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End of life communication

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https://www.readbyqxmd.com/read/28096009/perceptions-of-dying-well-and-distressing-death-by-acute-care-nurses
#1
Christine A Becker, Greg Wright, Kristen Schmit
AIM: This study aims to identify perceptions of nurses practicing in four adult inpatient units regarding their actions to provide quality end of life care for dying patients, their definitions of dying well, and their symptoms of distress and actions they took for relief. BACKGROUND: Nurses caring for patients who are dying want them to have the best death possible; however, many nurses are not prepared for every death which may occur. METHODS: Qualitative questionnaire data were collected from 49 nurses on four adult inpatient nursing units to analyze nurse perceptions of distressing death and dying well...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095941/preparation-for-the-end-of-life-and-life-completion-during-late-stage-lung-cancer-an-exploratory-analysis
#2
Gail Adorno, Cara Wallace
OBJECTIVE: Our aim was to explore preparation for the end of life (EoL) and life closure among persons with advanced metastatic lung cancer. Understanding quality of life through the lens of preparation and completion is important since the trajectory of lung cancer can be relatively short, often leading to application of cancer-directed therapies near death without the opportunity for advance planning or palliative care. Clinical research is needed to understand the kinds of distress specific to older adults with advanced lung cancer that are amendable to palliative care interventions...
January 18, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28095838/communication-with-families-regarding-organ-and-tissue-donation-after-death-in-intensive-care-comfort-protocol-for-an-intervention-study
#3
Julie E Potter, Robert G Herkes, Lin Perry, Rosalind M Elliott, Anders Aneman, Jorge L Brieva, Elena Cavazzoni, Andrew T H Cheng, Michael J O'Leary, Ian M Seppelt, Val Gebski
BACKGROUND: Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation. METHODS: This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28090365/nurse-communication-about-goals-of-care
#4
REVIEW
Elaine Wittenberg, Betty Ferrell, Joy Goldsmith, Haley Buller, Tammy Neiman
Conversations about goals of care with the patient and family are a critical component of advanced practice in oncology. However, there are often inadequate team structures, training, or resources available to assist advanced practitioners in initiating these conversations. We conducted a study to assess nurses' perceived role and communication tasks in such conversations about goals of care. In a cross-sectional survey of 109 nurses attending a comprehensive 2-day end-of-life nursing education course, nurses were asked to describe how they would participate in a "goals of care" meeting in three different scenarios...
March 2016: Journal of the Advanced Practitioner in Oncology
https://www.readbyqxmd.com/read/28076529/relationships-between-oncohematopediatrics-mothers-and-children-in-communicating-bad-news
#5
Selene Beviláqua Chaves Afonso, Maria Cecília de Souza Minayo
We present a study about the relations between pediatric oncological haematologists, mothers, and children in sharing bad news (BN) in a public hospital in Rio de Janeiro. The text emphasizes the intertwining of technique and emotions for the treatment of children with diagnoses in which the fatal outcome is always a probability. We used a qualitative approach, privileging participant observation and open interviews with oncologists (at this service all professionals were female) and mothers. We sought to understand the importance of communication which includes expressions and control of emotions; bioethical issues that require sensitivity, serenity, and truth about approaching the end of life; and how the professionals balance proximity to children and families and objectivity in their activity...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28075655/experiences-and-preferences-for-end-of-life-care-for-young-adults-with-cancer-and-their-informal-carers-a-narrative-synthesis
#6
Nothando Ngwenya, Charlotte Kenten, Louise Jones, Faith Gibson, Susie Pearce, Mary Flatley, Rachael Hough, L Caroline Stirling, Rachel M Taylor, Geoff Wong, Jeremy Whelan
To review the qualitative literature on experiences of and preferences for end-of-life care of people with cancer aged 16-40 years (young adults) and their informal carers. A systematic review using narrative synthesis of qualitative studies using the 2006 UK Economic and Social Research Council research methods program guidance. Seven electronic bibliographic databases, two clinical trials databases, and three relevant theses databases were searched from January 2004 to October 2015. Eighteen articles were included from twelve countries...
