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Poor end-of-life care

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https://www.readbyqxmd.com/read/29777380/investigating-the-prognostic-ability-of-health-related-quality-of-life-on-survival-a-prospective-cohort-study-of-adults-with-lung-cancer
#1
Laura C Pinheiro, Bryce B Reeve
BACKGROUND: Health-related quality of life (HRQOL) is an important predictor for overall survival (OS). To date, no studies compared associations between HRQOL assessed before and after a cancer diagnosis for OS. Our objectives were to (1) investigate associations between HRQOL changes and OS and (2) identify the best HRQOL assessment time point to predict OS. METHODS: We used the Surveillance, Epidemiology and End Results linked with the Medicare Health Outcomes Survey data...
May 18, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29776432/a-comprehensive-postpartum-follow-up-health-care-program-for-women-with-history-of-preeclampsia-protocol-for-a-mixed-methods-research
#2
Mastaneh Kamravamanesh, Shahnaz Kohan, Negin Rezavand, Ziba Farajzadegan
BACKGROUND: Long-term postpartum follow-up is of great importance since women with preeclampsia history are at high risk of upcoming health complications. However, postpartum follow-up rates are poor. According to evidences, preeclampsia is not just a transient health problem; rather it causes short term and long term complications, which affect women's life for years after delivery. Although it seems the problem is solved by the end of pregnancy, the follow-up of subjects should not be stopped after delivery...
May 18, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29754514/what-sources-of-bereavement-support-are-perceived-helpful-by-bereaved-people-and-why-empirical-evidence-for-the-compassionate-communities-approach
#3
Samar M Aoun, Lauren J Breen, Ishta White, Bruce Rumbold, Allan Kellehear
AIMS: To determine who provides bereavement support in the community, what sources are perceived to be the most or least helpful and for what reason, and to identify the empirical elements for optimal support in developing any future compassionate communities approach in palliative care. DESIGN: A population-based cross-sectional investigation of bereavement experiences. Sources of support (informal, community and professional) were categorised according to the Public Health Model of Bereavement Support; most helpful reasons were categorised using the Social Provisions Scale, and least helpful were analysed using inductive content analysis...
May 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29753578/racial-ethnic-disparities-in-end-of-life-care-quality-among-lung-cancer-patients-a-seer-medicare-based-study
#4
Siddharth Karanth, Suja S Rajan, Gulshan Sharma, Jose-Miguel Yamal, Robert O Morgan
INTRODUCTION: Cancer end-of-life care and associated racial-ethnic disparities have been in focus during the last few years due to concerns regarding subjective care variations and poor quality of care. Given the high mortality rate and disease burden of lung cancer, end-of-life care quality is particularly crucial for this disease. This study uses previously validated measures and examines racial-ethnic disparities in lung cancer end-of-life care quality. METHODS: This study involves retrospective analysis of patients ≥66 years, who were diagnosed with stage I-IV lung cancer, and who died on or before December 31, 2013, using the Surveillance Epidemiology and End Result-Medicare data from 1991-2013...
May 10, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29747525/providing-care-for-a-person-with-late-stage-dementia-at-home-what-are-carers-experiences
#5
Laura Dempsey, Maura Dowling, Philip Larkin, Kathy Murphy
Background It is widely reported that carers who provide care for a family member with dementia endure physical and psychological burdens. Not only do they fulfil an important role for the person with dementia but also for the wider society. This study aims to explore the experiences of carers who provide end-of-life care for a person with late-stage dementia at home. Method Semi-structured interviews were conducted with 17 current carers and 6 past carers of a family member with late-stage dementia. Data was analysed using interpretative phenomenological analysis...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29746283/spiritual-care-in-cancer-patients-a-need-or-an-option
#6
Carla I Ripamonti, Federico Giuntoli, Silvia Gonella, Guido Miccinesi
PURPOSE OF REVIEW: Because of cancer is generally perceived as a life-threatening illness, patients often develop spiritual needs upon the diagnosis. Spirituality impacts patient quality of life (QoL) and provides a context in which to derive hope and meaning to cope with illness. The goal of this review is to give an overview of the most relevant studies with a focus on the relationship between spiritual well being, QoL and hope in patients with cancer, in addition to exploring the importance of spiritual issues both for patients and healthcare professionals...
May 8, 2018: Current Opinion in Oncology
https://www.readbyqxmd.com/read/29736116/providing-palliative-care-in-rural-nepal-perceptions-of-mid-level-health-workers
#7
Rajesh N Gongal, Shambhu Kumar Upadhyay, Kedar Prasad Baral, Max Watson, George W Kernohan
Introduction: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where the Mid-Level Health Workers (MHWs) are the major service providers. Their views on providing palliative care are most important in determining how the service is organized and developed. Aim: This study aims to ascertain the perceptions of MHWs about palliative care in their local community, to inform service development. Methods: A qualitative descriptive design, using focus group discussions, was used to collect data from a rural district of Makwanpur, 1 of the 75 districts of Nepal...
