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Palliative caregiver

Helena S Stöckle, Sigrid Haarmann-Doetkotte, Claudia Bausewein, Martin J Fegg
BACKGROUND: Existential behavioural therapy (EBT) is a recently developed intervention to support informal caregivers of patients in a specialist palliative care unit and was initially established as a six-session group programme. This pilot study aimed to test the feasibility and acceptability of an adapted short-term, individual approach of EBT in preparation for a randomized controlled trial (RCT). METHODS: The study was conducted in a prospective, mixed methods design including four quantitiative assessments with embedded qualitative interviews at one assessment...
October 24, 2016: BMC Palliative Care
Anika Sparla, Sebastian Flach-Vorgang, Matthias Villalobos, Katja Krug, Martina Kamradt, Kadiatou Coulibaly, Joachim Szecsenyi, Michael Thomas, Sinikka Gusset-Bährer, Dominik Ose
PURPOSE: Lung cancer is a disease with a high percentage of patients diagnosed in an advanced stage. In a situation of palliative treatment, both patients and their relatives experience diverse types of distress and burden. Little research has been done to identify the individual difficulties and resources for patients with advanced lung cancer and their relatives. Especially, standardized questionnaire-based exploration may not assess the specific distressing issues that pertain to each individual on a personal level...
2016: Patient Preference and Adherence
Rocío Rojí, Antonio Noguera-Tejedor, Fernando Pikabea-Díaz, José Miguel Carrasco, Carlos Centeno
CONTEXT: A mandatory course in palliative care (PC) is organized for all final-year medical students at the University of Navarre. It consists of 24 lectures, 4 workshops, and 1 scheduled five hour clinical PC service experience at two different sites. In the 48 hours after the visit and related to the clinical experience, each student has to complete a 500-word reflective writing (RW) piece. OBJECTIVE: To investigate how a brief PC clinical experience helps equip the medical student...
October 18, 2016: Journal of Palliative Medicine
Maria Norinder, Ida Goliath, Anette Alvariza
OBJECTIVE: Patients who receive palliative home care are in need of support from family members, who take on great responsibility related to caregiving but who often feel unprepared for this task. Increasing numbers of interventions aimed at supporting family members in palliative care have been described and evaluated. It is not known whether and how these interventions actually affect the care or support provided to a patient, even though it has been suggested that family members would be likely to provide better care and support and thus allow for positive experiences for patients...
October 17, 2016: Palliative & Supportive Care
Joseph Arthur, Sriram Yennu, Kresnier Perez Zapata, Hilda Cantu, Jimin Wu, Diane Liu, Eduardo Bruera
BACKGROUND: Data on the use of question prompt sheets (QPS) in palliative care is limited. Our team previously developed a single page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients. METHODS: 100/104(96%) eligible patients and 68/68(100%) caregivers received the QPS during their first palliative care clinic. 12 palliative medicine specialists also participated in the study...
October 12, 2016: Journal of Pain and Symptom Management
Wsam A Ghandourh
Advanced cancer patients commonly have misunderstandings about the intentions of treatment and their overall prognosis. Several studies have shown that large numbers of patients receiving palliative radiation or chemotherapy hold unrealistic hopes of their cancer being cured by such therapies, which can affect their ability to make well-informed decisions about treatment options. This review aimed to explore this discrepancy between patients' and physicians' expectations by investigating three primary issues: (1) the factors associated with patients developing unrealistic expectations; (2) the implications of having unrealistic hopes and the effects of raising patients' awareness about prognosis; and (3) patients' and caregivers' perspective on disclosure and their preferences for communication styles...
August 9, 2016: Journal of Medical Radiation Sciences
Daryl Bainbridge, Deanna Bryant, Hsien Seow
INTRODUCTION: Measuring palliative care experience using patient-reported outcomes is becoming important for assessing and improving quality, though most validated outcome tools solely use scaled questions. We analyzed open text survey responses from bereaved caregivers to identify strengths and weaknesses in the quality of end-of-life care services and to assess the usefulness of qualitative survey data for quality improvement. METHODS: This was a retrospective observational study involving bereaved caregivers of decedents who had received palliative homecare services in one of six healthcare regions in Ontario, Canada...
