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End of life care

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https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#1
Deborah R Kaye, Hye Sung Min, Edward C Norton, Zaojun Ye, Jonathan Li, James M Dupree, Chad Ellimoottil, David C Miller, Lindsey A Herrel
PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval...
February 13, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29441244/smartphone-based-reminder-system-to-promote-pelvic-floor-muscle-training-for-the-management-of-postnatal-urinary-incontinence-historical-control-study-with-propensity-score-matched-analysis
#2
Kaori Kinouchi, Kazutomo Ohashi
Background: The purpose of this study was to evaluate the efficacy of a smartphone-based reminder system in promoting pelvic floor muscle training (PFMT) to help postpartum women manage urinary incontinence (UI). Methods: Forty-nine and 212 postpartum women in the intervention and control groups, respectively, received PFMT guidance using a leaflet and verbal instruction as the standard care at an obstetrics clinic in Japan. Women in the intervention group also received PFMT support using the smartphone-based reminder system between January and August 2014...
2018: PeerJ
https://www.readbyqxmd.com/read/29440801/a-retrospective-study-of-end-of-life-care-decisions-in-the-critically-ill-in-a-surgical-intensive-care-unit
#3
Yi Lin Lee, Yee Yian Ong, Sze Ying Thong, Shin Yi Ng
Aim: Progress in medical care and technology has led to patients with more advanced illnesses being admitted to the Intensive Care Unit (ICU). The practice of approaching end-of-life (EOL) care decisions and limiting care is well documented in Western literature but unknown in Singapore. We performed a retrospective cohort study to describe the practice of EOL care in patients dying in a Singapore surgical ICU (SICU). The surgical critical care population was chosen as it is unique because surgeons are frequently involved in the EOL process...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29440385/a-moment-for-compassion-emerging-rhetorics-in-end-of-life-care
#4
Shahaduz Zaman, Alexander Whitelaw, Naomi Richards, Hamilton Inbadas, David Clark
Compassion is an emotional response to the suffering of others. Once felt, it entails subsequent action to ameliorate their suffering. Recently, 'compassion' has become the flagship concept to be fostered in the delivery of end-of-life care, and a rallying call for social action and public health intervention. In this paper, we examine the emerging rhetorics of compassion as they relate to end-of-life care and offer a critique of the expanding discourse around it. We argue that, even where individuals 'possess' compassion or are 'trained' in it, there are difficulties for compassion to flow freely, particularly within Western society...
February 10, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29440148/interventions-in-hospitalised-patients-with-cancer-the-importance-of-impending-death-awareness
#5
Eric Cornelis Theodorus Geijteman, Marcella van der Graaf, Frederika E Witkamp, Sanne van Norden, Bruno H Stricker, Carin C D van der Rijt, Agnes van der Heide, Lia van Zuylen
OBJECTIVES: Burdensome and futile interventions with the aim of prolonging life should be avoided in dying patients. However, current clinical practice has hardly been investigated.We examined the number and type of diagnostic and therapeutic medical interventions in hospitalised patients with cancer in their last days of life. In addition, we investigated if physician awareness of impending death affected the use of these interventions. METHODS: Questionnaire study and medical record study...
February 9, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29440050/carer-experience-of-end-of-life-service-provision-a-social-network-analysis
#6
Rosemary Leonard, Debbie Horsfall, John Rosenberg, Kerrie Noonan
OBJECTIVE: To identify the position of formal service providers in the networks of those providing end-of-life care in the home from the perspective of the informal network. METHODS: Using third-generation social network analysis, this study examined the nature and strength of relationships of informal caring networks with formal service providers through individual carer interviews, focus groups of caring networks and outer network interviews. RESULTS: Service providers were usually highly valued for providing services, equipment, pain management and personalised care for the dying person plus support and advice to the principal carer about both caring tasks and negotiating the health system...
