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Journal of Palliative Care

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https://www.readbyqxmd.com/read/29332504/changes-in-distress-measured-by-the-distress-thermometer-as-reported-by-patients-in-home-palliative-care-in-germany
#1
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 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29332503/-they-said-on-the-death-certificate%C3%A2-but-really-what-i-think-happened-characterizing-cause-of-death-in-va-medical-centers
#2
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
https://www.readbyqxmd.com/read/29332502/associations-between-home-death-and-the-use-and-type-of-care-at-home
#3
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
https://www.readbyqxmd.com/read/29301449/feelings-of-burden-in-palliative-care-a-qualitative-analysis-of-medical-records
#4
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
https://www.readbyqxmd.com/read/29249198/beyond-competence-perspectives-from-two-centuries
#5
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
https://www.readbyqxmd.com/read/29153052/palliative-care-issues-and-challenges-in-saudi-arabia-knowledge-assessment-among-nursing-students
#6
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
https://www.readbyqxmd.com/read/29113549/the-final-30-days-of-life-a-study-of-patients-with-gastrointestinal-cancer-in-ontario-canada
#7
Shaila J Merchant, Katherine Lajkosz, Susan B Brogly, Christopher M Booth, Sulaiman Nanji, Sunil V Patel, Nancy N Baxter
BACKGROUND: Studies have reported overly aggressive end-of-life care (EOLC) in many cancers. We investigate trends in, and factors associated with, aggressive EOLC among patients who died of gastrointestinal (GI) cancers in Ontario, Canada. METHODS: All patients with primary cause of death from esophageal, gastric, colon, and anorectal cancer from January 2003 to December 2013 were identified through the Ontario Cancer Registry, and information was collected from linked databases...
July 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29084485/factors-associated-with-opinions-about-hospice-among-older-adults-race-familiarity-with-hospice-and-attitudes-matter
#8
Joonyup Lee, John G Cagle
Attitudes and opinions about end-of-life care among older adults are understudied. Using survey data from the American Association of Retired Persons (AARP) membership in Florida (N = 2714), this study identified predictors of opinions about hospice (OAH) among older adults. Relationships between race/ethnicity and attitudes were also examined. Results showed race of the respondent was the strongest predictor of one's OAH. Predictors of positive opinions of hospice included being of Caucasian race, non-Hispanic ethnicity, better health, greater familiarity with hospice, a high importance of pain control, the importance of fulfilling personal goals, a desire to have health-care professionals involved in one's care, and having engaged in advance care planning...
July 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28845743/the-influence-of-physical-and-psychosocial-factors-on-disruptive-pain-among-seriously-ill-home-care-patients
#9
Jacob G S Davidson, Dawn M Guthrie
OBJECTIVES: To estimate the prevalence and correlates of disruptive pain in a sample of seriously ill home care patients in the Canadian province of Ontario. METHODS: The design was a cross-sectional analysis of secondary data from 2757 patients aged 65+. RESULTS: Overall, 69.0% (n = 1902) had any level of pain and 41.6% (n = 1146) indicated that their pain disrupted their usual activities. In the univariate analysis of demographics, the risk of disruptive pain decreased significantly with increasing age ( P < ...
April 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29281947/an-exploration-of-palliative-care-needs-of-people-with-end-stage-renal-disease-on-dialysis-family-caregiver-s-perspectives
#10
Victor Maddalena, Fiona O'Shea, Brendan Barrett
Patients with end-stage renal disease supported on dialysis experience high morbidity and mortality. Little is known about family caregiver experiences during the disease. Qualitative research methods were used to explore the experiences of family caregivers caring for patients receiving dialysis. In-depth, semi-structured, in-person interviews were completed with 18 family caregivers in rural and urban settings. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic and descriptive analysis...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29260613/documentation-of-crucial-information-relating-to-critically-ill-patients
#11
Alexandria Bear, Elizabeth Thiel
BACKGROUND: Medical decision-making has evolved to the modern model of shared decision-making among patients, surrogate decision-makers, and medical providers. As such, informed consent discussions with critically ill patients often should include larger discussions relating to values and goals of care. Documentation of care options and prognosis serves as an important component of electronic communication relating to patient preferences among care providers. OBJECTIVE: This retrospective chart review study sought to evaluate the prevalence of documentation of critical data, care options, prognosis, and medical plan, within primary team and palliative care consult team documentation...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29260612/using-the-surprise-question-in-nursing-homes-a-prospective-mixed-methods-study
#12
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 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29188753/the-use-of-language-in-hospice-care-and-the-impact-on-patients-and-families
#13
Valerie Gant
This narrative account describes the perspective of family members experience of hospice care.
