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Seven types of uncertainty when clinicians care for pediatric patients with advanced cancer

HILL, Douglas L. ; WALTER, Jennifer K. ; SZYMCZAK, Julia E. ; DIDOMENICO, Concetta ; PARIKH, Shefali ; FEUDTNER, Chris
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 01/2020, vol.59, n°1, p. 86-94

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Stability and impact of symptom clusters in patients with end-stage renal disease undergoing dialysis

NAM, Marques Shek ; KWOK SO, Winnie ; WONG, Cho Lee ; HUI, Yun Ho ; HAU SIM HO, Eva ; CHOI, Kai Chow ; COOPER, Bruce ; MIASKOWSKI, Christine
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 01/2020, vol.59, n°1, p. 67-76

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Survival after anticancer treatment of terminally ill patients with ovarian carcinoma

KAJIYAMA, Hiroaki ; SUZUKI, Shiro ; SHIMBO, Akiko ; UTSUMI, Fumi ; YOSHIKAWA, Nobuhisa ; KIKKAWA, Fumitaka
JOURNAL OF PALLIATIVE MEDICINE, 15/04/2020, Pagination inconnue

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Souffrance des proches de patients atteints d’une maladie en phase terminale - identifier pour mieux accompagner en milieu hospitalier

TRAN, Rosalie ; MARTINEZ, Laura ; CANTIN, Boris
REVUE INTERNATIONALE DE SOINS PALLIATIFS, 12/2019, vol.34, n°4, p. 129-133

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Accompagner une personne en fin de vie - prendre soin de l'autre dans ses derniers moments

BRUYNEEL, Annick Danielle
Eyrolles , 02/2020 , 191 p.

Lisette - la fin de vie racontée aux petits et aux grands

JAVAUX, Amélie ; HUQUE, Corinne ; POUMAY, Aurore ; WAXWEILER, Charline ; MASSON, Annick
Mijade , 2019 , 32 p.

Repeated subcutaneous esketamine administration for depressive symptoms and pain relief in a terminally ill cancer patient - a case report

BARBOSA, Matheus Ghossain ; DELFINO, Rodrigo Simonini ; SARIN, Luciana Maria ; JACKOWSKI, Andrea Parolin
PALLIATIVE MEDICINE, 18/03/2020, Pagination inconnue

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Oral health problems among palliative and terminally ill patients - an integrated systematic review

VENKATASALU, Munikumar Ramasamy ; MURANG, Zaidah Rizidah ; RAMASAMY, Divya Thirumalai Rajam ; DHALIWAL, Jagjit Singh
BMC oral health, 18/03/2020, vol.20, n°1, p. 1-11

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Grave new world - the conspiracy of silence surrounding non-voluntary euthanasia

BOKEK-COHEN, Ya'arit ; TARABEIH, Mahdi
Applied nursing research, 04/2020, vol.52, Pagination inconnue

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Immediate effect of fan therapy in terminal cancer with dyspnea at rest - a meta-analysis

KAKO, Jun ; KOBAYASHI, Masamitsu ; OOSONO, Yasufumi ; KAJIWARA, Kohei ; MIYASHITA, Mika
The American journal of hospice and palliative care, 04/2020, vol.37, n°4, p. 294-299

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Support interventions for families of people with terminal cancer in palliative care

AREIA, Neide P. ; GONGORA, José N. ; MAJOR, Sofia ; OLIVEIRA, Vivianne D. ; RELVAS, Ana P.
Palliative and supportive care, 26/02/2020, p. 1-9

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High c-reactive protein to albumin ratio and the short-term survival prognosis within 30 days in terminal cancer patients receiving palliative care in a hospital setting - a retrospective analysis

JU, Sang-Yhun ; MA, Soo-Jin
Medicine, 02/2020, vol.99, n°9, p. 1-7

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The assessment of spiritual well-being in cancer patients with advanced disease - which are its meaningful dimensions?

