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Hospice Palliative Care

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https://www.readbyqxmd.com/read/28063867/-it-s-like-heart-failure-it-s-chronic%C3%A2-and-it-will-kill-you-a-qualitative-analysis-of-burnout-among-hospice-and-palliative-care-clinicians
#1
Dio Kavalieratos, Daniel E Siconolfi, Karen E Steinhauser, Janet Bull, Robert M Arnold, Keith M Swetz, Arif H Kamal
CONTEXT: Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. OBJECTIVES: We explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28063859/assessing-palliative-care-content-in-dementia-care-guidelines-a-systematic-review
#2
REVIEW
Pamela Durepos, Abigail Wickson-Griffiths, Afeez Abiola Hazzan, Sharon Kaasalainen, Vasilia Vastis, Lisa Battistella, Alexandra Papaioannou
CONTEXT: Families of persons with dementia continue to report unmet needs during end-of-life. Strategies to improve care and quality of life for persons with dementia include development of clinical practice guidelines (CPG) and an integrative palliative approach. OBJECTIVES: We aimed to assess palliative care content in dementia CPGs in order to identify the presence or limitations of recommendations and discussion pertaining to common issues or domains affected by illness as described by the Canadian Hospice Palliative Care 'Square of Care'...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062473/treatment-targeted-at-underlying-disease-versus-palliative-care-in-terminally-ill-patients-a-systematic-review
#3
Tea Reljic, Ambuj Kumar, Farina A Klocksieben, Benjamin Djulbegovic
OBJECTIVE: To assess the efficacy of active treatment targeted at underlying disease (TTD)/potentially curative treatments versus palliative care (PC) in improving overall survival (OS) in terminally ill patients. DESIGN: We performed a systematic review and meta-analysis of randomised controlled trials (RCT). Methodological quality of included RCTs was assessed using the Cochrane risk of bias tool. DATA SOURCES: Medline and Cochrane databases were searched, with no language restriction, from inception to 19 October 2016...
January 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28056515/race-ethnicity-as-a-predictor-for-location-of-death-in-patients-with-acute-neurovascular-events
#4
Say Salomon, Elizabeth Chuang, Deepa Bhupali, Daniel Labovitz
BACKGROUND: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. METHODS: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056514/race-as-a-predictor-of-palliative-care-referral-time-hospice-utilization-and-hospital-length-of-stay
#5
Brooke Worster, Declan Kennedy Bell, Vibin Roy, Amy Cunningham, Marianna LaNoue, Susan Parks
BACKGROUND: Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services. OBJECTIVE: To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients' overall hospital length of stay among patients of an inpatient palliative care service...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28043807/on-the-ground-floor-looking-up-managing-trainees-uncertainty-at-the-end-of-life
#6
Ravi B Parikh, Dhruv Khullar
Recent US healthcare policy changes set the stage for integrating palliative and end-of-life care into routine medicine. However, these changes may not affect the daily practice of medical trainees-fellows, residents, and medical students-who as front-line care providers are not always equipped with the skills needed to treat terminally ill patients. We review evidence on trainees' discomfort with end-of-life care and highlight limitations of recent policy changes. Key barriers to proficiency include inadequate conversational training, prognostic uncertainty, and unfamiliarity with hospice and palliative care...
December 30, 2016: Healthcare
https://www.readbyqxmd.com/read/28042068/empowering-bereaved-parents-through-the-development-of-a-comprehensive-bereavement-program
#7
Jennifer M Snaman, Erica C Kaye, Deena R Levine, Brittany Cochran, Robin Wilcox, Charlene K Sparrow, Nancy Noyes, Lisa Clark, Wendy Avery, Justin N Baker
Parents who experience the loss of a child have unique and valuable insights into the grief journey and can help healthcare providers identify key components intrinsic to the development, implementation, and maintenance of a comprehensive bereavement program. The bereavement program at St. Jude Children's Research Hospital was developed by pediatric palliative care experts in collaboration with bereaved parents to standardize and improve the institutional support provided to families around and after the death of a child...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28042066/repurposing-medications-for-hospice-palliative-care-symptom-control-is-no-longer-sufficient-a-manifesto-for-change
#8
David C Currow, Amy P Abernethy, Marie Fallon, Russell K Portenoy
The World Health Organisation (WHO) essential medications list for hospice / palliative care reflects that, with the judicious use of currently available medications, the majority of symptoms can be lessened, and some controlled completely. Even with optimal use of current medications, symptom control is still unacceptable for many people. Currently available medications offer great benefit to a minority of patients, some benefit to an additional group, and no benefit or harms to others. In symptom control, development of new drugs is advancing at a glacial pace, contrasting to the rapid advances seen in many other disciplines...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28039504/end-of-life-care-for-head-and-neck-cancer-patients-a-population-based-study
#9
Tzu-Lung Kuo, Ching-Heng Lin, Rong-San Jiang, Ting-Ting Yen, Chen-Chi Wang, Kai-Li Liang
PURPOSE: Head and neck cancers (HNCs) usually present a poor prognosis and cause high morbidity rates. Recent surveys have demonstrated that HNC incidence rates are still on the increase in many countries. Our study objective was to assess the end-of-life care for patients with HNCs in Taiwan. METHODS: Data was retrieved from Taiwan's National Health Insurance Research Database, where we identified patients who had been diagnosed with HNCs from January 1997 to December 2010...
