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Palliative care, end of life care, hospice

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https://www.readbyqxmd.com/read/28817366/trajectory-of-dyspnea-and-respiratory-distress-among-patients-in-the-last-month-of-life
#1
Margaret L Campbell, Jason M Kiernan, John Strandmark, Hossein N Yarandi
BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28800999/promoting-palliative-care-internationally-building-leaders-to-promote-education-practice-and-advocacy
#2
Pam Malloy, Betty Ferrell, Rose Virani, Polly Mazanec
In February 2000, nine nursing educators, practitioners, and researchers met in Nashville, TN to develop a palliative care curriculum specifically for nurses. The following month, twenty-two advisors from nursing organizations across the United States convened in Washington, DC to review the recommended curriculum development and dissemination plans for end-of-life care throughout nursing schools, hospitals, hospices, homecare, and geriatric settings. The Robert Wood Johnson Foundation (RWJF) provided funding for curriculum and competency development and for 6 national train-the-trainer courses to be held from 2001 to 2003...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28799821/a-review-of-palliative-and-hospice-care-in-the-context-of-islam-dying-with-faith-and-family
#3
Maximiliano Mendieta, Robert W Buckingham
BACKGROUND: By starting to understand Muslim culture, we can seek common ground with Islamic culture within the American experience and bridge opportunities for better palliative and hospice care here and in Middle Eastern countries. The United States, Canada, and Europe are education hubs for Middle Eastern students, creating an opportunity for the palliative and hospice care philosophy to gain access by proxy to populations of terminally ill patients who can benefit from end-of-life care...
August 11, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28797861/the-worldwide-hospice-palliative-care-alliance
#4
Stephen R Connor
The Worldwide Hospice Palliative Care Alliance (WHPCA) is an international non-governmental organization registered as a charity in England and Wales that was established in 2008 following a series of international gatherings that highlighted the important need for palliative care to be included in global policy and health planning. The vision of the WHPCA is a world with universal access to hospice and palliative care. Its mission is to foster, promote and influence the delivery of affordable, quality palliative care...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28793905/the-liverpool-care-pathway-a-systematic-review-discarded-in-cancer-patients-but-good-enough-for-dying-nursing-home-patients
#5
Bettina S Husebø, Elisabeth Flo, Knut Engedal
BACKGROUND: The Liverpool Care Pathway (LCP) is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying people with dementia...
August 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28792780/an-update-nih-research-funding-for-palliative-medicine-2011-2015
#6
Elizabeth Brown, R Sean Morrison, Laura P Gelfman
BACKGROUND: The evidence base to support palliative care clinical practice is inadequate and opportunities to improve the palliative care evidence base remain despite the field's rapid growth. OBJECTIVE: To examine current NIH funding of palliative medicine research, changes since our 2013 report, and trends since our 2008 report. DESIGN: We sought to identify NIH funding of palliative medicine from 2011 to 2015 in two stages: (I) we searched the NIH grants database "RePorter" for grants with key words "palliative care," "end-of-life care," "hospice," and "end of life" and (II) we identified palliative care researchers likely to have secured NIH funding using three strategies...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28767296/advance-care-planning-discussions-with-adolescent-and-young-adult-cancer-patients-admitted-to-a-community-palliative-care-service-a-retrospective-case-note-audit
#7
Sophie Fletcher, Rachel Hughes, Sarah Pickstock, Kirsten Auret
PURPOSE: Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. METHODS: Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015...
August 2, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28763469/end-of-life-care-for-immigrants-in-germany-an-epidemiological-appraisal-of-berlin
#8
Antje Henke, Peter Thuss-Patience, Asita Behzadi, Oliver Henke
BACKGROUND: Since the late 1950's, a steadily increasing immigrant population in Germany is resulting in a subpopulation of aging immigrants. The German health care system needs to adjust its services-linguistically, culturally, and medically-for this subpopulation of patients. Immigrants make up over 20% of the population in Germany, yet the majority receive inadequate medical care. As many of the labor immigrants of the 1960s and 1970s are in need of hospice and palliative care (HPC), little is known about this specialized care for immigrants...
