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Journal of Palliative Medicine

David Stevenson, Nicholas Sinclair
BACKGROUND: Complaints are an opportunity for patients and family members to report allegations of substandard care. No prior studies have examined complaints in hospice care and what might be learned from them. OBJECTIVES: To describe hospice complaint trends, characterize state investigation practices, and assess the relationship between complaints and hospice agency traits of interest. METHODS: Retrospective analyses merged hospice complaints from 2005 to 2015 with agency characteristics from Medicare Cost Reports and Provider of Service files...
July 17, 2018: Journal of Palliative Medicine
Yan Liang, Hong Liang, Jing Wang, Hanzhang Xu, Bei Wu
BACKGROUND: Little is known about the end-of-life (EOL) care preference and its associated factors among community-dwelling adults in Mainland China. This study investigated the EOL care preference and its associated factors among community-dwelling Chinese adults in Shanghai, China. METHODS: A cross-sectional survey was conducted in Shanghai, China, from April to June in 2013. A total of 1200 older adults aged 60 years and older and another 200 middle-aged and older adults aged 45 years and older who lost their only child were included in the current study...
July 17, 2018: Journal of Palliative Medicine
Danial Qureshi, Peter Tanuseputro, Richard Perez, Hsien Seow
BACKGROUND/OBJECTIVES: Place of death is a commonly reported indicator of palliative care quality, but does not provide details of service utilization near end of life. This study aims to explore place of care trajectories in the last two weeks of life in a general population and by disease cohorts. DESIGN/SETTING: A retrospective population-based cohort study using linked administrative-health data to examine Ontario decedents between April 1, 2010 and December 31, 2012...
July 16, 2018: Journal of Palliative Medicine
Ryoichi Ichihashi, Kouichi Tanabe, Kenta Horio, Kunihiro Tsuchiya, Setsuko Hirata, Kaori Gassho, Kazuyo Yasuda, Akina Ishikawa, Kazuki Sato, Tatsuya Morita, Takuya Saiki
BACKGROUND: Toileting independence is considered to be important factors for achieving a "good death" for terminally ill patients. AIM: To clarify the period from loss of the ability to access toilets independently to death in end-stage cancer patients. DESIGN: Observational study. SETTING/PARTICIPANTS: The medical records of all end-stage cancer patients who had died while using home care services provided by Medical Corporation Kagayaki General Home Care Clinic between September 2011 and August 2017, were retrospectively reviewed...
July 16, 2018: Journal of Palliative Medicine
Amanda Copenhaver Moale, Sahana Rajasekhara, William Ueng, Rahul Mhaskar
BACKGROUND: Patients' religious and spiritual values impact their goals and perception of illness, especially at the end of life (EOL). According to the Joint Commission, identifying spiritual beliefs may improve cultural competency and patient-centered care. However, clinicians may be uncomfortable discussing spirituality and unaware of basic religious teachings. OBJECTIVES: To assess clinician understanding and knowledge of key Christian, Jewish, and Islamic teachings around EOL care before and after a one-hour educational intervention through video podcast...
July 13, 2018: Journal of Palliative Medicine
Antonio Noguera, Deborah Bolognesi, Eduardo Garralda, Monica Beccaro, Aleksandra Kotlinska-Lemieszek, Carl Johan Furst, John Ellershaw, Frank Elsner, Agnes Csikos, Marilene Filbet, Guido Biasco, Carlos Centeno
BACKGROUND: In Europe in recent decades, university teaching of palliative medicine (PM) has evolved. In some countries it has been introduced as a compulsory subject in all medical schools, but in a majority of countries it remains an isolated subject at few universities. OBJECTIVE: To explore how PM has been introduced into the curricula and how it is currently being taught at different European universities. METHOD: Case study method using face-to-face semistructured interviews with experienced PM professors, comparing how they have developed PM undergraduate programs at their universities...
