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end of life decision making

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https://www.readbyqxmd.com/read/28816094/theories-of-health-care-decision-making-at-the-end-of-life-a-meta-ethnography
#1
Kyounghae Kim, Katherine Heinze, Jiayun Xu, Melissa Kurtz, Hyunjeong Park, Megan Foradori, Marie T Nolan
The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015...
August 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28815814/supporting-end-of-life-decision-making-case-studies-of-relational-closeness-in-supported-decision-making-for-people-with-severe-or-profound-intellectual-disability
#2
Joanne Watson, Erin Wilson, Nick Hagiliassis
BACKGROUND: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions. METHODS: Five people with severe or profound intellectual disability's experiences of supported decision making were examined...
August 16, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28814131/what-factors-influence-women-s-perceptions-of-their-systemic-recurrence-risk-after-breast-cancer-treatment
#3
Kamaria L Lee, Nancy K Janz, Brian J Zikmund-Fisher, Reshma Jagsi, Lauren P Wallner, Allison W Kurian, Steven J Katz, Paul Abrahamse, Sarah T Hawley
BACKGROUND: Breast cancer patients' misunderstanding of their systemic cancer recurrence risk has consequences on decision-making and quality of life. Little is known about how women derive their risk estimates. METHODS: Using Los Angeles and Georgia's SEER registries (2014-2015), a random sample of early-stage breast cancer patients was sent surveys about 2 to 3 months after surgery ( N = 3930; RR, 68%). We conducted an inductive thematic analysis of open-ended responses about why women chose their risk estimates in a uniquely large sub-sample ( N = 1,754)...
August 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28806952/socio-cultural-contexts-of-end-of-life-conversations-and-decisions-bereaved-family-cancer-caregivers-retrospective-co-constructions
#4
Jennifer Nyawira Githaiga, Leslie Swartz
BACKGROUND: End-of-life communication becomes increasingly difficult in terminal cancer, which inevitably entails conversations around dying and death. In resource-limited areas, the context of end-of-life communication is usually home-based palliative care comprising mostly women in the family who play critical roles as informal caregivers. This article examined the content and contexts of family end-of-life conversations and decisions based on the retrospective accounts of a sample of bereaved women family cancer caregivers in Nairobi, Kenya...
August 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28805170/perspectives-of-patients-close-relatives-nurses-and-physicians-on-end-of-life-medication-management
#5
Marianne K Dees, Eric C T Geijteman, Wim J M Dekkers, Bregje A A Huisman, Roberto S G M Perez, Lia van Zuylen, Agnes van der Heide, Evert van Leeuwen
OBJECTIVE: Our aim was to gain insight into the perspectives of patients, close relatives, nurses, and physicians on medication management for patients with a life expectancy of less than 3 months. METHOD: We conducted an empirical multicenter study with a qualitative approach, including in-depth interviews with patients, relatives, nurses, specialists, and general practitioners (GPs). We used the constant comparative method and ATLAS.ti (v. 7.1) software for our analysis...
August 14, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28804867/sources-of-distress-for-physicians-and-nurses-working-in-swiss-neonatal-intensive-care-units
#6
Sabine D Klein, Hans Ulrich Bucher, Manya J Hendriks, Ruth Baumann-Hölzle, Jürg C Streuli, Thomas M Berger, Jean-Claude Fauchère, On Behalf Of The Swiss Neonatal End-Of-Life Study Group
BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#7
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28800520/a-modified-delphi-process-to-identify-clinical-and-research-priorities-in-patient-and-family-centred-critical-care
#8
Simon J W Oczkowski, Selena Au, Amanda Roze des Ordons, Marlyn Gill, Melissa L Potestio, Orla Smith, Tasnim Sinuff, Henry T Stelfox, Alison E Fox-Robichaud
PURPOSE: To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS: We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions were rated in 3 successive rounds on a scale from 1 to 7. Median score was used to rate each item's priority, with 5 or more indicating "essential priority," 4 or 5 "moderate priority" and 3 or less "low priority...
August 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28797850/advance-care-planning-in-palliative-care-for-people-with-intellectual-disabilities-a-systematic-review
#9
REVIEW
Hille Voss, Anique Vogel, Annemieke Ma Wagemans, Anneke L Francke, Job Fm Metsemakers, Annemie M Courtens, Anke Je de Veer
CONTEXT: Advance care planning (ACP) is defined as a person-centred, ongoing process of communication that facilitates patients' understanding, reflection and discussion of goals, values and preferences for future care. There is evidence for the general palliative care population that ACP increases compliance with patients' end-of-life preferences and improves quality of care near the end of life. OBJECTIVES: To gain insight into what is known about the use and effects of ACP in palliative care for people with intellectual disabilities (ID)...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28789928/engaging-patients-in-complex-clinical-decision-making-successes-pitfalls-and-future-directions
#10
REVIEW
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
August 5, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28781022/determinants-of-last-line-treatment-in-metastatic-breast-cancer
#11
Marika Cinausero, Lorenzo Gerratana, Elisa De Carlo, Donatella Iacono, Marta Bonotto, Valentina Fanotto, Vanessa Buoro, Debora Basile, Maria Grazia Vitale, Karim Rihawi, Gianpiero Fasola, Fabio Puglisi
BACKGROUND: In metastatic breast cancer (MBC) patients, the identification of factors helping clinicians in the choice between active therapy versus best supportive care is needed clinically. The aim of the present study was to identify the clinicopathologic factors that could improve the prognostic valuation of MBC patients and clinical decision-making at the end of life. PATIENTS AND METHODS: The present study analyzed data from a retrospective series of 522 MBC patients treated at the oncology department (University Hospital of Udine) from January 2004 to June 2014...