2017: PloS One
https://www.readbyqxmd.com/read/28761725/impact-of-intervention-aimed-at-improving-the-integration-of-oncology-units-and-local-palliative-care-services-results-of-the-multicentre-prospective-sequential-mirto-study
#9
Andrea A Martoni, Barbara Melotti, Claudia Degli Esposti, Vita Mutri, Giorgio Lelli, Silvia Ansaloni, Erico Piva, Elena Strocchi, Franco Pannuti
BACKGROUND: Chemotherapy (CT) in patients with advanced cancer (ACP) near the end of life is an increasing practice of oncology units. A closer integration with palliative care (PC) services could reduce the use of potentially harmful CT. This prospective study is aimed at assessing whether a more integrated care model could reduce CT use near the end of life and increase local PC service utilisation. METHODS: The study enrolled sequentially two cohorts of ACP with an estimated life expectancy of ≤6 months...
2017: ESMO Open
https://www.readbyqxmd.com/read/28753122/stepwise-psychosocial-palliative-care-a-new-approach-to-the-treatment-of-posttraumatic-stress-disorder-at-the-end-of-life
#10
David B Feldman
Although evidence-based therapies for Posttraumatic Stress Disorder (PTSD) exist for physically healthy populations, these often do not adequately address PTSD in dying patients. Particularly because these interventions require 8-16 weekly sessions, and the median stay in U.S. hospices is 17.5 days (National Hospice and Palliative Care Organization [NHPCO], 2015 ), there is a potentially serious timing mismatch. Moreover, these treatments may temporarily increase trauma symptoms (Nishith, Resick, & Griffin, 2002 ), resulting in some patients dying in greater distress than had they not received care...
July 28, 2017: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#11
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28707460/the-effect-of-hospice-consultation-on-aggressive-treatment-of-lung-cancer
#12
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent five years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at SNUH who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed...
July 14, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28689992/characteristics-of-palliative-care-consultation-at-an-academic-level-one-trauma-center
#13
Emily B Rivet, Paula Ferrada, Tara Albrecht, J Brian Cassel, Beth Broering, Danielle Noreika, Egidio Del Fabbro
BACKGROUND: The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance. METHODS: A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period. RESULTS: The palliative care team evaluated 82 patients with a median age of 60 years...
June 28, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28687558/seizure-management-in-children-requiring-palliative-care-a-review-of-current-practice
#14
Nicola Harris, Megumi Baba, Charlotte Mellor, Rebekah Rogers, Kirsty Taylor, Antonia Beringer, Peta Sharples
OBJECTIVES: Controlling seizures in children approaching death can be difficult, and there is a limited evidence base to guide best practice. We compared current practice against the guidance for seizure management produced by the Association of Paediatric Palliative Medicine (APPM). METHODS: Retrospective case note review of episodes of challenging seizure management in children receiving end-of-life care over a 10-year period (2006-2015) in the south-west region of England...
July 7, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28680279/palliative-care-as-a-public-health-issue-understanding-disparities-in-access-to-palliative-care-for-the-homeless-population-living-in-toronto-based-on-a-policy-analysis
#15
REVIEW
B Henry, N Dosani, L Huynh, N Amirault
Even in a developed country such as Canada, there are disparities in just access to adequate health care-and, more specifically, palliative care. That inequality is most notable in an underserved group such as the homeless population. Even the word "homeless" has become both a negative descriptor and a stereotype in our society. We posit that the provision of hospice palliative care is structured on several problematic assumptions: an expectation that patients will have an informal support network (family and friends), a stable and secure residence, a predictive terminal illness trajectory, and reasonable access to health care...
