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https://www.readbyqxmd.com/read/28537965/the-affordable-care-act-and-end-of-life-care-for-patients-with-cancer
#1
Ravi B Parikh, Alexi A Wright
The Affordable Care Act (ACA) expanded access to high-quality end-of-life care for Americans with serious illness, including cancer. Before the ACA was enacted in 2010, nearly 715,000 patients died in hospitals annually, despite evidence that most Americans prefer to die at home. Moreover, fewer than half of Medicare beneficiaries used hospice before death, despite evidence that hospice services improve cancer patients' quality of life near death and caregivers' bereavement outcomes. The ACA-stipulated programs and subsequent efforts were designed to address these deficiencies in access to high-quality end-of-life care...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28532723/self-reported-frequency-of-nurse-provided-spiritual-care
#2
Elizabeth Johnston Taylor, Iris Mamier, Patricia Ricci-Allegra, Joanne Foith
AIM: To describe how frequently RNs provide 17 spiritual care therapeutics (or interventions) during a 72-80h timeframe. BACKGROUND: Plagued by conceptual muddiness as well as weak methods, research quantifying the frequency of spiritual care is not only methodologically limited, but also sparse. METHODS: Secondary analysis of data from four studies that used the Nurse Spiritual Care Therapeutics Scale (NSCTS). Data from US American RNs who responded to online surveys about spiritual care were analyzed...
June 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#3
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#4
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/28527242/-small-cell-lung-cancer-associated-with-multiple-paraneoplastic-syndromes
#5
Diana L Franco, Leslie Thomas
We report the case of a patient presenting with multiple severe electrolyte disturbances who was subsequently found to have small cell lung cancer. Upon further evaluation, she demonstrated three distinct paraneoplastic processes, including the syndrome of inappropriate antidiuretic hormone, Fanconi syndrome, and an inappropriate elevation in fibroblast growth factor-23 (FGF23). The patient underwent one round of chemotherapy, but she was found to have progressive disease. After 36 days of hospitalization, the patient made the decision to enter hospice care and later she expired...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28523210/care-pathway-for-cancer-survivorship-in-korea-trend-of-breast-cancer-pathway-from-2003-to-2010
#6
Hwa Jeong Seo, Dong Yong Noh
OBJECTIVES: The survival rate of cancer patients has exceeded 60%. Although cancer survivors may die of other diseases except cancer, the health management system including chronic disease prevention-management for cancer survivors, has not been established in the diverse aspects. Therefore, services according to care pathway of cancer patients need to be provided through a support system based on a platform concept that can be used to meet patient needs in various ways. METHODS: A sample cohort database (2002-2010) of approximately 1 million persons-2% of the whole nation (50 million)-was used to estimate cancer survivors through a principal care pathway for cancer management...
April 2017: Healthcare Informatics Research
https://www.readbyqxmd.com/read/28514908/using-action-learning-sets-to-support-change-in-end-of-life-care
#7
Karen Gillett, Liz Reed, Liz Bryan
Purpose The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course. Design/methodology/approach The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period...
May 2, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28513869/transition-of-intravenous-treprostinil-to-oral-therapy-in-a-patient-with-functional-class-iv-chronic-thromboembolic-pulmonary-hypertension
#8
Kristina M Thurber, Breann M Williams, Ruth E Bates, Robert P Frantz
Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual CTEPH, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with CTEPH may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42-year-old man with T12 paraplegia complicated by CTEPH (functional class IV with substantial right ventricular dysfunction) and severe pressure ulcers...
May 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28511720/identifying-models-of-delivery-care-domains-and-quality-indicators-relevant-to-palliative-day-services-a-scoping-review-protocol
#9
Seán R O'Connor, Martin Dempster, Noleen K McCorry
BACKGROUND: With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services...
May 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28507429/factors-associated-with-the-attitudes-of-oncology-nurses-toward-hospice-care-in-china
#10
Fei-Min Yang, Zhi-Hong Ye, Lei-Wen Tang, Wei-Lan Xiang, Lin-Juan Yan, Min-Li Xiang
OBJECTIVE: To examine factors that are associated with the apprehension levels of oncology nurses toward hospice care. Factors examined in this study included demographics, nursing experience, education levels, title and post, personal experiences, and attitudes toward end-of-life care. METHODS: Questionnaires were provided to nurses (n=201) from three first-tier hospitals in China. A quantitative scale, Professional End-of-life Care Attitude Scale (PEAS), was used to assess personal and professional apprehension levels toward hospice care...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28506145/areas-of-control-desired-by-patients-and-families-referred-to-hospice-care-perspectives-of-hospice-admissions-staff
#11
Hyunjin Noh
Sense of control in end-of-life (EOL) care plays a critical role in the patient's well-being. However, little is known about the areas of control essential to patients and families at a specific time point in the illness trajectory: when patients stop curative treatments and are referred to hospice. This study qualitatively explored such areas. Sixteen admissions staff members from four hospice agencies were interviewed about their perceptions of areas in which patients and families worried about losing control by accepting hospice...
