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https://www.readbyqxmd.com/read/27912043/palliative-care-interventions-for-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#1
Michelle S Diop, James L Rudolph, Kristin M Zimmerman, Mary A Richter, L Michal Skarf
OBJECTIVE: To systematically characterize interventions and effectiveness of palliative care for advanced heart failure (HF) patients. BACKGROUND: Patients with advanced heart failure experience a high burden of distressing symptoms and diminished quality of life. Palliative care expertise with symptom management and healthcare decision-making benefits HF patients. METHODS: A systematic PubMed search was conducted from inception to June 2016 for studies of palliative care interventions for HF patients...
December 2, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893951/events-leading-to-hospital-related-disenrollment-of-home-hospice-patients-a-study-of-primary-caregivers-perspectives
#2
Veerawat Phongtankuel, Shawn Paustian, Manney Carrington Reid, Amanda Finley, Angela Martin, John Delfs, Rosemary Baughn, Ronald D Adelman
BACKGROUND: Approximately 25% of hospice disenrollments in the United States occur as the result of hospitalization, which can lead to burdensome transitions and undesired care. Informal caregivers (e.g., spouses, children) play a critical role in caring for patients on home hospice. Research examining hospital-related disenrollment among these patients is limited. OBJECTIVE: To understand the events surrounding the hospitalization of patients discharged from home hospice through the perspective of their informal caregivers...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27885907/the-challenges-of-implementing-a-multi-centre-audit-of-end-of-life-care-in-care-homes
#3
Jean Levy, Julie Kinley, Frances Conway
AIMS: This article aims to share the experience of a hospice in facilitating a multi-centre audit of end-of-life care in care homes, particularly noting the challenges and enablers of carrying out the audit. METHODS: The audit was a retrospective multi-centre survey of bereaved relatives/next of kin of residents who died in the care home, using an anonymous, validated questionnaire: the Family Perception of Care Scale. Questionnaires were sent 3-months after bereavement...
November 2, 2016: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/27865257/pain-and-social-processes-for-hospice-cancer-patients-an-integrative-review
#4
REVIEW
Olga Ehrlich, Rachel K Walker
PURPOSE: Hospice cancer patients experience poorly-controlled pain in spite of widely-disseminated evidence-based guidelines for use by hospice care practitioners. Pain management occurs in the context of the interdisciplinary team, centered on a caring triad in the home: the person with pain, their caregiver, and their nurse. This review: 1) Summarizes what is known about differing ways that members of the hospice caring triad (patients, caregivers, and nurses) interpret and respond to cancer pain, in order to develop a cancer pain social processes theoretical framework, 2) Identifies gaps in understanding of hospice cancer pain social processes, and 3) Identifies framework concepts for research-based clinical practice with potential to improve pain outcomes...
December 2016: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/27834750/baseline-predictors-of-poor-outcome-in-patients-too-good-to-treat-with-intravenous-thrombolysis
#5
Syed F Ali, Khawja Siddiqui, Hakan Ay, Scott Silverman, Aneesh Singhal, Anand Viswanathan, Natalia Rost, Michael Lev, Lee H Schwamm
BACKGROUND AND PURPOSE: Several studies have reported poor outcomes in patients too good to treat with intravenous thrombolysis because of mild or rapidly improving symptoms. We sought to determine baseline clinical and imaging predictors of poor outcome in these patients. METHODS: Among 3950 consecutive stroke admissions (2009-2015) in our local Get With the Guidelines-Stroke database, 632 patients presented ≤4.5 hours and did not receive tissue-type plasminogen activator, with 380 of 632 (60...
November 10, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27820595/the-relationship-between-index-hospitalizations-sepsis-and-death-or-transition-to-hospice-care-during-30-day-hospital-readmissions
#6
Brett W Dietz, Tiffanie K Jones, Dylan S Small, David F Gaieski, Mark E Mikkelsen
BACKGROUND: Hospital readmissions are common, expensive, and increasingly used as a metric for assessing quality of care. The relationship between index hospitalizations and specific outcomes among those readmitted remains largely unknown. OBJECTIVES: Identify risk factors present during the index hospitalization associated with death or transition to hospice care during 30-day readmissions and examine the contribution of infection in readmissions resulting in death...