July 9, 2018: Journal of Palliative Medicine
Molly Touzel, Joshua Shadd
BACKGROUND: The term "palliative approach" has emerged to connote healthcare activities provided consistent with the philosophy of palliative care, but not limited to specialized care providers or settings. A rigorous understanding of the palliative approach requires a conceptual model, which links the philosophy of palliative care to specific actions of practitioners, and is applicable to patients with any life-threatening illness, at any point on the disease trajectory, and provided by any care provider in any setting...
July 9, 2018: Journal of Palliative Medicine
Kedar Kirtane, Lois Downey, Stephanie J Lee, J Randall Curtis, Ruth A Engelberg
BACKGROUND: Racial/ethnic minority patients with nonhematologic malignancies (non-HM) have lower rates of hospice care, advance directive use, and palliative care utilization than non-Hispanic white (NHW) patients. Less is known regarding racial/ethnic minority patients with hematologic malignancies (HM). OBJECTIVES: To study hospital utilization among racial/ethnic minority patients with HM and compare end-of-life outcome measures to patients with non-HM. METHODS: We performed a retrospective cohort study (2010-2015) using electronic health records from an integrated academic health center to study differences in hospital utilization patterns and documentation of advance care planning between patients with HM and non-HM...
July 5, 2018: Journal of Palliative Medicine
Keita Tagami, Ayumi Okizaki, Tomofumi Miura, Yuki Sumazaki Watanabe, Yoshihisa Matsumoto, Tatsuya Morita, Maiko Fujimori, Hiroya Kinoshita
BACKGROUND: Breakthrough cancer pain (BTcP) is a predictor of interference with general activities and poor pain management. The extent of this influence has not yet been determined. OBJECTIVE: This study aimed to investigate the influence of BTcP on general activities, and pain management in patients with controlled background pain. DESIGN: Single-center prospective observational study. SETTING/SUBJECTS: The study cohort comprised 258 consecutive patients (female, 40...
July 5, 2018: Journal of Palliative Medicine
Sean Marks, Alexis Williams, Wendy Peltier, Ann Helms, Chad Carlson
Status epilepticus is a common and under-recognized cause of unconsciousness among hospitalized patients. It can clinically mimic delirium and other causes of acute mental status change, especially when clinically relevant seizure activity is not appreciated on physical examination. While the successful treatment of status epilepticus may require anesthetic dosing of antiepileptics such as barbiturates, these seemingly drastic therapeutic measures are justified when goals of care are life prolonging as they may allow a patient to regain consciousness and meaningfully interact with loved ones...
June 29, 2018: Journal of Palliative Medicine
Rachel Thienprayoon, Evaline Alessandrini, Millicent Frimpong-Manso, Daniel Grossoehme
BACKGROUND: In 2017, the Ohio Pediatric Palliative Care and End-of-Life Network (OPPEN) published nine domains of high-quality care for pediatric home-based hospice and palliative care (HBHPC). Eight domains established by the National Consensus Project (NCP) were validated for pediatric HBHPC, and a ninth domain of "Continuity and Coordination of Care" was added. OBJECTIVE: The aim of this study was to establish definition criteria for each of these domains...
June 29, 2018: Journal of Palliative Medicine
Katherine Ramos, S Nicole Hastings, Hayden B Bosworth, Jessica J Fulton
BACKGROUND: Psychosocial interventions for palliative care populations, individuals with life-limiting illness, improve distress; however, less is known about these interventions among military Veterans. OBJECTIVES: This quality improvement project evaluated a palliative psychology group intervention to reduce depression, anxiety, and stress among Veterans with advanced life-limiting illness. METHODS: Veterans receiving palliative care at a mid-Atlantic VA healthcare system were referred by a mental health provider...
June 29, 2018: Journal of Palliative Medicine
Rabia S Atayee, Andrew M Sam, Kyle P Edmonds
INTRODUCTION: Palliative care uses a team approach, including physicians, nurses, social workers, chaplains, and pharmacists. The pharmacist's role within palliative care teams is increasing and initial favorable outcomes have been reported. METHODS: This retrospective study evaluated adult hospitalized patients seen by a part-time palliative care specialist pharmacist as part of the palliative care consultation team at an academic health system during a 15-month period between September 1, 2015, and March 30, 2017...
