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Palliative Care AND (Services OR Models)

Joshua D Niznik, Song Zhang, Maria K Mor, Xinhua Zhao, Mary Ersek, Sherrie L Aspinall, Walid F Gellad, Joshua M Thorpe, Joseph T Hanlon, Loren J Schleiden, Sydney Springer, Carolyn T Thorpe
OBJECTIVES: To evaluate the predictive validity of an adapted version of the Minimum Data Set (MDS) Mortality Risk Index-Revised (MMRI-R) based on MDS version 3.0 assessment items (MMRI-v3) and to compare the predictive validity of the MMRI-v3 with that of a single MDS item indicating limited life expectancy (LLE). DESIGN: Retrospective, cross-sectional study of MDS assessments. Other data sources included the Veterans Affairs (VA) Residential History File and Vital Status File...
October 18, 2018: Journal of the American Geriatrics Society
Sebastiano Mercadante, Francesco Masedu, Marco Maltoni, Daniela De Giovanni, Luigi Montanari, Cristina Pittureri, Raffaella Bertè, Domenico Russo, Laura Ursini, Franco Marinangeli, Federica Aielli
The aim of this study is to investigate the relationship between delirium and symptom expression in advanced cancer patients admitted to palliative care services. This is a secondary analysis of a consecutive sample of advanced cancer patients who were admitted to home care and hospices, and prospectively assessed for a period of 10 months. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS (Memorial Delirium Assessment Scale) were measured at admission (T0) and after seven days of home care or hospice care (T7)...
October 17, 2018: Internal and Emergency Medicine
Connie Lethin, Lottie Giertz, Emme-Li Vingare, Ingalill Rahm Hallberg
BACKGROUND: In dementia care, it is crucial that the chain of care is adapted to the needs of people with dementia and their informal caregivers throughout the course of the disease. Assessing the existing dementia care system with regard to facilities, availability and utilization may provide useful information for ensuring that the professional dementia care and service system meets the needs of patients and their families from disease onset to end of life. METHODS: The aim of this study was to further develop and test a mapping system, and adapt it to a local context...
October 16, 2018: BMC Health Services Research
Stacy M Fischer, Danielle M Kline, Sung-Joon Min, Sonia Okuyama-Sasaki, Regina M Fink
Importance: Strategies to increase access to palliative care, particularly for racial/ethnic minorities, must maximize primary palliative care and community-based models to meet the ever-growing need in a culturally sensitive and congruent manner. Objective: To investigate if a culturally tailored patient navigator intervention can improve palliative care outcomes for Latino adults with advanced cancer. Design, Setting, and Participants: The Apoyo con Cariño (Support With Caring) randomized clinical trial was conducted from July 2012 to March 2016...
September 20, 2018: JAMA Oncology
Steven Vanderstichelen, Joachim Cohen, Yanna Van Wesemael, Luc Deliens, Kenneth Chambaere
Ageing populations increasingly face chronic and terminal illnesses, emphasising the importance of palliative care and quality of life for terminally ill people. Facing resource constraints in professional healthcare, some governments expect informal caregivers like volunteers to assume a greater share of care provision. We know volunteers are present in palliative care and perform many roles, ranging from administration to providing companionship. However, we do not know how involved they are in the organisation of care and how healthcare organisations appraise their involvement...
October 16, 2018: Health & Social Care in the Community
Natasha Smallwood, David Currow, Sara Booth, Anna Spathis, Louis Irving, Jennifer Philip
BACKGROUND: Chronic obstructive pulmonary disease (COPD) guidelines recommend early access to palliative care together with optimal, disease-directed therapy for people with advanced disease, however, this occurs infrequently. This study explored the approaches of respiratory and palliative medicine specialists to palliative care and advance care planning (ACP) in advanced COPD. METHODS: An online survey was emailed to all specialists and trainees in respiratory medicine in Australia and New Zealand (ANZ), and to all palliative medicine specialists and trainees in ANZ and the United Kingdom...
October 15, 2018: BMC Palliative Care
Bahaaldin Alsoufi, Courtney McCracken, Lazaros K Kochilas, Martha Clabby, Kirk Kanter
BACKGROUND: Several advances have led to improved hospital survival following neonatal palliation (NP) of single ventricle (SV) anomalies. Nonetheless, a number of patients continue to suffer from interstage mortality (ISM) prior to subsequent Glenn. We aim to study patients' characteristics and anatomic, surgical, and clinical details associated with ISM. METHODS: A total of 453 SV neonates survived to hospital discharge following NP. Competing risk analysis modeled events after NP (Glenn, transplantation, or death) and examined variables associated with ISM...
