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End of life care

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https://www.readbyqxmd.com/read/28735270/subcutaneous-levetiracetam-for-the-management-of-seizures-at-the-end-of-life
#1
REVIEW
Anna Elizabeth Sutherland, John Curtin, Victoria Bradley, Olivia Bush, Maggie Presswood, Victoria Hedges, Katrien Naessens
OBJECTIVES: To report the results of a combined case series analysis of subcutaneous levetiracetam (Keppra) for the management of seizures in palliative care patients. METHODS: A comprehensive literature review on the use of subcutaneous levetiracetam was performed, and these data were combined with a prospective observational audit of its use in terminal care undertaken in a regional palliative care network. RESULTS: 7 papers were identified from the literature review-four case reports and three observational case series-reporting on a total of 53 cases where subcutaneous levetiracetam was administered...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28735269/patient-family-agreement-on-values-and-preferences-for-life-sustaining-treatment-results-of-a-multicentre-observational-study
#2
Amane Abdul-Razzak, Daren K Heyland, Jessica Simon, Sunita Ghosh, Andrew G Day, John J You
OBJECTIVES: To quantify agreement between patients and their family members on their own values and preferences for use or non-use of life-sustaining treatments for the patient. METHODS: Hospitalised patients aged 55 years or older with advanced pulmonary, cardiac, liver disease or metastatic cancer or aged 80 years or older from medical wards at 16 Canadian hospitals and their family members completed a questionnaire including eight items about values related to life-sustaining treatment and a question about preferences for life-sustaining treatments...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28734864/reasons-for-seeking-clinical-care-for-lower-urinary-tract-symptoms-a-mixed-methods-study
#3
James W Griffith, Emily E Messersmith, Brenda W Gillespie, Jonathan B Wiseman, Kathryn E Flynn, Ziya Kirkali, John W Kusek, Tamara Bavendam, David Cella, Karl J Kreder, Jasmine J Nero, Maria E Corona, Catherine S Bradley, Kimberly S Kenton, Brian T Helfand, Robert M Merion, Kevin P Weinfurt
PURPOSE: The primary objective of this study was to evaluate reasons for seeking care among men and women with lower urinary tract symptoms (LUTS). METHODS: Participants were recruited from urology and urogynecology clinics, and the community. The sample was enriched with persons expected to have abnormal or diminished bladder sensations (e.g., participants with lower back surgery, participants aged 65+). In-person interviews were conducted, beginning with an open-ended assessment of urinary symptoms and associated bother, followed by more directed questions, including reasons for seeking or not seeking treatment...
July 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28734561/avoiding-adult-in-hospital-cardiac-arrest-a-retrospective-cohort-study-to-determine-preventability
#4
Gordon Bingham, Irma Bilgrami, Mandy Sandford, Sarah Larwill, Judit Orosz, Carl Luckhoff, Tony Kambourakis
INTRODUCTION: This study had three main aims. Develop a methodology for reviewing in-hospital cardiac arrests (IHCA). Assess appropriateness and potential preventability of IHCAs. Identify areas for improvement within the rapid response system (RRS). DESIGN: A retrospective cohort study of IHCA identified from an existing organisational electronic database of medical emergency (MET) and Code Blue team activation. Potential preventability of IHCA and Code Blue team activation were established by an expert panel based on a standardised case review process with descriptive and content analyses for each IHCA event...
July 19, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28733697/perspectives-of-newly-diagnosed-advanced-cancer-patients-receiving-dignity-therapy-during-cancer-treatment
#5
Ann Marie Dose, Lori M Rhudy
PURPOSE: Dignity therapy is a psychosocial intervention that has been used primarily at the end of life to improve quality of life and other patient outcomes, but many individuals are unable to complete it due to health decline and death. The purpose of this study was to identify what individuals with advanced pancreatic or lung cancer with limited life expectancy, undergoing active cancer treatment describe during the dignity therapy intervention as important to them when not immediately facing end of life...
