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care of patients at the end of life

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https://www.readbyqxmd.com/read/28731821/trust-in-physicians-continuity-and-coordination-of-care-and-quality-of-death-in-patients-with-advanced-cancer
#1
Jun Hamano, Tatsuya Morita, Sakiko Fukui, Yoshiyuki Kizawa, Satoru Tunetou, Yasuo Shima, Makoto Kobayakawa, Maho Aoyama, Mitsunori Miyashita
BACKGROUND: Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. OBJECTIVE: To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home...
July 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28731382/external-validation-and-clinical-utility-of-a-prediction-model-for-6-month-mortality-in-patients-undergoing-hemodialysis-for-end-stage-kidney-disease
#2
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28727487/improving-care-with-a-portfolio-of-physician-led-cancer-quality-measures-at-an-academic-center
#3
Julie Bryar Porter, Eben Lloyd Rosenthal, Marcy Winget, Andrea Segura Smith, Sridhar Belavadi Seshadri, Yohan Vetteth, Eileen F Kiamanesh, Amogh Badwe, Ranjana H Advani, Mark K Buyyounouski, Steven Coutre, Frederick Dirbas, Vasu Divi, Oliver Dorigo, Kristen N Ganjoo, Laura J Johnston, Lawrence David Recht, Joseph B Shrager, Eila C Skinner, Susan M Swetter, Brendan C Visser, Douglas W Blayney
PURPOSE: Development and implementation of robust reporting processes to systematically provide quality data to care teams in a timely manner is challenging. National cancer quality measures are useful, but the manual data collection required is resource intensive, and reporting is delayed. We designed a largely automated measurement system with our multidisciplinary cancer care programs (CCPs) to identify, measure, and improve quality metrics that were meaningful to the care teams and their patients...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28727207/palliative-care-physicians-experiences-of-end-of-life-communication-a-focus-group-study
#4
C Udo, M Lövgren, G Lundquist, B Axelsson
The aim of this study was to explore palliative home care physicians' experiences regarding end-of-life breakpoint communication (BPC). This is a qualitative study where focus group interviews were conducted and analysed using qualitative content analysis. The results show that the participants saw themselves as being responsible for accomplishing BPC, and they were convinced that it should be regarded as a process of communication initiated at an early stage, i.e. proactively. However, BPC was often conducted as a reaction to the patient's sudden deterioration or sometimes not at all...
July 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28726731/the-use-of-imaging-in-the-prediction-and-assessment-of-cancer-treatment-toxicity
#5
REVIEW
Hossein Jadvar
Multimodal imaging is commonly used in the management of patients with cancer. Imaging plays pivotal roles in the diagnosis, initial staging, treatment response assessment, restaging after treatment and the prognosis of many cancers. Indeed, it is difficult to imagine modern precision cancer care without the use of multimodal molecular imaging, which is advancing at a rapid pace with innovative developments in imaging sciences and an improved understanding of the complex biology of cancer. Cancer therapy often leads to undesirable toxicity, which can range from an asymptomatic subclinical state to severe end organ damage and even death...
July 20, 2017: Diagnostics
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#6
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28723253/end-of-life-services-among-patients-with-cancer-evidence-from-cancer-registry-records-linked-with-commercial-health-insurance-claims
#7
Cara L McDermott, Catherine Fedorenko, Karma Kreizenbeck, Qin Sun, Bruce Smith, J Randall Curtis, Ted Conklin, Scott D Ramsey
PURPOSE: Despite guidelines emphasizing symptom management over aggressive treatment, end-of-life care for persons with cancer in the United States is highly variable. In consultation with a regional collaboration of patients, providers, and payers, we investigated indicators of high-quality end-of-life care to describe patterns of care, identify areas for improvement, and inform future interventions to enhance end-of-life care for patients with cancer. METHODS: We linked insurance claims to clinical information from the western Washington SEER database...
July 19, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28721463/exstrophy-bladder-reconstruction-or-diversion-for-the-underprivileged
#8
REVIEW
Yogesh Kumar Sarin, Virender Sekhon
The surgical techniques for management of bladder exstrophy epispadias complex have evolved from staged reconstruction, complete primary repair to radical mobilization. Post-operative complications add to the multiplicity of surgical procedures at each step. The end results are variable with many achieving continence rates of 85-89% only after bladder augmentation and clean intermittent catheterization. The situation is further complicated in resource-poor settings, where illiteracy and poverty are the driving factors for choosing a single operative procedure for creation of low pressure reservoir aiming at upper tract preservation and good primary continence...