November 2018: World Journal for Pediatric & Congenital Heart Surgery
Markus Ebke, Andreas Koch, Kim Dillen, Ingrid Becker, Raymond Voltz, Heidrun Golla
Background: The 12-months "surprise" question (12-SQ) for estimating prognosis and the need for integrating palliative care (PC) services has not yet been investigated for neurological patients. Objective: Test the value of the 12-SQ on a sample of neurorehabilitation patients. Methods: All patients newly registered in the Department of Neurorehabilitation, Dr. Becker Rhein-Sieg-Clinic (8/2016-03/2017) were asked to participate. The treating neurorehabilitation physicians (NP) and an external consulting PC physician (PCP) independently estimated patients' prognosis using the 12-SQ; while symptom burden was independently assessed using the standardized palliative outcome measurement HOPE-SP-CL, a set of additional neurological issues, and ECOG...
2018: Frontiers in Neurology
Jane L Phillips, Nicole Heneka, Louise Hickman, Lawrence Lam
BACKGROUND: Pain is highly prevalent in all health care settings, and frequently poorly managed. Effective pain management is predicated on a continuous cycle of screening, assessing, intervening and evaluating. Identifying gaps in nurses' self-perceived pain assessment competencies is an essential first step in the design of tailored interventions to embed effective pain assessment into routine clinical practice, and improve patient reported pain outcomes. Yet, few validated instruments focus on the competencies required for undertaking a comprehensive pain assessment, with most focusing on clinician's pain management competencies...
October 10, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Sarah Chuzi, Sarah Hale, Jason Arnold, Amy Zhou, Rebecca Harap, Kathleen L Grady, Jonathan D Rich, Clyde W Yancy, Adeboye Ogunseitan, Eytan Szmuilowicz, Jane E Wilcox
INTRODUCTION: In 2013 the Centers for Medicare and Medicaid Services (CMS) issued a mandate requiring that all patients undergoing destination therapy ventricular assist device (DT VAD) implantation have access to a palliative care team prior to surgery. Subsequently, many VAD programs implemented a mandatory pre-implantation palliative care consultation for patients considering DT VAD. However, little is known about the quality of these consults. METHODS: All patients undergoing DT VAD at Northwestern Memorial Hospital from October 30, 2013 (the CMS decision date) through March 1, 2018 were included...
October 10, 2018: Journal of Pain and Symptom Management
David Wang, Caleb Ing, Craig Blinderman, May Hua
CONTEXT: In the intensive care unit (ICU), 14% of patients meet criteria for specialized palliative care, but whether subgroups of patients differ in their palliative care needs is unknown. OBJECTIVES: To use latent class analysis (LCA) to separate ICU patients into different classes of palliative care needs, and determine if such classes differ in their palliative care resource requirements. METHODS: Retrospective cohort study of ICU patients who received specialized palliative care, August 2013 - August 2015...
October 10, 2018: Journal of Pain and Symptom Management
Thomas R Freeman, Leslie Boisvert, Eric Wong, Stephen Wetmore, Heather Maddocks
OBJECTIVE: To determine the range of services and procedures offered by family physicians who define themselves as comprehensive practitioners and compare responses across 3 generations of alumni of a single family practice program. DESIGN: Cross-sectional survey. SETTING: Western University in London, Ont. PARTICIPANTS: All graduates of the family medicine program between 1985 and 2012. MAIN OUTCOME MEASURES: Self-reported provision of the following types of care: in-office care, in-hospital care, intrapartum obstetrics, housecalls, palliative care, after-hours care, nursing home care, minor surgery, emergency department care, sport medicine, and walk-in care...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Silvia Librada Flores, Emilio Herrera Molina, Fátima Díaz Díez, María José Redondo Moralo, Cristina Castillo Rodríguez, Kathleen McLoughlin, Julian Abel, Tamen Jadad Garcia, Miguel Ángel Lucas Díaz, Inmaculada Trabado Lara, María Dolores Guerra-Martín, María Nabal
BACKGROUND: End-of-life needs can be only partly met by formalized health and palliative care resources. This creates the opportunity for the social support network of family and community to play a crucial role in this stage of life. Compassionate communities can be the missing piece to a complete care model at the end of life. OBJECTIVE: The main objective of this study is to evaluate the REDCUIDA (Redes de Cuidados or Network of Care) intervention for the development and management of networks of care around people with advanced disease or at the end of life...
