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End of life communication

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https://www.readbyqxmd.com/read/28636108/understanding-the-influences-and-impact-of-patient-clinician-communication-in-cancer-care
#1
Jennifer Elston Lafata, Laura A Shay, Jodi M Winship
BACKGROUND: Patient-clinician communication is thought to be central to care outcomes, but when and how communication affects patient outcomes is not well understood. OBJECTIVE: We propose a conceptual model and classification framework upon which the empirical evidence base for the impact of patient-clinician communication can be summarized and further built. DESIGN: We use the proposed model and framework to summarize findings from two recent systematic reviews, one evaluating the use of shared decision making (SDM) on cancer care outcomes and the other evaluating the role of physician recommendation in cancer screening use...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28634216/respecting-patient-choices-using-the-go-wish-cards-as-a-teaching-tool
#2
Hibah Osman, Katia El Jurdi, Ramzi Sabra, Thalia Arawi
BACKGROUND: Individuals have different values and priorities that can have an important impact on their medical management. Understanding this concept can help physicians provide medical care that is in line with the goals of their patients. Communicating this message effectively to students is challenging. OBJECTIVE: To report our experience with using Go Wish cards in the medical education setting. DESIGN: A thematic analysis of student reflection papers using grounded theory...
June 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28631959/advance-care-planning-for-patients-with-amyotrophic-lateral-sclerosis
#3
Benjamin H Levi, Zachary Simmons, Courtney Hanna, Allyson Brothers, Erik Lehman, Elana Farace, Megan Bain, Renee Stewart, Michael J Green
PURPOSE: To determine whether an advance care planning (ACP) decision-aid could improve communication about end-of-life treatment wishes between patients with amyotrophic lateral sclerosis (ALS) and their clinicians. METHODS: Forty-four patients with ALS (>21, English-speaking, without dementia) engaged in ACP using an interactive computer based decision-aid. Before participants completed the intervention, and again three months later, their clinicians reviewed three clinical vignettes, and made treatment decisions (n = 18) for patients...
March 5, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28627303/the-surprise-question-in-paediatric-palliative-care-a-prospective-cohort-study
#4
Kimberley Burke, Lucy Helen Coombes, Antoinette Menezes, Anna-Karenia Anderson
BACKGROUND: The question 'would you be surprised if this patient died in the next 12-months' is widely used for identifying adult patients in the last year of life. However, this has not yet been studied in children. AIM: To assess the prognostic accuracy of the surprise question when used by a multidisciplinary team to predict survival outcomes of children with life-limiting conditions over a 3 and 12 month period. DESIGN: A prospective cohort study...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28623155/care-toward-the-end-of-life-in-older-populations-and-its-implementation-facilitators-and-barriers-a-scoping-review
#5
REVIEW
Diane Erin Threapleton, Roger Y Chung, Samuel Y S Wong, Eliza L Y Wong, Nicole Kiang, Patsy Y K Chau, Jean Woo, Vincent C H Chung, Eng Kiong Yeoh
PURPOSE: To inform health system improvements for care of elderly populations approaching the end of life (EOL) by identifying important elements of care and implementation barriers and facilitators. DESIGN: A scoping review was carried out to identify key themes in EOL care. Articles were identified from MEDLINE, the Cochrane Library, organizational websites, and internet searches. Eligible publications included reviews, reports, and policy documents published between 2005 and 2016...
June 13, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28622379/end-of-life-care-for-people-with-dementia-the-views-of-health-professionals-social-care-service-managers-and-frontline-staff-on-key-requirements-for-good-practice
#6
Richard Philip Lee, Claire Bamford, Marie Poole, Emma McLellan, Catherine Exley, Louise Robinson
BACKGROUND: Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those with cancer; with increased hospitalisation, inadequate pain control and fewer palliative care interventions. Understanding the views of those service managers and frontline staff who organise and provide care is crucial in order to develop better end of life care for people with dementia. METHODS AND FINDINGS: Qualitative interviews and focus groups were conducted from 2013 to 2015 with 33 service managers and 54 staff involved in frontline care, including doctors, nurses, nursing and care home managers, service development leads, senior managers/directors, care assistants and senior care assistants/team leads...
