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https://www.readbyqxmd.com/read/29027836/developing-macroindicators-of-palliative-care-development-in-africa-a-process-with-in-country-and-international-experts
#1
John Y Rhee, Eduardo Garralda, Eve Namisango, Emmanuel Luyirika, Liliana de Lima, Richard A Powell, Carlos Centeno
BACKGROUND: Indicators specific to the African context are important to measure palliative care (PC) development accurately. OBJECTIVE: To describe the process used to develop a set of PC macroindicators for Africa. DESIGN: Open-ended interviews on national PC development were conducted with five African Country Experts. Indicators were rated (1-4) by 14 Country Experts for validity and feasibility. An additional 11 interviews were conducted to ensure indicator saturation...
October 13, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29023625/readily-identifiable-risk-factors-of-nursing-home-residents-oral-hygiene-dementia-hospice-and-length-of-stay
#2
Sheryl Zimmerman, Sophie Austin, Lauren Cohen, David Reed, Patricia Poole, Kimberly Ward, Philip D Sloane
BACKGROUND/OBJECTIVES: The poor oral hygiene of nursing home (NH) residents is a matter of increasing concern, especially because of its relationship with pneumonia and other health events. Because details and related risk factors in this area are scant and providers need to be able to easily identify those residents at most risk, this study comprehensively examined the plaque, gingival, and denture status of NH residents, as well as readily available correlates of those indicators of oral hygiene, including items from the Minimum Data Set (MDS)...
October 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29017018/what-is-the-impact-of-population-ageing-on-the-future-provision-of-end-of-life-care-population-based-projections-of-place-of-death
#3
Anna E Bone, Barbara Gomes, Simon N Etkind, Julia Verne, Fliss Em Murtagh, Catherine J Evans, Irene J Higginson
BACKGROUND: Population ageing represents a global challenge for future end-of-life care. Given new trends in place of death, it is vital to examine where the rising number of deaths will occur in future years and implications for health and social care. AIM: To project where people will die from 2015 to 2040 across all care settings in England and Wales. DESIGN: Population-based trend analysis and projections using simple linear modelling...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28990397/examining-the-role-of-primary-care-physicians-and-challenges-faced-when-their-patients-transition-to-home-hospice-care
#4
Ariel Shalev, Veerawat Phongtankuel, Katherine Lampa, M C Reid, Brian M Eiss, Sonica Bhatia, Ronald D Adelman
BACKGROUND: The transition into home hospice care is often a critical time in a patient's medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care. OBJECTIVES: To understand PCPs' experiences, challenges, and preferences when their patients transition to home hospice care...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28988735/identifying-advanced-illness-patients-in-the-emergency-department-and-having-goals-of-care-discussions-to-assist-with-early-hospice-referral
#5
Tara Liberman, Andrzej Kozikowski, Nancy Kwon, Brian Emmert, Meredith Akerman, Renee Pekmezaris
BACKGROUND: The emergency department (ED) is often where patients with advanced illness (AI) present when faced with an acute deterioration in their disease. OBJECTIVES: To investigate the effectiveness of our AI Management program in the ED on key outcomes. METHODS: We conducted a pre-post study with a retrospective chart review with ED patients at an academic, tertiary care hospital in the New York metropolitan area. We assessed changes from baseline to intervention period on percent of patients identified in the ED with AI, percent who received an ED-led goals-of-care (GOC) discussion, and percent referred to hospice from the ED...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28983996/gps-assessment-of-cooperation-with-other-health-care-providers-involved-in-cancer-care-a-cross-sectional-study
#6
I Koné, G Klein, A Siebenhofer, A Dahlhaus, C Güthlin
Cancer is a complex disease requiring the involvement of several health care providers. A possible constant in the cancer care process is the general practitioner (GP). The aim of this project was to evaluate GPs' satisfaction with cooperation with other health care providers in the cancer care process of their patients and to explore which variables are associated with higher satisfaction with cooperation with other health care providers. We considered the following health care providers: outpatient oncology specialists, physicians in relatively small hospitals (≤400 beds), physicians in relatively large hospitals (>400 beds), home care services, outpatient psycho(onco)logists/psychotherapists, hospice/palliative care units and specialised palliative home care...
