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Journal of Palliative Care

Anand S Iyer, Roberto P Benzo, Marie A Bakitas
No abstract text is available yet for this article.
July 2018: Journal of Palliative Care
Osayande Osagiede, Dorin T Colibaseanu, Aaron C Spaulding, Ryan D Frank, Amit Merchea, Scott R Kelley, Ryan J Uitti, Sikander Ailawadhi
BACKGROUND: Palliative care has been increasingly recognized as an important part of cancer care but remains underutilized in patients with solid cancers. There is a current gap in knowledge regarding why palliative care is underutilized nationwide. OBJECTIVE: To identify the factors associated with palliative care use among deceased patients with solid cancer tumors. METHODS: Using the 2016 National Cancer Data Base, we identified deceased patients (2004-2013) with breast, colon, lung, melanoma, and prostate cancer...
July 2018: Journal of Palliative Care
Jay J Shen, Eunjeong Ko, Pearl Kim, Sun Jung Kim, Yong-Jae Lee, Jae-Hoon Lee, Ji Won Yoo
AIM: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. MATERIALS AND METHODS: A retrospective nationwide cohort analysis was performed using weighted National Inpatient Sample (NIS) data obtained from 2010 to 2014...
July 2018: Journal of Palliative Care
Dena Schulman-Green, Jenny J Lin, Cardinale B Smith, Shelli Feder, Nina A Bickell
INTRODUCTION: Goals of care (GoC) conversations optimally begin early in the course of cancer care, yet most happen near the end of life. We sought to describe oncologist-reported facilitators of and barriers to GoC conversations with patients who have advanced cancer. METHODS AND MATERIALS: We conducted individual, semistructured qualitative interviews with oncologists from 4 academic, community, municipal, and rural hospitals in New York and Connecticut. Interview topics included approach to GoC conversations, facilitators, barriers, and organizational influences...
July 2018: Journal of Palliative Care
Katherine Whitehead, Donna Spaner
We report on the case of an elderly patient in a palliative care unit who fell and sustained a hip fracture. Hip fractures are potentially terminal events for elderly patients with other life-limiting conditions. The case highlights the need for more evidence to determine the best approach to care for hip fractures in patients who are in the final weeks or months of life.
July 2018: Journal of Palliative Care
Joyeeta G Dastidar, Min Jiang
BACKGROUND: Patients who are frequently admitted to Medicine inpatient services comprise a distinct subset of readmitted patients about whom not much is known. OBJECTIVE: We sought to characterize this group including mortality rates, with the goal of better understanding this population. DESIGN: Observational study of frequently hospitalized patients defined as 4 or more admissions over a 6-month period, with hospitalization defined as nonelective admission to the hospital...
July 2018: Journal of Palliative Care
Josee-Lyne Ethier, Thivaher Paramsothy, John J You, Robert Fowler, Sonal Gandhi
BACKGROUND: Earlier goals of care (GOC) discussions in patients with advanced cancer are associated with less aggressive end-of-life care including decreased use of medical technologies. Unfortunately, conversations often occur late in the disease trajectory when patients are acutely unwell. Here, we evaluate practitioner perspectives of patient, family, physician, and external barriers to early GOC discussions in the ambulatory oncology setting. METHODS: A previously published survey to assess barriers to GOC discussions among clinicians on inpatient medical wards was modified for the ambulatory oncology setting and distributed to oncologists from 12 centers in Ontario, Canada...
July 2018: Journal of Palliative Care
Kristi Soileau, Nanette Elster
The hospice philosophy embraces palliative care for the terminally ill, for whom quality of life is the central focus of comfort care management. Often, caregivers hesitate or simply do not elect to extend oral care for patients nearing the end of life, due to difficulties encountered in patient compliance, a sense of futility in doing so, staff time constraints in prioritizing care, underfunding, or a lack of education as to how and why such care should be delivered to the hospice patient. This article aims to show physiological and psychosocial reasons why the hospice patient has a need for properly and regularly implemented oral care and why dental professionals have an ethical responsibility to address the current void that exists in hospice-centered oral care...
April 2018: Journal of Palliative Care
Marie Nordström, Peter Strang
OBJECTIVE: At the initiative of Stockholm County Council, a survey was performed by an independent investigator to evaluate satisfaction among patients and their families with the advanced palliative home care teams in the county of Stockholm. The survey was performed in 2010 and compiled in 2011. The aim was to evaluate the impressions of patients and their families of the support given by the palliative home care teams in the Stockholm area and to evaluate the management of symptom control, availability, continuity, confidence, and quality of communication...
April 2018: Journal of Palliative Care
Deborah Ejem, Shawn Bauldry, Marie Bakitas, Patricia Drentea
Informal caregivers play a vital role in supporting seriously ill patients. However, informal caregiving is burdensome and can lead to negative health outcomes for the caregiver and the care recipient. The study's aim was to evaluate relationships among caregiver burden, care recipient depressive symptomology, and race. Guided by the social exchange perspective, we examined cross-sectional dyadic data from the National Long-Term Care Survey (N = 1279). Using ordinal logistic regression, we found that higher caregiver-reported objective burden was associated with higher care recipient depressive symptoms ( P < ...
April 2018: Journal of Palliative Care
Matthew Adamson, Kelsey Choi, Stephen Notaro, Crina Cotoc
BACKGROUND: In cancer communication, patients and physicians often understand a patient's experience and situation differently. This can negatively impact health outcomes and the physician-patient relationship. AIM: To explore how cancer patients' interpretations of the physician's role as information giver affect the communication relationship with the physician and their information-seeking behavior regarding different aspects of their cancer care. DESIGN: Participants completed a semistructured qualitative interview addressing their treatment experience and communication with their physician...
