BMJ Supportive & Palliative Care最新文献_第3页

Handheld fans for dyspnoea in respiratory failure: randomised controlled trial. 治疗呼吸衰竭患者呼吸困难的手持风扇：随机对照试验。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-26 DOI: 10.1136/spcare-2024-004922

Dan Yue, Xuqin Xie, Gaoyu Chen, Zhimei Luo, Linjie Fan, Desheng Sun

{"title":"Handheld fans for dyspnoea in respiratory failure: randomised controlled trial.","authors":"Dan Yue, Xuqin Xie, Gaoyu Chen, Zhimei Luo, Linjie Fan, Desheng Sun","doi":"10.1136/spcare-2024-004922","DOIUrl":"10.1136/spcare-2024-004922","url":null,"abstract":"Objective: Fan therapy is widely acknowledged as an essential component in the management of dyspnoea with numerous studies supporting its efficacy in alleviating dyspnoea among patients with chronic illnesses. However, there is limited evidence regarding the effectiveness of fan therapy in reducing dyspnoea in patients with respiratory failure undergoing continuous oxygen therapy. This study aimed to assess the efficacy of fan therapy in mitigating dyspnoea in this specific patient population through a randomised controlled trial.Methods: Participants meeting the inclusion criteria were randomly assigned to either an experimental group or a control group. In the experimental group, a handheld fan (HHF) was directed at the face, while in the control group the fan was aimed at the legs. Both interventions were conducted at a distance of 15-30 cm for 10 min. Key physiological and subjective measures, including heart rate, respiratory rate, blood pressure, blood oxygen saturation, facial skin temperature and Visual Analogue Scale (VAS) scores, were recorded immediately after fan therapy.Results: The experimental group demonstrated a statistically significant reduction in VAS scores (p<0.05) compared with the control group indicating that fan therapy effectively alleviates dyspnoea in patients with respiratory failure receiving continuous oxygen therapy.Conclusion: HHFs are affordable, widely accessible and highly effective in relieving dyspnoea with minimal risk. Therefore, fan therapy should be considered as a complementary treatment for patients with respiratory failure and incorporated alongside standard therapeutic interventions for the condition.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"231-236"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family voices from the bedside: National Audit of Care at the End of Life (England and Wales). 来自床边的家庭声音：国家临终关怀审计（英格兰和威尔士）。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-26 DOI: 10.1136/spcare-2024-005287

Mary Miller

{"title":"Family voices from the bedside: National Audit of Care at the End of Life (England and Wales).","authors":"Mary Miller","doi":"10.1136/spcare-2024-005287","DOIUrl":"10.1136/spcare-2024-005287","url":null,"abstract":"Introduction: The National Audit of Care at the End of Life reports the quality of care provided to people dying in hospital. This paper reports the bereavement (quality) survey data about the families' view of care provided to the patient and support provided to the family.Methods: Anonymised summary data were retrieved from 'Key findings for patients and carers on the quality of end of life care in acute and community hospitals' reports 2019-2022 and the summary report 2018.Results: 9089 respondents provided feedback about care received. In more than 70% of the cases, care provided to the dying person was described as good, excellent or outstanding. At least 66% of respondents reported that care provided to them was good, excellent or outstanding. At least 76% of respondents felt that staff communicated sensitively, and more than 70% felt they were happy with the level of involvement in decisions about the patient's care.Conclusion: The voices of dying patients and those at the bedside are critical in helping understand and improve care at the end of life. Co-ordinating our ask and focusing on agreed key outcomes are important to achieve the pragmatic principle of 'one death one review'.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"266-269"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacogenomics and symptom management in palliative and supportive care: A scoping review. 姑息治疗和支持性治疗中的药物基因组学和症状管理：范围综述。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-26 DOI: 10.1136/spcare-2024-005205

Caroline Barry, Martyn Patel

{"title":"Pharmacogenomics and symptom management in palliative and supportive care: A scoping review.","authors":"Caroline Barry, Martyn Patel","doi":"10.1136/spcare-2024-005205","DOIUrl":"10.1136/spcare-2024-005205","url":null,"abstract":"Context: Pharmacogenomics (PGx) is an area of expanding research, which could indicate whether an individual is likely to benefit from a symptom control medication. Palliative and supportive care (PSC) could be an area that benefits from PGx, however, little is known about the current evidence base for this.Objective: To determine how PGx can be applied in PSC, whether there is any evidence of benefit, and to understand the extent and type of evidence that supports the use of PGx in PSC.Methods: A search of six databases up to July 2024. Reference snowballing from review articles and screened papers was used to identify any missed articles.Results: 11 articles were reviewed. A total of 550 patients had a PGx test across 8/11 studies. Up to half of the patients had an actionable PGx result, and in one study there were 4.6 drug-gene interactions per patient. Implementation of PGx was found to be feasible. Clinician adherence to advice given was under-reported. No studies reported health economics analysis, or was designed to definitively answer whether PGx was better than standard care.Conclusions: It is both feasible and acceptable to conduct PGx testing in a supportive and palliative care setting. Many supportive care medications are amenable to PGx. Clinician adherence to recommendations is variable and there is no clear evidence that PGx enhances palliative/supportive care patient outcomes. Prospective, clinical trials are needed to establish whether PGx can improve symptom management for people receiving PSC.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"158-167"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcutaneous electrical acupoint stimulation for upper limb spasticity after stroke: effect and feasibility-a randomised pilot study. 经皮穴位电刺激治疗中风后上肢痉挛：效果和可行性——一项随机试验研究。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-26 DOI: 10.1136/spcare-2024-005174

