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End of life communication

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https://www.readbyqxmd.com/read/29791717/termination-of-pregnancy-following-a-prenatal-diagnosis-of-down-syndrome-a-qualitative-study-of-the-decision-making-process-of-pregnant-couples
#1
Stina Lou, Kathrine Carstensen, Olav Bjørn Petersen, Camilla Palmhøj Nielsen, Lone Hvidman, Maja Retpen Lanther, Ida Vogel
In Denmark, first trimester screening has a very high uptake (>90%). If Down syndrome is diagnosed, termination rates are high (>95%). The aim of this study was to investigate the timing of the decision of termination of pregnancy following a Down syndrome diagnosis and the factors influencing this decision MATERIAL AND METHODS: Semi-structured, qualitative interview study with 21 couples who had received a prenatal diagnosis of Down syndrome and decided to terminate the pregnancy. Participants were recruited from obstetric departments between February 2016 and July 2017...
May 23, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29790421/facilitators-and-barriers-to-oncologists-conduct-of-goals-of-care-conversations
#2
Dena Schulman-Green, Jenny J Lin, Cardinale B Smith, Shelli Feder, Nina A Bickell
INTRODUCTION: Goals of care (GoC) conversations optimally begin early in the course of cancer care, yet most happen near the end of life. We sought to describe oncologist-reported facilitators of and barriers to GoC conversations with patients who have advanced cancer. METHODS AND MATERIALS: We conducted individual, semistructured qualitative interviews with oncologists from 4 academic, community, municipal, and rural hospitals in New York and Connecticut. Interview topics included approach to GoC conversations, facilitators, barriers, and organizational influences...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29790153/centenarians-end-of-life-thoughts-and-plans-is-their-social-network-on-the-same-page
#3
Kathrin Boerner, Kyungmin Kim, Yijung Kim, Christoph Rott, Daniela S Jopp
OBJECTIVES: To explore how centenarians think about and plan for the end of life (EOL) and to what extent their primary contacts (proxy informants) are aware of these thoughts. DESIGN: Population-based study with semistructured in-person interviews. SETTING: Defined geographical region approximately 60 km around Heidelberg, Germany. PARTICIPANTS: Subsample drawn from the larger study of centenarians (N = 78) with data on centenarians' EOL thoughts from the centenarian and the proxy informant...
May 22, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29788956/building-bridges-paediatric-palliative-care-in-belgium-a-secondary-data-analysis-of-annual-paediatric-liaison-team-reports-from-2010-to-2014
#4
Marie Friedel, Bénédicte Brichard, Christine Fonteyne, Marleen Renard, Jean-Paul Misson, Els Vandecruys, Corinne Tonon, Françoise Verfaillie, Georgette Hendrijckx, Nathalie Andersson, Ilse Ruysseveldt, Katrien Moens, Jean-Marie Degryse, Isabelle Aujoulat
BACKGROUND: Although continuity of care in paediatric palliative care (PPC) is considered to be an essential element of quality of care, it's implementation is challenging. In Belgium, five paediatric liaison teams (PLTs) deliver palliative care. A Royal Decree issued in 2010 provides the legal framework that defines the PLTs' missions, as ensuring continuity of curative and palliative care between the hospital and home for children diagnosed with life-limiting conditions. This national study describes how PLTs ensure continuity of care by describing their activities and the characteristics of the children they cared for from 2010 to 2014...