July 18, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28716617/dignity-therapy-and-life-review-for-palliative-care-patients-a-qualitative-study
#9
Dean Vuksanovic, Heather Green, Shirley Morrissey, Sharelle Smith
CONTEXT: Dignity Therapy (DT) is a psychotherapeutic intervention whose aim is to bolster the sense of purpose, meaning and sense of dignity in patients with terminal disease. OBJECTIVES: The aim of this study was to explore, compare and better understand the content of standard DT, waitlist DT (WDT) and Life Review (LR) that utilised the DT interview protocol but omitted the creation of legacy documents. METHODS: Efficacy of these interventions was previously documented in a sample of 56 participants...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716616/relationship-between-spirituality-meaning-in-life-psychological-distress-wish-for-hastened-death-and-their-influence-on-quality-of-life-in-palliative-care-patients
#10
Mathieu Bernard, Florian Strasser, Claudia Gamondi, Giliane Braunschweig, Michaela Forster, Karin Kaspers-Elekes, Silvia Walther Veri, Gian Domenico Borasio
CONTEXT: Spiritual, existential, and psychological issues represent central components of quality of life (QOL) in palliative care. A better understanding of the dynamic underlying these components is essential for the development of interventions tailored to the palliative context. OBJECTIVES: The aims were to explore (i) the relationship between spirituality, meaning in life, wishes for hastened death and psychological distress in palliative patients, and (ii) the extent to which these non-physical determinants influence QOL...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28712988/the-spanish-adaptation-of-the-palliative-performance-scale-version-2-among-cancer-patients-at-the-end-of-life-psychometric-properties
#11
Eva Barallat, Maria Nabal, Jaume Canal, Javier Trujillano, Montse Gea-Sánchez, Philip J Larkin, Michael G Downing
BACKGROUND: Palliative Performance Scale (PPS) is a reliable tool to assess performance status in cancer patients receiving palliative care. Spanish validated and culturally adapted tools are needed. OBJECTIVES: To develop PPS translation and cross-cultural adaptation into Spanish. To assess its psychometric properties. DESIGN: Translation process with cross-cultural adaptation to produce Spanish Palliative Performance Scale (PPS-SPANISH)...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711753/psychometric-properties-of-the-greek-version-of-the-patient-dignity-inventory-in-advanced-cancer-patients
#12
Efi Parpa, Sotiria Kostopoulou, Eleni Tsilika, Antonis Galanos, Stylianos Katsaragakis, Kyriaki Mystakidou
CONTEXT: The Patient Dignity Inventory (PDI) is an instrument to measure dignity distressing aspects at the end of life. OBJECTIVES: The aims of the current study was the translation of the PDI in Greek language as well as to measure its psychometric aspects in a palliative care unit. METHODS: A back-translation method was obtained at the Greek version. 120 advanced cancer patients completed the Greek version of the PDI, the Greek Hospital Anxiety and Depression Scale (Gr-HADS), The Greek Schedule of attitudes towards hastened death (SAHD-Gr) and the Greek SF-12 (Short Form Health Survey: SF-12)...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711070/female-adolescents-with-chronic-or-end-stage-kidney-disease-and-strategies-for-their-care
#13
Maria E Diaz-Gonzalez De Ferris, Ana Catalina Alvarez-Elías, Michael Ted Ferris, Mara Medeiros
The prevalence of chronic or end-stage kidney disease in pediatric girls is lower than in boys, however, girls have unique morbidities that can have great effect on their quality of life. For female adolescents, creatinine excretion peaks at approximately 14 years of age and is significantly less than males, owing to lower muscle mass. Females have higher nitric oxide activity, and estrogens may contribute to lower blood pressure. Females excrete less growth hormone during the prepubertal and pubertal years...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28709581/trends-in-end-of-life-care-and-healthcare-spending-in-women-with-uterine-cancer
#14
Benjamin Margolis, Ling Chen, Melissa K Accordino, Grace Clarke Hillyer, June Y Hou, Ana I Tergas, William M Burke, Alfred I Neugut, Cande V Ananth, Dawn L Hershman, Jason D Wright
BACKGROUND: High intensity care including hospitalizations, chemotherapy and other interventions at the end of life is costly and often of little value for cancer patients. Little is known about patterns of end of life care and resource utilization for women with uterine cancer. OBJECTIVE: We examined the costs and predictors of aggressive end of life care for women with uterine cancer. METHODS: In this observational cohort study the Surveillance, Epidemiology and End Results-Medicare linked database was used to identify women >65 who died from uterine cancer from 2000-2011...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28708343/-knowing-where-the-patients-would-like-to-die
