that palliativecare teams alter end-of-life experiences of patients and their caregivers? Is there evidence that palliativecare teams alter end-of-life experiences of patients and their caregivers? Higginson I J, Finlay I G, Goodwin D M, Hood K, Edwards A G, Cook A, Douglas H R, Normand C E CRD summary This review evaluated the effectiveness of palliativecare (...) and hospice care teams compared with conventional care. The authors found only a small positive effect on patient outcomes. The authors used a quantitative synthesis despite the presence of clinical and statistical heterogeneity, so the results should be interpreted with caution. Authors' objectives To evaluate the effectiveness of palliativecare and hospice care teams (PCHCT). Searching MEDLINE, CINAHL, Cancerlit, PsycINFO, EMBASE, PallCare Index, the Cochrane EPOC Register of trials, SIGLE, ASSIA
Doctors' perceptions of palliativecare for heart failure: focus group study. To identify doctors' perceptions of the need for palliativecare for heart failure and barriers to change.Qualitative study with focus groups.North west England.General practitioners and consultants in cardiology, geriatrics, palliativecare, and general medicine.Doctors supported the development of palliativecare for patients with heart failure with the general practitioner as a central figure. They were reluctant (...) to endorse expansion of specialist palliativecare services. Barriers to developing approaches to palliativecare in heart failure related to three main areas: the organisation of health care, the unpredictable course of heart failure, and the doctors' understanding of roles. The health system was thought to work against provision of holistic care, exacerbated by issues of professional rivalry and control. The priorities identified for the future were developing the role of the nurse, better community
Dignity-conserving care--a new model for palliativecare: helping the patient feel valued. The basic tenets of palliativecare may be summarized as the goal of helping patients to die with dignity. The term "dignity" provides an overarching framework that may guide the physician, patient, and family in defining the objectives and therapeutic considerations fundamental to end-of-life care. Dignity-conserving care is care that may conserve or bolster the dignity of dying patients. Using segments (...) of interviews with a patient with advanced lung cancer, his wife, and his palliativecare physician, this article illustrates and explores various aspects of dignity-conserving care and the model on which it is based. Dignity-conserving care offers an approach that clinicians can use to explicitly target the maintenance of dignity as a therapeutic objective and as a principle of bedside care for patients nearing death.
Secondary and tertiary palliativecare in US hospitals. Palliativecare services provide secondary and tertiary levels of palliativecare, the interdisciplinary care of patients in which the goal is comfort and quality of life. Primary palliativecare refers to the basic skills and competencies required of all physicians and other health care professionals. Secondary palliativecare refers to the specialist clinicians and organizations that provide consultation and specialty care. Tertiary (...) palliativecare refers to the academic medical centers where specialist knowledge for the most complex cases is practiced, researched, and taught. The case of Reverend J, a man with advanced cancer admitted to an acute palliativecare unit in a teaching hospital, illustrates the use of secondary and tertiary clinical palliativecare services in hospitals and health care systems.
Do hospital-based palliative teams improve care for patients or families at the end of life? Do hospital-based palliative teams improve care for patients or families at the end of life? Do hospital-based palliative teams improve care for patients or families at the end of life? Higginson I J, Finlay I, Goodwin D M, Cook A M, Hood K, Edwards A G, Douglas H R, Norman C E Authors' objectives To assess the effectiveness of hospital-based palliativecare on the process and outcomes of care (...) for patients and families at the end of life. Searching The databases searched were: MEDLINE from 1977 to 1999; CINAHL from 1982 to 1998; Cancerlit from 1983 to 1999; PsycINFO from 1979 to 1999; EMBASE from 1979 to 1999; PallCare Index (1998); and the Cochrane EPOC Register of trials. The keywords were 'palliative', 'hospice', 'terminal care', 'terminally ill', 'dying', 'end-of-life' and associated terms. These were combined with 'effective', 'evaluate', 'random', 'methods', 'economics', 'statistics
Benzodiazepines and related drugs for insomnia in palliativecare. Insomnia, a subjective complaint of poor sleep and associated impairment in daytime function, is a common problem. Currently, benzodiazepines are the most used pharmacological treatment for this complaint. They are considered helpful for occasional short-term use up to four weeks but longer term use is not advised due to potential problems regarding tolerance, dosing escalation, psychological addiction and physical dependence (...) ABSTRACTS, PSYCINFO, CANCERLIT, HEALTHSTAR, WEB OF SCIENCE, SIGLE, Dissertation Abstracts, ZETOC and the MetaRegister of ongoing trials. These were searched from 1960 to 2001 or as much of this range as possible. Additional articles were sought by handsearching reference lists in standard textbooks and reviews in the field and by contacting academic centres in palliativecare and pharmaceutical companies. There were no language restrictions.Studies considered for inclusion were randomized controlled