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death dying and reflective practice

I Tuffrey-Wijne, T Rose
BACKGROUND: Most staff working in intellectual disability services will be confronted with people with intellectual disabilities who need support around death, dying and bereavement. Previous studies suggest that intellectual disability staff tend to protect clients from knowing about death and avoid communication about death. The aims of this study were to gain further insight into the individual, organisational and contextual factors that affect the communication of death-related bad news to people with intellectual disabilities by intellectual disability staff and to develop guidelines for services to enable appropriate communication with clients about death and dying...
April 7, 2017: Journal of Intellectual Disability Research: JIDR
Marjolaine Frenette, Jocelyne Saint-Arnaud, Karim Serri
In order to promote better practices and communication around end-of-life decision-making, several Canadian hospitals in the province of Quebec have developed a tool called "Levels of Intervention" (LOI). No work to date has been published demonstrating improvement since these forms were implemented. The purpose of the present study was to obtain information about the use of LOI forms across Quebec hospitals and to identify gaps in practice as well as areas for improvement. A retrospective study was undertaken of 299 charts of patients who had died in three Quebec hospitals with a LOI ordered...
March 21, 2017: Journal of Bioethical Inquiry
Tina Maschi, Marina Richter
Death and dying in prisons constitute a topic of growing importance across the globe. Based on the contributions made in this special issue, we reflect on current debates and outline recommendations for dialogue and practice. Scientific dialogue across the Atlantic, and across the globe, provides insights into different national carceral systems and their ways of dealing with end of life behind bars. At the same time, the comparison also helps to identify basic needs and practices that can work in various settings...
January 2017: Journal of Correctional Health Care
T Pennaforte, A Moussa, A Janvier
Technological progress and improved clinical knowledge have increased survival of neonates who would previously have died. Survival is sometimes accompanied by a risk of short- or long-term adverse outcomes, which may lead to complex decisions about withholding or withdrawing life-sustaining interventions. These decisions are among the most difficult decisions in pediatric practice. They also involve communicating with parents and are emotionally charged. Many articles examining end-of-life decisions in neonatology state the need for healthcare providers to be caring, compassionate, and human without offering clear, practical advice...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Maija Butters
Finland holds a unique place in the geographical and cultural map of Europe by being situated between the East and the West. This article will offer a historical overview of Finland's death culture from the point of view of the various religious and ideological practices that reflect influence from these two sides. I also explore the factors that may explain the Lutheran Church's hegemony over death and dying in Finland.
January 2017: Death Studies
Lisbeth Thoresen, Rolf Ahlzén, Kari Nyheim Solbrække
Advance care planning (ACP) is an international concept for improving patient autonomy and communication in the context of anticipated deterioration and end-of-life care. In a preparatory conversation, health care professionals facilitate one or more conversations where nursing home residents are invited to reflect on, and articulate wishes and preferences concerning future medical treatment and end-of-life care. Our aim with this study was to increase knowledge of existing ACP practices in Norwegian nursing homes...
August 2016: Journal of Aging Studies
Marilyn Swinton, Mita Giacomini, Feli Toledo, Trudy Rose, Tracy Hand-Breckenridge, Anne Boyle, Anne Woods, France Clarke, Melissa Shears, Robert Sheppard, Deborah Cook
RATIONALE: The austere setting of the intensive care unit (ICU) can suppress expressions of spirituality. OBJECTIVES: To describe how family members and clinicians experience and express spirituality during the dying process in a 21-bed medical-surgical ICU. METHODS: Reflecting the care of 70 dying patients, we conducted 208 semistructured qualitative interviews with 76 family members and 150 clinicians participating in the Three Wishes Project...
January 15, 2017: American Journal of Respiratory and Critical Care Medicine
Kristian Jansen, Sabine Ruths, Kirsti Malterud, Margrethe Aase Schaufel
OBJECTIVE: Explore the impact of existential vulnerability for nursing home doctors' experiences with dying patients and their families. METHODS: We conducted a qualitative study based on three focus group interviews with purposive samples of 17 nursing home doctors. The interviews were audio-recorded, transcribed, and analyzed with systematic text condensation. RESULTS: Nursing home doctors experienced having to balance treatment compromises in order to assist patients' and families' preparation for death, with their sense of professional conduct...
July 12, 2016: Patient Education and Counseling
Geena Saini, Elizabeth L Sampson, Sarah Davis, Nuriye Kupeli, Jane Harrington, Gerard Leavey, Irwin Nazareth, Louise Jones, Kirsten J Moore
BACKGROUND: Most people with advanced dementia die in nursing homes where families may have to make decisions as death approaches. Discussions about end-of-life care between families and nursing home staff are uncommon, despite a range of potential benefits. In this study we aimed to examine practices relating to end-of-life discussions with family members of people with advanced dementia residing in nursing homes and to explore strategies for improving practice. METHODS: An ethnographic study in two nursing homes where the Compassion Intervention was delivered...
July 7, 2016: BMC Palliative Care
Yvonne Dexter
The sudden or anticipated death of a child is one of the most challenging and unique experiences that children's nursing students will encounter in practice. There is evidence to suggest that the effect this can have on a practitioner can affect quality of care. Although education for nurses about dealing with death has been studied, there is limited research into the education of those working with dying children and how effective it is in preparing them to deal with the situation. This deficit presents those involved in children's nurse education with a significant challenge and an opportunity to be innovative...
