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Hospice, Palliative

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https://www.readbyqxmd.com/read/28196784/addressing-palliative-care-clinician-burnout-in-organizations-a-workforce-necessity-an-ethical-imperative
#1
Krista L Harrison, Elizabeth Dzeng, Christine S Ritchie, Tait D Shanafelt, Arif H Kamal, Janet H Bull, Jon C Tilburt, Keith M Swetz
Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. This is especially problematic in hospice and palliative care: patients are often frail, elderly, vulnerable and complex; access to care is often outstripped by need; and demand for clinical experts will increase as palliative care further integrates into usual care. Efforts to mitigate and prevent burnout currently focus on individual clinicians...
February 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28193270/the-experience-of-providing-end-of-life-care-at-a-children-s-hospice-a-qualitative-study
#2
Tracey McConnell, Sam Porter
BACKGROUND: More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a children's hospice. METHODS: Qualitative research incorporating interviews and a focus group. Data were analysed using thematic analysis. Purposeful sampling led to a total of 15 care team staff recruited from a children's hospice offering palliative and specialist care to life-limited children and young people...
February 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28186928/collecting-biological-material-from-palliative-care-patients-in-the-last-weeks-of-life-a-feasibility-study
#3
Séamus Coyle, Aileen Scott, Amara Callistus Nwosu, Richard Latten, James Wilson, Catriona R Mayland, Stephen Mason, Chris Probert, John Ellershaw
OBJECTIVE: To assess the feasibility of prospectively collecting biological samples (urine) from palliative care patients in the last weeks of life. SETTING: A 30-bedded specialist hospice in the North West of England. PARTICIPANTS: Participants were adults with a diagnosis of advanced disease and able to provide written informed consent. METHOD: Potential participants were identified by a senior clinician over a 12-week period in 2014...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28174374/-development-of-spiritual-care-in-cancer-treatment-in-japan
#4
Susumu Shimazono
Spiritual care started worldwide in the late 1960s with the development of the hospice movement and death studies. Why did spiritual care start duringthis time in history ? In some Christian societies, of that time,"pastoral care" evolved into an interfaith "spiritual care" where in the caretaker was the main agent instead of the caregiver. On the other hand, the importance of palliative care for cancer patients was gradually acknowledged. In addition, this progress was accompanied by the academic development of "death studies" which is called "death and life studies" in Japan...
January 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28169946/differences-in-utilization-of-life-support-and-end-of-life-care-for-medical-icu-patients-with-versus-without-cancer
#5
Geoffrey Koff, Urvashi Vaid, Edward Len, Albert Crawford, David A Oxman
OBJECTIVES: To explore differences in the utilization of life support and end-of-life care between patients dying in the medical ICU with cancer compared with those without cancer. DESIGN: Retrospective review of 403 deaths or hospice transfers in the medical ICU from January 1, 2012, to June 30, 2013. SETTING: Urban tertiary care university hospital. PATIENTS: Consecutive medical ICU deaths or hospice transfers over an 18-month period...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28160875/understanding-palliative-care-and-hospice-a%C3%A2-review-for-primary-care-providers
#6
REVIEW
Mary K Buss, Laura K Rock, Ellen P McCarthy
Palliative care provides invaluable clinical management and support for patients and their families. For most people, palliative care is not provided by hospice and palliative medicine specialists, but rather by their primary care providers. The recognition of hospice and palliative medicine as its own medical subspecialty in 2006 highlighted the importance of palliative care to the practice of medicine, yet many health care professionals harbor misconceptions about palliative care, which may be a barrier to ensuring that the palliative care needs of their patients are identified and met in a timely fashion...
February 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28158232/the-effects-of-hospice-shared-care-for-gastric-cancer-patients
#7
Kun-Siang Huang, Shih-Ho Wang, Seng-Kee Chuah, Kun-Ming Rau, Yu-Hung Lin, Meng-Che Hsieh, Li-Hsueh Shih, Yen-Hao Chen
BACKGROUND: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. METHODS: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81)...
