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Palliative Care AND (Services OR Models)

Bettina Korn, Maria Bailey-Scanlan, Leo Honse Ribeiro, Julie Broderick
PURPOSE: This study aimed to investigate the practice of advance care planning (ACP) education within pulmonary rehabilitation programs (PRPs) in Ireland. METHODS: All 27 PRPs in the Republic of Ireland were surveyed between May and September 2015, eliciting detailed quantitative and qualitative information about ACP education delivery. Data were analyzed using SPSS statistical software and content analysis. RESULTS: Twenty-two PRPs (82%) took part in the survey, with 86% (n = 19) of these being delivered in a hospital setting...
August 13, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
Domenica Disalvo, Tim Luckett, Georgina Luscombe, Alexandra Bennett, Patricia Davidson, Lynnette Chenoweth, Geoffrey Mitchell, Dimity Pond, Jane Phillips, Elizabeth Beattie, Stephen Goodall, Meera Agar
BACKGROUND: Prescribing medications for nursing home residents with advanced dementia should focus on optimizing function and comfort, reducing unnecessary harms and aligning care goals with a palliative approach. OBJECTIVE: The aim of the study was to estimate the proportion of Australian nursing home residents with advanced dementia receiving potentially inappropriate medications, and identify those most commonly prescribed and factors associated with their use...
August 14, 2018: Journal of Palliative Medicine
Carsten Eggers, Richard Dano, Juliane Schill, Gereon R Fink, Lars Timmermann, Raymond Voltz, Heidrun Golla, Stefan Lorenzl
Background: Palliative care in Parkinson's Disease (PD) patients considerably differs from palliative care in oncology patients. Integrated care models are a concept to support patients and improve management of PD symptoms. However, it is not known if the access to PD patients at the end of life can be achieved through integrated care models. Aim: To analyze an integrated model of care for PD patients with the aim to identify if this integrated model of care has access to PD patients at the end of life. Material and Methods: The Cologne Parkinson's network was designed as a randomized, controlled prospective clinical trial in order to increase quality of life of PD patients...
2018: Frontiers in Neurology
Anastasia K Kalpakidou, Chris Todd, Vaughan Keeley, Jane Griffiths, Karen Spencer, Victoria Vickerstaff, Rumana Z Omar, Patrick Stone
BACKGROUND: More accurate methods of prognostication are likely to lead to improvements in the quality of care of patients approaching the ends of their lives. The Prognosis in Palliative care Scales (PiPS) are prognostic models of survival. The scores are calculated using simple clinical data and observations. There are two separate PiPS models; PiPS-A for patients without blood test results and PiPS-B for patients with blood test results. Both models predict whether a patient is likely to live for "days", "weeks" or "months" and have been shown to perform as well as clinicians' estimates of survival...
August 13, 2018: BMC Palliative Care
Meghan McDarby, Brian D Carpenter
OBJECTIVE: To identify factors that hinder or facilitate the palliative care consultation team's (PCCT) successful collaboration with other providers from the perspectives of both PCCT and nonpalliative specialists. METHODS: Qualitative study, including semistructured interviews with PCCT and nonpalliative care providers from various specialties at 4 Midwestern hospitals. Interviews were audio-recorded and transcribed into written text documents for thematic analysis...
August 14, 2018: American Journal of Hospice & Palliative Care
J Brian Cassel, Tara A Albrecht
OBJECTIVE: To describe palliative care integration into oncology, including several models that facilitate this integration, important considerations when initiating a program, special oncologic populations that would benefit from palliative care, and challenges to consider. DATA SOURCES: Palliative care and oncology literature over the past decade. CONCLUSION: Multiple models exist to facilitate the integration of palliative care based on the needs of the providers or payers...
August 9, 2018: Seminars in Oncology Nursing
Joseph J Fins, James L Bernat
This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation...