December 30, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28029300/hospice-utilization-and-its-effect-on-acute-care-needs-at-the-end-of-life-in-medicare-beneficiaries-with-hepatocellular-carcinoma
#10
Hanna K Sanoff, YunKyung Chang, Melissa Reimers, Jennifer L Lund
INTRODUCTION: Hepatocellular carcinoma (HCC) is a poor-prognosis cancer with a high symptom burden. Multidisciplinary HCC care is complex and unique in cancer medicine. We sought to determine whether the distinct process affects hospice use and how hospice affects end-of-life acute care utilization. PATIENTS AND METHODS: Patients dying after HCC diagnosed from 2004 to 2011 were identified within SEER-Medicare. Hospice use and associated factors were described using logistic regression...
December 28, 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28025631/amniotic-band-syndrome-perinatal-hospice-and-palliative-care-versus-active-management
#11
Shadi Rezai, Justin Faye, Annika Chadee, Sri Gottimukkala, Ruchi Upadhyay, Carla Lara, Benamanahalli H Rajegowda, Andrew D Corwin, Rasila V Lala, Jessica Vernon, Dilfuza Nuritdinova, Stephen Chasen, Cassandra E Henderson
Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28018868/pediatric-palliative-care-in-canada-in-2012-a-cross-sectional-descriptive-study
#12
Kimberley Widger, Dawn Davies, Adam Rapoport, Christina Vadeboncoeur, Stephen Liben, Amrita Sarpal, Simone Stenekes, Claude Cyr, Lysanne Daoust, Marie-Claude Grégoire, Marli Robertson, Heather Hodgson-Viden, Julie Laflamme, Harold Siden
BACKGROUND: Pediatric palliative care focuses on comprehensive symptom management and enhancing quality of life for children with life-threatening conditions and their families. Our aim was to describe Canadian programs that provided specialized pediatric palliative care in 2012 and the children who received it and to estimate the proportion of children who might benefit that received specialized care. METHODS: A cross-sectional descriptive design was used. Specialized pediatric palliative care programs were included in the study if they offered multidisciplinary consulting pediatric palliative care services to a wide range of children and served all populations of children with life-threatening illness regardless of diagnosis...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28001466/the-intensive-palliative-care-unit-changing-outcomes-for-hospitalized-cancer-patients-in-an-academic-medical-center
#13
Haipeng Zhang, Constance Barysauskas, Elizabeth Rickerson, Paul Catalano, Joseph Jacobson, Carol Dalby, Charlotta Lindvall, Kathy Selvaggi
BACKGROUND: Patients with advanced cancer often require complex symptom management. At Dana-Farber/Brigham and Women's Cancer Center, the intensive palliative care unit (IPCU) admits symptomatic oncology patients with uncontrolled symptoms throughout the trajectory of illness. Patients are uniquely managed by an interdisciplinary team of clinicians who focus on symptom management and advance care planning. OBJECTIVE: The purpose of our analysis was to investigate goals-of-care outcomes and healthcare utilization after admission to the IPCU...
December 21, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28000411/the-role-of-radiation-therapy-in-palliative-care-of-children-with-advanced-cancer-clinical-outcomes-and-patterns-of-care
#14
Sumeeta Varma, Debra L Friedman, Mark J Stavas
BACKGROUND: There are few published data to guide the use and timing of palliative radiation therapy (RT) in children. We aimed to determine the clinical outcomes of palliative RT in children and the relationship with palliative care and hospice referrals. PROCEDURE: A retrospective chart review was performed on all patients younger than 18 years who received palliative RT in our clinic from January 2005 to January 2015. RESULTS: In the specified time period, 50 children underwent 83 courses of palliative RT...
