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Maika Natsume, Kiyotaka Watanabe, Satoko Matsumoto, Daisuke Naruge, Kazuhiko Hayashi, Junji Furuse, Masafumi Kawamura, Hiromitsu Jinno, Keiji Sano, Ryoji Fukushima, Gakuji Osawa, Etsuko Aruga, Yojiro Hashiguchi, Atsushi Tanaka, Hajime Takikawa, Nobuhiko Seki
BACKGROUND: It is important for cancer patients to receive end-of-life care at the desired place. OBJECTIVE: To identify issues in selection of place for end-of-life care of cancer patients to realize their optimal survivorship. DESIGN AND SETTING: Between September 2015 and January 2016, a questionnaire consisting of 33 items, including end-of-life care place preferences, was administered to cancer patients who attended three university hospitals in Japan...
March 22, 2018: Journal of Palliative Medicine
Laura Veneroni, Andrea Ferrari, Marta Podda, Tullio Proserpio, Elena Pagani Bagliacca, Maura Massimino, Carlo Alfredo Clerici
The issue of quality of life, particularly of patients affected by cancer, is very controversial, especially with adolescent patients who have no prospects of recovery. This article aims to describe the psychological mechanisms, which affect teenage patients with terminal cancer, in order to allow the best quality of life possible. The adaptation of teenager patients suffering from terminal illnesses is also related to other non-medical issues such as psychological, legal and ethical considerations. A correct and balanced communication with such patients is needed, in order of maintaining a positive mental approach ("hope") so that the teens are able to come to terms with the hard reality...
March 2018: Recenti Progressi in Medicina
Barbora Szonowská
Despite the advances in dialysis technology over the past decades, patients with advanced chronic kidney disease (CKD) have a high symptom burden, shortened survival and substantial physical, emotional and spiritual suffering. Number of frailty patients with advanced chronic kidney disease is growing and for many of them the beginning or continuation of dialysis is associated with a high risk of short-term mortality or worsening of functional status. Identifying these fragile patients and integrating palliative care into standard nephrological care improves patients quality of life and has the potential to prolong their lives without demanding dialysis treatment...
2018: Casopís Lékar̆ů C̆eských
Jindřich Polívka
Palliative care is focused on enhancing quality of life for seriously ill. Hospice care is a comprehensive care provided by an interdisciplinary team for patients whose diseases cannot be cured and are approaching the end of life. To be eligible for admission to hospice care is required to be terminally ill with a life expectancy of 6 months or less. Currently, hospices are the main providers of specialized palliative care in the Czech Republic. This article is focused on the current state of palliative care and specifically on hospice care in the Czech Republic...
2018: Casopís Lékar̆ů C̆eských
Isra Black, Ásgeir Rúnar Helgason
BACKGROUND: Morbidity arising from unprepared bereavement is a problem that affects close personal relations of individuals at the end-of-life. The bereavement studies literature demonstrates that a lack of preparedness for a loved one's death is a risk factor for secondary psychological morbidity among survivors. Short awareness time of death negatively correlates to preparedness for bereavement. The absence of disclosure of end-of-life diagnosis and prognosis to close personal relations ('death talk') between patients and loved ones, or health professionals and loved ones, may contribute to short awareness time of death...
March 21, 2018: BMC Palliative Care
Frances R Nedjat-Haiem, Iraida V Carrion, Krystyna Gonzalez, Elizabeth D Bennett, Kathleen Ell, Mary O'Connell, Beti Thompson, Shiraz I Mishra
Advance care planning (ACP) does not readily occur in medical settings and often gets missed. Older Latinos need ACP information to encourage advance directive (AD) completion indicating preferences for end-of-life (EOL) care. OBJECTIVE: To explore the experiences with counseling using motivational interviewing (MI) techniques and social workers to encourage ACP communication among older Latinos with advance chronic diseases. This study describes stages of readiness to plan for EOL care...
January 1, 2018: American Journal of Hospice & Palliative Care
Lorinda Lindemulder, Sarah Gouwens, Kathryn Stefo
No abstract text is available yet for this article.
April 2018: Nursing
Fiona Springall
People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme...
March 21, 2018: Nursing Standard
Sarah Ziegler, Margareta Schmid, Matthias Bopp, Georg Bosshard, Milo Alan Puhan
BACKGROUND: In the last decade, the number of patients continuously deeply sedated until death increased up to fourfold. The reasons for this increase remain unclear. OBJECTIVE: To identify socio-demographic and clinical characteristics of sedated patients, and concurrent possibly life-shortening medical end-of-life decisions. DESIGN: Cross-sectional death certificate study in German-speaking Switzerland in 2001 and 2013. PARTICIPANTS: Non-sudden and expected deaths (2001: N = 2281, 2013: N = 2256) based on a random sample of death certificates and followed by an anonymous survey on end-of-life practices among attending physicians...
March 20, 2018: Journal of General Internal Medicine
Koonal K Shah, Aki Tsuchiya, Allan J Wailoo
A source of debate in the health care priority setting literature is whether to weight health gains to account for equity considerations, such as concern for those with very short life expectancy. This paper reviews the empirical evidence in the published social sciences literature relevant to the following research question: do members of the public wish to place greater weight on a unit of health gain for end-of-life patients than on that for other types of patients? An electronic search of the Social Sciences Citation Index for articles published until October 2017 was conducted, with follow-up of references to obtain additional data...
March 7, 2018: Social Science & Medicine
Patricia Sobradillo Ecenarro, Marta Inchausti Iguiñiz, Sandra Pedrero Tejada, Nuria Marina Malanda, María Alfonso Imizcoz, Laura Ansola Marlasca, Bernardino Alcázar Navarrete
Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience...
