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https://www.readbyqxmd.com/read/29315996/a-spiritual-care-toolkit-an-evidence-based-solution-to-meet-spiritual-needs
#1
Donna D Kincheloe, Lois M Stallings Welden, Ann White
AIMS: To determine differences between baseline spiritual perspectives of nurses, patients, and their families and examine the effectiveness of a spiritual care toolkit as an intervention to facilitate meeting spiritual needs of hospitalized patients and families. BACKGROUND: Provision of spiritual care by nurses in the acute care environment is an issue of high priority for patients. Nurses report lack of: time, comfort, training, cultural knowledge, and mobilization of resources as obstacles to spiritual care delivery...
January 9, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29314437/prolonged-grief-disorder-and-depression-are-distinct-for-caregivers-across-their-first-bereavement-year
#2
Wei-I Tsai, Su-Ching Kuo, Fur-Hsing Wen, Holly G Prigerson, Siew Tzuh Tang
BACKGROUND: Prolonged grief disorder (PGD) and depression are recognized as distinct emotional-distress disorders for bereaved family caregivers. However, this distinction has been mostly validated in cross-sectional studies, neglecting the dynamic characteristics of bereaved caregivers' emotional distress. OBJECTIVE: To validate the distinction between symptoms of PGD and depression across the first bereavement year for family caregivers of terminally ill cancer patients...
January 4, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29302600/a-few-realistic-questions-raised-by-organ-retrieval-in-the-intensive-care-unit
#3
REVIEW
Olivier Lesieur, Liliane Genteuil, Maxime Leloup
Organ transplantation saves the lives of many persons who would otherwise die from end-stage organ disease. The increasing demand for donated organs has led to a renewed interest in donation after circulatory determination of death (CDD). In many countries (including France), terminally ill patients who die of circulatory arrest after a planned withdrawal of life support may be considered as organ donors under certain conditions. While having equal responsibility towards the potential donor and the persons awaiting a transplant, caregivers may experience an ethical dilemma between the responsibility to deliver the best care to the dying, and the need to retrieve the organs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29301524/what-does-complex-mean-in-palliative-care-triangulating-qualitative-findings-from-3-settings
#4
Emma Carduff, Sarah Johnston, Catherine Winstanley, Jamie Morrish, Scott A Murray, Juliet Spiller, Anne Finucane
BACKGROUND: Complex need for patients with a terminal illness distinguishes those who would benefit from specialist palliative care from those who could be cared for by non-specialists. However, the nature of this complexity is not well defined or understood. This study describes how health professionals, from three distinct settings in the United Kingdom, understand complex need in palliative care. METHODS: Semi-structured qualitative interviews were conducted with professionals in primary care, hospital and hospice settings...
January 4, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29298714/paediatric-palliative-care-improves-patient-outcomes-and-reduces-healthcare-costs-evaluation-of-a-home-based-program
#5
P H Chong, J A De Castro Molina, K Teo, W S Tan
BACKGROUND: Around the world, different models of paediatric palliative care have responded to the unique needs of children with life shortening conditions. However, research confirming their utility and impact is still lacking. This study compared patient-related outcomes and healthcare expenditures between those who received home-based paediatric palliative care and standard care. The quality of life and caregiver burden for patients receiving home-based paediatric palliative care were also tracked over the first year of enrolment to evaluate the service's longitudinal impact...
January 3, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29290244/surgical-transfer-decision-making-how-regional-resources-are-allocated-in-a-regional-transfer-network
#6
Kristy Kummerow Broman, Michael J Ward, Benjamin K Poulose, Margaret L Schwarze
BACKGROUND: Tertiary care centers often operate above capacity, limiting access to emergency surgical care for patients at nontertiary facilities. For nontraumatic surgical emergencies there are no guidelines to inform patient selection for transfer to another facility. Such decisions may be particularly difficult for gravely ill patients when the benefits of transfer are uncertain. METHODS: To characterize surgeons' decision-making strategies for transfer, a qualitative analysis of semistructured interviews was conducted with 16 general surgeons who refer and accept patients within a regional transfer network...
January 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29289656/accurate-prognostic-awareness-facilitates-whereas-better-quality-of-life-and-more-anxiety-symptoms-hinder-end-of-life-care-discussions-a-longitudinal-survey-study-in-terminally-ill-cancer-patients-last-six-months-of-life
#7
Siew Tzuh Tang, Chen Hsiu Chen, Fur-Hsing Wen, Jen-Shi Chen, Wen-Cheng Chang, Chia-Hsun Hsieh, Wen-Chi Chou, Ming-Mo Hou
BACKGROUND: Terminally ill cancer patients do not engage in end-of-life (EOL)-care discussions or do so only when death is imminent, despite guidelines for EOL-care discussions early in their disease trajectory. Most studies on patient-reported EOL-care discussions are cross-sectional without exploring the evolution of EOL-care discussions as death approaches. Cross-sectional studies cannot determine the direction of association between EOL-care discussions and patients' prognostic awareness, psychological well-being, and quality of life (QOL)...
