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Primary palliative care

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https://www.readbyqxmd.com/read/28818633/patient-and-caregiver-reported-assessment-tools-for-palliative-care-summary-of-the-2017-ahrq-technical-brief
#1
Rebecca Aslakson, Sydney M Dy, Renee F Wilson, Julie Waldfogel, Allen Zhang, Sarina R Isenberg, Alex Blair, Joshua Sixon, Karen A Robinson
CONTEXT: Assessment tools are data collection instruments that are completed by or with patients or caregivers and which collect data at the individual patient or caregiver level. OBJECTIVES: To (1) summarize palliative care assessment tools completed by or with patients or caregivers, and (2) identify needs for future tool development and evaluation. METHODS: We completed: (1) a systematic review of systematic reviews; (2) a supplemental search of previous reviews and websites, and/or (3) a targeted search for primary articles when no tools existed in a domain...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818571/timing-of-palliative-care-team-referrals-for-inpatients-receiving-rapid-response-services-a-retrospective-pilot-study-in-a-us-hospital
#2
M Williams, M Cardona-Morrell, P Stevens, J Bey, M E Smith Glasgow
BACKGROUND/OBJECTIVES: Research indicates up to one-third of rapid response team calls relate to end-of-life symptoms. The CriSTAL criteria were developed as a screening tool to identify high risk of death within three months. The primary purpose of this pilot study was to investigate the timing of palliative care referrals in patients receiving rapid response team services, and patients' CriSTAL criteria score on admission. The potential feasibility of using the CriSTAL tool to stimulate earlier Palliative Care Team (PCT) referral served as an underlying goal, and investigation of a relationship between specific CriSTAL criteria and the prediction of in-hospital death was a secondary objective...
August 8, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28809459/intensity-of-integrated-cancer-palliative-care-plans-and-end-of-life-acute-medical-hospitalisation-among-cancer-patient%C3%A2-in-northern-italy
#3
Michele Pellizzari, Maria Rolfini, Eliana Ferroni, Valentina Savioli, Nicola Gennaro, Elena Schievano, Francesco Avossa, Elisabetta Pinato, Maria Cristina Ghiotto, Franco Figoli, Domenico Mantoan, Antonio Brambilla, Ugo Fedeli, Mario Saugo
A high hospital utilisation at the end of life (EOL) is an indicator of suboptimal quality of health care. We evaluated the impact of the intensity of different Integrated Cancer Palliative Care (ICPC) plans on EOL acute medical hospitalisation among cancer decedents. Decedents of cancer aged 18-84 years, who were residents in two Italian regions, were investigated through integrated administrative data. Outcomes considered were prolonged hospital stay for medical reasons, 2+ hospitalisations during the last month of life and hospital death...
August 15, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28807704/palliative-care-albania
#4
Rudina Rama, Valbona Mane-Carcani, Fatmir Prifti, Kristo Huta, Ali Xhixha, Stephen R Connor
Sixty-percent of cancer patients are diagnosed with advanced stages of disease and those diagnosed in early stages face challenges to receive adequate treatment. Palliative care has had significant developments in recent years in Albania, due to a close partnership with the Ministry of Health, local non-profit organizations, and the Open Society Foundation Albania. In 2011, a five-year action plan for palliative care as one of four parts of the National Cancer Control Plan was approved. At the end of 2014, the first palliative care law was approved by Parliament...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807366/prospective-screening-with-the-validated-opioid-risk-tool-demonstrates-gynecologic-oncology-patients-are-at-low-risk-for-opioid-misuse
#5
Christine Garcia, Carolyn Lefkowits, Elizabeth Pelkofski, Leslie Blackhall, Linda R Duska
OBJECTIVE: To characterize risk for opioid misuse among gynecologic oncology patients. METHODS: The Opioid Risk Tool (ORT), a validated screen for opioid misuse risk, was administered to a convenience sample of patients with gynecologic cancer receiving opioid prescriptions in gynecologic oncology or palliative care clinics from January 2012-June 2016. Demographic and clinical information was abstracted on chart review. The primary outcome was ORT risk level (low vs...
