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American Journal of Hospice & Palliative Care

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https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#1
Ellis Dillon, Judith Chuang, Atul Gupta, Sharon Tapper, Steve Lai, Peter Yu, Christine Ritchie, Ming Tai-Seale
CONTEXT: Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. OBJECTIVES: In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28193106/improving-end-of-life-care-knowledge-among-senior-baccalaureate-nursing-students
#2
Toni L Glover, Cynthia Garvan, Rose M Nealis, Sandra W Citty, David J Derrico
OBJECTIVE: It is imperative that nurses are proficient and comfortable providing care to patients at the end of life. Recent studies show that nurses' knowledge of end-of-life care is less than optimal. Effective, evidence-based methods to infuse palliative and end-of-life care education into the undergraduate nursing curriculum are needed. METHODS: A descriptive pre- and postassessment evaluating senior nursing students' acquisition of knowledge on end-of-life care after attending the End-of-Life Nursing Education Consortium (ELNEC) core course was conducted...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28193105/a-qualitative-analysis-of-information-sharing-in-hospice-interdisciplinary-group-meetings
#3
Karla T Washington, George Demiris, Debra Parker Oliver, Jeffrey A Swarz, Alexandria M Lewis, Uba Backonja
BACKGROUND: In the United States, hospice agencies are required to convene interdisciplinary group (IDG) meetings no less frequently than every 15 days to review patients' care plans. Challenges associated with information sharing during these meetings can impede efficiency and frustrate attendees. OBJECTIVES: We sought to examine information sharing in the context of hospice IDG meetings as a first step toward developing an informatics tool to support interdisciplinary collaboration in this setting...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28193104/multidisciplinary-training-on-spiritual-care-for-patients-in-palliative-care-trajectories-improves-the-attitudes-and-competencies-of-hospital-medical-staff
#4
Joep van de Geer, Nic Veeger, Marieke Groot, Hetty Zock, Carlo Leget, Jelle Prins, Kris Vissers
OBJECTIVES: Patients value health-care professionals' attention to their spiritual needs. However, this is undervalued in health-care professionals' education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. METHODS: A pragmatic multicenter trial using a quasi-experimental pretest-posttest design as part of an action research study...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28166640/what-matters-most-a-mixed-methods-study-of-critical-aspects-of-a-home-based-palliative-program
#5
Claire K Ankuda, Kaileen Kersting, Timothy C Guetterman, Jessica Haefner, Evan Fonger, Michael Paletta, Faith Hopp
BACKGROUND: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. AIM: To identify what services are critical and why they matter to patients in a home-based palliative program. SETTING/PARTICIPANTS: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28135811/palliative-care-in-new-york-state-nursing-homes
#6
Paula E Lester, Fernando Kawai, Lucan Rodrigues, James Lolis, Diana Martins-Welch, Alexander Shalshin, Melissa J Fazzari, Cynthia X Pan
OBJECTIVE: To describe the current landscape of palliative care (PC) in nursing homes (NHs) in New York State (NYS). MEASUREMENTS: A statewide survey was completed by 149 respondents who named 61 different NHs as their workplace. Questions were related to presence, type, and composition of PC programs; perceptions of PC; barriers to implementing PC; and qualifying medical conditions. RESULTS: Hospice is less available than palliative or comfort care programs, with three-fourths of NYS NH responded providing a PC program...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28135810/post-acute-care-facility-as-a-discharge-destination-for-patients-in-need-of-palliative-care-in-brazil
#7
Luiz Guilherme L Soares, André M Japiassu, Lucia C Gomes, Rogéria Pereira
Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28133973/effect-of-a-whole-person-model-of-care-on-patient-experience-in-patients-with-complex-chronic-illness-in-late-life
#8
Nathan D Shippee, Tetyana P Shippee, Patrick D Mobley, Karl M Fernstrom, Heather R Britt
BACKGROUND: Patients with serious chronic illness are at a greater risk of depersonalized, overmedicalized care as they move into later life. Existing intervention research on person-focused care for persons in this transitional period is limited. OBJECTIVE: To test the effects of LifeCourse, a team-based, whole-person intervention emphasizing listening to and knowing patients, on patient experience at 6 months. DESIGN: This is a quasi-experimental study with patients allocated to LifeCourse and comparison groups based on 2 geographic locations...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28103711/the-experience-of-hospital-death
#9
Elise C Carey, Ann M Dose, Katherine M Humeniuk, Yichen C Kuan, Ashley D Hicks, Abigale L Ottenberg, Jon C Tilburt, Barbara Koenig
BACKGROUND: The quality of perimortem care received by patients who died at our hospitals was unknown. OBJECTIVE: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents' families. DESIGN: Telephone survey that included established measures and investigator-developed content. SETTING: Large, tertiary care center known for high-quality, cost-effective care. PARTICIPANTS: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28100061/outpatient-palliative-care-and-aggressiveness-of-end-of-life-care-in-patients-with-metastatic-colorectal-cancer
#10
Si Won Lee, Hyun Jung Jho, Ji Yeon Baek, Eun Kyung Shim, Hyun Mi Kim, Ji Yeon Ku, Eun Jung Nam, Yoon-Jung Chang, Hye Jin Choi, Sun Young Kim
BACKGROUND: Palliative care in outpatient setting has been shown to promote better symptom management and transition to hospice care among patients with advanced cancer. Nevertheless, specialized palliative care is rarely provided at cancer centers in Korea. Herein, we aimed to assess aggressiveness of end-of-life care for patients with metastatic colorectal cancer according to the use of outpatient palliative care (OPC) at a single cancer center in Korea. METHODS: We performed a retrospective medical record review for 132 patients with metastatic colorectal cancer who died between 2011 and 2014...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28073292/health-care-utilization-after-hospice-enrollment-in-patients-with-heart-failure-and-cancer
