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Palliative care, end of life care, hospice

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https://www.readbyqxmd.com/read/29678173/the-japan-hospice-and-palliative-evaluation-study-4-a-cross-sectional-questionnaire-survey
#1
Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita
BACKGROUND: Constant evaluation is important for maintaining and improving the quality of end-of-life care. We therefore conduct the fourth Japan Hospice and Palliative Evaluation Study (J-HOPE4) as a continuous evaluation study. In this present paper, we describe the design of J-HOPE4. The main purposes of J-HOPE4 are as follows:1) to evaluate the processes, structures, and outcomes of palliative care acute hospitals, palliative care units, and home hospice services; 2) to examine bereaved family members' self-reported psychosocial conditions, such as grief and depression as bereavement outcomes;3) to provide data to ensure and improve the quality of care provided by participating institutions via feedback based on the results from each institution; and 4) provide clinical and academic information concerning the implications of various issues in palliative care by conducting additional studies...
April 20, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29678168/self-competence-in-death-work-among-health-and-social-care-workers-a-region-wide-survey-in-hong-kong
#2
Johnny T K Cheung, Doreen W H Au, Wallace C H Chan, Jenny H Y Chan, Kenway Ng, Jean Woo
BACKGROUND: According to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates...
April 20, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29669147/impact-and-reception-of-a-required-4-week-palliative-medicine-rotation
#3
B Brent Simmons, Alison Petrie, Edward Gracely
BACKGROUND AND OBJECTIVES: Hospice and palliative medicine (HPM) is one of three Accreditation Council for Graduate Medical Education accredited clinical subspecialties available to family medicine graduates for fellowship training. Despite this, training is not currently a curriculum requirement. We have pioneered a required 4-week palliative medicine rotation into the curriculum. METHODS: Twenty-eight residents who completed the palliative medicine rotation across four classes were surveyed to assess how the rotation improved their level of comfort with providing end-of-life (EOL) care and to demonstrate the need of formal palliative medicine training...
April 2018: Family Medicine
https://www.readbyqxmd.com/read/29656703/the-ethics-of-concurrent-care-for-children-a-social-justice-perspective
#4
Kim Mooney-Doyle, Jessica Keim-Malpass, Lisa C Lindley
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life-including fatigue, pain, dyspnea, and anxiety-with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29649400/impact-of-inpatient-palliative-care-on-quality-of-end-of-life-care-and-downstream-acute-and-postacute-care-utilization
#5
Peter S Khang, Susan E Wang, In-Lu Amy Liu, Heather L Watson, Sandra Y Koyama, Dan N Huynh, Janet S Lee, Huong Q Nguyen
BACKGROUND: Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM: Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN: Retrospective cohort design. SETTING/PARTICIPANTS: Adult decedents from January 1, 2012, to December 31, 2014, who had at least one hospitalization at 11 Kaiser Permanente Southern California medical centers in the 12 months before death and not hospitalized for a trauma-related condition or receiving home-based PC or hospice were included in the cohort...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649399/a-rules-based-algorithm-to-prioritize-poor-prognosis-cancer-patients-in-need-of-advance-care-planning
#6
Christine M Bestvina, Kristen E Wroblewski, Bobby Daly, Brittany Beach, Selina Chow, Andrew Hantel, Monica Malec, Michael T Huber, Blase N Polite
BACKGROUND: Accurate understanding of the prognosis of an advanced cancer patient can lead to decreased aggressive care at the end of life and earlier hospice enrollment. OBJECTIVE: Our goal was to determine the association between high-risk clinical events identified by a simple, rules-based algorithm and decreased overall survival, to target poor prognosis cancer patients who would urgently benefit from advanced care planning. DESIGN: A retrospective analysis was performed on outpatient oncology patients with an index visit from April 1, 2015, through June 30, 2015...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649394/perspective-on-care-at-the-end-of-life-at-hospice-africa-uganda
#7
Joshua Campbell, Nasur Buyinza, Joshua Hauser
BACKGROUND: Since its beginning in 1993, Hospice Africa Uganda (HAU) has become a leader in palliative care in Africa. Despite this, there remains a sparsity of research elucidating the priorities of patients in their care at the end of life. This study aimed to identify those priorities in three groups: patients with life-limiting illness, their caregivers, and their healthcare providers at HAU, and thus to identify differences in what these groups find important in the last month of life...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29608380/the-alzheimer-s-disease-home-hospice-knowledge-scale-development-validity-and-reliability
#8
Pnina Sela-Katz, Perla Werner
BACKGROUND: Several instruments are available to assess knowledge about hospice care, but none specifically address knowledge about home hospice for persons with Alzheimer's disease (AD). AIM: To develop and validate the Alzheimer's Disease Home Hospice Knowledge Scale (AD-HHK-S). METHODS: A total of 107 Israeli family caregivers of persons with dementia (mean age=71.2; 73% female) participated in the study. RESULTS: The AD-HHK-S included 28 true/false items assessing 3 areas of knowledge: knowledge about hospice, knowledge about home hospice, and knowledge about home hospice for AD...
