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End of life communication

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https://www.readbyqxmd.com/read/28941964/unmet-palliative-care-needs-among-patients-with-end-stage-kidney-disease-a-national-registry-study-about-the-last-week-of-life
#1
Lena Axelsson, Anette Alvariza, Jenny Lindberg, Joakim Öhlén, Cecilia Håkanson, Helene Reimertz, Carl-Johan Fürst, Kristofer Årestedt
CONTEXT: End-stage kidney disease (ESKD) is characterized by high physical and psychological burden and therefore, more knowledge about the palliative care provided close to death is needed. OBJECTIVES: To describe symptom prevalence, relief and management during the last week of life, as well as end-of-life communication, in patients with ESKD. METHODS: This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (ICD-10-SE; N18...
September 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28941542/end-of-life-and-bereavement-care-in-pediatric-intensive-care-units
#2
REVIEW
Markita L Suttle, Tammara L Jenkins, Robert F Tamburro
Most childhood deaths in the United States occur in hospitals. Pediatric intensive care clinicians must anticipate and effectively treat dying children's pain and suffering and support the psychosocial and spiritual needs of families. These actions may help family members adjust to their loss, particularly bereaved parents who often experience reduced mental and physical health. Candid and compassionate communication is paramount to successful end-of-life (EOL) care as is creating an environment that fosters meaningful family interaction...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28939708/the-decisions-interventions-and-goals-in-implantable-cardioverter-defibrillator-therapy-dignity-pilot-study
#3
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939306/training-surgeons-and-anesthesiologists-to-facilitate-end-of-life-conversations-with-patients-and-families-a-systematic-review-of-existing-educational-models
#4
Katherine E Bakke, Stephen P Miranda, Manuel Castillo-Angeles, Christy E Cauley, Elizabeth J Lilley, Rachelle Bernacki, Angela M Bader, Richard D Urman, Zara Cooper
OBJECTIVE: Despite caring for patients near the end-of-life (EOL), surgeons and anesthesiologists report low confidence in their ability to facilitate EOL conversations. This discrepancy exists despite competency requirements and professional medical society recommendations. The objective of this systematic review is to identify articles describing EOL communication training available to surgeons and anesthesiologists, and to assess their methodological rigor to inform future curricular design and evaluation...
September 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28938102/self-management-support-at-the-end-of-life-patients-carers-and-professionals-perspectives-on-managing-medicines
#5
N Campling, A Richardson, M Mulvey, M Bennett, B Johnston, S Latter
BACKGROUND: Pain is a frequently reported symptom by patients approaching the end of life and well-established that patients and carers hold fears relating to opioids, and experience side effects related to their use. The management of medicines is intrinsic to achieving effective pain relief. The concept of self-management support whilst well characterised in the context of chronic illness has not been elaborated with respect to end of life care. AIM: To identify patient, carer and professional views on the concept of self-management support at end of life, specifically in relation to analgesia and related medicines (for side-effect management) in order to describe, characterise and explain self-management support in this context...
September 6, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28937339/locked-out
#6
Veronica Johansson, Surjo R Soekadar, Jens Clausen
Brain-computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed "complete locked-in syndrome," a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort...