May 22, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29788744/general-practitioners-participation-in-cancer-treatment-in-norway
#5
Knut Holtedahl, Benedicte I Scheel, May-Lill Johansen
INTRODUCTION: General practitioners (GPs) participate in a patient's cancer care to different extents at different times, from prevention and diagnosis to treatment and end-of-life care. Traditionally, the GP has had a minor role in cancer treatment. However, oncological and surgical services frequently delegate limited cancer treatment tasks to GPs, especially in rural areas far from hospitals. The aim of this study was to explore the extent of GPs' participation in cancer treatment in Norway...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29781722/survey-of-north-american-multidisciplinary-cleft-palate-and-craniofacial-team-clinic-administration
#6
Kristin D Pfeifauf, Kamlesh B Patel, Alison Snyder-Warwick, Gary B Skolnick, Sibyl Scheve, Sybill D Naidoo
OBJECTIVE: This study aims to provide an understanding of the ways cleft palate (CP) and craniofacial teams address billing, administration, communication of clinical recommendations, appointment scheduling, and diagnosis-specific protocols. DESIGN: An online clinic administration survey was developed using data from an open-ended telephone questionnaire. The online survey was distributed by e-mail to the American Cleft Palate-Craniofacial Association (ACPA) nurse coordinator electronic mailing list, used regularly by the ACPA and its members to communicate with teams...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29779361/palliative-and-end-of-life-care-for-heart-failure-patients-in-an-aging-society
#7
Takahiro Okumura, Akinori Sawamura, Toyoaki Murohara
The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#8
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29775556/let-s-talk-about-it-supporting-family-communication-during-end-of-life-care-of-pediatric-patients
#9
Meghan L Marsac, Christine Kindler, Danielle Weiss, Lindsay Ragsdale
BACKGROUND: Communication is key in optimizing medical care when a child is approaching end of life (EOL). Research is yet to establish best practices for how medical teams can guide intrafamily communication (including surviving siblings) when EOL care is underway or anticipated for a pediatric patient. While recommendations regarding how medical teams can facilitate communication between the medical team and the family exist, various barriers may prevent the implementation of these recommendations...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29763271/adults-with-developmental-disabilities-a-comprehensive-approach-to-medical-care
#10
Clarissa Kripke
Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities now approaches that of the general population. According to the neurodiversity model of care, developmental disability is accepted as a valued part of human neurologic diversity. The social model focuses on improving participation in society with accommodations such as adaptive equipment or improvements to the social and physical environment...
May 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29761752/addressing-cancer-patient-and-caregiver-role-transitions-during-home-hospice-nursing-care
#11
Janella Hudson, Maija Reblin, Margaret F Clayton, Lee Ellington
OBJECTIVE: Many family caregivers and hospice patients experience role changes resulting from advancing illness and the need for increased caregiver responsibility. Successful navigation of conflicts that arise because of these role transitions has been linked to higher quality of patient care and improved caregiver bereavement adjustment. Nursing communication with patients and their caregivers plays an important role in facilitating these transitions. Our objective is to describe patient-caregiver-nurse communication during transitions at end of life...
May 15, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29757818/surrogates-experiences-of-engaging-in-physician-orders-for-life-sustaining-treatment-discussions-for-persons-with-advanced-dementia
#12
Hyejin Kim, Christine Bradway, Susan E Hickman, Mary Ersek
BACKGROUND AND PURPOSE: Little is known about surrogates' experiences of engaging in Physician Orders for Life-Sustaining Treatment (POLST) discussions. This study describes family surrogates' experiences when engaging in POLST discussions with primary care providers. METHODS: Semistructured interviews were conducted with 10 family surrogates of individuals with advanced dementia who were enrolled in a Program of All-Inclusive Care for the Elderly or resided in a nursing home...
February 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#13
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29750673/quality-of-life-perception-cognitive-function-and-psychological-status-in-a-real-world-population-of-glioblastoma-patients-treated-with-radiotherapy-and-temozolomide-a-single-center-prospective-study
#14
Giuseppe Lombardi, Eleonora Bergo, Paola Del Bianco, Luisa Bellu, Ardi Pambuku, Mario Caccese, Leonardo Trentin, Vittorina Zagonel
BACKGROUND: Health-related quality of life (HRQoL), cognitive function, and psychological status represent an important focus during the treatment of glioblastoma patients. Nevertheless, few randomized, prospective clinical trials have analyzed these factors, and very little is known in the real-clinical world. We evaluated these characteristics in glioblastoma patients treated with standard first-line therapy outside clinical trials. PATIENTS AND METHODS: In total, 111 newly, histologically diagnosed glioblastoma patients treated at our oncology center with radiotherapy and temozolomide were prospectively enrolled...
