Read by QxMD icon Read

barriers to end of life discussions

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...
October 7, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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
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
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...
September 13, 2016: Otolaryngology—Head and Neck Surgery
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
John J Oosterink, Mariska G Oosterveld-Vlug, Jolien J Glaudemans, H Roeline W Pasman, Dick L Willems, Bregje D Onwuteaka-Philipsen
BACKGROUND: Timely end-of-life (EOL) discussions between patients and physicians are considered essential for high-quality EOL care, but research shows that these discussions frequently do not occur or occur late. In oncology, one barrier for timely EOL discussions is poor collaboration between oncologic specialists and GPs. OBJECTIVE: To explore interprofessional communication and coordination between oncologic specialists and GPs on EOL discussions. METHODS: We conducted in-depth interviews with 16 GPs and 14 oncologic specialists...
September 1, 2016: Family Practice
Michele Poliziani, Marco Koch, Xierong Liu
BACKGROUND: The recommended reinjection interval for botulinum neurotoxin (BoNT) formulations in the treatment of cervical dystonia (CD) is generally ≥12 weeks, though intervals ≥10 weeks are approved for incobotulinumtoxinA in Europe. However, recurring symptoms can occur before the end of this period. Using qualitative research, we sought a greater understanding of disease burden, unmet patient needs, and barriers to treatment. METHODS: We conducted online semistructured, focus-group discussions, and online forum follow-up discussions among patients with CD, focusing on disease burden, patient needs, injection cycle preferences, and relationships with health care professionals...
2016: Patient Preference and Adherence
Tarek Samy Abdelaziz, Antje Lindenmeyer, Jyoti Baharani, Hema Mistry, Alice Sitch, R Mark Temple, Gavin Perkins, Mark Thomas
INTRODUCTION: Acute kidney injury (AKI) contributes to morbidity and mortality, and its care is often suboptimal and/or delayed. The Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD) study is a large pilot testing provision of early specialist advice, to improve outcomes for patients with AKI. METHODS AND ANALYSIS: This before and after study will test an Outreach service for adult patients with AKI, identified using the national algorithm. During the 2-month before phase, AKI outcomes (30-day mortality, need for dialysis or AKI stage deterioration) will be observed in the intervention and control hospitals and their respective community areas; no interventions will be delivered...
2016: BMJ Open
Susan Fryer, Gary Bellamy, Tessa Morgan, Merryn Gott
BACKGROUND: In most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a key care aspect of their work, namely their experience of caring for dying residents. METHODS: Twenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions...
2016: BMC Palliative Care
Abiola O Keller, Carmen R Valdez, Rebecca J Schwei, Elizabeth A Jacobs
BACKGROUND: Health care providers are better able to diagnose depression and initiate treatment when patients disclose symptoms. However, many women are reluctant to disclose depressive symptoms. Little is known about the experience of disclosing depression symptoms in primary care among racially and ethnically diverse women across the life course. We qualitatively explore experiences of disclosure of depressive symptoms to primary care providers among self-identified African American, Hispanic and non-Hispanic White women...
September 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
K Evenblij, G A M Widdershoven, B D Onwuteaka-Philipsen, H de Kam, H R W Pasman
UNLABELLED: WHAT IS KNOWN ON THE SUBJECT?: Nurses play an important role in monitoring and supporting patients and their relatives at the end of life. To date, there is a lack of recent empirical research on the experiences of psychiatric nurses in providing palliative care to psychiatric patients who suffer from life-threatening physical co-morbidity. The limited literature available indicates that palliative care for psychiatric patients needs to be improved. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This explorative study is unique in offering an insight into current palliative care practice for psychiatric patients and showed that one in three nurses working in Dutch mental health facilities is involved in palliative care provision...
August 2016: Journal of Psychiatric and Mental Health Nursing
Ronald Spice, Monica Lau, Grace Perez, Nathan Turley, Tanvir Chowdhury Turin
OBJECTIVE: To explore Calgary family physicians' knowledge about hospices, their attitudes toward the referral process, and their understanding of barriers to referral for hospice care. DESIGN: Surveys were mailed to 400 randomly selected participants. The survey contained 18 questions related to hospice care, physician experience, attitudes, and perceived barriers to making a hospice referral. SETTING: Calgary, Alta. PARTICIPANTS: Family physicians...
