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end of life decision making

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https://www.readbyqxmd.com/read/29221845/characterizing-the-role-of-u-s-surgeons-in-the-provision-of-palliative-care-a-systematic-review-and-mixed-methods-meta-synthesis
#1
REVIEW
Pasithorn A Suwanabol, Arielle E Kanters, Ari C Reichstein, Lauren M Wancata, Lesly A Dossett, Emily B Rivet, Maria J Silveira, Arden M Morris
CONTEXT: The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease, but also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that aren't clear. OBJECTIVES: We sought to characterize surgeon-specific determinants of palliative care in seriously-ill and dying patients. METHODS: We performed a systematic review of the literature focused on surgery and palliative care within PubMed, CINHAL, EMBASE, Scopus, and Ovid Medline databases from January 1, 2000 through December 31, 2016 according to PRISMA guidelines...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29212490/attitudes-towards-assisted-suicide-and-euthanasia-among-care-dependent-older-adults-50-in-austria-the-role-of-socio-demographics-religiosity-physical-illness-psychological-distress-and-social-isolation
#2
Erwin Stolz, Hannes Mayerl, Peter Gasser-Steiner, Wolfgang Freidl
BACKGROUND: Care-dependency constitutes an important issue with regard to the approval of end-of-life decisions, yet attitudes towards assisted suicide and euthanasia are understudied among care-dependent older adults. We assessed attitudes towards assisted suicide and euthanasia and tested empirical correlates, including socio-demographics, religiosity, physical illness, psychological distress and social isolation. METHODS: A nationwide cross-sectional survey among older care allowance recipients (50+) in private households in Austria was conducted in 2016...
December 7, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29212487/recognizing-difficult-trade-offs-values-and-treatment-preferences-for-end-of-life-care-in-a-multi-site-survey-of-adult-patients-in-family-practices
#3
Michelle Howard, Nick Bansback, Amy Tan, Doug Klein, Carrie Bernard, Doris Barwich, Peter Dodek, Aman Nijjar, Daren K Heyland
BACKGROUND: Decisions about care options and the use of life-sustaining treatments should be informed by a person's values and treatment preferences. The objective of this study was to examine the consistency of ratings of the importance of the values statements and the association between values statement ratings and the patient's expressed treatment preference. METHODS: We conducted a multi-site survey in 20 family practices. Patients aged 50 and older self-completed a questionnaire assessing the importance of eight values (rated 1 to 10), and indicated their preference for use of life-sustaining treatment (5 options)...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29200118/palliative-care-end-of-life-care-and-advance-care-planning-in-neuro-oncology
#4
Tobias Walbert
PURPOSE OF REVIEW: Despite new therapeutic approaches, most patients with high-grade glioma face limited overall survival and have a high symptom burden throughout their disease trajectory, especially in the end-of-life phase. This article provides an overview of the role of palliative care in neuro-oncology. Management recommendations are made for neurologic symptoms in patients with advanced brain tumors, including headaches, nausea, and fatigue. Special attention is given to how and when to involve subspecialty palliative care and hospice services to improve symptom management during active tumor treatment and in the end-of-life phase of patients with brain tumors...
December 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29199905/potentially-inappropriate-medication-in-primary-care-at-the-end-of-life-a-mixed-method-study
#5
Peter Pype, Fien Mertens, Fleur Helewaut, Bert D'Hulster, An De Sutter
CONTEXT: Polypharmacy results in adverse drug interactions, high pill burden, and medication costs. Stopping or diminishing potentially inappropriate medication (PIM), is complex . Data on the use of PIM in a primary care context are scarce and deprescribing barriers for general practitioners (GP) are underexplored. OBJECTIVE: Describing the use of PIM in primary care at the end of life, and exploring the barriers for GPs to deprescribe. METHODS: Retrospective chart review of 210 consecutive patients referred to a palliative home care service and semi-structured interviews with 11 GPs...