July 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#6
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28733461/should-heart-failure-be-regarded-as-a-terminal-illness-requiring-palliative-care-a-study-of-heart-failure-patients-carers-and-clinicians-understanding-of-heart-failure-prognosis-and-its-management
#7
Rachel Stocker, Helen Close, Helen Hancock, A Pali S Hungin
OBJECTIVES: Communication and planning for heart failure (HF) care near the end of life is known to be complex. Little is known about how the patient experience of palliative assessment and communication needs change over time, and how this might inform management. Our aim was to explore experiences of giving or receiving a prognosis and advanced palliative care planning (ACP) for those with HF. METHODS: We carried out a longitudinal grounded theory study, employing in-depth interviews with 14 clinicians (primary and secondary care) and observations of clinic and home appointments, followed by a series of interviews with 13 patients with HF and 9 carers...
July 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28733295/the-impact-of-healthcare-professionals-personality-and-religious-beliefs-on-the-decisions-to-forego-life-sustaining-treatments-an-observational-multicentre-cross-sectional-study-in-greek-intensive-care-units
#8
Asimenia Ntantana, Dimitrios Matamis, Savvoula Savvidou, Kyriaki Marmanidou, Maria Giannakou, Μary Gouva, George Nakos, Vasilios Koulouras
OBJECTIVES: To assess the opinion of intensive care unit (ICU) personnel and the impact of their personality and religious beliefs on decisions to forego life-sustaining treatments (DFLSTs). SETTING: Cross-sectional, observational, national study in 18 multidisciplinary Greek ICUs, with >6 beds, between June and December 2015. PARTICIPANTS: 149 doctors and 320 nurses who voluntarily and anonymously answered the End-of-Life (EoL) attitudes, Personality (EPQ) and Religion (SpREUK) questionnaires...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28732151/patients-attitudes-and-experiences-of-disease-modifying-anti-rheumatic-drugs-in-rheumatoid-arthritis-and-spondyloarthritis-a-qualitative-synthesis
#9
Ayano Kelly, Kathleen Tymms, David J Tunnicliffe, Daniel Sumpton, Chandima Perera, Kieran Fallon, Jonathan C Craig, Walter Abhayaratna, Allison Tong
OBJECTIVES: Non-adherence to disease-modifying anti-rheumatic drugs (DMARDS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) results in increased disease activity and symptoms and poorer quality of life. We aimed to describe patients' attitudes and experiences of DMARDs in RA and SpA to inform strategies to improve medication adherence. METHODS: Databases (MEDLINE, Embase, PsycINFO, CINAHL) were searched to January 2016. Thematic synthesis was used to analyze the findings...
July 21, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28731821/trust-in-physicians-continuity-and-coordination-of-care-and-quality-of-death-in-patients-with-advanced-cancer
#10
Jun Hamano, Tatsuya Morita, Sakiko Fukui, Yoshiyuki Kizawa, Satoru Tunetou, Yasuo Shima, Makoto Kobayakawa, Maho Aoyama, Mitsunori Miyashita
BACKGROUND: Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. OBJECTIVE: To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home...
July 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28731382/external-validation-and-clinical-utility-of-a-prediction-model-for-6-month-mortality-in-patients-undergoing-hemodialysis-for-end-stage-kidney-disease
#11
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28731379/quasi-experimental-evaluation-of-a-multifaceted-intervention-to-improve-quality-of-end-of-life-care-and-quality-of-dying-for-patients-with-advanced-dementia-in-long-term-care-institutions
#12
René Verreault, Marcel Arcand, Lucie Misson, Pierre J Durand, Edeltraut Kroger, Michèle Aubin, Maryse Savoie, Thomas Hadjistavropoulos, Sharon Kaasalainen, Annick Bédard, Annie Grégoire, Pierre-Hughes Carmichael
BACKGROUND: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. AIM: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. DESIGN: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28731361/the-impact-of-teaching-prognostication-at-the-end-of-life-a-pre-post-interventional-study
#13
Alexandria Bear, Tucker Keuter, Jayshil J Patel
BACKGROUND: Providing accurate and valid prognostic information significantly influences end-of-life care. Disclosing a poor prognosis can be among the most difficult of physician responsibilities, thus having appropriate knowledge during training is crucial for appropriate prognostication. OBJECTIVE: To provide internal medicine (IM) house staff with a pre- and posteducational survey to determine their ability to accurately prognosticate 5 common end-stage diseases...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28729130/information-needs-about-palliative-care-and-euthanasia-a-survey-of-patients-in-different-phases-of-their-cancer-trajectory
#14
Kim Beernaert, Chloë Haverbeke, Simon Van Belle, Luc Deliens, Joachim Cohen
OBJECTIVE: We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients. METHODS: Cancer patients consulting a university hospital (N=620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where "palliative care for all" is a patient's right embedded in the law and euthanasia is possible under certain conditions...
