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End of life discussions

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https://www.readbyqxmd.com/read/29775556/let-s-talk-about-it-supporting-family-communication-during-end-of-life-care-of-pediatric-patients
#1
Meghan L Marsac, Christine Kindler, Danielle Weiss, Lindsay Ragsdale
BACKGROUND: Communication is key in optimizing medical care when a child is approaching end of life (EOL). Research is yet to establish best practices for how medical teams can guide intrafamily communication (including surviving siblings) when EOL care is underway or anticipated for a pediatric patient. While recommendations regarding how medical teams can facilitate communication between the medical team and the family exist, various barriers may prevent the implementation of these recommendations...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29774649/end-of-life-trajectory-of-coping-and-self-care-of-patients-with-idiopathic-pulmonary-fibrosis-a-meta-synthesis-using-meta-ethnography
#2
Yasuko Igai
AIM: This study aimed to extract patient narratives regarding the end-of-life trajectory of their self-care and coping experiences as patients with idiopathic pulmonary fibrosis and to use meta-ethnography to discover common metaphors of their experience in order to inform the development of nursing interventions. METHODS: A comprehensive search of qualitative research using electronic databases, in English and Japanese, regarding patients with IPF, identified four articles...
May 17, 2018: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/29774476/japanese-physicians-attitudes-toward-end-of-life-discussion-with-pediatric-patients-with-cancer
#3
Saran Yoshida, Chitose Ogawa, Ken Shimizu, Mariko Kobayashi, Hironobu Inoguchi, Yoshio Oshima, Chikako Dotani, Rika Nakahara, Masashi Kato
PURPOSE: We explored pediatricians' practices and attitudes concerning end-of-life discussions (EOLds) with pediatric patients with cancer, and identified the determinants of pediatricians' positive attitude toward having EOLds with pediatric patients. METHODS: A multicenter questionnaire survey was conducted with 127 pediatricians specializing in the treatment of pediatric cancer. RESULTS: Forty-two percent of participants reported that EOLds should be held with the young group of children (6-9 years old), 68% with the middle group (10-15 years old), and 93% with the old group (16-18 years old)...
May 17, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29772308/prostheses-as-extensions-of-the-body-progress-and-challenges
#4
REVIEW
Maria Niedernhuber, Damiano G Barone, Bigna Lenggenhager
Recent years have seen a surge of interest in the incorporation of artificial limbs. This research promises to provide individuals with sensorimotor disorders such as amputations with prostheses which feel like their own body part. While neuroscience made a leap towards uncovering the basic neurocognitive mechanisms of bodily self-consciousness, the development of incorporated prosthetic limbs still faces substantial challenges in basic neuroscience and in clinical reality. Here we critically examine recent findings on prosthesis incorporation to aid patient rehabilitation in the context of advances in cognitive and applied neuroscience as well as technology...
May 14, 2018: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/29771249/-new-italian-law-about-end-of-life-self-determination-and-shared-care-pathway
#5
Rosagemma Ciliberti, Matteo Gulino, Ilaria Gorini
The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Taking into consideration the Italian deontological and juridical context, along with the main jurisprudential judgements, the law has been analysed. The Authors discussed the new rules and the bioethical issues also in relation to the provisions stated by the Convention on Human Rights and Biomedicine (Convention of Oviedo)...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#6
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29767578/-death-is-difficult-in-any-language-a-qualitative-study-of-palliative-care-professionals-experiences-when-providing-end-of-life-care-to-patients-from-culturally-and-linguistically-diverse-backgrounds
#7
Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth A Lobb
BACKGROUND: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care. AIM: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture...
May 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29766727/-human-life-as-goodness-why-euthanasia-is-morally-unacceptable
#8
David Černý
The current discussion of the moral admissibility or inadmissibility of euthanasia should, in my opinion, consider the greatest possible number of the shared premises of the two opinion camps. That is why I followed a thesis in this paper that the question of the good life is the focus of ethical interest, as this is what connects the advocates and the opponents to euthanasia. In the first part of the paper I critically discuss the two main theories of the good life widely embraced among the advocates of euthanasia: hedonism and desire-fulfilment theory...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29764323/swaps-and-chains-and-vouchers-oh-my-evaluating-how-saving-more-lives-impacts-the-equitable-allocation-of-live-donor-kidneys
#9
Evelyn M Tenenbaum
Live kidney donation involves a delicate balance between saving the most lives possible and maintaining a transplant system that is fair to the many thousands of patients on the transplant waiting list. Federal law and regulations require that kidney allocation be equitable, but the pressure to save patients subject to ever-lengthening waiting times for a transplant has been swinging the balance toward optimizing utility at the expense of justice. This article traces the progression of innovations created to make optimum use of a patient's own live donors...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29764322/biting-the-hands-that-feed-the-alligators-a-case-study-in-morbid-obesity-extremes-end-of-life-care-and-prohibitions-on-harming-and-accelerating-the-end-of-life
#10
Michael J Malinowski
Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention ("CDC"), American Heart Association ("AHA"), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of "extreme morbid obesity" ("EMO")-situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29764178/compassionate-communities-in-canada-it-is-everyone-s-responsibility
#11
Bonnie Tompkins
Prof. Allan Kellehear first developed a contemporary public health approach to palliative and end-of-life care. Countries around the world have since adopted the theory of practice that mobilizes palliative care as a public health issue-particularly the Compassionate Communities (CC) model. In the wake of Canada's Medical Assistance in Dying (MAiD) legislation and its growing senior population, quality palliative care has enjoyed a renewed focus. Pallium Canada is helping communities across the country understand and adopt the CC model, through education, knowledge mobilization, project facilitation, and leadership...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29764175/caring-communities-as-collective-learning-process-findings-and-lessons-learned-from-a-participatory-research-project-in-austria
#12
Klaus Wegleitner, Patrick Schuchter
BACKGROUND: By now, the public health end-of-life care approach is well established and has induced diverse initiatives-subsumed under the concept of compassionate or caring communities-to engage the community in supporting vulnerable, dying people and their beloved ones. In the light of a participatory research project our paper examines the question: what are the deeper ideas behind caring communities and what constitutes a caring community? METHODS: A multi-level analysis based on (I) qualitative research with focus groups and interviews with community members within the project; (II) the reflection of the role of participatory research in caring community initiatives, and (III) the meta-analysis of an international expert workshop, which allowed to discuss our experiences and insights in the light of international caring community models and expertise...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29763344/from-the-valley-of-death-to-the-crossroads-of-opportunity-a-discussion-of-evolving-benefit-risk-evaluation-standards
#13
Peter J Pitts, Patrick Brady
A series of recent US Food and Drug Administration (FDA) approvals (such as Sarepta's Exondys 51, Merck's Keytruda, and Portola's Bevyxxa) has generated significant interest within the drug development ecosystem. Facilitated regulatory pathways aimed toward expediting medicines to patients suffering from serious and life-threatening conditions are a good thing, even if it raises curiosity and introduces some degree of uncertainty. Over the last 20 years, two key words in drug development have been speed and innovation...
