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palliative care

Maree Johnson, Tracy Levett-Jones, R Langdon, Gabrielle Weidemann, Elizabeth Manias, Bronwyn Everett
OBJECTIVES: We sought to evaluate the perceptions of nurses of an e-learning educational program to encourage the use of behavioural strategies-blocking, engaging, mediating, multitasking, and preventing-to reduce the negative effects of interruptions during medication administration. DESIGN: A qualitative design was used to evaluate the impact of this e-learning educational intervention on nurses' behaviour. SETTINGS: Two wards (palliative care and aged care) from two different hospitals within a large local health service within Sydney Australia, were included in the study...
June 30, 2018: Nurse Education Today
Barbara A Jack, Tracy K Mitchell, Mary R O'Brien, Sergio A Silverio, Katherine Knighting
BACKGROUND: Good end-of-life care planning is vital to ensure optimal care is provided for patients and their families. Two key factors are open and honest advance care planning conversations between the patient (where possible), family, and health care professionals, focusing on exploring what their future wishes are; and the development of an advance care plan document. However, in paediatric and neonatal settings, there has been little research to demonstrate how advance care planning conversations take place...
July 13, 2018: BMC Palliative Care
William J Archibald, Philip J Meacham, AnnaLynn M Williams, Andrea M Baran, Adrienne I Victor, Paul M Barr, Deepak M Sahasrahbudhe, Clive S Zent
Melanoma is significantly more common and is associated with a poorer prognosis in patients with an underlying B-cell malignancy. This study reports on the management of patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) and a subsequent diagnosis of melanoma. In the Wilmot Cancer Institute CLL cohort, which includes 470 patients followed for 2849 person-years, 18 patients (3.8%) developed 22 melanomas. Fourteen melanomas were invasive, a significantly higher rate as compared with the age and sex matched general population (standardized incidence ratio [SIR] 6...
July 6, 2018: Leukemia Research
Christa Schorr, Mark Angelo
No abstract text is available yet for this article.
August 2018: Critical Care Medicine
Kirstine Skov Benthien, Mathilde Adsersen, Morten Aagaard Petersen, Eva Soelberg Vadstrup, Per Sjøgren, Mogens Groenvold
BACKGROUND: The use of chemotherapy in the last 14 days of life should be as low as possible. AIM: To study the factors related to the use of chemotherapy in the last 14 days of life and the factors related to concurrent antineoplastic treatment and specialized palliative care. DESIGN: This was a population-based cohort study. The data were collected from the Danish Register of Causes of Death, the Danish National Patient Register, and the Danish Palliative Care Database...
July 1, 2018: Palliative Medicine
Muhammad Farhan Khaliq, Rayan E Ihle, James Perry
Strongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF- α inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation. S. stercoralis infection remains a diagnostic challenge...
2018: Case Reports in Infectious Diseases
Alessandro Laviano, Luca Di Lazzaro, Angela Koverech
Newly diagnosed cancer patients are frequently found suffering from a metastatic disease, which poses additional challenges to the delivery of effective therapies. Chemotherapy and radiotherapy are associated with side effects which reduce tolerance to treatment and likelihood of tumour response. Identifying preventable factors of reduced response to therapy would translate into better care of cancer patients. Among other factors, malnutrition, as diagnosed by non-volitional weight loss, and cachexia, as revealed by sarcopenia, are universally recognised negative prognostic factors...
July 13, 2018: Proceedings of the Nutrition Society
Brian N Fink, Paul P Rega, Martha E Sexton, Carolina Wishner
IntroductionWhile the art and science of disaster triage continue to evolve, the education of the US health care student in matters pertaining to disaster preparedness and response remains stifled. Unfortunately, these students will be assuming major decision-making responsibilities regarding catastrophes that will be complicated by climate change, nuclear threats, global terrorism, and pandemics. Meanwhile, Sort, Assess, Life-Saving Interventions, Treatment, and/or Transport (SALT) triage is being advocated over the globally popular Simple Triage and Rapid Treatment (START) algorithm for multiple reasons: (1) it's an all-hazard approach; (2) it has four medical interventions; and (3) it has an additional triage color for victims with non-survivable injuries...
