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"Advance Directive"

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https://www.readbyqxmd.com/read/28925295/characteristics-of-patients-with-existing-advance-directives-evaluating-motivations-around-advance-care-planning
#1
Joanne E Genewick, Dorothy M Lipski, Katherine M Schupack, Angela L H Buffington
INTRODUCTION: Although 80% of patients endorse an advance directive (AD), less than 35% of American adults have a documented AD. Much research has been done on barriers to creating ADs; however, there is a paucity of research addressing motivations for creating ADs. Previous research has identified 4 categories of influence for engaging in advance care planning (ACP). This study aimed to quantify the influence of these 4 motivating categories in creating an AD. METHODS: Participants included 238 adults with documented ADs...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28915078/pediatric-specific-end-of-life-care-quality-measures-an-unmet-need-of-a-vulnerable-population
#2
Emily E Johnston, Abby R Rosenberg, Arif H Kamal
We must ensure that the 20,000 US children (age 0 to 19 years) who die as a result of serious illness annually receive high-quality end-of-life care. Ensuring high-quality end-of-life care requires recognition that pediatric end-of-life care is conceptually and operationally different than that for adults. For example, in-hospital adult death is considered an outcome to be avoided, whereas many pediatric families may prefer hospital death. Because pediatric deaths are comparatively rare, not all centers offer pediatric-focused palliative care and hospice services...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28901283/a-systematic-review-of-religious-beliefs-about-major-end-of-life-issues-in-the-five-major-world-religions
#3
Rajshekhar Chakraborty, Areej R El-Jawahri, Mark R Litzow, Karen L Syrjala, Aric D Parnes, Shahrukh K Hashmi
OBJECTIVE: The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL). METHOD: This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus...
October 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28887268/association-of-advance-directives-completion-with-the-utilization-of-life-sustaining-treatments-during-the-end-of-life-care-in-older-patients
#4
Yung-Feng Yen, Li-Ying Huang, Hsiao-Yun Hu, Wen-Jung Sun, Ming-Chung Ko, Ya-Ling Lee, Sheng-Jean Huang, Dachen Chu
CONTEXT: Evidence is mixed regarding the impact of advance directives (AD) on the utilisation of end-of-life treatments. OBJECTIVES: This study evaluated the effect of AD on the utilization of end-of-life treatments during the last month of life in older patients. METHODS: Taipei City Hospital initiated an advance care planning (ACP) program to promote AD for admitted patients in 2015. This prospective study recruited deceased older patients who completed ACP communication between 2015 and 2016...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28876712/-ethics-and-the-decision-of-cardiopulmonary-resuscitation
#5
Nathalie Tebib-Jauslin, Marcos Schwab, Alexandre Leszek
Following the guidelines of the Swiss Academy of Medical Science, most Swiss hospitals have implemented advanced directives that define what should be undertaken in case of cardiorespiratory arrest for every patient. This remains difficult to apply for physicians and difficult to understand for patients. From a medical perspective, some confusion occurs around medical directives. Difficulties include subjective misinterpretation of patient's quality of life, as well as decision making bias. In addition, patients overestimate the cardiopulmonary reanimation success rate, modify their choices with time and health status, and might lack their individual ability of discernment...
September 6, 2017: Revue M├ędicale Suisse
https://www.readbyqxmd.com/read/28875731/outpatient-palliative-cardiology-service-embedded-within-a-heart-failure-clinic-experiences-with-an-emerging-model-of-care
#6
Benjamin Gandesbery, Krista Dobbie, Eiran Z Gorodeski
BACKGROUND: The role of palliative care consultation in the outpatient treatment of patients with symptomatic heart failure (HF) is poorly studied. In August 2015, we created an outpatient palliative care service embedded within the HF clinic at Cleveland Clinic main campus. AIM: To characterize patients cared for by our novel outpatient palliative cardiology service, including their degree of HF, symptoms, comorbidities, topics addressed in clinic, palliative treatments prescribed, advanced directives status, and mortality...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28875720/psychiatric-advance-directives-in-australian-mental-health-legislation
#7
Calina Ouliaris, Warren Kealy-Bateman
OBJECTIVE: Following the recent widespread reform of mental-health legislation in Australia, psychiatric advance directives (PADs) have now been incorporated in four jurisdictions. We contextualise the potential role for PADs within the Australian legal framework and note their varying introduction across jurisdictions, with a focus on progressive legislation in the Australian Capital Territory (ACT). CONCLUSION: The formal recognition of PADs effectively shifts the trajectory of mental-health law towards a stronger recognition of consumer autonomy, albeit to varying degrees across jurisdictions...
