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https://www.readbyqxmd.com/read/28922291/population-based-models-of-planning-for-palliative-care-in-older-people
#1
David C Currow, Jane Phillips, Meera Agar
PURPOSE OF REVIEW: Health service planning requires demographic, clinical, and health systems data and is unique to each health system. Planning for palliative care in older people must include patients and their carers. This review explores literature from the last 24 months. RECENT FINDINGS: The proportion of people living in skilled nursing facilities is increasing and many residents require quality palliative care. Simultaneously, the complexity of care for older people is also increasing...
September 16, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28915078/pediatric-specific-end-of-life-care-quality-measures-an-unmet-need-of-a-vulnerable-population
#2
Emily E Johnston, Abby R Rosenberg, Arif H Kamal
We must ensure that the 20,000 US children (age 0 to 19 years) who die as a result of serious illness annually receive high-quality end-of-life care. Ensuring high-quality end-of-life care requires recognition that pediatric end-of-life care is conceptually and operationally different than that for adults. For example, in-hospital adult death is considered an outcome to be avoided, whereas many pediatric families may prefer hospital death. Because pediatric deaths are comparatively rare, not all centers offer pediatric-focused palliative care and hospice services...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28913848/effect-of-the-duration-of-hospice-and-palliative-care-on-the-quality-of-dying-and-death-in-patients-with-terminal-cancer-a-nationwide-multicentre-study
#3
J Y Choi, K A Kong, Y J Chang, H J Jho, E M Ahn, S K Choi, S Park, M K Lee
Early referral to hospice and palliative care (HPC) has significant benefits, but little is known about the appropriate time for referral. The purpose of this study of terminal cancer patients was to identify the most appropriate time for referral to HPC. Cross-sectional correlation study design was used. Participants were the bereaved relatives, who were the adult primary caregivers of the 1,829 terminal cancer patients who died 2-6 months previously in nationwide centres that provide HPC in Korea. A post-bereavement survey (Good Death Inventory, GDI) of family caregivers was used to assess patients' quality of dying and death...
September 15, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28910509/the-experience-of-palliative-care-service-provision-for-people-with-non-malignant-respiratory-disease-and-their-family-carers-an-all-ireland-qualitative-study
#4
Clare Mc Veigh, Joanne Reid, Philip Larkin, Sam Porter, Peter Hudson
AIM: To explore specialist and generalist palliative care provision for people with non-malignant respiratory disease, in rural and urban areas in the North and Republic of Ireland. BACKGROUND: Globally, palliative care is recommended as an appropriate healthcare option for people with advanced non- malignant lung disease. Yet, there is limited evidence regarding the integration of palliative care for this client group. DESIGN: Qualitative study...
September 14, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28902325/interface-between-social-support-quality-of-life-and-depression-in-users-eligible-for-palliative-care
#5
Cissa Azevedo, Juliana Dias Reis Pessalacia, Luciana Regina Ferreira da Mata, Elma Lourdes Campos Pavone Zoboli, Maria da Graça Pereira
OBJECTIVE: Analyzing the relationship between social support, quality of life and depression in patients eligible for palliative care at Primary Health Care of a municipality in the interior of Minas Gerais, Brazil. METHOD: A correlational cross-sectional study carried out with patients treated in six primary health care units. Data were submitted to descriptive statistical analysis, tests for differences between averages and medians, and correlation tests. The significance level was 0...
August 28, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28898605/the-team-approach-to-improving-oncology-outcomes-by-incorporating-palliative-care-in-practice
#6
Marie A Bakitas, Areej El-Jawahri, Morag Farquhar, Betty Ferrell, Corita Grudzen, Irene Higginson, Jennifer S Temel, Camilla Zimmermann, Thomas J Smith
Palliative care (PC) concurrent with usual oncology care is now the standard of care that is recommended for any patient with advanced cancer to begin within 8 weeks of diagnosis on the basis of evidence-driven national clinical practice guidelines; however, there are not enough interdisciplinary palliative care teams to provide such care. How and what can an oncology office incorporate into usual care, borrowing the tools used in PC randomized clinical trials (RCTs), to improve care for patients and their caregivers? We reviewed the multiple RCTs for common practical elements and identified methods and techniques that oncologists can use to deliver some parts of concurrent interdisciplinary PC...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28895471/the-indirect-costs-of-palliative-care-in-end-stage-cancer-a-real-life-longitudinal-register-and-questionnaire-based-study
#7
Olli Haltia, Niilo Färkkilä, Risto Paavo Roine, Harri Sintonen, Kimmo Taari, Juha Hänninen, Juho Tuomas Lehto, Tiina Saarto
BACKGROUND: Palliative care needs are increasing as more people are dying from incurable diseases. Healthcare costs have been reported to be highest during the last year of life, but studies on the actual costs of palliative care are scarce. AIM: To explore the resource use and costs of palliative care among end-stage breast, colorectal and prostate cancer patients after termination of life-prolonging oncological treatments, that is, during the palliative care period...
