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American Journal of Hospice & Palliative Care

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https://www.readbyqxmd.com/read/29179573/the-value-of-rehabilitation-medicine-for-patients-receiving-palliative-care
#1
Sarah A Wittry, Ny-Ying Lam, Thomas McNalley
BACKGROUND: Rehabilitation medicine is a multidisciplinary field aimed at improving patients' quality of life by improving function. Patients receiving palliative care frequently share common symptoms including fatigue, decreased functional independence, mood disorders, pain, and breathlessness. Many rehabilitation interventions can improve these symptoms. OBJECTIVE: To evaluate the scope and effectiveness of rehabilitation interventions and exercise programs in improving quality of life and distressing symptoms in patients receiving palliative care...
June 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29145731/decline-of-physical-activity-in-terminally-ill-patients-could-be-useful-for-predicting-short-term-survival
#2
Hiroki Yasui, Satoru Iwase, Keisuke Ariyoshi, Masanori Nojima, Kazuhiro Yoshiuchi
BACKGROUND: Although it is recommended that all terminally ill patients receive advance care planning (ACP), this is occasionally challenging because of the difficulty in predicting survival. There are some indexes for predicting survival, but few are accurate, especially at the terminal stages of illness. METHODS: Twenty-two patients at the terminal stages of cancer were retrospectively analyzed. We assessed their physical activity and condition using activities of daily living (ADL) scores for 1 month before the death...
May 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29121790/knowledge-skills-and-attitudes-regarding-the-use-of-medical-cannabis-in-the-hospice-population-an-educational-intervention
#3
Kelly S Mendoza, Mary Lynn McPherson
BACKGROUND: Currently, 28 states and the District of Columbia have legalized cannabis for medical use despite its remaining Schedule I federally. Benefits of medical cannabis (MC) have been demonstrated in nausea/vomiting associated with chemotherapy, cachexia associated with HIV/AIDS, and certain types of neuropathic pain. However, it is unclear how comfortable hospice providers are with the concept of MC. OBJECTIVE: The aim of this study is to determine changes in knowledge, self-perceived skills, and attitudes (KSA) of hospice providers regarding MC after an online educational intervention...
May 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29050492/prevalence-of-dementia-in-a-geriatric-palliative-care-unit
#4
Amanda T Lo, Jurgis Karuza, Anna Berall, Giulia-Anna Perri
OBJECTIVES: To determine the prevalence of dementia in a palliative care unit (PCU) and to determine whether there is a difference between length of stay (LOS) and Palliative Performance Scale (PPS) score in individuals admitted with a primary diagnosis of dementia compared to individuals admitted with other noncancer and cancer diagnoses. DESIGN: Descriptive retrospective chart review. SETTING: Geriatric PCU in an academic community geriatric hospital...
May 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29186983/the-accuracy-of-the-edmonton-symptom-assessment-system-for-the-assessment-of-depression-in-patients-with-cancer-a-systematic-review-and-meta-analysis
#5
Sorawit Boonyathee, Kittiphon Nagaviroj, Thunyarat Anothaisintawee
BACKGROUND: Depression is a common health problem among patients with cancer. The Edmonton Symptom Assessment System (ESAS) is one of many tools that have been used to evaluate depression in these patients. Nevertheless, the diagnostic performance and the appropriate cutoff point of the ESAS for the assessment of depression in these patients have varied in the studies. PURPOSE: To determine the diagnostic accuracy and the optimal cutoff point for the ESAS for the assessment of depression in patients with cancer...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29172637/discrepancies-between-the-supports-needed-for-discharge-of-patients-with-terminal-cancer-to-family-caregivers-and-what-supports-were-actually-provided-in-japan-assessment-of-palliative-care-unit-nurses
#6
Yasufumi Oosono, Kazuhito Yokoyama, Hiroaki Itoh, Miyuki Enomoto, Miki Ishiwata
OBJECTIVES: Even if patients with terminal cancer hope to spend the rest of their lives at home, they are often unable to leave the hospital early due to their family caregivers' anxiety. This study aimed to investigate in Japan the discrepancies between the supports needed by and actually provided by palliative care unit nurses (PCUNs) to the family caregivers for discharge of patients with terminal cancer. METHODS: In this cross-sectional study, self-administered questionnaires including 6-point Likert-type scales assessing the reasons for difficulties in transition to home-based care were distributed to 1227 PCUNs...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29141459/factors-associated-with-caregivers-resilience-in-a-terminal-cancer-care-setting
#7
In Cheol Hwang, Young Sung Kim, Yong Joo Lee, Youn Seon Choi, Sun Wook Hwang, Hyo Min Kim, Su-Jin Koh
