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Journal of Palliative Medicine

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https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#1
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29792733/feasibility-and-acceptability-of-nurse-led-primary-palliative-care-for-older-adults-with-chronic-conditions-a-pilot-study
#2
Shigeko Seiko Izumi, Basilia Basin, Margo Presley, Jean McCalmont, Jon P Furuno, Brie Noble, Judith G Baggs, J Randall Curtis
BACKGROUND: Many older adults live with serious illness for years before their death. Nurse-led primary palliative care could improve their quality of life and ability to stay in their community. OBJECTIVES: To assess feasibility and acceptability of a nurse-led Transitional Palliative Care (TPC) program for older adults with serious illness. METHODS: The study was a pilot trial of the TPC program in which registered nurses assisted patients with symptom management, communication with care providers, and advance care planning...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29792535/does-the-poly-adp-ribose-polymerase-inhibitor-veliparib-merit-further-study-for-cancer-associated-weight-loss-observations-and-conclusions-from-60-prospectively-treated-patients
#3
Jason D Doles, Kelly A Hogan, Jennifer O'Connor, Andrea E Wahner Hendrickson, Olivia Huston, Aminah Jatoi
BACKGROUND: More than 80% of patients with advanced cancer develop weight loss. Because preclinical data suggest poly (ADP-ribose) polymerase (PARP) inhibitors can treat this weight loss, this study was undertaken to explore the PARP inhibitor veliparib for this indication. OBJECTIVE: The current study was undertaken to analyze prospectively gathered data on weight in cancer patients on PARP inhibitors. DESIGN/SETTING: The current study relied on a previously published, prospectively conducted phase 1 single institution trial that combined veliparib and topotecan (NCT01012817) as antineoplastic therapy for advanced cancer patients...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#4
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29775556/let-s-talk-about-it-supporting-family-communication-during-end-of-life-care-of-pediatric-patients
#5
Meghan L Marsac, Christine Kindler, Danielle Weiss, Lindsay Ragsdale
BACKGROUND: Communication is key in optimizing medical care when a child is approaching end of life (EOL). Research is yet to establish best practices for how medical teams can guide intrafamily communication (including surviving siblings) when EOL care is underway or anticipated for a pediatric patient. While recommendations regarding how medical teams can facilitate communication between the medical team and the family exist, various barriers may prevent the implementation of these recommendations...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29775550/palliative-sedation-with-oral-medicines-in-an-infant-with-generalized-severe-junctional-epidermolysis-bullosa
#6
Keith P Pasichow, Meg Frizzola, Elissa G Miller
Generalized severe junctional epidermolysis bullosa is a rare mechanobullous skin disorder that is uniformly fatal. We present the case of an infant who received palliative pain management and ultimately proportionate palliative sedation. However, because of the extent of the patient's skin disease, we were unable to provide palliative medication through parenteral routes. We discuss the provision of enteral palliative sedation, including the pharmacology, and creative use of medications to achieve sufficient palliation in this difficult and unique situation...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29768117/experiences-and-expectations-of-bereavement-contact-among-caregivers-of-patients-with-advanced-cancer
#7
Maisam Makarem, Shan Mohammed, Nadia Swami, Ashley Pope, Nanor Kevork, Monika Krzyzanowska, Gary Rodin, Breffni Hannon, Camilla Zimmermann
BACKGROUND: Contact with bereaved caregivers is not standard practice among cancer physicians, and little is known about its impact on caregivers. OBJECTIVE: Our aim was to describe the experiences and opinions of caregivers regarding bereavement contact from healthcare providers (HCP). DESIGN: Semistructured qualitative interviews were conducted with 61 bereaved caregivers. SUBJECTS: Bereaved caregivers of advanced cancer patients who had completed a randomized controlled trial of an early palliative care intervention were approached one to five years after the patient's death...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29768074/cancer-treatment-and-end-of-life-care
#8
Sudha Sinha, Jaskirt Kaur Matharu, Jean Jacob, Gayatri Palat, Eva Brun, Thomas Wiebe, Mikael Segerlantz
AIM: To study to what extent tumor-specific treatment (chemo- or radiotherapy) was given during the last 30 days in life and to examine how many of the patients were referred to a specialized palliative care unit (PCU), at a low-resource governmental hospital in India. PATIENTS AND METHODS: Medical records of adult cancer patients deceased between April 1 and May 31 in 2016, and pediatric cancer patients deceased between April 1 and September 30 in 2016 were collected...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29768072/an-integrated-developmental-four-year-medical-school-curriculum-in-palliative-care-a-longitudinal-content-evaluation-based-on-national-competency-standards