May 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28503542/role-of-physical-activity-in-mortality-prediction-in-elderly-hospice-patients
#12
Hye-Sang Park, Kyu-Tae Lee, Tae-Woon Kim
The prediction of life-expectancy in terminally ill patients is important both for medical and social reasons but it is widely recognized as being inaccurate. The aim of this study was to investigate the mortality predictors and indicators of life extension among elderly patients in a hospice service center. In order to determine the mortality predictors, we investigated the relationship between patients' cognitive status using the Korean-Mini Mental State Examination & Global Deterioration Scale (K-MMSE & GDS), the patient's physical function using the instrumental Activities of Daily Living (ADL) score, and the patient's blood component values...
April 2017: Journal of Exercise Rehabilitation
https://www.readbyqxmd.com/read/28502400/bags-batteries-and-boxes-a-qualitative-interview-study-to-understand-how-syringe-drivers-are-adapted-and-used-by-healthcare-staff
#13
Christopher James Vincent, Ann Blandford
Syringe drivers are medical devices that are critical for end of life care. They deliver continuous medication over extended periods of time. Their design contributes to the quality of experience for both patients and healthcare professionals. Little research has been published about the factors that influence the usability of this type of equipment for frontline users (i.e. those in direct contact with patients) and how equipment gets introduced. Understanding how syringe drivers are used in practice can help improve the design of equipment...
September 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28494634/changing-place-of-death-in-children-who-died-after-discharge-from-paediatric-intensive-care-units-a-national-data-linkage-study
#14
Lorna K Fraser, Sarah Fleming, Roger Parslow
BACKGROUND: Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. AIM: To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. DESIGN: National data linkage study. SETTING/PARTICIPANTS: All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28491911/navigating-long-term-care
#15
James D Holt
Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28489813/implementing-a-novel-model-for-hospice-and-palliative-care-in-the-emergency-department-an-experience-from-a-tertiary-medical-center-in-taiwan
#16
Tzu-Chieh Weng, Ya-Chun Yang, Ping-Jen Chen, Wen-Fu Kuo, Wei-Lin Wang, Ya-Ting Ke, Chien-Chin Hsu, Kao-Chang Lin, Chien-Cheng Huang, Hung-Jung Lin
Hospice and palliative care has been recognized as an essential part of emergency medicine; however, there is no consensus on the optimal model for the delivery of hospice and palliative care in the emergency department (ED). Therefore, we conducted a novel implementation in a tertiary medical center in Taiwan. In the preintervention period, we recruited a specialist for hospice and palliative medicine in the ED to lead our intervention. In the early stage of the intervention, starting on July 1, 2014, we encouraged and funded ED physicians and nurses to receive training for hospice and palliative medicine and residents of emergency medicine to rotate to the hospice ward...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28488910/methadone-induced-neurotoxicity-in-advanced-cancer-a-case-report
#17
Ann M Hoff, Kristopher N Hartwig, Drew A Rosielle
Methadone use as a second-line agent for severe cancer-related pain is increasing in the field of hospice and palliative care. It has a number of qualities that make its use favorable, including lack of known active metabolites and presumed relative safety from adverse effects such as opioid-induced neurotoxicity (OIN). This article describes a case of a patient undergoing treatment of severe cancer-related pain who developed OIN in the setting of oral methadone use. As the use of methadone increases, more research into its pharmacologic and pharmacokinetic properties will be necessary...
May 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28488523/story-in-numbers
#18
(no author information available yet)
Survey of UK children's hospices by the charity Together for Short Lives.
May 10, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28488485/staff-praised-for-help-after-stabbing
#19
(no author information available yet)
Two hospice nurses have been commended for coming to the aid of a woman who was stabbed in a knife attack.
May 10, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28486069/does-respite-care-address-the-needs-of-palliative-care-service-users-and-carers-their-perspectives-and-experiences
#20
Anna Wolkowski, Susan M Carr
AIM: To establish whether respite care addresses the needs of palliative care service users and carers. BACKGROUND: Respite care is often described in UK policy and guidance as a key need to providing support for this group and yet little is known about it and there is a lack of research to support its efficacy. DESIGN: The approach was qualitative and the methodology was interpretive. The method used was constructivist grounded theory. METHODS: Data collection was carried out by unstructured informal interview with three couples and two bereaved carers who had experienced hospice respite care...
April 2, 2017: International Journal of Palliative Nursing
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