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End-of-life issues

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https://www.readbyqxmd.com/read/28731382/external-validation-and-clinical-utility-of-a-prediction-model-for-6-month-mortality-in-patients-undergoing-hemodialysis-for-end-stage-kidney-disease
#1
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28731379/quasi-experimental-evaluation-of-a-multifaceted-intervention-to-improve-quality-of-end-of-life-care-and-quality-of-dying-for-patients-with-advanced-dementia-in-long-term-care-institutions
#2
René Verreault, Marcel Arcand, Lucie Misson, Pierre J Durand, Edeltraut Kroger, Michèle Aubin, Maryse Savoie, Thomas Hadjistavropoulos, Sharon Kaasalainen, Annick Bédard, Annie Grégoire, Pierre-Hughes Carmichael
BACKGROUND: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. AIM: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. DESIGN: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28725839/nursing-strategies-for-engaging-families-of-older-immigrants-hospitalized-for-end-of-life-care-an-australian-study
#3
Megan-Jane Johnstone, Alison M Hutchinson, Helen Rawson, Bernice Redley
BACKGROUND: Engaging with families of older non-English-speaking background (NESB) immigrants hospitalized for end-of-life (EOL) care can be challenging, especially when their cultures, lifeways, and family decision-making processes are unfamiliar to the nurses caring for them. Despite the recognized importance of family engagement when providing EOL care, the issue of ethnic minority family engagement has received little attention in the field. AIM: To explore and describe the strategies nurses use to facilitate engagement with families of older immigrant NESB patients hospitalized for EOL care...
September 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28720203/the-personal-and-professional-face-of-the-basque-urologist-jos%C3%A3-juli%C3%A3-n-guim%C3%A3-n-rezola-1898-1980
#4
J C Angulo
OBJECTIVE: To understand certain outstanding aspects of the life of the Basque surgeon and urologist Julián Guimón Rezola. His personal and bibliographic documentary legacy helps reconstruct his works and personal character. MATERIAL AND METHODS: We analysed the written works of Julián Guimón Rezola and a collection of documents, letters, photographs, illustrations and objects from his personal and professional life, accessed through his family. We analysed the content of the author's main publications and related the documents to historic facts...
July 15, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28718858/donationsutredningen-%C3%A3-ppnar-f%C3%A3-r-nya-organdonatorer-kr%C3%A3-ver-reflexion-om-m%C3%A3-nniskov%C3%A3-rdesprincipen-och-samtycke
#5
Stellan Welin
Swedish white paper on donation can give more donors without compromising ethics The White Paper on organ donation (SOU 2015:84) proposes new regulations for organ donation. In particular it spells out that it is permissible to take medical steps to preserve organs while the patient is still alive. It is proposed that this should be allowed after the medical team has declared that the continuation of life sustaining treatment is futile. The white paper opens up for donation after cardiac death. There has been some critique of the white paper for lack of deeper ethical discussions...