#15
Karine Vantieghem, Françoise Laurent
The majority of the population wishes to die at home. However, most patients die in hospitals or nursing homes. What do health care professionals know about the choices of their patients in this matter? This study concerns persons who died from natural causes during the 1st semester of 2013 in 2 districts of the canton of Vaud. 241 of their health care professionals answered a questionnaire. Only 35.6 % knew their patient's wishes pertaining to where their death should take place. Despite the opportunity to speak about it with one's GP, the issue is not usually raised...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28708340/-%C3%A2-doctor-i-would-like-to-stay-at-home-%C3%A2-about-the-partnership-between-a-specialized-palliative-home-care-team-and-general-practitioners
#16
Olivier Giet, Anne Vacanti-Robert, May Monney, Jocelyne Métrailler
During home care, general practitioners are faced with complex end-of-life situations. This leads to difficulties in taking care of the patient alone, and may require support from a multi-professional specialized palliative home care team. The palliative care teams follow these situations upon request from the GPs or home nurses, in order to provide help in encountered difficulties. The palliative care teams' activity is based on mentoring, anticipating possible future difficulties and managing crises. In order to have a real working partnership between the home palliative care teams and the GPs it is essential to have a mutual understanding of how each entity works and what kind of help they can provide...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28707460/the-effect-of-hospice-consultation-on-aggressive-treatment-of-lung-cancer
#17
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent five years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at SNUH who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed...
July 14, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28707029/-traumatized-relatives-of-intensive-care-patients
#18
REVIEW
A Niecke, G Schneider, C S Hartog, G Michels
Relatives are not only visitors in the intensive care unit, but provide support and care for patients at the end of life, and serve as an important source of information for clinicians. They are confronted, often unexpectedly and unprepared, with life-threatening illness, death and dying and life-threatening decisions to limit therapy. Thus, they are often substantially burdened themselves and are in need of support. It is undisputed that communication with relatives can have an adaptive or also traumatic influence on the experience gained...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28705196/better-palliative-care-for-people-with-a-dementia-summary-of-interdisciplinary-workshop-highlighting-current-gaps-and-recommendations-for-future-research
#19
Siobhán Fox, Carol FitzGerald, Karen Harrison Dening, Kate Irving, W George Kernohan, Adrian Treloar, David Oliver, Suzanne Guerin, Suzanne Timmons
BACKGROUND: Dementia is the most common neurological disorder worldwide and is a life-limiting condition, but very often is not recognised as such. People with dementia, and their carers, have been shown to have palliative care needs equal in extent to those of cancer patients. However, many people with advanced dementia are not routinely being assessed to determine their palliative care needs, and it is not clear why this is so. MAIN BODY: An interdisciplinary workshop on "Palliative Care in Neurodegeneration, with a focus on Dementia", was held in Cork, Ireland, in May 2016...
July 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28705009/palliative-care-and-advance-care-planning-for-pancreas-and-other-cancers
#20
Rajiv Agarwal, Andrew S Epstein
The principles of palliative care are fundamental to support and treat the physical, mental, and psychosocial health of patients living with pancreatic cancer. In addition to its proven advantages to help manage disease-related symptoms, improve accurate illness understanding, and enhance the quality of life and survival outcomes for patients with advanced disease, the inclusion of palliative care principles (whether by a specialist or by the primary oncology team) with standard oncologic care strengthens timely and quality advance care planning (ACP)...
June 2017: Chinese Clinical Oncology
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