#9
Erin M Denney-Koelsch, Robert Horowitz, Timothy Quill, Constance D Baldwin
BACKGROUND: While palliative care (PC) competencies for medical school graduates have been defined, the lack of established curriculum models and assessment tools hampers curricular evaluation. OBJECTIVE: To describe the scope and content of the University of Rochester's longitudinal, integrated four-year PC curriculum after 17 years of implementation, review student evaluative responses, and compare the curriculum to national competency standards. DESIGN AND SETTING: Combining and reorganizing a published PC curriculum assessment tool and a list of medical school PC competencies, we created a novel nine-topic framework to assess the content coverage of our curriculum...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29762075/predicting-length-of-hospice-stay-an-application-of-quantile-regression
#10
Brystana G Kaufman, David Klemish, Cordt T Kassner, Jerome P Reiter, Fan Li, Matthew Harker, Emily C O'Brien, Donald H Taylor, Nrupen A Bhavsar
BACKGROUND: Use of the Medicare hospice benefit has been associated with high-quality care at the end of life, and hospice length of use in particular has been used as a proxy for appropriate timing of hospice enrollment. Quantile regression has been underutilized as an alternative tool to model distributional changes in hospice length of use and hospice payments outside of the mean. OBJECTIVE: To test for heterogeneity in the relationship between patient characteristics and hospice outcomes across the distribution of hospice days...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29762074/use-of-artificial-hydration-at-the-end-of-life-a-survey-of-australian-and-new-zealand-palliative-medicine-doctors
#11
Jacqueline Oehme, Caitlin Sheehan
BACKGROUND: Dying is ubiquitous, yet the optimal management of hydration in the terminal phase is undetermined. Palliative care (PC) doctors' practices may act as a de facto measure of the benefits and burdens of artificial hydration (AH) use. OBJECTIVE: To identify PC doctors' AH prescribing practices for imminently dying patients and possible influencing factors. METHODS: An online survey of doctors belonging to the Australian and New Zealand Society of Palliative Medicine...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29762072/healthcare-users-experiences-of-communicating-with-healthcare-professionals-about-children-who-have-life-limiting-conditions-a-qualitative-systematic-review
#12
Stuart Ekberg, Natalie K Bradford, Anthony Herbert, Susan Danby, Patsy Yates
BACKGROUND: Globally, an estimated eight million children could benefit from palliative care each year. Effective communication about children with life-limiting conditions is well recognized as a critical component of high-quality pediatric palliative care. OBJECTIVE: To synthesize existing qualitative research exploring healthcare users' experiences of communicating with healthcare professionals about children with life-limiting conditions. DESIGN: The results of a systematic literature search were screened independently by two reviewers...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29762070/developing-a-palliative-care-competency-framework-for-health-professionals-and-volunteers-the-nova-scotian-experience
#13
Meg McCallum, Janet Carver, David Dupere, Sharon Ganong, J David Henderson, Ann McKim, Lisa McNeil-Campbell, Holly Richardson, Judy Simpson, Cheryl Tschupruk, Heather Jewers
BACKGROUND AND OBJECTIVES: In 2014, Nova Scotia released a provincial palliative care strategy and implementation working groups were established. The Capacity Building and Practice Change Working Group, comprised of health professionals, public advisors, academics, educators, and a volunteer supervisor, was asked to select palliative care education programs for health professionals and volunteers. The first step in achieving this mandate was to establish competencies for health professionals and volunteers caring for patients with life-limiting illness and their families and those specializing in palliative care...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29757064/factors-associated-with-the-effectiveness-of-intravenous-administration-of-chlorpromazine-for-delirium-in-patients-with-terminal-cancer
#14
Hideaki Hasuo, Kenji Kanbara, Ryohei Fujii, Kazuki Uchitani, Hiroko Sakuma, Mikihiko Fukunaga
BACKGROUND: Delirium in patients with terminal cancer is irreversible and increases treatment resistance, which leads to a deterioration in quality of life. OBJECTIVE: To investigate factors affecting the effectiveness and safety of intravenous chlorpromazine for irreversible delirium in patients with terminal cancer. DESIGN/MEASUREMENTS: Multiple regression analysis for factors affecting treatment effectiveness was carried out based on a retrospective comparison between responders and nonresponders to intravenous chlorpromazine...
