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End of life communication

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https://www.readbyqxmd.com/read/28235727/acceptable-regret-model-in-the-end-of-life-setting-patients-require-high-level-of-certainty-before-forgoing-management-recommendations
#1
Athanasios Tsalatsanis, Iztok Hozo, Benjamin Djulbegovic
BACKGROUND: The acceptable regret model postulates that under some circumstances decision-makers may tolerate wrong decisions. The purpose of this work is to empirically evaluate the acceptable regret model of decision-making in the end-of-life care setting, where terminally ill patients consider seeking curative treatment versus accepting hospice/palliative care. METHODS: We conducted interviews with 48 terminally ill patients to assess their preferences about end-of-life treatment choices...
February 21, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28227992/modeling-and-design-of-antennas-for-implantable-telemetry-applications
#2
Arun Venkatasubramanian, Brandon Gifford, Arun Venkatasubramanian, Brandon Gifford, Brandon Gifford, Arun Venkatasubramanian
Incorporating an RF communications link in an implanted medical device can increase its range of applicability and improve quality of life for the patient. Developments in support electronics decrease design risk, but the implanted antenna remains a critical component of a communications link that operates at very low received power. Transmitted power is limited both by regulatory restrictions and, for most implanted devices, by power source capacity. Dielectric losses and wave trapping in the body result in transmission losses much greater than seen in free space communications...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224693/analysis-of-team-types-based-on-collaborative-relationships-among-doctors-home-visiting-nurses-and-care-managers-for-effective-support-of-patients-in-end-of-life-home-care
#3
Junko Fujita, Sakiko Fukui, Sumie Ikezaki, Chizuru Otoguro, Mayuko Tsujimura
AIM: To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. METHODS: A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis...
February 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28220317/role-of-narrative-based-medicine-in-proper-patient-assessment
#4
Giovanni Rosti
Improving patient-physician communication is an area of medicine that deserves greater attention. Narrative medicine can be considered as one tool that can aid in fostering better communication. Current medical practice is dominated by evidence-based medicine, and dictates what therapies the clinician will offer in a given circumstance, ideally supported by (evidence-based) guidelines. However, when taken alone it tends to decentralize the patient. There are many different approaches that can be used to understand the patient and what he or she is experiencing as a result of their illness...
February 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#5
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28211000/the-implementation-and-evaluation-of-a-communication-skills-training-program-for-oncology-nurses
#6
Smita C Banerjee, Ruth Manna, Nessa Coyle, Stacey Penn, Tess E Gallegos, Talia Zaider, Carol A Krueger, Philip A Bialer, Carma L Bylund, Patricia A Parker
Many nurses express difficulty in communicating with their patients, especially in oncology settings where there are numerous challenges and high-stake decisions during the course of diagnosis and treatment. Providing specific training in communication skills is one way to enhance the communication between nurses and their patients. We developed and implemented a communication skills training program for nurses, consisting of three teaching modules: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging interactions with families...
February 16, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28199030/lessons-learned-from-the-science-of-caring-extending-the-reach-of-psychosocial-oncology-the-international-psycho-oncology-society-2016-sutherland-award-lecture
#7
Barry D Bultz
In medicine, referral to a medical oncology specialty is based on recent history, physical examination, pathology, surgery reports, imaging, blood work and the patient's vital signs. By contrast, referral to a psychosocial specialist has typically been based on the patients expressed request for psychosocial support or the health care team's observation of the patient's limited adjustment or poor coping with the diagnosis, treatment or end of life distress. These observations are usually based on clinical acumen not on metrics...
February 15, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28193270/the-experience-of-providing-end-of-life-care-at-a-children-s-hospice-a-qualitative-study
#8
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/28193243/bite-size-research-bmc-research-notes-goes-back-to-its-roots
#9
EDITORIAL
Dirk Krüger, Diana M Marshall
Since it first launched in 2008, BMC Research Notes has been a place where researchers can publish short notes and observations, research outputs which are useful for the community but which can end up hidden in the lab notebook or as a footnote in a dataset. In order to re-affirm the importance of publishing these kinds of outputs, the journal is renewing its focus on publishing note articles as well as other potentially dark data such as short null results. Publishing these articles is useful for many researchers, therefore we are also expanding the scope to all scientific and clinical disciplines including health sciences, life sciences, physical sciences, mathematics and all engineering disciplines...