February 10, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29439584/palliative-care-educational-interventions-for-prelicensure-health-care-students-an-integrative-review
#7
Megan Lippe, Bailey Johnson, Stephanie Barger Mohr, Kyle Rhoads Kraemer
To provide adequate care, students from all health-care professions require education regarding palliative and end-of-life (EOL) care prior to entering professional practice. In particular, students need proper training to be equal members of interprofessional teams providing palliative and EOL care. However, limited information is currently available about the effectiveness of educational interventions relating to palliative and EOL care. Thus, an assessment of educational interventions to utilize in providing this education is warranted...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29439104/costs-at-the-end-of-life-perspectives-for-north-carolina
#8
Natalie C Ernecoff, Sally C Stearns
Many elders require supportive services, with many costs covered by Medicaid. Once terminal illness sets in, palliative care and hospice may help control cost while ensuring quality. This commentary reviews trends in cost at the end of life and describes selected strategies to improve patient-centered care in North Carolina.
January 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29437940/the-effect-of-text-messaging-on-latent-tuberculosis-treatment-adherence-a-randomised-controlled-trial
#9
James C Johnston, Mia L van der Kop, Kirsten Smillie, Gina Ogilvie, Fawziah Marra, Mohsen Sadatsafavi, Kamila Romanowski, Matthew A Budd, Jan Hajek, Victoria Cook, Richard T Lester
There is limited high-quality evidence available to inform the use of text messaging to improve latent tuberculosis infection (LTBI) treatment adherence.We performed a parallel, randomised controlled trial at two sites to assess the effect of a two-way short message service on LTBI adherence. We enrolled adults initiating LTBI therapy from June 2012 to September 2015 in British Columbia, Canada. Participants were randomised in a 1:1 ratio to standard LTBI treatment (control) or standard LTBI treatment plus two-way weekly text messaging (intervention)...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29437545/are-repeated-self-reports-of-psychological-variables-feasible-for-patients-near-the-end-of-life-at-a-palliative-care-unit
#10
Sandra Stephanie Mai, Christina Gerlach, Irene Schmidtmann, Annika Renate Vogt, Viola Zeller, Karl-Heinz Renner, Martin Weber
BACKGROUND: Patient-reported outcome (PRO) measurement is crucial to assess the benefit of psychotherapeutic interventions. Is repeated assessment of psychometric self-report data possible, as inpatient palliative care patients suffer from physical and psychological symptoms? What is the self-perceived strain caused by the assessment? Objective The main objective of this study was to investigate the feasibility of a repeated comprehensive psychometric self-assessment of inpatient palliative care patients...
February 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29436435/an-overview-of-the-spiritual-importances-of-end-of-life-care-among-the-five-major-faiths-of-the-united-kingdom
#11
Mohsin Choudry, Aishah Latif, Katharine G Warburton
For many who pertain to particular theological paradigms, their faith cannot be compartmentalised, but is mobilised to inform all aspects of their being, most notably their ethical and moral persuasions. As clinicians, the concept that there are good and bad deaths is already known; understanding the origin and depth of non-physical suffering, and aiming to alleviate it is not possible without learning the individual experiences and beliefs that go with it. Spiritual care forms a fundamental consideration in the endeavor to address the holistic experience of those patients receiving palliative care...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436433/updates-in-palliative-care-recent-advancements-in-the-pharmacological-management-of-symptoms
#12
Angela Star, Jason W Boland
Symptom management is an important part of both palliative care and end-of-life care. This article will examine the recent research evidence about drugs commonly used for symptom management in adult patients receiving palliative care. In particular, the management of symptoms where recent palliative care-based evidence has changed recommended practice will be reviewed. This includes: breathlessness, delirium, nausea and vomiting in bowel obstruction, opioid-induced constipation and upper respiratory tract secretions...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436432/passing-the-baton-of-trust
#13
Catherine Millington-Sanders
Proactive, shared decision making between key professionals and sensitive communication with patients, and those important to them, can never be overestimated. Projected annual deaths in England and Wales are set to rise, highlighting the increasing need for high quality palliative and end-of-life care. The Royal College of General Practitioners and Marie Curie have worked in partnership to develop the Daffodil Standards, an evidenced-based, structured approach for practices using quality improvement methodology to help improve care for patients at an advanced stage of serious illness or approaching end of life...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436431/compassionate-communities-and-end-of-life-care
#14
Julian Abel
Compassionate communities as part of the public health approach to end-of-life care (EoLC) offers the possibility of solving the inequity of the difference in provision of care for those people with incurable cancer and those with non-cancer terminal illnesses. The naturally occurring supportive network surrounding the patient is the starting point for EoLC. The network can provide both hands-on care and support to those providing hands-on care. Healthcare professionals can build much stronger partnerships with these supportive networks and transform EoLC at home...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436430/end-of-life-care-updates-for-busy-clinicians
#15
Angela Star
No abstract text is available yet for this article.
