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American Journal of Hospice & Palliative Care

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August 2018: American Journal of Hospice & Palliative Care
Yoshiaki Okamoto, Tatsuya Morita, Satoru Tsuneto, Maho Aoyama, Yoshiyuki Kizawa, Yasuo Shima, Mitsunori Miyashita
BACKGROUND: Few data are available on bereaved family members' perspective on the frequency of symptoms and degree of distress among terminal patients with cancer. METHODS: We sent a questionnaire to 1472 bereaved family members of terminal patients with cancer in 20 general hospitals. The questionnaire asked them (1) to indicate which symptoms the patients had, (2) to rate on a 4-point scale the extent to which the symptom was distressing, as follows: 1 = not distressing, 2 = slightly distressing, 3 = quite distressing, and 4 = very distressing at the point of 2 weeks before the patient had died...
July 2018: American Journal of Hospice & Palliative Care
Nathan A Boucher, Karen E Steinhauser, Kimberly S Johnson
OBJECTIVES: To describe older Veteran's perspectives on the current delivery of religious or spiritual (R/S) care. METHODS: Semi-structured interviews with older veterans with advanced stage cancer, heart failure, or pulmonary disease to elicit views on when, how, and by whom religious and spiritual care is preferred. RESULTS: The sample (n = 17) was largely male (94%), non-Hispanic white (52.9%), Christian (82.3%), and most had at least some college education (64...
July 2018: American Journal of Hospice & Palliative Care
Stephanie Stiel, Maria Heckel, Kim Nikola Wendt, Martin Weber, Christoph Ostgathe
BACKGROUND: Patient-reported outcomes are usually considered to be the gold standard assessment. However, for the assessment of quality of dying and death, ratings of informal caregivers (ICGs) or health-care professionals (HCPs) must be considered for ethical and methodological reasons. This article aims to present results of ICGs' and HCPs' estimates of the questionnaire, quality of dying and death (QoDD) on patients who died in PCUs and to compare the level of agreement of both ratings/raters...
July 2018: American Journal of Hospice & Palliative Care
Olga Ehrlich, Rachel K Walker
BACKGROUND: Qualitative pain research for hospice patients with cancer and their caregivers involves recruiting and retaining participants with multiple vulnerabilities and ethical and logistical challenges. These have been reported for studies of individuals or dyads. However, there are no reports of the related challenges and outcomes where the sampled population was a hospice triad. OBJECTIVES: Qualitative research about pain management for home hospice patients with cancer contributes rich descriptive data and such studies are critical to improving cancer pain outcomes...
July 2018: American Journal of Hospice & Palliative Care
Joanne Hall, Sadie P Hutson, Frankie West
As part of a mixed methods study determining end-of-life and advanced care planning needs in southern Appalachia, a narrative analysis was done of stories told in interviews of 8 selected participants using transcript data. Narratives were fraught with contradiction and paradox. Tensions were evident about living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The primary finding was that stigma, from several sources, and shrinking circles of social support for people living with HIV/AIDS, all of whom were in treatment, combined to create a sense of solitariness...
July 2018: American Journal of Hospice & Palliative Care
Airin Wolf, Catherine F Garlid, Kristiina Hyrkas
OBJECTIVES: Today some studies of physicians' perceptions of hope are available, but not studies of how hope informs patient care. The objectives of this qualitative study were to describe the ways physicians conceptualize hope and how these may inform interactions with their patients. METHODS: Ten physicians working in a large tertiary care teaching hospital were interviewed. They represented palliative care, oncology, and 7 other specialties. Minimal amount of background information was collected...
July 2018: American Journal of Hospice & Palliative Care
Ann Kutney-Lee, Joan Carpenter, Dawn Smith, Joshua Thorpe, Alina Tudose, Mary Ersek
Surveys of bereaved family members are increasingly being used to evaluate end-of-life (EOL) care and to measure organizational performance in EOL care quality. The Bereaved Family Survey (BFS) is used to monitor EOL care quality and benchmark performance in the Veterans Affairs (VA) health-care system. The objective of this study was to develop a case-mix adjustment model for the BFS and to examine changes in facility-level scores following adjustment, in order to provide fair comparisons across facilities...