July 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28727487/improving-care-with-a-portfolio-of-physician-led-cancer-quality-measures-at-an-academic-center
#15
Julie Bryar Porter, Eben Lloyd Rosenthal, Marcy Winget, Andrea Segura Smith, Sridhar Belavadi Seshadri, Yohan Vetteth, Eileen F Kiamanesh, Amogh Badwe, Ranjana H Advani, Mark K Buyyounouski, Steven Coutre, Frederick Dirbas, Vasu Divi, Oliver Dorigo, Kristen N Ganjoo, Laura J Johnston, Lawrence David Recht, Joseph B Shrager, Eila C Skinner, Susan M Swetter, Brendan C Visser, Douglas W Blayney
PURPOSE: Development and implementation of robust reporting processes to systematically provide quality data to care teams in a timely manner is challenging. National cancer quality measures are useful, but the manual data collection required is resource intensive, and reporting is delayed. We designed a largely automated measurement system with our multidisciplinary cancer care programs (CCPs) to identify, measure, and improve quality metrics that were meaningful to the care teams and their patients...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28727486/association-of-physician-orders-for-life-sustaining-treatment-form-use-with-end-of-life-care-quality-metrics-in-patients-with-cancer
#16
Sandra L Pedraza, Stacey Culp, Mark Knestrick, Evan Falkenstine, Alvin H Moss
PURPOSE: Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs). METHODS: We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28727207/palliative-care-physicians-experiences-of-end-of-life-communication-a-focus-group-study
#17
C Udo, M Lövgren, G Lundquist, B Axelsson
The aim of this study was to explore palliative home care physicians' experiences regarding end-of-life breakpoint communication (BPC). This is a qualitative study where focus group interviews were conducted and analysed using qualitative content analysis. The results show that the participants saw themselves as being responsible for accomplishing BPC, and they were convinced that it should be regarded as a process of communication initiated at an early stage, i.e. proactively. However, BPC was often conducted as a reaction to the patient's sudden deterioration or sometimes not at all...
July 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28726731/the-use-of-imaging-in-the-prediction-and-assessment-of-cancer-treatment-toxicity
#18
REVIEW
Hossein Jadvar
Multimodal imaging is commonly used in the management of patients with cancer. Imaging plays pivotal roles in the diagnosis, initial staging, treatment response assessment, restaging after treatment and the prognosis of many cancers. Indeed, it is difficult to imagine modern precision cancer care without the use of multimodal molecular imaging, which is advancing at a rapid pace with innovative developments in imaging sciences and an improved understanding of the complex biology of cancer. Cancer therapy often leads to undesirable toxicity, which can range from an asymptomatic subclinical state to severe end organ damage and even death...
July 20, 2017: Diagnostics
https://www.readbyqxmd.com/read/28725864/dying-from-cancer-communication-empathy-and-the-clinical-imagination
#19
Larry D Cripe, Richard M Frankel
Medical oncologists and patients with advanced cancer struggle to discuss prognosis, goals, options, and values in a timely fashion. As a consequence, many patients die receiving aggressive treatment potentially inconsistent with their fully informed preferences and experience increased symptom burden and distress. The goals of patient - oncologist communication include exchanging information, building relationship, and engaging in shared decisions. Empathy is perhaps especially essential to effective patient - oncologist communication when the end of life is approaching...
June 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28725839/nursing-strategies-for-engaging-families-of-older-immigrants-hospitalized-for-end-of-life-care-an-australian-study
#20
Megan-Jane Johnstone, Alison M Hutchinson, Helen Rawson, Bernice Redley
BACKGROUND: Engaging with families of older non-English-speaking background (NESB) immigrants hospitalized for end-of-life (EOL) care can be challenging, especially when their cultures, lifeways, and family decision-making processes are unfamiliar to the nurses caring for them. Despite the recognized importance of family engagement when providing EOL care, the issue of ethnic minority family engagement has received little attention in the field. AIM: To explore and describe the strategies nurses use to facilitate engagement with families of older immigrant NESB patients hospitalized for EOL care...
September 2016: Journal of patient experience
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