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https://www.readbyqxmd.com/read/27903942/the-reckoning-point-as-a-marker-for-formal-palliative-and-end-of-life-care-in-mexican-american-families
#1
Bronwynne C Evans, David W Coon
Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the "point of reckoning" in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver...
November 2016: Journal of Family Nursing
https://www.readbyqxmd.com/read/27903774/-they-shouldn-t-be-coming-to-the-ed-should-they-a-descriptive-service-evaluation-of-why-patients-with-palliative-care-needs-present-to-the-emergency-department
#2
Emilie Green, Sarah Ward, Will Brierley, Ben Riley, Henna Sattar, Tim Harris
BACKGROUND: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. METHODS: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period...
November 30, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27900548/predictors-of-response-to-corticosteroids-for-dyspnea-in-advanced-cancer-patients-a-preliminary-multicenter-prospective-observational-study
#3
Masanori Mori, Akemi Naito Shirado, Tatsuya Morita, Kenichiro Okamoto, Yoshinobu Matsuda, Yoshihisa Matsumoto, Hirohide Yamada, Hiroki Sakurai, Etsuko Aruga, Keisuke Kaneishi, Hiroaki Watanabe, Takashi Yamaguchi, Takuya Odagiri, Shuji Hiramoto, Hiroyuki Kohara, Naoki Matsuo, Hideki Katayama, Tomohiro Nishi, Takashi Matsui, Satoru Iwase
PURPOSE: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients. METHODS: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0-10 Numerical Rating Scale (NRS) (worst during the last 24 h)...
November 29, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27899400/study-protocol-a-phase-iii-randomised-double-blind-parallel-arm-stratified-block-randomised-placebo-controlled-trial-investigating-the-clinical-effect-and-cost-effectiveness-of-sertraline-for-the-palliative-relief-of-breathlessness-in-people-with-chronic-breathlessness
#4
Gareth J Watts, Katherine Clark, Meera Agar, Patricia M Davidson, Christine McDonald, Lawrence T Lam, Dimitar Sajkov, Nicola McCaffrey, Matthew Doogue, Amy P Abernethy, David C Currow
INTRODUCTION: Breathlessness remains a highly prevalent and distressing symptom for many patients with progressive life-limiting illnesses. Evidence-based interventions for chronic breathlessness are limited, and there is an ongoing need for high-quality research into developing management strategies for optimal palliation of this complex symptom. Previous studies have suggested that selective serotonin reuptake inhibitors such as sertraline may have a role in reducing breathlessness...
November 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/27898141/bostadsort-avg%C3%A3-r-den-palliativa-v%C3%A3-rdens-resurser-och-kvalitet-satsningar-f%C3%A3-r-att-%C3%A3-ka-kompetensen-beh%C3%A3-vs
#5
Bertil Axelsson, Bengt Sallerfors, Carl Johan Furst
Access to palliative care is unequally distributed across Sweden and thus does not meet the needs. The holistic perspective of palliative care is sometimes contrasted with the usual medical focus on organ failure and disease. Palliative consultation teams provide specialist palliative care competencies for staff caring for patients in primary care, nursing homes and in hospitals. Efforts to increase knowledge and skills in palliative care is needed at undergraduate university level and through postgraduate and specialist training...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27894377/effect-of-a-spiritual-care-training-program-for-staff-on-patient-outcomes
#6
Grace Meijuan Yang, Yung Ying Tan, Yin Bun Cheung, Weng Kit Lye, Sock Hui Amy Lim, Wan Ru Ng, Christina Puchalski, Patricia Soek Hui Neo
OBJECTIVE: Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative care for patients with an advanced serious illness. The aim of our study was to determine whether a training program for healthcare professionals on spirituality and the taking of a spiritual history would result in improved patient quality of life (QoL) and spiritual well-being. METHOD: This was a cluster-controlled trial of a spiritual care training program for palliative care doctors and nurses...