August 2016: Canadian Family Physician Médecin de Famille Canadien
Jeanette Ziehm, Erik Farin, Jonas Schäfer, Kathrin Woitha, Gerhild Becker, Stefan Köberich
BACKGROUND: Compared to patients with cancer, heart failure patients are seldom candidates for palliative care. Numerous studies have investigated reasons why heart failure patients do not receive palliative care; however, none of these studies have ever evaluated the situation in the German health care setting. This study aims to identify German healthcare providers' (HCP) perception of barriers and facilitators to palliative care of patients with chronic heart failure. METHODS: We conducted an online-survey with 315 nurses and physicians of different medical disciplines...
2016: BMC Health Services Research
Emilia Fan, Joel J Rhee
Nurses are well positioned to initiate and conduct advance-care planning (ACP) conversations; however, there has been limited research on practice nurses performing this role in Australia. The aim of the present study was to understand the beliefs, attitudes, perceptions, confidence, training and educational needs of New South Wales practice nurses with regards to involvement in ACP. A cross-sectional online survey was conducted in August to October 2014. Nurses were recruited through nursing organisations and Medicare Locals...
August 5, 2016: Australian Journal of Primary Health
Brenda Sabo, Grace Johnston
UNLABELLED: Reports highlight the growing unmet need for palliative care as it applies to all cancers, yet the system and health care professionals (HCP) appear slow to respond. The following discussion paper highlights the current state of palliative care within the context of the primary malignant brain tumour (PMBT) population and argues for a shift in the current health care system's approach, which continues to place greater emphasis on cure over care. METHODS: An exploration of extant literature over the past 10 years...
2016: Canadian Journal of Neuroscience Nursing
K Afshar, K Geiger, G Müller-Mundt, J Bleidorn, N Schneider
BACKGROUND: Most patients in the last phase of life can be treated in the context of generalist palliative care, especially by general practitioners. In contrast to specialized palliative care, non-cancer patients predominate in this setting. OBJECTIVE: The aim of this article is to review the literature and elaborate current topics for non-cancer patients at the end-of-life in primary palliative care. MATERIALS AND METHODS: A literature search was carried out in the databases PubMed and Scopus from 2008 to 2013 followed by a qualitative content analysis according to the PRISMA statement...
July 11, 2016: Der Schmerz
Emma Wilkinson, Gurch Randhawa, Edwina Brown, Maria Da Silva Gane, John Stoves, Graham Warwick, Tahira Akhtar, Regina Magee, Sue Sharman, Ken Farrington
BACKGROUND: Variation in provision of palliative care in kidney services and practitioner concerns to provide equitable access led to the development of this study which focussed on the perspectives of South Asian patients and their care providers. As people with a South Asian background experience a higher risk of Type 2 Diabetes (T2DM) and end stage kidney failure (ESKF) compared to the majority population but wait longer for a transplant, there is a need for end of life care to be accessible for this group of patients...
2016: BMC Palliative Care
Oreofe O Odejide, Angel M Cronin, Nolan B Condron, Sean A Fletcher, Craig C Earle, James A Tulsky, Gregory A Abel
PURPOSE: Patients with blood cancers have been shown to receive suboptimal care at the end of life (EOL) when assessed with standard oncology quality measures (eg, no chemotherapy ≤ 14 days before death). As they were developed primarily for solid tumors, it is unclear if these measures are appropriate for patients with hematologic malignancies. Moreover, barriers to high-quality EOL care for this specific patient population are largely unknown. METHODS: In 2015, we asked a national cohort of hematologic oncologists about the acceptability of eight standard EOL quality measures...
September 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Gail L Towsley, Susan L Beck, Lee Ellington, Bob Wong
Me & My Wishes are facilitated, resident-centered video-recorded conversations to communicate current and end-of-life care preferences. We describe the video production process of two prototypes in the long-term care (LTC) setting and discuss lessons learned around developing this type of intervention. Partnering with an LTC community allowed us to create videos on-site, document staff time, handle any barriers with video production, and evaluate the process. In this article, we will describe the process of two residents creating Me & My Wishes videos...
July 5, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Sarah Mitchell, Joelle Loew, Catherine Millington-Sanders, Jeremy Dale
BACKGROUND: With increasing numbers of people living with complex life-limiting multimorbidity in the community, consideration must be given to improving the organisation and delivery of high-quality palliative and end-of-life care (EOLC). AIM: To provide insight into the experience of GPs providing EOLC in the community, particularly the facilitators and barriers to good-quality care. DESIGN AND SETTING: A web-based national UK questionnaire survey circulated via the Royal College of General Practitioners, NHS, Marie Curie, and Macmillan networks to GPs...
September 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"