January 11, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28074585/a-good-death
#7
Tia Powell, Adira Hulkower
A good death is hard to find. Family members tell us that loved ones die in the wrong place-the hospital-and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively new and still vulnerable aspect of medical care...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28062349/-best-case-worst-case-training-surgeons-to-use-a-novel-communication-tool-for-high-risk-acute-surgical-problems
#8
Jacqueline M Kruser, Lauren J Taylor, Toby C Campbell, Amy Zelenski, Sara K Johnson, Michael J Nabozny, Nicole M Steffens, Jennifer L Tucholka, Kris L Kwekkeboom, Margaret L Schwarze
CONTEXT: Older adults often have surgery in the months preceding death, which can initiate post-operative treatments inconsistent with end-of-life values. "Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. OBJECTIVE: To evaluate a structured training program designed to teach surgeons how to use BC/WC. METHODS: Twenty-five surgeons from one tertiary-care hospital completed a two-hour training session followed by individual coaching...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062345/tumor-talk-and-child-well-being-perceptions-of-good-and-bad-news-among-parents-of-children-with-advanced-cancer
#9
Angela M Feraco, Veronica Dussel, Liliana Orellana, Tammy I Kang, J Russell Geyer, Abby R Rosenberg, Chris Feudtner, Joanne Wolfe
CONTEXT: Little is known about how parents of children with advanced cancer classify news they receive about their child's medical condition. OBJECTIVE: To develop concepts of "good news" and "bad news" in discussions of advanced childhood cancer from parent perspectives. METHODS: Parents of children with advanced cancer cared for at three children's hospitals were asked to share details of conversations in the preceding 3 months that contained "good news" or "bad news" related to their child's medical condition...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28060462/end-of-life-care-for-people-dying-with-dementia-in-general-practice-in-belgium-italy-and-spain-a-cross-sectional-retrospective-study
#10
Yolanda W H Penders, Gwenda Albers, Luc Deliens, Guido Miccinesi, Tomás Vega Alonso, Maite Miralles, Sarah Moreels, Lieve Van den Block
AIM: To describe and compare end-of-life care for people with mild or severe dementia in general practice in Belgium, Italy and Spain, in terms of place of care, place of death, treatment aims, use of specialized palliative care and communication with general practitioners (GPs). METHODS: Cross-sectional retrospective survey was carried out of nationwide networks of GPs in Belgium, Italy and Spain, including patients who died aged 65 years or older in 2009-2011 and were judged by the GP to have had dementia (n = 1623)...
January 6, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28056642/-end-of-life-could-be-on-any-ward-really-a-qualitative-study-of-hospital-volunteers-end-of-life-care-training-needs-and-learning-preferences
#11
Lisa Jane Brighton, Jonathan Koffman, Vicky Robinson, Shaheen A Khan, Rob George, Rachel Burman, Lucy Ellen Selman
BACKGROUND: Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care. AIMS: To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods...
January 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28053511/the-state-of-multiple-sclerosis-current-insight-into-the-patient-health-care-provider-relationship-treatment-challenges-and-satisfaction
#12
Mar Tintoré, Maggie Alexander, Kathleen Costello, Martin Duddy, David E Jones, Nancy Law, Gilmore O'Neill, Antonio Uccelli, Robert Weissert, Sibyl Wray
BACKGROUND: Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. METHODS: A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28042062/end-of-life-care-and-quality-of-dying-in-twenty-three-acute-geriatric-hospital-wards-in-flanders-belgium
#13
Rebecca Verhofstede, Tinne Smets, Joachim Cohen, Kim Eecloo, Massimo Costantini, Nele Van Den Noortgate, Luc Deliens
OBJECTIVES: To describe the nursing and medical interventions performed in the last 48 hours of life and the quality of dying of patients dying in acute geriatric hospital wards. METHODS: Design: Cross-sectional descriptive study between October 1(st) 2012 and September 30(th) 2013. SETTING: Twenty-three acute geriatric wards in 13 hospitals in Flanders, Belgium. PARTICIPANTS: Patients hospitalized for more than 48 hours before dying in the participating wards...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28030488/a-novel-method-of-optimizing-patient-and-family-centered-care-in-the-icu-family-presence-on-icu-rounds
#14
Steven R Allen, Jose Pascual, Niels Martin, Patrick Reilly, Gina Luckianow, Elizabeth Datner, Kimberly A Davis, Lewis J Kaplan
BACKGROUND: Patient and family centered care permeates critical care where there are often multiple teams involved in management. A method of facilitating information sharing to support shared decision-making is essential in appropriately rendering care.This study sought to determine whether incorporating family members on rounds in the ICU improves patient and family knowledge, and whether doing so improves team time management and satisfaction with the process. METHODS: A nonrandomized, comparative before and after trial of incorporating family members on rounds (July-December 2009 vs January-July 2010) in a single quarternary center's Surgical ICU assessed: 1) family member knowledge, 2) nurse and physician satisfaction with the intervention, 3) frequency and timing of family meetings, and 4) physician workflow...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28029695/sense-of-control-in-end-of-life-decision-making
#15
Rafael D Romo, Theresa A Allison, Alexander K Smith, Margaret I Wallhagen
OBJECTIVES: To explore how older adults in the community with a limited life expectancy make healthcare decisions and the processes used when they are not in an acute crisis. DESIGN: Grounded theory. SETTING: Medical programs and geriatrics clinics at the University of California, San Francisco, and the San Francisco Veterans Affairs Medical Center. PARTICIPANTS: Community-dwelling adults aged 67 to 98 with a life expectancy of less than 1 year (N = 20)...