December 21, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27995269/-new-legal-regulations-for-palliative-care-with-implications-for-politics-and-practice
#15
Heiner Melching
In December 2015 two different laws were adopted. Both are of importance for palliative care. One of the laws criminalizes commercial, "business-like" assisted suicide (§ 217 German Criminal Code), the other one aims to improve hospice and palliative care in Germany. Through the latter far-reaching changes in Social Code Books V and XI, as well as of the Hospital Finance Act have been made. This new Act to Improve Hospice and Palliative Care (HPG) focuses, amongst others, on: (a) Better funding of hospice services, by raising the minimum grant for patients in inpatient hospices paid per day by the health insurance funds by about 28...
January 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27976624/palliative-care-for-dementia-patients
#16
France Hirot
Dementia is a life-limiting disease without curative treatments but the data suggest that advanced dementia is not viewed as a terminal diagnosis by physicians. Although symptoms of dementia and cancer patients are similar, palliative care is less frequently proposed for dementia patients. However, professionals and family members of demented patients strongly favor comfort care for end-stage dementia. To improve the patients' relief near the end of life, advance care planning with patients and their proxies should be encouraged...
December 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/27969036/description-of-good-patient-care-at-the-end-of-life
#17
Sanghee Kim, Minjeong Seo
OBJECTIVES: The study's objective was to describe nurses' perceptions of and experiences with good end-of-life care in Korea. METHODS: A qualitative descriptive design was applied with 11 Korean nurses who worked in hospice and palliative care settings. Individual 90-120 minute interviews were conducted and content analysis was performed. RESULTS: The following four major themes were extracted from questions regarding nurses' experiences of good end-of-life care: 1) providing appropriate care for symptom management, 2) being present, 3) establishing good relationships, and 4) tailoring care for individualized needs...
November 2016: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/27965885/evaluation-of-the-effectiveness-of-music-therapy-in-improving-the-quality-of-life-of-palliative-care-patients-a-randomised-controlled-pilot-and-feasibility-study
#18
Tracey McConnell, Lisa Graham-Wisener, Joan Regan, Miriam McKeown, Jenny Kirkwood, Naomi Hughes, Mike Clarke, Janet Leitch, Kerry McGrillen, Sam Porter
BACKGROUND: Music therapy is frequently used as a palliative therapy. In consonance with the goals of palliative care, the primary aim of music therapy is to improve people's quality of life by addressing their psychological needs and facilitating communication. To date, primarily because of a paucity of robust research, the evidence for music therapy's effectiveness on patient reported outcomes is positive but weak. This pilot and feasibility study will test procedures, outcomes and validated tools; estimate recruitment and attrition rates; and calculate the sample size required for a phase III randomised trial to evaluate the effectiveness of music therapy in improving the quality of life of palliative care patients...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27964735/strength-in-numbers-patient-experiences-of-group-exercise-within-hospice-palliative-care
#19
Lorna Malcolm, Gill Mein, Alison Jones, Helena Talbot-Rice, Matthew Maddocks, Katherine Bristowe
BACKGROUND: Exercise is increasingly recognized as a core component of palliative rehabilitation. The group exercise model is often adopted as a means of reaching more patients with limited resource. Despite the growth of quantitative research examining this area of practice, few qualitative studies have looked at the patient experience of participating in group exercise in a palliative setting, and most exclude patients with a non-cancer diagnosis. METHODS: The aim of this study was to explore patients' experiences of participating in group exercise classes in a hospice setting...
December 13, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27951604/-integration-of-palliative-and-hospice-care-structures-in-the-care-of-neurological-patients-opinion-of-chief-consultant-neurologists-in%C3%A2-germany
#20
H Golla, M Ebke, R Rolke, S Lorenzl, W Nacimiento, T Thiekötter, G R Fink, R Gold, R Voltz
An online survey of chief neurological consultants was conducted to find out how they judged the demand for and access to palliative and hospice care (PHC) structures for their neurological patients (NP) as well as their collaboration with PHC structures. 110 of 881 chief consultants who were contacted participated in the survey. About 10 % of their NP were considered suitable for PHC. They estimated that 9 % of the deceased had died from their underlying neurological disease. The integration of PHC structures into the management of various neurological diseases was considered worthwhile but 51...
December 2016: Fortschritte der Neurologie-Psychiatrie
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