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Communication, education, palliative

Amir Shanan, Brenda Stevens, Gail Bishop, Kathleen Cooney, Shea Cox, Robin Downing, Kathy Mitchener, Nancy Soares, Tammy Wynn
End-of-life (EOL) care and decisionmaking embody the critical final stage in a pet's life and are as important and meaningful as the sum of the clinical care provided for all prior life stages. EOL care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client. Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support. Veterinarians should not allow an EOL patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place...
September 29, 2016: Journal of the American Animal Hospital Association
Yuya Hagiwara, Jeanette Ross, Shuko Lee, Sandra Sanchez-Reilly
BACKGROUND: Few educational interventions have been developed to teach Family Meeting (FM) communication skills at the undergraduate level. We developed an innovative curriculum to address this gap. METHODS: Fourth year medical students during 2011-2013 (n = 674) completed training for conducting a FM. To assess the effectiveness of this training, students completed a FM Objective Structured Clinical Exam (OSCE) that included 15 domains rated on a 1-5 point Likert scale...
September 20, 2016: American Journal of Hospice & Palliative Care
Melissa J BLoomer, Ruth Endacott, Kristen Ranse, Maureen A Coombs
AIM: The aim of this study was to explore how nurses navigate communication with families during withdrawal of life-sustaining treatment in Intensive Care. BACKGROUND: Death in the intensive care unit is seldom unexpected and often happens following the withdrawal of life-sustaining treatment. A family-centred approach to care relies on the development of a therapeutic relationship and understanding of what is happening to the patient. Whilst previous research has focused on the transition from cure to palliation and the nurse's role in supporting families, less is known about how nurses navigate communication with families during treatment withdrawal...
September 20, 2016: Journal of Clinical Nursing
Mila Petrova, Julia Riley, Julian Abel, Stephen Barclay
BACKGROUND: Electronic Palliative Care Coordination Systems (EPaCCS) are England's pre-eminent initiative in enabling advance care planning and improved communication and coordination at the end of life. EPaCCS have been under development for 8 years after being proposed, as Locality Registers, in the 2008 End of Life Care Strategy for England. EPaCCS are electronic registers or tools and processes for sharing data which aim to enable access to information about dying patients. Striking outcomes have been reported around EPaCCS, such as 77...
September 16, 2016: BMJ Supportive & Palliative Care
Andrew W Schram, Gavin W Hougham, David O Meltzer, Gregory W Ruhnke
BACKGROUND: There is an emerging literature on the physician competencies most meaningful to patients and their families. However, there has been no systematic review on physician competency domains outside direct clinical care most important for patient- and family-centered outcomes in critical care settings at the end of life (EOL). Physician competencies are an essential component of palliative care (PC) provided at the EOL, but the literature on those competencies relevant for patient and family satisfaction is limited...
August 31, 2016: American Journal of Hospice & Palliative Care
Amara Callistus Nwosu, Daniel Monnery, Victoria Louise Reid, Laura Chapman
OBJECTIVES: Podcasts have the potential to facilitate communication about palliative care with researchers, policymakers and the public. Some podcasts about palliative care are available; however, this is not reflected in the academic literature. Further study is needed to evaluate the utility of podcasts to facilitate knowledge-transfer about subjects related to palliative care. The aims of this paper are to (1) describe the development of a palliative care podcast according to international recommendations for podcast quality and (2) conduct an analysis of podcast listenership over a 14-month period...
August 31, 2016: BMJ Supportive & Palliative Care
Carmen María Sarabia-Cobo, Ana Rosa Alconero-Camarero, Lucía Lavín-Alconero, Isabel Ibáñez-Rementería
BACKGROUND: Major deficiencies exist in undergraduate nursing education for Palliative Care. Opportunities to care for dying patients are often unavailable to students in traditional clinical settings. Palliative care simulation is an innovative strategy that may help to prepare undergraduate nursing students to provide quality palliative/end of life care. It is valuable to explore the student nurses' beliefs, feelings and satisfaction regarding the impact that simulation clinic applied to palliative care has and how it influenced their overall experience of caring for a dying patient and the patient's family...
