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https://www.readbyqxmd.com/read/28817366/trajectory-of-dyspnea-and-respiratory-distress-among-patients-in-the-last-month-of-life
#1
Margaret L Campbell, Jason M Kiernan, John Strandmark, Hossein N Yarandi
BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817348/palliative-care-consults-in-u-s-nursing-homes-not-just-for-the-dying
#2
Julie C Lima, Susan C Miller
BACKGROUND: Little is known about nursing home (NH) residents who receive palliative care (PC) consults in the United States. OBJECTIVE: Separately by short versus long (≥90 days) stays, to describe NH residents with PC consults compared to a prevalent NH sample. DESIGN: Descriptive longitudinal study. SETTING/SUBJECTS: NH residents in 2008-2010 in 54 NHs. MEASUREMENTS: Resident characteristics came from merged Medicare and NH data from the Centers for Medicare and Medicaid Services and consult information from two PC organizations that were the sole PC consult providers in the study NHs...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28814321/relatives-perceived-quality-of-palliative-care-comparisons-between-care-settings-in-which-patients-die
#3
Dolf de Boer, Jolien M Hofstede, Anke J E de Veer, Natasja J H Raijmakers, Anneke L Francke
BACKGROUND: Dying in the preferred setting is an indicator of good palliative care quality. Most people prefer to die at home. But does the quality of care as perceived by their relatives vary depending on the care setting that is the place of death? The aim is to compare (from the relatives perspective) whether there are perceived differences in the quality of palliative care between the settings in which people die. METHODS: Multivariate linear regression analyses have been carried out using an existing dataset containing information collected using the relatives' version of the Consumer Quality Index (CQ-index) Palliative Care...
August 16, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28813635/standardization-and-scaling-of-a-community-based-palliative-care-model
#4
Janet Bull, Arif H Kamal, Matthew Harker, Donald H Taylor, Lindsay Bonsignore, John Morris, Lisa Massie, Parampal Singh Bhullar, Mary Howell, Mark Hendrix, Deeana Bennett, Amy Abernethy
BACKGROUND: Although limited, the descriptions of Community-Based Palliative Care (CBPC) demonstrates variability in team structures, eligibility, and standardization across care settings. OBJECTIVE: In 2014, Four Seasons Compassion for Life, a nonprofit hospice and palliative care (PC) organization in Western North Carolina (WNC), was awarded a Centers for Medicare and Medicaid Services Health Care Innovation (CMMI) Award to expand upon their existing innovative model to implement, evaluate, and demonstrate CBPC in the United States...
August 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28813191/effect-and-efficiency-of-an-embedded-palliative-care-nurse-practitioner-in-an-oncology-clinic
#5
Anne M Walling, Sarah F D'Ambruoso, Jennifer L Malin, Sara Hurvitz, Ann Zisser, Anne Coscarelli, Robin Clarke, Andrew Hackbarth, Christopher Pietras, Frances Watts, Bruce Ferrell, Samuel Skootsky, Neil S Wenger
PURPOSE: To test a simultaneous care model for palliative care for patients with advanced cancer by embedding a palliative care nurse practitioner (NP) in an oncology clinic. METHODS: We evaluated the effect of the intervention in two oncologists' clinics beginning March 2014 by using implementation strategies, including use of a structured referral mechanism, routine symptom screening, integration of a psychology-based cancer supportive care center, implementation team meetings, team training, and a metrics dashboard for continuous quality improvement...
August 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28812945/phase-of-illness-in-palliative-care-cross-sectional-analysis-of-clinical-data-from-community-hospital-and-hospice-patients
#6
Harriet Mather, Ping Guo, Alice Firth, Joanna M Davies, Nigel Sykes, Alison Landon, Fliss Em Murtagh
BACKGROUND: Phase of Illness describes stages of advanced illness according to care needs of the individual, family and suitability of care plan. There is limited evidence on its association with other measures of symptoms, and health-related needs, in palliative care. AIMS: The aims of the study are as follows. (1) Describe function, pain, other physical problems, psycho-spiritual problems and family and carer support needs by Phase of Illness. (2) Consider strength of associations between these measures and Phase of Illness...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28810503/two-is-a-perfect-number-patient-doctor-relationship-and-patient-attachment-style-in-palliative-care
#7
Iwona Zaporowska-Stachowiak, Katarzyna Stachowiak, Katarzyna Stachnik
We tested the association between the palliative patient's attachment style and the patient-doctor relationship, by means of Revised Adult Attachment Scale and a self-designed, patient-doctor relationship questionnaire. The study included 110 (52 M, 58 F) cancer, hospice patients, aged 36-80 years. We observed 54 percent of secure, 18 percent of dismissive, 9 percent of preoccupied, and 19 percent of fearful styles. Securely attached patients developed significantly ( p < .05) better relationships with doctors than insecure patients...
