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Poor end-of-life care

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https://www.readbyqxmd.com/read/28091431/determinants-of-quality-of-life-among-community-dwelling-persons-with-spinal-cord-injury-a-path-analysis
#1
End Ekechukwu, J O Ikrechero, A O Ezeukwu, A V Egwuonwu, L Umar, U M Badaru
CONTEXT: Recent advancement in technology and medical care has resulted in an increase not only in disability arising from spinal cord injury (SCI) but also its attendant challenges such as poor quality of life (QoL). AIM: To test a theoretical model of predictors of QoL among persons with SCI. SETTINGS AND DESIGN: Study was conducted in the South Eastern Nigeria. A longitudinal study design was employed. MATERIALS AND METHODS: A total of 64 persons with SCI discharged from in-hospital admission participated in this study...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28086849/successful-outcome-following-pneumonectomy-in-a-teenage-boy-with-cystic-fibrosis-a-case-report
#2
Zheyi Liew, Santosh Mallikarjuna, Asif Hasan, F Kate Gould, Su Bunn, Matthew F Thomas, Jim L Lordan, Christopher O'Brien, Malcolm Brodlie
BACKGROUND: Cystic fibrosis lung disease is generally a diffuse process however rarely one lung may become particularly damaged through chronic collapse and consolidation resulting in end-stage bronchiectasis with relative sparing of the contralateral lung. This clinical situation is sometimes referred to as "destroyed lung". Lung resection surgery is seldom indicated in cystic fibrosis and the associated medical literature is relatively sparse. CASE PRESENTATION: A 14 year old boy was referred to our centre for lung transplantation assessment...
January 13, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28039504/end-of-life-care-for-head-and-neck-cancer-patients-a-population-based-study
#3
Tzu-Lung Kuo, Ching-Heng Lin, Rong-San Jiang, Ting-Ting Yen, Chen-Chi Wang, Kai-Li Liang
PURPOSE: Head and neck cancers (HNCs) usually present a poor prognosis and cause high morbidity rates. Recent surveys have demonstrated that HNC incidence rates are still on the increase in many countries. Our study objective was to assess the end-of-life care for patients with HNCs in Taiwan. METHODS: Data was retrieved from Taiwan's National Health Insurance Research Database, where we identified patients who had been diagnosed with HNCs from January 1997 to December 2010...
December 30, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28029300/hospice-utilization-and-its-effect-on-acute-care-needs-at-the-end-of-life-in-medicare-beneficiaries-with-hepatocellular-carcinoma
#4
Hanna K Sanoff, YunKyung Chang, Melissa Reimers, Jennifer L Lund
INTRODUCTION: Hepatocellular carcinoma (HCC) is a poor-prognosis cancer with a high symptom burden. Multidisciplinary HCC care is complex and unique in cancer medicine. We sought to determine whether the distinct process affects hospice use and how hospice affects end-of-life acute care utilization. PATIENTS AND METHODS: Patients dying after HCC diagnosed from 2004 to 2011 were identified within SEER-Medicare. Hospice use and associated factors were described using logistic regression...
December 28, 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27997278/the-appropriate-provision-of-primary-versus-specialist-palliative-care-to-cancer-patients-oncologists-perspectives
#5
Risha Gidwani, Andrea Nevedal, Manali Patel, Douglas W Blayney, Christine Timko, Kavitha Ramchandran, P Adam Kelly, Steven M Asch
BACKGROUND: Many cancer patients do not receive recommended palliative care (PC). Oncologists' perspectives about PC have not been adequately described qualitatively and may explain some of the gaps in the delivery of PC. OBJECTIVE: To characterize U.S. oncologists' perceptions of: primary and specialist PC; experiences interacting with PC specialists; and the optimal interface of PC and oncology in providing PC. DESIGN: In-depth interviews with practicing oncologists...
December 20, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27986800/a-matter-of-life-and-death-controversy-at-the-interface-between-clinical-and-legal-decision-making-in-prolonged-disorders-of-consciousness
#6
Lynne Turner-Stokes
Best interests decision-making and end-of-life care for patients in permanent vegetative or minimally conscious states (VS/MCS) is a complex area of clinical and legal practice, which is poorly understood by most clinicians, lawyers and members of the public. In recent weeks, the Oxford Shrieval lecture by Mr Justice Baker ('A Matter of Life and Death', 11 October 2016) and its subsequent reporting in the public press has sparked debate on the respective roles of clinicians, the Court of Protection and the Mental Capacity Act 2005 in decisions to withhold or withdraw life-sustaining treatments from patients with disorders of consciousness...