December 4, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29197715/end-of-life-care-of-elderly-patients-with-dementia-a-cross-sectional-study-of-family-carer-decision-making
#6
Rafaella I Peixoto, Vera M da Silveira, Rogério D Zimmermann, Adriana de M Gomes
BACKGROUND: Dementia syndromes pose a major worldwide challenge to public health. In terminal stage of dementia, carers are responsible for decision making in end-of-life treatment and there may be multiple factors that contribute to the choice of a palliative or invasive treatment. AIM: To identify possible factors that influence the decision-making of family caregivers on implementing invasive or palliative interventions for people with end stage dementia. DESIGN: A structured interview with family caregivers of elderly patients addressing aspects of the following categories: elderly with dementia, caregiver, medical treatment history...
November 28, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29191724/moral-distress-at-the-end-of-a-life-when-family-and-clinicians-don-t-agree-on-implantable-cardioverter-defibrillator-deactivation
#7
Jill M Steiner, Kristen K Patton, Jordan M Prutkin, James N Kirkpatrick
A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end-of-life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. The patient was unable to adequately participate in the decision-making process...
November 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29191185/compassionate-collaborative-care-an-integrative-review-of-quality-indicators-in-end-of-life-care
#8
Kathryn Pfaff, Adelais Markaki
BACKGROUND: Compassion and collaborative practice are individually associated with high quality healthcare. When combined in a compassionate collaborative care (CCC) practice framework, they are reported to improve health, strengthen care provision, and control health costs. Little is known about how to integrate and measure CCC, yet it is fundamentally applied in palliative and end-of-life care settings. This study aimed to identify quality indicators of CCC by systematically reviewing and synthesizing the current state of the palliative and end-of-life care literature...
December 1, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29191183/an-economic-model-of-advance-care-planning-in-australia-a-cost-effective-way-to-respect-patient-choice
#9
Kim-Huong Nguyen, Marcus Sellars, Meera Agar, Sue Kurrle, Adele Kelly, Tracy Comans
BACKGROUND: Advance care planning (ACP) is a process of planning for future health and personal care. A person's values and preferences are made known so that they can guide decision making at a future time when that person cannot make or communicate his or her decisions. This is particularly relevant for people with dementia because their ability to make decisions progressively deteriorates over time. This study aims to evaluate the cost-effectiveness of delivering a nationwide ACP program within the Australian primary care setting...
December 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29189085/sharing-end-of-life-care-preferences-with-family-members-who-has-the-discussion-and-who-does-not
#10
Lindsay J Peterson, Debra Dobbs, Hongdao Meng, Alyssa Gamaldo, Kevin O'Neil, Kathryn Hyer
BACKGROUND: Research suggests that greater engagement in family discussions concerning end-of-life (EOL) care preferences could improve advance care planning and EOL outcomes. However, a substantial number of people have not had such discussions. OBJECTIVE: The study's objective was to understand attitudes and experiences influencing engagement in discussions of EOL care preferences with family members, including the role of healthcare providers in such discussions...
November 30, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29185254/technical-comment-on-biskup-e-et-al-oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#11
Silvio A Ñamendys-Silva
No abstract text is available yet for this article.
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29185248/reply-to-technical-comment-on-biskup-e-et-al-oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#12
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
No abstract text is available yet for this article.
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29179708/comparing-doctors-legal-compliance-across-three-australian-states-for-decisions-whether-to-withhold-or-withdraw-life-sustaining-medical-treatment-does-different-law-lead-to-different-decisions
#13
Ben P White, Lindy Willmott, Colleen Cartwright, Malcolm Parker, Gail Williams, Juliet Davis
BACKGROUND: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity...
November 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29178843/a-qualitative-evidence-synthesis-to-explore-healthcare-professionals-experience-of-prescribing-opioids-to-adults-with-chronic-non-malignant-pain
#14
Fran Toye, Kate Seers, Stephanie Tierney, Karen Louise Barker
BACKGROUND: Despite recent guidelines suggesting that patients with chronic non-malignant pain might not benefit, there has been a significant rise in opioid prescription for chronic non-malignant pain. This topic is important because an increasing number of HCPs are prescribing opioids despite very limited evidence for long-term opioid therapy for chronic non-malignant pain outside of end-of-life care. To better understand the challenges of providing effective treatment, we conducted the first qualitative evidence synthesis to explore healthcare professionals' experience of treating people with chronic non-malignant pain...
