2,568 results match your criteria Am J Hosp Palliat Care[Journal]


Prelude to Death or Practice Failure? Trombley-Brennan Terminal Tissue Injury Update.

Am J Hosp Palliat Care 2019 Apr 16:1049909119838969. Epub 2019 Apr 16.

3 Biostatistics Unit, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA.

In 2012, we published a study in this journal exploring the emergence of unique skin changes in end-of-life patients admitted to a palliative care unit. The purpose of the study was to describe the skin changes and identify the relationship between these changes and time of death. In the above study of 80 patients, the skin changes were found to be unique and different from Kennedy terminal ulcers and deep tissue injuries. Read More

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http://dx.doi.org/10.1177/1049909119838969DOI Listing

Outcomes and Cost of Patients With Terminal Cancer Admitted to Acute Care in the Final 2 Weeks of Life: A Retrospective Chart Review.

Am J Hosp Palliat Care 2019 Apr 16:1049909119843285. Epub 2019 Apr 16.

1 Division of Critical Care, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Background: Patients with terminal conditions are often admitted to the emergency department (ED) for acute medical services, but studies have suggested that multiple ED admissions may negatively impact end-of-life (EOL) care. Research have shown that incorporating palliative care (PC) is integral to optimal EOL care, but it is an aspect of medical practice that is often neglected. The current study sought to provide an overview of health outcomes and hospital costs of patients with cancer admitted to The Ottawa Hospital and/or received acute medical services during their final 2 weeks of life. Read More

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http://dx.doi.org/10.1177/1049909119843285DOI Listing

Informal Caregivers' Perceptions of Needs From Hospice Providers: An Integrative Review.

Am J Hosp Palliat Care 2019 Apr 16:1049909119842365. Epub 2019 Apr 16.

1 College of Nursing, Marquette University, Milwaukee, WI, USA.

Introduction: In the United States, informal caregivers (ICs) provide care to over 70% of patients at the end of life. Approximately 500 000 ICs contribute to the end-of-life care for patients in the United Kingdom. Hospice care is expanding worldwide to meet the needs of these ICs. Read More

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http://dx.doi.org/10.1177/1049909119842365DOI Listing

The Timing of Family Meetings in the Medical Intensive Care Unit.

Am J Hosp Palliat Care 2019 Apr 14:1049909119843133. Epub 2019 Apr 14.

1 Department of Medicine, University of Chicago, Chicago, IL, USA.

Purpose: Family meetings in the medical intensive care unit can improve outcomes. Little is known about when meetings occur in practice. We aimed to determine the time from admission to family meetings in the medical intensive care unit and assess the relationship of meetings with mortality. Read More

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http://dx.doi.org/10.1177/1049909119843133DOI Listing
April 2019
4 Reads

How Is End-of-Life Care With and Without Dementia Associated With Informal Caregivers' Outcomes?

Am J Hosp Palliat Care 2019 Apr 14:1049909119836932. Epub 2019 Apr 14.

5 Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands.

Background: Palliative care for older people with life-limiting diseases often involves informal caregivers, but the palliative care literature seldom focuses on the negative and positive aspects of informal caregiving.

Objective: To assess the association of proximity to end of life (EOL) and dementia caregiving with informal caregivers' burden of care and positive experiences and explain differences in outcomes.

Design: Data on 1267 informal caregivers of community-dwelling older people were selected from a nationally representative cross-sectional survey and analyzed using analysis of variance and multivariable regression analyses. Read More

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http://dx.doi.org/10.1177/1049909119836932DOI Listing

The Support, Education, and Advocacy (SEA) Program of Care for Women With Metastatic Breast Cancer: A Nurse-Led Palliative Care Demonstration Program.

Am J Hosp Palliat Care 2019 Apr 11:1049909119839696. Epub 2019 Apr 11.

3 Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.

Background: Women with metastatic breast cancer (MBC) experience unique symptom management and psychosocial needs due to aggressive, yet palliative treatment with a progressive, chronic illness.

Objective: This article describes the effect of a quality improvement project for coordination of supportive care in MBC. Program evaluations included referral rates for supportive services, patient-reported outcomes of symptom distress, generalized anxiety, and overall well-being. Read More

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http://dx.doi.org/10.1177/1049909119839696DOI Listing

Simulation-Based Palliative Care Communication for Pediatric Critical Care Fellows.