October 6, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28980071/prevalence-of-delirium-in-advanced-cancer-patients-in-home-care-and-hospice-and-outcomes-after-1%C3%A2-week-of-palliative-care
#7
Sebastiano Mercadante, Francesco Masedu, Isabella Balzani, Daniela De Giovanni, Luigi Montanari, Cristina Pittureri, Raffaella Bertè, Domenico Russo, Laura Ursini, Franco Marinangeli, Federica Aielli
AIM: The aim of this study was to assess the prevalence of delirium in advanced cancer patients admitted to different palliative care services in Italy and possible related factors. The secondary outcome was to assess the changes of delirium after 1 week of palliative care. METHODS: A consecutive sample of patients was screened for delirium in period of 1 year in seven palliative care services. General data, including primary tumor, age, gender, concomitant disease, palliative prognostic score (PaP), and Karnofsky status, were collected...
October 5, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28979824/when-the-opioid-medications-go-missing-confidentiality-and-safety-in-adolescents
#8
Muhammad Hassan Majeed
Patients receiving end-of-life or palliative care usually possess an ample supply of opioid pain medications to help alleviate their pain. The risk of these drugs being diverted is high because such patients often have an excess of these medications, and because they are typically unable to manage medications themselves. For example, adolescents might steal these medications for recreational use. The author presents a case in which a minor admitted stealing and using opioid pain medication belonging to her mother, who was in hospice home care...
May 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28978301/dying-comfortably-in-very-old-age-with-or-without-dementia-in-different-care-settings-a-representative-older-old-population-study
#9
Jane Fleming, Rowan Calloway, Anouk Perrels, Morag Farquhar, Stephen Barclay, Carol Brayne
BACKGROUND: Comfort is frequently ranked important for a good death. Although rising numbers of people are dying in very old age, many with dementia, little is known about symptom control for "older old" people or whether care in different settings enables them to die comfortably. This study aims to examine, in a population-representative sample, associations between factors potentially related to reported comfort during very old people's final illness: physical and cognitive disability, place of care and transitions in their final illness, and place of death...
October 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28974462/quality-hospice-care-in-adult-family-homes-barriers-and-facilitators
#10
Karla T Washington, George Demiris, Debra Parker Oliver, Gemille Purnell, Paul Tatum
OBJECTIVES: Older adults in need of residential services are increasingly spending their final days in small, domestic-style care settings such as adult family homes. In this study, we sought to identify processes that facilitated the provision of quality hospice care to seriously ill residents of adult family homes and their family members. DESIGN: We conducted a secondary analysis of qualitative data collected as part of a randomized clinical trial of a problem-solving intervention for family members of hospice patients...
September 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28964559/communication-among-cancer-patients-caregivers-and-hospice-nurses-content-process-and-change-over-time
#11
Lee Ellington, Margaret F Clayton, Maija Reblin, Gary Donaldson, Seth Latimer
OBJECTIVE: First, to describe communication of home hospice nurse visits to cancer patient-caregiver dyads. Second, to assess change in communication related to domains of care over the course of visits. METHODS: Multi-site prospective observational longitudinal study of audio-recorded home hospice visits (N=537 visits; 101 patient-caregiver dyads; 58 nurses). Communication was coded using the Roter Interaction Analysis System to describe content and process. Conversation representing three care domains (physical, psychosocial/daily life, and emotional) was calculated from RIAS categories across speakers and analyzed to assess change in communication over time...
September 22, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28957486/admissions-to-inpatient-care-facilities-in-the-last-year-of-life-of-community-dwelling-older-people-in-europe
#12
Anouk Overbeek, Lieve Van den Block, Ida J Korfage, Yolanda W H Penders, Agnes van der Heide, Judith A C Rietjens
Background: In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). Methods: Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life...
October 1, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28953539/end-of-life-care-for-ww-ii-korea-and-vietnam-era-veterans
#13
Brenda Elliott
Military Veterans have made many sacrifices for our country and deserve high-quality care at end of life. The purpose of this article is to discuss the WW II, Korean and Vietnam Veteran population, and common concerns at the end of life. Areas of focus include spiritual and emotional needs, posttraumatic stress disorder, and pain management. Understanding of military/Veteran culture, the stoic mindset, and moral injury may provide foundational knowledge for nonmilitary home care and hospice clinicians to understand Veteran patients and their families...
October 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28950683/symptom-clusters-and-quality-of-life-in-hospice-patients-with-cancer
#14
Suha Omran, Yousef Khader, Susan McMillan
Background: Symptom control is an important part of palliative care and important to achieve optimal quality of life (QOL). Studies have shown that patients with advanced cancer suffer from diverse and often severe physical and psychological symptoms. The aim is to explore the influence of symptom clusters on QOL among patients with advanced cancer. Materials and Methods: 709 patients with advanced cancer were recruited to participate in a clinical trial focusing on symptom management and QOL. Patients were adults newly admitted to hospice home care in one of two hospices in southwest Florida, who could pass mental status screening...