November 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29176085/maintaining-compassion-for-the-suffering-terminal-patient-while-preserving-life-an-orthodox-jewish-approach
#15
Daniel Eisenberg
Regardless of one's religious beliefs, the process of making end-of-life decisions is inherently difficult and emotionally trying. The caregiver, family member, or friend is faced with making heart-wrenching decisions for loved ones where the line between support and cruelty may feel blurred. By evaluating the process by which traditional Judaism harmonizes the apparently conflicting obligations of the caregiver in end-of-life scenarios through three practical cases, all people can gain insight into managing this delicate balancing act and may develop generalizable approaches that recognize and appreciate the particularities of each patient's needs...
2017: Perspectives in Biology and Medicine
https://www.readbyqxmd.com/read/29173831/an-exploration-of-medical-emergency-team-intervention-at-the-end-of-life-for-people-with-advanced-cancer
#16
Christine Brown, Allison Drosdowsky, Meinir Krishnasamy
PURPOSE: Recent advances in cancer therapies offer survival benefit when cure is no longer possible. The contribution of the Medical Emergency Teams (METs) in the context of advancing disease has received little empirical consideration. This study set out to explore MET intervention at the end of life for people with advanced cancer in an Australian comprehensive cancer centre, and its impact on quality of death. METHOD: A retrospective medical chart review was undertaken to explore MET response for people with advanced (incurable) cancer nearing end of life...
December 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/29170612/visual-analytics-tools-for-sustainable-lifecycle-design-current-status-challenges-and-future-opportunities
#17
Devarajan Ramanujan, William Z Bernstein, Senthil K Chandrasegaran, Karthik Ramani
The rapid rise in technologies for data collection has created an unmatched opportunity to advance the use of data-rich tools for lifecycle decision-making. However, the usefulness of these technologies is limited by the ability to translate lifecycle data into actionable insights for human decision-makers. This is especially true in the case of sustainable lifecycle design (SLD), as the assessment of environmental impacts, and the feasibility of making corresponding design changes, often relies on human expertise and intuition...
2017: Journal of Mechanical Design
https://www.readbyqxmd.com/read/29169385/standardised-outcomes-in-nephrology-polycystic-kidney-disease-song-pkd-study-protocol-for-establishing-a-core-outcome-set-in-polycystic-kidney-disease
#18
Yeoungjee Cho, Benedicte Sautenet, Gopala Rangan, Jonathan C Craig, Albert C M Ong, Arlene Chapman, Curie Ahn, Dongping Chen, Helen Coolican, Juliana Tze-Wah Kao, Ron Gansevoort, Ronald Perrone, Tess Harris, Vicente Torres, York Pei, Peter G Kerr, Jessica Ryan, Talia Gutman, Martin Howell, Angela Ju, Karine E Manera, Armando Teixeira-Pinto, Lorraine A Hamiwka, Allison Tong
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common potentially life threatening inherited kidney disease and is responsible for 5-10% of cases of end-stage kidney disease (ESKD). Cystic kidneys may enlarge up to 20 times the weight of a normal kidney due to the growth of renal cysts, and patients with ADPKD have an increased risk of morbidity, premature mortality, and other life-time complications including renal and hepatic cyst and urinary tract infection, intracranial aneurysm, diverticulosis, and kidney pain which impair quality of life...
November 23, 2017: Trials
https://www.readbyqxmd.com/read/29166565/hospital-based-physicians-intubation-decisions-and-associated-mental-models-when-managing-a-critically-and-terminally-ill-older-patient
#19
Shannon Haliko, Julie Downs, Deepika Mohan, Robert Arnold, Amber E Barnato
BACKGROUND: Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. OBJECTIVE: We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. METHODS: Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29161396/demands-and-requests-for-inappropriate-or-inadvisable-treatments-at-the-end-of-life-what-do-you-do-at-2-o-clock-in-the-morning-when-%C3%A2
#20
L McCrossan, R Siegmeth
In an era when healthcare has become increasingly complex and patient expectations are higher than ever before, we can find the decision-making process for patients, potentially at the end of their lives, increasingly difficult. In the shift from paternalism to patient choice, we can struggle to know what to do when faced with a patient, their family, or both requesting or demanding inadvisable, inappropriate, or futile treatments. It can feel as if we are being asked to subject patients to intrusions and interventions that 'just feel wrong'...
December 1, 2017: British Journal of Anaesthesia
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