August 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28807707/quality-improvement-pearls-for-the-palliative-care-and-hospice-professional
#8
Arif H Kamal, Jonathan M Nicolla, Steve Power
Rapid changes in how palliative care clinicians are evaluated and paid present an imperative for clinicians to adeptly and routinely perform quality improvement in usual practice. Like empathic communication and facilitating goals of care discussions, quality improvement skills must be learned, honed, and practiced so identifying problems and brainstorming solutions becomes a natural component of delivering serious illness care. Using our experience in both failures and successes in performing quality improvement, herein we provide a prioritized list of ten pearls specifically aimed to palliative care and hospice professionals...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807702/factors-associated-with-use-of-u-s-community-based-palliative-care-for-children-with-life-limiting-or-life-threatening-illnesses-and-their-families-an-integrative-review
#9
REVIEW
Jackelyn Y Boyden, Martha A Q Curley, Janet A Deatrick, Mary Ersek
CONTEXT: As children with life-limiting and life-threatening illnesses live longer, challenges to meeting their complex health care needs arise in homes and communities, as well as in hospitals. Integrated knowledge regarding community-based pediatric palliative care (CBPPC) is needed to strategically plan for a seamless continuum of care for children and their families. OBJECTIVE: The purpose of this integrative review paper is to explore factors that are associated with the use of CBPPC for U...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803085/palliative-care-in-south-africa
#10
Cornelia Drenth, Zodwa Sithole, Esme Pudule, Sheryl Wüst, Nicola GunnClark, Liz Gwyther
The Hospice Palliative Care Association (HPCA) was established in 1987 by hospices in South Africa who felt the need for a national body to share best practices and to promote palliative care services in South Africa. HPCA supports member hospices in providing palliative care to people of any age with a life-limiting condition. HPCA has the further aim to ensure access to palliative care in settings other than member hospices. Many projects were launched over the years to influence policy, and to educate medical practitioners, nurses, social workers, theologians, and community caregiver; and to develop services...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803074/hospice-palliative-care-development-in-hungary
#11
Agnes Csikos, Csilla Busa, Katalin Muszbek
During the past 25 years many developmental steps have occurred in Hungary in palliative care. Further education and service development is needed to provide a quality palliative care for all the Hungarian people. Hungary has a universal health care system with a developed infrastructure. The first Hungarian hospice team started in 1991. At that time the concept of hospice care was unknown. Symptom control and psychosocial support for the dying patient was inadequate. The regulatory framework was based on the 1997 Health Care Act which was followed by significant palliative care legislation including documents on the legal requirements for palliative care (2004)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801006/palliative-care-in-kazakhstan
#12
Gulnara Kunirova, Ainur Shakenova
In Kazakhstan, like most ex-Soviet Union countries palliative care began in the late 1990's with the opening of the Almaty Hospice in 1999. Since that time, several palliative care services have opened in urban centers but there is little coverage in rural areas. Palliative care has grown due to the collaborative work of Parliament leaders, Ministry of Health, local governments officials, Public Health Higher School, National Center for Health Development, academic medical institutions, oncology and palliative care experts, NGO's, Soros Foundation Kazakhstan, and international experts...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28800999/promoting-palliative-care-internationally-building-leaders-to-promote-education-practice-and-advocacy
#13
Pam Malloy, Betty Ferrell, Rose Virani, Polly Mazanec
In February 2000, nine nursing educators, practitioners, and researchers met in Nashville, TN to develop a palliative care curriculum specifically for nurses. The following month, twenty-two advisors from nursing organizations across the United States convened in Washington, DC to review the recommended curriculum development and dissemination plans for end-of-life care throughout nursing schools, hospitals, hospices, homecare, and geriatric settings. The Robert Wood Johnson Foundation (RWJF) provided funding for curriculum and competency development and for 6 national train-the-trainer courses to be held from 2001 to 2003...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28799821/a-review-of-palliative-and-hospice-care-in-the-context-of-islam-dying-with-faith-and-family
#14
Maximiliano Mendieta, Robert W Buckingham
BACKGROUND: By starting to understand Muslim culture, we can seek common ground with Islamic culture within the American experience and bridge opportunities for better palliative and hospice care here and in Middle Eastern countries. The United States, Canada, and Europe are education hubs for Middle Eastern students, creating an opportunity for the palliative and hospice care philosophy to gain access by proxy to populations of terminally ill patients who can benefit from end-of-life care...