November 29, 2016: Palliative & Supportive Care
https://www.readbyqxmd.com/read/27893952/acceptability-and-impact-of-a-required-palliative-care-rotation-with-prerotation-and-postrotation-observed-simulated-clinical-experience-during-internal-medicine-residency-training-on-primary-palliative-communication-skills
#7
Maxwell T Vergo, Sharona Sachs, Meredith A MacMartin, Kathryn B Kirkland, Amelia M Cullinan, Lisa A Stephens
BACKGROUND: Improving communication training for primary palliative care using a required palliative care rotation for internal medicine (IM) residents has not been assessed. OBJECTIVE: To assess skills acquisition and acceptability for IM residents not selecting an elective. DESIGN: A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of clinical experience, and finally a post-OSCE to crystallize learner-centric take home points...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893951/events-leading-to-hospital-related-disenrollment-of-home-hospice-patients-a-study-of-primary-caregivers-perspectives
#8
Veerawat Phongtankuel, Shawn Paustian, Manney Carrington Reid, Amanda Finley, Angela Martin, John Delfs, Rosemary Baughn, Ronald D Adelman
BACKGROUND: Approximately 25% of hospice disenrollments in the United States occur as the result of hospitalization, which can lead to burdensome transitions and undesired care. Informal caregivers (e.g., spouses, children) play a critical role in caring for patients on home hospice. Research examining hospital-related disenrollment among these patients is limited. OBJECTIVE: To understand the events surrounding the hospitalization of patients discharged from home hospice through the perspective of their informal caregivers...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#9
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27893130/effect-of-inpatient-palliative-care-on-quality-of-life-2-weeks-after-hematopoietic-stem-cell-transplantation-a-randomized-clinical-trial
#10
Areej El-Jawahri, Thomas LeBlanc, Harry VanDusen, Lara Traeger, Joseph A Greer, William F Pirl, Vicki A Jackson, Jason Telles, Alison Rhodes, Thomas R Spitzer, Steven McAfee, Yi-Bin A Chen, Stephanie S Lee, Jennifer S Temel
Importance: During hospitalization for hematopoietic stem cell transplantation (HCT), patients receive high-dose chemotherapy before transplantation and experience significant physical and psychological symptoms and poor quality of life (QOL). Objective: To assess the effect of inpatient palliative care on patient- and caregiver-reported outcomes during hospitalization for HCT and 3 months after transplantation. Design, Setting, and Participants: Nonblinded randomized clinical trial among 160 adults with hematologic malignancies undergoing autologous/allogeneic HCT and their caregivers (n = 94)...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27892676/palliative-care-for-patients-with-gynecologic-cancer-in-japan-a-japan-society-of-gynecologic-palliative-medicine-jsgpm-survey
#11
Masayuki Futagami, Yoshihito Yokoyama, Tetsumi Sato, Kazuyoshi Hirota, Muneaki Shimada, Etsuko Miyagi, Nao Suzuki, Masaki Fujimura
Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29...
January 10, 2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27890302/-facilitators-and-barriers-regarding-end-of-life-care-at-nursing-homes-a-focus-group-study
#12
María Remedios Sánchez-García, Marina Moreno-Rodríguez, César Hueso-Montoro, Concepción Campos-Calderón, Ana Varella-Safont, Rafael Montoya-Juárez
AIM: To identify the facilitators and barriers experienced by professional related to end of life care in nursing homes. DESIGN: Descriptive qualitative research with phenomenological orientation, through content analysis. PLACEMENT: Nursing Homes at Primary Care District in Granada (Spain). PARTICIPANTS: Fifteen clinical professionals with, at least 6 months of experience in nursing homes, without specific background in palliative care...
November 24, 2016: Atencion Primaria
https://www.readbyqxmd.com/read/27881247/pain-management-in-ckd-a-guide-for-nephrology-providers
#13
Holly M Koncicki, Mark Unruh, Jane O Schell
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis...
November 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27876636/concordance-between-veterans-self-report-and-documentation-of-surrogate-decision-makers-implications-for-quality-measurement
#14
Kimberly K Garner, Patricia Dubbert, Shelly Lensing, Dennis H Sullivan
CONTEXT: The Measuring What Matters (MWM) initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. OBJECTIVES: To better understand the potential implementation of this MWM quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker...
