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care of patients at the end of life

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https://www.readbyqxmd.com/read/27922028/a-randomized-double-blind-placebo-controlled-trial-to-examine-the-effectiveness-of-lubiprostone-on-constipation-symptoms-and-colon-transit-time-in-diabetic-patients
#1
Jennifer Christie, Sagar Shroff, Nikrad Shahnavaz, Latoya A Carter, Melanie S Harrison, Karan A Dietz-Lindo, John Hanfelt, Shanthi Srinivasan
OBJECTIVES: Constipation is the most common GI symptom in patients with diabetes mellitus (DM). Importantly, patients with constipation have lower health-related quality of life than those without constipation. Effective therapies for constipation are limited and there is a paucity of data evaluating the treatment of constipation in diabetics. METHODS: Diabetic patients with chronic idiopathic constipation (CIC) as defined by Rome III criteria were recruited from outpatient clinics at a tertiary-care center and a Veterans Administration Hospital...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27920697/end-of-life-practices-in-france-under-the-claeys-leonetti-law-report-of-three-cases-in-the-oncology-unit
#2
Alexandre de Nonneville, Anthony Marin, Theo Chabal, Veronique Tuzzolino, Marie Fichaux, Sebastien Salas
On February 2, 2016, the French government enacted the Claeys-Leonetti law introducing the right to deep and continuous sedation and forbade euthanasia for end-of-life patients. This article reports the first descriptions of this kind of intervention at the final stage of life of 3 patients and highlights the need of patient-centered goals and the importance of close collaboration between the patient, family, and medical and paramedical team to achieve a higher quality of final palliative care.
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920549/management-of-hypoglycemia-in-nondiabetic-palliative-care-patients-a-prognosis-based-approach
#3
REVIEW
Victor C Kok, Ping-Hsueh Lee
Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%-60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode...
2016: Palliative Care
https://www.readbyqxmd.com/read/27919358/risk-factors-for-lack-of-statin-therapy-in-patients-with-diabetes-and-coronary-artery-disease
#4
Huabing Zhang, Jorge Plutzky, Maria Shubina, Alexander Turchin
BACKGROUND: Patients with both diabetes and coronary artery disease (CAD) have exceedingly high cardiovascular risk. Nevertheless, little is known about prevalence of statin therapy in this population and reasons why some patients may not be receiving this potentially life-saving treatment. OBJECTIVE: To investigate prevalence and predictors of statin therapy in patients with combined diabetes and CAD. METHODS: We conducted a retrospective cohort study of primary care patients with diabetes and CAD followed at 2 academic medical centers between 2000 and 2011...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#5
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
December 5, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27915265/the-ethics-of-unilateral-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-with-defibrillator-deactivation-patient-perspectives
#6
Margaret Daeschler, Ralph J Verdino, James N Kirkpatrick
AIMS: Decisions about deactivation of implantable cardioverter defibrillators (ICDs) are complicated. Unilateral do-not-resuscitate (DNR) orders (against patient/family wishes) have been ethically justified in cases of medical futility. Unilateral deactivation of ICDs may be seen as a logical extension of a unilateral DNR order. However, the ethical implications of unilateral ICD deactivation have not been explored. METHODS AND RESULTS: Sixty patients who had an ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were interviewed at a quaternary medical centre outpatient electrophysiology practice...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#7
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27911238/managing-overlapping-surgery-an-analysis-of-1018-neurosurgical-and-spine-cases
#8
Jian Guan, Andrea A Brock, Michael Karsy, William T Couldwell, Meic H Schmidt, John R W Kestle, Randy L Jensen, Andrew T Dailey, Richard H Schmidt
OBJECTIVE Overlapping surgery-the performance of parts of 2 or more surgical procedures at the same time by a single lead surgeon-has recently come under intense scrutiny, although data on the effects of overlapping procedures on patient outcomes are lacking. The authors examined the impact of overlapping surgery on complication rates in neurosurgical patients. METHODS The authors conducted a retrospective review of consecutive nonemergent neurosurgical procedures performed during the period from May 12, 2014, to May 12, 2015, by any of 5 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27909034/advance-care-planning-in-patients-with-incurable-cancer-study-protocol-for-a-randomised-controlled-trial
#9
Stephanie Johnson, Josephine Clayton, Phyllis N Butow, William Silvester, Karen Detering, Jane Hall, Belinda E Kiely, Jonathon Cebon, Stephen Clarke, Melanie L Bell, Martin Stockler, Phillip Beale, Martin H N Tattersall
INTRODUCTION: There is limited evidence documenting the effectiveness of Advance Care Planning (ACP) in cancer care. The present randomised trial is designed to evaluate whether the administration of formal ACP improves compliance with patients' end-of-life (EOL) wishes and patient and family satisfaction with care. METHODS AND ANALYSIS: A randomised control trial in eight oncology centres across New South Wales and Victoria, Australia, is designed to assess the efficacy of a formal ACP intervention for patients with cancer...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908943/planning-for-deactivation-of-implantable-cardioverter-defibrillators-at-the-end-of-life-in-patients-with-heart-failure
#10
Destiny R Brady
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908501/prospective-evaluation-of-surgical-palliative-care-immersion-training-for-general-surgery-residents
#11
Mustafa Raoof, Lisa O'Neill, Leigh Neumayer, Mindy Fain, Robert Krouse
BACKGROUND: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. STUDY DESIGN: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework...
November 27, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27900726/survey-on-german-palliative-care-specialists-experiences-with-advance-directives
#12
Julia Zenz, Michael Zenz
INTRODUCTION: Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD). METHODS: A questionnaire was handed out to attendants of a palliative care symposium. RESULTS: Complete answers were obtained from 126 physicians and 276 nurses...