2017: PloS One
https://www.readbyqxmd.com/read/28156659/novel-tool-utilized-as-a-trigger-for-advance-care-planning-in-hospitalized-oncology-patients
#8
Sandhya Rao, Diane Sarnacki, Alexandra Dobie, Karla Damus, Gretchen Gignac
: 22 Background: Study Purpose: reduce inpatient oncology readmissions; determine if there is a need to standardize trigger for Advance Care Planning in the inpatient oncology population. METHODS: Investigational Quality Improvement Study January-June 2014. Retrospective chart review of oncology readmissions on the BMC Hematology and Oncology service during a 6 month period, January-June 2013 (N = 68). Data abstracted included: demographics (age, race/ethnicity, primary language, education, marital status, ECOG); type and stage of cancer; type of consults (palliative, spiritual, social services, integrative, PT/OT, hospice, visiting nurse)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156654/recovery-of-cancer-patients-social-lives-upon-referral-to-palliative-care-units
#9
Yasuo Hirayama, Takayuki Machino, Toshiro Kusakabe, Kenji Nakamura, Hiroyoshi Mihara, Satoko Itoh, Kunihiko Ishitani
: 107 Background: Our hospital is a cancer-specific facility that treats patients from diagnosis to terminal care. We evaluate the possibility of effective cancer chemotherapies for patients referred to our palliative care unit from other hospitals through case conferences in our institution. Even the patients referred to the palliative care unit of our institution are sometimes assessed as "very likely to be improved by standard or semi-standard treatment" by the palliative care and oncologic teams in our institution...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156644/barriers-to-patients-understanding-of-prognosis-in-advanced-cancer
#10
Jason Palopoli, Mark Maddox, Adonas Woodard, Kristine Marie Ward, Maneesh Rajiv Jain, Pamela A Crilley, Dave Topolsky, John King, Sigmund Benham Khan, Maelys Amat, Michael Styler
: 24 Background: An informed decision requires good communication between the patient and their oncologist in regards to diagnosis and prognosis, especially in patients with terminal cancer. This discussion entails education about their disease, treatment options, and potential outcomes. The purpose of this study was to assess advanced-stage cancer oncology patients' comprehension of their disease, treatment options and goals of therapy. METHODS: Subjects included patients with a diagnosis of metastatic cancer with an option for palliative or life extending chemotherapy in an out-patient office at Drexel University College of Medicine...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#11
(no author information available yet)
: 53 Background: The disciplines of palliative care (PC) and clinical ethics (CE) share common content but also important distinctions in method, skill set, and clinical role in a given patient encounter. Particularly in cases of advance care planning, complex decision-making, and clarifying goals oncology teams may be challenged to know which consultation service to involve. METHODS: Case report and commentary. RESULTS: A 60 year-old man with a 3-year history of glioblastoma multiforme presented with sudden onset right-sided weakness and altered mental status...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156627/making-treatment-decisions-at-end-of-life-in-a-comprehensive-cancer-center
#12
Lee Ellington, Kathi Mooney
: 51 Background: End of life treatment decisions are challenging for cancer patients and oncology providers. Patients must understand their prognosis and options, deciding if and when to increase palliative care and decrease tumor-focused therapy. Cancer centers committed to offering clinical trials and evaluate new therapies add complexity to these decisions. To better define crucial points for decision making, we reviewed the care patients received during the last 6 months of life at one comprehensive cancer center...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156625/clinical-and-health-care-setting-of-patients-admitted-at-pain-control-center-hospice-of-solofra-a-feasibility-model-of-end-of-life-care-in-the-avellino-province-of-italy
#13
Carmela Fasano, Luisa M Rizzo, A M Strollo, Elena De Vinco, Vincenzo Landolfi, Elena Altieri, Mario Nicola Vittorio Ferrante, Sergio Canzanella, Giuseppe Servillo, Lucia Genua, Maddalena Zampi, Gaetano D'Onofrio
: 59 Background: The Pain Control Center Hospice of Solofra (Italy) is managed with a mixed public / private, the first experience in the Campania region.We have evaluated the treatment procedures and the clinical outcome to make a comparison by between 123 evaluable patients in palliative care in 2015 and 232 evaluable patients in the biennium 2012-2014. METHODS: The following characteristics: patient gender, mean hospitalization time, differentiation between cancer and non cancer patients, medical weapon use, venous access type, enteral and parenteral feeding, pain killer use,Karnofsky scale...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156623/a-quality-improvement-approach-to-oncologist-referrals-for-hospice-care
#14
(no author information available yet)