July 14, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28716618/evaluation-of-a-video-based-seminar-to-raise-healthcare-professionals-awareness-of-culturally-sensitive-end-of-life-care
#6
Dulce M Cruz-Oliver, Theodore K Malmstrom, Michael Roegner, Gwen Yeo
OBJECTIVE: To investigate the effect of a newly developed telenovela, or video soap opera, on healthcare professionals (HCP)' awareness of caregivers' stress and patients' cultural approaches to end-of-life (EOL) care decisions. METHODS: A multi-center cross-sectional study among three communities in New York, Miami and Missouri. Participants from a convenience sample of multidisciplinary HCP were randomly assigned to view power point presentation with either a control-video or an intervention-telenovela about caregiving as part of a one- hour audiovisual seminar and completed a pre-posttest questionnaire to evaluate reaction and learning...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716616/relationship-between-spirituality-meaning-in-life-psychological-distress-wish-for-hastened-death-and-their-influence-on-quality-of-life-in-palliative-care-patients
#7
Mathieu Bernard, Florian Strasser, Claudia Gamondi, Giliane Braunschweig, Michaela Forster, Karin Kaspers-Elekes, Silvia Walther Veri, Gian Domenico Borasio
CONTEXT: Spiritual, existential, and psychological issues represent central components of quality of life (QOL) in palliative care. A better understanding of the dynamic underlying these components is essential for the development of interventions tailored to the palliative context. OBJECTIVES: The aims were to explore (i) the relationship between spirituality, meaning in life, wishes for hastened death and psychological distress in palliative patients, and (ii) the extent to which these non-physical determinants influence QOL...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28708343/-knowing-where-the-patients-would-like-to-die
#8
Karine Vantieghem, Françoise Laurent
The majority of the population wishes to die at home. However, most patients die in hospitals or nursing homes. What do health care professionals know about the choices of their patients in this matter? This study concerns persons who died from natural causes during the 1st semester of 2013 in 2 districts of the canton of Vaud. 241 of their health care professionals answered a questionnaire. Only 35.6 % knew their patient's wishes pertaining to where their death should take place. Despite the opportunity to speak about it with one's GP, the issue is not usually raised...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28708339/-advance-directives-and-advance-care-planning
#9
Petra Vayne-Bossert, Christiane Vailloud, Dominique Ducloux, Caroline Matis, Laurence Déramé
Advance directives (AD) and Advance Care Planning (ACP) are two measures a person may undertake to assure that their treatment preferences will be respected until the end of his / her life. Anticipation is based on an open and honest communication between the patient, the durable medical power of attorney and the health care professionals. ADs and ACPs are based on a person's values and beliefs that are important to his quality of life. ACP is a continuing process, initiated by health care professionals and integrated into the health care plan of a person...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28708107/family-communication-at-the-end-of-life
#10
EDITORIAL
Maureen P Keeley
People often feel awkward and ill at ease when faced with the opportunity for communication at the end of life, thus the overall theme for the articles in this special issue is the creation of more awareness and knowledge regarding the depth, breadth, and importance of current research exploring family communication at the end of life. This introductory essay attempts to accomplish the following: (1) discuss the importance of talk regarding death; (2) highlight the formative role of family interactions on the death and dying process; and (3) outline the articles in this special issue...
July 14, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28701211/inpatient-rehabilitation-for-adult-patients-with-marfan-syndrome-an-observational-pilot-study
#11
Dieter Benninghoven, Denise Hamann, Yskert von Kodolitsch, Meike Rybczynski, Julia Lechinger, Friedrich Schroeder, Marina Vogler, Eike Hoberg
BACKGROUND: Advances in medical, interventional and surgical treatment have increased average life expectancy of patients with congenital heart defects. As a result a new group of adult patients with congenital cardiac defects requires medical rehabilitation. Patients with Marfan syndrome (MFS) are a relevant group among these patients. So far, no reports on the effectiveness of specialized rehabilitation programmes for MFS patients exist. We implemented an inpatient 3-week rehabilitation program for MFS patients at the Muehlenberg-Clinic for rehabilitation and assessed the medical safety as well as the impact of the program on physical fitness and psychological wellbeing of participants by means of an observational pilot study...
July 12, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28700092/oral-paracetamol-acetaminophen-for-cancer-pain
#12
REVIEW
Philip J Wiffen, Sheena Derry, R Andrew Moore, Ewan D McNicol, Rae F Bell, Daniel B Carr, Mairead McIntyre, Bee Wee
BACKGROUND: Pain is a common symptom with cancer, and 30% to 50% of all people with cancer will experience moderate to severe pain that can have a major negative impact on their quality of life. Non-opioid drugs are commonly used to treat mild to moderate cancer pain, and are recommended for this purpose in the WHO cancer pain treatment ladder, either alone or in combination with opioids.A previous Cochrane review that examined the evidence for nonsteroidal anti-inflammatory drugs (NSAIDs) or paracetamol, alone or combined with opioids, for cancer pain was withdrawn in 2015 because it was out of date; the date of the last search was 2005...