BACKGROUND: Resilience implies characteristics such as self-efficacy, adaptability to change, optimism, and the ability to recover from traumatic stress. Studies on resilience in family caregivers (FCs) of patients with terminal cancer are rare. This study aims to examine the factors associated with FCs' resilience in a terminal cancer care setting. METHODS: This is a cross-sectional study of 273 FCs from 7 hospice and palliative care units in Korea. Resilience was categorized as high and low, and factors associated with resilience were grouped or categorized into subscales...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29141457/disparities-associated-with-inpatient-palliative-care-utilization-by-patients-with-metastatic-gynecologic-cancers-a-study-of-3337-women
#8
Emily B Rosenfeld, John K Chan, Austin B Gardner, Natasha Curry, Lejla Delic, Daniel S Kapp
OBJECTIVE: To determine the factors associated with inpatient palliative care (PC) use in patients with metastatic gynecologic cancer. METHODS: Data were obtained from the Nationwide Inpatient Sample (NIS) for patients with metastatic cervical, uterine, and ovarian cancers. Chi-square and multivariate models were used for statistical analyses. RESULTS: Of 67 947 inpatients with metastatic gynecologic cancer, 3337 (5%) utilized PC (median age: 63 years, range: 18-102 years)...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29121791/unexpected-survivors-children-with-life-limiting-conditions-of-uncertain-prognosis
#9
Savithri Nageswaran, Anna Hurst, Andrea Radulovic
OBJECTIVE: Prognostication of survival is difficult in children with life-limiting illnesses because of the rarity of these conditions and technological advances improving survival. The objective of this article is to describe the characteristics of children with life-limiting illnesses who survived longer than the expectations of health-care providers. STUDY DESIGN: This is a retrospective cohort study conducted in a tertiary-care children's hospital in North Carolina...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29034687/predictors-of-placement-of-inpatient-palliative-care-consult-orders-among-patients-with-breast-lung-and-colon-cancer-in-a-safety-net-hospital-system
#10
Lauren N Smith, Ramona L Rhodes, Lei Xuan, Ethan A Halm
BACKGROUND: The provision of palliative and end-of-life care to patients who are underrepresented and underserved provides unique challenges and opportunities. OBJECTIVES: To examine predictors of placement of inpatient palliative care consult orders among patients with breast, lung, and colorectal cancer hospitalized in a safety net hospital in 2010. METHODS: Simple and multivariable logistic regression of data on selected patients with cancer was performed to identify predictors of placement of inpatient palliative care consult orders...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29020799/is-there-a-role-for-5-ht-3-receptor-antagonists-in-the-treatment-of-opioid-induced-pruritus
#11
Saima Rashid, Disha D Trivedi, Mudher Al-Shathir, Marie Moulton, Steven J Baumrucker
Pruritus is an unpleasant irritation symptom that can be related to various systemic and dermatological conditions. Although underreported, pruritus is a common adverse event noted after use of opioid pain medications. This article reviews the current understanding of the mechanism of opioid-induced pruritus (OIP) and various pharmacological therapies. 5-Hydroxytryptamine 3 (5-HT3 ) receptor antagonists are potentially effective for treating OIP and may be a valuable treatment option if further controlled studies are encouraging...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28992715/-my-future-is-now-a-qualitative-study-of-persons-living-with-advanced-cancer
#12
Ann H Cottingham, Larry D Cripe, Kevin L Rand, Richard M Frankel
OBJECTIVES: Advance care planning (ACP) enables individuals to deliberate about future preferences for care based upon their values and beliefs about what is important in life. For many patients with advanced cancer, however, these critical conversations do not occur. A growing body of literature has examined the end-of-life wishes of seriously ill patients. Few studies have explored what is important to persons as they live with advanced cancer. The aim of the current study was to address this gap and to understand how clinicians can support patients' efforts to live in the present and plan for the future...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28990397/examining-the-role-of-primary-care-physicians-and-challenges-faced-when-their-patients-transition-to-home-hospice-care
#13
Ariel Shalev, Veerawat Phongtankuel, Katherine Lampa, M C Reid, Brian M Eiss, Sonica Bhatia, Ronald D Adelman
BACKGROUND: The transition into home hospice care is often a critical time in a patient's medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care. OBJECTIVES: To understand PCPs' experiences, challenges, and preferences when their patients transition to home hospice care...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28990396/physicians-perceptions-of-shared-decision-making-in-neonatal-and-pediatric-critical-care
#14
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Ross M Hays, Ardith Z Doorenbos
BACKGROUND: Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. OBJECTIVE: To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28982259/the-comfort-measures-order-set-at-a-tertiary-care-academic-hospital-is-there-a-comparable-difference-in-end-of-life-care-between-patients-dying-in-acute-care-when-cmos-is-utilized