December 28, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29288982/c-terminal-and-intact-fgf23-in-critical-illness-and-their-associations-with-acute-kidney-injury-and-in-hospital-mortality
#8
Karolina Rygasiewicz, Tomasz Hryszko, Andrzej Siemiatkowski, Szymon Brzosko, Alicja Rydzewska-Rosolowska, Beata Naumnik
BACKGROUND: FGF23 proved its value in prognostication of cardiovascular events and mortality among renal patients and general population. Limited data exist whether FGF23 may have any use in prediction of negative outcomes among critically ill patients admitted to intensive care unit (ICU). METHODS: Single center cohort study performed among patients admitted to ICU. The primary exposure was FGF23 plasma concentration measured within 24 h of ICU admission. The primary outcome was incident Acute Kidney Injury (AKI) and in-hospital mortality during the ICU stay...
December 27, 2017: Cytokine
https://www.readbyqxmd.com/read/29283927/are-informal-caregivers-of-persons-with-dementia-open-to-extending-medical-aid-in-dying-to-incompetent-patients-findings-from-a-survey-conducted-in-quebec-canada
#9
Gina Bravo, Claudie Rodrigue, Marcel Arcand, Jocelyn Downie, Marie-France Dubois, Sharon Kaasalainen, Cees M Hertogh, Sophie Pautex, Lieve Van den Block
Euthanasia is a controversial and complex issue, especially when involving incompetent patients. On December 10, 2015, Quebec became the first Canadian province to give access to medical aid in dying (MAiD) (ie, euthanasia performed by a physician) to competent patients who satisfy strictly defined criteria. Less than 2 years later, Quebec is considering extending MAiD to incompetent patients who made an advance request. With the objective of contributing scientific data to current societal debates, we conducted a survey among 471 informal caregivers of persons with dementia, reached through Alzheimer Societies...
December 27, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29277477/the-communicative-role-of-companion-pets-in-patient-centered-critical-care
#10
Jill Yamasaki
OBJECTIVE: This study examines a personal pet hospital visitation program dedicated to preserving the human-animal bond during chronic, critical, or terminal illness to understand the novel ways companion pets facilitate meaningful communication between patients, providers, and families in hospital settings. METHODS: I thematically analyzed data collected through a variety of qualitative methods, including participant observation, informal and semi-structured interviews, and a review of organizational materials...
December 18, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29276987/are-life-extending-treatments-for-terminal-illnesses-a-special-case-exploring-choices-and-societal-viewpoints
#11
Neil McHugh, Job van Exel, Helen Mason, Jon Godwin, Marissa Collins, Cam Donaldson, Rachel Baker
Criteria used by the National Institute for Health and Care Excellence (NICE) to assess life-extending, end-of-life (EoL) treatments imply that health gains from such treatments are valued more than other health gains. Despite claims that the policy is supported by societal values, evidence from preference elicitation studies is mixed and in-depth research has shown there are different societal viewpoints. Few studies elicit preferences for policies directly or combine different approaches to understand preferences...
December 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29248898/confidence-in-palliative-care-issues-by-medical-students-and-internal-medicine-residents
#12
Ana Carolina Montouro Storarri, Giovana Dalmedico de Castro, Lilian Castiglioni, Patricia Maluf Cury
BACKGROUND: Palliative care (PC) is a relatively new field in Brazil, but this knowledge is of great importance in medical practice. OBJECTIVE: To evaluate the degree of confidence among medical students and first-year and second-year internal medicine residents in addressing issues of death and terminal illness with patients and their families. METHOD: A modified version of the Self-Efficacy in Palliative Care Scale was applied to 293 students in their first year to sixth year at the School of Medicine of São José do Rio Preto and to 43 residents in their first year or second year of medical practice at the same institution in Brazil, in 2015...
December 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29244207/information-about-expert-decision-and-post-decision-distortion-of-facts-of-own-decision
#13
Ola Svenson, Nichel Gonzalez, Amina Memon, Torun Lindholm
Cognitive representations of decision problems are dynamic. During and after a decision, evaluations and representations of facts change to support the decision made by a decision maker her- or himself (Svenson, 2003). We investigated post-decision distortion of facts (consolidation). Participants were given vignettes with facts about two terminally ill patients, only one of whom could be given lifesaving surgery. In Study 1, contrary to the prediction, the results showed that facts were distorted after a decision both by participants who were responsible for the decisions themselves and when doctors had made the decision...
December 15, 2017: Scandinavian Journal of Psychology
https://www.readbyqxmd.com/read/29237650/needs-of-cancer-patients-in-palliative-care-during-medical-visits-qualitative-study
#14
Dominik Melhem, Serge Daneault
OBJECTIVE: To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully. DESIGN: Qualitative study performed using semistructured interviews. SETTING: Palliative care departments (ambulatory and intrahospital). PARTICIPANTS: Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment...
