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care of patients at the end of life

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https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#1
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28526493/improving-comfort-around-dying-in-elderly-people-a-cluster-randomised-controlled-trial
#2
Kim Beernaert, Tinne Smets, Joachim Cohen, Rebecca Verhofstede, Massimo Costantini, Kim Eecloo, Nele Van Den Noortgate, Luc Deliens
BACKGROUND: Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly people. METHODS: We did a cluster randomised controlled trial in acute geriatric wards in ten hospitals in Flemish Region, Belgium, between Oct 1, 2012, and March 31, 2015...
May 16, 2017: Lancet
https://www.readbyqxmd.com/read/28526095/improving-hospital-based-end-of-life-care-processes-and-outcomes-a-systematic-review-of-research-output-quality-and-effectiveness
#3
Amy Waller, Natalie Dodd, Martin H N Tattersall, Balakrishnan Nair, Rob Sanson-Fisher
BACKGROUND: As in other areas of health delivery, there is a need to ensure that end-of-life care is guided by patient centred research. A systematic review was undertaken to examine the quantity and quality of data-based research aimed at improving the (a) processes and (b) outcomes associated with delivering end-of-life care in hospital settings. METHODS: Medline, EMBASE and Cochrane databases were searched between 1995 and 2015 for data-based papers. Eligible papers were classified as descriptive, measurement or intervention studies...
May 19, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28526048/men-s-and-women-s-response-to-treatment-and-perceptions-of-outcomes-in-a-randomized-controlled-trial-of-injectable-opioid-assisted-treatment-for-severe-opioid-use-disorder
#4
Heather Palis, Kirsten Marchand, Daphne Guh, Suzanne Brissette, Kurt Lock, Scott MacDonald, Scott Harrison, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter, Eugenia Oviedo-Joekes
BACKGROUND: To test whether there are gender differences in treatment outcomes among patients receiving injectable opioids for the treatment of long-term opioid-dependence. The study additionally explores whether men and women have different perceptions of treatment effectiveness. METHODS: This study is a secondary analysis from SALOME, a double-blind, phase III, randomized controlled trial testing the non-inferiorirty of injectable hydromorphone to injectable diacetylmorphine among 202 long-term street opioid injectors in Vancouver (Canada)...
May 19, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28524892/palliative-radiation-therapy-knowledge-and-referrals-among-primary-care-providers
#5
Sydney Schone
Cancer is a leading cause of death worldwide. Many individuals have significant symptoms related to this disease. Palliative radiation therapy (PRT) can relieve symptoms at the end of life for those with metastatic cancer. PRT is underused in treating patients with symptomatic cancer at the end of life, particularly in rural and remote settings, despite the evidence that supports it. The purpose of this evidence-based practice study is to (a) assess the knowledge of rural primary care providers about PRT, (b) disseminate evidence on the indications for PRT, and...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28523402/advances-in-the-care-of-primary-immunodeficiencies-pids-from-birth-to-adulthood
#6
Nizar Mahlaoui, Klaus Warnatz, Alison Jones, Sarita Workman, Andrew Cant
Primary immunodeficiencies (PIDs) are a widely heterogeneous group of inherited defects of the immune system consisting of many clinical phenotypes with at least 300 underlying genetic deficits currently known. Patients with PIDs can present with, or develop during the course of their life, a susceptibility to recurrent and chronic infection along with autoimmune, allergic, inflammatory, and/or proliferative disorders, all potentially leading to end-organ damage. In recent years, a combination of basic and clinical research has greatly improved understanding of the underlying immunological and genetic defects in PIDs, leading to improved diagnosis, classification, and treatment approaches...
May 18, 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28521799/what-are-the-differences-among-occupational-groups-related-to-their-palliative-care-specific-educational-needs-and-intensity-of-interprofessional-collaboration-in-long-term-care-homes
#7
S Kaasalainen, T Sussman, M Bui, N Akhtar-Danesh, R D Laporte, L McCleary, A Wickson Griffiths, K Brazil, D Parker, V Dal Bello-Haas, A Papaioannou, J O'Leary
BACKGROUND: The purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes. METHODS: A cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman's approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery...
