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https://www.readbyqxmd.com/read/29166565/hospital-based-physicians-intubation-decisions-and-associated-mental-models-when-managing-a-critically-and-terminally-ill-older-patient
#1
Shannon Haliko, Julie Downs, Deepika Mohan, Robert Arnold, Amber E Barnato
BACKGROUND: Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. OBJECTIVE: We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. METHODS: Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29165958/advanced-practice-nurses-and-end-of-life-care-for-patients-with-progressive-chronic-kidney-disease-and-end-stage-renal-disease
#2
Vicki Montoya
No abstract text is available yet for this article.
May 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29165139/analysis-of-the-evidence-practice-gap-to-facilitate-proper-medical-care-for-the-elderly-investigation-using-databases-of-utilization-measures-for-national-database-of-health-insurance-claims-and-specific-health-checkups-of-japan-ndb
#3
Takeo Nakayama, Yuichi Imanaka, Yasushi Okuno, Genta Kato, Tomohiro Kuroda, Rei Goto, Shiro Tanaka, Hiroshi Tamura, Shunichi Fukuhara, Shingo Fukuma, Manabu Muto, Motoko Yanagita, Yosuke Yamamoto
As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation...
June 6, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29165012/changing-focus-end-of-life-care-in-a-new-york-state-managed-long-term-care-program
#4
Mary Ann Meeker, Deborah P Waldrop
In the United States, managed long-term care programs offer a noninstitutional approach to meeting the needs of increasing numbers of frail elders. Providing services that support both quality of life and quality of dying poses unique challenges. Using a qualitative descriptive design, we explored these challenges from the perspectives of care providers. Themes were identified using qualitative content analysis techniques applied to transcripts of 33 semistructured interviews. Professionals comprising an interdisciplinary care team and home health aide direct care providers described cues by which they identified movement into the end-of-life phase, their understandings of how care changed, and their concerns and recommendations for improvement...
October 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29164739/can-specially-trained-community-care-workers-effectively-support-patients-and-their-families-in-the-home-setting-at-the-end-of-life
#5
Roslyn G Poulos, Damian Harkin, Christopher J Poulos, Andrew Cole, Rod MacLeod
Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs)...
November 21, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/29163800/end-of-life-care-in-children-with-hematologic-malignancies
#6
Jessica I Hoell, Jens Warfsmann, Stefan Balzer, Arndt Borkhardt, Gisela Janssen, Michaela Kuhlen
Introduction: Hematologic malignancies (HM) represent the most common neoplasms in childhood. Despite improved overall survival rates, they are still a major contributor to cancer death in children. Aims: To determine the proportion of children with HM in pediatric palliative care (PPC) and to identify the clinical characteristics and symptoms in comparison to children with extracranial solid tumors (non HM patients). Patients and Methods: This study was conducted as a single-center retrospective cohort study of patients in the care of a large specialized PPC team...
October 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/29161539/home-is-where-the-future-is-the-brightfocus-foundation-consensus-panel-on-dementia-care
#7
Quincy M Samus, Constantine G Lyketsos, Betty Smith Black, Diane Bovenkamp, Michael Buckley, Christopher Callahan, Karen Davis, Laura N Gitlin, Nancy Hodgson, Deirdre Johnston, Helen C Kales, Michele Karel, John Jay Kenney, Shari M Ling, Maï Panchal, Melissa Reuland, Amber Willink
INTRODUCTION: A national consensus panel was convened to develop recommendations on future directions for home-based dementia care (HBDC). METHODS: The panel summarized advantages and challenges of shifting to HBDC as the nexus of care and developed consensus-based recommendations. RESULTS: The panel developed five core recommendations: (1) HBDC should be considered the nexus of new dementia models, from diagnosis to end of life in dementia; (2) new payment models are needed to support HBDC and reward integration of care; (3) a diverse new workforce that spans the care continuum should be prepared urgently; (4) new technologies to promote communication, monitoring/safety, and symptoms management must be tested, integrated, and deployed; and (5) targeted dissemination efforts for HBDC must be employed...
November 18, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/29161396/demands-and-requests-for-inappropriate-or-inadvisable-treatments-at-the-end-of-life-what-do-you-do-at-2-o-clock-in-the-morning-when-%C3%A2
#8
L McCrossan, R Siegmeth
In an era when healthcare has become increasingly complex and patient expectations are higher than ever before, we can find the decision-making process for patients, potentially at the end of their lives, increasingly difficult. In the shift from paternalism to patient choice, we can struggle to know what to do when faced with a patient, their family, or both requesting or demanding inadvisable, inappropriate, or futile treatments. It can feel as if we are being asked to subject patients to intrusions and interventions that 'just feel wrong'...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161388/critical-care-at-the-end-of-life-balancing-technology-with-compassion-and-agreeing-when-to-stop
#9
H Montgomery, M Grocott, M Mythen
Modern intensive care saves lives. However, the substantial related financial costs are, for many, married to substantial costs in terms of suffering. In the most sick, the experience of intensive care is commonly associated with the development of profound physical debility, which may last years after discharge. Likewise, the negative psychological impact commonly experienced by such patients during their care is now widely recognized, as is the persistence of psychological morbidity. Such issues become increasingly important as the population of the frail elderly increases, and the health and social care services face budgetary restriction...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159708/mainstreaming-genetics-in-palliative-care-barriers-and-suggestions-for-clinical-genetic-services
#10
A Dearing, N Taverner
Palliative healthcare professionals (PHCPs) frequently do not refer their eligible patients for genetic testing. After the death of the affected individual, clinically relevant information for family members is lost. In previous research, PHCPs stated that the end-of-life setting is not appropriate to discuss genetic issues. It is unclear if this has changed due to increasing awareness of genetics in the media and efforts to mainstream genetic testing. Semi-structured interviews of PHCPs were analysed by thematic analysis...