October 2016: Nurse Education Today
Rachel Freeman, Emmanuel Bk Luyirika, Eve Namisango, Fatia Kiyange
The high burden of non-communicable diseases and communicable diseases in Africa characterised by late presentation and diagnosis makes the need for palliative care a priority from the point of diagnosis to death and through bereavement. Palliative care is an intervention that requires a multidisciplinary team to address the multifaceted needs of the patient and family. Thus, its development takes a broad approach that involves engaging all key stakeholders ranging from policy makers, care providers, educators, the public, patients, and families...
2016: Ecancermedicalscience
Margaret Kreher
Symptom control at the end of life is an identified ongoing gap in end-of-life care. Increased demand for high-quality symptom control; limited supply of specialty trained clinicians; lack of consistent high-quality evidence-based interventions; and education deficits among clinicians, patients, and families in end-of-life processes contribute to this gap. High-value end-of-life care is centered on high-quality communication about goals of care. This article reviews primary palliative care concepts of communication and symptom control to provide a framework for primary care physicians to use in the care of patients at the end of life...
September 2016: Medical Clinics of North America
Jeanette Ziehm, Erik Farin, Katharina Seibel, Gerhild Becker, Stefan Köberich
BACKGROUND: Even though struggling with similar symptom burden, patients with chronic heart failure (CHF) receive less palliative care than patients suffering from malignant diseases. Researchers have found that this might be related to lack of knowledge about palliative care, insufficient interprofessional communication as well as the cyclic course of disease which makes accurate prognosis difficult. However, research findings have shown that patients with CHF benefit from palliative care...
2016: BMC Palliative Care
Hye-Young Shim, Yoon Jung Chang, Kiu-Sang Kawk, Tran Thi Xuan Mai, Jin Young Choi, Eun Mi Ahn, Hyun Jung Jho, So-Jung Park
Purpose: Hospice and palliative care services (HPC) are not commonly utilized in Korea; however, palliative care teams (PCTs) have been found to be effective at addressing the shortcomings in HPC. In this study, we attempted to outline unmet palliative care needs of terminal cancer patients and the potential benefits of PCTs as perceived by doctors in Korea. Materials and Methods: We surveyed 474 doctors at 10 cancer-related academic conferences from June to November 2014 with a self-report questionnaire to assess their perceptions of end-of-life (EOL) care needs and the expected effects of PCTs on caring for terminal cancer patients...
August 10, 2016: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Jeanette Ziehm, Erik Farin, Jonas Schäfer, Kathrin Woitha, Gerhild Becker, Stefan Köberich
BACKGROUND: Compared to patients with cancer, heart failure patients are seldom candidates for palliative care. Numerous studies have investigated reasons why heart failure patients do not receive palliative care; however, none of these studies have ever evaluated the situation in the German health care setting. This study aims to identify German healthcare providers' (HCP) perception of barriers and facilitators to palliative care of patients with chronic heart failure. METHODS: We conducted an online-survey with 315 nurses and physicians of different medical disciplines...
2016: BMC Health Services Research
Lynne T Braun, Kathleen L Grady, Jean S Kutner, Eric Adler, Nancy Berlinger, Renee Boss, Javed Butler, Susan Enguidanos, Sarah Friebert, Timothy J Gardner, Phil Higgins, Robert Holloway, Madeleine Konig, Diane Meier, Mary Beth Morrissey, Tammie E Quest, Debra L Wiegand, Barbara Coombs-Lee, George Fitchett, Charu Gupta, William H Roach
The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions...
September 13, 2016: Circulation
Danielle Fitzpatrick, Rebecca Heah, Simon Patten, Helena Ward
PURPOSE: There is an increasing demand for quality palliative care teaching within undergraduate medical education. Studies suggest that many junior doctors feel underprepared to perform end-of-life care. Previous systematic reviews on palliative care teaching within medical schools have identified significant variability and lack of consistency in teaching. This review aims to update the literature on the current status of palliative care teaching to undergraduates within medical schools...
