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Quality and palliative care

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https://www.readbyqxmd.com/read/28822798/meaning-in-life-as-a-mediator-between-physical-impairment-and-the-wish-to-hasten-death-in-patients-with-advanced-cancer
#1
Mariona Guerrero-Torrelles, Cristina Monforte-Royo, Joaquín Tomás-Sábado, Frederic Marimon, Josep Porta-Sales, Albert Balaguer
CONTEXT: Meaning in life (MiL) is a key factor for ensuring spiritual wellbeing and quality of life among patients with life-threatening illnesses. However, the role of MiL in relation to the wish to hasten death (WTHD) and its interaction with other physical and psychological factors in patients with advanced cancer has not yet been studied. OBJECTIVE: To analyse the relationship between the WTHD and MiL, and to propose a theoretical model of functional relationships between WTHD, performance status, depression and MiL...
August 16, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28822692/complex-clinical-intersection-palliative-care-in-patients-with-dementia
#2
REVIEW
Ellen E Lee, Beverly Chang, Steven Huege, Jeremy Hirst
Because of the rapidly growing older population and increases in longevity, rates of dementia have been rising. Clinical challenges of treating dementia include limited resources and lack of curative therapies. Palliative care approaches improve quality of life and alleviate suffering for dementia patients at the end of life, although implementation may be limited by societal acceptance and feasibility. This review examines the published literature on pain assessments, pain and behavior interventions, tools for advanced care planning, and clinical concerns in dementia patients...
June 29, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28818864/palliative-care-for-hospitalized-patients-with-stroke-results-from-the-2010-to-2012-national-inpatient-sample
#3
Tarvinder Singh, Steven R Peters, David L Tirschwell, Claire J Creutzfeldt
BACKGROUND AND PURPOSE: Substantial variability exists in the use of life-prolonging treatments for patients with stroke, especially near the end of life. This study explores patterns of palliative care utilization and death in hospitalized patients with stroke across the United States. METHODS: Using the 2010 to 2012 nationwide inpatient sample databases, we included all patients discharged with stroke identified by International Classification of Diseases-Ninth Revision codes...
August 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28818633/patient-and-caregiver-reported-assessment-tools-for-palliative-care-summary-of-the-2017-ahrq-technical-brief
#4
Rebecca Aslakson, Sydney M Dy, Renee F Wilson, Julie Waldfogel, Allen Zhang, Sarina R Isenberg, Alex Blair, Joshua Sixon, Karen A Robinson
CONTEXT: Assessment tools are data collection instruments that are completed by or with patients or caregivers and which collect data at the individual patient or caregiver level. OBJECTIVES: To (1) summarize palliative care assessment tools completed by or with patients or caregivers, and (2) identify needs for future tool development and evaluation. METHODS: We completed: (1) a systematic review of systematic reviews; (2) a supplemental search of previous reviews and websites, and/or (3) a targeted search for primary articles when no tools existed in a domain...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818069/path-modeling-of-knowledge-attitude-and-practice-toward-palliative-care-consultation-service-among-taiwanese-nursing-staff-a-cross-sectional-study
#5
Hsueh-Hsing Pan, Hsiu-Ling Shih, Li-Fen Wu, Yu-Chun Hung, Chi-Ming Chu, Kwua-Yun Wang
BACKGROUND: The Taiwanese government has promoted palliative care consultation services (PCCS) to support terminally ill patients in acute ward settings to receive palliative care since 2005. Such an intervention can enhance the quality of life and dignity of terminally ill patients. However, research focusing on the relationship between the knowledge, attitude and practice of a PCCS using path modelling in nursing staff is limited. Therefore, the aim of this study was to elucidate the effect of path modeling on the knowledge, attitude and practice toward PCCS in Taiwanese nursing staff...
August 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28814906/psychosocial-challenges-for-patients-with-advanced-lung-cancer-interventions-to-improve-well-being
#6
REVIEW
Rebecca H Lehto
As compared to other cancers, lung malignancies are associated with high symptom burden, poorer prognosis, and stigmatization. Such factors increase psychological distress and negatively impact quality of life. Research has documented the efficacy of psychosocial interventions to alleviate psychological distress and promote well-being among patients with cancer. This article summarizes the current literature on psychosocial interventions in lung cancer. Major types of psychosocial interventions in lung cancer include cognitive-behavioral therapies, psycho-education, mind-body, exercise, and supportive or palliative care strategies...
