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End of life communication

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https://www.readbyqxmd.com/read/28532225/pneumonia-in-nursing-home-patients-with-advanced-dementia-decisions-intravenous-rehydration-therapy-and-discomfort
#1
Jenny T van der Steen, Paola Di Giulio, Fabrizio Giunco, Massimo Monti, Simona Gentile, Daniele Villani, Silvia Finetti, Francesca Pettenati, Lorena Charrier, Franco Toscani
BACKGROUND: Comfort may be an appropriate goal in advanced dementia. Longitudinal studies on physician decision-making and discomfort assessed by direct observation are rare, and intravenous rehydration therapy is controversial. METHODS: To assess treatment decisions and discomfort in patients with advanced dementia and pneumonia and to compare by intravenous rehydration therapy, we used data from the observational multicenter Italian End of Life Observatory-Prospective Study On DEmentia patients Care...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28521799/what-are-the-differences-among-occupational-groups-related-to-their-palliative-care-specific-educational-needs-and-intensity-of-interprofessional-collaboration-in-long-term-care-homes
#2
S Kaasalainen, T Sussman, M Bui, N Akhtar-Danesh, R D Laporte, L McCleary, A Wickson Griffiths, K Brazil, D Parker, V Dal Bello-Haas, A Papaioannou, J O'Leary
BACKGROUND: The purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes. METHODS: A cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman's approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery...
May 18, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28514908/using-action-learning-sets-to-support-change-in-end-of-life-care
#3
Karen Gillett, Liz Reed, Liz Bryan
Purpose The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course. Design/methodology/approach The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period...
May 2, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#4
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28506309/social-isolation-and-cancer-management-advanced-rectal-cancer-with-patient-delay-following-the-2011-triple-disaster-in-fukushima-japan-a-case-report
#5
Akihiko Ozaki, Claire Leppold, Toyoaki Sawano, Masaharu Tsubokura, Manabu Tsukada, Tetsuya Tanimoto, Masahiro Kami, Hiromichi Ohira
BACKGROUND: Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care. CASE PRESENTATION: In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy...
May 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28506145/areas-of-control-desired-by-patients-and-families-referred-to-hospice-care-perspectives-of-hospice-admissions-staff
#6
Hyunjin Noh
Sense of control in end-of-life (EOL) care plays a critical role in the patient's well-being. However, little is known about the areas of control essential to patients and families at a specific time point in the illness trajectory: when patients stop curative treatments and are referred to hospice. This study qualitatively explored such areas. Sixteen admissions staff members from four hospice agencies were interviewed about their perceptions of areas in which patients and families worried about losing control by accepting hospice...
May 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28505740/weakly-coupled-map-lattice-models-for-multicellular-patterning-and-collective-normalization-of-abnormal-single-cell-states
#7
Vladimir García-Morales, José A Manzanares, Salvador Mafe
We present a weakly coupled map lattice model for patterning that explores the effects exerted by weakening the local dynamic rules on model biological and artificial networks composed of two-state building blocks (cells). To this end, we use two cellular automata models based on (i) a smooth majority rule (model I) and (ii) a set of rules similar to those of Conway's Game of Life (model II). The normal and abnormal cell states evolve according to local rules that are modulated by a parameter κ. This parameter quantifies the effective weakening of the prescribed rules due to the limited coupling of each cell to its neighborhood and can be experimentally controlled by appropriate external agents...
April 2017: Physical Review. E
https://www.readbyqxmd.com/read/28505118/communicatively-constructing-the-bright-and-dark-sides-of-hope-family-caregivers-experiences-during-end-of-life-cancer-care
#8
Jody Koenig Kellas, Katherine M Castle, Alexis Johnson, Marlene Z Cohen
(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; (3) Results: Two overarching patterns of hope emerged...
May 15, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28501793/ethical-issues-in-death-dying-and-palliation-the-ijme-sixth-national-bioethics-conference
#9
Rakhi Ghoshal, V Deepa, Sunita Simon Kurpad
The IJME Sixth National Bioethics Conference (6th NBC), on the theme "Healing and dying with dignity: ethical issues in palliative care, end-of-life care and euthanasia", was held in Pune, Maharashtra from January 12-15, 2017. Palliative care (PC) and end-of-life care (EOLC) are closely related areas of concern, yet they have been neglected so far. There is an urgent need to discuss these issues in India due to the changing demographics, socioeconomic and work profiles of the population, people's living conditions and health status, and the contexts of the country's population...
May 10, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#10
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28494477/new-zealand-plastic-surgeons-life-time-contribution-to-peer-reviewed-literature
#11
Tess Brian, Brandon Adams
AIM: The New Zealand Medical Association commits the New Zealand doctor to evidence-based medicine, scholarship, teaching, collaboration and communication. To assess this commitment, one measure, contribution to the peer-reviewed literature, was examined for one group of New Zealand doctors: plastic surgeons. METHOD: Plastic surgeons with a current practising certificate were identified on the New Zealand medical register (April 2016). Scopus database was searched for publications by each...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28489813/implementing-a-novel-model-for-hospice-and-palliative-care-in-the-emergency-department-an-experience-from-a-tertiary-medical-center-in-taiwan
#12
Tzu-Chieh Weng, Ya-Chun Yang, Ping-Jen Chen, Wen-Fu Kuo, Wei-Lin Wang, Ya-Ting Ke, Chien-Chin Hsu, Kao-Chang Lin, Chien-Cheng Huang, Hung-Jung Lin
Hospice and palliative care has been recognized as an essential part of emergency medicine; however, there is no consensus on the optimal model for the delivery of hospice and palliative care in the emergency department (ED). Therefore, we conducted a novel implementation in a tertiary medical center in Taiwan. In the preintervention period, we recruited a specialist for hospice and palliative medicine in the ED to lead our intervention. In the early stage of the intervention, starting on July 1, 2014, we encouraged and funded ED physicians and nurses to receive training for hospice and palliative medicine and residents of emergency medicine to rotate to the hospice ward...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28488291/advance-care-planning-with-individuals-experiencing-homelessness-literature-review-and-recommendations-for-public-health-practice
#13
Sarah A Hubbell
Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness...