: 45 Background: Cancer patients frequently experience short lengths of service in home hospice care. METHODS: The Oncology Clinical Guidance Council, composed of medical, surgical, gynecological and radiation oncologists sets standards of care for the OhioHealth system serving central Ohio. The Council was polled for consensus on how long a cancer patient should be enrolled in hospice care. Then, median length of stay of patients referred by 18 medical oncologists from their offices to OhioHealth hospice for calendar year 2014 were obtained...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156620/usage-of-oregon-s-death-with-dignity-act-dwda
#15
Michael Leo LeBlanc, Dawn L Hershman, Lee M Ellis, Frank L Meyskens
: 44 Background: In 1997, OR enacted a voter initiative allowing terminally ill residents to self-administer physician-prescribed medication to end their lives. Statute requires prescriptions written for lethal medications be reported; the state also collects demographic and intended use data. We wished to to evaluate and report participation trends. METHODS: OR's Public Health Division gathers compliance forms from prescribing/consulting physicians, pharmacists, and psychiatrists, prescribing physician follow-up forms, and death certificates...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156613/what-does-palliative-care-mean-diverse-definitions-from-cancer-care-providers
#16
Rebecca A Ferrer, Michelle Mollica, Grace Huang, Angela Falisi, Wen-Ying Sylvia Chou
: 40 Background: Existing literature on the epistemology of palliative care has mostly centered on patient/family perspectives. Understanding how multi-disciplinary healthcare providers themselves define palliative care is a critical step towards addressing barriers and harnessing facilitators that affect optimal delivery. METHODS: Semi-structured key informant interviews (N = 19) were conducted with members of healthcare provider teams as part of a qualitative study on goals of care for cancer patients enrolled in clinical trials...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156609/icu-deaths-in-patients-with-advanced-cancer-criteria-to-decrease-potentially-inappropriate-admissions-and-analysis-of-advance-planning-discussions
#17
Alva B Weir
: 47 Background: A significant number of advanced cancer admissions to intensive care unit (ICU) are inappropriate, as they do not prolonged survival. No clear consensus criteria for reasonable admissions of advanced cancer patients have been developed. METHODS: We established four criteria for ICU admissions in advanced cancer patients: post procedure complication, recent cancer diagnosis, good performance status and life expectancy of > 6 months. We reviewed charts of all patients who died in the ICU at a university-affiliated hospital between 2005-2010...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156608/when-home-means-another-nation-the-power-and-pitfalls-of-repatriation-at-the-end-of-life-from-a-tertiary-cancer-centre
#18
(no author information available yet)
: 46 Background: How people die lives on in the memory of those who survive. It is therefore pivotal for palliative teams to help craft an ending in line with patient and family goals. It has been observed in a tertiary cancer centre that there is often a spiritual imperative for patients to return to their nation of birth, once treatment is stopped and mortality accepted. METHODS: Retrospective chart review of 3 patients repatriated for end of life care to their nation of birth (Romania, Portugal, Ireland), focusing on: the conversations about the goal of repatriation and its meaning to the patient; the practical barriers and enablers of repatriation of patients with advanced cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156601/what-s-in-the-special-sauce-of-protocol-driven-outpatient-palliative-care-consultations
#19
Marie Bakitas, J Nicholas Dionne-Odom, Jennifer Frost, Margaret Plunkett, Lisa A Lisa A Stephens, Peggy Bishop
: 139 Background: Initial outpatient palliative care consultations (OPCC) in clinics are usually requested for uncontrolled symptoms. The purpose of this substudy was to determine the nature of recommendations made in early PC (EPC) protocol-driven OPCC. METHODS: Using a standardized tool, we conducted a content analysis on the assessment and plan components of protocol-driven OPCCs. OPCCs were conducted as a component of the ENABLE [Educate, Nurture, Advise, Before Life Ends] RCT (10/2010-9/2013) consisting of an OPCC and 6 structured weekly telephone coaching sessions and monthly follow up either at study entry (early) or 12 weeks later (delayed)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156590/healthcare-utilization-among-cancer-patients-prior-to-hospice
#20
Richard F Riedel, Christel N Rushing, Anthony N Galanos
: 135 Background: The integration of palliative medicine in oncologic care has become increasingly recognized and supported. We have previously reported improved health system and quality of care outcomes for solid tumor patients admitted to our novel, fully-integrated palliative care (PC) and medical oncology inpatient service at Duke University Medical Center (DUMC). In this study, we explored healthcare utilization in patients specifically discharged to hospice pre- and post-PC integration...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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