November 4, 2016: Medical Care
https://www.readbyqxmd.com/read/27815169/caring-for-dying-patients-in-the-nursing-home-voices-from-frontline-nursing-home-staff
#7
John G Cagle, Kathleen T Unroe, Morgan Bunting, Brittany Bernard, Susan C Miller
CONTEXT: Nursing homes are an important site for end of life care, yet little is known about the perspectives of the front line staff who provide a majority of this care. OBJECTIVE: To describe, from the staff perspective, positive/negative experiences related to caring for dying residents. METHODS: Qualitative analysis using survey data from staff working in 52 Indiana nursing homes. PARTICIPANTS: 707 frontline staff who provide nursing, nurse aide and social work services responded to open-ended prompts...
November 1, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27813718/how-home-hospice-care-facilitates-patient-and-family-engagement
#8
Ellis C Dillon
Little is known about how patient and family engagement manifests in home hospice care. This qualitative study included interviews and observation of home hospice care with 18 patients, 11 caregivers, and 26 hospice workers in the United States. Structural factors (e.g., home setting, ample time, personal relationships), hospice worker strategies (e.g., patient education and presenting choices), and family member support facilitated engagement. Barriers to engagement included difficult relationships and unavailable or unwilling family members...
November 4, 2016: Death Studies
https://www.readbyqxmd.com/read/27807156/subcutaneous-infusion-of-fluids-for-hydration-or-nutrition-a-review
#9
REVIEW
Riccardo Caccialanza, Thierry Constans, Paolo Cotogni, Gary P Zaloga, Alessandro Pontes-Arruda
Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small-gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route...
November 2, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27801708/pediatric-critical-care-transport-as-a-conduit-to-terminal-extubation-at-home-a-case-series
#10
Corina Noje, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Sapna R Kudchadkar
OBJECTIVES: To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. DESIGN: We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. SETTING: All cases were identified from our institutional pediatric transport database. PATIENTS: Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes...
October 28, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27798016/supporting-the-provision-of-palliative-care-in-the-home-environment-a-proof-of-concept-single-arm-trial-of-a-palliative-carers-education-package-precept
#11
Liz Forbat, Erna Haraldsdottir, Marsha Lewis, Ken Hepburn
INTRODUCTION: Practical educational interventions for palliative carers are needed. Current supports frequently rely on carers travelling to a central venue to receive education. A substantial gap therefore exists around determining how high-quality relevant information can be delivered nationally, with limited cost implications, using educational methods that are acceptable to carers in palliative care. This study seeks to design and assess feasibility and acceptability of a distance-learning approach to educating carers...
October 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/27793144/family-and-healthcare-professionals-perceptions-of-a-pilot-hospice-at-home-programme-for-children-a-qualitative-study
#12
Maria Brenner, Michael Connolly, Des Cawley, Frances Howlin, Jay Berry, Claire Quinn
BACKGROUND: Parents commonly report a significant improvement in quality of life following the provision of hospice and supportive care and have identified a need for such a service in the home. The purpose of this study was to understand the experiences of families receiving a nurse led pilot hospice at home programme and the experiences of healthcare professionals delivering and engaging with the programme. METHODS: An exploratory, qualitative study was conducted, including telephone interviews with parents and focus groups and individual interviews with healthcare professionals...
October 28, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27788655/an-overview-of-the-challenges-facing-care-homes-in-the-uk
#13
Carol Cousins, Ruth Burrows, Gary Cousins, Eileen Dunlop, Gary Mitchell
Care homes are an increasingly important part of the UK's healthcare system. Despite their importance, particularly in providing care for older people with complex needs, the sector is often disadvantaged and overlooked by commissioners, policymakers and researchers. The authors provide an overview of some important challenges for the sector. These challenges relate to funding, education and research, overseas staff, career pathways and staff recruitment and retention. They conclude that recruitment and retention of registered nurses is arguably the greatest challenge, as high staff turnover is the catalyst for other challenges identified...
October 28, 2016: Nursing Older People
https://www.readbyqxmd.com/read/27776986/reliability-and-validity-of-the-resistiveness-to-care-scale-among-cognitively-impaired-older-adults
#14
Elizabeth Galik, Barbara Resnick, Erin Vigne, Sarah Dee Holmes, Victoria Nalls
BACKGROUND: Resistiveness to care is behavior that prevents or interferes with caregivers' performing or assisting with activities of daily living and puts residents at risk for inappropriate use of antipsychotic drugs, other restraining interventions, social isolation, and physical abuse. The purpose of this study was to establish the psychometric properties of a previously developed Resistiveness to Care measure. PROCEDURES: This was a descriptive study using baseline data from an ongoing randomized controlled trial testing a Function and Behavior Focused Care (FBFC) intervention...