October 12, 2018: JMIR Research Protocols
Bethann Scarborough, Suzanne Goldhirsch, Emily Chai
INTRODUCTION: Palliative care remains underutilized despite evidence supporting its value. Multiple professional organizations have endorsed broader and earlier access to palliative care, yet barriers exist that impede successful implementation of palliative care. We report on development of an ambulatory palliative medicine practice (Supportive Oncology) embedded within an academic cancer center. METHODS: An incremental strategy was used to ensure the sustainability of the practice...
October 2018: Journal of Palliative Medicine
Joanna M Cain, Lynette Denny
Women's cancer rates are increasing in low- and middle-income countries, with presentations that are often far advanced requiring intense symptom management, thus advancing the urgent need to address palliative care. Most resource settings have some options available to assist women with advanced gynecologic cancer, and a combination of leveraging these and expanding on emerging models for palliative care could lessen suffering and improve care for women with gynecologic cancers globally. Providing palliative care for women with cancer is constrained by resources (human and physical), lack of equipment, lack of access, and policy absence or barriers...
October 2018: International Journal of Gynaecology and Obstetrics
Cornelius Engelmann, Karen Louise Thomsen, Nekisa Zakeri, Mohammed Sheikh, Banwari Agarwal, Rajiv Jalan, Rajeshwar P Mookerjee
BACKGROUND: Acute-on-chronic liver failure (ACLF) is a severe complication of cirrhosis and is defined by organ failure and high rates of short-term mortality. Patients with ACLF are managed with multiorgan support in the intensive care unit (ICU). Currently, it is unclear when this supportive care becomes futile, particularly in patients who are not candidates for liver transplant. The aim of this study was to determine whether the currently available prognostic scores can identify patients with ACLF in whom prolonged ICU care is likely to be futile despite maximal treatment efforts...
October 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
Shelli L Feder, Janet P Tate, Kathleen M Akgün, Julie A Womack, Sangchoon Jeon, Marjorie Funk, Roger J Bedimo, Matthew J Budoff, Adeel A Butt, Kristina Crothers, Nancy S Redeker
BACKGROUND: The number of adults with heart failure (HF) and HIV infection is increasing. These patients may benefit from palliative care (PC). OBJECTIVES: Determine the association between HIV infection, other HIV characteristics, and PC among hospitalized patients with HF in the Veterans Health Administration (VHA). DESIGN: Nested case-control study of patients with HF hospitalized from 2003 to 2015 and enrolled in the Veterans Aging Cohort Study...
October 10, 2018: American Journal of Hospice & Palliative Care
Stacy M Fischer, Sung-Joon Min, Adam Atherly, Danielle M Kline, Wendolyn S Gozansky, John Himberger, Joseph Lopez, Kathleen Lester, Regina M Fink
Latinos are more likely to experience uncontrolled pain, and institutional death, and are less likely to engage in advance care planning. Efforts to increase access to palliative care must maximize primary palliative care and community based models to meet the ever-growing need in a culturally sensitive and congruent manner. Patient navigator interventions are community-based, culturally tailored models of care that have been successfully implemented to improve disease prevention, early diagnosis, and treatment...
October 10, 2018: Research in Nursing & Health
Antonio Noguera, Ramón Robledano, Eduardo Garralda
PURPOSE OF REVIEW: The aim of this review is to understand how palliative care teaching (PCT) as a patient-centered learning model, influences medical undergraduate students' professional development. RECENT FINDINGS: To study PCT medical undergraduate students' learning experiences, we have employed the medical teaching concept, 'hidden curriculum,' as a way of describing attitudes and behavior conveyed implicitly by palliative care educators. Fifteen studies were selected: ten of those studies used a qualitative approach; two are theoretical explanations of the topic explored, one guideline, one review and just one quantitative study, made up the review...
October 8, 2018: Current Opinion in Supportive and Palliative Care
Gonzalo Brito-Pons, Silvia Librada-Flores
PURPOSE OF REVIEW: Compassion has been recognized as a key aspect of high-quality healthcare, particularly in palliative care. This article provides a general review of the current understanding of compassion in palliative care and summarizes emergent compassionate initiatives in palliative care at three interdependent levels: compassion for patients, compassion in healthcare professionals, and compassionate communities at the end of life. RECENT FINDINGS: Compassion is a constructive response to suffering that enhances treatment outcomes, fosters the dignity of the recipient, and provides self-care for the giver...
October 8, 2018: Current Opinion in Supportive and Palliative Care
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