November 19, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27872409/complexity-analysis-of-decision-making-in-the-critically-ill
#15
Barbara J Daly, Sara L Douglas, Elizabeth O'Toole, James Rowbottom, Alan Hoffer, Amy R Lipson, Christopher Burant
RATIONALE: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life. OBJECTIVE: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27872166/consistency-of-medical-record-reporting-of-a-set-of-indicators-for-proactive-palliative-care-in-patients-with-chronic-obstructive-pulmonary-disease-a-pilot-study
#16
Ria G Duenk, Stans C Verhagen, Mireille Ae Janssen, Richard Pnr Dekhuijzen, Kris Cp Vissers, Yvonne Engels, Yvonne Heijdra
To identify patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (COPD) who have a poor prognosis and might benefit from proactive palliative care, a set of indicators had been developed from the literature. A patient is considered eligible for proactive palliative care when meeting ≥2 criteria of the proposed set of 11 indicators. In order to develop a doctor-friendly and patient-convenient tool, our primary objective was to examine whether these indicators are documented consistently in the medical records...
November 21, 2016: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/27871280/comparing-conventional-radiotherapy-with-stereotactic-body-radiotherapy-in-patients-with-spinal-metastases-study-protocol-for-an-randomized-controlled-trial-following-the-cohort-multiple-randomized-controlled-trial-design
#17
Joanne M van der Velden, Helena M Verkooijen, Enrica Seravalli, Jochem Hes, A Sophie Gerlich, Nicolien Kasperts, Wietse S C Eppinga, Jorrit-Jan Verlaan, Marco van Vulpen
BACKGROUND: Standard radiotherapy is the treatment of first choice in patients with symptomatic spinal metastases, but is only moderately effective. Stereotactic body radiation therapy is increasingly used to treat spinal metastases, without randomized evidence of superiority over standard radiotherapy. The VERTICAL study aims to quantify the effect of stereotactic radiation therapy in patients with metastatic spinal disease. METHODS/DESIGN: This study follows the 'cohort multiple Randomized Controlled Trial' design...
November 21, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27871265/the-association-between-different-opioid-doses-and-the-survival-of-advanced-cancer-patients-receiving-palliative-care
#18
Anon Sathornviriyapong, Kittiphon Nagaviroj, Thunyarat Anothaisintawee
BACKGROUND: Concerns that opioids may hasten death can be a cause of the physicians' reluctance to prescribe opioids, leading to inadequate symptom palliation. Our aim was to find if there was an association between different opioid doses and the survival of the cancer patients that participated in our palliative care program. METHODS: A retrospective study was conducted at Ramathibodi Hospital, Bangkok between January 2013 and December 2015. All of the cancer patients that were referred to palliative care teams by their primary physicians were included in the study...
November 21, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27870079/cost-effectiveness-analysis-of-second-line-chemotherapy-agents-for-advanced-gastric-cancer
#19
Simon W Lam, Maya Wai, Jessica E Lau, Michael McNamara, Marc Earl, Belinda Udeh
STUDY OBJECTIVE: Gastric cancer is the fifth most common malignancy and second leading cause of cancer-related mortality. Chemotherapy options for patients who fail first-line treatment are limited. Thus, the objective of this study was to assess the cost-effectiveness of second-line treatment options for patients with advanced or metastatic gastric cancer. DESIGN: Cost-effectiveness analysis using a Markov model to compare the cost-effectiveness of six possible second-line treatment options for patients with advanced gastric cancer who have failed previous chemotherapy: irinotecan, docetaxel, paclitaxel, ramucirumab, paclitaxel plus ramucirumab, and palliative care...
November 21, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27859889/anxiety-depression-and-quality-of-life-in-family-caregivers-of-palliative-cancer-patients-during-home-care-and-after-the-patient-s-death
#20
H Götze, E Brähler, L Gansera, A Schnabel, A Gottschalk-Fleischer, N Köhler
We examined psychological parameters in family caregivers of palliative cancer patients before and after the death of the patients. Caregivers' data about depression and anxiety (Hospital Anxiety and Depression Scale), quality-of-life (Short Form-8 Health Survey), and social support (Oslo Social Support Scale) were collected at the beginning of home care (t1) and 2 months after the patient had died (t2). Regression models were employed to examine factors related to depression and anxiety in the bereaved caregivers...
November 17, 2016: European Journal of Cancer Care
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