keyword
MENU ▼
Read by QxMD icon Read
search

palliative ethics

keyword
https://www.readbyqxmd.com/read/28818633/patient-and-caregiver-reported-assessment-tools-for-palliative-care-summary-of-the-2017-ahrq-technical-brief
#1
Rebecca Aslakson, Sydney M Dy, Renee F Wilson, Julie Waldfogel, Allen Zhang, Sarina R Isenberg, Alex Blair, Joshua Sixon, Karen A Robinson
CONTEXT: Assessment tools are data collection instruments that are completed by or with patients or caregivers and which collect data at the individual patient or caregiver level. OBJECTIVES: To (1) summarize palliative care assessment tools completed by or with patients or caregivers, and (2) identify needs for future tool development and evaluation. METHODS: We completed: (1) a systematic review of systematic reviews; (2) a supplemental search of previous reviews and websites, and/or (3) a targeted search for primary articles when no tools existed in a domain...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807699/communication-challenges-of-oncologists-and-intensivists-caring-for-pediatric-oncology-patients-a-qualitative-study
#2
Folasade Odeniyi, Pamela G Nathanson, Theodore E Schall, Jennifer K Walter
CONTEXT: The families of oncology patients requiring intensive care often face increasing complexity in communication with their providers, particularly when patients are cared for by providers from different disciplines. OBJECTIVE: To describe experiences and challenges faced by pediatric oncologists and intensivists and how the oncologist-intensivist relationship impacts communication and initiation of goals of care discussions (GCDs). METHODS: We conducted semi-structured interviews with a convenience sample of ten physicians, including pediatric oncology and intensive care attendings and fellows...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28795404/palliative-drug-treatments-for-breathlessness-in-cystic-fibrosis
#3
REVIEW
Nishant Jaiswal, Meenu Singh, Amit Agarwal, Kiran K Thumburu
BACKGROUND: Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of breath is common in cystic fibrosis, especially as the disease progresses. Reversing the underlying cause is the priority when treating breathlessness (dyspnoea), but when it is not feasible, palliation (easing) becomes the primary goal to improve an individual's quality of life. A range of drugs administered by various routes have been used, but no definite guidelines are available...
August 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28793184/survey-highlights-the-need-for-specific-interventions-to-reduce-frequent-conflicts-between-healthcare-professionals-providing-paediatric-end-of-life-care
#4
Marie-Anne Archambault-Grenier, Marie-Hélène Roy-Gagnon, France Gauvin, Hubert Doucet, Nago Humbert, Sanja Stojanovic, Antoine Payot, Sylvie Fortin, Annie Janvier, Michel Duval
AIMS: This study explored how paediatric healthcare professionals experienced and coped with end-of-life conflicts and identified how to improve coping strategies. METHODS: A questionnaire was distributed to all 2,300 professionals at a paediatric university hospital, covering the frequency of end-of-life conflicts, participants, contributing factors, resolution strategies, outcomes and the usefulness of specific institutional coping strategies. RESULTS: Of the 946 professionals (41%) who responded, 466 had witnessed or participated in paediatric end-of-life discussions: 73% said these had led to conflict, more frequently between professionals (58%) than between professionals and parents (33%)...
August 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28789928/engaging-patients-in-complex-clinical-decision-making-successes-pitfalls-and-future-directions
#5
REVIEW
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28780728/predictive-model-of-complexity-in-early-palliative-care-a-cohort-of-advanced-cancer-patients-palcom-study
#6
Albert Tuca, Mónica Gómez-Martínez, Aleix Prat
PROPOSAL: Model of early palliative care (PC) integrated in oncology is based on shared care from the diagnosis to the end of life and is mainly focused on patients with greater complexity. However, there is no definition or tools to evaluate PC complexity. The objectives of the study were to identify the factors influencing level determination of complexity, propose predictive models, and build a complexity scale of PC. PATIENTS AND METHOD: We performed a prospective, observational, multicenter study in a cohort of advanced cancer patients with an estimated prognosis ≤ 6 months...
August 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#7
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
August 3, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28776066/-management-of-an-elderly-patient-in-the-emergency-room-at-the-end-of-life-a%C3%A2-medical-ethics-challenge
#8
G Michels, R Nies, S Ortmann, R Pfister, F Salomon
A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent...
