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Advance care planning, end of life

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https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#1
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29779361/palliative-and-end-of-life-care-for-heart-failure-patients-in-an-aging-society
#2
Takahiro Okumura, Akinori Sawamura, Toyoaki Murohara
The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#3
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29775694/advance-care-planning-in-a-multi-cultural-family-centric-community-a-qualitative-study-of-healthcare-professionals-patients-and-caregivers-perspectives
#4
Sumytra Menon, Marijke Kars, Chetna Malhotra, Alastair V Campbell, J J M van Delden
CONTEXT: Advance care planning has been shown to improve end-of-life care but it was developed in the USA and most research has been conducted in western communities. OBJECTIVES: We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses and medical social workers regarding advance care planning in a multi-cultural family-centric community. METHODS: We conducted an explorative qualitative study, using focus groups and individual in-depth interviews...
May 15, 2018: Journal of Pain and Symptom Management
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/29757917/nurse-practitioners-completion-of-physician-orders-for-scope-of-treatment-forms-in-west-virginia-a-secondary-analysis-of-12-months-of-data-from-the-state-registry
#6
Lori Anne Constantine, Toni Dichiacchio, Evan C Falkenstine, Alvin H Moss
BACKGROUND AND PURPOSE: Advanced care planning documents, such as the Physician Orders for Life-Sustaining Treatment (POLST), require authorized medical provider signatures; only recently have nurse practitioners (NPs) been authorized to sign these forms. Recent legislation in West Virginia (WV) granting NPs signatory authority on POLST forms and the creation of a statewide registry provides an opportunity to examine the completion rates. The aim of this study was to investigate how recent legislation allowing NPs signatory authority for POLST forms has affected POLST completion...
January 2018: Journal of the American Association of Nurse Practitioners
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
#7
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/29752324/dances-with-denial-have-medical-oncology-outpatients-conveyed-their-end-of-life-wishes-and-do-they-want-to
#8
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
https://www.readbyqxmd.com/read/29751360/intact-intraoperative-fluorescence-angiography-ifa-to-prevent-anastomotic-leak-in-rectal-cancer-surgery-a-randomised-controlled-trial
#9
G Armstrong, J Croft, N Corrigan, J M Brown, V Goh, P Quirke, C Hulme, D Tolan, A Kirby, R Cahill, R O'Connell, D Miskovic, M Coleman, D G Jayne
PURPOSE: Anastomotic leak (AL) is a major complication of rectal cancer surgery. Despite advances in surgical practice, rates of AL have remained static at around 10-15%. The aetiology of AL is multifactorial, but one of the most crucial risk factors, which is mostly under the control of the surgeon, is blood supply to the anastomosis. The MRC/NIHR IntAct study will determine whether assessment of anastomotic perfusion using a fluorescent dye (Indocyanine Green) and near-infrared laparoscopy can minimise the rate of anastomotic leak as compared to conventional white light laparoscopy...
May 11, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29735287/palliative-care-in-heart-failure-review
#10
REVIEW
Katie Wiskar, Mustafa Toma, Barret Rush
Palliative care (PC) is now recommended by all major cardiovascular societies for advanced heart failure (HF). PC is a philosophy of care that uses a holistic approach to address physical, psychosocial, and spiritual needs in patients with a terminal disease process. In HF, PC has been shown to improve symptoms and quality of life, facilitate advanced care planning, decrease hospital readmissions, and decrease hospital-associated healthcare costs. Although PC is still underutilized in HF, uptake is increasing...
February 21, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29713689/improving-rates-of-implantable-cardioverter-defibrillator-deactivation-in-end-of-life-care
#11
M R Javaid, Suzanne Squirrell, Fahad Farooqi
Implantable cardioverter defibrillators (ICDs) save lives in selected patients at risk of sudden cardiac death. However, in patents suffering with terminal illness, ICD therapy could pose a risk of unnecessary futile shocks which could lead to undignified discomfort in their final days of life. National guidelines advise that patients approaching the end of their natural life should be offered a compassionate choice of having their defibrillator deactivated. Following an actual clinical incident involving a patient receiving avoidable ICD shocks in his final hours, we identified shortcomings in communication and gaps in knowledge about ICD management in end-of-life care...
2018: BMJ open quality
https://www.readbyqxmd.com/read/29708996/mild-cognitive-dysfunction-of-caregivers-and-its-association-with-care-recipients-end-of-life-plans-and-preferences
#12
Keiko Kurita, Mark S Lachs, Ronald D Adelman, Eugenia L Siegler, M Cary Reid, Holly G Prigerson
Little is known about the association between cognitive dysfunction among informal caregivers and patients' plans and preferences for patients' end of life care. We report on the frequency of cognitive dysfunction among both patients and caregivers and examine associations between caregivers' cognitive screening scores and end of life plans and preferences of patients with advanced cancer. The current sample was derived from a National Cancer Institute- and National Institute of Mental Health-funded study of patients with distant metastasis who had disease progression on at least first-line chemotherapy, and their informal caregivers (n = 550 pairs)...