August 7, 2018: Archives of Physical Medicine and Rehabilitation
Grégory Ninot, Philippe Debourdeau, Françoise Blanc-Legier, Françoise De Crozals, Gaétan De Rauglaudre, Samy Khouri, Sylvie Kirscher, Laurent Mineur, Isabelle Piollet, Isabelle Sant, Pierre Schillinger, Daniel Serin
Advances in early detection and treatment have pushed in a few decades the management of cancers from a management model of the end of life to the management of a chronic disease. This evolution has accelerated the development of supportive care in two directions, firstly towards the best possible support to the end of life in advanced cancer patients (palliative care) and secondly to the limitation of treatment toxicities, the prevention of relapse and the return to life as "normal" as possible (care for after cancer)...
August 7, 2018: Bulletin du Cancer
Catherine Walshe, Nancy Preston, Sheila Payne, Steve Dodd, Guillermo Perez Algorta
CONTEXT: Trends in symptoms and functional ability are known towards the end of life, but less is understood about quality of life, particularly prospectively following service referral. OBJECTIVES: This study compares quality of life trajectories of people with and without cancer, referred to volunteer provided palliative care services. METHODS: A secondary analysis of the ELSA trial (n = 85 people with cancer and n = 72 without cancer). Quality of life data (WHOQOL-BREF) were collected at baseline (referral), 4, 8 and 12 weeks...
August 7, 2018: Journal of Pain and Symptom Management
Agnes Katalin Urban, Celine Foote, Frank P Brennan, Mark Brown, Brendon Lee
AIM: To explore the quality of deaths in the acute hospital under a Nephrology service at two teaching hospitals in Sydney with Renal Supportive Care services over time. METHODS: Retrospective chart review of all deaths in the years 2004, 2009 and 2014 at St George Hospital (SGH) and in 2014 at Concord Repatriation General Hospital (CRGH). Domains assessed were recognition of dying, invasive interventions, symptom assessment, anticipatory prescribing, documentation of spiritual needs and bereavement information for families...
August 9, 2018: Nephrology
Jenifer Jeba, Shrikant Atreya, Sulagna Chakraborty, Nikki Pease, Ann Thyle, Alka Ganesh, Gayatri Palat, Lulu Matthew, Sahaya Anbarasi, Raman Kumar, Mary Ann Muckaden, Alan Barnard, Mhoira Leng, Dan Munday, Scott A Murray
Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit...
March 2018: Journal of Family Medicine and Primary Care
Joseph J Fins, James L Bernat
This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation...
August 8, 2018: Neurology
Christy Noble, Laurie Grealish, Andrew Teodorczuk, Brenton Shanahan, Balaji Hiremagular, Jodie Morris, Sarah Yardley
BACKGROUND: There is a pressing need to improve end-of-life care in acute settings. This requires meeting the learning needs of all acute care healthcare professionals to develop broader clinical expertise and bring about positive change. The UK experience with the Liverpool Care of the Dying Pathway (LCP), also demonstrates a greater focus on implementation processes and daily working practices is necessary. METHODS: This qualitative study, informed by Normalisation Process Theory (NPT), investigates how a tool for end-of-life care was embedded in a large Australian teaching hospital...
August 8, 2018: BMC Palliative Care
Cheryl L Craigs, Robert M West, Adam Hurlow, Michael I Bennett, Lucy E Ziegler
BACKGROUND: The UK National Health Service is striving to improve access to palliative care for patients with advanced cancer however limited information exists on the level of palliative care support currently provided in the UK. We aimed to establish the duration and intensity of palliative care received by patients with advanced cancer and identify which cancer patients are missing out. METHODS: Retrospective cancer registry, primary care and secondary care data were obtained and linked for 2474 patients who died of cancer between 2010 and 2012 within a large metropolitan UK city...
2018: PloS One
Hibah Osman, Sudip Shrestha, Sarah Temin, Zipporah V Ali, Rumalie A Corvera, Henry D Ddungu, Liliana De Lima, Maria Del Pilar Estevez-Diz, Frank D Ferris, Nahla Gafer, Harmala K Gupta, Susan Horton, Graciela Jacob, Ruinuo Jia, Frank L Lu, Daniela Mosoiu, Christina Puchalski, Carole Seigel, Olaitan Soyannwo, James F Cleary
Purpose The purpose of this new resource-stratified guideline is to provide expert guidance to clinicians and policymakers on implementing palliative care of patients with cancer and their caregivers in resource-constrained settings and is intended to complement the Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update of 2016. Methods ASCO convened a multidisciplinary, multinational panel of experts in medical oncology, family medicine, radiation oncology, hematology/oncology, palliative and/or hospice care, pain and/or symptom management, patient advocacy, public health, and health economics...
