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https://www.readbyqxmd.com/read/29847327/reexamining-the-call-of-duty-teaching-boundaries-in-medical-school
#1
Justin A Chen, Leah B Rosenberg, Brian J Schulman, Jonathan E Alpert, Robert J Waldinger
Although healthy physician-patient boundaries are essential to medical practice, published research on how to teach this important topic to medical students is lacking. Physician-patient boundaries, the interpersonal limits placed on behavior within a clinical relationship, protect providers and patients alike, and they represent a key component of professionalism. However, these boundaries may be difficult to teach and frequently are not presented as part of the formal curriculum, except in communication-focused specialties such as psychiatry and palliative care...
May 29, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29796406/trends-in-geriatrics-graduate-medical-education-programs-and-positions-2001-to-2018
#2
Aldis H Petriceks, John C Olivas, Sakti Srivastava
It is no secret that the average age of the U.S. population is increasing, and this has special significance for the U.S. health care system. The number of individuals above 65 years old is predicted to increase 55% by 2030, and all the while, there is a looming physician shortage, one especially relevant for Geriatricians. Therefore, current Geriatricians must have objective information to assess the past, present, and future state of this important specialty. However, little literature exists regarding the recent changes in Geriatrics-related graduate medical education programs...
January 2018: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29610828/interactions-between-physicians-and-skilled-home-health-care-agencies-in-the-certification-of-medicare-beneficiaries-plans-of-care-results-of-a-nationally-representative-survey
#3
Cynthia M Boyd, Bruce Leff, Julia Bellantoni, Navpreet Rana, Jennifer L Wolff, David L Roth, Kim Carl, Orla C Sheehan
Background: Physicians are required to certify a plan of care for patients who receive Medicare skilled home health care (SHHC) services. The Centers for Medicare & Medicaid Services form 485 (CMS-485) is typically used for certification of SHHC plans of care and for interactions between SHHC agencies and physicians. Little is known about how physicians use the CMS-485 or their perceptions of its usefulness with respect to coordinating care with SHHC agencies. Objective: To determine how physicians interact with SHHC agencies and use the CMS-485 in care coordination for patients receiving SHHC services...
May 15, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29532465/voluntary-stopping-eating-and-drinking
#4
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29498614/psychosocial-standards-of-care-for-children-with-cancer-and-their-families-a-national-survey-of-pediatric-oncology-social-workers
#5
Barbara Jones, Jennifer Currin-Mcculloch, Wendy Pelletier, Vicki Sardi-Brown, Peter Brown, Lori Wiener
In 2015, an interdisciplinary group of psychosocial experts developed The Standards of Psychosocial Care for Children with Cancer and Their Families. This paper presents data from a national survey of pediatric oncology social workers and their experiences in delivering psychosocial care to children and families. In total, 107 social workers from 81 cancer institutions participated in a 25-item online survey that mirrored the 15 Standards for Psychosocial Care. Both closed and open-ended questions were included...
April 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29496535/refractory-schizophrenia-attempted-suicide-and-withdrawal-of-life-support-a-clinical-ethics-case-report
#6
Cory Taylor, Jamie C Fertal, Solomon Liao
BACKGROUND: Withdrawal of life support for an individual with refractory schizophrenia after attempted suicide remains controversial. Discussion regarding prognosis of mental illness and the distinction between somatic and mental illness brings out many ethical issues. This article will examine the role and weight of severe persistent mental illness in the withdrawal of life support after attempted suicide. CASE DESCRIPTION: A 30-year-old gentleman with deafness and schizophrenia was admitted with multiple self-inflicted visceral stab wounds...
February 26, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29452704/substance-use-disorder-among-current-cancer-patients-rates-and-correlates-nationally-in-the-department-of-veterans-affairs
#7
Pochu Ho, Robert Rosenheck
BACKGROUND: Substance use disorders (SUDs) are known to cause or complicate treatment of many types of cancers. OBJECTIVES: We sought to systematically assess rates of current SUDs among patients currently in treatment for cancer. METHODS: The National Veteran Health Administration administrative data from fiscal year 2012 were used to compare veterans with both cancer and comorbid SUDs to veterans with cancer but no SUDs and those with a SUD but no cancer...
