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"Advance Directive"

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https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#1
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#2
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
https://www.readbyqxmd.com/read/28520863/persistent-gaps-in-use-of-advance-directives-among-nursing-home-residents-receiving-maintenance-dialysis
#3
Manjula Kurella Tamura, Sai Liu, Maria E Montez-Rath, Ann M O'Hare, Yoshio N Hall, Karl A Lorenz
No abstract text is available yet for this article.
May 18, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28520838/effect-of-the-prepare-website-vs-an-easy-to-read-advance-directive-on-advance-care-planning-documentation-and-engagement-among-veterans-a-randomized-clinical-trial
#4
Rebecca L Sudore, John Boscardin, Mariko A Feuz, Ryan D McMahan, Mary T Katen, Deborah E Barnes
Importance: Documentation rates of patients' medical wishes are often low. It is unknown whether easy-to-use, patient-facing advance care planning (ACP) interventions can overcome barriers to planning in busy primary care settings. Objective: To compare the efficacy of an interactive, patient-centered ACP website (PREPARE) with an easy-to-read advance directive (AD) to increase planning documentation. Design, Setting, and Participants: This was a comparative effectiveness randomized clinical trial from April 2013 to July 2016 conducted at multiple primary care clinics at the San Francisco VA Medical Center...
May 18, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28512268/advance-directives-cancer-patients-preferences-and-family-based-decision-making
#5
Yan-Fang Xing, Jin-Xiang Lin, Xing Li, Qu Lin, Xiao-Kun Ma, Jie Chen, Dong-Hao Wu, Li Wei, Liang-Hong Yin, Xiang-Yuan Wu
BACKGROUND: Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. OBJECTIVES: This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved...
April 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28511607/increasing-the-use-of-psychiatric-advance-directives
#6
Douglas P Olsen
No abstract text is available yet for this article.
May 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28504894/preventing-burdensome-transitions-of-nursing-home-residents-with-advanced-dementia-it-s-more-than-advance-directives
#7
Ruth Palan Lopez, Susan L Mitchell, Jane L Givens
BACKGROUND: Although a palliative approach to care is recommended for people with advanced dementia, many nursing home (NH) residents with dementia experience burdensome interventions such as hospital transfers at the end of life. OBJECTIVE: The goal of this study was to examine how decisions to transfer NH residents with advanced dementia are made, from the perspective of NH nurses and physicians. METHODS: A qualitative, descriptive method was used...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#8
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28488291/advance-care-planning-with-individuals-experiencing-homelessness-literature-review-and-recommendations-for-public-health-practice
#9
Sarah A Hubbell
Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness...
May 10, 2017: Public Health Nursing
https://www.readbyqxmd.com/read/28485515/consensus-statement-of-the-international-summit-on-intellectual-disability-and-dementia-related-to-end-of-life-care-in-advanced-dementia
#10
Philip McCallion, Mary Hogan, Flavia H Santos, Mary McCarron, Kathryn Service, Sandy Stemp, Seth Keller, Juan Fortea, Kathleen Bishop, Karen Watchman, Matthew P Janicki
BACKGROUND: Adults with intellectual disability are affected by dementia at equivalent and elevated rates, many surviving into advanced age. End of life care and support considerations come into play among these individuals when most are in the advanced stage of dementia. METHODS: A preliminary report summarizing available literature and making initial recommendations was developed by a workgroup, reviewed by all conference participants and then was finalized by the workgroup...
May 9, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#11
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28481607/engagement-in-steps-of-advance-health-care-planning-by-homeless-veterans
#12
Patricia M Dubbert, Kimberly K Garner, Shelly Lensing, J Glen White, Dennis H Sullivan
Communicating health care preferences in advance, so that wishes can be honored if the person becomes unable to participate in decision-making, is especially important for vulnerable populations such as homeless veterans. Hospitals are required to inform patients of their rights to document their preferences, but completion rates for advance directives are low. Conceptualizing advance health care planning as a series of health behavior steps emphasizing communication is recommended for improving engagement in advance health care planning...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28479121/ethical-considerations-and-palliative-care-in-patients-with-amyotrophic-lateral-sclerosis-a-review
#13
REVIEW
V Danel-Brunaud, L Touzet, L Chevalier, C Moreau, D Devos, S Vandolaeghe, L Defebvre
Amyotrophic lateral sclerosis (ALS) is not a curable disease, but it is treatable. By definition, much of the care provided to ALS patients is palliative, even though active life-sustaining strategies are available to prolong survival. Healthcare professionals must develop communication skills that help patients cope with the inexorable progression of the disease and the inevitability of death. Symptomatic treatments as well as respiratory insufficiency and nutritional life-sustaining therapies must be regularly evaluated as the disease progresses, without losing sight of the burden placed on the patient's non-professional caregivers...