August 11, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28804708/pediatric-palliative-care-initiative-in-cambodia
#6
Mahmut Yaşar Çeliker, Yos Pagnarith, Kazumi Akao, Dim Sophearin, Sokchea Sorn
Cancer care with curative intent remains difficult to manage in many resource-limited settings such as Cambodia. Cambodia has a small workforce with limited financial and health-care resources resulting in delayed diagnoses and availability of limited therapeutic tools. Thus, palliative care becomes the primary form of care in most cases. Although palliative care is becoming an integral part of medical care in developed countries, this concept remains poorly understood and utilized in developing countries. Angkor Hospital for Children serves a relatively large pediatric population in northern Cambodia...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28795860/access-to-palliative-care-consultation-and-advance-care-planning-for-adults-with-high-risk-leukemia
#7
Ashley T Freeman, William A Wood, Alexandra Fox, Laura C Hanson
BACKGROUND: Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC consultation and ACP for inpatients with high-risk leukemia. Secondary objectives were to describe components of ACP and PC practices. METHODS: We enrolled all patients with high-risk leukemia (acute leukemia ≥65 years or relapsed leukemia >18 years) admitted to the University of North Carolina Cancer Hospital from October 1, 2015, to August 1, 2016...
August 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#8
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28789719/meaning-of-life-representation-of-death-and-their-association-with-psychological-distress
#9
Ines Testoni, Giulia Sansonetto, Lucia Ronconi, Maddalena Rodelli, Gloria Baracco, Luigi Grassi
OBJECTIVE: This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression. METHOD: The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT)...
August 9, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28783424/practice-patterns-attitudes-and-barriers-to-palliative-care-consultation-by-gynecologic-oncologists
#10
Alexandre Buckley de Meritens, Benjamin Margolis, Craig Blinderman, Holly G Prigerson, Paul K Maciejewski, Megan J Shen, June Y Hou, William M Burke, Jason D Wright, Ana I Tergas
PURPOSE: We sought to describe practice patterns, attitudes, and barriers to the integration of palliative care services by gynecologic oncologists. METHODS: Members of the Society of Gynecologic Oncology were electronically surveyed regarding their practice of incorporating palliative care services and to identify barriers for consultation. Descriptive statistics were used, and two-sample z-tests of proportions were performed to compare responses to related questions...
August 7, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28782375/primary-palliative-care-education-a-pilot-survey
#11
Thomas Carroll, Neal Weisbord, Alec O'Connor, Timothy Quill
The demand for palliative services is outpacing the availability of specialist palliative care clinicians. One strategy to fill this gap is to improve "primary palliative care" skills and knowledge of all clinicians who care for seriously ill patients. Previous educational efforts have shown mixed results, and one possible explanation is unrecognized discordance of educational goals between those offering education and potential primary palliative care learners. The article describes the results and feasibility of a needs assessment survey comparing interest in palliative care education topics and settings among both palliative care specialists (PCS) and nonpalliative care specialists (NPCS)...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28777877/timely-access-to-care-in-the-treatment-of-rectal-cancer-and-the-effect-on-quality-of-life
#12
Sofie Walming, Mattias Block, David Bock, Eva Angenete
AIM: The aim of this study was to investigate if a delay in a patient's first contact with a health care professional, and any subsequent delay in diagnosis, affected self-assessed quality of life prior to start of treatment for rectal cancer. METHOD: Questionnaires were administered when the patients had been informed of the diagnosis and planned treatment. The primary endpoint was self-assessed quality of life according to a seven-point Likert scale. The response variables were dichotomized and analysed by unadjusted and adjusted binary logistic regression...
August 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28768490/lymphocyte-count-or-percentage-which-can-better-predict-the-prognosis-of-advanced-cancer-patients-following-palliative-care
#13
Weiwei Zhao, Peng Wang, Huixun Jia, Menglei Chen, Xiaoli Gu, Minghui Liu, Zhe Zhang, Wenwu Cheng, Zhenyu Wu
BACKGROUND: The lymphocytes played an important role in the natural history of cancer. The aim of this study was to explore the prognostic value of lymphocyte count and percentage for survival in advanced cancer patients receiving palliative care. METHODS: A retrospective review of clinicopathological data from 378 consecutive advanced cancer patients and 106 extended follow-up patients treated with palliative care was conducted. Kaplan-Meier curves and multivariate cox regression analyses were used to evaluate the relationships of peripheral lymphocyte count (LC) and lymphocyte to white blood cell ratio (LWR) with overall survival (OS)...
August 2, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28760524/gaps-in-provision-of-primary-and-specialty-palliative-care-in-the-acute-care-setting-by-race-and-ethnicity
#14
Elizabeth Chuang, Aluko A Hope, Katherine Allyn, Elissa Szalkiewicz, Brittany Gary, Michelle N Gong
CONTEXT: Previous research has identified a large unmet need in provision of specialist-level palliative care services in the hospital. How much of this gap is filled by primary palliative care provided by generalists or non-palliative specialists has not been quantified. Estimates of racial and ethnic disparities have been inconsistent. OBJECTIVES: 1) To estimate primary and specialty palliative care delivery and to measure unmet needs in the inpatient setting and 2) to explore racial and ethnic disparities in palliative care delivery...
