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American Journal of Hospice & Palliative Care

Lisa C Lindley, Melanie J Cozad
OBJECTIVE: To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. METHODS: Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. RESULTS: Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -...
July 2017: American Journal of Hospice & Palliative Care
Aynur Aktas, Declan Walsh, Marianne Galang, Niamh O'Donoghue, Lisa Rybicki, Barbara Hullihen, Ellen Schleckman
INTRODUCTION: Malnutrition (MN) often goes unrecognized due to ineffective screening techniques. Published standards for multidisciplinary care exist but no consensus on best nutritional assessment for hospitalized patients. Malnutrition is common in cancer and adversely affects clinical outcomes. The Cleveland Clinic Nutrition Therapy Department used in-house criteria to classify MN in hospitalized patients. This study aimed to evaluate the registered dietitian (RD)'s role, the use of these criteria in the acute care palliative medicine unit (ACPMU), and investigate MN prevalence and severity among admitted patients with cancer...
July 2017: American Journal of Hospice & Palliative Care
Kathleen Leemans, L Deliens, L Van den Block, R Vander Stichele, A L Francke, J Cohen
BACKGROUND: A feasibility evaluation of a comprehensive quality indicator set for palliative care identified the need for a minimal selection of these indicators to monitor quality of palliative care services with short questionnaires for the patients, caregivers, and family carers. OBJECTIVES: To develop a minimal indicator set for efficient quality assessment in palliative care. DESIGN: A 2 round modified Research ANd Development corporation in collaboration with the University of California at Los Angeles (RAND/UCLA) expert consultation...
July 2017: American Journal of Hospice & Palliative Care
Mei Ching Lee, Daniel P Sulmasy, Joseph Gallo, Joan Kub, Mark T Hughes, Stuart Russell, Anela Kellogg, Sharon G Owens, Peter Terry, Marie T Nolan
INTRODUCTION: Many patients with advanced heart failure (HF) experience the life-extending benefits of implantable cardioverter-defibrillators (ICD), but at the end stage of HF, patients may experience shocks with increasing frequency and change the plan for end-of-life (EOL) care including the deactivation of the ICD. This report describes family members' experiences of patients with ICD making decisions at EOL. Understanding the decision-making of patients with ICD at EOL can promote informed decision-making and improve the quality of EOL care...
July 2017: American Journal of Hospice & Palliative Care
Elaine Wittenberg, Sandra L Ragan, Betty Ferrell
OBJECTIVE: Although spiritual care is considered one of the pillars of palliative care, many health-care providers never receive formal training on how to communicate about spirituality with patients and families. The aim of this study was to explore the spiritual care experiences of oncology nurses in order to learn more about patient needs and nurse responses. METHODS: A survey was circulated at a communication training course for oncology nurses in June 2015...
July 2017: American Journal of Hospice & Palliative Care
Rei Tanaka, Hiroshi Ishikawa, Tetsu Sato, Michihiro Shino, Teruaki Matsumoto, Keita Mori, Katsuhiro Omae, Iwao Osaka
BACKGROUND: Despite the risk of drug-induced delirium, it is difficult to avoid the use of opioids in palliative care. However, no previous study has carefully investigated how the development of delirium varies among patients injected with different opioids for the first time. OBJECTIVES: To reveal the difference in the incidence of delirium between different opioids. DESIGN: The incidence of delirium was compared among 114 patients who had started morphine, oxycodone, or fentanyl injection at Shizuoka Cancer Center between June 2012 and September 2014...
July 2017: American Journal of Hospice & Palliative Care
Yoshiko Yamashita Colclough
This study was conducted to highlight Native American (NA) perspectives on death taboo in order to examine the cultural appropriateness of hospice services for NA patients, if any. Searching literature that addressed taboo and death from historical, psychological, sociological, and anthropological aspects, a comparison of death perspectives was made between NAs and European Americans. A culturally sensitive transition from palliative care to hospice care was suggested for NA patients and their family.
