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end of life decisions

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https://www.readbyqxmd.com/read/28427472/optimising-conservative-management-of-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#1
Katherine J Simson, Clint T Miller, Jon Ford, Andrew Hahne, Luana Main, Timo Rantalainen, Wei-Peng Teo, Megan Teychenne, David Connell, Guy Trudel, Guoyan Zheng, Gary Thickbroom, Daniel L Belavy
BACKGROUND: Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain...
April 20, 2017: Trials
https://www.readbyqxmd.com/read/28426540/family-functioning-predicts-end-of-life-care-quality-in-patients-with-cancer-multicenter-prospective-cohort-study
#2
Myung Kyung Lee, Young Ho Yun
BACKGROUND: Treating patients with cancer within a family setting is the accepted standard of care and a hallmark of end-of-life (EoL) quality of care (QoC). OBJECTIVE: The aim of this study was to determine whether family caregiver functioning predicts EoL QoC received by terminally ill patients with cancer. METHODS: Family caregivers of terminally ill patients with cancer (n = 264) were enrolled from oncology inpatient and outpatient units of 12 large hospitals located in different regions throughout South Korea...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#3
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
April 20, 2017: Nursing Research
https://www.readbyqxmd.com/read/28424546/perspectives-of-older-people-living-in-long-term-care-facilities-and-of-their-family-members-toward-advance-care-planning-discussions-a-systematic-review-and-thematic-synthesis
#4
REVIEW
Veronica Mignani, Francesca Ingravallo, Elena Mariani, Rabih Chattat
OBJECTIVE: We aimed to search and synthesize qualitative studies exploring the perspectives of older people living in long-term care facilities and of their family members about advance care planning (ACP) discussions. METHODS: The enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework was used to guide the review and report its results. PubMed, CINAHL, and PsycINFO were searched for studies published between January 2000 and November 2015...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28423478/a-qualitative-study-of-community-nurses-decision-making-around-the-anticipatory-prescribing-of-end-of-life-medications
#5
Ben Bowers, Sarah Redsell
AIMS: To explore community nurses' decision-making processes around the prescribing of anticipatory medications for people who are dying. BACKGROUND: Community nurses frequently initiate the prescribing of anticipatory medications to help control symptoms in those who are dying. However, little is known about their decision-making processes in relation to when they instigate anticipatory prescribing and their discussions with families and General Practitioners. DESIGN: A qualitative interpretive descriptive enquiry...
April 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#6
Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock, Jean Kutner
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual's acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable...
April 18, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28419505/assisted-dying-disability
#7
Christopher A Riddle
This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal...
April 17, 2017: Bioethics
https://www.readbyqxmd.com/read/28417931/upstreaming-and-normalizing-advance-care-planning-conversations-a-public-health-approach
#8
Maryjo Prince-Paul, Evelina DiFranco
As a society, we simply don't talk about this universal experience called dying and death; in fact, we ignore it until we have to face it. Thus, it is often in a crisis experience when we have to make decisions while we are laden with uncertainty and intense emotions. Sixty percent of people say making sure their family is not burdened by tough decisions is extremely important, yet 56% of them have not held a conversation about its context. Instead of waiting to make end-of-life decisions, let us begin to think about what matters most while we are living, what we value most, and how we translate these values into conversations about what is important...
April 12, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28417132/awareness-and-attitudes-of-community-dwelling-individuals-in-singapore-towards-participating-in-advance-care-planning
#9
Qin Xiang Ng, Tricia Zl Kuah, Germaine Jm Loo, Wilbert Hh Ho, Norbert L Wagner, Judy Gk Sng, Grace Mj Yang, Bee Choo Tai
INTRODUCTION: Advance care planning (ACP) is an important aspect of end-of-life care that has been shown to improve patient autonomy in decision-making and reduce stress for surviving family members. Given the rapidly ageing population in Singapore, a greater emphasis on end-of-life care planning is needed. This study therefore sought to examine the awareness and attitudes of the general Singaporean community towards participating in ACP, which are not known hitherto. MATERIALS AND METHODS: A 24-item interviewer-administered questionnaire was constructed and administered via door-to-door survey amongst community-dwelling residents living in Housing and Development Board (HDB) flats across Singapore, selected via a two-stage stratified random sampling...