January 1, 2018: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/29761752/addressing-cancer-patient-and-caregiver-role-transitions-during-home-hospice-nursing-care
#14
Janella Hudson, Maija Reblin, Margaret F Clayton, Lee Ellington
OBJECTIVE: Many family caregivers and hospice patients experience role changes resulting from advancing illness and the need for increased caregiver responsibility. Successful navigation of conflicts that arise because of these role transitions has been linked to higher quality of patient care and improved caregiver bereavement adjustment. Nursing communication with patients and their caregivers plays an important role in facilitating these transitions. Our objective is to describe patient-caregiver-nurse communication during transitions at end of life...
May 15, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29757843/strategies-used-to-facilitate-the-discussion-of-advance-care-planning-with-older-adults-in-primary-care-settings-a-literature-review
#15
Guillermina R Solis, Bibiana M Mancera, Megan Johnson Shen
BACKGROUND AND PURPOSE: The purpose of this literature review was to evaluate strategies used in primary care settings to initiate advance care planning (ACP) conversations leading to the completion of an advance directive (AD). Approximately 50% of older adults have an AD; few talk to their primary care provider (PCP) about end-of-life wishes. The Institute of Medicine report and recent changes in Medicare reimbursement policies create opportunities for PCPs to address ACP in primary care settings...
May 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757818/surrogates-experiences-of-engaging-in-physician-orders-for-life-sustaining-treatment-discussions-for-persons-with-advanced-dementia
#16
Hyejin Kim, Christine Bradway, Susan E Hickman, Mary Ersek
BACKGROUND AND PURPOSE: Little is known about surrogates' experiences of engaging in Physician Orders for Life-Sustaining Treatment (POLST) discussions. This study describes family surrogates' experiences when engaging in POLST discussions with primary care providers. METHODS: Semistructured interviews were conducted with 10 family surrogates of individuals with advanced dementia who were enrolled in a Program of All-Inclusive Care for the Elderly or resided in a nursing home...
February 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757106/a-snapshot-of-australian-social-workers-in-palliative-care-and-their-work-with-estranged-clients
#17
Kylie Agllias
This paper describes a mixed method survey that was administered to a group of Australian palliative care social workers (n = 27). Specifically, it aimed to investigate the ways that social workers understood and worked with clients who were estranged from family at the end of life. Respondents suggested that estrangement potentially impacted clients emotionally, practically, and existentially. They were challenged to make clear assessments, provide emotional support, encourage news ways of thinking about estrangement, to manage practical issues, work with the client's family, and monitor their own professional role...
May 14, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29756557/barriers-to-end-of-life-discussions-among-hematologists-a-qualitative-study
#18
Chloé Prod'homme, Dominique Jacquemin, Licia Touzet, Regis Aubry, Serge Daneault, Laurent Knoops
BACKGROUND: Integrated palliative care is correlated with earlier end-of-life discussion and improved quality of life. Patients with haematological malignancies are far less likely to receive care from specialist palliative or hospice services compared to other cancers. AIM: The main goal of this study was to determine hematologists' barriers to end-of-life discussions when potentially fatal hematological malignancies recur. DESIGN: Qualitative grounded theory study using individual interviews...
May 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#19
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29752324/dances-with-denial-have-medical-oncology-outpatients-conveyed-their-end-of-life-wishes-and-do-they-want-to
#20
Amy Waller, Charles Douglas, Rob Sanson-Fisher, Nicholas Zdenkowski, Angela Pearce, Tiffany Evans, Justin Walsh
Objectives: This study surveyed a sample of medical oncology outpatients to determine (1) the proportion who have already discussed and documented their end-of-life (EOL) wishes; (2) when and with whom they would prefer to convey their EOL wishes; (3) the EOL issues they would want to discuss; and (4) the association between perceived cancer status and advance care planning (ACP) participation. Methods: Adult medical oncology outpatients were approached in the waiting room of an Australian tertiary treatment center...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
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