October 21, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27770068/death-with-dignity-in-washington-patients-with-amyotrophic-lateral-sclerosis
#15
Leo H Wang, Michael A Elliott, Lily Jung Henson, Elba Gerena-Maldonado, Susan Strom, Sharon Downing, Jennifer Vetrovs, Paige Kayihan, Piper Paul, Kate Kennedy, Joshua O Benditt, Michael D Weiss
OBJECTIVES: To describe the amyotrophic lateral sclerosis (ALS) patients who sought medication under the Washington State Death with Dignity (DWD) Act since its inception in 2009. METHODS: Chart review at 3 tertiary medical centers in the Seattle/Puget Sound region and comparison to publicly available data of ALS and all-cause DWD cohorts from Washington and Oregon. RESULTS: In Washington State, 39 patients with ALS requested DWD from the University of Washington, Virginia Mason, and Swedish Medical Centers beginning in 2009...
November 15, 2016: Neurology
https://www.readbyqxmd.com/read/27763390/vsed-at-home-with-hospice-the-experiences-of-a-husband-and-daughter
#16
Elizabeth Keller Jose, William S Jose
No abstract text is available yet for this article.
2016: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/27754758/sex-and-age-interactions-and-differences-in-outcomes-after-intracerebral-hemorrhage
#17
Michael L James, Margueritte Cox, Ying Xian, Eric E Smith, Deepak L Bhatt, Phillip J Schulte, Adrian Hernandez, Gregg C Fonarow, Lee H Schwamm
BACKGROUND: Compared to ischemic stroke, sex differences in response to intracerebral hemorrhage (ICH) are largely unexplored, and their potential interactions with patient age have not been examined. This study hypothesized that risk for poor outcome is greater in women with increasing age. METHODS AND RESULTS: The Get With The Guidelines(®)-Stroke database was used to assess differences between men and women with ICH. Data from 192,826 ICH patients admitted from January 1, 2009 through March 31, 2014 to 1,728 fully participating sites were analyzed using logistic regression to test interactions between age/sex and outcome...
October 18, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27720662/inappropriate-fentanyl-prescribing-among-nursing-home-residents-in-the-united-states
#18
Kevin M Fain, Carlos Castillo-Salgado, David D Dore, Jodi B Segal, Andrew R Zullo, G Caleb Alexander
OBJECTIVE: We quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naïve prescribing. DESIGN: Cross-sectional study. SETTING: Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. PARTICIPANTS: From a cross-section of all long-stay US nursing home residents in 2008 with an MDS assessment and Medicare Part D enrollment, we identified individuals (≥65 years old) who initiated transdermal fentanyl, excluding those with Alzheimer disease, severe cognitive impairment, cancer, or receipt of hospice care...
October 6, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27697783/conservative-management-and-end-of-life-care-in-an-australian-cohort-with-esrd
#19
Rachael L Morton, Angela C Webster, Kevin McGeechan, Kirsten Howard, Fliss E M Murtagh, Nicholas A Gray, Peter G Kerr, Michael J Germain, Paul Snelling
BACKGROUND AND OBJECTIVES: We aimed to determine the proportion of patients who switched to dialysis after confirmed plans for conservative care and compare survival and end of life care among patients choosing conservative care with those initiating RRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A cohort study of 721 patients on incident dialysis, patients receiving transplants, and conservatively managed patients from 66 Australian renal units entered into the Patient Information about Options for Treatment Study from July 1 to September 30, 2009 were followed for 3 years...
October 3, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27697564/continuous-home-care-reduces-hospice-disenrollment-and-hospitalization-after-hospice-enrollment
#20
Shi-Yi Wang, Melissa D Aldridge, Maureen Canavan, Emily Cherlin, Elizabeth Bradley
OBJECTIVES: To identify hospice and patient characteristics associated with the use of continuous home care (CHC), and to examine the associations between CHC utilization and hospice disenrollment or hospitalization after hospice enrollment. METHODS: Using 100% fee-for-service Medicare claims data for beneficiaries aged 66 years or older who died between July and December 2011, we identified the percentage of hospice agencies in which patients used CHC in 2011 and determined hospice and patient characteristics associated with use of CHC...
September 30, 2016: Journal of Pain and Symptom Management
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