2018: PloS One
https://www.readbyqxmd.com/read/29707561/integrated-respiratory-and-palliative-care-may-improve-outcomes-in-advanced-lung-disease
#13
Natasha Smallwood, Michelle Thompson, Matthew Warrender-Sparkes, Peter Eastman, Brian Le, Louis Irving, Jennifer Philip
The unaddressed palliative care needs of patients with advanced, nonmalignant, lung disease highlight the urgent requirement for new models of care. This study describes a new integrated respiratory and palliative care service and examines outcomes from this service. The Advanced Lung Disease Service (ALDS) is a long-term, multidisciplinary, integrated service. In this single-group cohort study, demographic and prospective outcome data were collected over 4 years, with retrospective evaluation of unscheduled healthcare usage...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29707152/advance-care-planning-and-outcome-in-pediatric-palliative-home-care
#14
Jessica I Hoell, Hannah L Weber, Stefan Balzer, Mareike Danneberg, Gabriele Gagnon, Laura Trocan, Arndt Borkhardt, Gisela Janßen, Michaela Kuhlen
Pediatric advance care planning seeks to ensure end-of-life care conforming to the patients/their families' preferences. To expand our knowledge of advance care planning and "medical orders for life-sustaining treatment" (MOLST) in pediatric palliative home care, we determined the number of patients with MOLST, compared MOLST between the four "Together for Short Lives" (TfSL) groups and analyzed, whether there was a relationship between the content of the MOLST and the patients' places of death...
April 3, 2018: Oncotarget
https://www.readbyqxmd.com/read/29661749/a-website-supporting-sensitive-religious-and-cultural-advance-care-planning-acptalk-formative-and-summative-evaluation
#15
Amanda Pereira-Salgado, Patrick Mader, Clare O'Callaghan, Leanne Boyd
BACKGROUND: Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations...
April 16, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29658817/racial-and-ethnic-differences-in-advance-care-planning-results-of-a-statewide-population-based-survey
#16
Melissa A Clark, Sharina D Person, Anna Gosline, Atul A Gawande, Susan D Block
BACKGROUND: Few studies have focused on racial and ethnic differences in advance care planning other than advance directives among population-based samples of adults across the lifespan. METHODS: Using data from a statewide random-digit dial telephone survey of adults 18 years or older (n = 1851), we investigated racial and ethnic differences in (1) designation of a healthcare agent (HCA); and (2) communication of goals, values, and preferences for end-of-life care with healthcare providers, a HCA, or other family members and friends...
April 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29650860/-end-of-life-decision-making-support-in-palliative-homecare
#17
Akitaka Yoshizawa, Hiroyoshi Ikeda, Takayuki Yoshizawa
Advance care planning is important in end-of-life decision making in home-based palliative care for both cancer patients and non-cancer patients.
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650621/barriers-to-and-enablers-of-advance-care-planning-with-patients-in-primary-care-survey-of-health-care-providers
#18
Michelle Howard, Carrie Bernard, Doug Klein, Dawn Elston, Amy Tan, Marissa Slaven, Doris Barwich, John J You, Daren K Heyland
OBJECTIVE: To identify barriers to and enablers of advance care planning (ACP) perceived by physicians and other health professionals in primary care. DESIGN: Cross-sectional, self-administered survey. SETTING: Ontario, Alberta, and British Columbia. PARTICIPANTS: Family physicians (n = 117) and other health professionals (n = 64) in primary care. MAIN OUTCOME MEASURES: Perceived barriers relating to the clinician, characteristics of patients, and system factors, rated on a 7-point scale from 0 (not at all) to 6 (an extreme amount), and enablers reported using an open-ended question...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29649399/a-rules-based-algorithm-to-prioritize-poor-prognosis-cancer-patients-in-need-of-advance-care-planning
#19
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/29649398/feasibility-and-patient-perceptions-of-video-declarations-regarding-end-of-life-decisions-by-hospitalized-patients
#20
Lisa M Quintiliani, Jessica E Murphy, Pablo Buitron de la Vega, Katherine R Waite, S Emily Armstrong, Lori Henault, Angelo E Volandes, Michael K Paasche-Orlow
BACKGROUND: A videotaped declaration by patients of their advance care planning preferences could be an opportunity to supplement advance directive forms and be a source of information for family, caregivers, and clinicians, yet research is needed to examine the content and acceptability of making declarations among patients. OBJECTIVE: To evaluate the content and acceptability of 'video declarations': the process of patients videotaping themselves describing their advance care planning preferences...
March 13, 2018: Journal of Palliative Medicine
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