September 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28865870/outcomes-that-define-successful-advance-care-planning-a-delphi-panel-consensus
#8
Rebecca L Sudore, Daren K Heyland, Hillary D Lum, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Karl Lorenz, Michelle Howard, Michael J Green, Jessica E Simon, Mariko A Feuz, John J You
CONTEXT: Standardized outcomes that define successful advance care planning (ACP) are lacking. OBJECTIVE: To create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. METHODS: This study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from 5 international ACP conferences to identify initial ACP outcome constructs...
August 30, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28863219/discussing-advance-care-planning-and-directives-in-the-general-population
#9
Pascal J de Caprariis, Bronwyn Rucker, Claudia Lyon
The concept of end-of-life planning, along with medical and legal issues, has been discussed and has evolved over several years. The 1990 Patient Self-Determination Act and individual states' Department of Health Advance Directive forms helped overcome past problems. Patients with terminal and chronic illness are now able to have their wishes recognized for their future care. Any healthy individual's decision during an advance care planning (ACP) discussion can be adversely affected by various factors; however, multiple barriers-religion, culture, education, and family dynamics-can influence the process...
September 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28851604/regulatory-logic-underlying-diversification-of-the-neural-crest
#10
REVIEW
Megan L Martik, Marianne E Bronner
The neural crest is a transient, multipotent population of cells that arises at the border of the developing nervous system. After closure of the neural tube, these cells undergo an epithelial-to-mesenchymal transition (EMT) to delaminate and migrate, often to distant locations in the embryo. Neural crest cells give rise to a diverse array of derivatives including neurons and glia of the peripheral nervous system, melanocytes, and bone and cartilage of the face. A gene regulatory network (GRN) controls the specification, delamination, migration, and differentiation of this fascinating cell type...
August 26, 2017: Trends in Genetics: TIG
https://www.readbyqxmd.com/read/28851337/which-online-format-is-most-effective-for-assisting-baby-boomers-to-complete-advance-directives-a-randomised-controlled-trial-of-email-prompting-versus-online-education-module
#11
Sandra L Bradley, Jennifer J Tieman, Richard J Woodman, Paddy A Phillips
BACKGROUND: Completion of Advance Directives (ADs), being financial and healthcare proxy or instructional documents, is relatively uncommon in Australia. Efforts to increase completion rates include online education and prompting which past literature suggests may be effective. The aim of this randomized controlled trial was to assess computer-based online AD information and email prompting for facilitating completion of ADs by Australian Baby Boomers (b.1946-1965) as well as factors which may impede or assist completion of these documents by this generation when using the online environment...
August 29, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28844985/pediatric-advance-care-planning-pacp-for-teens-with-cancer-and-their-families-design-of-a-dyadic-longitudinal-rcct
#12
Katherine B Curtin, Anne E Watson, Jichuan Wang, Obianuju C Okonkwo, Maureen E Lyon
Cancer is the leading cause of disease-related death for adolescents and young adults (AYAs) in the United States. Parents of AYAs with life-threatening illnesses have expressed the desire to talk to their children about end of life (EOL) care, yet, like caregivers of adult patients, struggle to initiate this conversation. Building Evidence for Effective Palliative/End of Life Care for Teens with Cancer is a longitudinal, randomized, controlled, single-blinded clinical trial aimed at evaluating the efficacy of FAmily CEntered disease-specific advance care planning (ACP) for teens with cancer (FACE-TC)...
August 24, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28842378/end-of-life-discussions-in-patients-with-heart-failure
#13
Kathleen A Young, Margaret M Redfield, Jacob J Strand, Shannon M Dunlay
BACKGROUND: Although guidelines call on clinicians to conduct regular conversations about advance care planning and end-of-life (EOL) preferences with patients with heart failure (HF), research suggests that physicians often avoid these discussions. METHODS AND RESULTS: Between January 20, 2014 and January 18, 2016, Southeastern Minnesota residents hospitalized with acute decompensated HF (ADHF) at Mayo Clinic hospitals were enrolled into an observational cohort study that included the administration of face-to-face questionnaires...