July 2017: American Journal of Hospice & Palliative Care
George E Dickinson
The purpose of this longitudinal study of US medical schools over a 40-year period was to ascertain their offerings on end-of-life (EOL) issues. At 5-year intervals, beginning in 1975, US medical schools were surveyed via a questionnaire to determine their EOL offerings. Data were reported with frequency distributions. The Institute of Medicine has encouraged more emphasis on EOL issues over the past 2 decades. Findings revealed that undergraduate medical students in the United States are now exposed to death and dying, palliative care, and geriatric medicine...
July 2017: American Journal of Hospice & Palliative Care
Marco Cascella, Maria Rosaria Muzio, Daniela Viscardi, Arturo Cuomo
Pain is a common and debilitating symptom in pelvic cancer diseases. Failure in controlling this pain through pharmacological approaches calls for employing multimodal management and invasive techniques. Various strategies are commonly used for this purpose, including palliative radiotherapy, epidural medications and intrathecal administration of analgesic and local anesthetic drugs with pumps, and neural or plexus blockade. This review focuses on the features of minimally invasive palliative procedures (MIPPs), such as radiofrequency ablation, laser-induced thermotherapy, cryoablation, irreversible electroporation, electrochemotherapy, microwave ablation, and cementoplasty as well as their role in palliation of cancer pelvic pain...
July 2017: American Journal of Hospice & Palliative Care
James Gerhart, Eric Schmidt, Teresa Lillis, Sean O'Mahony, Paul Duberstein, Michael Hoerger
AIM: Anger is a common reaction to cancer diagnosis which may impact patients' perceptions of their prognosis and goals of care. This study tested the hypothesis that men with prostate cancer who are anger prone are pessimistic regarding their cancer prognosis. METHODS: Two hundred and twelve men with a history of prostate cancer completed measures of personality traits, their prostate cancer prognosis, and their perception of their doctor's assessment of their prognosis...
July 2017: American Journal of Hospice & Palliative Care
Micah T Prochaska, Michael S Putman, Hyo Jung Tak, John D Yoon, Farr A Curlin
BACKGROUND: Utilization of hospice has increased significantly over the past 2 decades, but there has been no recent assessment of US physicians' opinions regarding and practices of referring patients to hospice. METHODS: We surveyed 2016 US physicians from various specialties. Respondents agreed or disagreed with 2 statements: "For most patients, hospice provides better care at the end of life than they would otherwise receive without hospice" and "Many patients who enter hospice end up missing out on medical interventions from which they would have benefited...
July 2017: American Journal of Hospice & Palliative Care
Ramona L Rhodes, Bryan Elwood, Simon C Lee, Jasmin A Tiro, Ethan A Halm, Celette S Skinner
BACKGROUND: Studies have identified racial differences in advance care planning and use of hospice for care at the end of life. Multiple reasons for underuse among African American patients and their families have been proposed and deserve further exploration. OBJECTIVE: The goal of this study was to examine perceptions of advance care planning, palliative care, and hospice among a diverse sample of African Americans with varying degrees of personal and professional experience with end-of-life care and use these responses to inform a culturally sensitive intervention to promote awareness of these options...
July 2017: American Journal of Hospice & Palliative Care
Carlo Lai, Massimiliano Luciani, Federico Galli, Emanuela Morelli, Francesca Del Prete, Patrizia Ginobbi, Italo Penco, Paola Aceto, Luigi Lombardo
OBJECTIVE: Aims of the present study were to investigate the association between awareness of own illness condition and psychological outcome in end-of-life phase and to test the association between the spirituality and the awareness of own illness condition. METHODS: Three hundred and ninety-nine terminally ill patients with cancer were enrolled in a hospice in central Italy. One hundred patients satisfied the inclusion criteria. The Systems of Belief Inventory, the Hospital Anxiety and Depression Scale, and a psychological interview to determine the level of awareness of the illness diagnosis (aware; partially aware; and not aware) were administered to terminally ill patients...