February 14, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28193106/improving-end-of-life-care-knowledge-among-senior-baccalaureate-nursing-students
#10
Toni L Glover, Cynthia Garvan, Rose M Nealis, Sandra W Citty, David J Derrico
OBJECTIVE: It is imperative that nurses are proficient and comfortable providing care to patients at the end of life. Recent studies show that nurses' knowledge of end-of-life care is less than optimal. Effective, evidence-based methods to infuse palliative and end-of-life care education into the undergraduate nursing curriculum are needed. METHODS: A descriptive pre- and postassessment evaluating senior nursing students' acquisition of knowledge on end-of-life care after attending the End-of-Life Nursing Education Consortium (ELNEC) core course was conducted...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28192224/qualitative-study-on-the-perceptions-of-terminally-ill-cancer-patients-and-their-family-members-regarding-end-of-life-experiences-focusing-on-palliative-sedation
#11
Young Eun, In-Wha Hong, Eduardo Bruera, Jung Hun Kang
CONTEXT: Patients with terminal cancer experience refractory symptoms in the last days of life. Although palliative sedation (PS) is recommended for patients suffering unbearable symptoms with imminent death, it requires clear communication between physicians and patients/caregivers. Understanding the demands and perceptions of patients and caregivers in the end-of-life phase are needed for effective communication. OBJECTIVE: To explore patient experiences regarding end-of-life status and PS...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#12
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186943/wordless-intervention-for-people-with-epilepsy-and-learning-disabilities-wield-a-randomised-controlled-feasibility-trial
#13
Silvana E Mengoni, Bob Gates, Georgina Parkes, David Wellsted, Garry Barton, Howard Ring, Mary Ellen Khoo, Deela Monji-Patel, Karin Friedli, Asif Zia, Lisa Irvine, Marie-Anne Durand
OBJECTIVE: To investigate the feasibility of a full-scale randomised controlled trial of a picture booklet to improve quality of life for people with epilepsy and learning disabilities. TRIAL DESIGN: A randomised controlled feasibility trial. Randomisation was not blinded and was conducted using a centralised secure database and a blocked 1:1 allocation ratio. SETTING: Epilepsy clinics in 1 English National Health Service (NHS) Trust. PARTICIPANTS: Patients with learning disabilities and epilepsy who had: a seizure within the past 12 months, meaningful communication and a carer with sufficient proficiency in English...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28186835/preparing-pediatric-healthcare-professionals-for-end-of-life-care-discussions-an-exploratory-study
#14
Amanda Henderson, Jeanine Young, Anthony Herbert, Natalie Bradford, Lee-Anne Pedersen
BACKGROUND: Preparedness to initiate end-of-life (EoL) discussions is a confronting and daunting task for all healthcare professionals. We conducted a group interview to explore healthcare professionals' experiences of preparing for EoL discussions with the patient and their family in a pediatric context. AIM: To identify what pediatric healthcare professionals consider important when preparing for an EoL discussion. METHODS: A qualitative design using a group interview...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28181897/-discontinuation-of-potentially-inappropriate-medications-at-the-end-of-life-perspectives-from-patients-their-relatives-and-physicians
#15
E C T Geijteman, M M A Tempelman, M K Dees, B A A Huisman, R S G M Perez, L van Zuylen, A van der Heide
OBJECTIVE: To obtain insight into the perspectives of patients, relatives and physicians towards potentially inappropriate medications (PIMs) at the end of life. DESIGN: Qualitative interview study. METHOD: An analysis of in-depth interviews with 17 patients who were diagnosed as having a life expectancy of less than three months, 12 patient relatives, and 20 medical specialists and 12 general practitioners who cared for them. For analysis we applied the constant comparative method, which forms part of the grounded theory approach...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28178386/evaluating-a-dignity-care-intervention-for-palliative-care-in-the-community-setting-community-nurses-perspectives
#16
Sonja McIlfatrick, Michael Connolly, Rita Collins, Tara Murphy, Bridget Johnston, Philip Larkin
AIM AND OBJECTIVES: To evaluate a Dignity Care Intervention (DCI) provided by community nurses seeking to address dignity concerns for people with advanced and life limiting conditions BACKGROUND: Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. DESIGN: A mixed methods study using online survey and focus group interviews and thematic analysis to examine data...
February 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28174659/making-an-impakt-improving-care-of-chronic-kidney-disease-patients-in-the-community-through-collaborative-working-and-utilizing-information-technology
#17
Gang Xu, Rupert Major, David Shepherd, Nigel Brunskill
Chronic kidney disease (CKD) is a serious long-term condition, which if left untreated causes significant cardiovascular sequele. It is well recognized management of modifiable risk factors, such as blood pressure (BP), can lead to improved long-term outcomes. A novel information technology (IT) solution presents a possible solution to help clinicians in the community identify and manage at risk patients more efficiently. The IMproving Patient care and Awareness of Kidney disease progression Together (IMPAKT) IT tool was used to identify patients with CKD and uncontrolled hypertension in the community...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28169857/intersection-of-prognosis-and-palliation-in-neurocritical-care
#18
Michael Rubin, Jordan Bonomo, J Claude Hemphill
PURPOSE OF REVIEW: Difficult discussions regarding end-of-life care are common in neurocritical care. Because of a patient's neurological impairment, decisions regarding continuing or limiting aggressive care must often be made by patients' families in conjunction with medical providers. This review provides perspective on three major aspects of this circumstance: prognostication, family-physician discussions, and determination of death (specifically as it impacts on organ donation). RECENT FINDINGS: Numerous studies have now demonstrated that prediction models developed from populations of brain-injured patients may be misleading when applied to individual patients...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28157431/increased-symptom-expression-among-patients-with-delirium-admitted-to-an-acute-palliative-care-unit
#19
Maxine de la Cruz, Sriram Yennu, Diane Liu, Jimin Wu, Akhila Reddy, Eduardo Bruera
INTRODUCTION: Delirium is the most common neuropsychiatric condition in very ill patients and those at the end of life. Previous case reports found that delirium-induced disinhibition may lead to overexpression of symptoms. It negatively affects communication between patients, family members, and the medical team and can sometimes lead to inappropriate interventions. Better understanding would result in improved care. Our aim was to determine the effect of delirium on the reporting of symptom severity in patients with advanced cancer...
February 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28156656/systematic-review-of-interventions-to-facilitate-advance-care-planning-acp-in-cancer-patients
#20
Hao-Wen Sim, Camilla Zimmermann, Monika K Krzyzanowska
: 21 Background: ACP refers to the process of consideration, documentation and communication of preferences for future care. ACP is crucial for patients (pts) with advanced cancer as it can guide substitute decision makers (SDM) and health care providers (HCP) to align care with preferences, thus improving quality of end-of-life care. METHODS: We performed a systematic review of MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane (Systematic Review and Clinical Trial) databases (1995 to 2015) to identify interventions that facilitate ACP for cancer pts (documentation or discussion of advance directives, SDM or code status)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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