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29187085/caring-for-dying-patient-and-their-families-the-lived-experiences-of-nursing-students-in-italy
#14
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...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29129136/palliative-medicine-becoming-a-subspecialty-of-the-royal-college-of-physicians-and-surgeons-of-canada
#15
Jana Pilkey, James Downar, Deborah Dudgeon, Leonie Herx, Doreen Oneschuk, Cori Schroder, Valerie Schulz
The discipline of palliative medicine in Canada started in 1975 with the coining of the term "palliative care." Shortly thereafter, the provision of clinical palliative medicine services started, although the education of the discipline lagged behind. In 1993, the Canadian Society of Palliative Care Physicians (CSPCP) started to explore the option of creating an accredited training program in palliative medicine. This article outlines the process by which, over the course of 20 years, palliative medicine training in Canada went from a mission statement of the CSPCP, to a 1 year of added competence jointly accredited by both the Royal College of Physicians and Surgeons of Canada (Royal College) and the College of Family Physicians of Canada, to a 2-year subspecialty of the Royal College with access from multiple entry routes and a formalized accrediting examination...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29110573/the-impact-of-integrated-multidisciplinary-palliative-care-program-on-symptoms-in-patients-at-the-palliative-care-ward-an-audit-and-a-protocol-of-prospective-controlled-investigation
#16
Andreas Jülich, Thomas Spreu, Britta Buchhold, Taras Usichenko
An integrated multidisciplinary palliative care (IMPC) program is a promising tool to improve symptom control in patients at the end of life. The aim was to study the feasibility of the IMPC program in patients at the palliative care (PC) ward. A retrospective audit, using the extended Edmonton Symptom Assessment Scale (ESAS), was conducted on the PC ward of the university hospital. Consecutive patients who were admitted for the IMPC program during 1 year were considered. One hundred forty-eight cases (93% with underlying cancer) were analyzed...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29110572/tracheostomy-as-a-comfort-measure-in-children-with-life-limiting-conditions
#17
Valerie Marshall, Francesca Holt, Suzanne Crowe
Palliative care for children who can expect only a short life has expanded over the last decade. Greater understanding of the measures required to ensure comfort and acceptable quality of life within the critical care environment has grown in tandem. Some more invasive interventions may be considered a "step too far" by some practitioners, including feeding gastrostomy, contracture release, and tracheostomy. Tracheostomy can facilitate a number of measures, which may enhance the brief life of the child and their family...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29096574/use-of-standardized-assessment-tools-to-improve-the-effectiveness-of-palliative-care-rounds-a-quality-improvement-initiative
#18
Donna Spaner, Valerie B Caraiscos, Christina Muystr, Margaret Lyn Furman, Jodi Zaltz-Dubin, Marilyn Wharton, Katherine Whitehead
BACKGROUND: Optimal care for patients in the palliative care setting requires effective clinical teamwork. Communication may be challenging for health-care workers from different disciplines. Daily rounds are one way for clinical teams to share information and develop care plans for patients. OBJECTIVE: The objective of this initiative was to improve the structure and process of daily palliative care rounds by incorporating the use of standardized tools and improved documentation into the meeting...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29084484/alcohol-dependence-in-palliative-care-a-review-of-the-current-literature
#19
Aisling MacCormac
PURPOSE: Alcohol misuse affects up to 28% of palliative care inpatients. This article aims to summarize the existing literature on the care of palliative patients with alcohol dependence. METHODS: The author searched CINAHL, Scopus, MEDLINE, and PubMed from inception until July 2017 using search terms including "alcohol*," "dependence," and "palliative." The results were reported in a narrative manner. RESULTS: Identification of alcohol-dependent patients can be improved through the use of validated tools such as "Cut Down, Annoyed, Guilty, Eye Opener" (CAGE) and "Alcohol Use Disorders Identification Test" (AUDIT)...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28969501/the-strengths-and-challenges-of-palliative-day-care-centers-qualitative-study-with-the-professionals-involved
#20
Bieke Vandaele, Kenneth Chambaere, Ignaas Devisch
BACKGROUND: Palliative day-care centers are a marginal service within the palliative care landscape. Relevant research on the potential and added value of this service model is lacking, and it may therefore be underappreciated. AIM: To examine how representatives of Belgian palliative day-care centers perceive their strengths and added value, as well as the biggest challenges to their survival. DESIGN: Qualitative study of individual interviews and an overarching focus group...
January 1, 2017: Journal of Palliative Care
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