RABITTI, Elisa ; CAVUTO, Silvio ; IANI, Luca ; OTTONELLI, Simona ; DE VINCENZO, Francesco ; COSTANTINI, Massimo
BMC palliative care, 06/03/2020, vol.19, n°1, p. 1-8

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Survival time after marked reduction in oral intake in terminally ill noncancer patients - a retrospective study

HOSOI, Takahiro ; OZONE, Sachiko ; HAMANO, Jun
Journal of general and family medicine, 03/2020, vol.21, n°2, p. 9-14

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Communicating about death and dying with adults with intellectual disabilities who are terminally ill or bereaved - a UK-wide survey of intellectual disability support staff

TUFFREY-WIJNE, Irene ; FINLAYSON, Janet ; BERNAL, Jane ; TAGGART, Laurence ; LAM, Claire Kar Kei ; TODD, Stuart
Journal of applied research in intellectual disabilities, 18/02/2020, Pagination inconnue

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Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients - the mediating role of job burnout

OGINSKA-BULIK, Nina ; MICHALSKA, Paulina
Psychological services, 24/02/2020, Pagination inconnue

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Facing death in medical training - a view from students in Mexico

RIO, Asunción Álvarez-Del ; MARVAN, Ma Luisa ; GOMEZ AVALOS, Julieta
OMEGA JOURNAL OF DEATH AND DYING, 02/2020, vol.80, n°3, p. 340-354

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Uncertainty and certain death - the role of clinical trials in terminal cancer care

CORTEZ, Dagoberto ; HALPIN, Michael
Sociology of health and illness, 24/01/2020, p. 1-15

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Drug therapy for delirium in terminally ill adults

FINUCANE, Anne M. ; JONES, Louise ; LEURENT, Baptiste ; SAMPSON, Elizabeth L. ; STONE, Patrick ; TOOKMAN, Adrian J. ; CANDY, Bridget
The Cochrane database of systematic reviews, 21/01/2020, vol.1, Pagination inconnue

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Thème : Médicaments - Pharmacie.

