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Journal of Palliative Medicine

Säde Korpi, Veera V Salminen, Reetta P Piili, Niina Paunu, Tiina Luukkaala, Juho T Lehto
BACKGROUND: The optimal treatment of malignant ascites (MA) and feasibility of the management with free drainage remain unclear. OBJECTIVE: To study the success of drainage, complications, and survival after paracentesis or insertion of an indwelling tunneled catheter (TC) for the MA performed on a day-case basis. DESIGN AND SETTING: We evaluated 118 paracenteses and 48 insertions of TCs performed in 104 patients with MA at the Palliative Care Outpatient Unit of Tampere University Hospital...
February 28, 2018: Journal of Palliative Medicine
Richard D Urman, Elizabeth J Lilley, Marguerite Changala, Charlotta Lindvall, David L Hepner, Angela M Bader
BACKGROUND: Periprocedural providers are encountering more patients with code status limitations (CSLs) regarding their preferences for resuscitation and life-sustaining treatment who choose to undergo palliative procedures. Surgical and anesthesia guidelines for preprocedural reconsideration of CSLs have been available for several years, but it is not known whether they are being followed in practice. OBJECTIVE: We assessed compliance with existing guidelines for patients undergoing venting gastrostomy tube (VGT) for malignant bowel obstruction (MBO), serving as an example of a palliative procedure received by patients near the end of life...
February 26, 2018: Journal of Palliative Medicine
Haipeng Zhang, David Liu, Sean Marks, Elizabeth M Rickerson, Adam Wright, William J Gordon, Adam Landman
BACKGROUND: Fast Facts Mobile (FFM) was created to be a convenient way for clinicians to access the Fast Facts and Concepts database of palliative care articles on a smartphone or tablet device. We analyzed usage patterns of FFM through an integrated analytics platform on the mobile versions of the FFM application. OBJECTIVE: The primary objective of this study was to evaluate the usage data from FFM as a way to better understand user behavior for FFM as a palliative care educational tool...
February 26, 2018: Journal of Palliative Medicine
Mathilde Ledoux, Colombe Tricou, Maxime Roux, Soazic Dreano-Hartz, Murielle Ruer, Marilène Filbet
BACKGROUND: In France, cancer has become the leading cause of death. Intensive care units (ICU) focus on survival, which may not be an appropriate setting to provide palliative care (PC) as needed by cancer patients and families. OBJECTIVE: To describe the cancer patients who died in the ICU in 2010 in a French academic medical center. DESIGN: Retrospective study Measurements: We reviewed medical records of all cancer patients who died in the ICU in 2010...
February 26, 2018: Journal of Palliative Medicine
Nicole Heneka, Tim Shaw, Debra Rowett, Samuel Lapkin, Jane L Phillips
BACKGROUND: Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medications to manage multiple comorbidities. Understanding factors contributing to opioid errors in inpatient palliative care services is a largely underexplored, yet, essential aspect of patient safety...
February 23, 2018: Journal of Palliative Medicine
Carly Zapata, Hillary D Lum, Emily Wistar, Claire Horton, Rebecca L Sudore
BACKGROUND: Primary care providers in safety-net settings often do not have time to discuss advance care planning (ACP). Group visits (GV) may be an efficient means to provide ACP education. OBJECTIVES: To assess the feasibility and impact of a video-based website to facilitate GVs to engage diverse adults in ACP. DESIGN: Feasibility pilot among patients who were ≥55 years of age from two primary care clinics in a Northern California safety-net setting...
February 20, 2018: Journal of Palliative Medicine
David B Bekelman, Rachel Johnson-Koenke, Daniel W Bowles, Stacy M Fischer
BACKGROUND: Patients with cancer could benefit from early primary (i.e., basic) palliative care. Scalable models of care delivery are needed. OBJECTIVE: Examine the feasibility of a stepped peer navigator and social work intervention developed to improve palliative care outcomes. DESIGN: Single-arm prospective clinical trial. The peer navigator educated patients to advocate for pain and symptom management with their healthcare providers, motivated patients to pursue advance care planning, and discussed the role of hospice...