May 2018: Psychosomatics
https://www.readbyqxmd.com/read/29331192/-psychiatry-and-palliative-care-collaboration-for-the-benefit-of-the-patient
#8
Lionel Regard
As palliative care units continue to develop, the provision of end-of-life care for patients with a chronic mental illness needs to be addressed. Aside from the somatic comorbidities to which these patients are particularly exposed and in view of the specificity of psychiatric treatment, the forms of end-of-life support for a patient with schizophrenia are described here, based on the experience of a psychiatric unit in the Var region.
January 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/28982637/pediatric-chronic-patients-at-outpatient-clinics-a-study-in-a-latin-american-university-hospital
#9
Renata A Alveno, Caroline V Miranda, Caroline G Passone, Aurora R Waetge, Elza S Hojo, Sylvia C L Farhat, Vicente Odone-Filho, Uenis Tannuri, Werther B Carvalho, Magda Carneiro-Sampaio, Clovis A Silva
OBJECTIVE: To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital. METHODS: A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0-9 years) and adolescents (10-19 years)...
October 2, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28946598/5-minutes-mindfulness-for-palliative-care-integrating-evidence-and-good-design
#10
Melvyn W B Zhang, Roger C M Ho, C G Ng
In psychiatry, mindfulness based intervention has been increasingly popular as a means of psychosocial intervention over the last decade. With the alvanche of technological advances, there has been a myriad of mindfulness based applications. Recent reviews have highlighted how these applications are lacking in functionalities and without demonstrated efficacy. Other reviews have emphasized that there is a need to take into consideration the design of an application, due to placebo effects. It is the aim of this technical note to illustrate how the 5-Minutes Mindfulness application, which is an application designed to provide mindfulness exercises to relieve distress and suffering amongst palliative patients, have been conceptualized...
December 4, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28941093/staging-in-bipolar-disorder-from-theoretical-framework-to-clinical-utility
#11
Michael Berk, Robert Post, Aswin Ratheesh, Emma Gliddon, Ajeet Singh, Eduard Vieta, Andre F Carvalho, Melanie M Ashton, Lesley Berk, Susan M Cotton, Patrick D McGorry, Brisa S Fernandes, Lakshmi N Yatham, Seetal Dodd
Illness staging is widely utilized in several medical disciplines to help predict course or prognosis, and optimize treatment. Staging models in psychiatry in general, and bipolar disorder in particular, depend on the premise that psychopathology moves along a predictable path: an at-risk or latency stage, a prodrome progressing to a first clinical threshold episode, and one or more recurrences with the potential to revert or progress to late or end-stage manifestations. The utility and validity of a staging model for bipolar disorder depend on its linking to clinical outcome, treatment response and neurobiological measures...
October 2017: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
https://www.readbyqxmd.com/read/28892432/patient-clinician-communication-american-society-of-clinical-oncology-consensus-guideline
#12
REVIEW
Timothy Gilligan, Nessa Coyle, Richard M Frankel, Donna L Berry, Kari Bohlke, Ronald M Epstein, Esme Finlay, Vicki A Jackson, Christopher S Lathan, Charles L Loprinzi, Lynne H Nguyen, Carole Seigel, Walter F Baile
Purpose To provide guidance to oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. Methods ASCO convened a multidisciplinary panel of medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities, and advocacy experts to produce recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, and randomized controlled trials published from 2006 through October 1, 2016...
November 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28890435/pain-control-in-thoracic-oncology
#13
Christine Peeters-Asdourian, Gilbert Massard, Paragi H Rana, Paul Van Houtte, Andrew P White, Bogdan Grigoriu, Dominique Lossignol, Mohammed Almalki, Jean Alexiou, Jean-Luc Engelholm, Jean-Paul Sculier
This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28866901/anxiety-and-psychosomatic-symptoms-in-palliative-care-from-neuro-psychobiological-response-to-stress-to-symptoms-management-with-clinical-hypnosis-and-meditative-states
#14
Anirudh Kumar Satsangi, Maria Paola Brugnoli
Psychosomatic disorder is a condition in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. It is a condition of dysfunction or structural damage in physical organs through inappropriate activation of the involuntary nervous system and the biochemical response. In this framework, this review will consider anxiety disorders, from the perspective of the psychobiological mechanisms of vulnerability to extreme stress in severe chronic illnesses. Psychosomatic medicine is a field of behavioral medicine and a part of the practice of consultation-liaison psychiatry...