DELIRE ; PHASE TERMINALE ; CONTROLE SYMPTOME ; THERAPEUTIQUE MEDICAMENTEUSE

BACKGROUND: Delirium is a syndrome characterised by an acute disturbance of attention and awareness which develops over a short time period and fluctuates in severity over the course of the day. It is commonly experienced during inpatient admission in the terminal phase of illness. It can cause symptoms such as agitation and hallucinations and is distressing for terminally ill people, their families and staff. Delirium may arise from any number of causes and treatment should aim to address these causes. When this is not possible, or treatment is unsuccessful, drug therapy to manage the symptoms may become necessary. This is the second update of the review first published in 2004.
OBJECTIVES: To evaluate the effectiveness and safety of drug therapies to manage delirium symptoms in terminally ill adults.
SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL and PsycINFO from inception to July 2019, reference lists of retrieved papers, and online trial registries.
SELECTION CRITERIA: We included randomised controlled trials of drug therapies in any dose by any route, compared to another drug therapy, a non-pharmacological approach, placebo, standard care or wait-list control, for the management of delirium symptoms in terminally ill adults (18 years or older).
DATA COLLECTION AND ANALYSIS: We independently screened citations, extracted data and assessed risk of bias. Primary outcomes were delirium symptoms; agitation score; adverse events. Secondary outcomes were: use of rescue medication; cognitive status; survival. We applied the GRADE approach to assess the overall quality of the evidence for each outcome and we include eight 'Summary of findings' tables.
MAIN RESULTS: We included four studies (three new to this update), with 399 participants. Most participants had advanced cancer or advanced AIDS, and mild- to moderate-severity delirium. Meta-analysis was not possible because no two studies examined the same comparison. Each study was at high risk of bias for at least one criterion. Most evidence was low to very low quality, downgraded due to very serious study limitations, imprecision or because there were so few data. Most studies reported delirium symptoms; two reported agitation scores; three reported adverse events with data on extrapyramidal effects; and none reported serious adverse events. 1. Haloperidol versus placebo There may be little to no difference between placebo and haloperidol in delirium symptoms within 24 hours (mean difference (MD) 0.34, 95% confidence interval (CI) -0.07 to 0.75; 133 participants). Haloperidol may slightly worsen delirium symptoms compared with placebo at 48 hours (MD 0.49, 95% CI 0.10 to 0.88; 123 participants with mild- to moderate-severity delirium). Haloperidol may reduce agitation slightly compared with placebo between 24 and 48 hours (MD -0.14, 95% -0.28 to -0.00; 123 participants with mild- to moderate-severity delirium). Haloperidol probably increases extrapyramidal adverse effects compared with placebo (MD 0.79, 95% CI 0.17 to 1.41; 123 participants with mild- to moderate-severity delirium). 2. Haloperidol versus risperidone There may be little to no difference in delirium symptoms with haloperidol compared with risperidone within 24 hours (MD -0.42, 95% CI -0.90 to 0.06; 126 participants) or 48 hours (MD -0.36, 95% CI -0.92 to 0.20; 106 participants with mild- to moderate-severity delirium). Agitation scores and adverse events were not reported for this comparison. 3. Haloperidol versus olanzapine We are uncertain whether haloperidol reduces delirium symptoms compared with olanzapine within 24 hours (MD 2.36, 95% CI -0.75 to 5.47; 28 participants) or 48 hours (MD 1.90, 95% CI -1.50 to 5.30, 24 participants). Agitation scores and adverse events were not reported for this comparison. 4. Risperidone versus placebo Risperidone may slightly worsen delirium symptoms compared with placebo within 24 hours (MD 0.76, 95% CI 0.30 to 1.22; 129 participants); and at 48 hours (MD 0.85, 95% CI 0.32 to 1.38; 111 participants with mild- to moderate-severity delirium). There may be little to no difference in agitation with risperidone compared with placebo between 24 and 48 hours (MD -0.05, 95% CI -0.19 to 0.09; 111 participants with mild- to moderate-severity delirium). Risperidone may increase extrapyramidal adverse effects compared with placebo (MD 0.73 95% CI 0.09 to 1.37; 111 participants with mild- to moderate-severity delirium). 5. Lorazepam plus haloperidol versus placebo plus haloperidol We are uncertain whether lorazepam plus haloperidol compared with placebo plus haloperidol improves delirium symptoms within 24 hours (MD 2.10, 95% CI -1.00 to 5.20; 50 participants with moderate to severe delirium), reduces agitation within 24 hours (MD 1.90, 95% CI 0.90 to 2.80; 52 participants), or increases adverse events (RR 0.70, 95% CI -0.19 to 2.63; 31 participants with moderate to severe delirium). 6. Haloperidol versus chlorpromazine We are uncertain whether haloperidol reduces delirium symptoms compared with chlorpromazine at 48 hours (MD 0.37, 95% CI -4.58 to 5.32; 24 participants). Agitation scores were not reported. We are uncertain whether haloperidol increases adverse events compared with chlorpromazine (MD 0.46, 95% CI -4.22 to 5.14; 24 participants). 7. Haloperidol versus lorazepam We are uncertain whether haloperidol reduces delirium symptoms compared with lorazepam at 48 hours (MD -4.88, 95% CI -9.70 to 0.06; 17 participants). Agitation scores were not reported. We are uncertain whether haloperidol increases adverse events compared with lorazepam (MD -6.66, 95% CI -14.85 to 1.53; 17 participants). 8. Lorazepam versus chlorpromazine We are uncertain whether lorazepam reduces delirium symptoms compared with chlorpromazine at 48 hours (MD 5.25, 95% CI 0.38 to 10.12; 19 participants), or increases adverse events (MD 7.12, 95% CI 1.08 to 15.32; 18 participants). Agitation scores were not reported.
SECONDARY OUTCOMES: use of rescue medication, cognitive impairment, survival There were insufficient data to draw conclusions or assess GRADE.
AUTHORS' CONCLUSIONS: We found no high-quality evidence to support or refute the use of drug therapy for delirium symptoms in terminally ill adults. We found low-quality evidence that risperidone or haloperidol may slightly worsen delirium symptoms of mild to moderate severity for terminally ill people compared with placebo. We found moderate- to low-quality evidence that haloperidol and risperidone may slightly increase extrapyramidal adverse events for people with mild- to moderate-severity delirium. Given the small number of studies and participants on which current evidence is based, further research is essential.

Origine : PubMed

Cross-cultural adaptation and validation of questionnaire for knowledge, attitudes, and behavioral intentions in Italian nurses with regard to provision of artificial nutrition and hydration to patients terminally ill with cancer

ALBANESI, Beatrice ; MARCHETTI, Anna ; FACCHINETTI, Gabriella ; CLARI, Marco ; DELLAFIORE, Federica ; PIERVISANI, Loredana ; LUSIGNANI, Maura ; DE MARINIS, Maria Grazia ; PIREDDA, Michela
Nutrition, 22/11/2019, vol.72, p. 110655-

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