March 2, 2018: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29596042/ten-tips-nephrologists-wish-the-palliative-care-team-knew-about-caring-for-patients-with-kidney-disease
#9
Amar D Bansal, Amanda Leonberg-Yoo, Jane O Schell, Jennifer S Scherer, Christopher A Jones
Many patients with chronic kidney disease (CKD) and end-stage renal disease have unmet palliative care (PC) needs. Physical and emotional symptoms are common. Some, like uremia and fluid overload, improve with dialysis, but the increasing age of patients initiating renal replacement therapy leaves many untreatable comorbidities like dementia and frailty to negatively impact quality of life. Written by nephrologists and PC clinicians, this article will help PC providers to have a richer understanding of kidney disease-related symptom burden, disease trajectory, prognosis, and barriers to hospice enrollment for patients with CKD and end-stage renal disease...
April 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29573054/relational-ethics-of-delirium-care-findings-from-a-hospice-ethnography
#10
David Kenneth Wright, Susan Brajtman, Mary Ellen Macdonald
Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end-of-life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end-of-life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients' comfort and dignity were deemed most at stake and therefore commanded nurses' primary attention...
March 24, 2018: Nursing Inquiry
https://www.readbyqxmd.com/read/29564899/-hospice-continuing-care-during-patients-life
#11
Jindřich Polívka
Palliative care is focused on enhancing quality of life for seriously ill. Hospice care is a comprehensive care provided by an interdisciplinary team for patients whose diseases cannot be cured and are approaching the end of life. To be eligible for admission to hospice care is required to be terminally ill with a life expectancy of 6 months or less. Currently, hospices are the main providers of specialized palliative care in the Czech Republic. This article is focused on the current state of palliative care and specifically on hospice care in the Czech Republic...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29533131/the-hospice-patient-s-right-to-oral-care-making-time-for-the-mouth
#12
Kristi Soileau, Nanette Elster
The hospice philosophy embraces palliative care for the terminally ill, for whom quality of life is the central focus of comfort care management. Often, caregivers hesitate or simply do not elect to extend oral care for patients nearing the end of life, due to difficulties encountered in patient compliance, a sense of futility in doing so, staff time constraints in prioritizing care, underfunding, or a lack of education as to how and why such care should be delivered to the hospice patient. This article aims to show physiological and psychosocial reasons why the hospice patient has a need for properly and regularly implemented oral care and why dental professionals have an ethical responsibility to address the current void that exists in hospice-centered oral care...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29508165/determinants-and-outcomes-of-hospice-utilization-among-patients-with-advance-staged-hepatocellular-carcinoma-in-a-veteran-affairs-population
#13
Winnie Y Zou, Hashem B El-Serag, Yvonne H Sada, Sarah L Temple, Shubhada Sansgiry, Fasiha Kanwal, Jessica A Davila
BACKGROUND: Hospice provides integrative palliative care for advance-staged hepatocellular carcinoma (HCC) patients, but hospice utilization in HCC patients in the USA is not clearly understood. AIMS: We examined hospice use and subsequent clinical course in advance-staged HCC patients. METHODS: We conducted a retrospective study on a national, Veterans Affairs cohort with stage C or D HCC. We evaluated demographics, clinical factors, treatment, and clinical course in relation to hospice use...