July 13, 2018: Prehospital and Disaster Medicine
Katja Krug, René Alexander Ballhausen, Regine Bölter, Peter Engeser, Michel Wensing, Joachim Szecsenyi, Frank Peters-Klimm
BACKGROUND: Family caregivers (FCGs) of patients at the end of life (EoL) cared for at home receive support from professional and non-professional care providers. Healthcare providers in general practice play an important role as they coordinate care and establish contacts between the parties concerned. To identify potential intervention targets, this study deals with the challenges healthcare providers in general practice face in EoL care situations including patients, caregivers and networks...
July 13, 2018: BMC Family Practice
Sofia Nissmark, Agneta Malmgren Fänge
BACKGROUND: Today people can live a long time with a chronic cancer diagnosis, and it affects the entire family. Family members to patients in palliative care often have to leave valued occupations due to lack of time and energy, while new roles are forced upon them, potentially affecting their health. OBJECTIVE: To explore occupational balance, needs and roles among family members to persons in palliative care. METHODS: Six semi-structured interviews were conducted with family members to terminally ill persons enrolled to specialized palliative care...
July 13, 2018: Scandinavian Journal of Occupational Therapy
Xavier Gómez-Batiste, Carles Blay, Marc Antoni Broggi, Cristina Lasmarias, Laura Vila, Jordi Amblàs, Joan Espaulella, Xavier Costa, Marisa Martínez-Muñoz, Bernabé Robles, Salvador Quintana, Joan Bertran, Francesc Torralba, Carmen Benito, Nuria Terribas, Josep Maria Busquets, Carles Constante
Palliative care must be early applied to all types of advanced chronic and life limited prognosis patients, present in all health and social services. Patients' early identification and registry allows introducing palliative care gradually concomitant with other measures. Patients undergo a systematic and integrated care process, meant to improve their life quality, which includes multidimensional assessment of their needs, recognition of their values and preferences for advance care planning purposes, treatments review, family care, and case management...
January 1, 2018: Journal of Palliative Care
C J Lucas, P Galettis, J Schneider
There is increasing interest in the use of cannabinoids for disease and symptom management, but limited information available regarding their pharmacokinetics and pharmacodynamics to guide prescribers. Cannabis medicines contain a wide variety of chemical compounds, including the cannabinoids delta-9-tetrahydrocannabinol (THC), which is psychoactive, and the non-psychoactive cannabidiol (CBD). Cannabis use is associated with both pathological and behavioural toxicity and accordingly, is contraindicated in the context of significant psychiatric, cardiovascular, renal or hepatic illness...
July 12, 2018: British Journal of Clinical Pharmacology
Ambra Mara Giovannetti, Claudia Borreani, Elisabetta Bianchi, Andrea Giordano, Sabina Cilia, Susanna Cipollari, Ilaria Rossi, Claudia Cavallaro, Valentina Torri Clerici, Edoardo Rossetti, Maria Consiglia Stefanelli, Amadio Totis, Angelo Pappalardo, Gina Occhipinti, Paolo Confalonieri, Simone Veronese, Maria Grazia Grasso, Francesco Patti, Paola Zaratin, Mario Alberto Battaglia, Alessandra Solari
BACKGROUND: We performed a qualitative study to investigate the experiences of participants in a multicentre randomized controlled trial on a home-based palliative approach (HPA) for adults with severe multiple sclerosis (MS) and their caregivers. Our aim was to explore the strengths and challenges of the intervention, and circumstances that may have influenced its efficacy. METHODS: Participants to the qualitative study were the patients, their caregivers, patient referring physicians, and the teams who delivered the HPA intervention...
