Search

Objectives To provide an overview of the four major palliative care delivery models: ambulatory clinics, home-based programs, inpatient palliative care units, and inpatient consultation services. The advantages and disadvantages of each model and the generalist and specialist roles in palliative care will be discussed. Data Sources Literature review. Conclusion The discipline of palliative care continues to experience growth in the number of programs and in types of delivery models. Ambulatory- and home-based models are the newest on the scene. Implications for Nursing Practice Nurses caring for oncology patients with life-limiting disease should be informed about these models for optimal impact on patient care outcomes. Oncology nurses should demonstrate generalist skills in the care of the seriously ill and access specialist palliative care providers as warranted by the patient's condition. [ABSTRACT FROM AUTHOR]

Abstract: Context: Treatment of pain in palliative care patients is challenging. Adjunctive methods of pain management are desirable. Music therapy offers a nonpharmacologic and safe alternative. Objectives: To determine the efficacy of a single music therapy session to reduce pain in palliative care patients. Methods: Two hundred inpatients at University Hospitals Case Medical Center were enrolled in the study from 2009 to 2011. Patients were randomly assigned to one of two groups: standard care alone (medical and nursing care that included scheduled analgesics) or standard care with music therapy. A clinical nurse specialist administered pre- and post-tests to assess the level of pain using a numeric rating scale as the primary outcome, and the Face, Legs, Activity, Cry, Consolability Scale and the Functional Pain Scale as secondary outcomes. The intervention incorporated music therapist-guided autogenic relaxation and live music. Results: A significantly greater decrease in numeric rating scale pain scores was seen in the music therapy group (difference in means [95% CI] −1.4 [−2.0, −0.8]; P <0.0001). Mean changes in Face, Legs, Activity, Cry, Consolability scores did not differ between study groups (mean difference −0.3, [95% CI] −0.8, 0.1; P >0.05). Mean change in Functional Pain Scale scores was significantly greater in the music therapy group (difference in means −0.5 ([95% CI] −0.8, 0.3; P <0.0001). Conclusion: A single music therapy intervention incorporating therapist-guided autogenic relaxation and live music was effective in lowering pain in palliative care patients. [Copyright &y& Elsevier]