August 22, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28840485/how-surrogates-decide-a-secondary-data-analysis-of-decision-making-principles-used-by-the-surrogates-of-hospitalized-older-adults
#14
Rohit Devnani, James E Slaven, Gabriel T Bosslet, Kianna Montz, Lev Inger, Emily S Burke, Alexia M Torke
BACKGROUND: Many hospitalized adults do not have the capacity to make their own health care decisions and thus require a surrogate decision-maker. While the ethical standard suggests that decisions should focus on a patient's preferences, our study explores the principles that surrogates consider most important when making decisions for older hospitalized patients. OBJECTIVES: We sought to determine how frequently surrogate decision-makers prioritized patient preferences in decision-making and what factors may predict their doing so...
August 24, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28831512/-advance-directive-of-probands-in-pharmaceutical-research-a-medical-ethics-discussion
#15
REVIEW
M Haupt, F Jessen, H Fangerau
In the fourth Act on the amendment of pharmaceutical legal and other regulations in November 2016, the legislature has designated the proband advance directive based on the instrument of patient advance directive to enable group beneficial research with persons not capable of giving consent. This article describes the existing conditional need for group beneficial research and presents the problem of the decisive instrument for advance directives at the center of the considerations. The features of the proband advance directive concluded by the legislature stand in opposition to a successful implementation, particularly due to the necessary concrete clarification content far in advance for informed research participants...
August 22, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28828037/concordance-of-the-indian-mental-healthcare-act-2017-with-the-world-health-organization-s-checklist-on-mental-health-legislation
#16
Richard M Duffy, Brendan D Kelly
BACKGROUND: India is revising its mental health legislation with the Indian Mental Healthcare Act 2017 (IMHA). When implemented, this legislation will apply to over 1.25 billion people. In 2005, the World Health Organization (WHO) published a Resource Book (WHO-RB) on mental health, human rights and legislation, including a checklist of 175 specific items to be addressed in mental health legislation or policy in individual countries. Even following the publication of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (2006), the WHO-RB remains the most comprehensive checklist for mental health legislation available, rooted in UN and WHO documents and providing the most systematic, detailed framework for human rights analysis of mental health legislation...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28826983/impact-of-a-stay-in-the-intensive-care-unit-on-the-preparation-of-advance-directives-descriptive-exploratory-qualitative-study
#17
Pascal Andreu, Auguste Dargent, Audrey Large, Nicolas Meunier-Beillard, Sandrine Vinault, Uriel Leiva Rojas, Fiona Ecarnot, S├ębastien Prin, Pierre-Emmanuel Charles, Isabelle Fournel, Jean-Philippe Rigaud, Jean-Pierre Quenot
BACKGROUND: Our objective was to assess, through a qualitative, exploratory study, the thought processes of patients regarding the formulation of Advance Directives (AD) after a stay in the ICU. METHODS: Study performed from May to July 2016 using telephone interviews performed by four senior ICU physicians. Inclusion criteria were: patients discharged from ICU to home >3 months previously. Semi-directive interviews with patients focused on 5 main points surrounding AD...
August 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28815400/advance-directives-and-the-descendant-argument
#18
Jukka Varelius
By issuing an advance treatment directive, an autonomous person can formally express what kinds of treatment she wishes and does not wish to receive in case she becomes ill or injured and unable to autonomously decide about her treatment. While many jurisdictions and medical associations endorse them, advance treatment directives have also been criticized. According to an important criticism, when a person irreversibly loses her autonomy what she formerly autonomously desired ceases to be of (central) importance in deciding about her treatment...
August 16, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28806952/socio-cultural-contexts-of-end-of-life-conversations-and-decisions-bereaved-family-cancer-caregivers-retrospective-co-constructions
#19
Jennifer Nyawira Githaiga, Leslie Swartz
BACKGROUND: End-of-life communication becomes increasingly difficult in terminal cancer, which inevitably entails conversations around dying and death. In resource-limited areas, the context of end-of-life communication is usually home-based palliative care comprising mostly women in the family who play critical roles as informal caregivers. This article examined the content and contexts of family end-of-life conversations and decisions based on the retrospective accounts of a sample of bereaved women family cancer caregivers in Nairobi, Kenya...
August 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28806026/physician-perceptions-of-barriers-to-advance-care-planning
#20
Lauren Fanta, Jill Tyler
BACKGROUND: Numerous studies have confirmed the importance of advance care planning. Despite the benefits of directed end-of-life discussions, a variety of barriers including discomfort with the topic, physician ideology, lack of time and reimbursement, delaying discussions, and lack of training impede physicians from facilitating these crucial conversations with their patients. This study aims to understand physicians' perceptions to additional barriers to advance care planning with patients and their families...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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