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Poor end-of-life care

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27803571/initial-experience-of-head-and-neck-cancer-patients-treated-in-an-oncologist-led-palliative-cancer-care-clinic-at-a-tertiary-cancer-care-center-in-uttar-pradesh-is-the-initiative-of-a-full-fledged-palliative-care-for-cancer-patients-justified
#11
Punita Lal, Mranalini Verma, Gaurav Kumar, Resham Shrivastava, Shaleen Kumar
INTRODUCTION: Poor socioeconomic status and illiteracy attribute to the advanced presentation of head and neck cancer (HNC) patients in India and are candidates for palliation in our setup. We set up a palliative cancer care clinic (PCCC), and an audit of initial 153 HNC patients is presented. AIMS AND OBJECTIVES: To assess the impact of palliative cancer care services. METHODOLOGY: Data of advanced HNC patients suited for palliation were collected to document demography, symptomatology, cancer treatment, and supportive care...
October 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27803566/clinical-impact-of-education-provision-on-determining-advance-care-planning-decisions-among-end-stage-renal-disease-patients-receiving-regular-hemodialysis-in-university-malaya-medical-centre
#12
Albert Hing Wong, Loh Ee Chin, Tan Li Ping, Ng Kok Peng, Lim Soo Kun
INTRODUCTION: Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. AIM: To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC)...
October 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27802289/has-metal-on-metal-resurfacing-been-a-cost-effective-intervention-for-health-care-providers-a-registry-based-study
#13
Ruth Pulikottil-Jacob, Martin Connock, Ngianga-Bakwin Kandala, Hema Mistry, Amy Grove, Karoline Freeman, Matthew Costa, Paul Sutcliffe, Aileen Clarke
BACKGROUND: Total hip replacement for end stage arthritis of the hip is currently the most common elective surgical procedure. In 2007 about 7.5% of UK implants were metal-on-metal joint resurfacing (MoM RS) procedures. Due to poor revision performance and concerns about metal debris, the use of RS had declined by 2012 to about a 1% share of UK hip procedures. This study estimated the lifetime cost-effectiveness of metal-on-metal resurfacing (RS) procedures versus commonly employed total hip replacement (THR) methods...
2016: PloS One
https://www.readbyqxmd.com/read/27793125/living-well-after-breast-cancer-randomized-controlled-trial-protocol-evaluating-a-telephone-delivered-weight-loss-intervention-versus-usual-care-in-women-following-treatment-for-breast-cancer
#14
Marina M Reeves, Caroline O Terranova, Jane M Erickson, Jennifer R Job, Denise S K Brookes, Nicole McCarthy, Ingrid J Hickman, Sheleigh P Lawler, Brianna S Fjeldsoe, Genevieve N Healy, Elisabeth A H Winkler, Monika Janda, J Lennert Veerman, Robert S Ware, Johannes B Prins, Theo Vos, Wendy Demark-Wahnefried, Elizabeth G Eakin
BACKGROUND: Obesity, physical inactivity and poor diet quality have been associated with increased risk of breast cancer-specific and all-cause mortality as well as treatment-related side-effects in breast cancer survivors. Weight loss intervention trials in breast cancer survivors have shown that weight loss is safe and achievable; however, few studies have examined the benefits of such interventions on a broad range of outcomes and few have examined factors important to translation (e...
October 28, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27789776/chemotherapy-near-the-end-of-life-for-chinese-patients-with-solid-malignancies
#15
Jin Sheng, Ya-Xiong Zhang, Xiao-Bo He, Wen-Feng Fang, Yun-Peng Yang, Gui-Nan Lin, Xuan Wu, Ning Li, Jing Zhang, Lin-Zhu Zhai, Yuan-Yuan Zhao, Yan Huang, Ning-Ning Zhou, Hong-Yun Zhao, Li Zhang
INTRODUCTION: There are increasing concerns about the negative impacts of chemotherapy near the end of life (EOL). There is discrepancy among different countries about its use, and little is known about the real-world situation in China. PATIENTS AND METHODS: This retrospective study was conducted at six representative hospitals across China. Adult decedents with a record of advanced solid cancer and palliative chemotherapy were consecutively screened from 2010 through 2014...
