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https://www.readbyqxmd.com/read/29331475/end-of-life-care-for-patients-with-advanced-kidney-disease-in-the-us-veterans-affairs-health-care-system-2000-2011
#1
Susan P Y Wong, Margaret K Yu, Pamela K Green, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare
BACKGROUND: Little is known about patterns of end-of-life care for patients with advanced kidney disease not treated with maintenance dialysis. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: A sample of 14,071 patients with sustained estimated glomerular filtration rates < 15mL/min/1.73m2 treated in the US Veterans Affairs health care system who died during 2000 to 2011. Before death, 12,756 of these patients had been treated with dialysis, 503 had been discussing and/or preparing for dialysis therapy, and for 812, there had been a decision not to pursue dialysis therapy...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29327100/-provision-of-palliative-care-for-people-with-advanced-dementia
#2
REVIEW
J Diehl-Schmid, L Riedl, U Rüsing, J Hartmann, M Bertok, C Levin, J Hamann, M Arcand, S Lorenzl, B Feddersen, R J Jox
As a result of a literature-based expert process, this review provides an overview about the principles of palliative care for people with advanced dementia that are relevant for clinical practice. In particular, the indications, impact and aims of palliative care for advanced dementia are described. Life-prolonging measures and management of symptoms at the end of life are discussed. Furthermore, the overview focuses on the legal basis of decision making.
January 11, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29323412/microsystems-of-recovery-in-homeless-services-the-influence-of%C3%A2-service-provider-values-on-service-users-recovery-experiences
#3
Rachel M Manning, Ronni Michelle Greenwood
There is still much to learn about how aspects of the ecology of homelessness shape homeless adults' recovery experiences. In the present mixed-methods study, the relationship of service providers' work-related values to their service users' recovery experiences in the microsystem of homelessness were examined. Service providers completed semi-structured qualitative interviews about their service users, daily work activities, and work-related goals. At three time points, their service users completed quantitative measures of choice, mastery, and recovery in four life domains: physical health, psychiatric symptoms, substance use, and community integration...
January 11, 2018: American Journal of Community Psychology
https://www.readbyqxmd.com/read/29321079/the-enactment-stage-of-end-of-life-decision-making-for-children
#4
Jane Elizabeth Sullivan, Lynn Heather Gillam, Paul Terence Monagle
OBJECTIVES: Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process...
January 11, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29317084/-reversal-of-neuromuscular-block-with-sugammadex-in-five-heart-transplant-pediatric-recipients
#5
Ricardo Vieira Carlos, Marcelo Luis Abramides Torres, Hans Donald de Boer
Heart transplantation is a frequent procedure in the treatment of end-stage cardiac dysfunction. Therefore, these patient populations will also be more frequent exposed to other more common surgical procedures after their transplantation. Anesthesiologist should be aware in their assessment of these patients, especially regarding some specific issues related to patients with a history of heart transplantation, like reversal of neuromuscular block. Several reports described that cholinesterase inhibitors drugs, like neostigmine, may produce a dose-dependent life-threatening bradycardia in heart transplant recipients while other publication described the safe use of neostigmine...
January 6, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#6
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29310331/eliciting-community-perspectives-on-research-with-older-adults-living-with-hiv-through-focus-groups
#7
Annie L Nguyen, Brandon Brown, Jeff Taylor, Marlene Estevez, Rick Loftus
Approximately half of all people living with HIV in the US are age 50 and older. Existing research highlights the health challenges of these individuals, but little work has focused on gathering input about concerns in participating in HIV and aging research. Prior to designing a prospective cohort study on HIV and aging, we elicited feedback from potential participants on general attitudes toward participation in a prospective HIV cohort study, and perspectives on important research topics relevant to older adults living with HIV...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29305321/factors-associated-with-symptom-relief-in-end-of-life-care-in-residential-care-homes-a-national-register-based-study
#8
Sofia Andersson, Kristofer Årestedt, Olav Lindqvist, Carl-Johan Fürst, Margareta Brännström
BACKGROUND: Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. AIM: To explore the presence of symptoms and symptom relief, and identify factors associated with symptom relief of pain, nausea, anxiety, and shortness of breath among RCH residents in end-of-life care. METHOD: The data consisted of all expected deaths at RCHs registered in the Swedish Register of Palliative Care (n=22 855)...