May 18, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28516890/tocilizumab-in-the-treatment-of-patients-with-rheumatoid-arthritis-in-real-clinical-practice-results-of-an-italian-observational-study
#8
Roberto Caporali, Luca Idolazzi, Stefano Bombardieri, Gianfranco Ferraccioli, Roberto Gerli, Marco Govoni, Marco Matucci Cerinic, Giovanni Pomponio, Fausto Salaffi, Rossella Tirri, Francesca Benaglio, Laura Bianchino, Piercarlo Sarzi-Puttini
OBJECTIVES: To describe the effectiveness and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, in a cohort of patients with rheumatoid arthritis (RA) recruited in clinical practice. METHODS: TRUST was an observational study in RA patients who started treatment with TCZ in the 6 months prior to site activation and were still on treatment at start of study; patients were followed up to 12 months after the first TCZ infusion. RESULTS: 322 RA patients were enrolled in 59 Italian centres (mean age: 55...
May 8, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#9
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28506865/protocol-driven-neurological-prognostication-and-withdrawal-of-life-sustaining-therapy-after-cardiac-arrest-and-targeted-temperature-management
#10
Irina Dragancea, Matthew P Wise, Nawaf Al-Subaie, Julius Cranshaw, Hans Friberg, Guy Glover, Tommaso Pellis, Rebecca Rylance, Andrew Walden, Niklas Nielsen, Tobias Cronberg
BACKGROUND: Brain injury is reportedly the main cause of death for patients resuscitated after out-of-hospital cardiac arrest (OHCA). However, the majority may actually die following withdrawal of life-sustaining therapy (WLST) with a presumption of poor neurological recovery. We investigated how the protocol for neurological prognostication was used and how related treatment recommendations might have affected WLST decision-making and outcome after OHCA in the Targeted Temperature Management (TTM) trial...
May 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28506309/social-isolation-and-cancer-management-advanced-rectal-cancer-with-patient-delay-following-the-2011-triple-disaster-in-fukushima-japan-a-case-report
#11
Akihiko Ozaki, Claire Leppold, Toyoaki Sawano, Masaharu Tsubokura, Manabu Tsukada, Tetsuya Tanimoto, Masahiro Kami, Hiromichi Ohira
BACKGROUND: Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care. CASE PRESENTATION: In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy...
May 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28506145/areas-of-control-desired-by-patients-and-families-referred-to-hospice-care-perspectives-of-hospice-admissions-staff
#12
Hyunjin Noh
Sense of control in end-of-life (EOL) care plays a critical role in the patient's well-being. However, little is known about the areas of control essential to patients and families at a specific time point in the illness trajectory: when patients stop curative treatments and are referred to hospice. This study qualitatively explored such areas. Sixteen admissions staff members from four hospice agencies were interviewed about their perceptions of areas in which patients and families worried about losing control by accepting hospice...
May 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28504892/palliative-care-interventions-before-left-ventricular-assist-device-implantation-in-both-bridge-to-transplant-and-destination-therapy
#13
Shunichi Nakagawa, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Craig D Blinderman
BACKGROUND: The optimal level of palliative care (PC) involvement in left ventricular assist device (LVAD) therapy has yet to be determined. OBJECTIVE: Describe the feasibility of PC intervention to elucidate patients' goals and values in LVAD therapy in both destination therapy (DT) and bridge to transplant (BTT). DESIGN: Single center, prospective, single-arm study. SETTING/SUBJECTS: All patients who received mandatory PC consultation, using a semistructured script, before LVAD implantation (PreVAD evaluation)...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28503990/assessing-the-utilization-of-radiotherapy-near-end-of-life-at-a-finnish-university-hospital-a-retrospective-cohort-study
#14
Liisa K Rautakorpi, Johanna M Mäkelä, Fatemeh Seyednasrollah, Anna M Hammais, Tarja Laitinen, Outi M Hirvonen, Heikki Minn, Laura L Elo, Sirkku M Jyrkkiö
BACKGROUND: Palliative radiotherapy can improve quality of life for cancer patients during the last months of life. However, very short life expectancy may devastate the benefit of the treatment. This single center study assesses the utilization of radiotherapy during the last weeks of life. MATERIAL AND METHODS: All cancer patients (N = 38,982) treated with radiotherapy (N = 11,395) in Turku University Central Hospital during 2005-2013 were identified in the database consisting of electronic patient records...