March 20, 2018: COPD
Claudia Bozzaro
Physician-assisted dying (assisted suicide and euthanasia) is currently an intensely discussed topic in several countries. Despite differences in legislation and application, countries with end-of-life laws have similar eligibility criteria for assistance in dying: individuals must be in a hopeless situation and experience unbearable suffering. Hopelessness, as a basic aspect of the human condition, is a central topic in Albert Camus' philosophical work The Myth of Sisyphus, which addresses the question of suicide...
March 20, 2018: Theoretical Medicine and Bioethics
Eva Schildmann, Sebastian Pörnbacher, Helen Kalies, Claudia Bausewein
BACKGROUND: Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. AIM: To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palliative care unit. DESIGN: Retrospective cohort study, using medical records. Explorative statistical analysis (SPSS 23). SETTING/PARTICIPANTS: Patients who died on a palliative care unit from August 2014 to July 2015...
March 1, 2018: Palliative Medicine
Regina Emily Robbins, Mark Gilbert
This study explores the reflective processes of Scottish artist, Norman Gilbert, as he created twenty-five drawings depicting his wife, Pat Gilbert, as she lay dying following an Alzheimer's-related stroke. Norman, ninety-one, had drawn Pat regularly over their sixty-five-year marriage. One week after Pat died, Norman was interviewed by a family friend to chronicle his reflections on the drawings. The drawings along with the interview transcript are analyzed qualitatively as a case study. Norman's Hospital Drawings of Pat transform what was initially a private experience into a shared comprehension of end of life and bereavement...
March 20, 2018: Journal of Medical Humanities
Fen Li, Bifan Zhu, Zhimin He, Xiaoxi Zhang, Changying Wang, Linan Wang, Peipei Song, Lingling Ding, Chunlin Jin
The aim of this study was to use data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) to determine the factors affecting end-of-life hospital costs of patients. A total number of 43,806 decedents who died in medical facilities in 2015 were examined. These individuals, accounted for 34.85% of all deaths in 2015 in Shanghai. Descriptive analysis and multiple linear regression analysis were performed using STATA 13.0. Results indicated that 88.94% of the decedents who died in medical facilities were over age 60...
2018: Bioscience Trends
Bifan Zhu, Fen Li, Changying Wang, Linan Wang, Zhimin He, Xiaoxi Zhang, Peipei Song, Lingling Ding, Chunlin Jin
One aim of the current study was to track end-of-life care using individual data in Shanghai, China to profile hospital costs for decedents and those for the entire population. A second aim of this study was to clarify the effect of proximity to death. Data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) were examined. For decedents who died in medical facilities in 2015, inpatient care was tracked for 1 year before death. A total of 43,765 decedents were included in the study, accounting for 35% of total deaths in 2015 in Shanghai...
2018: Bioscience Trends
Derrick S Haslem, Ingo Chakravarty, Gail Fulde, Heather Gilbert, Brian P Tudor, Karen Lin, James M Ford, Lincoln D Nadauld
The impact of precision oncology on guiding treatment decisions of late-stage cancer patients was previously studied in a retrospective analysis. However, the overall survival and costs were not previously evaluated. We report the overall survival and healthcare costs associated with precision oncology in these patients with advanced cancer. Building on a matched cohort study of 44 patients with metastatic cancer who received all of their care within a single institution, we evaluated the overall survival and healthcare costs for each patient...
February 23, 2018: Oncotarget
Emily E Adams, Morgan L Wrightson
The present study aims to synthesize current evidence on the impact of LVAD implantation on quality of life. Current evidence was systematically reviewed to obtain relevant quantitative and qualitative articles published after 2007. Sandelowski's recommended steps for meta-summary were used to analyze the 19 studies that met the inclusion criteria. LVADs can improve HF symptoms and some aspects of QoL. Emotional and physical adaptation involves many changes and learning to manage the device takes time. Functional limitations still exist and patients still lack independence...
March 15, 2018: Heart & Lung: the Journal of Critical Care
Maarten Vermorgen, Aline De Vleminck, Luc Deliens, Dirk Houttekier, Nele Spruytte, Chantal Van Audenhove, Joachim Cohen, Kenneth Chambaere
OBJECTIVE: Deaths from chronic illness are often preceded by a potentially life-shortening end-of-life decision (ELD). Involving family in these ELDs may have psychosocial benefits for them and the dying person. This study aims to examine how often ELDs are discussed with relatives of the dying person and which characteristics determine their involvement in those ELDs. METHODS: A questionnaire survey was conducted in 2013 among physicians attending a large, stratified and representative sample of deaths (n = 6188) in Flanders...
March 2, 2018: Patient Education and Counseling
Maria Heckel, Stephanie Stiel, Franziska A Herbst, Johanna M Tiedtke, Alexander Sturm, Thomas Adelhardt, Christian Bogdan, Cornel Sieber, Oliver Schöffski, Frieder R Lang, Christoph Ostgathe
PURPOSE: Palliative care professionals are frequently confronted with patients colonized or infected with MDRO. One major challenge is how to balance necessary isolation measures and social inclusion as one of the main principles of palliative and end-of-life care. To date, MDRO-specific policies and protocols vary widely between institutions. AIM: provide empirical recommendations on how to deal with hospitalized MDRO patients in end-of-life care. METHODS: Recommendations were developed based on (i) initial results of face-to-face interviews and focus groups, (ii) impartial experts' comments and consensus on the draft via online survey and (iii) a face-to-face meeting with consortium members to finalize recommendations...
March 16, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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