How Do We Start Palliative Care for Patients With End-Stage Liver Disease?
Sookyung Kim, Kyunghwa Lee, Changhwan Kim and 2 others
PMID 34269708WHAT IT FOUND
Nurses caring for people with end-stage liver disease can start palliative care early, assess symptoms, discuss goals and support families.
The review found limited evidence, not proof of effectiveness.
Key findings
01The review identified 11 palliative care components for end-stage liver disease, with interdisciplinary approach, early palliative care, goals-of-care discussion, symptom management and psychosocial support most frequent.
02The review reported that patients receiving early palliative care improved in itching, well-being, appetite, anxiety and fatigue.
03The review reported increases in DNR orders and palliative care consultations, and decreased length of stay.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 12 articles, and only six were empirical studies. Six of the 12 included articles were literature reviews, and five studies used medical records. Very few experimental studies examined palliative care effectiveness for end-stage liver disease. Outcome measures varied, and family effects were poorly measured. Ten of the 12 articles were from Western countries, and two were from Asia.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the symptom improvements, increased DNR orders and shorter hospital stay as proof that palliative care works. The review included only 12 articles, and very few were experimental studies.