February 20, 2018: Journal of Palliative Medicine
Stéphane Jouffre, Joanne Ghazal, René Robert, Jean Reignier, Dolores Albarracín
BACKGROUND: While following patients' advance directives (ADs) is legally binding, French physicians in Intensive Care Unit (ICU) perceive them as complicating their decision. Decision making and ICU residents benefit from personalizing the dying process. In France, ADs can include personal information. OBJECTIVE: Whether personalizing ADs affects ICU residents' decisions and perception of the patient. SUBJECTS AND DESIGN: Sixty-six ICU residents assigned to three experimental groups and presented with a case file for an ICU patient...
February 20, 2018: Journal of Palliative Medicine
Marvin Omar Delgado-Guay, Jeannette Ferrer, Jewel Ochoa, Hilda Cantu, Janet L Williams, Minjeong Park, Eduardo Bruera
BACKGROUND: Patients with advanced cancer experience severe physical, psychosocial, and spiritual distress requiring palliative care (PC). There are limited literature regarding characteristics and outcomes of patients evaluated by PC services at public hospitals (PHs). Objective, Design, Setting/Subjects, and Measurements: To compare the outcomes of advanced cancer patients undergoing PC at a PH and those at a comprehensive cancer center (CCC). We reviewed 359 consecutive advanced cancer patients (PH, 180; CCC, 179) undergoing PC...
February 16, 2018: Journal of Palliative Medicine
Sandra Stephanie Mai, Christina Gerlach, Irene Schmidtmann, Annika Renate Vogt, Viola Zeller, Karl-Heinz Renner, Martin Weber
BACKGROUND: Patient-reported outcome (PRO) measurement is crucial to assess the benefit of psychotherapeutic interventions. Is repeated assessment of psychometric self-report data possible, as inpatient palliative care patients suffer from physical and psychological symptoms? What is the self-perceived strain caused by the assessment? Objective The main objective of this study was to investigate the feasibility of a repeated comprehensive psychometric self-assessment of inpatient palliative care patients...
February 13, 2018: Journal of Palliative Medicine
Kara Bischoff, Eleanor Yang, Gayle Kojimoto, Nancy Shepard Lopez, Sarah Holland, Brook Calton, Sarah H Adkins, Stephanie Cheng, Bruce J Miller, Michael W Rabow
BACKGROUND: Outpatient palliative care (PC) has been shown to positively impact quality of life and decrease healthcare utilization, but there are limited data describing what activities render these benefits. OBJECTIVE: Describe the topics addressed by an outpatient PC team during scheduled visits. DESIGN: Longitudinal cohort study. SETTING: The Symptom Management Service, an ambulatory PC program at an academic comprehensive cancer center...
February 12, 2018: Journal of Palliative Medicine
Kavita V Dharmarajan, Shayna E Rich, Candice A Johnstone, Lauren M Hertan, Randy Wei, Lauren E Colbert, Joshua A Jones, Arif H Kamal, Christopher A Jones
As palliative care (PC) moves upstream in the course of advanced illness, it is critical that PC providers have a broad understanding of curative and palliative treatments for serious diseases. Possessing a working knowledge of radiation therapy (RT), one of the three pillars of cancer care, is crucial to PC providers given RT's role in both the curative and palliative settings. This article provides PC providers with a primer on the vocabulary of RT; the team of people involved in the planning of RT; and common indications, benefits, and side effects of treatment...
February 12, 2018: Journal of Palliative Medicine
Vania F S Mayoral, Fernanda B Fukushima, Aniela M Rodrigues, Raissa P Carvalho, Larissa P Carvalho, Leandro A F V Pinheiro, Bertha F Polegato, Marcos F Minicucci, Rick Bassett, Alvin H Moss, Karl E Steinberg, Edison I O Vidal
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) paradigm is considered one of the most important strategies to respect patients' values at the end of life in the United States. The cross-cultural adaptation of POLST entailed several methodological considerations, which may be informative for international researchers who may also consider bringing POLST to their countries as a means to promote care at the end of life that is consistent with patients' preferences...