October 27, 2016: Oncologist
https://www.readbyqxmd.com/read/27786538/new-opioid-prescribing-guidelines-released-in-the-us-what-impact-will-they-have-in-the-care-of-older-patients-with-persistent-pain
#16
Fabio Guerriero, M Carrington Reid
To address the dramatic opioid epidemic and related-deaths from overdoses in the US, the Centers for Disease Control and Prevention (CDC) released a Guideline for Prescribing Opioids for Chronic Pain earlier this year. The guideline is designed to support clinicians caring for patients outside the context of active cancer treatment or palliative or end-of-life care. In this editorial, we review specific CDC recommendations that we believe could have positive or negative consequences when providing care to older adults with persistent pain...
October 27, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27775989/evidence-for-implementation-strategies-to-provide-palliative-care-in-the-neonatal-intensive-care-unit
#17
Megan Quinn, Sheila Gephart
BACKGROUND: Palliative care is a holistic framework that is designed to improve quality of life by identifying and treating distressing symptoms of life-threatening or complex conditions. Neonatal palliative care (NPC) has potential benefits for parents, staff, and patients, yet evidence suggests that implementation and utilization of organized NPC services are low. PURPOSE: The purpose of this study is to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? SEARCH STRATEGY: A literature search was conducted using CINAHL (Cumulative Index of Nursing and Allied Health Literature), PubMed, and the Cochrane Library databases...
December 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27749945/ethics-emotions-and-the-skills-of-talking-about-progressing-disease-with-terminally-ill-adolescents-a-review
#18
Abby R Rosenberg, Joanne Wolfe, Lori Wiener, Maureen Lyon, Chris Feudtner
Importance: For clinicians caring for adolescent patients living with progressive, life-threatening illness, discussions regarding prognosis, goals of care, and treatment options can be extremely challenging. While clinicians should respect and help to facilitate adolescents' emerging autonomy, they often must also work with parents' wishes to protect patients from the emotional distress of hearing bad news. Observations: We reviewed the ethical justifications for and against truth-telling, and we considered the published ethical and practice guidance, as well as the perspectives of patients, parents, and clinicians involved in these cases...
October 17, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27739074/lung-volume-reduction-surgery-for-diffuse-emphysema
#19
REVIEW
Joseph Em van Agteren, Kristin V Carson, Leong Ung Tiong, Brian J Smith
BACKGROUND: Lung volume reduction surgery (LVRS) performed to treat patients with severe diffuse emphysema was reintroduced in the nineties. Lung volume reduction surgery aims to resect damaged emphysematous lung tissue, thereby increasing elastic properties of the lung. This treatment is hypothesised to improve long-term daily functioning and quality of life, although it may be costly and may be associated with risks of morbidity and mortality. Ten years have passed since the last version of this review was prepared, prompting us to perform an update...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27736633/completion-of-limitation-of-medical-treatment-forms-by-junior-doctors-for-patients-with-dementia-clinical-medicolegal-and-education-perspectives
#20
Jaclyn Yoong, Aleece MacPhail, Gael Trytel, Prashanti Yalini Rajendram, Margaret Winbolt, Joseph E Ibrahim
Objective Limitation of Medical Treatment (LMT) forms are an essential element of end-of-life care. Decision making around LMT is complex and often involves patients with dementia. Despite the complexity, junior doctors frequently play a central role in completing LMT forms. The present study sought perspectives from a range of stakeholders (hospital clinicians, medical education personnel, legal and advocacy staff) about junior doctors' roles in completing LMT forms in general and for patients with dementia...
October 14, 2016: Australian Health Review: a Publication of the Australian Hospital Association
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