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https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#1
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27907897/cost-effectiveness-of-embryo-transfer-strategies-a-decision-analytic-model-using-long-term-costs-and-consequences-of-singletons-and-multiples-born-as-a-consequence-of-ivf
#2
M M J van Heesch, A D I van Asselt, J L H Evers, M A H B M van der Hoeven, J C M Dumoulin, C E M van Beijsterveldt, G J Bonsel, R H M Dykgraaf, J B van Goudoever, C Koopman-Esseboom, W L D M Nelen, K Steiner, P Tamminga, N Tonch, H L Torrance, C D Dirksen
STUDY QUESTION: What is the cost-effectiveness of elective single embryo transfer (eSET) versus double embryo transfer (DET) strategies from a societal perspective, when applying a time horizon of 1, 5 and 18 years? SUMMARY ANSWER: From a short-term perspective (1 year) it is cost-effective to replace DET with single embryo transfer; however when intermediate- (5 years) and long-term (18 years) costs and consequences are incorporated, DET becomes the most cost-effective strategy, given a ceiling ratio of €20 000 per quality-adjusted life years (QALY) gained...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27906720/decisions-regarding-forgoing-life-sustaining-treatments
#3
Gail A Van Norman
PURPOSE OF REVIEW: Decisions to forego life-sustaining treatments are complex, and disagreements between physicians and patients occur. This review discusses recent findings regarding what factors influence physicians and patients or their surrogates in these decisions and considers whether futility arguments regarding life-sustaining treatments should be abandoned. RECENT FINDINGS: Cardiopulmonary resuscitation is one paradigm in the literature for studying end-of-life decision-making...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27898281/goals-of-care-or-goals-of-trust-how-family-members-perceive-goals-for-dying-nursing-home-residents
#4
Cherie Rosemond, Laura C Hanson, Sheryl Zimmerman
PURPOSE OF STUDY: Dementia affects more than 5 million Americans, and is a leading cause of death. Family members of nursing home (NH) residents with advanced dementia report difficulty making decisions about care toward the end of life. As part of a randomized trial testing an intervention to improve decision making, this qualitative study aimed to understand how family decision makers experienced goal-based decision making in advance of the death of their relative. DESIGN AND METHODS: This qualitative study was conducted as part of the goals of care clinical trial...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27898175/interventions-for-promoting-participation-in-shared-decision-making-for-children-with-cancer
#5
REVIEW
Imelda Coyne, Dónal P O'Mathúna, Faith Gibson, Linda Shields, Edith Leclercq, Greg Sheaf
BACKGROUND: This is an update of the Cochrane systematic review of shared decision-making (SMD) making published in 2013. Children's rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27894120/end-of-life-care-and-survival-without-major-brain-damage-in-newborns-at-the-limit-of-viability
#6
Fermín García-Muñoz Rodrigo, Lourdes Urquía Martí, José Ángel García Hernández, Josep Figueras Aloy, Alfredo García-Alix Pérez
BACKGROUND: The probabilities of survival and survival without major brain damage (MBD) are low in newborns at the limit of viability. Survival without MBD constitutes a major concern for parents and professionals. OBJECTIVES: To know the probabilities of survival without MBD in newborns ≤26 weeks' gestational age (GA) relative to the total number of survivors, whether these probabilities vary with GA, and how end-of-life (EoL) decisions influence these results...
November 29, 2016: Neonatology
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#7
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/27890302/-facilitators-and-barriers-regarding-end-of-life-care-at-nursing-homes-a-focus-group-study
#8
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/27885224/the-attitude-of-japanese-individuals-toward-end-of-life-care
#9
Hiroaki Nishioka, Hidenori Arai
OBJECTIVE: To understand the attitude of Japanese individuals toward end-of-life care. SUBJECTS AND METHODS: The present study was conducted among the individuals who participated in a public seminar and completed a questionnaire related to end-of-life care. We analyzed their responses. One hundred seventy-six participants (mean age: 64.7 years) answered the questionnaires, which asked whether they were familiar with the concept of a living will, who should decide their end-of-life care planning, what kind of nutritional support they would prefer to receive at the end-of-life, and what kind of medical treatments they were unwilling to receive...
2016: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#10
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27882864/patient-participation-in-palliative-care-decisions-an-ethnographic-discourse-analysis
#11
Emmanuelle Bélanger, Charo Rodríguez, Danielle Groleau, France Légaré, Mary Ellen MacDonald, Robert Marchand
The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team...
2016: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/27881828/-hope-for-the-best-prepare-for-the-worst-a-qualitative-interview-study-on-parents-needs-and-fears-in-pediatric-advance-care-planning
#12
Julia Desiree Lotz, Marion Daxer, Ralf J Jox, Gian Domenico Borasio, Monika Führer
BACKGROUND: Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. AIM: We aimed to investigate parents' views and needs regarding pediatric advance care planning...
