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"Advanced Care Planning"

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https://www.readbyqxmd.com/read/28096041/advance-care-planning-in-adults-with-congenital-heart-disease-a-patient-priority
#1
Lisa X Deng, Lacey P Gleason, Abigail M Khan, David Drajpuch, Stephanie Fuller, Leah A Goldberg, Christopher E Mascio, Sara L Partington, Lynda Tobin, Yuli Y Kim, Adrienne H Kovacs
BACKGROUND: Adult congenital heart disease (ACHD) patients with moderate or great defect complexity are at risk for premature death. Although early engagement in advance care planning (ACP) is recommended, previous research suggests that it seldom occurs. METHODS: This study investigated ACHD patient preferences for ACP and factors that impact preferences. ACHD patients completed an ACP preferences questionnaire, the Hospital Anxiety and Depression Scale and a measure of attachment styles...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28093312/palliative-medicine-and-preparedness-planning-for-patients-receiving-left-ventricular-assist-device-as-destination-therapy-challenges-to-measuring-impact-and-change-in-institutional-culture
#2
Brandon P Verdoorn, Angela J Luckhardt, Sara E Wordingham, Shannon M Dunlay, Keith M Swetz
CONTEXT: While left ventricular assist devices as destination therapy (DT-LVAD) can improve survival, quality of life, and functional capacity in well-selected patients with advanced heart failure, there remain unique challenges to providing quality end-of-life care in this population. Palliative care involvement is universally recommended, but how to best operationalize this care and measure success is unknown. OBJECTIVES: To characterize the process of preparedness planning (PP) for patients receiving DT-LVAD at our institution and better understand opportunities for quality improvement or procedural transferability...
January 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28086861/managing-shades-of-grey-a-focus-group-study-exploring-community-dwellers-views-on-advance-care-planning-in-older-people
#3
Natasha Michael, Clare O'Callaghan, Emma Sayers
BACKGROUND: Community-dwelling consumers of healthcare are increasing, many aging with life-limiting conditions and deteriorating cognition. However, few have had advance care planning discussions or completed documentation to ensure future care preferences are acted upon. This study examines the awareness, attitudes, and experiences of advance care planning amongst older people and unrelated offspring/caregivers of older people residing in the community. METHODS: Qualitative descriptive research, which included focus groups with older people (55+ years) and older people's offspring/caregivers living in an Australian city and surrounding rural region...
January 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28078098/transfer-of-nursing-home-residents-to-emergency-departments-organizational-differences-between-nursing-homes-with-high-vs-low-transfer-rates
#4
Marie Kirsebom, Mariann Hedström, Ulrika Pöder, Barbro Wadensten
AIM: To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department. DESIGN: Explorative. METHOD: In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department...
January 2017: Nursing Open
https://www.readbyqxmd.com/read/28073292/health-care-utilization-after-hospice-enrollment-in-patients-with-heart-failure-and-cancer
#5
Meredith A MacKenzie, Alexandra Hanlon
This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = ...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28069027/reliability-of-health-related-quality-of-life-assessments-made-by-older-adults-and-significant-others-for-health-states-of-increasing-cognitive-impairment
#6
Gina Bravo, Modou Sene, Marcel Arcand
BACKGROUND: Older adults are encouraged by many organizations to engage in advance care planning in the event of decisional incapacity. Planning for future health care often involves anticipating health-related quality of life (HRQoL) in states of reduced cognitive functioning. No study has yet examined whether anticipated HRQoL is stable over time. The accuracy with which significant others can predict how an older adult envisions HRQoL in a future state of cognitive impairment is also unknown...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28068789/pragmatic-trial-of-video-education-in-nursing-homes-the-design-and-rationale-for-a-pragmatic-cluster-randomized-trial-in-the-nursing-home-setting
#7
Vincent Mor, Angelo E Volandes, Roee Gutman, Constantine Gatsonis, Susan L Mitchell
Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28062341/implementation-and-impact-of-patient-lay-navigator-led-advance-care-planning-conversations
#8
