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https://www.readbyqxmd.com/read/28548914/quality-of-paediatric-hospice-care-for-children-with-and-without-multiple-complex-chronic-conditions
#1
Lisa C Lindley, Jessica Keim-Malpass
BACKGROUND: Hospice care for children with multiple complex chronic conditions (MCCC) is complicated given their unique health at the end of life (EOL). Little is known about the quality of the hospice care MCCC children receive and how that might differ from children without MCCC. OBJECTIVE: To compare the quality of hospice care (i.e., structures, processes, outcomes) between children with and without MCCC. METHODS: This retrospective, comparative study used data from the National Home and Hospice Care Survey, which included a nationally representative sample of paediatric hospice patients...
May 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28546269/towards-an-expert-consensus-to-delineate-a-clinical-syndrome-of-chronic-breathlessness
#2
Miriam J Johnson, Janelle Yorke, John Hansen-Flaschen, Robert Lansing, Magnus Ekström, Thomas Similowski, David C Currow
Breathlessness that persists despite treatment for the underlying conditions is debilitating. Identifying this discrete entity as a clinical syndrome should raise awareness amongst patients, clinicians, service providers, researchers and research funders.Using the Delphi method, questions and statements were generated via expert group consultations and one-to-one interviews (n=17). These were subsequently circulated in three survey rounds (n=34, n=25, n=31) to an extended international group from various settings (clinical and laboratory; hospital, hospice and community) and working within the basic sciences and clinical specialties...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28542833/why-are-patients-with-blood-cancers-more-likely-to-die-without-hospice
#3
Oreofe O Odejide, Angel M Cronin, Craig C Earle, James A Tulsky, Gregory A Abel
BACKGROUND: Although patients with blood cancers have significantly lower rates of hospice use than those with solid malignancies, data explaining this gap in end-of-life care are sparse. METHODS: In 2015, we conducted a mailed survey of a randomly selected sample of hematologic oncologists in the United States to characterize their perspectives regarding the utility and adequacy of hospice for blood cancer patients, as well as factors that might impact referral patterns...
May 22, 2017: Cancer
https://www.readbyqxmd.com/read/28542732/impact-of-subsequent-metastases-on-costs-and-medical-resource-use-for-prostate-cancer-patients-initially-diagnosed-with-localized-disease
#4
Tracy T Li, Neal D Shore, Maneesha Mehra, Mary B Todd, Ryan Saadi, Gaetan Leblay, Jyoti Aggarwal, Robert I Griffiths
BACKGROUND: The impact of subsequent metastases on costs and medical resource use (MRU) for prostate cancer (PC) patients initially diagnosed with localized disease was estimated. METHODS: Surveillance, Epidemiology, and End Results data, linked to Medicare (1999-2012), were used to identify 7482 patients diagnosed with subsequent metastases 12 months or more after the initial diagnosis of localized PC (cases), and they were matched to 25,709 localized PC patients without subsequent metastases (controls)...
May 23, 2017: Cancer
https://www.readbyqxmd.com/read/28541991/advance-care-planning-the-nurse-s-role
#5
Shigeko Izumi
: This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.
June 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28539976/a-review-of-specialist-palliative-care-provision-and-access-across-london-mapping-the-capital
#6
Sarah Cox, Fliss E M Murtagh, Adrian Tookman, Andrew Gage, Nigel Sykes, Maureen McGinn, Meeta Kathoria, Hilary Wilderspin, Liz Chart
Palliative care provision varies by diagnosis, geography, and setting. The Minimum Data-set provides high-level data on provision, but comprehensive comparative information about specialist palliative care (SPC) provision is lacking. The London Cancer Alliance - now RM Partners' Accountable Cancer Network - palliative care group (West/South London) and PallE8 (North/East London), with Marie Curie, sought to address this gap. The aim was to provide comparative data on SPC provision across London to support commissioners and providers to assess provision, identify gaps, and reduce inequity...
May 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/28537965/the-affordable-care-act-and-end-of-life-care-for-patients-with-cancer
#7
Ravi B Parikh, Alexi A Wright
The Affordable Care Act (ACA) expanded access to high-quality end-of-life care for Americans with serious illness, including cancer. Before the ACA was enacted in 2010, nearly 715,000 patients died in hospitals annually, despite evidence that most Americans prefer to die at home. Moreover, fewer than half of Medicare beneficiaries used hospice before death, despite evidence that hospice services improve cancer patients' quality of life near death and caregivers' bereavement outcomes. The ACA-stipulated programs and subsequent efforts were designed to address these deficiencies in access to high-quality end-of-life care...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28532723/self-reported-frequency-of-nurse-provided-spiritual-care
#8
Elizabeth Johnston Taylor, Iris Mamier, Patricia Ricci-Allegra, Joanne Foith
AIM: To describe how frequently RNs provide 17 spiritual care therapeutics (or interventions) during a 72-80h timeframe. BACKGROUND: Plagued by conceptual muddiness as well as weak methods, research quantifying the frequency of spiritual care is not only methodologically limited, but also sparse. METHODS: Secondary analysis of data from four studies that used the Nurse Spiritual Care Therapeutics Scale (NSCTS). Data from US American RNs who responded to online surveys about spiritual care were analyzed...