November 29, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27899006/french-women-s-representations-and-experiences-of-the-post-treatment-management-of-breast-cancer-and-their-perception-of-the-general-practitioner-s-role-in-follow-up-care-a-qualitative-study
#13
Catherine Laporte, Julie Vaure, Anne Bottet, Bénédicte Eschalier, Clémentine Raineau, Denis Pezet, Philippe Vorilhon
BACKGROUND: In France, the Cancer Plan II 2009-2013 was launched to improve post-cancer management and promote greater involvement of general practitioners (GPs) in follow-up care. OBJECTIVES: We investigated how women experienced the post-treatment management of breast cancer and perceived the role of the GP in follow-up care. DESIGN: We conducted a qualitative study based on semi-structured interviews with women with breast cancer in remission...
November 29, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/27896237/negative-religious-coping-positive-religious-coping-and-quality-of-life-among-hemodialysis-patients
#14
Zahra Taheri-Kharameh, Hadi Zamanian, Ali Montazeri, Azadeh Asgarian, Roya Esbiri
BACKGROUND: Religious coping is known as a main resource influencing how individuals cope with the complications and stressors of chronic disease. OBJECTIVES: The aim of this study was to assess the relationship between religious coping and quality of life among hemodialysis patients. METHODS: This cross-sectional study was conducted in Qom, Iran, from June 2012 to July 2013. Ninety-five end-stage renal disease (ESRD) patients undergoing hemodialysis were selected via the convenience sampling method...
November 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27894120/end-of-life-care-and-survival-without-major-brain-damage-in-newborns-at-the-limit-of-viability
#15
Fermín García-Muñoz Rodrigo, Lourdes Urquía Martí, José Ángel García Hernández, Josep Figueras Aloy, Alfredo García-Alix Pérez
BACKGROUND: The probabilities of survival and survival without major brain damage (MBD) are low in newborns at the limit of viability. Survival without MBD constitutes a major concern for parents and professionals. OBJECTIVES: To know the probabilities of survival without MBD in newborns ≤26 weeks' gestational age (GA) relative to the total number of survivors, whether these probabilities vary with GA, and how end-of-life (EoL) decisions influence these results...
November 29, 2016: Neonatology
https://www.readbyqxmd.com/read/27893954/does-primary-care-model-effect-healthcare-at-the-end-of-life-a-population-based-retrospective-cohort-study
#16
Michelle Howard, Mathieu Chalifoux, Peter Tanuseputro
BACKGROUND: Comprehensive primary care may enhance patient experience at end of life. OBJECTIVE: To examine whether belonging to different models of primary care is associated with end-of-life healthcare use and outcomes. DESIGN: Retrospective population cohort study, using health administrative databases to describe health services and costs in the last six months of life across three primary care models: enrolled to a physician remunerated mainly by capitation, with incentives for comprehensive care and access in some to allied health practitioners (Capitation); remunerated mainly from fee-for-service (FFS) with smaller incentives for comprehensive care (Enhanced FFS); and not enrolled, seeing physicians remunerated solely through FFS (Traditional FFS)...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27892676/palliative-care-for-patients-with-gynecologic-cancer-in-japan-a-japan-society-of-gynecologic-palliative-medicine-jsgpm-survey
#17
Masayuki Futagami, Yoshihito Yokoyama, Tetsumi Sato, Kazuyoshi Hirota, Muneaki Shimada, Etsuko Miyagi, Nao Suzuki, Masaki Fujimura
Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29...
January 10, 2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27892423/a-european-study-on-effectiveness-and-sustainability-of-current-cardiac-rehabilitation-programmes-in-the-elderly-design-of-the-eu-care-randomised-controlled-trial
#18
Eva Prescott, Esther P Meindersma, Astrid E van der Velde, Jose R Gonzalez-Juanatey, Marie Christine Iliou, Diego Ardissino, Giuseppe Biondi Zoccai, Uwe Zeymer, Leonie F Prins, Arnoud Wj Van't Hof, Matthias Wilhelm, Ed P de Kluiver
BACKGROUND: Cardiac rehabilitation (CR) is an evidence-based intervention to increase survival and quality of life. Yet studies consistently show that elderly patients are less frequently referred to CR, show less uptake and more often drop out of CR programmes. DESIGN: The European study on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR)...
October 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27890302/-facilitators-and-barriers-regarding-end-of-life-care-at-nursing-homes-a-focus-group-study
#19
María Remedios Sánchez-García, Marina Moreno-Rodríguez, César Hueso-Montoro, Concepción Campos-Calderón, Ana Varella-Safont, Rafael Montoya-Juárez
AIM: To identify the facilitators and barriers experienced by professional related to end of life care in nursing homes. DESIGN: Descriptive qualitative research with phenomenological orientation, through content analysis. PLACEMENT: Nursing Homes at Primary Care District in Granada (Spain). PARTICIPANTS: Fifteen clinical professionals with, at least 6 months of experience in nursing homes, without specific background in palliative care...
November 24, 2016: Atencion Primaria
https://www.readbyqxmd.com/read/27887622/learning-to-care-medical-students-reported-value-and-evaluation-of-palliative-care-teaching-involving-meeting-patients-and-reflective-writing
#20
EDITORIAL
Erica Borgstrom, Rachel Morris, Diana Wood, Simon Cohn, Stephen Barclay
BACKGROUND: Over recent years there has been an increase in teaching of both palliative care and reflective practice in UK medical schools. The palliative care teaching at the University of Cambridge School of Clinical Medicine is multi-faceted and involves students writing reflective essays after individually meeting patients approaching the end of life during their final year general practice and hospital medicine placements. This paper draws on two studies examining this teaching element to analyse what the students found valuable about it and to comment on the practice of meeting patients and subsequent reflective writing...
November 25, 2016: BMC Medical Education
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