2018: PloS One
Nizar Bhulani, Arjun Gupta, Ang Gao, Jenny Li, Chad Guenther, Chul Ahn, Elizabeth Paulk, Stephanie Houck, Muhammad S Beg
Background: Palliative care has been associated with improved survival and quality of life, with lower rate of end-of-life health care utilization and cost. We examined trends in palliative care utilization in older pancreatic cancer patients. Methods: Pancreatic cancer patients with and without palliative care consults were identified using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database between 2000 and 2009. Trend of palliative care use was studied...
June 2018: Journal of Gastrointestinal Oncology
Jacek T Soroka, Katherine Froggatt, Sara Morris
OBJECTIVES: Although the experiences of family caregivers have received attention, little research has specifically explored caregivers' confidence. Evidence shows that caregivers of hospice patients do not feel confident or prepared to care for relatives or friends who die at home. AIM: We aimed to elicit the views, feelings, and experiences of primary caregivers who provide unpaid care to dying family members in the home setting to better understand what contributes to their confidence during end-of-life care...
January 1, 2018: American Journal of Hospice & Palliative Care
Ariel M Lyons-Warren
It has long been recognized that patients with neurological conditions, and particularly pediatric neurology patients, are well suited for palliative care because they frequently have a high symptom burden and variable prognoses. In 1996, the American Academy of neurology formally recognized a need for neurologists to "understand and apply the principles of palliative medicine." Subsequently, some reviews have proposed a simultaneous care model in which palliative care is integrated for all neurology patients from the time of diagnosis...
January 1, 2018: American Journal of Hospice & Palliative Care
Clare Ellis-Smith, Irene J Higginson, Barbara A Daveson, Lesley A Henson, Catherine J Evans
BACKGROUND: Assessment of people with dementia is challenging; with undetected and under treated symptoms and concerns resulting in avoidable distress, and few evidence-based interventions to support this. We aimed to understand the mechanisms of action of a measure to support comprehensive assessment of people with dementia in care homes; and its acceptability, feasibility, and implementation requirements. METHODS: A qualitative study with an embedded quantitative component in three residential care homes, underpinned by an initial theoretical model of mechanisms of action...
2018: PloS One
Ashley Shreves, Trevor R. Pour, Nachi Gupta, Jeffrey Nusbaum
Dyspnea is one of the most distressing symptoms experienced by dying patients, and it is a common reason for such patients to seek care in the emergency department. Many underlying disease states and acute illnesses cause shortness of breath at the end of life, and management tends to be symptomatic rather than diagnostic, particularly in those for whom comfort is the most important goal. Opioids are the most effective and widely studied agents available for palliation of dyspnea in this population, while adjuvant therapies such as oxygen, noninvasive positive pressure ventilation, and hand-held fans may also be used...
July 1, 2018: Emergency Medicine Practice
Jonathan Sevilla-Cazes, Faraz S Ahmad, Kathryn H Bowles, Anne Jaskowiak, Tom Gallagher, Lee R Goldberg, Shreya Kangovi, Madeline Alexander, Barbara Riegel, Frances K Barg, Stephen E Kimmel
BACKGROUND: Heart failure patients have high 30-day hospital readmission rates. Interventions designed to prevent readmissions have had mixed success. Understanding heart failure home management through the patient's experience may reframe the readmission "problem" and, ultimately, inform alternative strategies. OBJECTIVE: To understand patient and caregiver challenges to heart failure home management and perceived reasons for readmission. DESIGN: Observational qualitative study...
July 10, 2018: Journal of General Internal Medicine
Molly T Williams, Eli Zimmerman, Megan Barry, Lindsay Trantum, Mary S Dietrich, Jennifer K Doersam, Mohana Karlekar
Despite advances in stroke care, patients continue to incur significant disability, are at risk for future events, and are inconsistently comanaged with palliative care (PC) specialty teams. The purpose of this study was to review patients with stroke admitted to our institution, comparing patients with and without PC consultation. We retrospectively reviewed medical record data of all patients with stroke admitted to our neurosciences ICU (NICU) in July 2014 to June 2015 with and without PC consultation. Review focused on stroke type, patient demographics, median days to discharge and death, and posthospitalization discharge...
January 1, 2018: American Journal of Hospice & Palliative Care
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