October 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28936744/cardiac-telocyte-derived-exosomes-and-their-possible-implications-in-cardiovascular-pathophysiology
#7
Mirca Marini, Lidia Ibba-Manneschi, Mirko Manetti
Among cardiac interstitial cells, the recently described telocytes (TCs) display the unique ability to build a supportive three-dimensional network formed by their very long and thin prolongations named telopodes. Cardiac TCs are increasingly regarded as pivotal regulators in intercellular signaling with multiple cell types, such as cardiomyocytes, stem/progenitor cells, microvessels, nerve endings, fibroblasts and immune cells, thus converting the cardiac stromal compartment into an integrated system that may drive either heart development or maintenance of cardiac homeostasis in post-natal life...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28935131/which-research-questions-are-important-for-the-bereaved-families-of-palliative-care-cancer-patients-a-nationwide-survey
#8
Akihiro Sakashita, Tatsuya Morita, Megumi Kishino, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita
CONTEXT: Bereaved family members are present from diagnosis to the end of life and can look back and evaluate the experience; additionally, the family itself is also an important subject in the care of the patient. Therefore, while it is essential to determine the priority research issues from the viewpoint of the patients and health care workers, it is also crucial to know the important research themes from the viewpoint of the bereaved family members. OBJECTIVES: The purpose of this study was to identify research priorities for palliative care in Japan, based on the viewpoint of bereaved family members...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28924399/changing-the-rules-of-the-game-how-do-we-measure-success-in-social-media
#9
REVIEW
Aisling M Hogan, Desmond C Winter
Ours will be the generation proud to say we shifted the sands of educational deserts by open access and proliferation, seeding of data sharing, and watering grassroots research in resource-compromised environments. Universal "social" media is defining features of modern professional life that provide powerful modes of knowledge acquisition/sharing to that end. Altmetric and other measurements stratify academic communications according to this alternate, online media presence (not academic penetrance). Are they meaningless, self-absorbed integers, or reliable yardsticks of scientific and educational prowess? Far beyond this trite, patronizing question from the minds of outdated, terrified technophobes, the real impact of "social" media is not narcissistic solipsism...
September 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28919539/the-nexus-between-the-documentation-of-end-of-life-wishes-and-awareness-of-dying-a-model-for-research-education-and-care
#10
Deborah P Waldrop, Jacqueline M McGinley, Brian Clemency
The convergence of medical treatment that can extend life with written medical orders that make it possible to refuse such treatment brings the differential dynamics of contemporary end-of-life decision-making into sharp focus. Communication between families and clinicians can be confusing, uncertain and pressured when death is imminent. These situations create distress that ultimately influences the end-of-life experience for people who are dying and those who care for them. This paper presents the analysis of the decisional dynamics that emerge from the intersection of the patient-family-provider awareness that death is near with the presence or absence of documentation of expressed wishes for end-of-life care...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28918408/effectiveness-cost-utility-and-implementation-of-a-decision-aid-for-patients-with-localised-prostate-cancer-and-their-partners-study-protocol-of-a-stepped-wedge-cluster-randomised-controlled-trial
#11
Hoda H M Al-Itejawi, Cornelia F van Uden-Kraan, Peter M van de Ven, Veerle M H Coupé, André N Vis, Jakko A Nieuwenhuijzen, Jeroen A van Moorselaar, Irma M Verdonck-de Leeuw
INTRODUCTION: Patient decision aids (PDAs) have been developed to help patients make an informed choice for a treatment option. Despite proven benefits, structural implementation falls short of expectations. The present study aims to assess the effectiveness and cost-utility of the PDA among newly diagnosed patients with localised prostate cancer and their partners, alongside implementation of the PDA in routine care. METHODS/ANALYSIS: A stepped-wedge cluster randomised trial will be conducted...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28917376/ayurvedic-versus-conventional-dietary-and-lifestyle-counseling-for-mothers-with-burnout-syndrome-a-randomized-controlled-pilot-study-including-a-qualitative-evaluation
#12
Christian S Kessler, Clemens Eisenmann, Frank Oberzaucher, Martin Forster, Nico Steckhan, Larissa Meier, Elmar Stapelfeldt, Andreas Michalsen, Michael Jeitler
OBJECTIVES: Ayurveda claims to be effective in the treatment of psychosomatic disorders by means of lifestyle and nutritional counseling. DESIGN: In a randomized controlled study mothers with burnout were randomized into two groups: Ayurvedic nutritional counseling (according to tradition), and conventional nutritional counseling (following the recommendations of a family doctor). Patients received five counseling sessions over twelve weeks. MAIN OUTCOME MEASURES: Outcomes included levels of burnout, quality of life, sleep, stress, depression/anxiety, and spirituality at three and six months...