November 20, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/29158371/perception-of-curability-among-advanced-cancer-patients-an-international-collaborative-study
#11
Sriram Yennurajalingam, Luis Fernando Rodrigues, Omar Shamieh, Colombe Tricou, Marilène Filbet, Kyaw Naing, Akhileshwaran Ramaswamy, Pedro Emilio Perez-Cruz, Mary Jocelyn S Bautista, Sofia Bunge, Mary Ann Muckaden, Vikash Sewram, Sarah Fakrooden, Antonio Tejedor Noguera, Shobha S Rao, Diane Liu, Minjeong Park, Janet L Williams, Zhanni Lu, Hilda Cantu, David Hui, Suresh K Reddy, Eduardo Bruera
BACKGROUND: There are limited data on illness understanding and perception of cure among advanced cancer patients around the world. The aim of the study was to determine the frequency and factors associated with inaccurate perception of curability among advanced cancer patients receiving palliative care across the globe. MATERIALS AND METHODS: Secondary analysis of a study to understand the core concepts in end-of-life care among advanced cancer patients receiving palliative care from 11 countries across the world...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#12
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29157290/commentary-on-a-participatory-inquiry-paradigm-used-to-assess-eol-simulation-participant-outcomes-and-design
#13
Jane M Gannon
Care at the end-of-life has attracted global attention, as health care workers struggle with balancing cure based care with end-of-life care, and knowing when to transition from the former to the latter. Simulation is gaining in popularity as an education strategy to facilitate health care provider decision-making by improving communication skills with patients and family members. This commentary focuses on the authors' simulation evaluation process. When data were assessed using a participatory inquiry paradigm, the evaluation revealed far more than a formative or summative evaluation of participant knowledge and skills in this area of care...
November 20, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29156918/challenges-and-ethical-issues-in-the-course-of-palliative-care-management-for-people-living-with-advanced-neurologic-diseases
#14
Varun Sreenivasan, Christa O'Hana S Nobleza
In the recent years, there has been an increase in awareness with regards to the role of palliative care (PC) in management of neurologic diseases. In 1996, the need to incorporate PC in the care for patients with neurologic conditions was recognized by the American Academy of Neurology (AAN) Ethics and Humanities Subcommittee. The gaps in research, education and the ability to deliver adequate PC were then acknowledged by the National Academy of Sciences with their publication of "Approaching death: improving care at the end of life" and most recently, continued goals in improving PC was highlighted by another recent publication "Dying in America: improving quality and honoring individual preferences near the end of life"...
October 19, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#15
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156908/enhanced-psychosocial-support-as-important-component-of-neuro-palliative-service
#16
Kwok-Ying Chan, Man-Lui Chan
There are unmet palliative care (PC) needs for psychosocial and spiritual distress of neurology patients such as bad stroke as well as in chronic neurodegenerative diseases. As such, psychosocial support to both patients and their caregivers should be enhanced in order to provide comprehensive neuro-PC. The first step in developing this type of support/program was to recognize the main psychosocial care needs of the population. Once these were determined, a program was specifically devised to meet those needs as efficiently and effectively as possible...
September 7, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156901/patient-centered-family-meetings-in-palliative-care-a-quality-improvement-project-to-explore-a-new-model-of-family-meetings-with-patients-and-families-at-the-end-of-life
#17
Christine R Sanderson, Philippa J Cahill, Jane L Phillips, Anne Johnson, Elizabeth A Lobb
BACKGROUND: Family meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard. METHODS: This pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team...
September 29, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156054/hospice-care-cancer-directed-therapy-and-medicare-expenditures-among-older-patients-dying-with-malignant-brain-tumors
#18
Laura L Dover, Caleb R Dulaney, Courtney P Williams, John B Fiveash, Bradford E Jackson, Paula P Warren, Elizabeth A Kvale, D Hunter Boggs, Gabrielle B Rocque
Background: End-of-life care for older adults with malignant brain tumors is poorly understood. The purpose of this study is to quantify end-of-life utilization of hospice care, cancer-directed therapy, and associated Medicare expenditures among older adults with malignant brain tumors. Methods: This retrospective cohort study included deceased Medicare beneficiaries age ≥65 with primary (PMBT) or secondary (SMBT) malignant brain tumor receiving care within a Southeastern cancer community network including academic and community hospitals from 2012-2015...
November 15, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29155291/measuring-the-psychosocial-dimensions-of-quality-of-life-in-advanced-cancer-patients-psychometrics-of-the-german-quality-of-life-at-the-end-of-life-cancer-psychosocial-qual-ec-p-questionnaire
#19
Britta Grünke, Rebecca Philipp, Sigrun Vehling, Katharina Scheffold, Martin Härter, Karin Oechsle, Frank Schulz-Kindermann, Anja Mehnert, Christopher Lo
CONTEXT: Quality of life is a central focus of care in advanced cancer. Specialized instruments, such as the QUAL-EC, may be useful to assess psychosocial issues associated with quality of life unique to this population. OBJECTIVES: To evaluate the measurement of the psychosocial dimensions of quality of life using the German translation of the QUAL-EC-Cancer-Psychosocial Questionnaire (QUAL-EC-P), including factor structure and psychometrics. METHODS: 183 patients with advanced cancer from the University Medical Center Hamburg-Eppendorf and University Medical Center Leipzig completed the QUAL-EC-P...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29153752/hospice-care-for-patients-with-dementia-in-the-united-states-a-longitudinal-cohort-study
#20
Aline De Vleminck, R Sean Morrison, Diane E Meier, Melissa D Aldridge
BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment...
November 16, 2017: Journal of the American Medical Directors Association
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