September 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28949793/medication-use-in-the-last-days-of-life-in-hospital-hospice-and-home-settings-in-the-netherlands
#15
Jimmy J Arevalo, Eric C T Geijteman, Bregje A A Huisman, Marianne K Dees, Wouter W A Zuurmond, Lia van Zuylen, Agnes van der Heide, Roberto S G M Perez
BACKGROUND: The purpose of medication management in the last days of life is to optimize patient's comfort. Little is known about the medication use in the days before death and how this relates to the care setting. OBJECTIVE: To describe medication use in the last week of life for patients dying in hospital, hospice, and home settings in the Netherlands. DESIGN: Retrospective chart review study. SETTING: A convenience sample of patient records from the three settings in three different regions in the Netherlands that cover more than half the country...
September 26, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28945629/critical-care-resource-utilization-and-outcomes-of-children-with-moderate-traumatic-brain-injury
#16
Theerada Chandee, Vivian H Lyons, Monica S Vavilala, Vijay Krishnamoorthy, Nophanan Chaikittisilpa, Arraya Watanitanon, Abhijit V Lele
OBJECTIVES: To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: National Trauma Data Bank. PATIENTS: Children under 18 years old with a diagnosis of moderate traumatic brain injury (admission Glasgow Coma Scale score of 9-13) in the National Trauma Data Bank between 2007 and 2014. MEASUREMENT AND MAIN RESULTS: We examined clinical characteristics, critical care resource utilization, and discharge outcomes...
September 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28945507/physician-behavior-toward-death-pronouncement-in-palliative-care-units
#17
Yutaka Hatano, Tatsuya Morita, Hiroyuki Otani, Naoko Igarashi, Yasuo Shima, Mitsunori Miyashita
BACKGROUND: There are few studies on bereaved caregivers' perceptions of physician behavior toward death pronouncement. Although previous research indicates that most caregivers are satisfied with physician behavior toward death pronouncement at home hospices, bereaved caregivers' perceptions of death pronouncement in palliative care units (PCUs) have not been investigated. OBJECTIVE: The aim was to examine bereaved caregivers' perceptions of physician behavior toward death pronouncement in PCUs...
September 25, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28942746/rapid-autopsy-of-a-patient-with-recurrent-anaplastic-ependymoma
#18
Katharine Rae Lange, Cheryl Fischer, Prajwal Rajappa, Scott Connors, David Pisapia, Jeffrey P Greenfield, Himisha Beltran, Mark Rubin, Juan Miguel Mosquera, Yasmin Khakoo
OBJECTIVE: Our aim was to outline a procedure for obtaining a rapid autopsy in order to collect high-quality postmortem tissue for genomic analysis. METHODS: This report details a bi-institutional collaborative effort to coordinate a rapid autopsy for a pediatric patient who had died at home. We discuss the scientific rationale for offering a rapid autopsy to caregivers of pediatric patients as well as parental perspectives on broaching the subject of autopsy. We then review the logistics and coordination involved with planning a rapid autopsy and the sequence of events needed to maximize tissue quality...
September 25, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28941964/unmet-palliative-care-needs-among-patients-with-end-stage-kidney-disease-a-national-registry-study-about-the-last-week-of-life
#19
Lena Axelsson, Anette Alvariza, Jenny Lindberg, Joakim Öhlén, Cecilia Håkanson, Helene Reimertz, Carl-Johan Fürst, Kristofer Årestedt
CONTEXT: End-stage kidney disease (ESKD) is characterized by high physical and psychological burden and therefore, more knowledge about the palliative care provided close to death is needed. OBJECTIVES: To describe symptom prevalence, relief and management during the last week of life, as well as end-of-life communication, in patients with ESKD. METHODS: This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (ICD-10-SE; N18...
September 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28941298/symptom-management-and-psychological-support-for-families-are-the-cornerstones-of-end-of-life-care-for-children-with-spinal-muscular-atrophy-type-1
#20
Chiara Di Pede, Caterina Agosto, Valentina De Tommasi, Alessandra De Gregorio, Franca Benini
AIM: This study described end-of-life care for children affected by spinal muscular atrophy type 1 (SMA1), which is characterised by progressive muscle weakness and develops in the first six months of life. METHODS: We retrospectively analysed 17 children (13 boys) who attended the University of Padua's paediatric palliative care centre in Italy from March 2000 to March 2015. All the children received supportive care without proactive respiratory intervention to prolong survival...
September 23, 2017: Acta Paediatrica
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