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https://www.readbyqxmd.com/read/28294479/understanding-advance-care-planning-within-the-south-asian-community
#1
Patricia D Biondo, Rashika Kalia, Rooh-Afza Khan, Nadia Asghar, Cyrene Banerjee, Debbie Boulton, Nancy Marlett, Svetlana Shklarov, Jessica E Simon
BACKGROUND: Advance care planning (ACP) is a process of reflection on and communication of a person's future health-care preferences. Evidence suggests visible minorities engage less in ACP. The South Asian ethnic group is the largest visible minority group in Canada, and information is needed to understand how ACP is perceived and how best to approach ACP within this diverse community. OBJECTIVE: To explore perspectives of South Asian community members towards ACP...
March 10, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28283409/topics-in-practice-management-integrating-advance-care-planning-into-practice
#2
REVIEW
Laura E Dingfield, Joshua B Kayser
Advanced respiratory diseases progress over time and often lead to death. As their condition worsens, patients may lose medical decision making ability. Advance care planning (ACP) is a process in which patients receive information about their diagnosis and prognosis; discuss values, goals and fears; articulate preferences about life-sustaining treatments and end-of-life care; and appoint a surrogate medical decision maker. This process may result in written documentation of patient preferences, or appointment of a health care power of attorney (HCPOA)...
March 7, 2017: Chest
https://www.readbyqxmd.com/read/28160875/understanding-palliative-care-and-hospice-a%C3%A2-review-for-primary-care-providers
#3
REVIEW
Mary K Buss, Laura K Rock, Ellen P McCarthy
Palliative care provides invaluable clinical management and support for patients and their families. For most people, palliative care is not provided by hospice and palliative medicine specialists, but rather by their primary care providers. The recognition of hospice and palliative medicine as its own medical subspecialty in 2006 highlighted the importance of palliative care to the practice of medicine, yet many health care professionals harbor misconceptions about palliative care, which may be a barrier to ensuring that the palliative care needs of their patients are identified and met in a timely fashion...
February 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28156656/systematic-review-of-interventions-to-facilitate-advance-care-planning-acp-in-cancer-patients
#4
Hao-Wen Sim, Camilla Zimmermann, Monika K Krzyzanowska
21 Background: ACP refers to the process of consideration, documentation and communication of preferences for future care. ACP is crucial for patients (pts) with advanced cancer as it can guide substitute decision makers (SDM) and health care providers (HCP) to align care with preferences, thus improving quality of end-of-life care. METHODS: We performed a systematic review of MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane (Systematic Review and Clinical Trial) databases (1995 to 2015) to identify interventions that facilitate ACP for cancer pts (documentation or discussion of advance directives, SDM or code status)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156561/a-qualitative-investigation-of-mindfulness-practice-to-support-advance-care-planning-acp
#5
Ann H Cottingham, Kathleen A Beck-Coon, Paul R Helft
15 Background: Despite ongoing attempts to increase ACP in the U.S, a national longitudinal study of patients with cancer found no significant change in participation in end-of-life (EOL) discussions or living will completion between 2000-2012. A key barrier to ACP includes emotional discomfort talking about EOL care preferences. Mindfulness practices facilitate emotional regulation through present-centered awareness and non-reactive coping. In this pilot, an intervention combining mindfulness training, mindful communication skill development, and information about ACP was hypothesized to increase ACP in patients with cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152705/value-in-cancer-care-regional-initiative-to-improve-care-through-data-reporting-and-interventions
#6
Teah Hoopes, Lotte Steuten, Veena Shankaran, Bernardo Goulart, Gary H Lyman, Thomas David Brown, Eric Y Chen, Ted Conklin, John M Corman, Matt Lonergan, Daniel Lessler, Renato Martins, Csaba Mera, John Whitelaw Rieke, Elie P Saikaly, Julie C Smith, F Marc Stewart, Richard Whitten, Scott David Ramsey
