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Palliative care, end of life care, hospice

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https://www.readbyqxmd.com/read/28432089/preparing-future-doctors-for-palliative-care-views-of-course-organisers
#1
Steven Walker, Jane Gibbins, Paul Paes, Stephen Barclay, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee
BACKGROUND: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE: To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction. METHODS: An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28425929/contradictions-and-promise-for-end-of-life-communication-among-family-and-friends-death-over-dinner-conversations
#2
Andrea Lambert South, Jessica Elton
The free, open-access website called "Let's Get Together and Talk about Death", or Death over Dinner (DoD), provides resources for initiating end-of-life conversations with family and friends by taking the frightening-talking about death-and transforming it into the familiar-a conversation over dinner. This qualitative, descriptive study uses grounded theory and thematic analysis to answer the following research question: How do friend and family groups communicate about death and dying in DoD conversations? To answer this question, 52 dinner groups were recruited and conversations were conducted, which consisted of a facilitator and volunteers...
April 20, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28425409/the-utilization-of-palliative-care-services-in-patients-with-cirrhosis-who-have-been-denied-liver-transplantation-a-single-center-retrospective-review
#3
Sean G Kelly, Toby C Campbell, Luke Hillman, Adnan Said, Michael R Lucey, Parul D Agarwal
INTRODUCTION AND AIM: Utilization of palliative care services in patients dying of end-stage liver disease (ESLD) is understudied. We performed a retrospective review of palliative care services among patients with ESLD unsuitable for liver transplantation (LT) at a tertiary care center. MATERIAL AND METHODS: Deceased ESLD patients considered unsuitable for LT from 2007-2012 were identified. Patients were excluded if they received a transplant, had an incomplete workup, were lost to follow up or whose condition improved so LT was not needed...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#4
Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock, Jean Kutner
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual's acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable...
April 18, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28419414/association-between-aggressive-care-and-bereaved-families-evaluation-of-end-of-life-care-for-veterans-with-non-small-cell-lung-cancer-who-died-in-veterans-affairs-facilities
#5
Mary Ersek, Susan C Miller, Todd H Wagner, Joshua M Thorpe, Dawn Smith, Cari R Levy, Risha Gidwani, Katherine Faricy-Anderson, Karl A Lorenz, Bruce Kinosian, Vincent Mor
BACKGROUND: To the authors' knowledge, little is known regarding the relationship between patients' and families' satisfaction with aggressive end-of-life care. Herein, the authors examined the associations between episodes of aggressive care (ie, chemotherapy, mechanical ventilation, acute hospitalizations, and intensive care unit admissions) within the last 30 days of life and families' evaluations of end-of-life care among patients with non-small cell lung cancer (NSCLC). METHODS: A total of 847 patients with NSCLC (34% of whom were aged <65 years) who died in a nursing home or intensive care, acute care, or hospice/palliative care (HPC) unit at 1 of 128 Veterans Affairs Medical Centers between 2010 and 2012 were examined...
April 17, 2017: Cancer
https://www.readbyqxmd.com/read/28413928/the-oncology-specialist-s-role-in-polst-form-completion
#6
Austin J Lammers, Dana M Zive, Susan W Tolle, Erik K Fromme
INTRODUCTION: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#7
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28399827/organization-level-principles-and-practices-to-support-spiritual-care-at-the-end-of-life-a-qualitative-study
#8
Paul Holyoke, Barry Stephenson
BACKGROUND: Though most models of palliative care specifically include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families. Organizations often leave responsibility for such care with individual care providers, some of whom are comfortable with this role and well supported, others who are not. This study looked to hospice programs founded and operated on specific spiritual foundations to identify, if possible, organizational-level practices that support high-quality spiritual care that then might be applied in secular healthcare organizations...
April 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28395519/palliative-care-training-in-cardiology-fellowship-a-national-survey-of-the-fellows
#9
Noura M Dabbouseh, Shivtej Kaushal, Wendy Peltier, Fabian M Johnston
OBJECTIVES: To address perspectives of cardiology fellows on the current state of palliative education and palliative and hospice resource utilization within their fellowship experiences. METHODS: We conducted an online national survey of cardiology fellows during the 2015 to 2016 academic year. Survey questions aimed to assess perceived importance of palliative care education, level of palliative care education during fellowship, and the structure of palliative care support at respondent institutions...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28393347/-an-experience-of-providing-palliative-care-in-a-long-term-care-facility-let-good-death-in-place-become-a-feasible-reality
#10
Ming-Mei Chen, Chun-Chen Chou, Kuei-Ying Hsu, Yung-Feng Yen, Ya-Ting Yang, Hsiu-Li Huang
As the number of elderly in long-term care facilities (LTCFs) continues to increase, the number of resident deaths in these facilities is expected to increase. Thus, LTCFs may become a main focus for end-of-life (EoL) care in the future. Therefore, promoting quality EoL care in LTCFs should be a priority issue. Currently, the four types of hospice services include hospice wards and hospice-share-services in hospitals and home hospice care and community hospice care in patient homes. However, to date, there has been limited discussion regarding promoting palliative care in LTCFs...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28384309/-if-i-had-stayed-back-home-i-would-not-be-alive-any-more%C3%A2-exploring-end-of-life-preferences-in-patients-with-migration-background
#11
Piret Paal, Johannes Bükki
BACKGROUND: In patients with life-limiting conditions and a history of migration, a higher risk of not dying at home and limited access to palliative care services has been reported. AIM: To explore the views and end-of-life preferences of patients with a migration history in Germany and to identify migration specific themes. DESIGN: Two-armed study using Kaufmann's 'understanding interview' ('focused interview') method and grounded theory approach...