February 12, 2018: Journal of Palliative Medicine
Eleanor Anderson Reid, Esayas Kebede Gudina, Nicola Ayers, Wondimagegnu Tigineh, Yoseph Mamo Azmera
BACKGROUND: Palliative care aims to reduce physical suffering and the emotional, spiritual, and psychosocial distress of life-limiting illness. Palliative care is a human right, yet there are vast disparities in its provision: of the 40 million people globally in need of palliative care, less than 10% receive it, largely in high-income countries. There is a particular paucity of data on palliative care needs across the spectrum of incurable disease in Ethiopia. OBJECTIVES: The aims of this research were to assess the overall burden of life-limiting illness, the costs associated with life-limiting illness, and barriers to accessing palliative care in Ethiopia...
February 9, 2018: Journal of Palliative Medicine
Jun Hamano, Ai Oishi, Yoshiyuki Kizawa
BACKGROUND: Identifying patients who require palliative care approach is challenging for family physicians, even though several identification tools have been developed for this purpose. OBJECTIVE: To explore the prevalence and characteristics of family practice patients who need palliative care approach as determined using Supportive and Palliative Care Indicators Tool (SPICT™, April 2015) in Japan. DESIGN: Single-center cross-sectional study...
February 9, 2018: Journal of Palliative Medicine
Kathryn Elizabeth Hudson, Steven Paul Wolf, Gregory P Samsa, Arif H Kamal, Amy Pickar Abernethy, Thomas William LeBlanc
BACKGROUND: Little is known about quality of life (QOL), depression, and end-of-life (EOL) outcomes among hospitalized patients with advanced cancer. OBJECTIVE: To assess whether the surprise question identifies inpatients with advanced cancer likely to have unmet palliative care needs. DESIGN: Prospective cohort study and long-term follow-up. SETTING/SUBJECTS: From 2008 to 2010, we enrolled 150 inpatients at Duke University with stage III/IV solid tumors or lymphoma/acute leukemia and whose physician would not be surprised if they died in less than one year...
February 8, 2018: Journal of Palliative Medicine
Vyjeyanthi S Periyakoil, Eric Neri, Helena Kraemer
BACKGROUND: To provide preference-sensitive care, we propose that clinicians might routinely inquire about their patients' bucket-lists and discuss the impact (if any) of their medical treatments on their life goals. METHODS: This cross-sectional, mixed methods online study explores the concept of the bucket list and seeks to identify common bucket list themes. Data were collected in 2015-2016 through an online survey, which was completed by a total of 3056 participants across the United States...
February 8, 2018: Journal of Palliative Medicine
Emily Morell Balkin, Lynn A Sleeper, James N Kirkpatrick, Keith M Swetz, Mary Katherine Coggins, Joanne Wolfe, Elizabeth D Blume
BACKGROUND: While the importance of pediatric palliative care (PPC) for children with life-threatening illness is increasingly recognized, little is known about physicians' attitudes toward palliative care for children with heart disease. OBJECTIVE: To compare the perspectives of PPC physicians and pediatric cardiologists regarding palliative care in pediatric heart disease. DESIGN: Cross-sectional web-based surveys. RESULTS: Responses from 183 pediatric cardiologists were compared to those of 49 PPC physicians (response rates 31% [183/589] and 28% [49/175], respectively)...
February 7, 2018: Journal of Palliative Medicine
Donald H Taylor, Nrupen A Bhavsar, Janet H Bull, Cordt T Kassner, Andrew Olson, Nathan A Boucher
BACKGROUND: On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. OBJECTIVE: To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. DESIGN: Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis...
February 7, 2018: Journal of Palliative Medicine
Katie E Nelson, Rebecca Wright, Martha Abshire, Patricia M Davidson
Death and dying remains a taboo topic in many social settings, and is underrepresented in health profession training. This report describes the use of the Death Café model as a forum for engaging students in discussion of death and dying with their peers and other health professionals. A Death Café is an opportunity for individuals to gather in an informal environment to exchange thoughts about issues associated with death, dying, loss, and illness. This report outlines the preparation, implementation, and evaluation of a Death Café event hosted at a nursing school as part of an academic health center...
February 2, 2018: Journal of Palliative Medicine
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