October 5, 2016: Journal of Pain and Symptom Management
David Li, Holly G Prigerson, Josephine Kang, Paul K Maciejewski
CONTEXT: Radiation therapy (RT) is used with palliative intent in patients with advanced stage cancer. Prior studies, primarily in patients with poor performance status (PS), suggest that RT is associated with aggressive medical care, which may impact patients' quality of life near death (QoD) adversely. OBJECTIVE: This study examines associations between RT use and patients' receipt of aggressive care and QoD based on patients' PS. METHODS: Multi-institutional, prospective cohort study of patients with end-stage cancers (N=312) and identified as terminally ill at study enrollment...
October 5, 2016: Journal of Pain and Symptom Management
Emanuele D'Amico, Aurora Zanghì, Francesco Patti, Mario Zappia
Multiple sclerosis (MS) is a progressive disease of the central nervous system with unknown etiology. It could be associated with severe disability and losses of physical, psychological and social role functioning over time. People with MS share experiences in common with people affected by diseases with a shorter and clearer terminal phase. Therefore, it is appropriate to offer a palliative care approach to people with severe MS and their caregivers. Areas covered: Benefits for severe MS patients and their caregivers were shown when palliative care was included in their care...
October 8, 2016: Expert Review of Neurotherapeutics
Maryam Vahidi, Nader Mahdavi, Elnaz Asghari, Hossein Ebrahimi, Jamal Eivazi Ziaei, Mina Hosseinzadeh, Hossein Namdar Areshtanab, Iraj Asvadi Kermani
PURPOSE: This study aimed to determine factors associated with caregiver burden among primary caregivers of women with breast cancer in Iran. METHODS: This was a descriptive correlation study conducted in 2012 on 150 main caregivers of patients with breast cancer who came to the oncology clinic of Shahid Ghazi hospital in Tabriz, Iran. A questionnaire which included caregiving-related factors and the Zarit Burden Interview was used for data collection after its validity and reliability were determined...
September 2016: Asian Nursing Research
Ravi B Parikh, Brynn Bowman, Constance Dahlin, Jeanne S Twohig, Diane E Meier
Early, integrated palliative care has been shown to improve quality of life and reduce utilization in both inpatient and outpatient settings. As health systems shift to risk-based payment structures, palliative care will play an increasing role in improving value of care outside of the hospital. Based on successful models of community-based palliative care, we identify six principles - interdisciplinary team-based care; 24/7 access and responsiveness; concurrent palliative care with disease-directed treatment; targeting services to high-risk patients; integrated medical and social supports; and caregiver support - that are widely implemented because of their impact on improving value for seriously ill individuals...
September 27, 2016: Healthcare
J McDonald, N Swami, B Hannon, C Lo, A Pope, A Oza, N Leighl, M Krzyzanowska, G Rodin, L W Le, C Zimmermann
BACKGROUND: Early palliative care improves the quality of life (QOL) and satisfaction with care of patients with advanced cancer, but little is known about its effect on caregivers. Here we report outcomes of caregiver satisfaction with care and QOL from a trial of early palliative care. PATIENT AND METHODS: Twenty-four medical oncology clinics were cluster-randomised, stratified by tumour site (lung, gastrointestinal, genitourinary, breast, gynaecological), to early palliative care team referral, or to standard oncology care with palliative care only as needed...
September 29, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Amir Shanan, Brenda Stevens, Gail Bishop, Kathleen Cooney, Shea Cox, Robin Downing, Kathy Mitchener, Nancy Soares, Tammy Wynn
End-of-life (EOL) care and decisionmaking embody the critical final stage in a pet's life and are as important and meaningful as the sum of the clinical care provided for all prior life stages. EOL care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client. Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support. Veterinarians should not allow an EOL patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place...
