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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
Kittiphon Nagaviroj, Thunyarat Anothaisintawee
PURPOSE: Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death. METHODS: A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014...
June 2017: American Journal of Hospice & Palliative Care
Nanako Koyama, Chikako Matsumura, Hiroaki Morii, Chiaki Hasegawa, Daiki Hira, Yataro Daigo, Tomohiro Terada, Yoshitaka Yano
BACKGROUND: Corticosteroids are frequently used to treat cancer-related fatigue (CRF), but it is yet to be established as standard care, and few reports have defined the appropriate time to start treatment. OBJECTIVES: We investigated the optimal time for starting betamethasone and evaluated the clinical validity of using the prognostic nutritional index (PNI) for this purpose. METHODS: Data were retrospectively collected for patients with terminal cancer receiving betamethasone for palliative care...
June 2017: American Journal of Hospice & Palliative Care
Arif H Kamal, Janet Bull, Steven P Wolf, Diane Portman, Jacob Strand, Kimberly S Johnson
CONTEXT: Differences among patient populations that present to consultative palliative care are not known. Such an appreciation would inform health-care delivery tailored to unique populations. OBJECTIVES: We aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. METHODS: We analyzed patient-reported, clinician-entered clinical encounter data from a large, multisite community-based, nonhospice palliative care collaborative...
June 2017: American Journal of Hospice & Palliative Care
José Klerton Luz Araújo, Adriana Del Giglio, Bruna Antenusse Munhoz, Fernando Luiz Affonso Fonseca, Felipe Melo Cruz, Auro Del Giglio
PURPOSE: Cancer chemotherapy can induce fatigue in about 20% to 30% of patients. So far, there is very little information as to the predictors of chemotherapy-induced fatigue (CIF). We evaluated potential predictors of CIF in a sample of patients with cancer with several types of solid tumors scheduled to receive chemotherapy according to institutional protocols. METHODS: Before their first and second chemotherapy cycles, patients answered to the Brief Fatigue Inventory (BFI), Chalder, Mini Nutritional Assessment (MNA), Stress thermometer, and HADS questionnaires as well as provided blood samples for inflammatory markers...
June 2017: American Journal of Hospice & Palliative Care
Kayo Hirooka, Hiroki Fukahori, Yumi Akita, Miwa Ozawa
OBJECTIVE: The aim of this study was to explore the factors associated with posttraumatic growth (PTG) among adolescents bereaved owing to parental cancer in Japan. METHODS: An anonymous cross-sectional Web-based survey was conducted, enrolling adolescents bereaved because of parental cancer in the previous 5 years. Posttraumatic growth, number of social support members, support from medical staff, and behaviors after bereavement were measured. Multiple linear regression was performed to explore the association between total PTG score and possible related factors...
June 2017: American Journal of Hospice & Palliative Care
Kristin R Baughman, Ruth Ludwick, Rebecca Fischbein, Kenelm McCormick, James Meeker, Mike Hewit, Jennifer Drost, Denise Kropp
BACKGROUND: Although patients prefer that physicians initiate advance care planning (ACP) conversations, few physicians regularly do so. Physicians may be reluctant to initiate ACP conversations because they lack self-efficacy in their skills. Yet, no validated scale on self-efficacy for ACP exists. Our objective was to develop a scale that measures physicians' ACP self-efficacy (ACP-SE) and to investigate the validity of the tool. METHODS: Electronic questionnaires were administered to a random sample of family medicine physicians (n = 188)...
June 2017: American Journal of Hospice & Palliative Care
Cara M Brock, Christopher M Herndon
INTRODUCTION: Currently more than 5800 hospice organizations operate in the United States.(1) Hospice organizations are required by the Centers for Medicare and Medicaid Services (CMS) to use volunteers for services provided to patients.(2) Although CMS regulates the amount of hours hospice volunteers should provide, there are currently no national requirements for objectives of training.(3) The purpose of this study was to gather information from a sample of hospices regarding volunteer coordinator background, current training for volunteers, importance of training objectives, and any comments regarding additional objectives...