January 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29302827/colonic-perforation-due-to-severe-cytomegalovirus-disease-in-granulomatosis-with-polyangiitis-after-immunosuppression
#9
REVIEW
Alessandra Soriano, Nazareno Smerieri, Stefano Bonilauri, Loredana De Marco, Alberto Cavazza, Carlo Salvarani
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients...
January 4, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29302599/what-are-the-ethical-aspects-surrounding-the-collegial-decisional-process-in-limiting-and-withdrawing-treatment-in-intensive-care
#10
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
The decision to limit or withdraw life-support treatment is an integral part of the job of a physician working in the intensive care unit, and of the approach to care. However, this decision is influenced by a number of factors. It is widely accepted that a medical decision that will ultimate lead to end-of-life in the intensive care unit (ICU) must be shared between all those involved in the care process, and should give precedence to the patient's wishes (either directly expressed by the patient or in written form, such as advance directives), and taking into account the opinion of the patient's family, including the surrogate if the patient is no longer capable of expressing themselves...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29300970/patients-knowledge-and-attitudes-regarding-living-with-implantable-electronic-devices-results-of-a-multicentre-multinational-patient-survey-conducted-by-the-european-heart-rhythm-association
#11
Kristina Hermann Haugaa, Tatjana S Potpara, Serge Boveda, Jean-Calude Deharo, Jian Chen, Dan Dobreanu, Stefano Fumagalli, Radoslaw Lenarczyk, Antonio Hernandez Madrid, Torben Bjerregaard Larsen, Elena Sciarrafia, Milos Taborsky, Roland Richard Tilz, Paolo Pieragnoli, Andrzej Przybylski, Nikolaos Dagres
The purpose of this patient survey was to analyse the knowledge, experiences, and attitudes regarding cardiac implantable electronic devices (CIED) in patients with pacemakers, implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization devices. Of the 1644 patients with CIEDs from seven European countries, 88% were over 50 years of age. Most patients (90%) knew what device they were implanted with and felt sufficiently informed about the indications for therapy. As many as 42% of patients needed additional information on the battery replacement and limitations in physical activity...
December 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29300339/a-retrospective-review-of-resuscitation-planning-at-a-children-s-hospital
#12
Jean Kelly, Jo Ritchie, Leigh Donovan, Carol Graham, Anthony Herbert
Resuscitation plans (RP) are an important clinical indicator relating to care at the end of life in paediatrics. A retrospective review of the medical records of children who had been referred to the Royal Children's Hospital, Brisbane, Australia who died in the calendar year 2011 was performed. Of 62 records available, 40 patients (65%) had a life limiting condition and 43 medical records (69%) contained a documented RP. This study demonstrated that both the underlying condition (life-limiting or life-threatening) and the setting of care (Pediatric Intensive Care Unit or home) influenced the development of resuscitation plans...
January 4, 2018: Children
https://www.readbyqxmd.com/read/29298109/the-progression-of-end-of-life-wishes-and-concordance-with-end-of-life-care
#13
Jennifer Hopping-Winn, Juliette Mullin, Laurel March, Michelle Caughey, Melissa Stern, Jill Jarvie
Since 2013, Kaiser Permanente Northern California has engaged in a systematic effort to elicit, document, and honor the care preferences of patients as they near the end of life. This is done through its Advanced Steps program, in which selected patients discuss their preferences for future medical care with their healthcare agent during a structured conversation with a trained advance care planning facilitator. The facilitator then translates the patient's wishes into an actionable medical order set using a Physician's Order for Life-Sustaining Treatment (POLST) form...
January 3, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29295879/the-right-place-at-the-right-time-medical-oncology-outpatients-perceptions-of-location-of-end-of-life-care
#14
Amy Waller, Rob Sanson-Fisher, Nicholas Zdenkowski, Charles Douglas, Alix Hall, Justin Walsh
Background: Helping people achieve their preferred location of care is an important indicator of quality end-of-life (EOL) care. Using a sample of Australian medical oncology outpatients, this study examined (1) their preferred location of EOL care; (2) their perceived benefits and worries of receiving care in that location; (3) the percentage who had discussed preferences with their doctor and/or support person; and (4) whether they wanted their doctor to ask them where they wanted to die. Methods: Adults with a confirmed diagnosis of cancer were approached between September 2015 and January 2016 in the waiting room of an Australian oncology outpatient clinic...