April 2018: Journal of Palliative Care
Lilit Karapetyan, Om Dawani, Heather S Laird-Fick
The immigrant population in the United States has grown over the past years. Undocumented immigrants account for 14.6% of the uninsured population in the United States. Decisions about end-of-life treatment are often difficult to reach in the best of situations. We present a 43-year-old undocumented Mexican female immigrant with metastatic sarcomatoid squamous cell cervical cancer and discuss the barriers that she faced during her treatment. Limited English proficiency, living below the poverty line, low level of education, and lack access to Medicare, Medicaid, or other insurance coverage under the Affordable Care Act are major causes of decreased health-care access and service utilization by the immigrant population...
April 2018: Journal of Palliative Care
Sotiria Kostopoulou, Efi Parpa, Eleni Tsilika, Stylianos Katsaragakis, Irene Papazoglou, Anna Zygogianni, Antonis Galanos, Kyriaki Mystakidou
PURPOSE: The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. METHODS: The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory-Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS)...
April 2018: Journal of Palliative Care
Halina Bogusz, Katarzyna Pękacka-Falkowska, Anita Magowska
The article focuses on British contribution to the development of palliative and hospice care in Poland in the 1980s and beyond. It is based on archival research in the hospices in Cracow and Poznan and broad-scoped Polish journals' review. The social background of the hospice movement in Poland is described. We explore the role of inspiration and help of Dame Cicely Saunders and other British leaders in the transfer of British hospice philosophy and practice of palliative care to the medical community in Poland...
April 2018: Journal of Palliative Care
Soumya J Niranjan, Chao-Hui S Huang, J Nicholas Dionne-Odom, Karina I Halilova, Maria Pisu, Patricia Drentea, Elizabeth A Kvale, Kerri S Bevis, Thomas W Butler, Edward E Partridge, Gabrielle B Rocque
CONTEXT: Respecting Choices is an evidence-based model of facilitating advance care planning (ACP) conversations between health-care professionals and patients. However, the effectiveness of whether lay patient navigators can successfully initiate Respecting Choices ACP conversations is unknown. As part of a large demonstration project (Patient Care Connect [PCC]), a cohort of lay patient navigators underwent Respecting Choices training and were tasked to initiate ACP conversations with Medicare beneficiaries diagnosed with cancer...
April 2018: Journal of Palliative Care
Jiaoli Cai, Denise N Guerriere, Hongzhong Zhao, Peter C Coyte
The main objective of this study was to examine whether and how the Palliative Performance Scale (PPS), a measure of a patient's function, was predictive of survival time for those in receipt of home-based palliative care. This was a prospective study, which included 194 cancer patients from November 17, 2013, to August 18, 2015. Data were collected from biweekly telephone interviews with caregivers. Kaplan-Meier survival curves were estimated to assess how survival time was correlated with initial PPS scores after admission to the home-based palliative care program...
April 2018: Journal of Palliative Care
Xavier Gómez-Batiste, Carles Blay, Marc Antoni Broggi, Cristina Lasmarias, Laura Vila, Jordi Amblàs, Joan Espaulella, Xavier Costa, Marisa Martínez-Muñoz, Bernabé Robles, Salvador Quintana, Joan Bertran, Francesc Torralba, Carmen Benito, Nuria Terribas, Josep Maria Busquets, Carles Constante
Palliative care must be early applied to all types of advanced chronic and life limited prognosis patients, present in all health and social services. Patients' early identification and registry allows introducing palliative care gradually concomitant with other measures. Patients undergo a systematic and integrated care process, meant to improve their life quality, which includes multidimensional assessment of their needs, recognition of their values and preferences for advance care planning purposes, treatments review, family care, and case management...
January 1, 2018: Journal of Palliative Care
Samantha E Opitz, Randy S Hebert
As the population ages, the corresponding rise in people living with life-limiting illnesses will lead to a greater need for clinician experts in palliative medicine. There are not enough physicians available to care for the growing number of patients, however. We believe that nurse practitioners are well positioned to meet this demand. In this paper, we will use the concept of disruptive innovations to provide support for our belief that nurse practitioners can, and should, take a larger role in palliative medicine...
January 1, 2018: Journal of Palliative Care
Imatullah Akyar, J Nicholas Dionne-Odom, Marie A Bakitas
OBJECTIVE: Models of early, community-based palliative care for individuals with New York Heart Association (NYHA) class III/IV heart failure and their families are lacking. We used the Medical Research Council process of developing complex interventions to conduct a formative evaluation study to translate an early palliative care intervention from cancer to heart failure. METHOD: One component of the parent formative evaluation pilot study was qualitative satisfaction interviews with 8 patient-caregiver dyad participants who completed Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare For Patient and Caregivers (ENABLE CHF-PC) intervention...
January 1, 2018: Journal of Palliative Care
Kaori Shimoinaba, Susan Lee, Claire E Johnson
BACKGROUND: This case report addresses a client from a minority cultural background in Australia and her complex cultural needs at the end of life. CASE HISTORY: A 66-year-old Japanese female client diagnosed with renal cancer, and lung and spine metastasis shared her story. Since a left nephrectomy in 2007, she has had hemodialysis 3 days a week. She left Japan more than 30 years ago and moved to Australia 20 years ago. With the 6-month prognosis, she expressed her desire to "go home...
January 1, 2018: Journal of Palliative Care
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