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https://www.readbyqxmd.com/read/29351343/minority-race-and-male-sex-as-risk-factors-for-non-beneficial-gastrostomy-tube-placements-after-stroke
#1
Roland Faigle, Joseph A Carrese, Lisa A Cooper, Victor C Urrutia, Rebecca F Gottesman
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes are widely used for enteral feeding after stroke; however, PEG tubes placed in patients in whom death is imminent are considered non-beneficial. AIM: We sought to determine whether placement of non-beneficial PEG tubes differs by race and sex. DESIGN AND SETTING/PARTICIPANTS: In this retrospective cohort study, inpatient admissions for stroke patients who underwent palliative/withdrawal of care, were discharged to hospice, or died during the hospitalization, were identified from the Nationwide Inpatient Sample between 2007 and 2011...
2018: PloS One
https://www.readbyqxmd.com/read/29350577/serial-palliative-performance-scale-assessment-in-a-university-general-hospital-a-pilot-study
#2
Rafael Barone de Medeiros, Ana Maria Nunes de Faria Stamm, Rachel Duarte Moritz, Paulo Fontoura Freitas, Lara Patrícia Kretzer, Juliana Vieira Gomes
BACKGROUND: Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making. OBJECTIVE: To evaluate the functional status of using serial PPS assessments of patients being assisted in collaboration with the palliative care team (PCT). DESIGN: Prospective cohort pilot study. MEASUREMENTS: The sample consisted of 64 cancer and noncancer inpatients being assisted in collaboration with the PCT during the period from 2012 to 2016 (included 12 months)...
January 19, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29350384/the-importance-of-psychosocial-factors-in-management-of-pulmonary-arterial-hypertension-patients
#3
Maria A Sobczak-Kaleta, Adam Torbicki, Jarosław D Kasprzak
Pulmonary arterial hypertension (PAH) is significantly reshaping personal and professional lives of patients due to its chronic nature, varying clinical profile and uncertain perspectives of treatment. PAH is at this time an incurable disease, which requires to consider not only strictly medical dimension, but also the psychosocial aspects of care. This paper discusses therefore the psychological problems most commonly reported by PAH patients. It reviews the instruments used to assess them. We describe the relationships between the quality of life and depressive symptoms and the physical activity of the PAH patients, which have deep treatment-related consequences...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349518/checkpoint-inhibitors-palliative-care-or-hospice
#4
REVIEW
Mellar P Davis, Rajiv Panikkar
PURPOSE: Checkpoint (CTLA-4, PD-1, and PD-L1) inhibitors have changed the face of oncology. A subset of patients enjoys long, gratifying treatment responses. Unfortunately, most patients do not respond even when expressing favorably markers such as PD-L1. Checkpoint inhibitors are largely palliative (though a subset have long-term cancer responses) and as such patient-related outcome measures should be included when evaluating benefits. The purpose of this review is to place checkpoint inhibitor trials within a palliation context...
January 19, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29346354/compassion-from-a-palliative-care-perspective
#5
Antonio Fernando, Conor Rea, Phillipa J Malpas
BACKGROUND: Compassion is a core virtue in medicine and lies at the heart of good medical care. It connects us to each other and reflects our need for relationships with others. AIM: Our aim is to explore how palliative care patients perceive, understand and experience compassion from health professionals, and to inform clinical practice. METHODS: Seven hospice managers in the North Island of New Zealand were contacted and invited to join the study...
January 19, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29346304/-total-pain-in-children-with-severe-neurological-impairment
#6
REVIEW
Timothy A Warlow, Richard D W Hain
Many children with palliative care needs experience difficulty in managing pain. Perhaps none more so than those with severe neurological impairment. For many years; behaviours in these children were misunderstood. As a result; pain was poorly recognised and inadequately managed. Significant advances have been made in the assessment and management of pain in this challenging group of patients. We summarise these advances; drawing on our own experience working with infants; children and young adults with palliative care needs within a UK tertiary paediatric palliative care service...
January 18, 2018: Children
https://www.readbyqxmd.com/read/29345756/clinical-intentions-of-antibiotics-prescribed-upon-discharge-to-hospice-care
#7
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29343195/caring-for-a-family-member-or-friend-with-dementia-at-the-end-of-life-a-scoping-review-and-implications-for-palliative-care-practice
#8
Timothy R Broady, Freya Saich, Tom Hinton
BACKGROUND: Although people with dementia receive substantial care from informal sources, there is limited research available that investigates how these carers experience end-of-life care. AIM: This review aimed to identify what is currently known about carers' experiences of providing end-of-life care to a family member or friend with dementia and draw implications for palliative care policy and service provision. DESIGN: A scoping literature review was conducted, first using a targeted key word search, followed by assessments of eligibility based on title and then abstract content...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343186/association-between-palliative-care-and-life-sustaining-treatments-for-patients-with-dementia-a-nationwide-5-year-cohort-study
#9
Ping-Jen Chen, Fu-Wen Liang, Chung-Han Ho, Shao-Yi Cheng, Yi-Chen Chen, Yu-Han Chen, Yueh-Chun Chen
BACKGROUND: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. AIM: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. DESIGN: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. SETTING/PARTICIPANTS: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343173/effects-of-two-feedback-interventions-on-end-of-life-outcomes-in-nursing-home-residents-with-dementia-a-cluster-randomized-controlled-three-armed-trial
#10
Jannie A Boogaard, Henrica Cw de Vet, Mirjam C van Soest-Poortvliet, Johannes R Anema, Wilco P Achterberg, Jenny T van der Steen
BACKGROUND: Despite increased attention for palliative care in dementia, recent studies found burdensome symptoms and unmet family caregiver needs in the last phase of life. Feedback is being used to improve the quality of palliative care, but we do not know how effective it is. AIM: To assess the effect of two feedback strategies on perceived quality of end-of-life care and comfort in dying nursing home residents with dementia. METHODS: In a cluster-randomized controlled trial, the End-of-Life in Dementia-Satisfaction With Care and the End-of-Life in Dementia-Comfort Assessment in Dying scales were completed by bereaved family caregivers of residents with dementia of 18 Dutch nursing homes...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343169/patients-and-carers-perspectives-of-palliative-care-in-general-practice-a-systematic-review-with-narrative-synthesis
#11
Emilie Green, Selena Knight, Merryn Gott, Stephen Barclay, Patrick White
BACKGROUND: General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner's role. AIMS: To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner's capacity to fulfil this perceived role...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#12
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29342021/nonoperative-management-of-perforated-hollow-viscera-in-a-palliative-care-unit
#13
Myrick C Shinall, Jesse M Ehrenfeld, Oliver L Gunter
No abstract text is available yet for this article.