January 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28854050/forensic-nursing-and-the-palliative-approach-to-care-an-empirical-nursing-ethics-analysis
#15
David Kenneth Wright, Brandi Vanderspank-Wright, Dave Holmes, Elise Skinner
BACKGROUND: A movement is underway to promote a palliative approach to care in all contexts where people age and live with life-limiting conditions, including psychiatric settings. Forensic psychiatry nursing-a subfield of mental health nursing- focuses on individuals who are in conflict with the criminal justice system. We know little about the values of nurses working in forensic psychiatry, and how these values might influence a palliative approach to care for frail and aging patients...
August 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28682527/issues-in-palliative-care
#16
Dean Schuyler
Through this column, we hope that practitioners in general medical settings will gain a more complete knowledge of the many patients who are likely to benefit from brief psychotherapeutic interventions. A close working relationship between primary care and psychiatry can serve to enhance patient outcome.
June 29, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28659013/-there-s-a-catch-22-the-complexities-of-pain-management-for-people-with-advanced-dementia-nearing-the-end-of-life-a-qualitative-exploration-of-physicians-perspectives
#17
Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja J McIlfatrick, Sharon M Morgan, Max Watson, Carole Parsons
BACKGROUND: Pain management is a cornerstone of palliative care. The clinical issues encountered by physicians when managing pain in patients dying with advanced dementia, and how these may impact on prescribing and treatment, are unknown. AIM: To explore physicians' experiences of pain management for patients nearing the end of life, the impact of these on prescribing and treatment approaches, and the methods employed to overcome these challenges. DESIGN: Qualitative, semi-structured interview study exploring barriers to and facilitators of pain management, prescribing and treatment decisions, and training needs...
October 1, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/28592238/a-survey-of-palliative-medicine-education-in-japan-s-undergraduate-medical-curriculum
#18
Yoichi Nakamura, Yusuke Takamiya, Mari Saito, Koichi Kuroko, Tatsuko Shiratsuchi, Kenzaburo Oshima, Yuko Ito, Satoshi Miyake
BACKGROUND: This study aimed to examine the status of undergraduate palliative care education among Japanese medical students using data from a survey conducted in 2015. METHODS: A questionnaire was originally developed, and the survey forms were sent to universities. The study's objectives, methods, disclosure of results, and anonymity were explained to participating universities in writing. Responses returned by the universities were considered to indicate consent to participate...
June 7, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/27551812/pediatric-palliative-care-and-child-psychiatry-a-model-for-enhancing-practice-and-collaboration
#19
Anna C Muriel, Joanne Wolfe, Susan D Block
As the field of Pediatric Palliative Care continues to develop, it is important to consider the scope of practice and the utility of collaboration with other specialties, including child and adolescent psychiatry. The integration of psychiatry and palliative medicine has been explored in adult practice, but has not yet been elaborated in pediatrics. This article proposes a clinical model of care that highlights the overlapping and unique expertise that each discipline brings, in a continuum of collaboration, and proposes an integrated care model for the most complex patients and families...
October 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27450328/palliative-psychiatry-for-severe-persistent-mental-illness-as-a-new-approach-to-psychiatry-definition-scope-benefits-and-risks
#20
REVIEW
Manuel Trachsel, Scott A Irwin, Nikola Biller-Andorno, Paul Hoff, Florian Riese
BACKGROUND: As a significant proportion of patients receiving palliative care suffer from states of anxiety, depression, delirium, or other mental symptoms, psychiatry and palliative care already collaborate closely in the palliative care of medical conditions. Despite this well-established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. DISCUSSION: Based on the WHO definition of palliative care, a, a working definition of palliative psychiatry is proposed...
July 22, 2016: BMC Psychiatry
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