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Quality and palliative care

Wei Gao, Vincent Crosby, Andrew Wilcock, Rachael Burman, Eli Silber, Nilay Hepgul, K Ray Chaudhuri, Irene J Higginson
BACKGROUND: There is no standard palliative care outcome measure for people with progressive long term neurological conditions (LTNC). This study aims to determine the psychometric properties of a new 8-item palliative care outcome scale of symptom burden (IPOS Neuro-S8) in this population. DATA AND METHODS: Data were merged from a Phase II palliative care intervention study in multiple sclerosis (MS) and a longitudinal observational study in idiopathic Parkinson's disease (IPD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP)...
2016: PloS One
Megan Quinn, Sheila Gephart
BACKGROUND: Palliative care is a holistic framework that is designed to improve quality of life by identifying and treating distressing symptoms of life-threatening or complex conditions. Neonatal palliative care (NPC) has potential benefits for parents, staff, and patients, yet evidence suggests that implementation and utilization of organized NPC services are low. PURPOSE: The purpose of this study is to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? SEARCH STRATEGY: A literature search was conducted using CINAHL (Cumulative Index of Nursing and Allied Health Literature), PubMed, and the Cochrane Library databases...
October 22, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Juan Jose Saldaña Barrios, Luis Mendoza, Edgardo Pitti, Miguel Vargas
In this work, the authors present two eHealth platforms that are examples of how health systems are migrating from client-server architecture to the web-based and ubiquitous paradigm. These two platforms were modeled, designed, developed and implemented with positive results. First, using ambient-assisted living and ubiquitous computing, the authors enhance how palliative care is being provided to the elderly patients and patients with terminal illness, making the work of doctors, nurses and other health actors easier...
October 21, 2016: Health Informatics Journal
Olga Tursunov, Nathan I Cherny, Freda DeKeyser Ganz
PURPOSE/OBJECTIVES: To describe the experience of family members of patients receiving palliative sedation at the initiation of treatment and after the patient has died and to compare these experiences over time.
. DESIGN: Descriptive comparative study.
. SETTING: Oncology ward at Shaare Zedek Medical Center in Jerusalem, Israel.
. SAMPLE: A convenience sample of 34 family members of dying patients receiving palliative sedation...
November 1, 2016: Oncology Nursing Forum
Sook-Nam Kim, Soon-Ock Choi, Seong Hoon Shin, Ji-Sun Ryu, Jeong-Won Baik
Purpose: A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. Material and Methods: The model development included Steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system...
October 18, 2016: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
Sheng-Yu Fan, I-Mei Lin, Jyh-Gang Hsieh, Chih-Jung Chang
CONTEXT: Psychosocial care is an important component of palliative care, which is also provided by physicians and nurses. OBJECTIVE: The aim of this study was to explore the experiences of physicians and nurses in palliative care regarding the process of psychosocial care, the difficulties, and the support needs from psychosocial care professionals. METHODS: A two-phase mixed methods study was conducted. In the first phase, 16 physicians and nurses with palliative care experience were recruited...
October 15, 2016: Journal of Pain and Symptom Management
Kelsey M Flint, Sarah J Schmiege, Larry A Allen, Timothy J Fendler, John Rumsfeld, David Bekelman
CONTEXT: Health status (i.e., symptoms, function, and quality of life) is an important palliative care outcome in patients with heart failure, however patterns of health status over time (i.e. trajectories) are not well described. OBJECTIVES: To identify health status trajectories in outpatients with heart failure, and assess whether depression, symptom burden, or sense of peace predict health status trajectory. METHODS: Observational study utilizing data from the Patient-Centered Disease Management for Heart Failure trial...
October 15, 2016: Journal of Pain and Symptom Management
Simon Noble
Simon Noble speaks to Sebastian Dennis-Beron, Commissioning Editor: Simon Noble is Clinical Professor in Palliative Medicine at Cardiff University and honorary consultant at the Royal Gwent Hospital in Newport. His main research interests are in the management of venous thromboembolism in advanced cancer, quality of life effects of venous thromboembolism and their therapies, clinical decision-making in venous thromboembolism management and the patient journey. He is involved at a national level in the delivery of evidence-based thromboprophylaxis for hospitalized patients through the All Party Thrombosis Group and sits on the NICE Guideline development group for thromboprophylaxis...
October 19, 2016: Future Oncology
Betty Ferrell, Elaine Wittenberg, Vanessa Battista, Gay Walker
OBJECTIVE: The goal of this study was to explore nurse experiences in communication with children about spiritual topics in order to develop training in this area. BACKGROUND: Although spiritual care is essential in pediatric palliative care, few providers receive training about communication with ill children about spirituality. METHODS: Researchers developed a brief survey to prompt nurses to reflect on pediatric palliative care experiences that included spiritual discussions...