#15
Christine Lau, Kalli Stilos, Allyson Nowell, Fanchea Lau, Jennifer Moore, Lesia Wynnychuk
BACKGROUND: Standardized protocols have been previously shown to be helpful in managing end-of-life (EOL) care in hospital. The comfort measures order set (CMOS), a standardized framework for assessing imminently dying patients' symptoms and needs, was implemented at a tertiary academic hospital. OBJECTIVE: We assessed whether there were comparable differences in the care of a dying patient when the CMOS was utilized and when it was not. METHODS: A retrospective chart review was completed on patients admitted under oncology and general internal medicine, who were referred to the inpatient palliative care team for "EOL care" between February 2015 and March 2016...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28978223/physical-signs-and-clinical-findings-before-death-in-ill-elderly-patients
#16
Keiji Matsunami, Katsuyuki Tomita, Hirokazu Touge, Hiromitsu Sakai, Akira Yamasaki, Eiji Shimizu
Few studies have examined variations in both the physical signs and clinical findings in the final days and hours before the death of elderly patients. We determined the physical signs and clinical findings in patients who were at least 75 years old or were diagnosed with cancer with impending death and examined the association of these parameters with the profile and timing of their endocardiography (ECG) and oxygen saturation (SpO2 ) changes prior to death. In this prospective, observational study, between April 2014 and June 2017, we enrolled elderly patients who were admitted to the Respiratory Medicine Ward in our hospital and were near death, which was determined based on certain symptoms such as a loss of oral intake...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28950727/patient-reported-outcomes-after-radiation-therapy-for-bone-metastases-as-a-function-of-age-a-secondary-analysis-of-the-ncic-ctg-sc-twenty-three-randomized-trial
#17
Selina Chow, Keyue Ding, Bo Angela Wan, Michael Brundage, Ralph M Meyer, Abdenour Nabid, Pierre Chabot, Genevieve Coulombe, Shahida Ahmed, Joda Kuk, A Rashid Dar, Aamer Mahmud, Alysa Fairchild, Carolyn F Wilson, Jackson S Y Wu, Kristopher Dennis, Carlo DeAngelis, Rebecca K S Wong, Liting Zhu, Edward Chow
PURPOSE: To explore the age difference in response and patient-reported outcomes in patients with cancer having bone metastases undergoing palliative radiotherapy. METHODS: Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life (QOL) Bone Metastases module (QLQ-BM22), EORTC QOL Core-15-Palliative (QLQ-C15-PAL), and Dexamethasone Symptom Questionnaire (DSQ) before a single 8-Gy radiation treatment, on days 10 and 42 after treatment...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28950726/educational-intervention-to-improve-code-status-discussion-proficiency-among-obstetrics-and-gynecology-residents
#18
Benjamin Margolis, Craig Blinderman, Alexandre Buckley de Meritens, Sudeshna Chatterjee-Paer, Rini B Ratan, Holly G Prigerson, June Y Hou, William M Burke, Jason D Wright, Ana I Tergas
BACKGROUND: Obstetrics and gynecology (OB/GYN) residents receive little formal training in conducting code status discussions (CSDs). OBJECTIVE: We piloted an educational intervention to improve resident confidence and competence at conducting CSDs. DESIGN: The OB/GYN residents at a single institution participated in a 3-part educational program. First, participants reviewed a journal article and completed an online module. Second, they received a didactic lecture followed by a resident-to-resident mock CSD...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28925295/characteristics-of-patients-with-existing-advance-directives-evaluating-motivations-around-advance-care-planning
#19
Joanne E Genewick, Dorothy M Lipski, Katherine M Schupack, Angela L H Buffington
INTRODUCTION: Although 80% of patients endorse an advance directive (AD), less than 35% of American adults have a documented AD. Much research has been done on barriers to creating ADs; however, there is a paucity of research addressing motivations for creating ADs. Previous research has identified 4 categories of influence for engaging in advance care planning (ACP). This study aimed to quantify the influence of these 4 motivating categories in creating an AD. METHODS: Participants included 238 adults with documented ADs...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28905637/recent-changes-in-end-of-life-decisions-for-newborns-in-a-korean-hospital
#20
Myo-Jing Kim, Jin-Hyeok Lee, Hyoung-Doo Lee
INTRODUCTION: Despite recent advances in neonatal intensive care in Korea, few studies exist on the end-of-life decisions in newborns. In this study, we sought to examine the status of end-of-life decisions in neonates, changes over time, and affecting factors. METHODS: This is a retrospective study of neonates who died between 2001 and 2015 in the neonatal intensive care unit of Dong-A University Hospital in Busan. The types of end-of-life decisions were divided into active resuscitation, withholding treatment, and withdrawing treatment...
April 2018: American Journal of Hospice & Palliative Care
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