September 29, 2016: Journal of the American Animal Hospital Association
Aurélie Duruflé, Claire Le-Meur, Marie-Pierre Reillon, Claire Lozach, Benoit Nicolas
Many mobile teams were created over the past decade in various medical specialties including physical medicine and rehabilitation (MPR). The Pôle Saint-Helier has created a mobile team of rehabilitation-reintegration (EM2R) in December 2012 with support from the Regional Health Agency of Brittany. It operates on the health territory No. 5 of Brittany near people experiencing neurological disability. Its main mission is to implement the necessary devices to facilitate the home return of people hospitalized after a neurological event or maintaining to home people with neurological disorders...
September 2016: Annals of Physical and Rehabilitation Medicine
Isseki Maeda, Mitsunori Miyashita, Akemi Yamagishi, Hiroya Kinoshita, Yutaka Shirahige, Noriko Izumi, Takuhiro Yamaguchi, Miyuki Igarashi, Masashi Kato, Tatsuya Morita
CONTEXT: A region-based palliative care intervention (OPTIM study) increased home death, access to specialist palliative care, quality of care, and quality of death and dying. OBJECTIVES: To examine changes in palliative care outcomes in different care settings (hospitals, palliative care units, and home) and obtain insights into how to improve region-level palliative care. METHODS: The intervention program was implemented between April 2008 and March 2011...
September 21, 2016: Journal of Pain and Symptom Management
A Brinkman-Stoppelenburg, M Boddaert, J Douma, A van der Heide
BACKGROUND: Palliative care expert teams in hospitals have positive effects on the quality of life and satisfaction with care of patients with advanced disease. Involvement of these teams in medical care is also associated with substantial cost savings. In the Netherlands, professional standards state that each hospital should have a palliative care team by 2017. We studied the number of hospitals that have a palliative care team and the characteristics of these teams. METHODS: In April 2015, questionnaires were mailed to key palliative care professionals in all general, teaching and academic hospitals in the Netherlands...
2016: BMC Health Services Research
Suzanne Rainsford, Roderick D MacLeod, Nicholas J Glasgow, Donna M Wilson, Christine B Phillips, Robert B Wiles
The 'good death' is one objective of palliative care, with many 'good death' viewpoints and research findings reflecting the urban voice. Rural areas are distinct and need special consideration. This scoping review identified and charted current research knowledge on the 'good' rural death through the perspectives of rural residents, including rural patients with a life-limiting illness, to identify evidence and gaps in the literature for future studies. A comprehensive literature search of English language articles (no date filter applied) was conducted in 2016 (2 January to 14 February) using five library databases...
September 19, 2016: Health & Social Care in the Community
Verónica Inés Veloso, Vilma Adriana Tripodoro
PURPOSE OF REVIEW: To revise the family caregiver's burden concept and to understand the implications for the patient, family and healthcare system. We analyzed recent literature in three main areas: the role of family caregiver at the end of life, the family caregiver's burden and the involvement of social care networks. RECENT FINDINGS: The family caregiver often accepts the caring as a natural action, presumably imposed by the society. A recent review described seven main roles of care which, according to family system and society, consist of different tasks and activities...
September 15, 2016: Current Opinion in Supportive and Palliative Care
Kirsten Hermans, Joachim Cohen, Nele Spruytte, Chantal Van Audenhove, Anja Declercq
AIM: The aims of the present study were: (i) to describe palliative care needs and symptoms of older adults anticipated to be in the last year of their life in Flemish nursing homes (Belgium); and (ii) to evaluate whether these needs differ between residents with and without dementia. METHODS: A cross-sectional study was carried out in 2014. Nurses and nursing assistants in 15 Flemish nursing homes (Belgium) completed the Palliative care Outcome Scale for 109 residents with palliative care needs...
September 16, 2016: Geriatrics & Gerontology International
Cécile Furstenberg
The concepts of responsibility and compassion are fundamental in ethics. These notions help to safeguard humaneness, especially in the field of health care and notably in palliative care. These concepts can be put into practice by caregivers and applied to daily practice.
August 2016: Revue de L'infirmière
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