July 28, 2016: American Journal of Hospice & Palliative Care
Ardith Z Doorenbos, Wayne C Levy, J Randall Curtis, Cynthia M Dougherty
CONTEXT: Heart failure patients contend with a markedly impaired quality of life, experiencing emotional distress and severe physical discomfort that increases in frequency in the last months of life. Improving communication between patients and providers about goals of care has the potential to improve patient-provider communication and patient outcomes. OBJECTIVES: To determine the effects of a goals-of-care (GoC) intervention compared to usual care on the number of GoC conversations, quality of communication between patients and providers, referrals to palliative care services and completion of advance care directives...
September 2016: Journal of Pain and Symptom Management
Gary Mitchell, Joanne Agnelli, Jessie McGreevy, Monica Diamond, Herlindina Roble, Elaine McShane, Joanne Strain
This article, the second of two, provides healthcare practitioners with an overview of best practice in palliative and end-of-life care, including nutrition, hydration, oral hygiene and pain management. Communication and spiritual care are discussed, as well as care after death. Providing support and education for families is an important aspect of palliative and end-of-life care. Care home nurses should ensure that the person living with dementia is at the centre of decision making, and provide care that is inclusive of their needs and wishes...
June 29, 2016: Nursing Standard
Sally Anstey, Tom Powell, Bernadette Coles, Rachel Hale, Dinah Gould
BACKGROUND: The delivery of end-of-life care in nursing homes is challenging. This situation is of concern as 20% of the population die in this setting. Commonly reported reasons include limited access to medical care, inadequate clinical leadership and poor communication between nursing home and medical staff. Education for nursing home staff is suggested as the most important way of overcoming these obstacles. OBJECTIVES: To identify educational interventions to enhance end-of-life care for nursing home staff and to identify types of study designs and outcomes to indicate success and benchmark interventions against recent international guidelines for education for palliative and end-of-life care...
September 2016: BMJ Supportive & Palliative Care
Eva-Marie Kloeppel, Hani Hanaya, Eckart Seilacher, Sarah Schroth, Patrick Liebl, Christian Keinki, Marie Jolin Koester, Jutta Huebner
In spite of a referral letter as an important document for communicating between physicians, whether it could also be useful as a source of information for patients has not yet established. We included cancer patients in palliative care setting, all of whom completed a standardized questionnaire regarding their opinion concerning the utility of a referral letter as a source of information and its requirements to achieve a better understanding. Completed questionnaires were received from 50 cancer patients. Ninety-four percent of participants agreed that a referral letter could be of great importance for procuring medical information to them...
June 20, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Debra K Litzelman, Ann H Cottingham, Wilma Griffin, Thomas S Inui, Steven S Ivy
OBJECTIVE: Although patients want to participate in discussions and decisions about their end-of-life care, studies show that providers frequently fail to invite them to explore advanced care preferences or goals for living. The purpose of our demonstration project was to provide education and coaching to individuals, health providers, and organizations across the state of Indiana intended to facilitate these conversations, documenting and honoring individuals' life goals and preferences for care during the final stages of life...
June 20, 2016: Palliative & Supportive Care
Kate Renton, Hilary Quinton, Anton-Paul Thomas Mayer
BACKGROUND: The use of simulation-based medical/nursing teaching is increasingly widespread. Simulation-based teaching offers an immersive learning experience where professionals can practice communication and practical skills in a safe, authentic environment. We designed a paediatric palliative simulation study day primarily aimed at nursing staff who manage these patients in the community/hospice. We believe this is the first of its kind in the UK. AIMS: To establish whether attendance at a paediatric palliative simulation study day improved confidence and knowledge in management of common and/or difficult situations in palliative care...
June 17, 2016: BMJ Supportive & Palliative Care
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