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Palliative nursing

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https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#1
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
December 5, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27914679/postgraduate-education-in-radiation-oncology-in-low-and-middle-income-countries
#2
J G Eriksen
Radiation therapy is one of the most cost-effective ways to treat cancer patients on both a curative and palliative basis in low- and middle-income countries (LMICs). Despite this, the gap in radiation oncology capacity is enormous and is even increasing due to a rapid rise in the incidence of cancer cases in LMICs. The urgent need for radiotherapy resources in terms of bunkers and megavoltage machines is important, but equally important is the tremendous lack of properly educated health care professionals...
November 30, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#3
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27908945/norwood-procedure-for-palliation-of-hypoplastic-left-heart-syndrome-right-ventricle-to-pulmonary-artery-conduit-vs-modified-blalock-taussig-shunt
#4
Dorothy M Beke
Patients with hypoplastic left heart syndrome undergo a series of operations to separate the pulmonary and systemic circulations. The first of at least 3 operations occurs in the newborn period, with a stage I palliation. The goal of stage I palliation is to provide pulmonary blood flow and create an unobstructed systemic outflow tract. Advances in surgical techniques and intraoperative and postoperative care have helped decrease morbidity and mortality for patients with hypoplastic left heart syndrome who have the stage I Norwood operation, but the patients continue to be at increased risk for hemodynamic collapse and adverse outcomes...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908943/planning-for-deactivation-of-implantable-cardioverter-defibrillators-at-the-end-of-life-in-patients-with-heart-failure
#5
Destiny R Brady
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27900726/survey-on-german-palliative-care-specialists-experiences-with-advance-directives
#6
Julia Zenz, Michael Zenz
INTRODUCTION: Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD). METHODS: A questionnaire was handed out to attendants of a palliative care symposium. RESULTS: Complete answers were obtained from 126 physicians and 276 nurses...
November 29, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27898287/international-association-for-hospice-and-palliative-care-position-statement-euthanasia-and-physician-assisted-suicide
#7
Liliana De Lima, Roger Woodruff, Katherine Pettus, Julia Downing, Rosa Buitrago, Esther Munyoro, Chitra Venkateswaran, Sushma Bhatnagar, Lukas Radbruch
BACKGROUND: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27898141/bostadsort-avg%C3%A3-r-den-palliativa-v%C3%A3-rdens-resurser-och-kvalitet-satsningar-f%C3%A3-r-att-%C3%A3-ka-kompetensen-beh%C3%A3-vs
#8
Bertil Axelsson, Bengt Sallerfors, Carl Johan Furst
Access to palliative care is unequally distributed across Sweden and thus does not meet the needs. The holistic perspective of palliative care is sometimes contrasted with the usual medical focus on organ failure and disease. Palliative consultation teams provide specialist palliative care competencies for staff caring for patients in primary care, nursing homes and in hospitals. Efforts to increase knowledge and skills in palliative care is needed at undergraduate university level and through postgraduate and specialist training...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27896390/-assisted-suicide-in-the-movies-what-is-not-shown
#9
Kurt W Schmidt
Whereas changes to the existing legal situation regarding assisted suicide have been a topic of controversial debate in Germany for the last few years, this issue has long been of interest for international film-makers. Since the mid-1980s, the theme of assisted suicide has repeatedly been taken up by cinema, predominantly as central to a relationship drama. A sick person asks somebody close to them for help. Often this somebody is a physician or a nurse, ultimately an obvious way of solving the practical problem of how the assistant is to gain access to a lethal substance...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27896389/-attitudes-and-experiences-regarding-physician-assisted-suicide-a-survey-among-members-of-the-german-association-for-palliative-medicine
#10
Maximiliane Jansky, Birgit Jaspers, Lukas Radbruch, Friedemann Nauck
BACKGROUND: The need to regulate physician-assisted suicide (PAS) and organizations offering assisted suicide has been controversially debated in Germany. Before the German parliament voted on various drafts in November 2015, the German Association for Palliative Medicine surveyed its members on their attitudes and experiences regarding PAS. METHOD: Items for the survey were derived from the literature and consented in a focus group. LITERATURE SEARCH: 2005-2015 - PubMed: PAS [Title/Abstract] UND survey (all countries), grey literature...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27894377/effect-of-a-spiritual-care-training-program-for-staff-on-patient-outcomes
#11
Grace Meijuan Yang, Yung Ying Tan, Yin Bun Cheung, Weng Kit Lye, Sock Hui Amy Lim, Wan Ru Ng, Christina Puchalski, Patricia Soek Hui Neo
OBJECTIVE: Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative care for patients with an advanced serious illness. The aim of our study was to determine whether a training program for healthcare professionals on spirituality and the taking of a spiritual history would result in improved patient quality of life (QoL) and spiritual well-being. METHOD: This was a cluster-controlled trial of a spiritual care training program for palliative care doctors and nurses...