January 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29290330/affective-science-and-avoidant-end-of-life-communication-can-the-science-of-emotion-help-physicians-talk-with-their-patients-about-the-end-of-life
#15
Jesse A Soodalter, Greg J Siegle, Michele Klein-Fedyshin, Robert Arnold, Yael Schenker
Despite believing end-of-life (EOL) discussions with patients are important, doctors often do not have them. Multiple factors contribute to this shortfall, which interventions including reimbursement changes and communication skills training have not significantly improved to date. One commonly cited but under-researched reason for physician avoidance of EOL discussion is emotional difficulty. High occupational demand for frequent difficult discussions may overload physicians' normal emotional functioning, leading to avoidance or failure...
December 11, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29290278/validation-of-the-decisional-conflict-scale-for-evaluating-advance-care-decision-conflict-in-community-dwelling-older-adults
#16
JinShil Kim, Shinmi Kim, Sun Woo Hong, Se-Won Kang, Minjeong An
PURPOSE: Decisional conflict is a significant and important barrier in end-of-life care planning, and it is often encountered in health professionals' discussions with patients and their families. Little is known about the measurement of decisional conflict, and existing measures are not suitable for all contexts. In this study, psychometric properties of the Decisional Conflict Scale, which was translated for the first time into Korean [Korean version of DCS (K-DCS)], were examined. METHODS: A sample of 273 community-dwelling elders was surveyed (mean age: 77...
December 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/29289656/accurate-prognostic-awareness-facilitates-whereas-better-quality-of-life-and-more-anxiety-symptoms-hinder-end-of-life-care-discussions-a-longitudinal-survey-study-in-terminally-ill-cancer-patients-last-six-months-of-life
#17
Siew Tzuh Tang, Chen Hsiu Chen, Fur-Hsing Wen, Jen-Shi Chen, Wen-Cheng Chang, Chia-Hsun Hsieh, Wen-Chi Chou, Ming-Mo Hou
BACKGROUND: Terminally ill cancer patients do not engage in end-of-life (EOL)-care discussions or do so only when death is imminent, despite guidelines for EOL-care discussions early in their disease trajectory. Most studies on patient-reported EOL-care discussions are cross-sectional without exploring the evolution of EOL-care discussions as death approaches. Cross-sectional studies cannot determine the direction of association between EOL-care discussions and patients' prognostic awareness, psychological well-being, and quality of life (QOL)...
December 28, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29288521/indigenous-cultural-competence-a-dental-faculty-curriculum-review
#18
C Forsyth, M Irving, M Tennant, S Short, J Gilroy
BACKGROUND: Indigenous Australians have more than double the rate of poor oral health than their non-Indigenous counterparts. Cultural competence of dental and oral health practitioners is fundamental to health care and quality of life in addressing health disparities in minority cultural groups in Australia. Higher education curricula reviews have identified the need for institutions to incorporate Indigenous culture and knowledge more widely into the curricula to improve educational outcomes for Indigenous Australians and to increase cultural competence for all students...
December 30, 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/29288287/a-contemporary-paradigm-integrating-spirituality-in-advance-care-planning
#19
Katie Lutz, Stefan R Rowniak, Prabjot Sandhu
In the 25 years since advance care planning first drew the attention of the national healthcare and legal systems, gains in the rate of advance care directive completion have been negligible despite the effort of researchers, ethicists, and lawmakers. With the benefit of sophisticated healthcare technology, patients are living longer. Despite the benefits of increased longevity, it is widely acknowledged that enough has not been done to adequately address end-of-life care decisions at the crossroads between medical futility and quality of life...
December 29, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29284551/family-care-conferences-in-long-term-care-exploring-content-and-processes-in-end-of-life-communication
#20
Pamela Durepos, Sharon Kaasalainen, Tamara Sussman, Deborah Parker, Kevin Brazil, Susan Mintzberg, Alyssa Te
OBJECTIVE: End-of-life (EoL) communication in long-term care (LTC) homes is often inadequate and delayed, leaving residents dying with unknown preferences or goals of care. Poor communication with staff contributes to families feeling unprepared, distressed, and dissatisfied with care. Family care conferences (FCCs) aim to increase structured systematic communication around goals and plans for the end of life. As part of the Strengthening a Palliative Approach to Care (SPA-LTC) project, FCCs were implemented in four LTC sites in Ontario, Canada...
December 29, 2017: Palliative & Supportive Care
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