September 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28894017/effects-of-early-integrated-palliative-care-on-caregivers-of-patients-with-lung-and-gastrointestinal-cancer-a-randomized-clinical-trial
#8
Areej El-Jawahri, Joseph A Greer, William F Pirl, Elyse R Park, Vicki A Jackson, Anthony L Back, Mihir Kamdar, Juliet Jacobsen, Eva H Chittenden, Simone P Rinaldi, Emily R Gallagher, Justin R Eusebio, Sarah Fishman, Harry VanDusen, Zhigang Li, Alona Muzikansky, Jennifer S Temel
BACKGROUND: The family and friends (caregivers) of patients with advanced cancer often experience tremendous distress. Although early integrated palliative care (PC) has been shown to improve patient-reported quality of life (QOL) and mood, its effects on caregivers' outcomes is currently unknown. MATERIALS AND METHODS: We conducted a randomized trial of early PC integrated with oncology care versus oncology care alone for patients who were newly diagnosed with incurable lung and noncolorectal gastrointestinal cancers and their caregivers...
September 11, 2017: Oncologist
https://www.readbyqxmd.com/read/28877699/honoring-the-voices-of-bereaved-caregivers-a-metasummary-of-qualitative-research
#9
Lorraine Holtslander, Sharon Baxter, Kelly Mills, Sarah Bocking, Tina Dadgostari, Wendy Duggleby, Vicky Duncan, Peter Hudson, Agatha Ogunkorode, Shelley Peacock
BACKGROUND: Family caregiving in the context of advanced disease in particular, can be physically and emotionally taxing. Caregivers can subsequently face bereavement exhausted with few supports, limited resources and a significant proportion will develop negative psychological and social outcomes. Although some research has attended to the bereavement experiences of family caregivers who had cared for a person requiring palliative care, a comprehensive qualitative understanding of the impact of caregiving on bereavement has not been articulated...
September 6, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28872031/palliative-care-and-management-of-troublesome-symptoms-for-people-with-chronic-obstructive-pulmonary-disease
#10
REVIEW
Matthew Maddocks, Natasha Lovell, Sara Booth, William D-C Man, Irene J Higginson
People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care...
September 2, 2017: Lancet
https://www.readbyqxmd.com/read/28870189/can-digital-stories-go-where-palliative-care-research-has-never-gone-before-a-descriptive-qualitative-study-exploring-the-application-of-an-emerging-public-health-research-method-in-an-indigenous-palliative-care-context
#11
Lisa Williams, Merryn Gott, Tess Moeke-Maxwell, Stella Black, Shuchi Kothari, Sarina Pearson, Tessa Morgan, Matua Rawiri Wharemate, Whaea Whio Hansen
BACKGROUND: The World Health Organization (WHO) has called for global approaches to palliative care development. Yet it is questionable whether one-size-fits-all solutions can accommodate international disparities in palliative care need. More flexible research methods are called for in order to understand diverse priorities at local levels. This is especially imperative for Indigenous populations and other groups underrepresented in the palliative care evidence-base. Digital storytelling (DST) offers the potential to be one such method...
September 4, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28866894/more-chemo-or-home-hospice-narrative-results-from-an-n-of-1-trial
#12
Keith M Swetz
Words matter. They have tremendous power to heal or hurt. And although the patients we care for in oncology and palliative medicine often die from, or despite, their neoplastic illness; caregivers and loved ones often hold onto the words that clinicians share with them during their times of struggle and grief. In this narrative, the author (as first person) reflects on some systemic challenges he faced in dealing with illness and loss when his father battled two distinct neoplastic processes. He explores the commonalities and differences that he experienced as a palliative care physician, and how that has guided his medical practice moving forward...
June 23, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28859792/how-medicine-has-changed-the-end-of-life-for-patients-with-cardiovascular-disease
#13
REVIEW
Haider J Warraich, Adrian F Hernandez, Larry A Allen
Advances in medicine have changed how patients experience the end of life. With longer life spans, there has also been an increase in years lived with disability. The clustering of illnesses in the last years of life is particularly pronounced in patients with cardiovascular disease. At the end of life, patients with cardiovascular disease are more symptomatic, less likely to die at home, and less likely to receive high-quality palliative care. Social determinants have created widening disparities in end-of-life care...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28859648/engaging-patients-and-families-to-create-a-feasible-clinical-trial-integrating-palliative-and-heart-failure-care-results-of-the-enable-chf-pc-pilot-clinical-trial
#14
Marie Bakitas, J Nicholas Dionne-Odom, Salpy V Pamboukian, Jose Tallaj, Elizabeth Kvale, Keith M Swetz, Jennifer Frost, Rachel Wells, Andres Azuero, Konda Keebler, Imatullah Akyar, Deborah Ejem, Karen Steinhauser, Tasha Smith, Raegan Durant, Alan T Kono
BACKGROUND: Early palliative care (EPC) is recommended but rarely integrated with advanced heart failure (HF) care. We engaged patients and family caregivers to study the feasibility and site differences in a two-site EPC trial, ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers). METHODS: We conducted an EPC feasibility study (4/1/14-8/31/15) for patients with NYHA Class III/IV HF and their caregivers in academic medical centers in the northeast and southeast U...