March 5, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29502379/-the-option-of-critical-patients-with-cancer-for-icu
#14
R Xia, D H Wang
With the improvement of diagnosis and treatment, tumor has become a chronic disease, and an increasing number of older patients will live with tumors. This change has led to an increase in demand for intensive care unit (ICU) and a challenge to the traditional ICU treatment concept. The option of ICU consists of two parts. The first is the option for admission. Since classic predictors of mortality are no longer relevant, we suggest broadening the criteria for ICU admission. Patients during the first course of cancer therapies should be treated with a full-code status similar to that of other patients without malignancy...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29494791/physician-assisted-suicide-and-midwest-social-workers-where-do-they-stand
#15
N Rose Gaston, Jill M Randall, Lisa R Kiesel
Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers' attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey...
March 1, 2018: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/29493362/the-state-of-the-science-on-integrating-palliative-care-in-heart-failure
#16
Laura P Gelfman, Marie Bakitas, Lynne Warner Stevenson, James N Kirkpatrick, Nathan E Goldstein
BACKGROUND: Heart failure (HF) is a chronic progressive illness associated with physical and psychological burdens, high morbidity, mortality, and healthcare utilization. Palliative care is interdisciplinary care that aims to relieve suffering and improve quality of life for persons with serious illness and their families. It is offered simultaneously with disease-oriented care, unlike hospice or end-of-life care. Despite the demonstrated benefits of palliative care in other populations, evidence for palliative care in the HF population is limited...
June 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29474102/defining-the-elements-of-early-palliative-care-that-are-associated-with-patient-reported-outcomes-and-the-delivery-of-end-of-life-care
#17
Michael Hoerger, Joseph A Greer, Vicki A Jackson, Elyse R Park, William F Pirl, Areej El-Jawahri, Emily R Gallagher, Teresa Hagan, Juliet Jacobsen, Laura M Perry, Jennifer S Temel
Purpose We describe the key elements of early palliative care (PC) across the illness trajectory and examine whether visit content was associated with patient-reported outcomes and end-of-life care. Methods We performed a secondary analysis of patients with newly diagnosed advanced lung or noncolorectal GI cancer (N = 171) who were randomly assigned to receive early PC. Participants attended at least monthly visits with board-certified PC physicians and advanced practice nurses at Massachusetts General Hospital...
February 23, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29466968/palliative-care-specialists-perceptions-concerning-referral-of-haematology-patients-to-their-services-findings-from-a-qualitative-study
#18
Dorothy McCaughan, Eve Roman, Alexandra G Smith, Anne C Garry, Miriam J Johnson, Russell D Patmore, Martin R Howard, Debra A Howell
BACKGROUND: Haematological malignancies (leukaemias, lymphomas and myeloma) are complex cancers that are relatively common, affect all ages and have divergent outcomes. Although the symptom burden of these diseases is comparable to other cancers, patients do not access specialist palliative care (SPC) services as often as those with other cancers. To determine the reasons for this, we asked SPC practitioners about their perspectives regarding the barriers and facilitators influencing haematology patient referrals...
February 21, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29464435/palliative-care-for-movement-disorders
#19
REVIEW
Christina L Vaughan, Benzi M Kluger
PURPOSE OF REVIEW: While care for patients with movement disorders has traditionally focused on motor symptoms, there is increasing evidence that optimal care for these disorders is more complex both in terms of the spectrum of symptoms experienced by patients (e.g., pain, depression) and the multidimensional needs of patients and their families. Palliative care is an approach to the care of patients and families affected by serious illnesses that seeks to relieve suffering by addressing complex medical symptoms, psychosocial issues, spiritual well-being, and goals of care...
February 21, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29463092/super-utilization-of-health-care-resources-among-gynecologic-oncology-patients
#20
Casey M Hay, Joseph L Kelley, Robert P Edwards, Kathleen M Pombier, John T Comerci
Super-utilizers account for many emergency department visits (EDV) and hospitalizations. Among Medicare/Medicaid patients, 5% to 10% account for >50% of spending. Little is known about super-utilization in gynecologic oncology. Charts of 64 gynecologic oncology patients with ≥3 EDV and/or admissions over 12 months were reviewed retrospectively. Cancer type distribution was 47% ovarian, 23% cervical, 23% endometrial, and 6% vulvar. Treatment at index visit was 61% chemotherapy, 16% no treatment, 8% recent surgery, and 6% radiation...
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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