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Early intervention of palliative care

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https://www.readbyqxmd.com/read/28731379/quasi-experimental-evaluation-of-a-multifaceted-intervention-to-improve-quality-of-end-of-life-care-and-quality-of-dying-for-patients-with-advanced-dementia-in-long-term-care-institutions
#1
René Verreault, Marcel Arcand, Lucie Misson, Pierre J Durand, Edeltraut Kroger, Michèle Aubin, Maryse Savoie, Thomas Hadjistavropoulos, Sharon Kaasalainen, Annick Bédard, Annie Grégoire, Pierre-Hughes Carmichael
BACKGROUND: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. AIM: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. DESIGN: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28718321/breathlessness-services-as-a-new-model-of-support-for-patients-with-respiratory-disease
#2
Claudia Bausewein, Michaela Schunk, Philipp Schumacher, Julika Dittmer, Anna Bolzani, Sara Booth
The complexity of breathlessness in advanced disease requires a diversity of measures ideally tailored to the individual patient needs. 'Breathlessness services' have been systematically developed and tested to provide specific interventions and support for patients and their carers. The aim of this article is (1) to identify and describe components of breathlessness services and (2) to describe the clinical model of one specific service in more detail. This article is based on a systematic review evaluating randomized controlled trials (RCTs) and quasi-RCTs which examine the effectiveness of services aiming to improve breathlessness of patients with advanced disease...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28717717/management-and-care-of-women-with-invasive-cervical-cancer-american-society-of-clinical-oncology-resource-stratified-clinical-practice-guideline
#3
Linus T Chuang, Sarah Temin, Rolando Camacho, Alfonso Dueñas-Gonzalez, Sarah Feldman, Murat Gultekin, Vandana Gupta, Susan Horton, Graciela Jacob, Elizabeth A Kidd, Kennedy Lishimpi, Carolyn Nakisige, Joo-Hyun Nam, Hextan Yuen Sheung Ngan, William Small, Gillian Thomas, Jonathan S Berek
PURPOSE: To provide evidence-based, resource-stratified global recommendations to clinicians and policymakers on the management and palliative care of women diagnosed with invasive cervical cancer. METHODS: ASCO convened a multidisciplinary, multinational panel of cancer control, medical and radiation oncology, health economic, obstetric and gynecologic, and palliative care experts to produce recommendations reflecting resource-tiered settings. A systematic review of literature from 1966 to 2015 failed to yield sufficiently strong quality evidence to support basic- and limited-resource setting recommendations; a formal consensus-based process was used to develop recommendations...
October 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28693520/strengthening-primary-health-care-teams-with-palliative-care-leaders-protocol-for-a-cluster-randomized-clinical-trial
#4
Joan Llobera, Noemí Sansó, Amador Ruiz, Merce Llagostera, Estefania Serratusell, Carlos Serrano, María Luisa Martín Roselló, Enric Benito, Eusebio J Castaño, Alfonso Leiva
BACKGROUND: The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs...
July 10, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28691498/delivering-end-of-life-cancer-care-perspectives-of-providers
#5
Manali I Patel, Vyjeyanthi S Periyakoil, David Moore, Andrea Nevedal, Tumaini R Coker
OBJECTIVES: Persistent gaps in end-of-life cancer care delivery and growing associated expenditures remain imminent US public health issues. The objective of this study was to understand clinical providers' experiences delivering cancer care for patients at the end of life and their perspectives on potential solutions to improve quality of care. METHODS: Semistructured interviews were conducted with 75 cancer care providers across the United States. The interviews were recorded, transcribed, and analyzed using constant comparative method of qualitative analysis...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28677437/chronic-heart-failure-part-2
#6
Lorna Young
[Figure: see text] What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The article explored the treatment and management of chronic heart failure, including the support and interventions that nurses can provide to patients. It also discussed the importance of considering palliative care in the early stages of the condition.