June 8, 2016: Nursing Children and Young People
Ching-Chi Huang, Jih-Yuan Chen, Hsien-Hsien Chiang
BACKGROUND: Despite the recent increase in attention to end-of-life hospice care, little empirical evidence regarding the process of emotional or mental transformation in caregivers is available. PURPOSE: This study explores the transformative process that occurs in nurses because of the spiritual suffering and conflict associated with after caring for dying patients. METHODS: A phenomenological approach was used to investigate eight nurses (27-40 years old) working in the hospice ward of a medical center in Taipei...
June 2016: Journal of Nursing Research: JNR
Jane Fleming, Morag Farquhar, Carol Brayne, Stephen Barclay
INTRODUCTION: Increasing longevity means more people will be dying in very old age, but little is known about the preferences of the 'oldest old' regarding their care at the end of life. AIMS: To understand very old people's preferences regarding care towards the end of life and attitudes towards dying, to inform policy and practice. METHODS: Qualitative data collection for n = 42 population-based cohort study participants aged 95-101 (88% women, 42% in long-term-care): topic-guided interviews with n = 33 participants and n = 39 proxy informants, most with both (n = 30: 4 jointly + separate interviews for 26 dyads)...
2016: PloS One
J Centofanti, M Swinton, J Dionne, A Barefah, A Boyle, A Woods, M Shears, D Heels-Ansdell, D Cook
OBJECTIVE: The objectives of this study were to describe residents' experiences with end-of-life (EOL) education during a rotation in the intensive care unit (ICU), and to understand the possible influence of the 3 Wishes Project. DESIGN: We enrolled dying patients, their families and 1-3 of their clinicians in the 3 Wishes Project, eliciting and honouring a set of 3 wishes to bring peace to the final days of a critically ill patient's life, and ease the grieving process for families...
March 31, 2016: BMJ Open
Xiaoli Gu, Menglei Chen, Minghui Liu, Zhe Zhang, Wenwu Cheng
PURPOSE: Different countries have various decision-making practices, which are formalized according to laws, rules, traditions, religious beliefs, and ethical views of different cultural backgrounds. We investigated the characteristics and factors associated with the decision-making details in terminally ill cancer patients in a tertiary cancer center in Shanghai, China. METHOD: A single center, retrospective study was performed among advanced cancer patients who died between March 2007 and December 2013 in ward at Palliative Care Unit, Fudan University Shanghai Cancer Center...
May 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Vasiliki Rahimzadeh, Gillian Bartlett, Cristina Longo, Laura Crimi, Mary Ellen Macdonald, Nada Jabado, Carolyn Ells
BACKGROUND: This paper defends the ethical and empirical significance of direct engagement with terminally ill children and adolescents in PPC research on health-related quality of life. Clinical trials and other forms of health research have resulted in tremendous progress for improving clinical outcomes among children and adolescents diagnosed with a life-threatening illness. Less attention has been paid, however, to engaging this patient population directly in studies aimed at optimizing health-related quality of life in PPC...
October 16, 2015: BMC Palliative Care
Kenji Mizumoto, Akira Endo, Gerardo Chowell, Yuichiro Miyamatsu, Masaya Saitoh, Hiroshi Nishiura
BACKGROUND: An outbreak of the Middle East respiratory syndrome (MERS), comprising 185 cases linked to healthcare facilities, occurred in the Republic of Korea from May to July 2015. Owing to the nosocomial nature of the outbreak, it is particularly important to gain a better understanding of the epidemiological determinants characterizing the risk of MERS death in order to predict the heterogeneous risk of death in medical settings. METHODS: We have devised a novel statistical model that identifies the risk of MERS death during the outbreak in real time...
September 30, 2015: BMC Medicine
Guido Fanelli, Thomas R Tölle, José DE Andrés, Winfried Häuser, Massimo Allegri, Silvana Montella, Hans G Kress
Opioid analgesics are important therapeutic options for chronic non-cancer pain (CNCP), recognized as a major public health issue with high social and economic burden. The increasing therapeutic opioid use for CNCP, misuse and abuse of prescription opioids have become matters of severe concern in USA. The recent position paper of the American Academy of Neurology (AAN) about the use of opioids in USA expresses growing alarms about opioid misuse/abuse, and has alerted physicians worldwide to rethink about their prescription practice...
January 2016: Minerva Anestesiologica
Michael Nair-Collins
The effort to develop international guidelines for determination of death purports to start with an objective examination of the biology of death. So far, however, it is showing once again how moral and metaphysical claims about death masquerade as scientific facts.
November 2015: Hastings Center Report
Darla D Beaty
Three principles that guide the bioethics movement in the United States and other Western societies apply to the approaches of death and dying in both the United States and Turkey. These three principles, Autonomy, Beneficence, and justice, are reflected in the practices of people in both countries. The issue of autonomy is of greater concern to those in the United States, while decisions are made entirely with family and physician involvement in Turkey. Beneficence and Justice can be identified as ethical issues in both countries...
2015: Omega
Vibha Dwivedi, Shweta Tiwary, Subhash C Lakhotia
Earlier we showed formulation-specific beneficial effects of dietary supplement of Ayurvedic Amalaki Rasayana (AR, a herbal formulation) and Rasa-Sindoor (RS, a mercury-based organo-metallic formulation) on various biological parameters in Drosophila, parallel to traditional Ayurvedic literature. These formulations also suppressed cell death and pathology in fly models of neurodegeneration. To understand basis of inhibition of apoptosis, we examined effects of AR and RS on induced and developmental apoptosis in Drosophila...
June 2015: Journal of Biosciences
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