#11
Meredith A MacKenzie, Alexandra Hanlon
This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = ...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056515/race-ethnicity-as-a-predictor-for-location-of-death-in-patients-with-acute-neurovascular-events
#12
Say Salomon, Elizabeth Chuang, Deepa Bhupali, Daniel Labovitz
BACKGROUND: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. METHODS: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056514/race-as-a-predictor-of-palliative-care-referral-time-hospice-utilization-and-hospital-length-of-stay
#13
Brooke Worster, Declan Kennedy Bell, Vibin Roy, Amy Cunningham, Marianna LaNoue, Susan Parks
BACKGROUND: Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services. OBJECTIVE: To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients' overall hospital length of stay among patients of an inpatient palliative care service...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056512/palliative-care-exposure-in-internal-medicine-residency-education
#14
Asher Edwards, Samuel Nam
As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27940902/religion-and-spiritual-care-in-pediatric-intensive-care-unit-parental-attitudes-regarding-physician-spiritual-and-religious-inquiry
#15
Tsovinar Arutyunyan, Folafoluwa Odetola, Ryan Swieringa, Matthew Niedner
OBJECTIVE: Parents of seriously ill children require attention to their spiritual needs, especially during end-of-life care. The objective of this study was to characterize parental attitudes regarding physician inquiry into their belief system. MATERIALS AND MAIN RESULTS: A total of 162 surveys from parents of children hospitalized for >48 hours in pediatric intensive care unit in a tertiary academic medical center were analyzed. Forty-nine percent of all respondents and 62% of those who identified themselves as moderate to very spiritual or religious stated that their beliefs influenced the decisions they made about their child's medical care...
December 9, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27895150/effects-of-va-facility-dog-on-hospitalized-veterans-seen-by-a-palliative-care-psychologist-an-innovative-approach-to-impacting-stress-indicators
#16
Cheryl A Krause-Parello, Cari Levy, Elizabeth Holman, John E Kolassa
The United States is home to 23 million veterans. In many instances, veterans with serious illness who seek healthcare at the VA receive care from a palliative care service. Animal-assisted intervention (AAI) is gaining attention as a therapeutic stress reducing modality; however, its effects have not been well studied in veterans receiving palliative care in an acute care setting. A crossover repeated-measures study was conducted to examine the effects of an animal-assisted intervention (AAI) in the form of a therapy dog on stress indicators in 25 veterans on the palliative care service at the VA Eastern Colorado Healthcare System in Denver, CO...
November 28, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/26494830/advance-directives-and-care-received-by-older-nursing-home-residents
#17
Erika R Manu, Lona Mody, Sara E McNamara, Caroline A Vitale
BACKGROUND: Research shows variable success as to whether care provided aligns with individual patient preferences as reflected in their advance directives (AD). OBJECTIVE: We aimed to study AD status and subsequent care received in older nursing home (NH) residents deemed at risk for infections and care transitions: those with a urinary catheter (UC), feeding tube (FT), or both. Design/participants/measurements: A subgroup analysis of a prospective cohort of 90 residents with a UC and/or FT from 15 NHs in southeast Michigan...
March 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/26430133/pediatric-primary-care-involvement-in-end-of-life-care-for-children
#18
Lisa C Lindley, Savithri Nageswaran
OBJECTIVES: To examine the relationship between pediatric primary care involvement and hospice and home health care use at end of life. METHODS: California Medicaid data were used to estimate the relationship between pediatric primary care involvement and use of hospice and home health care using generalized estimating equations. RESULTS: Of the 2037 children who died between 2007 and 2010, 11% used hospice and 23% used home health. Among all children, primary care was not related to hospice use and was associated with home health use, usual source of care (OR = 1...
March 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/26697881/advance-care-planning
#19
Laurence Tan, Lai Kiow Sim, Lynnette Ng, Hui Jin Toh, James Alvin Low
There has been a growing trend in addressing spiritual needs in caring for the person, especially nearing the end of one's life. Advance care planning (ACP) facilitates understanding of preferences and explores the spiritual and existential aspects of care. This study explores the views and preferences of a group of Catholic nuns in Singapore, specifically looking at what was meaningful and valuable to them when determining treatment options at the end of life. Twenty-three nuns were purposively recruited in July 2012...
February 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/26566929/student-and-faculty-reflections-of-the-hidden-curriculum
#20
Julia Bandini, Christine Mitchell, Zachary D Epstein-Peterson, Ada Amobi, Jonathan Cahill, John Peteet, Tracy Balboni, Michael J Balboni
The hidden curriculum, or the socialization process of medical training, plays a crucial role in the development of physicians, as they navigate the clinical learning environment. The purpose of this qualitative study was to examine medical faculty and students' perceptions of psychological, moral, and spiritual challenges during medical training in caring for critically ill patients. Focus groups were conducted with 25 Harvard Medical School (HMS) students, and interviews were conducted with 8 HMS faculty members...
February 2017: American Journal of Hospice & Palliative Care
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