July 5, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28616295/malignant-tracheal-necrosis-and-fistula-formation-following-palliative-chemoradiotherapy-a-case-report
#7
In Ae Kim, Hyeon Kang Koh, Sun Jong Kim, Kwang Ha Yoo, Kye Young Lee, Hee Joung Kim
Concurrent chemoradiotherapy is an essential treatment strategy for inoperable locally advanced non-small cell lung cancer (NSCLC). Although supportive care has improved, unexpected complications due to the disease or treatment can occur. Tracheomediastinal fistulas are very rare but can be a serious problem. Herein, we report a case of severe chondronecrosis of the distal trachea with formation of a fistula into a metastatic lymphadenopathy in a patient with stage IIIB NSCLC. The patient received external beam radiotherapy with a total dose of 35 Gy in 14 fractions, which was approximately half of the conventional therapeutic radiotherapy dose, along with concurrent cisplatin based chemotherapy...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616223/clinical-outcomes-of-self-expandable-metal-stent-sems-placement-as-palliative-treatment-for-malignant-colorectal-obstruction-a-single-center-study-from-japan
#8
Toshikatsu Nitta, Jun Kataoka, Masato Ohta, Kensuke Fujii, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Takashi Ishibashi
OBJECTIVES: We aimed to assess the efficacy of self-expanding metal stent (SEMS) implantation as palliative treatment for malignant colorectal obstruction. METHODS: We retrospectively reviewed the records of patients with malignant colorectal obstruction who underwent SEMS insertion as palliative treatment in our hospital between March 2013 and December 2016. We analyzed demographic, clinical, and operative characteristics. RESULTS: A total of 13 patients (8 males, 5 females; median age, 80...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28603881/early-palliative-care-for-adults-with-advanced-cancer
#9
REVIEW
Markus W Haun, Stephanie Estel, Gerta Rücker, Hans-Christoph Friederich, Matthias Villalobos, Michael Thomas, Mechthild Hartmann
BACKGROUND: Incurable cancer, which often constitutes an enormous challenge for patients, their families, and medical professionals, profoundly affects the patient's physical and psychosocial well-being. In standard cancer care, palliative measures generally are initiated when it is evident that disease-modifying treatments have been unsuccessful, no treatments can be offered, or death is anticipated. In contrast, early palliative care is initiated much earlier in the disease trajectory and closer to the diagnosis of incurable cancer...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28593859/european-association-for-neuro-oncology-eano-guidelines-for-palliative-care-in-adults-with-glioma
#10
REVIEW
Andrea Pace, Linda Dirven, Johan A F Koekkoek, Heidrun Golla, Jane Fleming, Roberta Rudà, Christine Marosi, E Le Rhun, Robin Grant, Kathy Oliver, Ingela Oberg, Helen J Bulbeck, Alasdair G Rooney, Roger Henriksson, H Roeline W Pasman, Stefan Oberndorfer, Michael Weller, Martin J B Taphoorn
Patients with glioma present with complex palliative care needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliative care approach. The multidisciplinary palliative care task force of the European Association of Neuro-Oncology did a systematic review of the available scientific literature to formulate the best possible evidence-based recommendations for the palliative care of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase...
June 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28589374/-integration-of-palliative-care-into-intensive-care-systematic-review
#11
K Adler, D Schlieper, D Kindgen-Milles, S Meier, J Schwartz, P van Caster, M S Schaefer, M Neukirchen
BACKGROUND: One of the prime aims of intensive care is to cure patients or at least to extend life duration, sometimes to the extent of losing quality of life. Palliative care aims to improve the quality of life of patients with life-limiting conditions; however, some patients need both intensive and palliative care. About 5-10% of all deaths in Germany and 20% of all deaths in the USA occur in an intensive care unit (ICU) and many of those as well as other patients may benefit from palliative care consultation...
June 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28583176/nurse-led-navigation-to-provide-early-palliative-care-in-rural-areas-a-pilot-study
#12
Barbara Pesut, Brenda Hooper, Marnie Jacobsen, Barbara Nielsen, Miranda Falk, Brian P O 'Connor
BACKGROUND: Few services are available to support rural older adults living at home with advancing chronic illness. The objective of this project was to pilot a nurse-led navigation service to provide early palliative support for rural older adults and their families living at home with advancing chronic illness. METHODS: Twenty-five older adults and 11 family members living with advancing chronic illness received bi-weekly home visits by a nurse navigator over a 2-year period...