July 2018: American Journal of Hospice & Palliative Care
Dorothee Meyer, Pia Schmidt, Boris Zernikow, Julia Wager
BACKGROUND: Multidisciplinary teamwork is considered central to pediatric palliative care. Although different studies state that volunteers play an essential role in palliative care, little is known about the collaboration between volunteers and staff. AIM: This study aims to explore and compare the perspectives of volunteers and staff regarding collaboration in a pediatric palliative care unit. DESIGN: A mixed-methods approach was chosen to appropriately reflect the complex aspects of collaboration...
July 2018: American Journal of Hospice & Palliative Care
Angela Ghesquiere, Daniel S Gardner, Caitlin McAfee, Cara Kenien, Elizabeth Capezuti, Elissa Kozlov, Jo Anne Sirey, M Carrington Reid
Although they experience high rates of chronic illness, low-income minority communities have traditionally underutilized palliative care services compared to whites and those with higher incomes. One reason for this trend is lack of screening by community providers. We utilized a community-based participatory research approach to develop and implement an innovative multidomain palliative care screening tool in aging service agencies. Participants were aging service providers and clients in the East and Central Harlem neighborhoods of New York City, which are characterized by high poverty, largely African American and Latino populations, disproportionally high rates of chronic conditions, and limited health-care access...
July 2018: American Journal of Hospice & Palliative Care
Clare O'Callaghan, Libby Byrne, Eleni Cokalis, David Glenister, Margaret Santilli, Rose Clark, Therese McCarthy, Natasha Michael
BACKGROUND: Pastoral care (also chaplaincy, spiritual care) assists people to find meaning, personal resources, and connection with self, others, and/or a higher power. Although essential in palliative care, there remains limited examination of what pastoral workers do. This study examined how pastoral workers use and consider the usefulness of art-based modalities. METHODS: Qualitative research was used to examine the practice wisdom (tacit practice knowledge) of pastoral workers experienced in using visual arts and music in palliative care...
July 2018: American Journal of Hospice & Palliative Care
Erica V Tartaglione, Elizabeth K Vig, Lynn F Reinke
PURPOSE: Palliative care improves symptom burden, distress, patient and family satisfaction, and survival for patients with cancer. Oncology professional societies endorse the integration of palliative care into routine care for patients with advanced cancers. Despite this, cultural differences between medical subspecialties and the limited number of clinicians trained in palliative care lower the adoption of integrated care models. We assessed oncologists' and palliative care clinicians' perceptions about integrating oncology and palliative care using a nurse delivering palliative care to patients newly diagnosed with lung cancer...
July 2018: American Journal of Hospice & Palliative Care
Shelli L Feder, Nancy S Redeker, Sangchoon Jeon, Dena Schulman-Green, Julie A Womack, Janet P Tate, Roger J Bedimo, Matthew J Budoff, Adeel A Butt, Kristina Crothers, Kathleen M Akgün
BACKGROUND: Patients with heart failure (HF) are at increased risk of unmet palliative care needs. The International Classification of Diseases, Ninth Revision ( ICD-9) code, V66.7, can identify palliative care services. However, code validity for specialist palliative care in the Veterans Health Administration (VHA) has not been determined. OBJECTIVE: To validate the ICD-9 code for specialist palliative care and determine common reasons for specialist palliative care consultation among VHA patients hospitalized with HF...
