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"Advance Directive"

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https://www.readbyqxmd.com/read/29148907/impact-of-patients-expressed-wishes-on-their-surrogate-decision-makers-preferred-decision-making-roles-in-japan
#1
Shuji Tsuda, Mieko Nakamura, Shigeru Aoki, Hiroshi Ono, Mitsuru Takagi, Hiroki Ohashi, Junichiro Miyachi, Yoshinori Matsui, Toshiyuki Ojima
BACKGROUND: Home medical care (HMC) patients and their families are expected to prepare for end-of-life decision making. OBJECTIVE: We investigated the decision readiness of HMC patients and their family surrogates. DESIGN: Cross-sectional survey. SETTING/SUBJECTS: We collected data from dyads, consisting of a HMC patient aged 65 years or older and a family member of the patient, recruited at four Japanese primary care clinics from January 2016 to November 2016...
November 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29142799/respiratory-failure-following-organophosphate-poisoning-a-literature-review
#2
REVIEW
Pirthvi Raj Giyanwani, Ujala Zubair, Osama Salam, Zarafshan Zubair
Organophosphates (OPs) account for a large portion of suicides globally. OP manifests as cholinergic crises, which underlie respiratory failure. There are many pathways by which respiration is inhibited secondary to organophosphate poisoning. These include central as well as peripheral mechanisms, with central mechanisms predominating. We conducted a literature review in June 2017. PubMed, Embase, and Google Scholar were searched for studies that reported acute organophosphate poisoning in humans. In our review, data were collected from studies published during the years 2001 to 2016...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29137615/advance-directives-proxy-opinions-and-treatment-restrictions-in-patients-with-severe-stroke
#3
Floor A S de Kort, Marjolein Geurts, Paul L M de Kort, Julia H van Tuijl, Ghislaine J M W van Thiel, L Jaap Kappelle, H Bart van der Worp
BACKGROUND: Patients with severe stroke often do not have the capacity to participate in discussions on treatment restrictions because of a reduced level of consciousness, aphasia, or another cognitive disorder. We assessed the role of advance directives and proxy opinions in the decision-making process of incapacitated patients. METHODS: Sixty patients with severe functional dependence (Barthel Index ≤6) at day four after ischemic stroke or intracerebral hemorrhage were included in a prospective two-center cohort study...
November 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29126829/palliative-care-in-diffuse-interstitial-lund-disease-results-of-a-spanish-survey
#4
Silvia Barril, Ana Alonso, José Antonio Rodríguez-Portal, Margarita Viladot, Jordi Giner, Francisco Aparicio, Ana Romero-Ortiz, Orlando Acosta, Diego Castillo
INTRODUCTION: Interstitial lung diseases (ILD) and, in particular, idiopathic pulmonary fibrosis, may have a significant impact on patient survival. Recent studies highlight the need for palliative care (PC) in the management of ILD patients. The aim of this study was to determine the current situation of PC in patients in Spain. METHODS: A 36-question survey addressing the main aspects of PC in ILD patients was designed. The survey was sent via email to all members of the Spanish Society of Pulmonology and Thoracic Surgery...
November 7, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29118785/advance-directives-as-support-of-autonomy-for-persons-with-dementia-a-pilot-study-among-persons-with-dementia-and-their-informal-caregivers
#5
Martina Schmidhuber, Sandra Haeupler, Velislava Marinova-Schmidt, Andreas Frewer, Peter L Kolominsky-Rabas
Background: Advance directives could be an important instrument to support a person's will once he/she is not able to consent anymore - if composed competently. A survey was conducted to identify the level of knowledge concerning possibilities and limits of advance directives. Methods: The study was conducted as part of the Bavarian Dementia Survey (BayDem). Data were collected from January 2014 to December 2015 by structured face-to-face interviews. Study participants were persons with dementia and their informal caregivers (n = 74)...
September 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/29114779/advance-directives-for-dementia-meeting-a-unique-challenge
#6
Barak Gaster, Eric B Larson, J Randall Curtis
No abstract text is available yet for this article.