November 29, 2016: Palliative & Supportive Care
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#12
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27890302/-facilitators-and-barriers-regarding-end-of-life-care-at-nursing-homes-a-focus-group-study
#13
María Remedios Sánchez-García, Marina Moreno-Rodríguez, César Hueso-Montoro, Concepción Campos-Calderón, Ana Varella-Safont, Rafael Montoya-Juárez
AIM: To identify the facilitators and barriers experienced by professional related to end of life care in nursing homes. DESIGN: Descriptive qualitative research with phenomenological orientation, through content analysis. PLACEMENT: Nursing Homes at Primary Care District in Granada (Spain). PARTICIPANTS: Fifteen clinical professionals with, at least 6 months of experience in nursing homes, without specific background in palliative care...
November 24, 2016: Atencion Primaria
https://www.readbyqxmd.com/read/27890024/end-of-life-experiences-and-deathbed-phenomena-as-reported-by-brazilian-healthcare-professionals-in-different-healthcare-settings
#14
Claudia Soares Dos Santos, Bianca Sakamoto Ribeiro Paiva, Alessandra Lamas Granero Lucchetti, Carlos Eduardo Paiva, Peter Fenwick, Giancarlo Lucchetti
OBJECTIVE: The objectives of the present study were to describe and compare the characteristics and reports of end-of-life experiences (ELEs) by healthcare professionals at different institutions and to investigate the influence of religious beliefs on these reports. METHOD: A multicenter study was carried out in Brazil that included six nursing homes (NHs), a cancer hospital (ONC), and a palliative care (PC) unit. Sociodemographic data, ELE reports (Fenwick's questionnaire), religiosity (the Duke Religion Index), spirituality (the Spirituality Self-Rating Scale), and mental health (the DASS-21 questionnaire) were assessed...
November 28, 2016: Palliative & Supportive Care
https://www.readbyqxmd.com/read/27885912/politics-and-palliative-care-mauritania
#15
Dion Smyth
Dion Smyth's review of palliative nursing on the internet.
November 2, 2016: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/27885910/an-end-of-life-care-nurse-service-for-people-with-copd-and-heart-failure-stakeholders-experiences
#16
Bridget Johnston, Carolyn Coole, Melanie Jay Narayanasamy
BACKGROUND: End-of-life care (EOLC) has historically been associated with cancer care. However, demographic changes indicate that future provision must also cater for other long term conditions (LTC). An EOLC-LTC service, delivered by palliative care nurses, is currently being piloted in one area in the East Midlands with patients with cardiac and respiratory disease. In order to inform future commissioning, it is important to gain the views and experiences of those involved with the service...
November 2, 2016: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/27883873/doctors
#17
Gaya Sritharan, Amber C Mills, Michele R Levinson, Anthea L Gellie
Objectives The aims of the present study were to investigate doctors' attitudes regarding the discussion and writing of not for resuscitation (NFR) orders and to identify potential barriers to the completion of these orders.Methods A questionnaire-based convenience study was undertaken at a tertiary hospital. Likert scales and open-ended questions were directed to issues surrounding the discussion, timing, understanding and writing of NFR orders, including legal and personal considerations.Results Doctors thought the presence of an NFR order both should and does alter care delivered by nursing staff, particularly delivery of pain relief, nursing observations and contacting the medical emergency team...
November 25, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27882864/patient-participation-in-palliative-care-decisions-an-ethnographic-discourse-analysis
#18
Emmanuelle Bélanger, Charo Rodríguez, Danielle Groleau, France Légaré, Mary Ellen MacDonald, Robert Marchand
The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team...
2016: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/27882391/-palliative-care-for-patients-with-turkish-or-arabic-migration-background-in-lower-saxony-a%C3%A2-survey-from-palliative-care-professionals-perspective
#19
Maximiliane Jansky, Sonja Owusu-Boakye, Friedemann Nauck
BACKGROUND AND OBJECTIVES: People with a migration background (MB) are an important part of German society. If and how they use specialised palliative care (SPC) has not been studied. We aimed to assess the current SPC for patients with Turkish or Arabic MB (the largest group of immigrants in Germany with a shared ascribed culture) from the point of view of healthcare professionals (HCP) in Lower Saxony. METHOD: All HCPs in institutions providing SPC (n = 90) were invited to participate in an anonymous online survey which contained closed and open questions about care for this patient group, characteristics of the last patient with Turkish or Arabic MB they cared for, and resources and strategies to care for these patients...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27878602/-he-is-not-that-important-anymore-general-practitioners-in-a%C3%A2-specialized-palliative-home-care-setting-from-a%C3%A2-patient-s-point-of-view
#20
Sven Schwabe, Gülay Ates, Benjamin Ewert, Jeroen Hasselaar, Michaela Hesse, Lisa Linge-Dahl, Birgit Jaspers, Lukas Radbruch
BACKGROUND: The outpatient medical care of palliative patients (PPs) has always fallen within the duties of general practitioners. Since the specialized palliative out-patient care (SAPV) legislation in 2007 palliative home care teams (PCTs) were established, providing holistic medical, nursing, and psychosocial support for patients with life-limiting illness and their care providers. OBJECTIVES: The article explores the role of GPs in palliative home care settings with PCTs from the patient's perspective...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
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