2017: PloS One
https://www.readbyqxmd.com/read/28375994/translating-research-to-practice-providing-critically-ill-children-the-opportunity-to-go-home-or-to-hospice-for-end-of-life-care
#12
Harriett Nelson, Sandra Mott
BACKGROUND: A freestanding quaternary pediatric hospital in New England has been facilitating parents' requests to take their child home or to a hospice facility from an Intensive Care Unit at end of life for the withdrawal of life sustaining measures for the past 16 years. However, knowledge of the aftermath of this decision was very limited. Before responding to a growing interest in making this service more available, an exploratory study was done to learn about the parents' perceptions of the experience over time...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28357971/palliative-and-end-of-life-care-in-the-masters-of-social-work-curriculum
#13
Cathy Berkman, Gary L Stein
OBJECTIVE: There is a shortage of social workers who have palliative care expertise. The aging U.S. population and advances in extending life for seriously ill persons require social workers in a wide range of health care and other settings with specialized palliative care expertise, as well as those with basic competence in palliative care. The objective of the present study was to document course content on palliative care in MSW programs in the United States and Canada. METHOD: A cross-sectional design with an online questionnaire was used...
March 30, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28341318/online-palliative-care-and-oncology-patient-education-resources-through-google-do-they-meet-national-health-literacy-recommendations
#14
Arpan V Prabhu, Tudor Crihalmeanu, David R Hansberry, Nitin Agarwal, Christine Glaser, David A Clump, Dwight E Heron, Sushil Beriwal
PURPOSE: The Google search engine is a resource commonly used by patients to access health-related patient education information. The American Medical Association and National Institutes of Health recommend that patient education resources be written at a level between the third and seventh grade reading levels. We assessed the readability levels of online palliative care patient education resources using 10 readability algorithms widely accepted in the medical literature. METHODS AND MATERIALS: In October 2016, searches were conducted for 10 individual terms pertaining to palliative care and oncology using the Google search engine; the first 10 articles written for the public for each term were downloaded for a total of 100 articles...
January 27, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28306661/referring-patients-to-hospice-or-palliative-care
#15
Kathleen Broglio, Anne Walsh
NPs care for patients with chronic diseases such as heart failure, chronic obstructive pulmonary disease, cancer, and dementia. As the disease progresses or patients age, disease-related symptoms may become increasingly burdensome, and these patients may benefit from hospice or palliative care. NPs can guide individuals in this process to optimize care and support at the end of life.
April 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28287357/a-review-of-agents-for-palliative-sedation-continuous-deep-sedation-pharmacology-and-practical-applications
#16
John Bodnar
Continuous deep sedation at the end of life is a specific form of palliative sedation requiring a care plan that essentially places and maintains the patient in an unresponsive state because their symptoms are refractory to any other interventions. Because this application is uncommon, many providers may lack practical experience in this specialized area and resources they can access are outdated, nonspecific, and/or not comprehensive. The purpose of this review is to provide an evidence- and experience-based reference that specifically addresses those medications and regimens and their practical applications for this very narrow, but vital, aspect of hospice care...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28264944/innovative-oncology-care-models-improve-end-of-life-quality-reduce-utilization-and-spending
#17
Erin Murphy Colligan, Erin Ewald, Sarah Ruiz, Michelle Spafford, Caitlin Cross-Barnet, Shriram Parashuram
Three models that received Health Care Innovation Awards from the Centers for Medicare and Medicaid Services (CMS) aimed to reduce the cost and use of health care services and improve the quality of care for Medicare beneficiaries with cancer. Each emphasized a different principle: the oncology medical home, patient navigation, or palliative care. Comparing participants in each model who died during the study period to matched comparators, we found that the oncology medical home and patient navigation models were associated with decreased costs in the last ninety days of life ($3,346 and $5,824 per person, respectively) and fewer hospitalizations in the last thirty days of life (fifty-seven and forty per 1,000 people, respectively)...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28260997/children-with-intellectual-disability-and-hospice-utilization
#18
Lisa C Lindley, Mari Beth Colman, John T Meadows
Over 42,000 children die each year in the United States, including those with intellectual disability (ID). Survival is often reduced when children with intellectual disability also suffer from significant motor dysfunction, progressive congenital conditions, and comorbidities. Yet, little is known about hospice care for children with intellectual disability. The purpose of this study was to explore the relationship between intellectual disability and hospice utilization. Additionally, we explored whether intellectual disability combined with motor dysfunction, progressive congenital conditions, and comorbidities influenced pediatric hospice utilization...
February 2017: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/28246083/commissioning-of-specialist-palliative-care-services-in-england
#19
Harriet Lancaster, Ilora Finlay, Maxwell Downman, James Dumas
OBJECTIVES: Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. METHODS: We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services...
February 28, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28235727/acceptable-regret-model-in-the-end-of-life-setting-patients-require-high-level-of-certainty-before-forgoing-management-recommendations
#20
Athanasios Tsalatsanis, Iztok Hozo, Benjamin Djulbegovic
BACKGROUND: The acceptable regret model postulates that under some circumstances decision-makers may tolerate wrong decisions. The purpose of this work is to empirically evaluate the acceptable regret model of decision-making in the end-of-life care setting, where terminally ill patients consider seeking curative treatment versus accepting hospice/palliative care. METHODS: We conducted interviews with 48 terminally ill patients to assess their preferences about end-of-life treatment choices...
February 21, 2017: European Journal of Cancer
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