June 29, 2018: Journal of Palliative Medicine
Natalie C Ernecoff, Sheryl Zimmerman, Susan L Mitchell, Mi-Kyung Song, Feng-Chang Lin, Kathryn L Wessell, Laura C Hanson
BACKGROUND: Nursing home (NH) residents with dementia experience high rates of intensive treatment near the end of life. Limited research examines whether treatment is concordant with goals of care (GOC). OBJECTIVES: We analyzed data from the GOC trial to describe family decision makers' preferred GOC and perceptions of goal-concordant care for NH residents with late-stage dementia We compared subsequent treatment orders when families chose a primary goal of comfort versus other goals...
June 29, 2018: Journal of Palliative Medicine
Stacie T Pinderhughes, Julie M Lehn, Arif H Kamal, Ryan Hutchinson, Lisa O'Neill, Christopher A Jones
BACKGROUND: The success of our hospital-based Palliative Care program stimulated requests to duplicate the program across the health system continuum of care. OBJECTIVE: To develop a model of care focused on a high-need, high-cost population that could be implemented across all care settings, including hospitals and patients' homes. METHODS: To fiscally support program expansion from hospital to home, we conducted a retrospective cost analysis for home-based Palliative Care (HBPC)-enrolled patients with continuous claims months before program enrollment through date of death...
June 29, 2018: Journal of Palliative Medicine
Pringl Miller
No abstract text is available yet for this article.
June 22, 2018: Journal of Palliative Medicine
Liliana De Lima, Natalia Arias Casais, Roberto Wenk, Lukas Radbruch, Tania Pastrana
BACKGROUND: International Association for Hospice and Palliative Care implemented Opioid Price Watch (OPW) to monitor availability, dispensing prices and affordability of opioids. We found that opioids with complex delivery mechanisms [fentanyl transdermal (TD) patches, sustained-release (SR) morphine, and SR oxycodone] had lower dispensing prices than immediate-release (IR) morphine formulations. OBJECTIVE: Identify the extent that SR and TD formulations are dispensed at lower prices than generic IR morphine and the possible reasons to explain this observation...
June 21, 2018: Journal of Palliative Medicine
Michael A Smith, Marla L Clayman, Joel Frader, Melanie Arenson, Natalie Haber-Barker, Claire Ryan, Linda Emanuel, Kelly Michelson
BACKGROUND: Little is known about how decision-making conversations occur during pediatric intensive care unit (PICU) family conferences (FCs). OBJECTIVE: Describe the decision-making process and implementation of shared decision making (SDM) during PICU FCs. DESIGN: Observational study. SETTING/SUBJECTS: University-based tertiary care PICU, including 31 parents and 94 PICU healthcare professionals involved in FCs. MEASUREMENTS: We recorded, transcribed, and analyzed 14 PICU FCs involving decision-making discussions...
June 19, 2018: Journal of Palliative Medicine
Ting Li, Su-Wei Wang, Jing-Jing Zhou, Qing-Zhuo Ren, Yu-Lin Gao
BACKGROUND: The Texas Revised Inventory of Grief-Present Scale (TRIG-Present) is a widely used tool to measure grief. Most existing research related to the assessment and characteristics of grief has been conducted sampling bereaved Western subjects and, as such, limited information is available on the experience of grief in Chinese samples. OBJECTIVE: This study aims to validate the Chinese version of the TRIG-Present (TRIG-Present-C) and explore the predictors of grief among bereaved adults in China...
June 18, 2018: Journal of Palliative Medicine
Alyson M Johnson, Joshua P Spaete, Paul S Jowell, Arif H Kamal, Deborah A Fisher
Patients diagnosed with advanced stages of gastrointestinal (GI) malignancies are often quite symptomatic, with symptoms primarily related to anatomic sites of obstruction. Endoscopic approaches to the palliation of GI malignancies have begun to overtake surgical approaches as first line in interventional management. We brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies...
June 15, 2018: Journal of Palliative Medicine
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