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436391/associations-between-pediatric-palliative-care-consultation-and-end-of-life-preparation-at-an-academic-medical-center-a-retrospective-ehr-analysis
#16
Matthew Stutz, Roy L Kao, Leanna Huard, Jonathan Grotts, Javier Sanz, Mindy K Ross
OBJECTIVES: Our aim in this study was to understand usage patterns of pediatric palliative care (PPC) consultation and associations with end-of-life preparation among pediatric patients who are deceased. METHODS: We reviewed 233 pediatric mortalities. Data extraction from the electronic health record included determination of PPC consultation by using Current Procedural Terminology codes. Diagnoses were identified by International Classification of Disease codes and were classified into categories of life-threatening complex chronic conditions (LT-CCCs)...
February 7, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29436003/is-hospitalisation-necessary-a-survey-of-frail-older-persons-with-cognitive-impairment-transferred-from-nursing-homes-to-the-emergency-department
#17
Maria Björck, Helle Wijk
BACKGROUND: Providing care for frail older persons is complex and demanding, and the transfer of older persons with cognitive impairment to the emergency department is associated with a high risk of them developing complications. AIM: To survey the most ill and frail older persons with cognitive impairment who were transferred from nursing homes to the emergency department, considering reasons for referral, symptoms and actions taken at the hospital. METHOD: A retrospective descriptive survey, conducting a review of 588 referral notes and medical records, analysed and presented with descriptive statistics and visualised with typical case narratives...
February 12, 2018: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29434048/hospital-end-of-life-care-in-haematological-malignancies
#18
Yvan Beaussant, Etienne Daguindau, Adrien Chauchet, Philippe Rochigneux, Christophe Tournigand, Régis Aubry, Lucas Morin
OBJECTIVE: To investigate patterns of care during the last months of life of hospitalised patients who died from different haematological malignancies. METHODS: Nationwide register-based study, including all hospitalised adults ≥20 years who died from haematological malignancies in France in 2010-2013. Outcomes included use of invasive cancer treatments and referral to palliative care. Percentages are adjusted for sex and age using direct standardisation. RESULTS: Of 46 629 inpatients who died with haematological malignancies, 24...
February 6, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29434021/end-of-life-care-for-infants-children-and-young-people-with-life-limiting-conditions-planning-and-management-the-nice-guideline-2016
#19
Ella Aidoo, Dilini Rajapakse
No abstract text is available yet for this article.
February 6, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29433576/barriers-and-facilitators-to-the-implementation-of-a-paediatric-palliative-care-team
#20
Lisa M Verberne, Marijke C Kars, Sasja A Schepers, Antoinette Y N Schouten-van Meeteren, Martha A Grootenhuis, Johannes J M van Delden
BACKGROUND: Over the last decade, paediatric palliative care teams (PPCTs) have been introduced to support children with life-limiting diseases and their families and to ensure continuity, coordination and quality of paediatric palliative care (PPC). However, implementing a PPCT into an organisation is a challenge. The objective of this study was to identify barriers and facilitators reported by healthcare professionals (HCPs) in primary, secondary or tertiary care for implementing a newly initiated multidisciplinary PPCT to bridge the gap between hospital and home...
February 12, 2018: BMC Palliative Care
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