April 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29735397/survival-rates-and-health-care-costs-for-patients-with-advanced-bladder-cancer-treated-and-untreated-with-chemotherapy
#8
Kyle Flannery, Xiting Cao, Jinghua He, Yichen Zhong, Amishi Y Shah, Ashish M Kamat
BACKGROUND: Systemic chemotherapy has long been the standard of care for advanced bladder cancer, but its cost implications are poorly understood. The objective of this analysis was to estimate survival and health care costs for patients with stage IV bladder cancer who did or did not receive chemotherapy. PATIENTS AND METHODS: This was a retrospective cohort study of patients identified in the Surveillance, Epidemiology, and End Results-Medicare database with a new primary diagnosis of stage IV bladder cancer between January 2007 and December 2011...
March 27, 2018: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29725638/potentially-avoidable-readmissions-in-united-states-hemodialysis-patients
#9
Anna T Mathew, Lisa Rosen, Renee Pekmezaris, Andrzej Kozikowski, Daniel W Ross, Thomas McGinn, Kamyar Kalantar-Zadeh, Steven Fishbane
Introduction: Patients with end-stage kidney disease have a high risk of 30-day readmission to hospital. These readmissions are financially costly to health care systems and are associated with poor health-related quality of life. The objective of this study was to describe and analyze the frequency, causes, and predictors of 30-day potentially avoidable readmission to hospital in patients on hemodialysis. Methods: We conducted a retrospective cohort study using the US Renal Data System data from January 1, 2008, to December 31, 2008...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29710226/association-between-functional-health-literacy-and-postoperative-recovery-health-care-contacts-and-health-related-quality-of-life-among-patients-undergoing-day-surgery-secondary-analysis-of-a-randomized-clinical-trial
#10
Maria Hälleberg Nyman, Ulrica Nilsson, Karuna Dahlberg, Maria Jaensson
Importance: Day surgery puts demands on the patients to manage their own recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes. Objective: To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of recovery (SwQoR), and health-related quality of life...
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29699765/gay-and-gray-session-an-interdisciplinary-approach-to-transgender-aging
#11
Kevin Johnson, Brandon C Yarns, Janet M Abrams, Lilith A Calbridge, Daniel D Sewell
With the overarching goals of improving the healthcare of older transgender individuals and of inspiring pertinent clinical research, a session at the 2017 American Association for Geriatric Psychiatry Annual Meeting focused on an interdisciplinary approach to transgender aging. The older the transgender adult, the more likely the individual grew up in a historical context when there was greater social stigma towards their gender identity, even among mental health professionals. In order to provide optimal healthcare to transgender adults, mental health care providers should become familiar with the basic terminology presented in this article...
February 7, 2018: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29694439/decision-making-process-and-factors-contributing-to-research-participation-among-general-practitioners-a-grounded-theory-study
#12
Seng Fah Tong, Chirk Jenn Ng, Verna Kar Mun Lee, Ping Yein Lee, Irmi Zarina Ismail, Ee Ming Khoo, Noor Azizah Tahir, Iliza Idris, Mastura Ismail, Adina Abdullah
INTRODUCTION: The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs' decision-making process to participate in research. METHODS: We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities. Five in-depth interviews and four focus group discussions were conducted among 21 GPs...
2018: PloS One
https://www.readbyqxmd.com/read/29661335/head-and-neck-cancer-in-the-elderly-frailty-shared-decisions-and-avoidance-of-low-value-care
#13
REVIEW
Leila J Mady, Marci L Nilsen, Jonas T Johnson
Head and neck cancer (HNC) is a disease of older adults. Recurrent and metastatic head and neck squamous cell carcinoma portends a poor prognosis, with median overall survival of less than 12 months. Within this vulnerable population, significant treatment-related toxicities and physical and psychosocial sequelae can be devastating to quality of life at the end of life. Shared decision making and early comprehensive palliative and support services are at the crux of the approach to older adults with HNC. In doing so, low-value care that fails to meet the goals of patients and their caregivers at the end-of-life may be avoided...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29649399/a-rules-based-algorithm-to-prioritize-poor-prognosis-cancer-patients-in-need-of-advance-care-planning
#14
Christine M Bestvina, Kristen E Wroblewski, Bobby Daly, Brittany Beach, Selina Chow, Andrew Hantel, Monica Malec, Michael T Huber, Blase N Polite
BACKGROUND: Accurate understanding of the prognosis of an advanced cancer patient can lead to decreased aggressive care at the end of life and earlier hospice enrollment. OBJECTIVE: Our goal was to determine the association between high-risk clinical events identified by a simple, rules-based algorithm and decreased overall survival, to target poor prognosis cancer patients who would urgently benefit from advanced care planning. DESIGN: A retrospective analysis was performed on outpatient oncology patients with an index visit from April 1, 2015, through June 30, 2015...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29620949/associations-between-race-and-dementia-status-and-the-quality-of-end-of-life-care
#15
Elizabeth A Luth, Holly G Prigerson
BACKGROUND: Non-Hispanic black and dementia patients receive more invasive and futile treatment at end of life (EOL) relative to others. Little is known about the relationship between race/ethnicity, dementia, and EOL care quality. OBJECTIVE: Identify the relationship between race/ethnicity, dementia, and proxy reporters' evaluation of EOL care quality in older adults. DESIGN: Latent class analysis (LCA) of national survey data. SETTING: 1588 deceased Medicare beneficiaries age 65 and older from the National Health and Aging Trends Study (2011-2016)...
