BMJ Supportive & Palliative Care最新文献_第9页

Support programme for bereaved relatives: a retrospective observational study. 遗属支持计划：一项回顾性观察研究。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2024-005234

Adèle Jarry, Aurélie Lepeintre, Diane Constant-David, Clementine Paul, Chloe Chauvin, Julien Nizard, Adrien Evin

引用次数: 0

Enteral and parenteral nutrition in patients with cancer: complication rates compared-updated systematic review and meta-analysis. 癌症患者的肠内和肠外营养：并发症发生率的比较——更新的系统评价和荟萃分析

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2024-005244

Ronald Chow, James H B Im, Jann Arends, Egidio Del Fabbro, Lukas Mortensen-Truscott, Denis Qeska, Shilpa Balaji, Chris Walsh, Geoffrey Watson, Michael Lock, Elizabeth Prsic, Lawson Eng, Camilla Zimmermann, Eduardo Bruera

{"title":"Enteral and parenteral nutrition in patients with cancer: complication rates compared-updated systematic review and meta-analysis.","authors":"Ronald Chow, James H B Im, Jann Arends, Egidio Del Fabbro, Lukas Mortensen-Truscott, Denis Qeska, Shilpa Balaji, Chris Walsh, Geoffrey Watson, Michael Lock, Elizabeth Prsic, Lawson Eng, Camilla Zimmermann, Eduardo Bruera","doi":"10.1136/spcare-2024-005244","DOIUrl":"10.1136/spcare-2024-005244","url":null,"abstract":"Background: The aim of this systematic review and meta-analysis is to compare the complication rates of enteral nutrition (EN) (oral or tube feeding (TF)) and parenteral nutrition (PN) in patients with any cancer.Methods: A systematic review of the literature until 2024 was conducted, including randomised controlled trials comparing EN and PN with respect to one or more of four endpoints: (1) infection, (2) nutrition support complications, (3) major complications and (4) mortality. A meta-analysis was conducted to generate summary effect estimates. Analysis was stratified by paediatric (≤21 years old) versus adults (>21 years old) patients. Subgroup analyses were conducted, based on including patients with (vs without) protein-energy malnutrition (PEM) and type of EN. Cumulative meta-analysis and leave-one-out analysis was conducted. Type I error was set at 0.05.Results: 49 studies reporting on 6361 patients were included: 41 reported on adults and 8 on children. Among adults, the infection rate was higher for PN compared with EN (risk ratio=1.07, 95% CI: 1.00 to 1.14), with no differences in rates of nutrition support complications, major complications or mortality. Among children, there were no differences in all four endpoints. On cumulative meta-analysis, EN was overall marginally superior to PN for infection, although results fluctuated over time between superiority and no difference. Subgroup analysis found no differences in effects among patients with (vs without) PEM and patients provided with EN options of standard care versus TF.Discussion: From the perspective of complications, EN and PN are equivalent, with EN demonstrating marginal superiority for infection among adults.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"281-290"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073578","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

Routine data and equitable palliative and end-of-life care. 常规数据和公平的姑息和临终关怀。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2024-005161

Joanna M Davies, Katherine E Sleeman, Peter May

引用次数: 0

Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract. COVID-19后慢性疲劳综合征：黄芪根提取物三盲随机临床试验。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2023-004595

Zahra-Sadat Banihashemi, Ismail Azizi-Fini, Mahdi Rajabi, Mahboobeh Maghami, Safoura Yadollahi

{"title":"Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract.","authors":"Zahra-Sadat Banihashemi, Ismail Azizi-Fini, Mahdi Rajabi, Mahboobeh Maghami, Safoura Yadollahi","doi":"10.1136/spcare-2023-004595","DOIUrl":"10.1136/spcare-2023-004595","url":null,"abstract":"Objective: This study aimed to evaluate the effect of Astragalus root extract on nurses suffering from post-COVID-19 chronic fatigue syndrome.Materials and methods: The study was designed as a triple-blind, randomised, controlled trial in Iran in 2023. 64 chronic fatigue syndrome nurses were randomly assigned to one of two groups: an intervention group (n=32) that received Astragalus root extract (500 mg two times per day) or a control group (n=32) that received a placebo. Changes in chronic fatigue syndrome scores were measured before to, at the end of and 1 month after the intervention. Data were analysed using descriptive and analytical statistics (T-tests, χ2, analysis of variances, Cochran's Q tests, McNemar and generalised estimating equations).Results: In comparison to before, chronic fatigue prevalence decreased statistically significantly at the end of the intervention group (13.8%) and 1 month later (17.2%). Further, the frequency differed between before and after (p=0.0001) and 1 month later (p=0.0001). In the control group, chronic fatigue was statistically significantly different before and after the intervention (72.2%; p=0.003). Having an underlying disease (B=0.84, OR=2.33; p=0.04) and being in the control group (B=2.15, OR=12.36; p=0.01) increased the risk of chronic fatigue, whereas increasing the length of time decreased it (B=-0.67, OR=0.50; p=0.0001).Conclusion: Astragalus root extract has been shown to reduce chronic fatigue in nurses. Therefore, this herbal extract can be used to reduce the incidence and treatment of chronic fatigue in nurses.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"359-366"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247369","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