July 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#13
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28693527/social-workers-involvement-in-advance-care-planning-a-systematic-narrative-review
#14
Chong-Wen Wang, Cecilia L W Chan, Amy Y M Chow
BACKGROUND: Advance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. Although a number of studies have documented social workers' attitudes toward, knowledge about, and involvement in advance care planning, the information is fragmented. The purpose of this review was to provide a narrative synthesis of evidence on social workers' perspectives and experiences regarding implementation of advance care planning...
July 10, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28691498/delivering-end-of-life-cancer-care-perspectives-of-providers
#15
Manali I Patel, Vyjeyanthi S Periyakoil, David Moore, Andrea Nevedal, Tumaini R Coker
OBJECTIVES: Persistent gaps in end-of-life cancer care delivery and growing associated expenditures remain imminent US public health issues. The objective of this study was to understand clinical providers' experiences delivering cancer care for patients at the end of life and their perspectives on potential solutions to improve quality of care. METHODS: Semistructured interviews were conducted with 75 cancer care providers across the United States. The interviews were recorded, transcribed, and analyzed using constant comparative method of qualitative analysis...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28687135/advance-care-planning-within-survivorship-care-plans-for-older-cancer-survivors-a-systematic-review
#16
REVIEW
Rónán O'Caoimh, Nicola Cornally, Ronan O'Sullivan, Ruth Hally, Elizabeth Weathers, Amanda H Lavan, Tara Kearns, Alice Coffey, Ciara McGlade, D William Molloy
Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care...
June 23, 2017: Maturitas
https://www.readbyqxmd.com/read/28682032/-diabetic-nephropathy-and-cardiovascular-risk
#17
Luigi Rossi, Loreto Gesualdo
The curious case of the Diabetic Nephropathy (DN) : paraphrasing the name of a famous movie is certainly an unusual way to deal with a medical-scientific issue, but it could be extremely functional. Benjamin Button, with his backward life, breaks the unquestionable certainty of human life progressing through fixed steps. Similarly, the knowledge of DN seems go backwards; therefore, although it is a pathology which clinicians are usually sure, maybe too sure, they know every aspect of, the clinical nephrologist managing a diabetic patient often finds himself/herself far from his/her old certainties and proper answers...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28680279/palliative-care-as-a-public-health-issue-understanding-disparities-in-access-to-palliative-care-for-the-homeless-population-living-in-toronto-based-on-a-policy-analysis
#18
REVIEW
B Henry, N Dosani, L Huynh, N Amirault
Even in a developed country such as Canada, there are disparities in just access to adequate health care-and, more specifically, palliative care. That inequality is most notable in an underserved group such as the homeless population. Even the word "homeless" has become both a negative descriptor and a stereotype in our society. We posit that the provision of hospice palliative care is structured on several problematic assumptions: an expectation that patients will have an informal support network (family and friends), a stable and secure residence, a predictive terminal illness trajectory, and reasonable access to health care...
June 2017: Current Oncology
https://www.readbyqxmd.com/read/28679803/epidemiology-and-patterns-of-care-at-the-end-of-life-rising-complexity-shifts-in-care-patterns-and-sites-of-death
#19
Melissa D Aldridge, Elizabeth H Bradley
In 2015 an estimated 2.7 million people in the United States (1 percent of the population) died. Although decedents' illness experience varies substantially, important trends in care at the end of life are evident. To identify the most pressing health care policy issues related to end-of-life care, we present a comprehensive picture of the epidemiology and care patterns of people in the last stage of life. We identify three key trends in end-of-life care: increasing diversity in the primary diagnoses of decedents, increases in multimorbidity and illness complexity among people with terminal illnesses, and shifts in patterns of care at the end of life and in sites of death...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28678000/implantable-cardioverter-defibrillator-knowledge-and-end-of-life-device-deactivation-a-cross-sectional-survey
#20
Samantha M McEvedy, Jan Cameron, Eugene Lugg, Jennifer Miller, Chris Haedtke, Muna Hammash, Martha J Biddle, Kyoung Suk Lee, Justin A Mariani, Chantal F Ski, David R Thompson, Misook Lee Chung, Debra K Moser
BACKGROUND: End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. AIM: To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. DESIGN: Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire...
June 1, 2017: Palliative Medicine
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