July 14, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28777113/family-satisfaction-with-end-of-life-care-in-the-intensive-care-unit-a-systematic-review-of-the-literature
#12
Susan DeSanto-Madeya, Parissa Safizadeh
BACKGROUND: Assessment of family satisfaction after the death of a loved one in the intensive care unit (ICU) provides a way to determine whether quality end-of-life care was received by the patient and family. The purpose of this systematic review was to explore the factors associated with family satisfaction with end-of-life care in the ICU. METHODS: A systematic literature review was conducted using electronic databases CINAHL, MEDLINE, EMBASE, and PsychINFO...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#13
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
August 3, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28775217/end-of-life-services-for-older-people-in-residential-care-homes-in-hong-kong
#14
REVIEW
J K Luk
Good end-of-life care is needed for older people living in residential care homes with advanced irreversible chronic medical illnesses and cancers. At present, the usual practice of residential care homes is to send older residents to acute hospitals when they are unwell, and some residents will die in hospital. Dying in hospital without choice for older people may not be in alignment with the principle of 'good death'. There are many barriers for older people to die in the place of their choice, particularly in a residential care home...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28760834/validation-of-quality-indicators-for-end-of-life-communication-results-of-a-multicentre-survey
#15
MULTICENTER STUDY
Daren K Heyland, Peter Dodek, John J You, Tasnim Sinuff, Tim Hiebert, Carolyn Tayler, Xuran Jiang, Jessica Simon, James Downar
BACKGROUND: The lack of validated quality indicators is a major barrier to improving end-of-life communication and decision-making. We sought to show the feasibility of and provide initial validation for a set of quality indicators related to end-of-life communication and decision-making. METHODS: We administered a questionnaire to patients and their family members in 12 hospitals and asked them about advance care planning and goals-of-care discussions. Responses were used to calculate a quality indicator score...
July 31, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28760833/measuring-quality-of-end-of-life-communication-and-decision-making-do-we-have-this-right
#16
Jeff Myers
No abstract text is available yet for this article.
July 31, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28760210/a-randomized-trial-of-a-1-hour-troponin-t-protocol-in-suspected-acute-coronary-syndromes-design-of-the-rapid-assessment-of-possible-acs-in-the-emergency-department-with-high-sensitivity-troponin-t-rapid-tnt-study
#17
RANDOMIZED CONTROLLED TRIAL
Cynthia Papendick, Andrew Blyth, Anil Seshadri, Michael J R Edmonds, Tom Briffa, Louise Cullen, Stephen Quinn, Jon Karnon, Anthony Chuang, Adam J Nelson, Matthew Horsfall, Erin Morton, Derek P Chew
BACKGROUND: Protocols incorporating high-sensitivity troponin to guide decision making in the disposition of patients with suspected acute coronary syndromes (ACS) in the emergency department have received a lot of attention. Traditionally, patients with chest pain have required long periods of observation in emergency department before being deemed safe for discharge. In an era of limited health service resources, a protocol that could discharge patients safely within an hour of presentation is extremely attractive...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28758559/small-for-size-syndrome-bridging-the-gap-between-liver-transplantation-and-graft-recovery
#18
Akila Rajakumar, Ilankumaran Kaliamoorthy, Mohamed Rela, M Susan Mandell
In living donor liver transplantation, optimal graft size is estimated from values like graft volume/standard liver volume and graft/recipient body weight ratio but the final functional hepatic mass is influenced by other donor and recipient factors. Grafts with insufficient functional hepatic mass can produce a life-threatening condition with rapidly progressive liver failure called small-for-size syndrome (SFSS). Diagnosis of SFSS requires careful surveillance for signs of inadequate hepatocellular function, residual portal hypertension, and systemic inflammation that suggest rapidly progressive liver failure...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28756187/under-implicit-pressure-young-black-and-latina-women-s-perceptions-of-contraceptive-care
#19
Anu Manchikanti Gómez, Mikaela Wapman
OBJECTIVE: To understand the ways in which young women of color experienced pressure from healthcare providers during contraceptive care, including the impact of these encounters on contraceptive decision-making and reproductive autonomy. METHODS: Data were drawn from a qualitative study of contraceptive decision-making, which included 38 young (age 18-24) Latina and Black women recruited using community-based and social media strategies. We analyzed in-depth interview data from a subsample of 27 young women who described experiencing pressure from healthcare providers during contraceptive care...
July 26, 2017: Contraception
https://www.readbyqxmd.com/read/28751157/end-of-life-decision-making-for-parents-of-extremely-preterm-infants
#20
Manya J Hendriks, Andrea Abraham
OBJECTIVE: To explore parental attitudes and values in the end-of-life decision-making process of extremely preterm infants (gestational age < 28 weeks). DESIGN: Hermeneutically oriented qualitative research design with in-depth interviews. SETTING: Level III NICU in Switzerland. PARTICIPANTS: Purposive sample of seven couples, five mothers, and one father (20 parents). METHODS: Qualitative content analysis was used to categorize and interpret themes from parents' narratives...
July 24, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
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