May 10, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29745483/-oncological-patients-in-primary-care-ruptures-and-transitions
#15
Christopher Chung, Dagmar M Haller, Sophie Pautex, Johanna Sommer
Patients with severe cancer go through a journey requiring the involvement of several healthcare providers. Several transitions of care occur: from the general practitioner to the oncologist, and then depending on the outcomes of treatment, the patient enters a palliative care phase, and eventually end of life care. Lack of coordination of the different actors can lead to repeated loss of the continuum of care. Each transition requires better communication between healthcare providers and also with the patient...
May 9, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29742629/death-in-trauma-the-role-of-the-acnp-in-patient-advocacy-and-familial-support-in-end-of-life-care-decision-making
#16
Stephanie N Barndt
The trauma acute care nurse practitioner (ACNP) participates in the care of critically-ill patients by utilizing his or her advanced clinical skills at the bedside and through communication with the interdisciplinary team, the patient, and the patient's family. Although the incidence of morbidity is decreasing in trauma, death can occur shortly after arrival to hospital, or in the days after initial injury, leading to the need for the unexpected conversation of end-of-life wishes with a patient or the patient's family...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742328/anonymous-body-or-first-patient-a-status-report-and-needs-assessment-regarding-the-personalization-of-donors-in-dissection-courses-in-german-austrian-and-swiss-medical-schools
#17
Friederike Hasselblatt, David A C Messerer, Oliver Keis, Tobias M Böckers, Anja Böckers
Many Anglo-American universities have undertaken a paradigm shift in how the dissection of human material is approached, such that students are encouraged to learn about the lives of body donors, and to respectfully "personalize" them as human beings, rather than treating the specimens as anonymous cadavers. For the purposes of this study, this provision of limited personal information regarding the life of a body donor will be referred to as "personalization" of body donors. At this time, it is unknown whether this paradigm shift in the personalization of body donors can be translated into the German-speaking world...
May 6, 2018: Anatomical Sciences Education
https://www.readbyqxmd.com/read/29729816/wasp-write-a-scientific-paper-special-cases-of-selective-non-treatment-and-or-dnr
#18
Pierre Mallia
Fetuses at low gestational age limit of viability, neonates with life threatening or life limiting congenital anomalies and deteriorating acutely ill newborn babies in intensive care, pose taxing ethical questions on whether to forego or stop treatment and allow them to die naturally. Although there is essentially no ethical difference between end of life decision between neonates and other children and adults, in the former, the fact that we are dealing with a new life, may pose greater problems to staff and parents...
May 3, 2018: Early Human Development
https://www.readbyqxmd.com/read/29729348/feeling-heard-understood-in-the-hospital-environment-benchmarking-communication-quality-among-patients-with-advanced-cancer-before-and-after-palliative-care-consultation
#19
Luke T Ingersoll, Fahad Saeed, Susan Ladwig, Sally A Norton, Wendy Anderson, Stewart C Alexander, Robert Gramling
CONTEXT: Maximizing value in palliative care requires continued development and standardization of communication quality indicators. OBJECTIVES: To describe the basic epidemiology of a newly-adopted patient-centered communication quality indicator for hospitalized palliative care patie9nts with advanced cancer. METHODS: Cross-sectional analysis of 207 advanced cancer patients who received palliative care consultation at two medical centers in the United States...
May 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29723565/using-social-network-analysis-to-investigate-positive-eol-communication
#20
Jiayun Xu, Rumei Yang, Andrew Wilson, Maija Reblin, Margaret F Clayton, Lee Ellington
CONTEXT: End of life (EOL) communication is a complex process involving the whole family and multiple care providers. Applications of analysis techniques that account for communication beyond the patient and patient/provider, will improve clinical understanding of EOL communication. OBJECTIVES: To introduce the use of social network analysis to EOL communication data, and to provide an example of applying social network analysis to home hospice interactions. METHODS: We provide a description of social network analysis using social network analysis to model communication patterns during home hospice nursing visits...
April 30, 2018: Journal of Pain and Symptom Management
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