June 5, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28558731/integration-and-activity-of-hospital-based-palliative-care-consultation-teams-the-insight-multicentric-cohort-study
#13
Pascale Vinant, Ingrid Joffin, Laure Serresse, Sophie Grabar, Hélène Jaulmes, Malika Daoud, Gabriel Abitbol, Pascale Fouassier, Isabelle Triol, Sylvie Rostaing, Marie-Dominique Brette, Isabelle Colombet
BACKGROUND: Hospital-based Palliative Care Consultation Teams (PCCTs) have a consulting role to specialist services at their request. Referral of patients is often late. Early palliative care in oncology has shown its effectiveness in improving quality of life, thereby questioning the "on request" model of PCCTs. Whether this evidence changed practice is unknown. This multicentre prospective cohort study aims to describe the activity and integration of PCCTs at the patient level. METHODS: For consecutive patients newly referred to participating PCCTs, the team collected the following data: circumstances of first referral, problems identified, number of interventions, patient's survival after first evaluation and place of death...
May 30, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28495366/multimorbidity-with-hiv-views-of-community-based-people-living-with-hiv-and-other-chronic-conditions
#14
Jacquelyn Slomka, Maryjo Prince-Paul, Allison Webel, Barbara J Daly
People living with HIV (PLWH) experience an increase in chronic conditions with aging, but little is known about experiences of living with multimorbidity with HIV. Because early palliative care services may improve well-being for individuals with multimorbidity, we planned to test an intervention to provide these services to community-dwelling PLWH with other chronic conditions. To tailor our intervention to the target population, we conducted four focus groups (n = 22) that elicited health-related needs, experiences, and views regarding palliative and other health services...
July 2017: Journal of the Association of Nurses in AIDS Care: JANAC
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
#15
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/28479121/ethical-considerations-and-palliative-care-in-patients-with-amyotrophic-lateral-sclerosis-a-review
#16
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 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28469900/a-unified-electronic-tool-for-cpr-and-emergency-treatment-escalation-plans-improves-communication-and-early-collaborative-decision-making-for-acute-hospital-admissions
#17
Mae Johnson, Martin Whyte, Robert Loveridge, Richard Yorke, Shairana Naleem
The National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) report 'Time to Intervene' (2012) stated that in a substantial number of cases, resuscitation is attempted when it was thought a 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision should have been in place. Early decisions about CPR status and advance planning about limits of care now form part of national recommendations by the UK Resuscitation Council (2016). Treatment escalation plans (TEP) document what level of treatment intervention would be appropriate if a patient were to become acutely unwell and were not previously formally in place at King's College Hospital...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28464346/review-article-maximising-quality-of-life-while-aspiring-for-quantity-of-life-in-end-stage-liver-disease
#18
REVIEW
R A Bhanji, E J Carey, K D Watt
BACKGROUND: With recent advances in the management of chronic liver disease and its complications, the long-term survival in cirrhosis has improved. Therefore, the number of individuals who will spend a significant proportion of their life with end-stage liver disease (ESLD) may continue to rise. Thus, more attention to quality of life (QOL) and its integration with traditional clinical endpoints is needed. AIMS: Recently, there have been many studies looking at treatment outcomes and their impact on the QOL in patients with ESLD...
July 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28384214/care-of-cancer-patients-at-the-end-of-life-in-a-german-university-hospital-a-retrospective-observational-study-from-2014
#19
Burkhard Dasch, Helen Kalies, Berend Feddersen, Caecilie Ruderer, Wolfgang Hiddemann, Claudia Bausewein
BACKGROUND: Cancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care. AIM: To describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28365652/interstage-home-monitoring-after-newborn-first-stage-palliation-for-hypoplastic-left-heart-syndrome-family-education-strategies
#20
Jo Ann Nieves, Karen Uzark, Nancy A Rudd, Jennifer Strawn, Anne Schmelzer, Nancy Dobrolet
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period...
April 2017: Critical Care Nurse
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