34 Background: In the context of many initiatives aimed at measuring quality and value in cancer care, the Hutchinson Institute for Cancer Outcomes Research (HICOR), partnered with community members to launch a regional, stakeholder-driven initiative to define and report value metrics for cancer care for Washington State. Region-wide Summits were held in 2014 and 2015. Participants included local healthcare delivery organizations, patient advocacy groups, payers, and policymakers. The 2014 Summit identified priority metrics; these metrics were reported at the 2015 Summit...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28133991/readiness-to-participate-in-advance-care-planning-a-qualitative-study-of-renal-failure-patients-families-and-healthcare-providers
#7
Lauren A Hutchison, Donna S Raffin-Bouchal, Charlotte A Syme, Patricia D Biondo, Jessica E Simon
Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28062341/implementation-and-impact-of-patient-lay-navigator-led-advance-care-planning-conversations
#8
Gabrielle B Rocque, J Nicholas Dionne-Odom, Chao-Hui Sylvia Huang, Soumya J Niranjan, Courtney P Williams, Bradford E Jackson, Karina I Halilova, Kelly M Kenzik, Kerri S Bevis, Audrey S Wallace, Nedra Lisovicz, Richard A Taylor, Maria Pisu, Edward E Partridge, Thomas W Butler, Linda A Briggs, Elizabeth A Kvale
CONTEXT: Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). OBJECTIVES: To evaluate implementation of lay navigator-led ACP. METHODS: A convergent, parallel mixed-methods design was used to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included 1) electronic navigation records, 2) navigator surveys (n = 45), 3) claims-based patient outcomes (n = 820), and 4) semistructured navigator interviews (n = 26)...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28052780/stakeholder-meeting-integrated-knowledge-translation-approach-to-address-the-caregiver-support-gap
#9
Jayna M Holroyd-Leduc, Jacqueline McMillan, Nathalie Jette, Suzette C Brémault-Phillips, Wendy Duggleby, Heather M Hanson, Jasneet Parmar
Family caregivers are an integral and increasingly overburdened part of the health care system. There is a gap between what research evidence shows is beneficial to caregivers and what is actually provided. Using an integrated knowledge translation approach, a stakeholder meeting was held among researchers, family caregivers, caregiver associations, clinicians, health care administrators, and policy makers. The objectives of the meeting were to review current research evidence and conduct multi-stakeholder dialogue on the potential gaps, facilitators, and barriers to the provision of caregiver supports...
January 5, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28030433/the-case-against-imminent-death-donation
#10
Grace S Lee, Vishnu S Potluri, Peter P Reese
PURPOSE OF REVIEW: Imminent death donation (IDD) is a proposal to procure organs from patients prior to the withdrawal of life support, which is anticipated to lead to death. In this review, we outline substantial concerns that the transplant community should consider when deliberating the possibility of practicing IDD. RECENT FINDINGS: Although there are several compelling theoretical and intuitive reasons to support IDD, its application has been hindered because of inadequate definitions or protocols...
December 26, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27978419/-why-didn
#11
Michele Levinson, Amber Mills, Jonathan Barrett, Gaya Sritharan, Anthea Gellie
Objective The aim of the present study was to understand the reasons for the delivery of non-beneficial cardiopulmonary resuscitation (CPR) attempts in a tertiary private hospital over 12 months. We determined doctors' expectations of survival after CPR for their patient, whether they had considered a not-for-resuscitation (NFR) order and the barriers to completion of NFR orders.Methods Anonymous questionnaires were sent to the doctors primarily responsible for a given patient's care in the hospital within 2 weeks of the unsuccessful CPR attempt...
December 16, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27893221/substance-use-and-psychological-distress-is-related-with-accommodation-status-among-homeless-immigrants
#12
Miguel Angel Navarro-Lashayas, Francisco Jose Eiroa-Orosa
Immigrant homelessness constitutes a cruel expression of social exclusion. We analyzed the relation of sociodemographic characteristics with stressful life events, substance use and psychological distress, giving a special importance to the influence of the time spent on the streets and the accommodation status of 107 homeless immigrants. To this end, both quantitative and qualitative methodologies were combined. Discussion groups with care resources practitioners and service users, were followed by in depth interviews combined with psychometric questionnaires...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/27880814/health-care-professionals-understandings-of-cross-cultural-interaction-in-end-of-life-care-a-focus-group-study
#13
Anna Milberg, Sandra Torres, Pernilla Ågård
OBJECTIVE: The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care. METHODS: Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews...