December 16, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27978419/-why-didn
#7
Michele Levinson, Amber Mills, Jonathan Barrett, Gaya Sritharan, Anthea Gellie
Objective The aim of the present study was to understand the reasons for the delivery of non-beneficial cardiopulmonary resuscitation (CPR) attempts in a tertiary private hospital over 12 months. We determined doctors' expectations of survival after CPR for their patient, whether they had considered a not-for-resuscitation (NFR) order and the barriers to completion of NFR orders.Methods Anonymous questionnaires were sent to the doctors primarily responsible for a given patient's care in the hospital within 2 weeks of the unsuccessful CPR attempt...
December 16, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27977605/burnout-in-the-intensive-care-unit-professionals-a-systematic-review
#8
Chien-Huai Chuang, Pei-Chi Tseng, Chun-Yu Lin, Kuan-Han Lin, Yen-Yuan Chen
BACKGROUND: Burnout has been described as a prolonged response to chronic emotional and interpersonal stress on the job that is often the result of a period of expending excessive effort at work while having too little recovery time. Healthcare workers who work in a stressful medical environment, especially in an intensive care unit (ICU), may be particularly susceptible to burnout. In healthcare workers, burnout may affect their well-being and the quality of professional care they provide and can, therefore, be detrimental to patient safety...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27940060/dialysis-in-children-and-adolescents-the-pediatric-nephrology-perspective
#9
Deepa H Chand, Sarah Swartz, Shamir Tuchman, Rudolph P Valentini, Michael J G Somers
The care of children with end-stage renal disease (ESRD) is highly specialized and often poorly understood by nonpediatric providers and facility/institution administrators. As such, this position paper has been created to offer provider, facility, and institutional guidance regarding the components of care necessary for children receiving dialysis. Key differences between adult and pediatric dialysis units are highlighted. Responsibilities and expectations of the members of the interdisciplinary dialysis team are outlined as they pertain specifically to the care of pediatric dialysis patients...
December 7, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27917548/nurses-comfort-level-with-spiritual-assessment-a-study-among-nurses-working-in-diverse-healthcare-settings
#10
Pamela H Cone, Tove Giske
AIMS: To gain knowledge about nurses' comfort level in assessing spiritual matters and to learn what questions nurses use in practice related to spiritual assessment. BACKGROUND: Spirituality is important in holistic nursing care; however, nurses report feeling uncomfortable and ill-prepared to address this domain with patients. Education is reported to impact nurses' ability to engage in spiritual care. DESIGN: This cross-sectional exploratory survey reports on a mixed-method study examining how comfortable nurses are with spiritual assessment...
December 5, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27881624/an-acceptance-and-commitment-therapy-self-help-intervention-for-carers-of-patients-in-palliative-care-protocol-of-a-feasibility-randomised-controlled-trial
#11
Esther L Davis, Frank P Deane, Geoffrey Cb Lyons
Undertaking a caregiving role at end of life can have enduring psychological consequences for carers, including poor adjustment in bereavement. Acceptance and commitment therapy-based interventions have demonstrated effectiveness in helping people cope with a range of life challenges. This article presents the protocol of a feasibility randomised controlled trial of an acceptance and commitment therapy self-help intervention for psychological distress and grief in carers of patients in palliative care. We will assess feasibility and acceptability of the trial procedures and intervention as well as preliminary effectiveness of the intervention on carer well-being outcomes...
November 22, 2016: Journal of Health Psychology
https://www.readbyqxmd.com/read/27880064/a-randomised-controlled-feasibility-trial-of-group-cognitive-behavioural-therapy-for-people-with-severe-asthma
#12
Janelle Yorke, Pauline Adair, Anne-Marie Doyle, Linda Dubrow-Marshall, Sharon Fleming, Leanne Holmes, Andrew Menzies-Gow, Rob Niven, Mark Pilling, Caroline Shuldham
OBJECTIVES: Evidence for the efficacy of Cognitive Behavioural Therapy (CBT) in asthma is developing but it is not known if this translates to benefits in severe asthma or if a group approach is acceptable to this patient group. This study aimed to assess the feasibility and acceptability of Group-CBT in severe asthma. METHOD: This was a two-centre, randomised controlled parallel group feasibility study. Eligible participants (patients with severe asthma and a clinically significant diagnosis of anxiety and/or depression - Hospital Anxiety and Depression Scale (HAD) score greater than 8 for the anxiety or depression sub-scale) received Group-CBT in weekly sessions for eight consecutive weeks and usual care or usual care only...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27867525/barriers-to-goals-of-care-discussions-with-hospitalized-patients-with-advanced-heart-failure-feasibility-and-performance-of-a-novel-questionnaire
#13
Natasha Aleksova, Catherine Demers, Patricia H Strachan, Jane MacIver, James Downar, Robert Fowler, Daren K Heyland, Heather J Ross, John J You
AIMS: Good end-of-life communication and decision-making are important to patients with advanced heart failure (HF) and their families, but their needs remain unmet. In this pilot study, we describe the feasibility and performance of a novel questionnaire aimed at identifying barriers and solutions to improve communication and decision-making about goals of care for hospitalized patients with advanced HF. METHODS: We distributed questionnaires to staff cardiologists, cardiology trainees, and cardiology nurses who provide care for HF patients at a Canadian teaching hospital...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27867144/palliative-care-in-pakistan
#14
Robyna Irshad Khan
Pakistan is a developing country of South East Asia, with all the incumbent difficulties currently being faced by the region. Insufficient public healthcare facilities, poorly regulated private health sector, low budgetary allocation for health, improper priority setting while allocating limited resources, have resulted essentially in an absence of palliative care from the healthcare scene. Almost 90% of healthcare expenditure is out of the patient's pocket with more than 45% of population living below the poverty line...