Gabrielle B Rocque, J Nicholas Dionne-Odom, Chao-Hui Sylvia Huang, Soumya J Niranjan, Courtney P Williams, Bradford E Jackson, Karina I Halilova, Kelly M Kenzik, Kerri S Bevis, Audrey S Wallace, Nedra Lisovicz, Richard A Taylor, Maria Pisu, Edward E Partridge, Linda A Briggs, Elizabeth A Kvale
CONTEXT: Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). OBJECTIVES: To evaluate implementation of lay navigator-led ACP. METHODS: A convergent, parallel mixed-methods design was employed to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included: (1) electronic navigation records, (2) navigator surveys (n=45), (3) claims-based patient outcomes (n=820), and (4) semi-structured navigator interviews (n=26)...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062339/defining-advance-care-planning-for-adults-a-consensus-definition-from-a-multidisciplinary-delphi-panel
#9
Rebecca L Sudore, Hillary D Lum, John J You, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Daniel D Matlock, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Jean S Kutner, Joan M Teno, Judy Thomas, Ryan D McMahan, Daren K Heyland
BACKGROUND: Despite increasing interest in advance care planning (ACP) and prior ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives. OBJECTIVE: To develop a consensus definition of ACP for adults. DESIGN: Delphi Panel SETTING/PARTICIPANTS: Participants included a multidisciplinary panel of international ACP experts consisting of 52 clinicians, researchers, and policy leaders from 4 countries, and a patient/surrogate advisory committee...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28061535/perioperative-goal-setting-consultations-by-surgical-colleagues-a-new-model-for-supporting-patients-families-and-surgeons-in-shared-decision-making
#10
Ana Berlin, Anastasia Kunac, Anne C Mosenthal
Patients with postoperative complications are often subjected to prolonged life-sustaining treatment based on erroneous assumptions about their goals of care. Shared decision making (SDM) is an evidence-based approach that helps ensure patients' wishes and values are honored in their course of treatment. Perioperative palliative care can help create goal-concordant trajectories of care for high risk, seriously ill, or complicated patients, through sophisticated prognostication, higher-level communication, and recommendations based on the best available evidence and patients' stated goals and priorities...
November 29, 2016: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28045583/a-model-to-promote-clinicians-understanding-of-the-continuum-of-advance-care-planning
#11
Shigeko Izumi, Erik K Fromme
No abstract text is available yet for this article.
January 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28042072/measuring-advance-care-planning-optimizing-the-advance-care-planning-engagement-survey
#12
Rebecca L Sudore, Daren K Heyland, Deborah E Barnes, Michelle Howard, Konrad Fassbender, Carole A Robinson, John Boscardin, John J You
CONTEXT: A validated 82-item Advance Care Planning (ACP) Engagement Survey measures a broad range of behaviors. However, concise surveys are needed. OBJECTIVES: To validate shorter versions of the Survey. METHODS: The Survey included 57 process (e.g. readiness) and 25 action items (e.g. discussions). For item reduction, we systematically eliminated questions based on face validity, item non-response, redundancy, ceiling effects, and factor analysis...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28040231/differences-between-pediatricians-and-internists-in-advance-care-planning-for-adolescents-with-cancer
#13
Nobuyuki Yotani, Yoshiyuki Kizawa, Haruo Shintaku
OBJECTIVE: To evaluate differences between pediatricians and internists in the practice of and barriers to advance care planning (ACP) for adolescent patients with cancer. STUDY DESIGN: A self-reported questionnaire was administered to assess the practice of ACP, advance directives, and barriers to ACP for adolescent patients with cancer. All 3392 Japanese board-certified hematologists were surveyed, and 600 hematologists (227 pediatricians, 373 internists) who take care of adolescent patients with cancer with decision-making capacity were analyzed...
December 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28038509/engaging-college-undergraduates-in-advance-care-planning
#14
Sara Sanders, Erin L Robinson
Advance care planning (ACP) is a critical part of long-term health-care planning, as no one knows when the ability to make personal medical decisions may be impaired. Many assume ACP is only necessary for older adults or those with life-threatening health conditions; however, there are growing discussions about healthy, young adults also engaging in ACP, as they too suffer from unexpected medical events that limit their ability to make medical decisions. The current study examined the reactions of college students following the completion of their advance care plans and then sharing these plans with friends and family...