November 6, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29112876/factors-influencing-attitudes-toward-advance-directives-in-korean-older-adults
#7
Ji Eun Lee, Dong Wook Shin, Ki Young Son, Hyun Jung Park, Jae-Young Lim, Mi Soon Song, Yeon-Hwan Park, BeLong Cho
AIM: We aimed to determine the factors influencing attitudes toward advance directives in Korean older adults with consideration of an Asian cultural background. METHODS: We recruited community-dwelling older adults aged 60 years or older at a regional senior welfare center in Korea. Demographic factors and mental and physical health status were examined using questionnaires and a physical examination. The questionnaire also assessed perceived necessity of advance directives and related experiences...
October 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29110888/-knowledge-and-attitudes-of-health-professionals-towards-advance-directives
#8
Juan Miguel Aguilar-Sánchez, María José Cabañero-Martínez, Francisca Puerta Fernández, Mireia Ladios-Martín, José Fernández-de-Maya, Julio Cabrero-García
OBJECTIVE: To evaluate the degree of knowledge and attitudes of medical and nursing professionals in two health departments to advance directives, as well as to examine their association with the sociodemographic and occupational variables of the professionals. METHODS: A cross-sectional survey on 329 health professionals was carried out through the internet and a standardised procedure. The knowledge and attitudes of the professionals about advance directives were examined using two validated questionnaires of 17 and 12 items, respectively...
October 27, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29074515/euthanasia-and-physician-assisted-suicide-not-meeting-due-care-criteria-in-the-netherlands-a-qualitative-review-of-review-committee-judgements
#9
David Gibbes Miller, Scott Y H Kim
ObjectivesTo assess how Dutch regional euthanasia review committees (RTE) apply the euthanasia and physician-assisted suicide (EAS) due care criteria in cases where the criteria are judged not to have been met ('due care not met' (DCNM)) and to evaluate how the criteria function to set limits in Dutch EAS practice. DESIGN: A qualitative review using directed content analysis of DCNM cases in the Netherlands from 2012 to 2016 published on the RTE website (https://www.euthanasiecommissie...
October 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/29072148/patient-family-eol-communication-and-its-predictors-reports-from-caregivers-of-latino-patients-in-the-rural-u-s-mexico-border-region
#10
Eunjeong Ko, Jaehoon Lee, Carlos Ramirez, Denicka Lopez, Stephanie Martinez
OBJECTIVE: Family caregivers play an important role in end-of-life (EoL) decision making when the patient is unable to make his/her own decisions. While communication about EoL care between patients and family is perhaps a first step toward advance care planning (ACP)/EoL decisions, not every culture puts great value on open communication about this topic. The aims of the present study were to explore EoL communication and the aspects of communication among caregivers of Latino patients in the rural United States (U...
October 26, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29071388/-advance-directives-in-clinical-practice-living-will-healthcare-power-of-attorney-and-care-directive
#11
J Hack, B Buecking, C L Lopez, S Ruchholtz, C A Kühne
In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e...
October 25, 2017: Der Internist
https://www.readbyqxmd.com/read/29070707/adverse-consequences-of-article-12-of-the-un-convention-on-the-rights-of-persons-with-disabilities-for-persons-with-mental-disabilities-and-an-alternative-way-forward
#12
Matthé Scholten, Jakov Gather
It is widely accepted among medical ethicists that competence is a necessary condition for informed consent. In this view, if a patient is incompetent to make a particular treatment decision, the decision must be based on an advance directive or made by a substitute decision-maker on behalf of the patient. We call this the competence model. According to a recent report of the United Nations (UN) High Commissioner for Human Rights, article 12 of the UN Convention on the Rights of Persons with Disabilities (CRPD) presents a wholesale rejection of the competence model...
October 25, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29066257/disparity-of-end-of-life-care-in-cancer-patients-with-and-without-schizophrenia-a-nationwide-population-based-cohort-study
#13
Huei-Kai Huang, Ying-Wei Wang, Jyh-Gang Hsieh, Chia-Jung Hsieh
BACKGROUND: Cancer patients with schizophrenia may face disparities in end-of life care, and it is unclear whether schizophrenia affects their medical care and treatment. METHODS: We conducted a nationwide population-based cohort study based on the National Health Insurance Research Database of Taiwan. The study population included patients >20years old who were newly diagnosed as having one of six common cancers between 2000 and 2012 (schizophrenia cohort: 1911 patients with both cancer and schizophrenia; non-schizophrenia cohort: 7644 cancer patients without schizophrenia)...