May 10, 2017: Public Health Nursing
https://www.readbyqxmd.com/read/28487434/fifteen-minute-consultation-practical-pain-management-in-paediatric-palliative-care
#14
Emily Jane Harrop, Karen Brombley, Katherine Boyce
Pain and distress in the paediatric palliative care population can be very difficult to manage. Clinical scenarios range from the acute management of cancer-related pain at the end of life to the ongoing long-term support of children with complex multimodal pain related to progressive neurological conditions. Understanding the child's underlying condition, possible causes of pain and their preferred mode of communication are important to the delivery of holistic care. Modification of environmental factors, basic care consideration and non-pharmacological measures have a large role to play, alongside conventional analgesics...
May 9, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28486693/oncologists-views-on-the-importance-of-general-practitioners-for-cancer-patients-a-qualitative-interview-study-from-germany
#15
Jennifer Engler, Insa Kone, Christine Holmberg, Walter Baumann, Andrea Siebenhofer, Corina Güthlin
Background.: Integrated cancer care requires cooperation between specialists and general practitioners (GPs). Mutual understanding of each other's tasks and responsibilities is essential if cooperation is to be successful. While GPs' opinions about oncologists have been addressed in previous studies, less is known about oncologists' views on the role of GPs' in cancer care, especially with regard to GPs' patient-centred, communication-based tasks. Objective.: To assess oncologists' views on the importance of GPs for cancer patients...
May 9, 2017: Family Practice
https://www.readbyqxmd.com/read/28481607/engagement-in-steps-of-advance-health-care-planning-by-homeless-veterans
#16
Patricia M Dubbert, Kimberly K Garner, Shelly Lensing, J Glen White, Dennis H Sullivan
Communicating health care preferences in advance, so that wishes can be honored if the person becomes unable to participate in decision-making, is especially important for vulnerable populations such as homeless veterans. Hospitals are required to inform patients of their rights to document their preferences, but completion rates for advance directives are low. Conceptualizing advance health care planning as a series of health behavior steps emphasizing communication is recommended for improving engagement in advance health care planning...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28479121/ethical-considerations-and-palliative-care-in-patients-with-amyotrophic-lateral-sclerosis-a-review
#17
REVIEW
V Danel-Brunaud, L Touzet, L Chevalier, C Moreau, D Devos, S Vandolaeghe, L Defebvre
Amyotrophic lateral sclerosis (ALS) is not a curable disease, but it is treatable. By definition, much of the care provided to ALS patients is palliative, even though active life-sustaining strategies are available to prolong survival. Healthcare professionals must develop communication skills that help patients cope with the inexorable progression of the disease and the inevitability of death. Symptomatic treatments as well as respiratory insufficiency and nutritional life-sustaining therapies must be regularly evaluated as the disease progresses, without losing sight of the burden placed on the patient's non-professional caregivers...
May 4, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28476218/-bioethics-in-end-of-life-decisions-in-neonatology-unresolved-issues
#18
Juan Arnaez, Juan Carlos Tejedor, Sonia Caserío, María Teresa Montes, María Teresa Moral, Javier González de Dios, Alfredo García-Alix
This document is the result of previous work carried out by different expert groups and submitted to multidisciplinary debate at a Conference about controversial, deficient, or new aspects in the field of neonatal palliative care, such as: 1) the deliberative decision-making process, 2) hospital and domiciliary palliative care, 3) donation after controlled cardiac death, and 4) moral stress in professionals. The most relevant conclusions were: the need to instruct professionals in bioethics and in the deliberative method to facilitate thorough and reasonable decision-making; the lack of development in the field of perinatal palliative care and domiciliary palliative care in hospitals that attend newborns; the need to provide neonatal units with resources that help train professionals in communication skills and in the management of moral distress, as well as delineate operational procedure and guidelines for neonatal organ donation...
May 2, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28474751/a-willingness-to-go-there-nurses-and-spiritual-care
#19
Mary E Minton, Mary J Isaacson, Brandon Michael Varilek, Jessica L Stadick, Shannon O'Connell-Persaud
AIMS AND OBJECTIVES: Describe rural and urban palliative/hospice care nurses' communication strategies while providing spiritual care for patients and families at end-of-life. BACKGROUND: Nurses aim to provide holistic care consisting of physical, psychological, and spiritual components. However, it is well documented that spiritual care is largely missing from nursing care. Internationally, spiritual care is a growing topic of interest, yet many nurses feel unprepared to deliver spiritual care...
May 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28471764/palliative-care-in-surgery-defining-the-research-priorities
#20
Elizabeth J Lilley, Zara Cooper, Margaret L Schwarze, Anne C Mosenthal
OBJECTIVE: To describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. BACKGROUND: Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care...
May 3, 2017: Annals of Surgery
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