Virtual reality reduces anxiety and pain in acute hospital palliative care: service evaluation. 虚拟现实减少急性医院姑息治疗中的焦虑和疼痛：服务评估。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2023-004572

Nancy Burridge, Alison Sillence, Lynda Teape, Ben Clark, Emma Bruce, Julie Armoogum, Daniella Leloch, Anna Spathis, Simon Etkind

{"title":"Virtual reality reduces anxiety and pain in acute hospital palliative care: service evaluation.","authors":"Nancy Burridge, Alison Sillence, Lynda Teape, Ben Clark, Emma Bruce, Julie Armoogum, Daniella Leloch, Anna Spathis, Simon Etkind","doi":"10.1136/spcare-2023-004572","DOIUrl":"10.1136/spcare-2023-004572","url":null,"abstract":"Objectives: Virtual reality (VR) might improve symptom management, but there is limited evidence regarding VR in palliative care. We evaluated the feasibility of VR and impact on anxiety and pain for patients in a hospital palliative care consultation service.Methods: Patients referred to a hospital specialist palliative care team, with anxiety or pain, were offered a VR intervention (a short audiovisual experience). Participants rated anxiety and pain on a 0-10 Likert severity scale pre intervention/post intervention and completed an evaluation form. Change in symptom scores was analysed by parametric statistics.Results: 28 participants used VR a total of 42 times with no adverse events. Mean pain score reduced by 29% from 4.10 (SD=2.71) pre intervention to 2.93 (SD=2.45) post intervention (t(27)=5.150, p<0.001). Mean anxiety scores reduced by 40% from 4.43 (SD=2.56) to 2.65 (SD=2.24) (t(27)=5.058, p<0.001). Patients rated the experience on average 4.75/5 and all would recommend use to a friend. VR was described as absorbing and relaxing.Conclusion: VR may improve anxiety and pain and was acceptable in this setting. Large-scale evaluation will generate important data on feasibility and implementation.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"387-390"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242676","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

Muscle metric: re-evaluating prognostic markers in metastatic breast cancer. 肌肉指标：重新评估转移性乳腺癌的预后指标。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2024-005328

Aynur Aktas, Rebecca Sheaff Greiner, Lejla Hadzikadic-Gusic, Danielle Boselli, Declan Walsh

引用次数: 0

Assisted ventilation withdrawal in motor neuron disease: updated results. 运动神经元疾病的辅助通气停药：最新结果。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2025-005389

Lucy Bleazard, Jonathan Palmer, David Wenzel, Thomas Jeffery, Christina Faull

{"title":"Assisted ventilation withdrawal in motor neuron disease: updated results.","authors":"Lucy Bleazard, Jonathan Palmer, David Wenzel, Thomas Jeffery, Christina Faull","doi":"10.1136/spcare-2025-005389","DOIUrl":"10.1136/spcare-2025-005389","url":null,"abstract":"Introduction: Patients with ventilator-dependent motor neuron disease (MND) may request withdrawal of their assisted ventilation. Facilitating this process as a healthcare professional (HCP) can be emotionally and practically challenging. The Association for Palliative Medicine (APM) issued guidance to support HCPs and invited anonymised accounts of the withdrawal process to provide an update on the guidance.Methods: HCPs submitted anonymised accounts via email. Quantitative data was analysed descriptively in Excel. Free-text comments were analysed thematically using an inductive, iterative approach.Results: 68 HCPs submitted 95 accounts of ventilation withdrawal between 2015 and 2024. Most patients received medications pre-withdrawal (94%), primarily a combination of an opioid and midazolam, mostly subcutaneously. Younger patients tended to need higher doses to achieve adequate symptom management prior to withdrawal. Practices of weaning the ventilator varied significantly between respondents. The median time to death following withdrawal of ventilation was 30 min, with three-quarters of patients dying within 2 hours.Conclusion: This is the largest data set to date regarding the withdrawal of assisted ventilation in MND. This updated analysis reaffirms that a personalised, titrated approach remains appropriate and effective. The revised APM Guidance 2025 incorporates new sections on recommendations for managing the ventilator.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"396-399"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699506","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

