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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/28426395/compassion-fatigue-and-compassion-satisfaction-in-hospice-social-work
#2
Sally B Pelon
As part of the interprofessional team of hospice caregivers, social workers are exposed to multiple stressors, both in their work with dying patients and their families and in functioning as professionals within rapidly changing health care organizations. Ongoing exposure to such stressors prompts concern about the emotional and psychological effect working with people who are dying may have on those who do it. Further, an understanding is needed regarding how hospice social workers interpret the costs and benefits of their work and how they cope with the dying and loss that pervade their everyday work lives...
April 20, 2017: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/28425929/contradictions-and-promise-for-end-of-life-communication-among-family-and-friends-death-over-dinner-conversations
#3
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
#4
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/28423917/management-of-opioid-induced-constipation-in-hospice-patients
#5
Leah Sera, Mary Lynn McPherson
BACKGROUND: Constipation is a common symptom in patients with advanced disease taking opioids. Opioid-induced constipation (OIC) is commonly treated with laxatives and stool softeners. Recently, newer agents have come to market which broaden options for patients in whom first-line therapies are not effective. OBJECTIVE: To determine what pharmacologic regimens are currently used in hospice programs to prevent and treat OIC, whether those regimens have changed with the introduction of newer agents and evidence discouraging the use of docusate, and whether hospice programs are standardizing the management of OIC...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28421919/the-power-of-music
#6
Rosie Emsley
At the end of the first year of my nursing degree I spent my clinical placement in a hospice, where the majority of patients were admitted for palliative care.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#7
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
#8
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
#9
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/28408618/national-policies-fostering-hospice-care-increased-hospice-utilization-and-reduced-the-invasiveness-of-end-of-life-care-for-cancer-patients
#10
Yu-Yun Shao, Emily Han-Chung Hsiue, Chih-Hung Hsu, Chien-An Yao, Ho-Min Chen, Mei-Shu Lai, Ann-Lii Cheng
BACKGROUND: In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed the impact of these national policies. METHODS: A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28406340/team-functioning-in-hospice-interprofessional-meetings-an-exploratory-study-of-providers-perspectives
#11
Karla T Washington, Yuqi Guo, David L Albright, Alexandria Lewis, Debra Parker Oliver, George Demiris
Interprofessional collaboration is the foundation of hospice service delivery. In the United States, hospice agencies are required to regularly convene interprofessional meetings during which teams review plans of care for the patients and families they serve. A small body of research suggests that team functioning could be significantly enhanced in hospice interprofessional meetings; however, systematic investigation of this possibility has been limited to date. The purpose of this qualitative study was to better understand the experiences and perspectives of hospice providers who regularly participate in interprofessional meetings as a first step toward improving teamwork in this setting...
April 13, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28404600/qualitative-interviews-exploring-palliative-care-perspectives-of-latinos-on-dialysis
#12
Lilia Cervantes, Jacqueline Jones, Stuart Linas, Stacy Fischer
BACKGROUND AND OBJECTIVES: Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015...
April 12, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#13
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
#14
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
#15
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
#16
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/28388292/end-of-life-racial-and-ethnic-disparities-among-patients-with-ovarian-cancer
#17
Jolyn S Taylor, Suja S Rajan, Ning Zhang, Larissa A Meyer, Lois M Ramondetta, Diane C Bodurka, David R Lairson, Sharon H Giordano
Purpose To assess disparities in end-of-life care among patients with ovarian cancer. Patients and Methods Using Texas Cancer Registry-Medicare data, we assessed patients with ovarian cancer deceased in 2000 to 2012 with at least 13 months of continuous Medicare coverage before death. Descriptive statistics and multivariate logistic regressions were conducted to evaluate end-of-life care, including chemotherapy in the final 14 days of life, intensive care unit (ICU) admission in the final 30 days of life, more than one emergency room (ER) or hospital admission in the final 30 days of life, invasive or life-extending procedures in the final 30 days of life, enrollment in hospice, enrollment in hospice during the final 3 days of life, and enrollment in hospice while not hospitalized...
April 7, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28384683/characterizing-18-years-of-the-death-with-dignity-act-in-oregon
#18
Charles Blanke, Michael LeBlanc, Dawn Hershman, Lee Ellis, Frank Meyskens
Importance: Numerous states have pending physician-aided dying (PAD) legislation. Little research has been done regarding use of PAD, or ways to improve the process and/or results. Objectives: To evaluate results of Oregon PAD, the longest running US program; to disseminate results; and to determine promising PAD research areas. Design, Setting, and Participants: A retrospective observational cohort study of 991 Oregon residents who had prescriptions written as part of the state's Death with Dignity Act...
April 6, 2017: JAMA Oncology
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
#19
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/28380721/planning-ahead
#20
Lusine Nahapetyan, Pamela Orpinas, Anne Glass, Xiao Song
Hospice is underutilized in the United States, and many patients enroll for short periods of times. The purpose of this cross-sectional study was to identify significant predictors of intentions to use hospice in community-dwelling older adults. The Theory of Planned Behavior informed the selection of predictors. Data were collected from 146 White older adults ( M age = 69.5; 69% females). Multiple linear regression analyses showed that higher hospice knowledge, normative beliefs that support hospice utilization, higher perceived control to use hospice, and preferences for end-of-life care that favor comfort and quality of life over living as long as possible were significant predictors of intentions to use hospice...
February 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
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