April 5, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29620556/parent-perspectives-of-receiving-early-information-about-palliative-and-end-of-life-care-options-from-their-child-s-pediatric-providers
#16
Verna L Hendricks-Ferguson, Joan E Haase
BACKGROUND: Parents of children diagnosed with cancer may experience decision regret about cancer treatment decisions and dissatisfaction with the perceived clarity in information received from their child's providers. OBJECTIVE: The aim of this study was to describe parental perspectives about receiving an early palliative care and end-of-life (PC/EOL) communication intervention titled "Communication Plan: Early through End of Life Intervention" (COMPLETE) from an interprofessional team of physician and registered nurse providers...
April 3, 2018: Cancer Nursing
https://www.readbyqxmd.com/read/29614131/association-between-quality-domains-and-health-care-spending-across-physician-networks
#17
Farah Rahman, Jun Guan, Richard H Glazier, Adalsteinn Brown, Arlene S Bierman, Ruth Croxford, Therese A Stukel
One of the more fundamental health policy questions is the relationship between health care quality and spending. A better understanding of these relationships is needed to inform health systems interventions aimed at increasing quality and efficiency of care. We measured 65 validated quality indicators (QI) across Ontario physician networks. QIs were aggregated into domains representing six dimensions of care: screening and prevention, evidence-based medications, hospital-community transitions (7-day post-discharge visit with a primary care physician; 30-day post-discharge visit with a primary care physician and specialist), potentially avoidable hospitalizations and emergency department (ED) visits, potentially avoidable readmissions and unplanned returns to the ED, and poor cancer end of life care...
2018: PloS One
https://www.readbyqxmd.com/read/29608934/transition-points-for-the-routine-integration-of-palliative-care-in-patients-with-advanced-cancer
#18
Anna Collins, Vijaya Sundararajan, Jodie Burchell, Jeremy Millar, Sue-Anne McLachlan, Meinir Krishnasamy, Brian H Le, Linda Mileshkin, Peter Hudson, Jennifer Philip
CONTEXT: Increasing emphases are being placed upon early integration of palliative care for patients with advanced cancers, yet barriers to implementation in clinical practice remain. Criteria to standardise referral have been endorsed, but their application are yet to be tested at the population level. OBJECTIVES: This study sought to: 1) establish the need for standardised referral by examining current end of life care outcomes of decedents with cancer; and 2) define transition points within a cancer illness course which are associated with poor prognosis, whereby palliative care should be routinely introduced to augment clinician- based decision making...
March 30, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29607636/the-quality-of-life-of-hemodialysis-patients-is-affected-not-only-by-medical-but-also-psychosocial-factors-a-canonical-correlation-study
#19
Kyungmin Kim, Gun Woo Kang, Jungmin Woo
BACKGROUND: The quality of life (QoL) of patients with end-stage renal disease (ESRD) is very poor, plausibly due to both psychosocial and medical factors. This study aimed to determine the relationship among psychosocial factors, medical factors, and QoL in patients with ESRD undergoing hemodialysis (HD). METHODS: In total, 55 male and 47 female patients were evaluated (mean age, 57.1 ± 12.0 years). The QoL was evaluated using the Korean version of World Health Organization Quality of Life Scale-Abbreviated Version...
April 2, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29573117/taking-parents-seriously-the-experiences-of-parents-with-a-son-or-daughter-in-adult-medium-secure-forensic-mental-health-care
#20
Gemma Finlay-Carruthers, Jason Davies, John Ferguson, Kevin Browne
Adult forensic mental health services provide care and treatment to individuals with complex offending and mental health histories. However, little attention has been paid to the parents of those receiving care within them. This research explored the experiences of parents with an adult son or daughter with mental illness in a medium secure mental health unit. Transcripts from semi-structured interviews were analysed using interpretative phenomenological analysis. This led to the identification of three superordinate themes: 'Something's not right'-onset of mental distress; 'It's a terrible battle'-relating with professionals; and 'A very sad fact of life'-caring with no end in sight were identified which together contained nine subordinate themes...
March 24, 2018: International Journal of Mental Health Nursing
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