August 31, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28856680/public-patient-and-carers-views-on-palliative-and-end-of-life-care-in-india
#15
REVIEW
M Ramasamy Venkatasalu, N Sirala Jagadeesh, S Elavally, Y Pappas, F Mhlanga, R Pallipalayam Varatharajan
AIM: To systematically review the existing evidence on the Indian public, patient and carers' perspectives on palliative and end-of-life care. BACKGROUND: With a growing population of terminally ill people across the world, there is also an increasing awareness among international health policy makers of the need to improve the quality of life for terminally ill patients. Understanding service users' (patients, family and public) perspectives is crucial in developing and sustaining successful community-centred palliative nursing policies and service models especially in countries like India with diverse population...
August 30, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28854923/validation-of-a-modified-voices-survey-to-measure-end-of-life-care-quality-the-caregivervoice-survey
#16
Hsien Seow, Daryl Bainbridge, Melissa Brouwers, Gregory Pond, John Cairney
BACKGROUND: Measuring the care experience at end-of-life (EOL) to inform quality improvement is a priority in many countries. We validated the CaregiverVoice survey, a modified version of the VOICES questionnaire, completed by bereaved caregivers to capture perceptions of care received in the last three months of a patient's life. METHODS: We conducted a retrospective survey of bereaved caregivers representing palliative care patients who died in a residential hospice and/or received palliative homecare in Ontario, Canada...
August 30, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28844985/pediatric-advance-care-planning-pacp-for-teens-with-cancer-and-their-families-design-of-a-dyadic-longitudinal-rcct
#17
Katherine B Curtin, Anne E Watson, Jichuan Wang, Obianuju C Okonkwo, Maureen E Lyon
Cancer is the leading cause of disease-related death for adolescents and young adults (AYAs) in the United States. Parents of AYAs with life-threatening illnesses have expressed the desire to talk to their children about end of life (EOL) care, yet, like caregivers of adult patients, struggle to initiate this conversation. Building Evidence for Effective Palliative/End of Life Care for Teens with Cancer is a longitudinal, randomized, controlled, single-blinded clinical trial aimed at evaluating the efficacy of FAmily CEntered disease-specific advance care planning (ACP) for teens with cancer (FACE-TC)...
August 24, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28844623/development-and-field-test-of-an-audit-tool-and-tracer-methodology-for-clinician-assessment-of-quality-in-end-of-life-care
#18
Marilyn Bookbinder, Amandine Hugodot, Katherine Freeman, Peter Homel, Elisabeth Santiago, Alexa Riggs, Maggie Gavin, Alice Chu, Ellen Brady, Pauline Lesage, Russell K Portenoy
CONTEXT: Quality improvement in end-of-life care generally acquires data from charts or caregivers. "Tracer" methodology, which assesses real-time information from multiple sources, may provide complementary information. OBJECTIVES: To develop a valid brief audit tool that can guide assessment and rate care when used in a clinician tracer to evaluate the quality of care for the dying patient. METHODS: To identify items for a brief audit tool, 248 items were created to evaluate overall quality, quality in specific content areas (e...
August 24, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28827940/assessment-of-private-homes-as-spaces-for-the-dying-elderly
#19
Tulika Bhattacharyya, Suhita Chopra Chatterjee, Dipannita Chand, Debolina Chatterjee, Jaydeep Sengupta
AIM: This study makes an assessment of end-of-life care of the elderly in private homes in Kolkata, West Bengal, India. PARTICIPANTS AND METHODS: Primary data were collected from private homes which supported elder care through observation and semi-structured interviews with primary family caregivers of the elderly. RESULTS: The study finds that the major factors preventing private homes from providing adequate care to the elderly were architecturally inadequate housing conditions, paucity of financial support, and scarcity of skilled caregivers...
July 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28827063/beyond-simple-planning-existential-dimensions-of-conversations-with-patients-at-risk-of-dying-from-heart-failure
#20
Valerie Schulz, Allison Crombeen, Denise Marshall, Joshua Shadd, Kori LaDonna, Lorelei Lingard
INTRODUCTION: Despite the recent promotion of communication guides to improve decision-making with patients nearing the end of their lives, these conversations remain challenging. Deeper and more comprehensive understanding of communication barriers that undermine discussions and decisions with patients at risk of dying from heart failure (HF) are vital for informing communication in healthcare. OBJECTIVES: To explore experiences and perspectives of patients with advanced HF, their caregivers and providers, regarding conversations for patients at risk of dying from HF...
August 4, 2017: Journal of Pain and Symptom Management
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