December 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28029308/effects-of-early-integrated-palliative-care-in-patients-with-lung-and-gi-cancer-a-randomized-clinical-trial
#16
Jennifer S Temel, Joseph A Greer, Areej El-Jawahri, William F Pirl, Elyse R Park, Vicki A Jackson, Anthony L Back, Mihir Kamdar, Juliet Jacobsen, Eva H Chittenden, Simone P Rinaldi, Emily R Gallagher, Justin R Eusebio, Zhigang Li, Alona Muzikansky, David P Ryan
Purpose We evaluated the impact of early integrated palliative care (PC) in patients with newly diagnosed lung and GI cancer. Patients and Methods We randomly assigned patients with newly diagnosed incurable lung or noncolorectal GI cancer to receive either early integrated PC and oncology care (n = 175) or usual care (n = 175) between May 2011 and July 2015. Patients who were assigned to the intervention met with a PC clinician at least once per month until death, whereas those who received usual care consulted a PC clinician upon request...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28012678/end-of-life-parental-communication-priorities-among-bereaved-fathers-due-to-cancer
#17
Eliza M Park, Allison M Deal, Justin M Yopp, Teresa Edwards, Elise M Stephenson, Claire E Hailey, Zev M Nakamura, Donald L Rosenstein
OBJECTIVES: To elicit widowed fathers' perspectives on which domains of parenting-related communication they consider most important for dying parents to discuss at the end of life (EOL). METHODS: Two hundred seventy nine fathers widowed by cancer completed a survey about their own depression and bereavement symptoms, their wife's illness, and EOL parental communication priorities. Chi square and Fisher's exact tests and logistic regression were used to evaluate relationships between maternal EOL characteristics and fathers' responses to parenting-related EOL communication priorities...
December 16, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28011081/from-theory-to-practice-measuring-end-of-life-communication-quality-using-multiple-goals-theory
#18
L J Van Scoy, A M Scott, J M Reading, C H Chuang, V M Chinchilli, B H Levi, M J Green
OBJECTIVES: To describe how multiple goals theory can be used as a reliable and valid measure (i.e., coding scheme) of the quality of conversations about end-of-life issues. METHODS: We analyzed conversations from 17 conversations in which 68 participants (mean age=51years) played a game that prompted discussion in response to open-ended questions about end-of-life issues. Conversations (mean duration=91min) were audio-recorded and transcribed. Communication quality was assessed by three coders who assigned numeric scores rating how well individuals accomplished task, relational, and identity goals in the conversation...
December 15, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28009732/patient-reported-limitations-to-surgical-buy-in-a-qualitative-study-of-patients-facing-high-risk-surgery
#19
Michael J Nabozny, Jacqueline M Kruser, Nicole M Steffens, Kristen E Pecanac, Karen J Brasel, Eva H Chittenden, Zara Cooper, Martin F McKneally, Margaret L Schwarze
OBJECTIVE: To characterize how patients buy-in to treatments beyond the operating room and what limits they would place on additional life-supporting treatments. BACKGROUND: During a high-risk operation, surgeons generally assume that patients buy-in to life-supporting interventions that might be necessary postoperatively. How patients understand this agreement and their willingness to participate in additional treatment is unknown. METHODS: We purposively sampled surgeons in Toronto, Ontario, Boston, Massachusetts, and Madison, Wisconsin, who are good communicators and routinely perform high-risk operations...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28009643/palliative-care-and-chronic-obstructive-pulmonary-disease-where-the-lines-meet
#20
Sarah E Harrington, Elizabeth Rogers, Megan Davis
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and is expected to increase as the population ages. Patients have a high symptom burden, low healthcare quality of life, and unmet needs at the end of life. This review highlights specific palliative care needs of patients with advanced COPD and opportunities to integrate palliative care into standard practice. RECENT FINDINGS: There are many barriers to providing integrated palliative care in COPD, including difficulty with prognostication, communication barriers surrounding advance care planning, and lack of access to specialty palliative care...
December 21, 2016: Current Opinion in Pulmonary Medicine
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