November 11, 2016: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/27858496/inverse-association-between-platelet-lymphocyte-ratio-and-prognosis-in-terminally-ill-cancer-patients-a-preliminary-study
#15
Yoonjoo Lee, Ye Won Kim, Dong Kyun Park, In Cheol Hwang
BACKGROUND: An elevated platelet-lymphocyte ratio (PLR) is an indicator for worse outcomes in cancer, but its significance at the end of life remains unclear. OBJECTIVE: This study aimed to investigate the value of PLR as an independent prognostic factor in terminally ill cancer patients. METHODS: This retrospective cohort study included 312 terminal cancer patients and was conducted in a palliative care unit of a tertiary cancer center. Patient demographic data, clinical information, and laboratory values, including complete blood cell count, were obtained...
November 18, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27834803/advance-care-planning-in-glioblastoma-patients
#16
REVIEW
Lara Fritz, Linda Dirven, Jaap C Reijneveld, Johan A F Koekkoek, Anne M Stiggelbout, H Roeline W Pasman, Martin J B Taphoorn
Despite multimodal treatment with surgery, radiotherapy and chemotherapy, glioblastoma is an incurable disease with a poor prognosis. During the disease course, glioblastoma patients may experience progressive neurological deficits, symptoms of increased intracranial pressure such as drowsiness and headache, incontinence, seizures and progressive cognitive dysfunction. These patients not only have cancer, but also a progressive brain disease. This may seriously interfere with their ability to make their own decisions regarding treatment...
November 8, 2016: Cancers
https://www.readbyqxmd.com/read/27833180/justice-and-health-care-when-ordinary-is-extraordinary
#17
James McTavish
In some Asian countries, the poor are often denied access to health care. In the Philippines, we have thousands of Catholic doctors, Catholic nurses, even Catholic administrators, but not a Catholic, understood as "universal," healthcare system available to all. This is a scandal and places heavy emotional and financial burdens on many families who need to pay the healthcare costs of sick loved ones. The Church teaches the principles of ordinary and extraordinary care, with only the former being morally obligatory...
February 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27821164/the-evaluation-of-a-remote-support-program-on-quality-of-life-and-evolution-of-disease-in-copd-patients-with-frequent-exacerbations
#18
Bernardino Alcazar, Pilar de Lucas, Joan B Soriano, Alonso Fernández-Nistal, Antonia Fuster, Jose Miguel Rodríguez González-Moro, Aurelio Arnedillo, Patricia García Sidro, María José Espinosa de Los Monteros
BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients often present considerable individual medical burden in their symptoms, limitations, and well-being that complicate medical treatment. To improve their overall health status, while reducing the number of exacerbations, a multidisciplinary approach including different elements of care is needed. The aim of this study was to evaluate the effects of a remote support program on COPD patients at high risk of experiencing worsening of their disease and other health-related outcomes...
November 8, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27815555/family-caregivers-conceptualisation-of-quality-end-of-life-care-for-people-with-dementia-a-qualitative-study
#19
Nathan Davies, Greta Rait, Laura Maio, Steve Iliffe
BACKGROUND: People with dementia have been described as the 'disadvantaged dying' with poor end-of-life care. Towards the end of life, people with dementia cannot report on the care they receive. It is therefore important to talk to caregivers; however, few have explored the views about end-of-life care from the caregivers' perspective. The majority of research on family caregivers has focussed on the burden and psychological impact of caring for a relative with dementia. AIM: This study aimed to explore the views of family caregivers about quality end-of-life care for people with dementia...
October 25, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27803573/end-of-life-characteristics-of-the-elderly-an-assessment-of-home-based-palliative-services-in-two-panchayats-of-kerala
#20
R Jayalakshmi, Suhita Chopra Chatterjee, Debolina Chatterjee
BACKGROUND: Home-based palliative services form the cornerstone of Kerala's palliative program. However, two issues need research: (a) whether family-homes can be considered as the locus of ageing and dying for marginal populations who experience deprivation and poverty and (b) whether the present delivery structure meets the needs of elderly population. These issues are examined in the context of two rural areas. The study explores end-of-life characteristics of the elderly - their sociodemographic status and living patterns, morbidity profile, and functional status...
October 2016: Indian Journal of Palliative Care
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