July 28, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28759277/the-experience-of-decision-making-in-the-care-of-children-with-palliative-care-needs-the-experiences-of-jordanian-mothers
#15
Maha Atout, Pippa Hemingway, Jane Seymour
The purpose of this study was to explore the experience of decision making in the care of children with palliative care needs in Jordan, from the perspective of their mothers. This study employed a collective qualitative case study approach. Data were collected in 3 pediatric wards in a Jordanian hospital. The study used 2 data collection methods: participant observation (197 observational hours) and 56 semi-structured interviews with 24 mothers, 12 physicians and 20 nurses. The findings show how Jordanian mothers seek to transfer the role of decision making to physicians, as they perceive themselves to be unable to make decisions about critical issues related to the treatment of their children...
July 31, 2017: Compr Child Adolesc Nurs
https://www.readbyqxmd.com/read/28758538/-you-can-only-give-warmth-to-your-baby-when-it-s-too-late-parents-bonding-with-their-extremely-preterm-and-dying-child
#16
Andrea Abraham, Manya J Hendriks
This study on end-of-life decisions in extremely preterm babies shows that the parents under study experience a multitude of stressors due to the immediate separation after birth, the alienating setting of the neonatal intensive care unit (NICU), the physical distance to the child, medical uncertainties, and upcoming decisions. Even though they are considered to be parents (assigned parenthood), they cannot act as primary caregivers. Instead, they depend on professional instructions for access and care. Embodied parenthood can be experienced only at the end-of-life, that is, during the dying trajectory and after the child's death...
July 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28753885/gastrointestinal-complications-following-radical-cystectomy-using-enhanced-recovery-protocol
#17
Soroush T Bazargani, Hooman Djaladat, Hamed Ahmadi, Gus Miranda, Jie Cai, Anne K Schuckman, Siamak Daneshmand
BACKGROUND: The development of enhanced recovery after surgery (ERAS) protocols for patients undergoing radical cystectomy (RC) represents a significant advance in perioperative care. OBJECTIVE: To evaluate gastrointestinal (GI) complications following RC and urinary diversion (UD) using our institutional ERAS protocol. DESIGN, SETTING, AND PARTICIPANTS: We identified 377 consecutive cases of open RC and UD for which our ERAS protocol was used from May 2012 to December 2015...
April 25, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28751079/one-size-does-not-fit-all-disease-profiles-of-serious-illness-patients-receiving-specialty-palliative-care
#18
Arif H Kamal, Donald H Taylor, Benjamin Neely, Matthew Harker, Parampal Bhullar, John Morris, Lindsay Bonsignore, Janet Bull
INTRODUCTION: Understanding the symptom profiles of seriously ill patients who receive palliative care, especially non-cancer diagnoses where the data is sparse, is critical to better targeting our resources to the needs of patients. METHODS: We performed a retrospective, multi-cohort study of patients evaluated during their first consultative palliative care visit in a community-based palliative care registry. We placed into one of seven major disease categories based on clinician-reported primary diagnosis for consultation...
July 24, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28750680/primary-tumor-location-as-a-predictor-of-the-benefit-of-palliative-resection-for-colorectal-cancer-with-unresectable-metastasis
#19
Rong-Xin Zhang, Wen-Juan Ma, Yu-Ting Gu, Tian-Qi Zhang, Zhi-Mei Huang, Zhen-Hai Lu, Yang-Kui Gu
BACKGROUND: It is still under debate that whether stage IV colorectal cancer patients with unresectable metastasis can benefit from primary tumor resection, especially for asymptomatic colorectal cancer patients. Retrospective studies have shown controversial results concerning the benefit from surgery. This retrospective study aims to evaluate whether the site of primary tumor is a predictor of palliative resection in asymptomatic stage IV colorectal cancer patients. METHODS: One hundred ninety-four patients with unresectable metastatic colorectal cancer were selected from Sun Yat-sen University Cancer Center Database in the period between January 2007 and December 2013...
July 27, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28748593/the-use-of-life-review-to-enhance-spiritual-wellbeing-in-patients-with-terminal-illnesses-an-integrative-review
#20
REVIEW
Cecilia W M Kwan, Marques S N Ng, Carmen W H Chan
AIMS AND OBJECTIVES: An integrative review of the current literature on using life review as an intervention to address the spiritual need of patients with terminal illnesses. BACKGROUND: Palliative care highlights the holistic approach of care including the spiritual aspect. Life review has been used in palliative nursing intending to enhance patients' emotional and spiritual wellbeing, and quality of life. However, there is a lack of publications that provide a structured overview on life review programs and their effectiveness...
July 26, 2017: Journal of Clinical Nursing
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