May 4, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28477205/-advance-directives-in-clinical-practice-living-will-healthcare-power-of-attorney-and-care-directive
#14
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...
May 5, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28471796/advance-directives
#15
Deborah Hale, Katherine Marshall
No abstract text is available yet for this article.
May 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28471713/a-randomized-controlled-trial-comparing-the-letter-project-advance-directive-to-traditional-advance-directive
#16
Vyjeyanthi S Periyakoil, Eric Neri, Helena Kraemer
BACKGROUND: Simpler alternatives to traditional advance directives that are easy to understand and available in multiple formats and can be initiated by patients and families will help facilitate advance care planning. The goal of this study was to compare the acceptability of the letter advance directive (LAD) to the traditional advance directive (TAD) of the state of California. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: A web-based, randomized controlled trial was conducted, in which the participants were randomized to one of two types of advance directives (ADs): the LAD (intervention) or the TAD (control)...
May 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28467145/implementing-an-advance-care-planning-intervention-in-community-settings-with-older-latinos-a-feasibility-study
#17
Frances R Nedjat-Haiem, Iraida V Carrion, Krystyna Gonzalez, Alejandra Quintana, Kathleen Ell, Mary O'Connell, Beti Thompson, Shiraz I Mishra
BACKGROUND: Older Latinos with serious medical conditions such as cancer and other chronic diseases lack information about advance care planning (ACP). ACP Intervention (ACP-I Plan) was designed for informational and communication needs of older Latinos to improve communication and advance directives (ADs). OBJECTIVE: To determine the feasibility of implementing ACP-I Plan among seriously ill, older Latinos (≥50 years) in Southern New Mexico with one or more chronic diseases (e...
May 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28461544/family-presence-at-first-cardiopulmonary-resuscitation-and-subsequent-limitations-on-care-in-the-medical-intensive-care-unit
#18
Rebecca L Krochmal, John W Blenko, Majid Afshar, Giora Netzer, Susan C Roy, Debra L Wiegand, Carl B Shanholtz
BACKGROUND: The association of family-witnessed cardiopulmonary resuscitation (CPR) and subsequent advance directives in the medical intensive care unit is unknown. OBJECTIVE: To compare clinical outcomes, including subsequent limitations on care, of family-witnessed vs family-unwitnessed CPR in the inpatient setting. METHODS: Analysis of demographics and outcomes pertaining to family presence in a retrospective cohort of consecutive patients receiving first CPR in the medical intensive care unit of a tertiary academic medical center...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28456948/advance-care-planning-communication-oncology-patients-and-providers-voice-their-perspectives
#19
Jennifer L Bires, Elizabeth F Franklin, Helen M Nichols, John G Cagle
Advance care planning helps to ensure that patients' end-of-life preferences are understood and discussed with providers. It is an important component of patient-centered care, particularly when patients are facing life-limiting illness. It also has ethical implications for providers, yet evidence suggests that these conversations are not always occurring, particularly in underserved populations. The aim of this study was to understand the challenges and personal beliefs regarding ACP through interviews with patients undergoing active cancer treatment and their oncology providers...
April 29, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28452141/a-nurse-practitioner-led-community-workshop-increasing-adult-participation-in-advance-care-planning
#20
Erin Splendore, Catherine Grant
BACKGROUND AND PURPOSE: Advance directives (ADs) and advance care planning (ACP) aid in expressing an individual's preferences and guide future medical decision-making. Despite the potential of ADs and ACP to positively impact care, consistently low rates of ADs and ACP (5%-39%) have been documented. The purpose of this project was to increase understanding and participation in the ACP process among rural-dwelling community members. METHODS: A pre-post repeated measures design with an evaluation component to measure understanding, completion, discussion, and dissemination of ADs and ACP...
April 28, 2017: Journal of the American Association of Nurse Practitioners
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