October 21, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/29045631/implementation-of-advance-care-planning-in-israel-a-convergence-of-top-down-and-bottom-up-processes
#14
Netta Bentur, Shelley Sternberg
Although public health has traditionally been concerned with primary, secondary, and tertiary prevention, more attention needs to be focused on patient-centered care at the end of life. Improved access to quality end-of-life care can be achieved by advance care planning (ACP). In this article, we present an example of the processes of change regarding ACP and preparing advance directives (ADs) that have begun to take place in Israel in recent years. We argue that these processes derive from the synergy between legislation on the one hand, and initiatives and action by health organizations on the other...
October 13, 2017: Gerontologist
https://www.readbyqxmd.com/read/29033602/early-in-hospital-clinical-deterioration-is-not-predicted-by-severity-of-illness-functional-status-or-comorbidity
#15
Janice Wang, Stella S Hahn, Myriam Kline, Rubin I Cohen
BACKGROUND: Prior studies concentrated on unplanned intensive care unit (ICU) transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT) activation within 48 hours of admission as an index of early clinical worsening. METHODS: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29030209/oncologists-and-patients-perceptions-of-initial-intermediate-and-final-goals-of-care-conversations
#16
Dena Schulman-Green, Cardinale B Smith, Jenny J Lin, Shelli Feder, Nina A Bickell
CONTEXT: While recommendations are for goals of care (GoC) conversations to happen early and often, their timing and content over the disease course remain unclear. OBJECTIVES: To describe perceptions of the timing and content of GoC conversations among oncologists and patients with advanced cancer. METHODS: Semi-structured interviews with oncologists and patients at four hospitals in New York and Connecticut. We analyzed data using interpretive description...
October 10, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28988561/discussing-advance-care-planning-insights-from-older-people-living-in-nursing-homes-and-from-family-members
#17
Francesca Ingravallo, Veronica Mignani, Elena Mariani, Giovanni Ottoboni, Marie Christine Melon, Rabih Chattat
BACKGROUND: Evidence concerning when and in which manner older people living in nursing homes (NHs) would prefer to discuss advance care planning (ACP) is still scarce. This study explored the attitudes of NH residents and family members toward ACP and their opinions as to the right time to broach the subject, the manner in which it should be approached, and the content of ACP. METHODS: This was a qualitative study using face-to-face interviews with 30 residents (age range 66-94), and 10 family members from 4 Italian NHs...
October 9, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28981694/protecting-me-from-my-directive-ensuring-appropriate-safeguards-for-advance-directives-in-dementia
#18
Cressida Auckland
With one in six people over 80 now suffering from dementia, advance directives provide an important means of empowerment. Upholding directives in the context of dementia, however, raises extra challenges, given the potential for the directive to conflict with an assessment of what is in the person's current best interests. Given the profound harm that tying a person with dementia to their previous wishes can do, it is essential that we have sufficient safeguards in place to ensure that we only uphold such directives where we can be sure they are truly autonomous and are intended to apply to the situation at hand-safeguards which are at present, severely lacking...
August 16, 2017: Medical Law Review
https://www.readbyqxmd.com/read/28967968/usefulness-of-questionnaires-on-advance-directives-in-haemodialysis-units
#19
Angel Rodríguez Jornet, Loreley Ana Betancourt Castellanos, Maria Isabel Bolós Contador, Juan Carlos Oliva Morera, José Antonio Ibeas López
Background: As renal replacement therapy has become universal practice in medicine, there is a need to consider whether this treatment is suitable for elderly people. These patients have high comorbidity and may require dialysis withdrawal in certain clinical circumstances. Advance directives (ADs) drawn up by patients facilitate treatment-related decisions if they lose cognitive capacity. Questionnaires dealing with possible extreme clinical circumstances can thus help clinicians and relatives reach pertinent decisions in such cases...
October 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28957882/impact-of-advance-care-planning-on-end-of-life-management
#20
Urška Lunder, Branka Červ, Hana Kodba-Čeh
PURPOSE OF REVIEW: The aim of this review is to critically appraise the recent evidence on different aspects of impact of advance care planning (ACP) in palliative care and to reflect on further implications on practice and research in the future. RECENT FINDINGS: Evidence about various ACP impacts is rapidly growing and most common outcome measures are still advance directive completion, change in hospital admission rate and patients' and families' views and experiences with ACP...
December 2017: Current Opinion in Supportive and Palliative Care
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