Yuting Wang, Lili Zhang, Rui Yin, Yuqing Zhang, Zifeng Dai, Min Wang, Jiali Song, Xiaonong Fan, Yanan Zhang, Sha Yang, Yan Shen, Chen Yang, Qian Song, Sihan Sun, Jian Liu

{"title":"Transcutaneous electrical acupoint stimulation for upper limb spasticity after stroke: effect and feasibility-a randomised pilot study.","authors":"Yuting Wang, Lili Zhang, Rui Yin, Yuqing Zhang, Zifeng Dai, Min Wang, Jiali Song, Xiaonong Fan, Yanan Zhang, Sha Yang, Yan Shen, Chen Yang, Qian Song, Sihan Sun, Jian Liu","doi":"10.1136/spcare-2024-005174","DOIUrl":"10.1136/spcare-2024-005174","url":null,"abstract":"Importance: Limb spasticity is a common issue among stroke patients. Transcutaneous electrical acupoint stimulation (TEAS) is recommended as an alternative therapy for managing upper limb spasticity after stroke; however, its potential effects and feasibility remain uncertain.Objective: To investigate the potential effects and feasibility of TEAS on motor function in patients with upper limb spasticity after stroke.Methods: This randomised controlled, double-blined pilot study was conducted in two phases. All the patients were randomly divided into two groups: the TEAS group and the sham TEAS group. The intervention period for both TEAS and sham TEAS was 6 weeks, with each session lasting 30 min and conducted thrice weekly. The outcomes measured were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, the effective improvement rate, the modified Ashworth Scale (MAS), the Wolf Motor Function Test (WMFT), the visual analogue scale (VAS), the Barthel index (BI) and the surface electromyography (sEMG).Results: All participants completed the course of therapy. Baseline characteristics were comparable across the two groups. Compared with the sham TEAS group, the TEAS group showed significant increases in FMA-UE score (P value=0.013), WMFT score (P value=0.001) and BI score (P value=0.008) at week 6. For integrated electromyogram (p=0.048) and root mean square of the biceps (p=0.033), lower scores were identified in the TEAS group compared with the sham TEAS group with a significant difference at week 6.Conclusion: TEAS was acceptable and feasible in participants with upper limb spasticity after stroke. A pivotal study of this therapy is justified.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"237-244"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Religious practices and quality of life in palliative care: insights from Tanzania.

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-23 DOI: 10.1136/spcare-2024-005360

Sonia Nada Edward Sokoine, Gad Kilonzo, Nadia Ahmed, Kelvin Furanaeli Sawe

引用次数: 0

Early oral feeding post gastrectomy in gastric cancer: quasi-experimental study.

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-18 DOI: 10.1136/spcare-2024-005183

Haiyan He, Yuanyuan Ma, Guo Liu, Shuying Liu, Qin Liu, Juan Yao, Chengcheng Huang, Jie Liu, Liang Zhou, Ting Wang, Teng Wang, Na Wang, Xiaolian Deng, Yaling Wang

{"title":"Early oral feeding post gastrectomy in gastric cancer: quasi-experimental study.","authors":"Haiyan He, Yuanyuan Ma, Guo Liu, Shuying Liu, Qin Liu, Juan Yao, Chengcheng Huang, Jie Liu, Liang Zhou, Ting Wang, Teng Wang, Na Wang, Xiaolian Deng, Yaling Wang","doi":"10.1136/spcare-2024-005183","DOIUrl":"https://doi.org/10.1136/spcare-2024-005183","url":null,"abstract":"Objective: This study aims to investigate the safety and feasibility of early oral feeding in patients with gastric cancer after gastrectomy.Methods: A total of 135 patients with gastric cancer who would receive gastrectomy were enrolled in the study, with 61 in early oral feeding group and 74 in control group. Outcomes included nutrient intake, nutritional status, gastrointestinal functions and symptoms, pain, physical activity time, clinical outcomes and inflammation markers.Results: In comparison with control group, patients in early oral feeding group had significantly higher compliance rates of oral energy and protein intake, lower needs of parenteral nutrition and shorter postoperative oral feeding start time during hospitalisation. Moreover, the compliance rate of oral protein intake at 1 week after discharge was higher in patients with gastric cancer of early oral feeding group compared with control group. The gastrointestinal function was better in early oral feeding group, evidenced by shorter time to the first flatus and dwell time for gastric tube.Conclusion: This study demonstrated that early oral feeding is safe and can significantly improve oral energy and oral protein intake and gastrointestinal functions during hospitalisation in patients with gastric cancer who received gastrectomy, as well as the oral protein intake after discharge.Trial registration: Chinese Clinical Trial Registry: ChiCTR2300069202.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Auriculotherapy and pain intensity and functional disability in older adults with chronic low back pain: randomised single-blind clinical trial.