August 11, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28797863/palliative-care-development-in-mongolia
#15
Odontuya Davaasuren, Frank Ferris
CONTEXT: Since the year 2000, Mongolia has established the foundation measures for a national palliative care program and has made several significant achievements. METHODS: Systematic reviews and observational studieson palliative care development in Mongolia have taken place overthe past 16 years. RESULTS: Mongolia began palliative care development in 2000 with the creation of the Mongolian Palliative Care Society and the Palliative Care Department...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797861/the-worldwide-hospice-palliative-care-alliance
#16
Stephen R Connor
The Worldwide Hospice Palliative Care Alliance (WHPCA) is an international non-governmental organization registered as a charity in England and Wales that was established in 2008 following a series of international gatherings that highlighted the important need for palliative care to be included in global policy and health planning. The vision of the WHPCA is a world with universal access to hospice and palliative care. Its mission is to foster, promote and influence the delivery of affordable, quality palliative care...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797860/palliative-care-for-tuberculosis
#17
Stephen R Connor
In 2014, 1.5 million people died of tuberculosis (TB) worldwide including 400,000 co-infected with HIV. TB remains a major cause of death and suffering globally, in spite of the fact that it is supposed to be a curable disease. Drug resistant forms of TB have developed as a result of poor treatment compliance including multi-drug and extreme drug resistant forms that take longer to treat and have higher likelihoods of treatment failure. In 2010, at the initiation of the TB community, a partnership was formed between the WHO Stop TB Program, the Worldwide Hospice Palliative Care Alliance, and the Open Society Foundation's International Palliative Care Initiative (OSF/IPCI) to explore how to improve the ability of TB professionals to deliver palliative care to their patients...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797851/palliative-care-development-in-georgia
#18
Nina Kiknadze, Pati Dzotsenidze
Georgia has established the foundational measures for a national palliative care program-policy, education, drug availability, and implementation. Amendments to legislation needed to develop palliative care have been approved. Palliative care has been recognized as a subspecialty in oncology, critical care, internal medicine and surgery. The National Plan for Palliative Care for 2011-2016 was approved. Opioids, especially oral morphine, are available on a limited basis for patients at home but oral morphine is not available for patients in the hospital...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797849/the-international-association-for-hospice-and-palliative-care-iahpc-advancing-hospice-and-palliative-care-worldwide
#19
Liliana De Lima, Lukas Radbruch
The International Association for Hospice and Palliative Care (IAHPC) is a membership based organization dedicated to the development and improvement of hospice and palliative care worldwide. The mission of IAHPC is to improve the quality of life of adults and children with life-threatening conditions and their families. The vision of IAHPC is universal access to high-quality palliative care, integrated into all levels of healthcare systems in a continuum of care with disease prevention, early diagnosis and treatment, to assure that any patient's or family caregiver's suffering is relieved to the greatest extent possible...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#20
Richard F Riedel, Kim Slusser, Steve Power, Christopher A Jones, Thomas W LeBlanc, Arif H Kamal, Devi Desai, Deborah Allen, Yinxi Yu, Steven Wolf, Anthony N Galanos
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partnership at a tertiary medical center during its first year of implementation. METHODS: We conducted a retrospective, longitudinal, pre- and postintervention cohort study at Duke University Hospital. Pre- and postintervention cohorts were defined as all patients admitted to the solid tumor inpatient service from September 1, 2009, to June 30, 2010, and September 1, 2011 to June 30, 2012, respectively...
August 10, 2017: Journal of Oncology Practice
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