2016: PloS One
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
#14
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/27803556/african-cultural-concept-of-death-and-the-idea-of-advance-care-directives
#15
REVIEW
Rabi Ilemona Ekore, Bolatito Lanre-Abass
An advance care directive is a person's oral or written instructions about his or her future medical care, if he or she becomes unable to communicate. It may be in written or oral form. Africans ordinarily do not encourage the contemplation of death or any discussion about their own or their loved ones' death. According to the African belief system, life does not end with death, but continues in another realm. Becoming an ancestor after death is a desirable goal of every individual, a feat which cannot be achieved if an individual asks for an unnatural death by attempting to utilize advance care directives...
October 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27718068/advance-directives-in-patients-with-advanced-cancer-receiving-active-treatment-attitudes-prevalence-and-barriers
#16
Julie C McDonald, Jeanne M du Manoir, Nanor Kevork, Lisa W Le, Camilla Zimmermann
PURPOSE: The purposes of the study were to assess awareness and prevalence of advance directives (ADs) among patients with advanced cancer undergoing active outpatient care and to determine factors associated with AD completion before and after the diagnosis of cancer. METHODS: Patients with advanced solid tumor malignancy receiving treatment at the Chemotherapy Day Unit were approached for recruitment. They completed an onsite questionnaire about completion and timing of ADs, demographic information, and perceived health; a review of their medical records was conducted to document their cancer care and co-morbidities...
February 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27666307/what-are-the-barriers-to-initiating-end-of-life-conversations-with-patients-in-the-last-year-of-life
#17
REVIEW
Alice Travers, Vanessa Taylor
INTRODUCTION: Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. METHOD: Six electronic databases were searched for potentially relevant records published between 2008 and 2015...
September 2, 2016: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/27663843/barriers-enablers-and-challenges-to-initiating-end-of-life-care-in-an-australian-intensive-care-unit-context
#18
Laura Anne Brooks, Elizabeth Manias, Patricia Nicholson
BACKGROUND: Patients admitted to Australian intensive care units are often critically unwell, and present the challenge of increasing mortality due to an ageing population. Several of these patients have terminal conditions, requiring withdrawal of active treatment and commencement of end-of-life (EOL) care. OBJECTIVES: The aim of the study was to explore the perspectives and experiences of physicians and nurses providing EOL care in the ICU. In particular, perceived barriers, enablers and challenges to providing EOL care were examined...
September 20, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27625024/factors-influencing-head-and-neck-surgical-oncologists-transition-from-curative-to-palliative-treatment-goals
#19
Kershena Liao, Jennifer Blumenthal-Barby, Andrew G Sikora
Objective The factors influencing head and neck surgical oncologists' goals of care and decisions to initiate conversations about transitioning to palliative-intent treatment for patients with limited curative treatment options are incompletely understood. Lack of guidance for physicians on this topic can lead to inconsistent utilization of palliative services, as well as confusing, upsetting experiences for patients and families. We review the literature investigating the clinical factors, inter- and intrapersonal factors, and financial and health care system considerations that head and neck cancer physicians weigh during this decision-making process...
January 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27590795/disability-experience-and-measurement
#20
Lois M Verbrugge
Top themes of international research on disability in the past three decades are discussed: disability dynamics, buffers and barriers for disability, disability trends, and disability among very old persons. Each theme is highlighted by research examples. Turning to measurement, I discuss traditional measures of disability, new longer and shorter ones, and composites like disability-free life expectancy, noting their merits. Contemporary models of disability are presented, ranging from visual images to formal theories...
October 2016: Journal of Aging and Health
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