August 3, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28754044/relational-approach-to-ethics-and-quality-improvement-in-institutional-care-for-people-with-dementia
#9
Dana Hradcová
BACKGROUND: Autonomy has become a key organizing principle in the official and expert discourses of the social services focused on strengthening of clients' independence and self-sufficiency. While "caring" has been seen as a threat to the autonomy of an individual, the care dependency and need for palliative care for people with dementia living in residential institutions are growing. METHODS: Participatory action research was realized in 9 homes providing services for people with dementia with the aim to improve the quality of care...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28716797/a-pragmatic-phase-iii-multisite-double-blind-placebo-controlled-parallel-arm-dose-increment-randomised-trial-of-regular-low-dose-extended-release-morphine-for-chronic-breathlessness-breathlessness-exertion-and-morphine-sulfate-beams-study-protocol
#10
David Currow, Gareth John Watts, Miriam Johnson, Christine F McDonald, John O Miners, Andrew A Somogyi, Linda Denehy, Nicola McCaffrey, Danny J Eckert, Philip McCloud, Sandra Louw, Lawrence Lam, Aine Greene, Belinda Fazekas, Katherine C Clark, Kwun Fong, Meera R Agar, Rohit Joshi, Sharon Kilbreath, Diana Ferreira, Magnus Ekström
INTRODUCTION: Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716621/healthcare-professionals-attitudes-about-physician-assisted-death-an-analysis-of-their-justifications-and-the-roles-of-terminology-and-patient-competency
#11
Derek W Braverman, Brian S Marcus, Paul G Wakim, Mark R Mercurio, Gary S Kopf
CONTEXT: Healthcare professionals (HCPs) are crucial to physician-assisted death (PAD) provision. OBJECTIVES: To quantitatively assess the favorability of justifications for or against PAD legalization among HCPs, the effect of the terms "suicide" and "euthanasia" on their views, and their support for three forms of PAD. METHODS: Our questionnaire presented three cases: physician-assisted suicide, euthanasia for a competent patient, and euthanasia for an incompetent patient with an advance directive for euthanasia...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28710111/managing-an-intentional-overdose-in-a-hospice
#12
Toby Dinnen, Hannah Armstrong, Paul Perkins
This case report describes a patient admitted unconscious to a hospice following an intentional overdose of oxycodone. She had previously declined conventional medical treatment for cancer and had made an advance decision stating that she wished to avoid hospital admission and refusing life-prolonging treatment. This case illustrates the practical and ethical challenges of managing an intentional overdose in a palliative care setting.
July 14, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28707846/palliative-sedation-ethical-aspects
#13
Guido Miccinesi, Augusto Caraceni, Marco Maltoni
Palliative sedation (PS), the medical act of decreasing a patient's awareness to relieve otherwise intractable suffering, is considered by some commentators to be controversial because of its consequences on residual survival and/or quality of life, and to be inappropriate for treating pure existential suffering. We will argue that PS must be always proportional, i.e. controlling refractory symptoms while keeping the loss of personal values (communication, affective relationships, care relationship) as low as possible, and that imminence of death is necessary too, from an ethical point of view, if a deep and continuous sedation (DCS) is proposed...
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28706092/development-of-an-intervention-to-support-patients-and-clinicians-with-advanced-lung-cancer-when-considering-systematic-anticancer-therapy-protocol-for-the-pact-study
#14
Despina Anagnostou, Stephanie Sivell, Simon Noble, Jason Lester, Anthony Byrne, Catherine Sampson, Mirella Longo, Annmarie Nelson
INTRODUCTION: Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695651/the-nurse-s-role-in-palliative-care-a-qualitative-meta-synthesis
#15
REVIEW
Ragnhild Johanne Tveit Sekse, Irene Hunskår, Sidsel Ellingsen
AIMS AND OBJECTIVES: To explore how nurses, across various health systems, describe their role in providing palliative care for patients with life-threatening illnesses. BACKGROUND: Despite the fact that nurses make up the largest group of healthcare professionals, little is known about their role in palliative care, across health services. DESIGN: A qualitative systematic review of studies. METHODS: A search was made for relevant articles, published between January 2000-June 2016...