Delirium pathophysiology in cancer: neurofilament light chain biomarker - narrative review. 癌症中的谵妄病理生理学：神经丝蛋白轻链生物标志物--综述。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2024-004781

Zita Kruize, Isa van Campen, Lisa Vermunt, Olaf Geerse, Josephine Stoffels, Charlotte Teunissen, Lia van Zuylen

{"title":"Delirium pathophysiology in cancer: neurofilament light chain biomarker - narrative review.","authors":"Zita Kruize, Isa van Campen, Lisa Vermunt, Olaf Geerse, Josephine Stoffels, Charlotte Teunissen, Lia van Zuylen","doi":"10.1136/spcare-2024-004781","DOIUrl":"10.1136/spcare-2024-004781","url":null,"abstract":"Background Delirium is a debilitating disorder with high prevalence near the end of life, impacting quality of life of patients and their relatives. Timely recognition of delirium can lead to prevention and/or better treatment of delirium. According to current hypotheses delirium is thought to result from aberrant inflammation and neurotransmission, with a possible role for neuronal damage. Neurofilament light chain (NfL) is a protein biomarker in body fluids that is unique to neurons, with elevated levels when neurons are damaged, making NfL a viable biomarker for early detection of delirium. This narrative review summarises current research regarding the pathophysiology of delirium and the potential of NfL as a susceptibility biomarker for delirium and places this in the context of care for patients with advanced cancer. Results Six studies were conducted exclusively on NfL in patients with delirium. Three of these studies demonstrated that high plasma NfL levels preoperatively predict delirium in older adult patients postoperatively. Two studies demonstrated that high levels of NfL in intensive care unit (ICU) patients are correlated with delirium duration and severity. One study found that incident delirium in older adult patients was associated with increased median NfL levels during hospitalisation. Conclusions Targeted studies are required to understand if NfL is a susceptibility biomarker for delirium in patients with advanced cancer. In this palliative care context, better accessible matrices, such as saliva or urine, would be helpful for repetitive testing. Improvement of biological measures for delirium can lead to improved early recognition and lay the groundwork for novel therapeutic strategies.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"319-325"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641598","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

Do not attempt cardiopulmonary resuscitation decision-making process: scoping review. 不要尝试心肺复苏的决策过程：范围界定综述。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-30 DOI: 10.1136/spcare-2023-004573

Owen Doody, Hope Davidson, John Lombard

{"title":"Do not attempt cardiopulmonary resuscitation decision-making process: scoping review.","authors":"Owen Doody, Hope Davidson, John Lombard","doi":"10.1136/spcare-2023-004573","DOIUrl":"10.1136/spcare-2023-004573","url":null,"abstract":"Objectives: To conduct a scoping review to explore the evidence of the process of do not attempt cardiopulmonary resuscitation (DNACPR) decision-making.Methods: We conducted a systematic search and review of articles from 1 January 2013 to 6 April 2023 within eight databases. Through multi-disciplinary discussions and content analytical techniques, data were mapped onto a conceptual framework to report the data.Results: Search results (n=66 207) were screened by paired reviewers and 58 papers were included in the review. Data were mapped onto concepts/conceptual framework to identify timing of decision-making, evidence of involvement, evidence of discussion, evidence of decision documented, communication and adherence to decision and recommendations from the literature.Conclusion: The findings provide insights into the barriers and facilitators to DNACPR decision-making, processes and implementation. Barriers arising in DNACPR decision-making related to timing, patient/family input, poor communication, conflicts and ethical uncertainty. Facilitators included ongoing conversation, time to discuss, documentation, flexibility in recording, good communication and a DNACPR policy. Challenges will persist unless substantial changes are made to support and promote examples of good practice. Overall, the review underlined the complexity of DNACPR decision-making and how it is a process shaped by multiple factors including law and policy, resource investment, healthcare professionals, those close to the patient and of central importance, the patient.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"400-410"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189434","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

Terminally Ill Adults Bill: an opportunity to improve continuing healthcare (CHC) in England. 终末期病人成人法案：改善英国持续医疗保健（CHC）的机会。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-04-29 DOI: 10.1136/spcare-2025-005448

Harrison Charles Duell, Mary Shifona Kumarasingam

引用次数: 0