January 15, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341836/a-cohort-study-of-patient-reported-outcomes-and-healthcare-utilization-in-acute-myeloid-leukemia-patients-receiving-active-cancer-therapy-in-the-last-six-months-of-life
#14
Jared R Lowe, Yinxi Yu, Steven Wolf, Greg Samsa, Thomas W LeBlanc
BACKGROUND: Evidence about the unique palliative care needs of patients with acute myeloid leukemia (AML) is limited. Improving the care of these patients will require a better understanding of their unmet needs, including symptom burden at the end of life, and patterns of healthcare utilization. OBJECTIVE: To describe AML patients' experiences in the last six months of life regarding symptom burden, blood product utilization, and use of palliative care services...
January 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29341818/medicine-as-it-should-be-teaching-team-and-teamwork-during-a-palliative-care-clerkship
#15
Barbara A Head, Christian Davis Furman, Andrew M Lally, Kimberly Leake, Mark Pfeifer
BACKGROUND: Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills. OBJECTIVE: Our objective was to assess the learning of senior medical students during a palliative care rotation. DESIGN: A constant comparison method based on grounded theory was used in this qualitative study. SETTING/SUBJECTS: Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship...
January 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29341551/reflection-on-curative-treatment-versus-palliation-of-symptoms-in-end-of-life-care
#16
Teresa Bridget Dowling
The conflicting tasks of treating or managing disease and preparing patients and their families for the end of life are well documented in haematology and palliative care settings. This article is a reflection on practice by a nursing student who was in the fourth year of an internship, and discusses a case study involving a woman at the end of life. It considers the approach to palliative and end of life care adopted in an oncology and haematology ward where there was a reluctance to be realistic about the limitations of treatments among some healthcare practitioners, who did not want to dispel unrealistic expectations of the patient's recovery as a result of continuing treatment...
January 17, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#17
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29337174/palliative-care-utilization-following-out-of-hospital-cardiac-arrest-in-the-united-states
#18
Aiham Albaeni, Nisha Chandra-Strobos, Shaker M Eid
AIMS: Palliative care (PC) has become an integral component of comprehensive care provided to critically ill patients. Little is known about the utilization of palliative care following Out-of-Hospital Cardiac Arrest (OHCA) in the United States. METHODS: We used the 2002 to 2013 National Inpatient Sample database to identify adults ≥ 18 years old with an ICD-9-CM principal diagnosis code of cardio-respiratory arrest or ventricular fibrillation (VF). Patients were categorized into two groups based on the presence of PC, then compared using Pearson χ2 test for categorical variables and linear regression for continuous variables...
January 11, 2018: Resuscitation
https://www.readbyqxmd.com/read/29336907/a-palliative-approach-to-falls-in-advanced-dementia
#19
REVIEW
Andrea Iaboni, Karen Van Ooteghem, Meghan N Marcil, Amy Cockburn, Alastair J Flint, Daphna Grossman, Ron Keren
Falls are viewed as a preventable cause of injury, functional loss, and death in older adults with dementia, and have been used as a marker of quality of care in long-term care facilities. Despite intensive intervention around fall prevention in these settings, falls and injury remain frequent, particularly among residents in the advanced stages of dementia. In this clinical review, we consider the common challenges and pitfalls in both the management of falls and the provision of palliative care in advanced dementia...
December 11, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29336714/urinary-retention-and-medication-utilization-on-a-palliative-care-unit-a-retrospective-observational-study
#20
T Graham Bergstra, Iris Gutmanis, Janette Byrne, Cathy Faulds, Patricia Whitfield, Sarah McCallum, Joshua Shadd
Urinary retention is a common problem at end-of-life that may be a result of medications used to control other symptoms. To determine whether use of retention-causing drugs was associated with catheterization for urinary retention among palliative care unit (PCU) patients, the authors reviewed charts of 91 consecutively admitted patients to a hospital-based PCU. Utilization of eight classes of retention-causing medications (opioids, antidopaminergics, benzodiazepines, anticholinergics, antidepressants, calcium channel antagonists, nonsteroidal anti-inflammatory drugs [NSAIDs], and H1 histamine antagonists) was compared between those catheterized for urinary retention (n = 34) and those never catheterized (n = 31)...
January 16, 2018: Journal of Pain & Palliative Care Pharmacotherapy
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