June 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#9
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#10
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28527242/-small-cell-lung-cancer-associated-with-multiple-paraneoplastic-syndromes
#11
Diana L Franco, Leslie Thomas
We report the case of a patient presenting with multiple severe electrolyte disturbances who was subsequently found to have small cell lung cancer. Upon further evaluation, she demonstrated three distinct paraneoplastic processes, including the syndrome of inappropriate antidiuretic hormone, Fanconi syndrome, and an inappropriate elevation in fibroblast growth factor-23 (FGF23). The patient underwent one round of chemotherapy, but she was found to have progressive disease. After 36 days of hospitalization, the patient made the decision to enter hospice care and later she expired...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28523210/care-pathway-for-cancer-survivorship-in-korea-trend-of-breast-cancer-pathway-from-2003-to-2010
#12
Hwa Jeong Seo, Dong Yong Noh
OBJECTIVES: The survival rate of cancer patients has exceeded 60%. Although cancer survivors may die of other diseases except cancer, the health management system including chronic disease prevention-management for cancer survivors, has not been established in the diverse aspects. Therefore, services according to care pathway of cancer patients need to be provided through a support system based on a platform concept that can be used to meet patient needs in various ways. METHODS: A sample cohort database (2002-2010) of approximately 1 million persons-2% of the whole nation (50 million)-was used to estimate cancer survivors through a principal care pathway for cancer management...
April 2017: Healthcare Informatics Research
https://www.readbyqxmd.com/read/28514908/using-action-learning-sets-to-support-change-in-end-of-life-care
#13
Karen Gillett, Liz Reed, Liz Bryan
Purpose The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course. Design/methodology/approach The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period...
May 2, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28513869/transition-of-intravenous-treprostinil-to-oral-therapy-in-a-patient-with-functional-class-iv-chronic-thromboembolic-pulmonary-hypertension
#14
Kristina M Thurber, Breann M Williams, Ruth E Bates, Robert P Frantz
Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual CTEPH, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with CTEPH may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42-year-old man with T12 paraplegia complicated by CTEPH (functional class IV with substantial right ventricular dysfunction) and severe pressure ulcers...
May 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28511720/identifying-models-of-delivery-care-domains-and-quality-indicators-relevant-to-palliative-day-services-a-scoping-review-protocol
#15
Seán R O'Connor, Martin Dempster, Noleen K McCorry
BACKGROUND: With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services...
May 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28507429/factors-associated-with-the-attitudes-of-oncology-nurses-toward-hospice-care-in-china
#16
Fei-Min Yang, Zhi-Hong Ye, Lei-Wen Tang, Wei-Lan Xiang, Lin-Juan Yan, Min-Li Xiang
OBJECTIVE: To examine factors that are associated with the apprehension levels of oncology nurses toward hospice care. Factors examined in this study included demographics, nursing experience, education levels, title and post, personal experiences, and attitudes toward end-of-life care. METHODS: Questionnaires were provided to nurses (n=201) from three first-tier hospitals in China. A quantitative scale, Professional End-of-life Care Attitude Scale (PEAS), was used to assess personal and professional apprehension levels toward hospice care...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28506145/areas-of-control-desired-by-patients-and-families-referred-to-hospice-care-perspectives-of-hospice-admissions-staff
#17
Hyunjin Noh
Sense of control in end-of-life (EOL) care plays a critical role in the patient's well-being. However, little is known about the areas of control essential to patients and families at a specific time point in the illness trajectory: when patients stop curative treatments and are referred to hospice. This study qualitatively explored such areas. Sixteen admissions staff members from four hospice agencies were interviewed about their perceptions of areas in which patients and families worried about losing control by accepting hospice...
May 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28502400/bags-batteries-and-boxes-a-qualitative-interview-study-to-understand-how-syringe-drivers-are-adapted-and-used-by-healthcare-staff
#18
Christopher James Vincent, Ann Blandford
Syringe drivers are medical devices that are critical for end of life care. They deliver continuous medication over extended periods of time. Their design contributes to the quality of experience for both patients and healthcare professionals. Little research has been published about the factors that influence the usability of this type of equipment for frontline users (i.e. those in direct contact with patients) and how equipment gets introduced. Understanding how syringe drivers are used in practice can help improve the design of equipment...
September 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28494634/changing-place-of-death-in-children-who-died-after-discharge-from-paediatric-intensive-care-units-a-national-data-linkage-study
#19
Lorna K Fraser, Sarah Fleming, Roger Parslow
BACKGROUND: Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. AIM: To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. DESIGN: National data linkage study. SETTING/PARTICIPANTS: All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28491911/navigating-long-term-care
#20
James D Holt
Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States...
January 2017: Gerontology & Geriatric Medicine
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