May 13, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28503041/pediatric-end-of-life-care-barriers-and-facilitators-perception-of-nursing-professionals-in-jordan
#15
Omar Mohammad Khraisat, Nemeh Ahmad Alakour, Teresa M O'Neill
INTRODUCTION: End-of-life care is a critical issue for pediatric population with terminal illness to ensure the best possible quality of care for them and their families. A survey was conducted to identify the barriers and facilitators to provide pediatric end-of-life care. METHODS: A descriptive cross-sectional study was conducted at three tertiary centers providing end-of-life care in Jordan. Two hundred critical care nurses were surveyed (response rate 93%). RESULTS: Nurses reported moderate level of experience in all areas of delivering pediatric end-of-life care...
April 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28500214/efficacy-of-the-telemedical-lifestyle-intervention-program-telipro-in-advanced-stages-of-type-2-diabetes-a-randomized-controlled-trial
#16
Kerstin Kempf, Bernd Altpeter, Janine Berger, Oliver Reuß, Matthias Fuchs, Michael Schneider, Babette Gärtner, Katja Niedermeier, Stephan Martin
OBJECTIVE: Lifestyle interventions are the foundation of treatment in newly diagnosed type 2 diabetes. However, their therapeutic potential in advanced disease stages is unknown. We evaluated the efficacy of the Telemedical Lifestyle intervention Program (TeLiPro) in improving metabolic control in advanced-stage type 2 diabetes. RESEARCH DESIGN AND METHODS: In this single-blind, active comparator, intervention study, patients with type 2 diabetes (with glycated hemoglobin [HbA1c] ≥7...
May 12, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28499320/-costs-of-medial-care-of-mrsa-patients-at-the-end-of-life-in-a-geriatric-ward
#17
Thomas Adelhardt, Stefanie Hessemer, Katrin Docter, Cornel Sieber, Christoph Ostgathe, Oliver Schöffski
Objective The present study addresses the financial effects of incidences of MRSA in the geriatric ward of a German hospital on patients receiving end-of-life care. The main cost drivers will be identified and the costs calculated. Methodology A retrospective analysis for a period of one year was conducted for the geriatric ward of a German hospital. In addition to the duration of the patient's stay and the total costs of his/her case, individual cost categories such as personnel and material costs were also examined...
May 12, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28499319/-aftermath-of-death-of-a-seriously-ill-family-member-online-survey-of-psychological-distress-and-care-satisfaction-of-relatives
#18
Antje Gottschalk-Fleischer, Norbert Köhler, Elmar Brähler, Anja Mehnert, Heide Götze
Aim of the study The aim of the study was to assess the level of psychosocial distress and satisfaction with care in family caregivers after the death of a close relative. Method Anxiety and depression (HADS) of family caregivers were evaluated in both bereaved family caregivers and a comparable group from the general population. Furthermore, satisfaction with care (ZUF-8) and social support (HOPE-Module, ESSI) were assessed after the patients had died. Regression models were employed to analyze associations between psychological distress and sociodemographic and care-related variables...
May 12, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28498025/understanding-meaning-in-life-interventions-in-patients-with-advanced-disease-a-systematic-review-and-realist-synthesis
#19
Mariona Guerrero-Torrelles, Cristina Monforte-Royo, Andrea Rodríguez-Prat, Josep Porta-Sales, Albert Balaguer
BACKGROUND: Among patients with advanced disease, meaning in life is thought to enhance well-being, promote coping and improve the tolerance of physical symptoms. It may also act as a buffer against depression and hopelessness. As yet, there has been no synthesis of meaning in life interventions in which contextual factors, procedures and outcomes are described and evaluated. AIMS: To identify meaning in life interventions implemented in patients with advanced disease and to describe their context, mechanisms and outcomes...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28495487/effect-of-psychiatric-illness-on-acute-care-utilization-at-end-of-life-from-serious-medical-illness
#20
Kyle Lavin, Dimitry S Davydow, Lois Downey, Ruth A Engelberg, Ben Dunlap, James Sibley, William B Lober, Kelson Okimoto, Nita Khandelwal, Elizabeth T Loggers, Joan M Teno, J Randall Curtis
CONTEXT: Little is known about psychiatric illness and utilization of end-of-life care. OBJECTIVES: We hypothesized that pre-existing psychiatric illness would increase hospital utilization at end-of-life among patients with chronic medical illness due to increased severity of illness and care fragmentation. METHODS: We reviewed electronic health records to identify decedents with one or more of eight chronic medical conditions based on International Classification of Diseases (ICD)-9 codes...
May 8, 2017: Journal of Pain and Symptom Management
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