October 18, 2016: Journal of Palliative Medicine
Katherine Clark, Lawrence T Lam, Nicholas J Talley, Jane L Phillips, David C Currow
OBJECTIVE: The aim of this work was to investigate whether variables identified as likely to impact the experience of constipation in other clinical settings similarly affected the experiences of constipated palliative care patients. BACKGROUND: The majority of palliative care patients with cancer are likely to be bothered by constipation symptoms at some point in their disease trajectory. Despite this, it remains unclear as to which factors predict more severe problems...
October 18, 2016: Journal of Palliative Medicine
Mimi Jenko, Nancy M Short
Bereavement services for families are an established part of hospice and palliative care. However, patients also die in the acute care and long-term care environments. Often, hospice is not involved, creating a potential gap in care. This article recounts a journey to improve care for all families of deceased patients, despite the presence or absence of hospice. A palliative care clinical nurse specialist led a quality improvement team, which used a systems thinking approach to develop and implement a downloadable bereavement booklet for families...
November 2016: Dimensions of Critical Care Nursing: DCCN
Traci M Kazmerski, Daniel J Weiner, Janice Matisko, Diane Schachner, Whitney Lerch, Carol May, Scott H Maurer
INTRODUCTION: Advance care planning (ACP), though recommended, has not been studied in adolescents with cystic fibrosis (CF). This quality improvement project engaged adolescents with advanced CF disease in ACP and assessed patient and CF provider attitudes and preferences regarding ACP discussions and tools. MATERIALS AND METHODS: Patients ≤22 years with advanced CF (FEV1 ≤40% predicted, >2 pulmonary exacerbations requiring IV antibiotics in 1 year, and/or use of home oxygen or non-invasive ventilation) were referred to the pediatric palliative care team (PC)...
October 17, 2016: Pediatric Pulmonology
Sophie Robinson, David W Kissane, Joanne Brooker, Courtney Hempton, Susan Burney
CONTEXT: The risk of suicide is elevated in palliative care patients compared to the general population. Various psychological factors, including depression, demoralization, loss of control, and low self-worth have been associated with a desire to hasten death. OBJECTIVES: The aim of this study was to investigate whether depression, demoralization, loss of control, and low self-worth mediated the relationship between global quality of life and desire to hasten death...
October 12, 2016: Journal of Pain and Symptom Management
Sarah Amador, Claire Goodman, Louise Robinson, Elizabeth L Sampson
BACKGROUND: People living and dying with non-cancer diagnoses, including dementia, have poorer access to generalist and specialist palliative care than people with cancer, and experience worse outcomes in terms of pain and symptom control, and quality and experience of care. In the UK, the National Council for Palliative Care (NCPC) ran a national survey of services for end-of-life care for people with dementia (2008) in which 16 services were identified, and reported on case studies and examples of good practice...
October 14, 2016: BMJ Supportive & Palliative Care
Tarek Assi, Elie El Rassy, Tony Ibrahim, Tania Moussa, Aline Tohme, Fadi El Karak, Fadi Farhat, Salma Faddoul, Marwan Ghosn, Joseph Kattan
INTRODUCTION: One major health care issue encountered in elderly cancer patients is the alteration of the quality of life. The purpose of our study is to evaluate the administration of chemotherapy in the last month of life (CLML) and to evaluate the impact of the palliative care consult (PCC) in the elderly patients. METHODS: We conducted a retrospective observational study that included elderly patients diagnosed with an end-stage cancer and who were deceased between the 1st of January 2012 and the 31st of December 2015...
October 13, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Wendy Shulver, Maggie Killington, Maria Crotty
BACKGROUND: Telehealth technologies, which enable delivery of healthcare services at distance, offer promise for responding to the challenges created by an ageing population. However, successful implementation of telehealth into mainstream healthcare systems has been slow and fraught with failure. Understanding of frontline providers' experiences and attitudes regarding telehealth is a crucial aspect of successful implementation. This study aims to examine healthcare worker views on telehealth, and their implications for implementation to mainstream healthcare services for older people...
October 12, 2016: BMC Medical Informatics and Decision Making
Brett C Bade, Gerard A Silvestri
Lung cancer patients are at high risk of suffering due to severe and refractory symptoms, concomitant respiratory comorbidity, frequent disease progression, and treatment that can worsen and compromise quality of life. Palliative care (PC) has shown multiple benefits to cancer patients such as better quality of life, higher patient and family satisfaction, improved disease understanding, less symptom burden, fewer depressive symptoms, less aggressive end of life care, and even improved survival with early implementation...
October 2016: Seminars in Respiratory and Critical Care Medicine
Joakim Öhlén, Lara Russell, Cecilia Håkanson, Anette Alvariza, Carl Johan Fürst, Kristofer Årestedt, Richard Sawatzky
CONTEXT: Symptom relief is a key goal of palliative care. There is a need to consider complexities in symptom relief patterns for groups of people in order to understand and evaluate symptom relief as an indicator of quality of care at end of life. OBJECTIVES: The aims of this study were to distinguish classes of patients who have different symptom relief patterns during the last week of life and to identify predictors of these classes in an adult register population...
October 7, 2016: Journal of Pain and Symptom Management
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