October 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28916293/is-there-ever-a-role-for-the-unilateral-do-not-attempt-resuscitation-order-in-pediatric-care
#13
Jonathan M Marron, Emma Jones, Joanne Wolfe
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. In rare cases, the medical team can be moved to enact a do not attempt resuscitation (DNAR) order against the wishes of the patient's parents. This manuscript presents one such illustrative case and discusses the ethical issues relevant to such challenging clinical scenarios...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28912058/translation-and-cultural-adaptation-of-the-quality-of-communication-questionnaire-for-icu-family-members-in-korea
#14
Minjeong Jo, Mi-Kyung Song, Marcia Van Riper, Yang-Sook Yoo, George J Knafl, Linda Beeber
BACKGROUND: There are no Korean instruments to assess the concepts associated with end-of-life communication quality. OBJECTIVES: To translate and culturally adapt the Quality of Communication (QOC) questionnaire into Korean and evaluate its acceptability and internal consistency. METHODS: We first translated the QOC from English into Korean, then back-translated from Korean to English, and evaluated the cultural appropriateness of the items...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28904011/continuation-of-non-essential-medications-in-actively-dying-hospitalised-patients
#15
Beverly Rosa Williams, F Amos Bailey, Elizabeth Kvale, Neal Steil, Patricia S Goode, Richard E Kennedy, Kathryn L Burgio
OBJECTIVE: The objective of this analysis was to examine the use of 11 non-essential medications in actively dying patients. METHODS: This was a planned secondary analysis of data from the Best Practices for End-of-Life Care for Our Nation's Veterans trial, a multicentre implementation trial of an intervention to improve processes of end-of-life care in inpatient settings. Supported with an electronic comfort care decision support tool, intervention included training hospital staff to identify actively dying patients, communicate the prognosis to patients/families and implement best practices of traditionally home-based hospice care...
September 13, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28899175/bion-s-agony-in-the-long-week-end
#16
Robert Ehrlich
In The Long Week-End Wilfred Bion focuses on his emotional distress during the first twenty-one years of his life. Rarely employing psychoanalytic terminology, he attempts to explore his emotional experience directly, struggling to find a language that could capture the complexity of inner life. Central to The Long Week-End is his desire to communicate how easily he could feel unintelligent, inept, weak, ashamed, guilty, angry, frightened, and cowardly in various settings. This self-criticism at times undermines his theoretical stance in this work, as he emphasizes the importance of doubt and uncertainty when attempting to comprehend most dimensions of experience...
August 2017: Journal of the American Psychoanalytic Association
https://www.readbyqxmd.com/read/28898603/strange-bedfellows-no-more-how-integrated-stem-cell-transplantation-and-palliative-care-programs-can-together-improve-end-of-life-care
#17
Deena R Levine, Justin N Baker, Joanne Wolfe, Leslie E Lehmann, Christina Ullrich
In the intense, cure-oriented setting of hematopoietic stem-cell transplantation (HSCT), delivery of high-quality palliative and end-of-life care is a unique challenge. Although HSCT affords patients a chance for cure, it carries a significant risk of morbidity and mortality. During HSCT, patients usually experience high symptom burden and a significant decrease in quality of life that can persist for long periods. When morbidity is high and the chance of cure remote, the tendency after HSCT is to continue intensive medical interventions with curative intent...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28892432/patient-clinician-communication-american-society-of-clinical-oncology-consensus-guideline
#18
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...
September 11, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28887268/association-of-advance-directives-completion-with-the-utilization-of-life-sustaining-treatments-during-the-end-of-life-care-in-older-patients
#19
Yung-Feng Yen, Li-Ying Huang, Hsiao-Yun Hu, Wen-Jung Sun, Ming-Chung Ko, Ya-Ling Lee, Sheng-Jean Huang, Dachen Chu
CONTEXT: Evidence is mixed regarding the impact of advance directives (AD) on the utilisation of end-of-life treatments. OBJECTIVES: This study evaluated the effect of AD on the utilization of end-of-life treatments during the last month of life in older patients. METHODS: Taipei City Hospital initiated an advance care planning (ACP) program to promote AD for admitted patients in 2015. This prospective study recruited deceased older patients who completed ACP communication between 2015 and 2016...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28872031/palliative-care-and-management-of-troublesome-symptoms-for-people-with-chronic-obstructive-pulmonary-disease
#20
REVIEW
Matthew Maddocks, Natasha Lovell, Sara Booth, William D-C Man, Irene J Higginson
People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care...
September 2, 2017: Lancet
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