June 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28688910/burden-of-palliative-care-issues-encountered-by-radiation-oncologists-caring-for-patients-with-advanced-cancer
#16
Gregory M Parker, Virginia T LeBaron, Monica Krishnan, Ron Y Shiloh, Alexander Spektor, Lauren Hertan, Tracy A Balboni
PURPOSE: Radiation oncologists frequently provide care for patients with advanced cancer who are in their last months or weeks of life. This study examined the previously not well-characterized types and frequencies of palliative care issues encountered in consultations for palliative radiation therapy (PRT). METHODS AND MATERIALS: This prospective, survey-based study assessed consecutive consults for PRT from May 19, 2014, to September 26, 2014 at 3 Boston-area community and academic, hospital-based centers...
May 25, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28680279/palliative-care-as-a-public-health-issue-understanding-disparities-in-access-to-palliative-care-for-the-homeless-population-living-in-toronto-based-on-a-policy-analysis
#17
REVIEW
B Henry, N Dosani, L Huynh, N Amirault
Even in a developed country such as Canada, there are disparities in just access to adequate health care-and, more specifically, palliative care. That inequality is most notable in an underserved group such as the homeless population. Even the word "homeless" has become both a negative descriptor and a stereotype in our society. We posit that the provision of hospice palliative care is structured on several problematic assumptions: an expectation that patients will have an informal support network (family and friends), a stable and secure residence, a predictive terminal illness trajectory, and reasonable access to health care...
June 2017: Current Oncology
https://www.readbyqxmd.com/read/28679640/palliative-sedation-with-propofol-for-an-adolescent-with-a-dnr-order
#18
Liza-Marie Johnson, Joel Frader, Joanne Wolfe, Justin N Baker, Doralina L Anghelescu, John D Lantos
Death from cancer is often painful. Usually, the pain can be relieved in ways that allow patients to remain awake and alert until the end. Sometimes, however, the only way to relieve pain is to sedate patients until they are unconscious. This method has been called palliative sedation therapy. Palliative sedation therapy is controversial because it can be misunderstood as euthanasia. We present a case in which an adolescent who is dying of leukemia has intractable pain. Experts in oncology, ethics, pain management, and palliative care discuss the trade-offs associated with different treatment strategies...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28674754/issues-related-to-family-history-of-cancer-at-the-end-of-life-a-palliative-care-providers-survey
#19
Catherine Gonthier, Sylvie Pelletier, Pierre Gagnon, Ana Marin, Jocelyne Chiquette, Bruno Gagnon, Louis Roy, Jude Emmanuel Cléophat, Yann Joly, Michel Dorval
Addressing the concerns of end-of-life patients or their relatives about their family history of cancer could benefit patients and family members. Little is known about how palliative care providers respond to these concerns. The purpose of this pilot study was to assess palliative care providers' knowledge about familial and hereditary cancers and explore their exposure to patients' and relatives' concerns about their family history of cancer, and their self-perceived ability to deal with such concerns. A cross-sectional survey was conducted in the Quebec City (Canada) catchment area among palliative care professionals...
July 3, 2017: Familial Cancer
https://www.readbyqxmd.com/read/28667207/a-cluster-randomised-controlled-proof-of-concept-study-to-explore-the-feasibility-and-effect-of-a-patient-directed-intervention-on-quality-of-life-in-patients-with-advanced-soft-tissue-sarcoma
#20
Markus Schuler, Stephan Richter, Gerhard Ehninger, Martin Bornhäuser, Leopold Hentschel
INTRODUCTION: Even with evolving and expanding therapeutical options for the treatment of advanced sarcomas over recent years, the balance between efficacy and toxicity still remains a major concern. Moreover, the symptom burden in patients with sarcoma remains high compared with other malignant diseases. It is, therefore, crucial to assess treatment effectiveness not only in terms of disease-related outcomes (eg, overall survival) but also from an individual and patient-centred perspective using the assessment of patient-reported outcomes (PROs)...
June 30, 2017: BMJ Open
keyword
keyword
31088
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"