February 2017: Omega
https://www.readbyqxmd.com/read/28034893/considering-the-cpr-decision-through-the-lens-of-prospect-theory-in-the-context-of-advanced-chronic-illness
#15
Mercedes Bern-Klug
It is common for people with advanced chronic illness to have many health care providers and many health care-related visits. It is also common, during those visits, to be asked whether attempts at cardiopulmonary resuscitation (CPR) are desired, in the event of cardiac arrest. Although the question is common, the implications of a "yes" or a "no" may not be well understood. Although CPR can be a life-saving procedure, it is not always in the patient's best interest. This article discusses experiences with CPR of 2 older women (and their adult children) during their last years of life, and uses concepts from prospect theory to make suggestions for changes in the way health care providers and patients approach advance care planning including the CPR decision...
December 29, 2016: Gerontologist
https://www.readbyqxmd.com/read/28032821/doctors-lawyers-and-advance-care-planning-time-for-innovation-to-work-together-to-meet-client-needs
#16
Nola M Ries, Maureen Douglas, Jessica Simon, Konrad Fassbender
Health organizations in canada have invested considerable resources in strategies to improve knowledge and uptake of advance care planning (acp). Yet barriers persist and many canadians do not engage in the full range of acp behaviours, including writing an advance directive and appointing a legally authorized decision-maker. not engaging effectively in acp disadvantages patients, their loved ones and their healthcare providers. This article advocates for greater collaboration between health and legal professionals to better support clients in acp and presents a framework for action to build connections between these typically siloed professions...
November 2016: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/28028678/the-effect-of-advance-directive-completion-on-hospital-care-among-chronically-homeless-persons-a-prospective-cohort-study
#17
Alexander K Leung, Matthew J To, Linh Luong, Zahra Syavash Vahabi, Victor L Gonçalves, John Song, Stephen W Hwang
Advance care planning is relevant for homeless individuals because they experience high rates of morbidity and mortality. The impact of advance directive interventions on hospital care of homeless individuals has not been studied. The objective of this study was to determine if homeless individuals who complete an advance directive through a shelter-based intervention are more likely to have information from their advance directive documented and used during subsequent hospitalizations. The advance directive included preferences for life-sustaining treatments, resuscitation, and substitute decision maker(s)...
December 27, 2016: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28028278/-feasibility-study-of-a-one-day-educational-program-to-train-advance-care-planning-facilitators-acpfs-in-regional-areas
#18
Mitsunori Nishikawa, Hisayuki Miura, Sanae Oya, Tomonari Kato, Hiroyuki Nagae, Yoshiyuki Osada, Tetsuya Watanabe, Sachiko Matsuoka, Yasuro Otsuka, Mie Yamaguchi, Kazuko Watanabe, Katsutoshi Kito, Hatsue Ooi, Naoko Suzuki
Promoting advance care planning in regional areas is important. Education For Implementing End-of-Life Discussion(EFIELD) is a two-day educational program for Advance Care Planning Facilitators(ACPFs)developed by the National Center for Geriatrics and Gerontology. Unfortunately, some trainers experience difficulties implementing the content of the program, and some trainees feel the program is too long for implementation in many regional areas. The purpose of the research is to clarify the feasibility of ACPFs education using a one-day program in regional areas...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28012054/licensing-surrogate-decision-makers
#19
Philip M Rosoff
As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions...
December 23, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28009643/palliative-care-and-chronic-obstructive-pulmonary-disease-where-the-lines-meet
#20
Sarah E Harrington, Elizabeth Rogers, Megan Davis
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and is expected to increase as the population ages. Patients have a high symptom burden, low healthcare quality of life, and unmet needs at the end of life. This review highlights specific palliative care needs of patients with advanced COPD and opportunities to integrate palliative care into standard practice. RECENT FINDINGS: There are many barriers to providing integrated palliative care in COPD, including difficulty with prognostication, communication barriers surrounding advance care planning, and lack of access to specialty palliative care...
December 21, 2016: Current Opinion in Pulmonary Medicine
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