July 2017: American Journal of Hospice & Palliative Care
Yong Liu, Fei Liu, Yang Yu, Qing Li, Xin Jin, Jin Li
AIM: To explore the frequencies and intensities of depressive symptoms associated with hospitalized patients with advanced cancer. METHODS: A total of 196 hospitalized patients with advanced cancer were surveyed with the Edmonton Symptom Assessment System and Self-Rating Depression Scale (SDS). The χ(2) test and Wilcoxon rank-sum test were used to compare the frequency and intensity of symptoms between patients with and without depressive disorders. Spearman rank correlation was used to test the correlation between depression and symptoms...
June 2017: American Journal of Hospice & Palliative Care
Deborah A Morris, Marissa Galicia-Castillo
OBJECTIVES: To describe the CARES program, a model of palliative care for nursing home residents. DESIGN: Descriptive analysis of the Caring About Residents' Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents. PROGRAM EVALUATION: The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred...
June 2017: American Journal of Hospice & Palliative Care
Nai-Ching Chi, George Demiris
CONTEXT: Pain management was the most identified burden faced by family caregivers in end-of-life caregiving. OBJECTIVES: To synthesize current scientific evidence on family caregivers' experience of pain management in end-of-life care. METHODS: A systematic review was conducted using CINAHL, Embase, PubMed, and Cochrane Library electronic databases. Data were extracted from each included paper and organized into tables to synthesize the findings...
June 2017: American Journal of Hospice & Palliative Care
Manisha Chandar, Bruce Brockstein, Alan Zunamon, Irwin Silverman, Sarah Dlouhy, Kathryn Ashlevitz, Cory Tabachow, Brittany Lapin, Bernard Ewigman, Theodore Mazzone, Jennifer Obel
BACKGROUND: Advance care planning (ACP) discussions afford patients and physicians a chance to better understand patients' values and wishes regarding end-of-life care; however, these conversations typically take place late in the course of a disease. The goal of this study was to clarify attitudes of oncologists, cardiologists, and primary care physicians (PCPs) toward ACP and to identify persistent barriers to timely ACP discussion following a quality improvement initiative at our health system geared at improvement in ACP implementation...
June 2017: American Journal of Hospice & Palliative Care
Madelaine Lawrence
The purpose of this article is to describe examples of near-death and other transpersonal experiences occurring during catastrophic events like floods, wars, bombings, and death camps. To date, researchers have limited their investigations of these transpersonal events to those occurring to seriously ill patients in hospitals, those dying from terminal illnesses, or to individuals experiencing a period of grief after the death of a loved one. Missing is awareness by first responders and emergency healthcare professionals about these transpersonal experiences and what to say to the individuals who have them...
June 2017: American Journal of Hospice & Palliative Care
Stephen Claxton-Oldfield, Anamika Bhatt
A survey was conducted to examine the frequency, acceptability, and functions of humor between hospice palliative care volunteers and their patients, from the volunteers' perspective. Thirty-two volunteers completed the survey, which was developed for this study. The results revealed that most patients and volunteers initiated humor either "often" or "sometimes" in their interactions. Over half of the volunteers considered humor to be either "very important" or "extremely important" in their interactions with patients (42% and 13%, respectively), with the patient being the determining factor as to whether and when it is appropriate or not (ie, volunteers take their lead from their patients)...
June 2017: American Journal of Hospice & Palliative Care
Nobuhisa Nakajima
PURPOSE: Various distresses appear in the terminal stage of cancer. Oral problems including dry mouth, stomatitis and candidiasis are one of the important problems which should be resolved. The purpose of this study was to investigate oral problems in this stage and improvement of dry mouth by oral care. METHODS: The study subjects were consecutive terminally ill cancer patients admitted over the past 2 years. Patients were divided based on the status of oral food intake into good oral food intake group (≥30%) and poor oral food intake group...
June 2017: American Journal of Hospice & Palliative Care
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