2017: Lung Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28814852/prognostic-variables-and-scores-identifying-the-end-of-life-in-copd-a-systematic-review
#7
REVIEW
Laura-Jane E Smith, Elizabeth Moore, Ifrah Ali, Liam Smeeth, Patrick Stone, Jennifer K Quint
INTRODUCTION: COPD is a major cause of mortality, and the unpredictable trajectory of the disease can bring challenges to end-of-life care. We aimed to investigate known prognostic variables and scores that predict prognosis in COPD in a systematic literature review, specifically including variables that contribute to risk assessment of patients for death within 12 months. METHODS: We conducted a systematic review on prognostic variables, multivariate score or models for COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28814378/mhealth-technologies-for-palliative-care-patients-at-the-interface-of-in-patient-to-outpatient-care-protocol-of-feasibility-study-aiming-to-early-predict-deterioration-of-patient-s-health-status
#8
Gudrun Theile, Vanessa Klaas, Gerhard Tröster, Matthias Guckenberger
BACKGROUND: Palliative care patients are a particularly vulnerable population and one of the critical phases in patients' trajectories is discharge from specialized in-patient palliative care into outpatient care, where availability of a palliative care infrastructure is highly variable. A relevant number of potentially avoidable readmissions and emergency visits of palliative patients is observed due to rapid exacerbation of symptoms indicating the need for a closer patient monitoring...
August 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28814321/relatives-perceived-quality-of-palliative-care-comparisons-between-care-settings-in-which-patients-die
#9
Dolf de Boer, Jolien M Hofstede, Anke J E de Veer, Natasja J H Raijmakers, Anneke L Francke
BACKGROUND: Dying in the preferred setting is an indicator of good palliative care quality. Most people prefer to die at home. But does the quality of care as perceived by their relatives vary depending on the care setting that is the place of death? The aim is to compare (from the relatives perspective) whether there are perceived differences in the quality of palliative care between the settings in which people die. METHODS: Multivariate linear regression analyses have been carried out using an existing dataset containing information collected using the relatives' version of the Consumer Quality Index (CQ-index) Palliative Care...
August 16, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28813191/effect-and-efficiency-of-an-embedded-palliative-care-nurse-practitioner-in-an-oncology-clinic
#10
Anne M Walling, Sarah F D'Ambruoso, Jennifer L Malin, Sara Hurvitz, Ann Zisser, Anne Coscarelli, Robin Clarke, Andrew Hackbarth, Christopher Pietras, Frances Watts, Bruce Ferrell, Samuel Skootsky, Neil S Wenger
PURPOSE: To test a simultaneous care model for palliative care for patients with advanced cancer by embedding a palliative care nurse practitioner (NP) in an oncology clinic. METHODS: We evaluated the effect of the intervention in two oncologists' clinics beginning March 2014 by using implementation strategies, including use of a structured referral mechanism, routine symptom screening, integration of a psychology-based cancer supportive care center, implementation team meetings, team training, and a metrics dashboard for continuous quality improvement...
August 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28810503/two-is-a-perfect-number-patient-doctor-relationship-and-patient-attachment-style-in-palliative-care
#11
Iwona Zaporowska-Stachowiak, Katarzyna Stachowiak, Katarzyna Stachnik
We tested the association between the palliative patient's attachment style and the patient-doctor relationship, by means of Revised Adult Attachment Scale and a self-designed, patient-doctor relationship questionnaire. The study included 110 (52 M, 58 F) cancer, hospice patients, aged 36-80 years. We observed 54 percent of secure, 18 percent of dismissive, 9 percent of preoccupied, and 19 percent of fearful styles. Securely attached patients developed significantly ( p < .05) better relationships with doctors than insecure patients...
August 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28809459/intensity-of-integrated-cancer-palliative-care-plans-and-end-of-life-acute-medical-hospitalisation-among-cancer-patient%C3%A2-in-northern-italy
#12
Michele Pellizzari, Maria Rolfini, Eliana Ferroni, Valentina Savioli, Nicola Gennaro, Elena Schievano, Francesco Avossa, Elisabetta Pinato, Maria Cristina Ghiotto, Franco Figoli, Domenico Mantoan, Antonio Brambilla, Ugo Fedeli, Mario Saugo
A high hospital utilisation at the end of life (EOL) is an indicator of suboptimal quality of health care. We evaluated the impact of the intensity of different Integrated Cancer Palliative Care (ICPC) plans on EOL acute medical hospitalisation among cancer decedents. Decedents of cancer aged 18-84 years, who were residents in two Italian regions, were investigated through integrated administrative data. Outcomes considered were prolonged hospital stay for medical reasons, 2+ hospitalisations during the last month of life and hospital death...