2017: PloS One
https://www.readbyqxmd.com/read/28618897/shared-decision-making-about-palliative-chemotherapy-a-qualitative-observation-of-talk-about-patients-preferences
#7
Inge Henselmans, Hanneke Wm Van Laarhoven, Jane Van der Vloodt, Hanneke Cjm De Haes, Ellen Ma Smets
BACKGROUND: Particularly at the end of life, treatment decisions should be shared and incorporate patients' preferences. This study examines elaboration and preference construction. AIM: To examine the values, appraisals and preferences that patients express, as well as the oncologists' communicative behaviour that facilitates these expressions in consultations on palliative chemotherapy. DESIGN: Verbatim transcripts of audio-recorded consultations ( n = 60) were analysed in MAXqda10 software...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28617622/treatment-and-communication-that-is-what-matters-an-analysis-of-complaints-regarding-end-of-life-care
#8
Jiska Cohen-Mansfield, Michal Skornick-Bouchbinder, Rinat Cohen, Shai Brill
BACKGROUND: Investigating complaints concerning end-of-life (EoL) care is a necessary step for improving the quality of life at its final stage. OBJECTIVE: We aimed to classify and quantify the aspects of EoL care that require improvement by analyzing caregivers' feedback on the care their relatives received before death. DESIGN: A survey of primary family caregivers of deceased patients. SETTING/SUBJECTS: Relatives of decedents were recruited through two geriatric medical centers and from persons contacted for other studies, who reported losing a relative...
June 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28617167/patient-reported-barriers-to-the-prekidney-transplant-evaluation-in-an-at-risk-population-in-the-united-states
#9
Mark B Lockwood, Milda R Saunders, Rachel Nass, Claire L McGivern, Patrick N Cunningham, W James Chon, Michelle A Josephson, Yolanda T Becker, Christopher S Lee
BACKGROUND: Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient-reported barriers to the prekidney transplant medical evaluation in populations largely at-risk for evaluation failure. METHODS: One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical, and quality of life data were collected prior to patients visit with a transplant surgeon/nephrologist (evaluation begins)...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28616221/time-timing-talking-and-training-findings-from-an-exploratory-action-research-study-to-improve-quality-of-end-of-life-care-for-minority-ethnic-kidney-patients
#10
Emma Wilkinson, Gurch Randhawa, Edwina Brown, Maria Da Silva Gane, John Stoves, Graham Warwick, Tahira Mir, Regina Magee, Sue Sharman, Ken Farrington
Background. With an ageing and increasingly diverse population at risk from rising levels of obesity, diabetes and cardiovascular disease, including kidney complications, there is a need to provide quality care at all stages in the care pathway including at the end of life and to all patients. Aim. This study purposively explored South Asian patients' experiences of kidney end of life care to understand how services can be delivered in a way that meets diverse patient needs. Methods. Within an action research design 14 focus groups (45 care providers) of kidney care providers discussed the recruitment and analysis of individual interviews with 16 South Asian kidney patients (eight men, eight women)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28610756/crossing-a-line-a-narrative-of-risk-taking-by-older-women-serving-as-caregivers
#11
Jennifer L Womack, Margareta Lilja, Gunilla Isaksson
BACKGROUND: Caregiving carried out by adults for other adults is increasing around the world as the demographics of many industrialized countries shift toward an older population with escalating care needs toward the end of life. Although much has been written about caregiving, few studies document the experiences of providing care as narrated by the caregivers. AIM: To explore the everyday experiences of older adults serving as primary informal caregivers to significant others...