March 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28416655/economic-inequality-increases-risk-taking
#10
B Keith Payne, Jazmin L Brown-Iannuzzi, Jason W Hannay
Rising income inequality is a global trend. Increased income inequality has been associated with higher rates of crime, greater consumer debt, and poorer health outcomes. The mechanisms linking inequality to poor outcomes among individuals are poorly understood. This research tested a behavioral account linking inequality to individual decision making. In three experiments (n = 811), we found that higher inequality in the outcomes of an economic game led participants to take greater risks to try to achieve higher outcomes...
April 17, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28414849/-the-rights-of-the-dying-the-refusal-of-medical-treatments-in-argentine-courts
#11
Juan Pedro Alonso
This paper addresses the judicialization of end of life medical decision-making, as part of the advance of the justice system in the regulation of medical practice and the rise of recognition of patient autonomy. The article analyzes, from a sociological standpoint, legal decisions regarding treatment refusal at the end of life produced by the Argentine courts between 1975 and 2015. Based on a qualitative design, 38 sentences collected from jurisprudential databases using key terms were analyzed. First, judicialized cases during the period are described; these are characterized by a high proportion of claims presented by health institutions, a pro-treatment bias in the legal actions requested, and a high percentage of unnecessary litigation in the absence of conflicts or in situations that do not require court intervention...
July 2016: Salud Colectiva
https://www.readbyqxmd.com/read/28410649/incident-dialysis-access-in-patients-with-end-stage-kidney-disease-what-needs-to-be-improved
#12
REVIEW
Louise M Moist, Charmaine E Lok
The initiation of dialysis is a challenging time of transition for patients, families, and their supporters. Patients with exposure to a comprehensive chronic kidney disease clinic may have had education and subsequent decision making regarding dialysis modality and access; however, many patients with or without prior education will require an urgent start to dialysis, requiring quick decisions regarding dialysis modality and access. In many countries, hemodialysis (HD) using a central venous catheter (CVC) is the most common initial renal replacement modality and dialysis access...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28408074/burnout-and-job-satisfaction-of-intensive-care-personnel-and-the-relationship-with-personality-and-religious-traits-an-observational-multicenter-cross-sectional-study
#13
Asimenia Ntantana, Dimitrios Matamis, Savvoula Savvidou, Maria Giannakou, Mary Gouva, George Nakos, Vasilios Koulouras
OBJECTIVES: To investigate if burnout in the Intensive Care Unit (ICU) is influenced by aspects of personality, religiosity and job satisfaction. RESEARCH METHODOLOGY: Cross-sectional study, designed to assess burnout in the ICU and to investigate possible determinants. Three different questionnaires were used: the Malach Burnout Inventory, the Eysenck Personality Questionnaire and the Spiritual/Religious Attitudes Questionnaire. Predicting factors for high burnout were identified by multivariate logistic regression analysis...