June 2017: American Journal of Hospice & Palliative Care
Susan E Thrane, Scott H Maurer, Dianxu Ren, Cynthia A Danford, Susan M Cohen
BACKGROUND: Pain may be reported in one-half to three-fourths of children with cancer and other terminal conditions and anxiety in about one-third of them. Pharmacologic methods do not always give satisfactory symptom relief. Complementary therapies such as Reiki may help children manage symptoms. OBJECTIVE: This pre-post mixed-methods single group pilot study examined feasibility, acceptability, and the outcomes of pain, anxiety, and relaxation using Reiki therapy with children receiving palliative care...
May 2017: American Journal of Hospice & Palliative Care
Mellar P Davis, Ruth Lagman, Armida Parala, Chirag Patel, Tanya Sanford, Flannery Fielding, Anita Brumbaugh, James Gross, Archana Rao, Sumreen Majeed, Shivani Shinde, Lisa A Rybicki
BACKGROUND: Hope is important to patients with cancer. Identifying factors that influence hope is important. Anxiety, depression, fatigue, and pain are reported to impair hope. The objective of this study was to determine whether age, gender, marital status, duration of cancer, symptoms, or symptom burden measured by the sum of severity scores on the Edmonton Symptom Assessment Scale (ESAS) correlated with hope measured by the Herth Hope Index (HHI). METHODS: Patients with advanced cancer in a palliative care unit participated...
April 2017: American Journal of Hospice & Palliative Care
Yoshiaki Okamoto, Satoru Tsuneto, Tatsuya Morita, Tatsuya Takagi, Megumi Shimizu, Mitsunori Miyashita, Etsuko Uejima, Yasuo Shima
OBJECTIVE: The aims of this study are to clarify the state of information regarding opioids for families and what kinds of experiences they had with opioids while the patient was followed as an outpatient and inpatient. PARTICIPANTS: This study was part of a cross-sectional nationwide survey of bereaved families of patients with cancer, namely, the Japan Hospice and Palliative Care Evaluation 2 study. The participants in this study comprised 572 bereaved families who had experienced the death of a family member during the period from January 2008 to December 2009 at 1 of 103 certificated palliative care units...
April 2017: American Journal of Hospice & Palliative Care
Iraida V Carrion, Frances Nedjat-Haiem, Melania Macip-Billbe, Ryan Black
PURPOSE: This study contributes to the sparse body of literature examining perceptions of coping among Latino men and women with a cancer diagnosis living in the United States. There are currently 50 million Latinos in the United States and, by 2050, projected to grow to 128 million. Although some research indicates that Latinos have unique sociocultural beliefs that influence their cancer care, very little is known about their perceptions of coping after being diagnosed with cancer. We examined Latino men and women's perceptions of coping to understand the meaning of their experience with cancer Method: Using criterion sampling technique, 60 immigrant and migrant Latino men and women diagnosed with cancer within the past 5 years were recruited from community-based organizations, clinics, and churches...
April 2017: American Journal of Hospice & Palliative Care
Katherine Clark, Abby Willis, Naomi Byfieldt
Although hospitals are the most likely place of death, the quality of care received by dying inpatients remains variable. This is concerning for both the dying person and their relatives, with poorer bereavement outcomes likely for those who perceived their family member suffered unduly. There is a real need to consider how this situation can be improved. This work was conducted with the aim of exploring the feasibility of including bereaved relatives' experiences as part of a larger project exploring the use of a care bundle to improve care of the dying inpatients...
April 2017: American Journal of Hospice & Palliative Care
Paul J Moon
Hospice admission assessment is a pivotal encounter for patient/family and hospice representative. For patient/family, the admission is the threshold by which a particular level of care can commence and, symbolically, a certain marker in health status trajectory is reached. For hospice representative, the admission episode is an occasion to inaugurate an ambience that can serve to frame future hospice care experiences for the patient/family. Through a narrative lens, hospice admission assessment can be seen as experiential time and space, where patient's and family's stories are mindfully and deliberately witnessed and explored...
April 2017: American Journal of Hospice & Palliative Care
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