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-18 DOI: 10.1136/spcare-2024-005170

Maryam Pourmohammadi, Zahra Tagharrobi, Khadijeh Sharifi, Zahra Sooki, Mohammad Zare, Fatemeh Zare Joshaghani

{"title":"Auriculotherapy and pain intensity and functional disability in older adults with chronic low back pain: randomised single-blind clinical trial.","authors":"Maryam Pourmohammadi, Zahra Tagharrobi, Khadijeh Sharifi, Zahra Sooki, Mohammad Zare, Fatemeh Zare Joshaghani","doi":"10.1136/spcare-2024-005170","DOIUrl":"https://doi.org/10.1136/spcare-2024-005170","url":null,"abstract":"Introduction: Considering the importance of chronic low back pain in disability in older adults, the present study aimed to investigate the effect of auriculotherapy on pain intensity and functional disability in this group.Materials and methods: This single-blind clinical trial was conducted on older adults with chronic low back pain in Kashan, Iran, 2019-2020. Seventy eligible older people were allocated to the intervention and sham groups via block randomisation. In the intervention group, pressure was applied using Varcaria seeds on the Shenmen, sympathetic, nerve subcortex and low back points. The visual analogue scale was completed at the beginning (T0), weekly (T1-T4) and 1 month after intervention (T5). Functional disability was assessed using Oswestry Disability Index at T0, T4 and T5. Data were analysed in per-protocol and intention-to-treat designs using repeated measures analysis of variance and analysis of covariance.Results: There was a significant difference between the two groups regarding disease duration (p=0.012). The interaction effect of time and intervention was significant on pain intensity and functional disability (effect size (ES)=0.858 and ES=0.789, p<0.0001). The pain intensity in the intervention group was significantly lower than in the sham group at T2-T5 (p<0.0001). The functional disability score in the intervention group was significantly lower than in the sham group at T4 and T5 (p<0.0001).Conclusion: Auriculotherapy can reduce pain intensity and functional disability in older adults with chronic low back pain; it can be used as a complementary medicine in care programmes for older adults with chronic low back pain.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Symptom reduction in advanced cancer from multi-session mindful breathing: randomised controlled study.

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-18 DOI: 10.1136/spcare-2024-005086

Yu Zhen Tung, Diana Leh Ching Ng, Natalie Zi Lai, Chui Munn Ang, Poh Khuen Lim, Sheriza Izwa Zainuddin, Chee Loong Lam, Ee Chin Loh, Chee Shee Chai, Seng Beng Tan

{"title":"Symptom reduction in advanced cancer from multi-session mindful breathing: randomised controlled study.","authors":"Yu Zhen Tung, Diana Leh Ching Ng, Natalie Zi Lai, Chui Munn Ang, Poh Khuen Lim, Sheriza Izwa Zainuddin, Chee Loong Lam, Ee Chin Loh, Chee Shee Chai, Seng Beng Tan","doi":"10.1136/spcare-2024-005086","DOIUrl":"https://doi.org/10.1136/spcare-2024-005086","url":null,"abstract":"Objectives: While single-session mindful breathing shows symptom reduction in palliative care, data on multi-session efficacy is lacking. This study aimed to determine the effectiveness of multi-session mindful breathing in reducing symptoms among patients with advanced cancer.Methods: Adult patients with advanced cancer who scored ≥4 in at least two or more symptoms based on the Edmonton Symptom Assessment Scale (ESAS) were recruited from January to March 2020 at the University of Malaya Medical Centre, Malaysia. Participants were randomly assigned to receive either four daily sessions of 30 min mindful breathing and standard care (intervention) or standard care alone (control). The outcome measured was the change in the ESAS score after each session.Results: 80 patients were recruited and randomised equally into the intervention and control groups. The demographic and clinical characteristics between the two groups were not statistically different. For the intervention group, there were statistically significant reductions in the total ESAS scores following all four sessions of 30 min mindful breathing (n1=40: z1=-5.09, p<0.001; z2=-3.77, p<0.001; z3=-4.38, p<0.001; z4=-3.27, p<0.05). For the control group, statistically significant reductions in the total ESAS scores were seen only after sessions 1 and 3 (n2=40: z1=-4.04, p<0.001; z3=-4.53, p<0.001).Conclusions: Our result provides evidence that four daily sessions of 30 min mindful breathing may be effective in reducing multiple symptoms rapidly in patients with advanced cancer.Trial registration number: NCT05910541.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The clock is ticking: can palliative care survive the dual crises of time and workforce shortages?

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-18 DOI: 10.1136/spcare-2024-005345

Raffaele Giusti, Giulio Ravoni, Giampiero Porzio

引用次数: 0

Immunotherapy and palliative medicine: opportunities and challenges.

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-02-18 DOI: 10.1136/spcare-2024-005362

Nessa Keane, Lynda McSorley, Leona Reilly

引用次数: 0