August 15, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28807707/quality-improvement-pearls-for-the-palliative-care-and-hospice-professional
#13
Arif H Kamal, Jonathan M Nicolla, Steve Power
Rapid changes in how palliative care clinicians are evaluated and paid present an imperative for clinicians to adeptly and routinely perform quality improvement in usual practice. Like empathic communication and facilitating goals of care discussions, quality improvement skills must be learned, honed, and practiced so identifying problems and brainstorming solutions becomes a natural component of delivering serious illness care. Using our experience in both failures and successes in performing quality improvement, herein we provide a prioritized list of ten pearls specifically aimed to palliative care and hospice professionals...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807702/factors-associated-with-use-of-u-s-community-based-palliative-care-for-children-with-life-limiting-or-life-threatening-illnesses-and-their-families-an-integrative-review
#14
REVIEW
Jackelyn Y Boyden, Martha A Q Curley, Janet A Deatrick, Mary Ersek
CONTEXT: As children with life-limiting and life-threatening illnesses live longer, challenges to meeting their complex health care needs arise in homes and communities, as well as in hospitals. Integrated knowledge regarding community-based pediatric palliative care (CBPPC) is needed to strategically plan for a seamless continuum of care for children and their families. OBJECTIVE: The purpose of this integrative review paper is to explore factors that are associated with the use of CBPPC for U...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28805571/palliative-care-and-nonmotor-symptoms-in-parkinson-s-disease-and-parkinsonism
#15
Nataliya Titova, K Ray Chaudhuri
The term palliative care (PC) is defined as a collection of interventions and strategies that helps to improve and sustain the quality of life of patients and caregivers in situations and scenarios associated with life-threatening illness. This is usually implemented by means of early identification and treatment of relevant motor and nonmotor issues such as pain, sleep, and autonomic dysfunction, dementia, and depression. In addition, a holistic PC program also includes delivery of physical, psychosocial, and spiritual support...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#16
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28804570/value-of-quality-of-life-analysis-in-liver-cancer-a-clinician-s-perspective
#17
REVIEW
Leung Li, Winnie Yeo
Health related quality of life (HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma (HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being...
July 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28803091/depression-a-major-contributor-to-poor-quality-of-life-in-patients-with-advanced-cancer
#18
K S Grotmol, H C Lie, M J Hjermstad, N Aass, D Currow, S Kaasa, T Å Moum, A Pigni, J H Loge
CONTEXT: Quality of life (QoL) and depression are important patient-reported outcomes in cancer care. However, the relative importance of depression severity in predicting QoL remains unclear due to few methodologically sound studies. OBJECTIVES: To examine whether depression contributes to impairment of QoL irrespective of prognostic factors and symptom burden. METHODS: 563 patients were included from the European Palliative Care Research Collaborative Study (EPCRC-CSA), an international, multi-centre, cross-sectional study...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803081/building-an-outpatient-kidney-palliative-care-clinical-program
#19
Jennifer S Scherer, Rebecca Wright, Caroline S Blaum, Stephen P Wall
CONTEXT: A diagnosis of advanced chronic kidney disease (CKD), or end stage renal disease (ESRD) represents a significant life change for patients and families. Individuals often experience high symptom burden, decreased quality of life, increased health care utilization, and end-of-life care discordant with their preferences. Early integration of palliative care with standard nephrology practice in the outpatient setting has the potential to improve quality of life through provision of expert symptom management, emotional support, and facilitation of advance care planning that honors the individual's values and goals...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803080/palliative-care-development-in-kyrgyzstan
#20
Aibek Mukambetov, Taalaigul Sabyrbekova, Lola Asanalieva, Ilim Sadykov, Alexander Aralbaev, Stephen Connor
Palliative care began in Kyrgyzstan in 2005 as a pilot home based care program in Osh Cancer Center and was supported by a small group of nurses and one physician from Scotland. In 2010, the Soros Foundation-Kyrgyzstan (SFK) and the Open Society Foundation's International Palliative Care Initiative (IPCI) began supporting work on palliative care policy, legislation, essential medicine availability, education, advocacy and implementation. A Ministry of Health working group was established to lead this initiative and technical assistance was provided by an international palliative care consultant...
August 9, 2017: Journal of Pain and Symptom Management
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