May 14, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29742006/aequanimitas-in-facing-death
#15
Devika Nair
No abstract text is available yet for this article.
May 9, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29733246/treating-tobacco-use-in-patients-with-incurable-malignancies-should-we-even-start-the-conversation
#16
Susan Trout, Adam O Goldstein, Lawrence Marks, Carol Ripley-Moffitt
BACKGROUND: Clinical practice guidelines recommend that all medical providers address tobacco use with patients, as the long-term health benefits of becoming tobacco free are well documented. What happens, though, when a patient has an incurable malignancy and, therefore, will not reap the long-term benefits? Clinical Consideration: Our case study encourages providers to consider the relevance of tobacco use treatment for those with incurable diseases. DISCUSSION: Although long-term benefits will not provide realistic motivation, other equally important rewards (e...
May 7, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29733235/pharmacological-management-of-symptoms-in-children-with-life-limiting-conditions-at-the-end-of-life-in-the-asia-pacific
#17
Lee Ai Chong, Poh Heng Chong, Joyce Chee
BACKGROUND: The provision of pediatric palliative care in Asia Pacific varies between countries and availability of essential medications for symptoms at the end of life in this region is unclear. OBJECTIVE: To determine medications available and used in the management of six symptoms at the end of life among pediatric palliative care practitioners in Asia Pacific. To identify alternative pharmacological strategies for these six symptoms if the oral route was no longer possible and injections are refused...
May 7, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29727264/palliative-medicine-family-conferences-reduce-spokesperson-distress-and-enhance-communication-in-advanced-cancer
#18
Ruth D Powazki, Declan Walsh, Aynur Aktas, Katherine Hauser
INTRODUCTION: Family conferences (FCs) may be important in communication. There is limited evidence about their value in palliative medicine. We examined specific information needs of patient-identified spokespersons (SP) and if the needs were met by a subsequent FC. Further data were collected on FC attendee characteristics, changes in SP distress, and SP assessment of FC value. METHODS: We conducted a prospective observational study of the family SP perspective of consecutive first time palliative medicine FCs for cancer patients...
May 4, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29727256/relationships-among-symptom-management-burden-coping-responses-and-caregiver-psychological-distress-at-end-of-life
#19
Karla T Washington, Chelsey M Wilkes, Christopher R Rakes, Sheila J Otten, Debra Parker Oliver, George Demiris
BACKGROUND: Family caregivers (FCGs) face numerous stressors and are at heightened risk of psychological distress. While theoretical explanations exist linking caregiving stressors with outcomes such as anxiety and depression, limited testing of these theories has occurred among FCGs of patients nearing the end of life. OBJECTIVE: Researchers sought to evaluate mediational relationships among burden experienced by hospice FCGs because of symptom management demands, caregivers' coping responses, and caregivers' psychological distress...
May 4, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29727249/reasons-for-and-frequency-of-end-of-life-hospital-admissions-gps-perspective-on-reducing-end-of-life-hospital-referrals
#20
Stéphanie Giezendanner, Klaus Bally, Dagmar M Haller, Corinna Jung, Ina C Otte, Hans-Ruedi Banderet, Bernice S Elger, Elisabeth Zemp, Heike Gudat
BACKGROUND: Many palliative care patients are admitted to hospital shortly before death even though the acute hospital setting is not considered ideal for end-of-life care (EOLC). OBJECTIVES: This study aimed to evaluate General Practitioners' (GPs') perspective on the frequency of and reasons for hospital referrals of these patients. METHODS: Cross-sectional survey involving a stratified random sample of 2000 GPs in Switzerland in 2014...
May 4, 2018: Journal of Palliative Medicine
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