June 2017: Current Oncology
https://www.readbyqxmd.com/read/28679815/increasing-veterans-hospice-use-the-veterans-health-administration-s-focus-on-improving-end-of-life-care
#16
Susan C Miller, Orna Intrator, Winifred Scott, Scott T Shreve, Ciaran S Phibbs, Bruce Kinosian, Richard M Allman, Thomas E Edes
In 2009 the Department of Veterans Affairs (VA) began a major, four-year investment in improving the quality of end-of-life care. The Comprehensive End of Life Care Initiative increased the numbers of VA medical center inpatient hospice units and palliative care staff members as well as the amount of palliative care training, quality monitoring, and community outreach. We divided male veterans ages sixty-six and older into categories based on their use of the VA and Medicare and examined whether the increases in their rates of hospice use in the last year of life differed from the concurrent increase among similar nonveterans enrolled in Medicare...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28674754/issues-related-to-family-history-of-cancer-at-the-end-of-life-a-palliative-care-providers-survey
#17
Catherine Gonthier, Sylvie Pelletier, Pierre Gagnon, Ana Marin, Jocelyne Chiquette, Bruno Gagnon, Louis Roy, Jude Emmanuel Cléophat, Yann Joly, Michel Dorval
Addressing the concerns of end-of-life patients or their relatives about their family history of cancer could benefit patients and family members. Little is known about how palliative care providers respond to these concerns. The purpose of this pilot study was to assess palliative care providers' knowledge about familial and hereditary cancers and explore their exposure to patients' and relatives' concerns about their family history of cancer, and their self-perceived ability to deal with such concerns. A cross-sectional survey was conducted in the Quebec City (Canada) catchment area among palliative care professionals...
July 3, 2017: Familial Cancer
https://www.readbyqxmd.com/read/28667087/development-of-tools-to-facilitate-palliative-and-supportive-care-referral-for-patients-with-idiopathic-pulmonary-fibrosis
#18
Charles Sharp, Heather Lamb, Nikki Jordan, Adrienne Edwards, Rachel Gunary, Patricia Meek, Ann B Millar, Clare Kendall, Huzaifa Adamali
OBJECTIVES: Palliative care is underused in non-malignant respiratory diseases, including interstitial lung diseases (ILDs). We investigated current practices around palliative and supportive care and explored the impact of a supportive care decision aid tool. METHODS: This was a single centre study in a UK ILD centre. Retrospective analysis of hospice referrals and patients with idiopathic pulmonary fibrosis (IPF) under the Bristol ILD (BILD) service were used to identify unmet palliative and supportive care needs...
June 30, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28663341/determinants-of-hospital-death-in-haematological-cancers-findings-from-a-qualitative-study
#19
Dorothy McCaughan, Eve Roman, Alexandra G Smith, Anne Garry, Miriam Johnson, Russell Patmore, Martin Howard, Debra A Howell
OBJECTIVES: Current UK health policy promotes enabling people to die in a place they choose, which for most is home. Despite this, patients with haematological malignancies (leukaemias, lymphomas and myeloma) are more likely to die in hospital than those with other cancers, and this is often considered a reflection of poor quality end-of-life care. This study aimed to explore the experiences of clinicians and relatives to determine why hospital deaths predominate in these diseases. METHODS: The study was set within the Haematological Malignancy Research Network (HMRN-www...
June 29, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28660841/the-care-experiences-of-patients-who-die-in-residential-hospice-a-qualitative-analysis-of-the-last-three-months-of-life-from-the-views-of-bereaved-caregivers
#20
Daryl Bainbridge, Mohanna Giruparajah, Hanyan Zou, Hsien Seow
OBJECTIVE: Despite the increasing prominence of residential hospices as a place of death and that, in many regards, this specialized care represents a gold standard, little is known about the care experience in this setting. Using qualitative survey data, we examined the positive and negative perceptions of care in hospices and in other prior settings. METHOD: Qualitative comments were extracted from the CaregiverVoice survey completed by bereaved caregivers of decedents who had died in 16 residential hospices in Ontario, Canada...
June 29, 2017: Palliative & Supportive Care
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