April 10, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28399022/palliative-and-end-of-life-care-in-nephrology-moving-from-observations-to-interventions
#14
Nwamaka D Eneanya, Michael K Paasche-Orlow, Angelo Volandes
PURPOSE OF REVIEW: In comparison with patients who have other serious illnesses, patients with advanced kidney disease have a higher rate of intensive care utilization at the end of life and receive palliative care less frequently. Consensus and clinical practice guidelines have therefore recommended the incorporation of palliative care earlier in the disease trajectory. This review summarizes recent literature on this aspect of care and will highlight future directions for patient-centered care within palliative nephrology...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28398367/-implantable-cardioverter-defibrillator-deactivation-at-the-end-of-life-ethical-clinical-and-communication-issues
#15
Massimo Romanò, Maria Antonella Piga, Roberta Bertona, Roberto Negro, Chiara Ruggeri, Federica Zorzoli, Rosvaldo Villani
The number of cardioverter-defibrillator implants is increasing worldwide, with the main indication being primary prevention of sudden cardiac death. During the follow-up, patients may die from progression of their underlying heart disease or from nonarrhythmic causes, such as malignancies, dementia and lung disease, without receiving appropriate shocks until the last few days or weeks of their life. These events occur roughly in 30% of patients, mainly in the last 24 hours before death. In this case, inappropriate and even appropriate shock deliveries can no longer prolong life and may simply lead to pain and reduced quality of life...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28394249/cognitive-behavioural-therapy-and-short-term-psychoanalytic-psychotherapy-versus-brief-psychosocial-intervention-in-adolescents-with-unipolar-major-depression-impact-a-multicentre-pragmatic-observer-blind-randomised-controlled-trial
#16
Ian M Goodyer, Shirley Reynolds, Barbara Barrett, Sarah Byford, Bernadka Dubicka, Jonathan Hill, Fiona Holland, Raphael Kelvin, Nick Midgley, Chris Roberts, Rob Senior, Mary Target, Barry Widmer, Paul Wilkinson, Peter Fonagy
BACKGROUND: Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. OBJECTIVE: To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28393995/-euthanasia-in-chile
#17
Víctor Hugo Carrasco M, Francisca Crispi
Euthanasia is a complex medical procedure. Even though end of life decisions are common situations in health practice, there is a lack of consensus about their terminology. In this manuscript, the main concepts about this issue are defined and delimited; including active and passive euthanasia and limitation of therapeutic effort. Then, a revision is made about the international experience on euthanasia, to then go through the Chile’s history in euthanasia and the population’s opinion. In Chile, euthanasia is an act that has been removed from the social dialogue and legislation...
December 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28391586/swallowing-impairment-is-a-significant-factor-for-predicting-life-prognosis-of-elderly-at-the-end-of-life
#18
Koji Naruishi, Yasufumi Nishikawa
BACKGROUND: In end-of-life care of elderly, the decision of care plan including gastrostomy is difficult frequently because of insufficient knowledge relating the life prognosis of elderly. It is important the families to decide correctly the life prognosis of elderly with geriatric diseases. Our purpose is to examine the significant factors for predicting life prognosis of elderly in end-of-life care. METHODS: A total of 320 elderly patients was enrolled (male/female 151/169; averaged age: male 84...
April 8, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28391343/cost-effectiveness-of-eculizumab-treatment-after-kidney-transplantation-in-patients-with-atypical-haemolytic-uraemic-syndrome
#19
Jan A J G van den Brand, Jacobien C Verhave, Eddy M Adang, Jack F M Wetzels
Background: Kidney transplantation in patients with atypical haemolytic uraemic syndrome (aHUS) is frequently complicated by recurrence of aHUS, often resulting in graft loss. Eculizumab prophylaxis prevents recurrence, improving graft survival. An alternative treatment strategy has been proposed where eculizumab is administered upon recurrence. We combined available evidence and performed a cost-effectiveness analysis of these competing strategies. Methods: A cost-effectiveness analysis using a decision analytical approach with Markov chain analyses was used to compare alternatives for aHUS patients with end-stage renal disease (ESRD): (i) dialysis treatment, (ii) kidney transplantation, (iii) kidney transplantation with eculizumab therapy upon recurrence of aHUS, (iv) kidney transplantation with eculizumab induction consisting of 12 months of prophylaxis and (v) kidney transplantation with lifelong eculizumab prophylaxis...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28389527/patient-autonomy-and-professional-expertise-in-decisions-near-the-end-of-life-commentary-on-francis-kamm
#20
Robert D Truog
No abstract text is available yet for this article.
April 7, 2017: Journal of Medical Ethics
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