December 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29234212/-right-to-try-legislation-moving-through-congress-but-drug-companies-and-some-patient-groups-want-changes
#15
Stephen Barlas
State "Right to Try" laws, which allow terminally ill patients to seek investigational treatments under certain circumstances, have created pressure for Congress to follow up with a federal law. Though facing opposition from patient advocates and the drug industry, a bill passed by the Senate is now making its way to the House.
December 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29219653/characteristics-and-outcome-of-intractable-vasculitis-syndrome-in-children-nation-wide-survey-in-japan
#16
Naoko Nakano, Masaaki Mori, Hiroaki Umebayashi, Naomi Iwata, Norimoto Kobayashi, Kenji Masunaga, Tomoyuki Imagawa, Takuji Murata, Noriko Kinjo, Kazushige Nagai, Mari Miyoshi, Syuji Takei, Shumpei Yokota, Eiichi Ishii
OBJECTIVE: Primary systemic vasculitis (PSV) is a rare disorder in children and difficult to distinguish from other diseases. However, appropriate diagnosis and prompt treatment will affect on the morbidity and mortality of intractable PSV. In this study, we conducted a nationwide survey in Japan, to clarify epidemiology and clinical outcome of PSV. METHODS: We had sent survey questionnaires to most of the Japanese institutions that employed pediatricians, requesting the number of patients with refractory PSV who were diagnosed and treated between 2007 and 2011...
December 8, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/29215662/-validation-of-the-scale-of-hope-in-terminal-illness-for-relatives-brief-version-shti-b-validity-and-reliability-analysis
#17
M Villacieros Durban, J C Bermejo, H Hassoun
BACKGROUND: Bermejo and Villacieros' Scale of Hope in Terminal Disease (SHTD) specifically collects meanings of hope facing terminal disease, including considerations relating to psycho-emotional support and that have a transcendental sense. The objective of this paper is to validate the SHTD abbreviated and rephrased to adapt all the items to a single domain. METHODS: Starting from the published SHTD, an exploratory factor analysis (EFA) was carried out with a sample of 177 valid questionnaires...
December 7, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29213079/human-cd26high-t-cells-elicit-tumor-immunity-against-multiple-malignancies-via-enhanced-migration-and-persistence
#18
Stefanie R Bailey, Michelle H Nelson, Kinga Majchrzak, Jacob S Bowers, Megan M Wyatt, Aubrey S Smith, Lillian R Neal, Keisuke Shirai, Carmine Carpenito, Carl H June, Michael J Zilliox, Chrystal M Paulos
CD8+ T lymphocytes mediate potent immune responses against tumor, but the role of human CD4+ T cell subsets in cancer immunotherapy remains ill-defined. Herein, we exhibit that CD26 identifies three T helper subsets with distinct immunological properties in both healthy individuals and cancer patients. Although CD26neg T cells possess a regulatory phenotype, CD26int T cells are mainly naive and CD26high T cells appear terminally differentiated and exhausted. Paradoxically, CD26high T cells persist in and regress multiple solid tumors following adoptive cell transfer...
December 6, 2017: Nature Communications
https://www.readbyqxmd.com/read/29202863/a-novel-family-dignity-intervention-fdi-for-enhancing-and-informing-holistic-palliative-care-in-asia-study-protocol-for-a-randomized-controlled-trial
#19
Andy Hau Yan Ho, Josip Car, Moon-Ho Ringo Ho, Geraldine Tan-Ho, Ping Ying Choo, Paul Victor Patinadan, Poh Heng Chong, Wah Ying Ong, Gilbert Fan, Yee Pin Tan, Robert A Neimeyer, Harvey M Chochinov
BACKGROUND: The lack of a holistic approach to palliative care can lead to a fractured sense of dignity at the end of life, resulting in depression, hopelessness, feelings of being a burden to others, and the loss of the will to live among terminally ill patients. Building on the clinical foundation of Dignity Therapy, together with the empirical understanding of dignity-related concerns of Asian families facing terminal illness, a novel Family Dignity Intervention (FDI) has been developed for Asian palliative care...
December 4, 2017: Trials
https://www.readbyqxmd.com/read/29196477/usage-of-unscheduled-hospital-care-by-homeless-individuals-in-dublin-ireland-a-cross-sectional-study
#20
Clíona Ní Cheallaigh, Sarah Cullivan, Jess Sears, Ann Marie Lawlee, Joe Browne, Jennifer Kieran, Ricardo Segurado, Austin O'Carroll, Fiona O'Reilly, Donnacha Creagh, Colm Bergin, Rose Anne Kenny, Declan Byrne
OBJECTIVES: Homeless people lack a secure, stable place to live and experience higher rates of serious illness than the housed population. Studies, mainly from the USA, have reported increased use of unscheduled healthcare by homeless individuals.We sought to compare the use of unscheduled emergency department (ED) and inpatient care between housed and homeless hospital patients in a high-income European setting in Dublin, Ireland. SETTING: A large university teaching hospital serving the south inner city in Dublin, Ireland...
December 1, 2017: BMJ Open
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