November 23, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27880025/attitudes-to-decisions-about-extremely-premature-infants-differed-between-swiss-linguistic-regions-in-population-based-study
#13
Manya J Hendriks, Sabine D Klein, Hans Ulrich Bucher, Ruth Baumann-Hölzle, Jürg C Streuli, Jean-Claude Fauchère
AIM: Studies have provided insights into the different attitudes and values of healthcare professionals and parents toward extreme prematurity. This study explored societal attitudes and values in Switzerland with regard to this patient group. METHODS: A nationwide trilingual telephone survey was conducted in the French, German and Italian speaking regions of Switzerland to explore the general population's attitudes and values with regard to extreme prematurity...
November 23, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27879155/managing-cognition-in-progressive-supranuclear-palsy
#14
Timothy Rittman, Ian Ts Coyle-Gilchrist, James B Rowe
Cognitive impairment is integral to the syndrome of progressive supranuclear palsy. It is most commonly described as a frontal dysexecutive syndrome but other impairments include apathy, impulsivity, visuospatial and memory functions. Cognitive dysfunction may be exacerbated by mood disturbance, medication and communication problems. In this review we advocate an individualized approach to managing cognitive impairment in progressive supranuclear palsy with the education of caregivers as a central component...
November 23, 2016: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/27878797/choosing-wisely-at-the-end-of-life-the-crucial-role-of-medical-indication
#15
Gian Domenico Borasio, Ralf J Jox
At the end of life, several treatments are administered routinely that lack medical indication and may cause significant harm to patients. Examples include artificial hydration and oxygen therapy in the dying phase, as well as enteral nutrition in advanced dementia. Medical indication is defined as the appropriateness of a therapeutic or diagnostic measure in the patient's concrete clinical situation, in light of the best available evidence. The decision about the absence or presence of a medical indication is a core competence of physicians...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27872409/complexity-analysis-of-decision-making-in-the-critically-ill
#16
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/27869300/changes-in-care-goals-and-treatment-orders-around-the-occurrence-of-health-problems-and-hospital-transfers-in-dementia-a-prospective-study
#17
Simone A Hendriks, Martin Smalbrugge, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVES: To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed-upon do-not-hospitalize orders. DESIGN: Data were collected as part of the Dutch End of Life in Dementia study (2007-2011), a longitudinal observational study with up to 3.5 years of follow-up. SETTING: Long-term care facilities (N = 28) in the Netherlands. PARTICIPANTS: Newly admitted nursing home patients (N = 372) in various stages of dementia...
November 21, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27867525/barriers-to-goals-of-care-discussions-with-hospitalized-patients-with-advanced-heart-failure-feasibility-and-performance-of-a-novel-questionnaire
#18
Natasha Aleksova, Catherine Demers, Patricia H Strachan, Jane MacIver, James Downar, Robert Fowler, Daren K Heyland, Heather J Ross, John J You
AIMS: Good end-of-life communication and decision-making are important to patients with advanced heart failure (HF) and their families, but their needs remain unmet. In this pilot study, we describe the feasibility and performance of a novel questionnaire aimed at identifying barriers and solutions to improve communication and decision-making about goals of care for hospitalized patients with advanced HF. METHODS: We distributed questionnaires to staff cardiologists, cardiology trainees, and cardiology nurses who provide care for HF patients at a Canadian teaching hospital...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27864564/hierarchical-structure-and-importance-of-patients-reasons-for-treatment-choices-in-knee-and-hip-osteoarthritis-a-concept-mapping-study
#19
Ellen M H Selten, Rinie Geenen, Willemijn H van der Laan, Roelien G van der Meulen-Dilling, Henk J Schers, Marc W Nijhof, Cornelia H M van den Ende, Johanna E Vriezekolk
OBJECTIVES: To improve patients' use of conservative treatment options of hip and knee OA, in-depth understanding of reasons underlying patients' treatment choices is required. The current study adopted a concept mapping method to thematically structure and prioritize reasons for treatment choice in knee and hip OA from a patients' perspective. METHODS: Multiple reasons for treatment choices were previously identified using in-depth interviews. In consensus meetings, experts derived 51 representative reasons from the interviews...
November 17, 2016: Rheumatology
https://www.readbyqxmd.com/read/27864126/the-use-of-life-sustaining-procedures-in-the-last-month-of-life-is-associated-with-more-depressive-symptoms-in-surviving-spouses
#20
Katherine A Ornstein, Melissa D Aldridge, Melissa M Garrido, Rebecca Gorges, Evan Bollens-Lund, Albert L Siu, Kenneth M Langa, Amy S Kelley
CONTEXT: Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression. OBJECTIVE: To determine the association between patients' use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses. METHODS: We used data from the Health and Retirement Study, a longitudinal survey of U...
November 15, 2016: Journal of Pain and Symptom Management
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