April 2017: Journal of Aging Studies
https://www.readbyqxmd.com/read/28604265/a-multi-professional-educational-intervention-to-improve-and-sustain-respondents-confidence-to-deliver-palliative-care-a-mixed-methods-study
#12
Elizabeth Reed, Jennifer Todd, Sally Lawton, Robert Grant, Clair Sadler, Jane Berg, Caroline Lucas, Max Watson
BACKGROUND: Education has been highlighted as fundamental in equipping healthcare professionals with essential knowledge and skills to provide good end-of-life care. Multiprofessional educational programmes have a positive influence on knowledge, attitude and confidence but few have sought to understand the longer term impact on care delivery. The European Certificate in Essential Palliative Care is an 8-week home-study-based programme for healthcare professionals and is currently run in nine centres...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28602377/end-of-life-care-in-the-treatment-of-heart-failure-in-older-adults
#13
REVIEW
John Arthur McClung
Heart failure presents unique challenges to the clinician who desires to provide excellent and humane care near the end of life. Accurate prediction of mortality in the individual patient is complicated by a chronic disease that is punctuated by recurrent acute episodes and sudden death. Health care providers continue to have difficulty communicating effectively with terminally ill patients and their caregivers regarding end-of-life care preferences, all of which needs to occur earlier rather than later. This article also discusses various means of providing palliative care, and specific issues regarding device therapy, cardiopulmonary resuscitation, and palliative sedation with concurrent discussion of the ethical ramifications and pitfalls of each...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28598947/moral-distress-in-picu-and-neonatal-icu-practitioners-a-cross-sectional-evaluation
#14
Charles Philip Larson, Karen D Dryden-Palmer, Cathy Gibbons, Christopher S Parshuram
OBJECTIVES: To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. DESIGN: Cross-sectional survey. SETTING: A large pediatric tertiary care center. SUBJECTS: Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. INTERVENTIONS: A 41-item questionnaire examining moral distress, burnout, and uncertainty...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28594366/rf-emf-risk-perception-revisited-is-the-focus-on-concern-sufficient-for-risk-perception-studies
#15
Peter M Wiedemann, Frederik Freudenstein, Christoph Böhmert, Joe Wiart, Rodney J Croft
An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected...
June 8, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28592468/improving-health-care-provider-communication-in-end-of-life-decision-making
#16
Tracey Wilson, Cathy Haut, Bimbola Akintade
Critical care providers are responsible for many aspects of patient care, primarily focusing on preserving life. However, nearly 40% of patients who are admitted to an adult critical care unit will not survive. Initiating a conversation about end-of-life decision-making is a daunting task. Often, health care providers are not trained, experienced, or comfortable facilitating these conversations. This article describes a quality improvement project that identified current views on end-of-life communication in the intensive care unit and potential barriers that obstruct open discussion, and offering strategies for improvement...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28590407/family-communication-about-end-of-life-decisions-and-the-enactment-of-the-decision-maker-role
#17
April R Trees, Jennifer E Ohs, Meghan C Murray
End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior...
June 7, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28585474/family-experience-with-osteogenesis-imperfecta-type-1-the-most-distressing-situations
#18
Margarida Custódio Dos Santos, Ana Filipa Pires, Kelly Soares, Luísa Barros
BACKGROUND: Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by decreased bone mass and increased bone fragility. Despite increasing research on the biomedical aspects of the disease, only a few studies focus on the psychosocial implications of living with OI. This study aimed to explore the situations that are perceived by OI type-1 children, their parents and siblings, as being the most distressing and stressful in their experience with the disease. METHODS: Seven families of children diagnosed with OI type 1 for longer than four years participated...
June 6, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28578815/three-years-experience-with-the-first-pediatric-hospice-in-asia
#19
Kohei Ando, Makoto Nabetani, Nobuyuki Yotani, Tatsushi Rin, Hiroyuki Sano
OBJECTIVE: Pediatric hospice has been the adoption of several service provision models in highly developed countries such as UK, Germany, Australia or Canada for a few decades, yet it has seldom been the case in the Asian Continent. This study aimed to evaluate the newest challenge for the children with Life-threatening illness (LTI) and described the characteristic of pediatric palliative care at the first pediatric hospice in Japan. METHODS: A retrospective review of all patients at our pediatric hospice in these three years was conducted...
May 31, 2017: Brain & Development
https://www.readbyqxmd.com/read/28570382/critical-care-nurses-suggestions-to-improve-end-of-life-care-obstacles-minimal-change-over-17-years
#20
Renea L Beckstrand, Kacie Hart Hadley, Karlen E Luthy, Janelle L B Macintosh
BACKGROUND: Critical-care nurses (CCNs) provide end-of-life (EOL) care on a daily basis as 1 in 5 patients dies while in intensive care units. Critical-care nurses overcome many obstacles to perform quality EOL care for dying patients. OBJECTIVES: The purposes of this study were to collect CCNs' current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998. METHODS: A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2000 members of the American Association of Critical-Care Nurses...
July 2017: Dimensions of Critical Care Nursing: DCCN
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