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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...
January 1, 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...
January 1, 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 < ...
January 1, 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...
January 1, 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...
January 1, 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)...
January 1, 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...
January 1, 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...
January 1, 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...
January 1, 2018: Journal of Palliative Care
Su Hyun Kim, Sangwook Kang, Mi-Kyung Song
AIM: To examine the intensity of care at the end of life among older adults in Korea and to identify the individual and institutional factors associated with care intensity. METHODS: This secondary data analysis included a sample of 6278 decedents aged 65 years or older who were identified from the 2009 to 2010 Korean National Health Insurance Service-National Sample Cohort Claims data. We examined the medical care received by the cohort in the last 30 days of their lives...
January 1, 2018: Journal of Palliative Care
Beverly Rosa Williams, F Amos Bailey, Patricia S Goode, Kathryn L Burgio
Cause of death information is a vital resource for family and public health, yet significant issues persist regarding its determination, documentation and communication. In this study, we aim to characterize cause of death attribution process from the perspective of next-of-kin of Veterans who died in Veterans Affairs (VA) Medical Centers. Using a semi-structured guide, we explored next-of-kin's experiences of the Veteran's terminal hospitalization and conducted a content analysis of interview texts. In over two-third of cases next-of-kin's understanding was not consistent with their recollection of physicians' determination of cause of death...
January 1, 2018: Journal of Palliative Care
Rebecca McEwen, Yukiko Asada, Frederick Burge, Beverley Lawson
Despite wishes for and benefits of home deaths, a discrepancy between preferred and actual location of death persists. Provision of home care may be an effective policy response to support home deaths. Using the population-based mortality follow-back study conducted in Nova Scotia, we investigated the associations between home death and formal care at home and between home death and the type of formal care at home. We found (1) the use of formal care at home at the end of life was associated with home death and (2) the use of formal home support services at home was associated with home death among those whose symptoms were well managed...
January 1, 2018: Journal of Palliative Care
Milenko Rakic, Monica Escher, Bernice S Elger, Sandra Eckstein, Nadia Pacurari, Susanne Zwahlen, Isabelle Wienand
BACKGROUND: Care for palliative care patients is often provided by unpaid caregivers (eg, family members) who take care of the patient's daily needs (eg, bathing, dressing). Family members of palliative care patients are involved in numerous ways. These tasks and responsibilities can make them feel burdened and even overburdened. AIM: We specifically looked at patients' medical records to determine what is being reported about burden and overburden and who seems to be mostly affected...
January 1, 2018: Journal of Palliative Care
Keith M Swetz
No abstract text is available yet for this article.
January 2018: Journal of Palliative Care
Stefanie Ohnhäuser, Johannes Wüller, Ann Christina Foldenauer, Tania Pastrana
AIM: To identify changes in distress as reported by patients in a home palliative care program over a 2-week period. METHODS: Prospective study in West Germany with consecutive patients cared for at home by a palliative care specialty team. Exclusion criteria were patients under 18 years of age, mentally or physically not able to complete the assessment questionnaires, or unable to comprehend German language. Distress was measured using the distress thermometer (DT); sociodemographic and medical data were collected from the patients' records...
January 2018: Journal of Palliative Care
Jill Rice, Linda Hunter, Amy T Hsu, Melissa Donskov, Tracy Luciani, Darene Toal-Sullivan, Vivian Welch, Peter Tanuseputro
BACKGROUND: The "Surprise Question" (SQ) is often used to identify patients who may benefit from a palliative care approach. The time frame of the typical question (a 12-month prognosis) may be unsuitable for identifying residents in nursing homes since it may not be able to differentiate between those who have a more imminent risk of death within a cohort of patients with high care needs. OBJECTIVE: To examine the accuracy and acceptability of 3 versions of the SQ with shortened prognostication time frames (3 months, 6 months, and "the next season") in the nursing home setting...
January 2018: Journal of Palliative Care
Reena George, Kumar Narayanan
A sense of failure and guilt can often be associated with the death of a patient. Using the Serenity Prayer as a framework, we present autobiographical narratives describing encounters that happened in Vellore, India over a hundred years apart. Powerlessness in the face of death, we suggest, is not the same as ignorance or incompetence. It could well be the breakthrough to a deeper wisdom and lasting empowerment.
July 2017: Journal of Palliative Care
Valerie Gant
This narrative account describes the perspective of family members experience of hospice care.
July 2017: Journal of Palliative Care
Lorenza Garrino, Claudia Contratto, Patrizia Massariello, Valerio Dimonte
BACKGROUND: The literature from recent decades persistently suggests that nurses are not adequately trained in caring for the dying. Numerous studies call for enhanced education in end-of-life care. OBJECTIVE: To explore student nurses' experience of caring for dying persons and their families and how this experience was influenced by their undergraduate education, with a view to improving end-of-life training. METHODS: Narrative interviews were administered to a purposive sample of 18 undergraduate students at Turin University's School of Nursing and analyzed following Giorgi's qualitative phenomenological methodology...
July 2017: Journal of Palliative Care
Omar Mohammad Khraisat, Mahmoud Hamdan, Mohannad Ghazzawwi
BACKGROUND: Nurses are the heart of the palliative care team who provide high standards of care since they spend the longest time with patients. However, lack of adequate knowledge of palliative care is considered as one of the main obstacles to palliative care improvement. AIM: A survey was conducted to assess Saudi nursing students' knowledge about palliative care. METHODS: Using a descriptive design, 154 students who enrolled in first year and who will graduate within 1 year were surveyed in a nursing college located in Riyadh, the capital of Saudi Arabia...
July 2017: Journal of Palliative Care
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