July 2018: American Journal of Hospice & Palliative Care
Elissa Kozlov, Claude Eghan, Sheila Moran, Keela Herr, M Carrington Reid
OBJECTIVE: To investigate how inpatient palliative care teams nationwide currently screen for and treat psychological distress. METHODS: A web-based survey was sent to inpatient palliative care providers of all disciplines nationwide asking about their practice patterns regarding psychological assessment and treatment. Descriptive statistics were used to characterize the sample and responses, and analysis of variance was conducted to determine whether certain disciplines were more likely to utilize specific treatment modalities...
July 2018: American Journal of Hospice & Palliative Care
Nina R O'Connor, Paul Junker, Scott M Appel, Robert L Stetson, Jeffrey Rohrbach, Salimah H Meghani
BACKGROUND: Hospitals are under increasing pressure to manage costs across multiple episodes of care. Most studies of the financial impact of palliative care have focused on costs during a single hospitalization. OBJECTIVE: To compare future acute health-care costs and utilization between patients who received inpatient palliative care consultation for goals of care (Palliative Care Service [PCS]) and a propensity-matched cohort of patients who did not receive palliative care consultation (non-PCS) in a single academic medical center...
July 2018: American Journal of Hospice & Palliative Care
Lisa C Lindley
BACKGROUND: Children with intellectual disability commonly lack access to pediatric hospice care services. Residential care may be a critical component in providing access to hospice care for children with intellectual disability. OBJECTIVE/HYPOTHESIS: This research tested whether residential care intensifies the relationship between intellectual disability and hospice utilization (ie, hospice enrollment, hospice length of stay), while controlling for demographic characteristics...
July 2018: American Journal of Hospice & Palliative Care
Leslie A Hoffman, Rakesh Mehta, T Robert Vu, Richard M Frankel
BACKGROUND: Medical students learn about death, dying, and palliative care (DDPC) through formal curricular offerings and informal clinical experiences; however, the lessons learned in the clinic may be at odds with the formal curriculum. Reflective writing is a means for students to "bracket" their DDPC experiences and reconcile conflicts between the formal and informal curriculum. OBJECTIVES: The aim of this study is to compare the level of reflection demonstrated in medical students' narratives on DDPC with other experiences and to examine the domains of professionalism that students perceive to be prevalent in their DDPC experiences...
June 2018: American Journal of Hospice & Palliative Care
Meredith A MacKenzie, Esther Smith-Howell, Patricia A Bomba, Salimah H Meghani
All individuals should receive care consistent with their expressed preferences during serious and chronic illnesses. Respecting Choices (RC) is a well-known model of advance care planning intended to assist individuals consider, choose, and communicate these preferences to health-care providers. In this systematic review, we evaluated the published literature on the outcomes of the RC and derivative models utilizing criteria developed by the Cochrane Collaborative. Eighteen articles from 16 studies were included, of which 9 were randomized controlled trials, 6 were observational, and 1 was a pre-posttest study...
June 2018: American Journal of Hospice & Palliative Care
Jennifer M Duff, Ryan M Thomas
BACKGROUND: Metastatic pancreatic ductal adenocarcinoma (mPDAC) has a poor prognosis despite chemotherapy advancements. Although hospice utilization has increased, timing of referral is not always optimal. AIM: To investigate whether palliative chemotherapy and travel distance to the treatment center impact hospice referral patterns in veterans of the US military in order to identify potential areas for improving referral timing. DESIGN: Demographic and clinical data were collected retrospectively according to the timing of hospice referral...
June 2018: American Journal of Hospice & Palliative Care
Nancy Dias, Debra Brandon, Joan E Haase, Paula Tanabe
PURPOSE: To examine bereaved parents' physical, mental, and social health during the first 6 months after their child's (<12 years) death from a life-threatening illness. BACKGROUND AND SIGNIFICANCE: Bereaved parents have higher mortality and morbidity rates when compared to nonbereaved parents. Acute illnesses, hospitalizations, and medication changes are highest in the first 6 months. An understanding of bereaved parents' health risk indicators can help inform development of health promotion and disease prevention measures...
June 2018: American Journal of Hospice & Palliative Care
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