July 2018: Journal of Global Oncology
Laura Rodriguez-Romo, Alberto Olaya Vargas, Sumit Gupta, Jaime Shalkow-Klincovstein, Lourdes Vega-Vega, Alfonso Reyes-Lopez, Carlo Cicero-Oneto, Juan Mejia-Arangure, Oscar Gonzalez-Ramella, Rafael Pineiro-Retif, Aracely Lopez-Facundo, Maria de Los Angeles Del Campo-Martinez, Isidoro Tejocote, Kelly Brennan, Christopher M Booth
Purpose Limited data describe the delivery of pediatric cancer care in Mexico. We report a nationwide survey of pediatric cancer units. Methods An electronic survey was distributed to 74 pediatric cancer units in Mexico to describe case volumes; organization of care; and availability of medical/surgical specialists, supportive care, complex therapies, and diagnostic services. Centers were classified as low (< 30 new patients/year), medium (30 to 59/year) and high (≥ 60/year). Results Sixty-two centers completed the survey (response rate, 84%)...
July 2018: Journal of Global Oncology
Gihad E Nesrallah, Stephanie N Dixon, Marnie MacKinnon, Sarbjit Vanita Jassal, Sarah E Bota, Jade S Dirk, Erin Arthurs, Peter G Blake, Manish M Sood, Amit X Garg, Sara N Davison
Background: Many patients who receive chronic hemodialysis have a limited life expectancy comparable to that of patients with metastatic cancer. However, patterns of home palliative care use among patients receiving hemodialysis are unknown. Objectives: We aimed to undertake a current-state analysis to inform measurement and quality improvement in palliative service use in Ontario. Methods: We conducted a descriptive study of outcomes and home palliative care use by Ontario residents maintained on chronic dialysis using multiple provincial healthcare datasets...
2018: Canadian Journal of Kidney Health and Disease
Rachel Wells, Macy L Stockdill, J Nicholas Dionne-Odom, Deborah Ejem, Kathryn L Burgio, Raegan W Durant, Sally Engler, Andres Azuero, Salpy V Pamboukian, Jose Tallaj, Keith M Swetz, Elizabeth Kvale, Rodney O Tucker, Marie Bakitas
BACKGROUND: Palliative care is specialized medical care for people with serious illness that is focused on providing relief from symptoms and stress and improving the quality of life (QOL) for patients and their families. To help the 6.5 million U.S. adults and families affected by heart failure manage the high symptom burden, complex decision-making, and risk of exacerbation and death, the early integration of palliative care is critical and has been recommended by numerous professional organizations...
August 6, 2018: Trials
Wynne E Morrison, France Gauvin, Emily Johnson, Jennifer Hwang
OBJECTIVES: To propose a model describing levels of integration of palliative care into the care of ICU patients. DATA SOURCES: Literature review and author opinion. CONCLUSIONS: All critical care team members should demonstrate and foster their core competencies in caring for patients with complex illness and uncertain prognosis, including at the end of life. We describe these core competencies of the ICU team member as "primary" palliative care skills...
August 2018: Pediatric Critical Care Medicine
Tammy I Kang, Jenny Hynson
OBJECTIVES: This article focuses on compassionate discharge from an ICU setting for pediatric patients. DATA SOURCES: Not Applicable. STUDY SELECTION: Not Applicable. DATA EXTRACTION: Not Applicable. DATA SYNTHESIS: The rationale for compassionate discharge is described, along with suggestions for assessing feasibility. A patient case highlights the potential benefits of and provides specific examples of steps involved in the process...
August 2018: Pediatric Critical Care Medicine
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