Am J Hosp Palliat Care 2019 Apr 11:1049909119839983. Epub 2019 Apr 11.

4 Division of Critical Care Medicine, Department of Pediatrics, Emory University, Atlanta, GA, USA.

Background: Pediatric palliative care (PPC) education is lacking in pediatric critical care medicine (PCCM) fellowships, despite the desire of many program directors and fellows to expand difficult conversation training. Simulation-based training is an experiential method for practicing challenging communication skills such as breaking bad news, disclosing medical errors, navigating goals of care, and supporting medical decision-making.

Methods: We describe a simulation-based PPC communication series for PCCM fellows, including presimulation session, simulation session, debriefing, and evaluation methods. Read More

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http://dx.doi.org/10.1177/1049909119839983DOI Listing
April 2019
1 Read

Moral Distress and Attitudes About Timing Related to Comfort Care for Hospitalized Patients: A Survey of Inpatient Providers and Nurses.

Am J Hosp Palliat Care 2019 Apr 9:1049909119843136. Epub 2019 Apr 9.

1 Department of Family Medicine, University of Washington, Seattle, WA, USA.

Context: Providing nonbeneficial care at the end of life and delays in initiating comfort care have been associated with provider and nurse moral distress.

Objective: Evaluate provider and nurse moral distress when using a comfort care order set and attitudes about timing of initiating comfort care for hospitalized patients.

Methods: Cross-sectional survey of providers (physicians, nurse practitioners, and physician assistants) and nurses at 2 large academic hospitals in 2015. Read More

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http://dx.doi.org/10.1177/1049909119843136DOI Listing
April 2019
2 Reads

The Forgotten.

Authors:
Jennifer Tsai

Am J Hosp Palliat Care 2019 Apr 8:1049909119839984. Epub 2019 Apr 8.

1 Warren Alpert Medical School of Brown University, Providence, RI, USA.

In this narrative, a third-year medical student recounts an experience with a patient she had while accompanying hospice and palliative workers on home visits. It was a tragic scene to witness, but somehow she left with spirits light. The afternoon with this woman-who suffered from Alzheimer's Disease-stood out. Read More

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http://dx.doi.org/10.1177/1049909119839984DOI Listing

A Practice Improvement Project to Increase Advance Care Planning in a Dementia Specialty Practice.

Am J Hosp Palliat Care 2019 Apr 4:1049909119841544. Epub 2019 Apr 4.

3 Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

This study was conducted to enhance the rate of advance care planning (ACP) conversations and documentation in a dementia specialty practice by increasing physician knowledge, attitudes, and skills. We used a pre- and postintervention paired design for physicians and 2 independent groups for patients. The ACP dementia educational program encompassed 3 objectives: (1) to understand the relevance of ACP to the dementia specialty practice, (2) to provide a framework to discuss ACP with patients and caregivers, and (3) to discuss ways to improve ACP documentation and billing in the electronic medical record. Read More

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http://dx.doi.org/10.1177/1049909119841544DOI Listing

Home Palliative Sedation Using Phenobarbital Suppositories: Time to Death, Patient Characteristics, and Administration Protocol.

Am J Hosp Palliat Care 2019 Apr 4:1049909119839695. Epub 2019 Apr 4.

1 Hospice of Central New York, Liverpool, NY, USA.

Background:: Most people in the United States and other countries cite their preferred location of death as their homes. However, intractable symptoms sometimes require hospitalization, especially if significant sedation becomes necessary. For over a decade, Hospice of Central New York has been using compounded phenobarbital suppositories with individuals in whom adequate sedation has not been achieved using sufficient doses of antipsychotics or benzodiazepines but prefer to remain in their homes. Read More

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http://dx.doi.org/10.1177/1049909119839695DOI Listing
April 2019
3 Reads

Pediatric Complex Chronic Conditions: Does the Classification System Work for Infants?

Am J Hosp Palliat Care 2019 Apr 3:1049909119838985. Epub 2019 Apr 3.

2 Martha S. Pitzer Center for Women, Children Youth, College of Nursing, The Ohio State University, Columbus, OH, USA.

Background:: One widely accepted approach to identify children with life-limiting health problems is the complex chronic conditions (CCCs) classification system. Although considered the "gold standard" for classifying children with serious illness, little is known about its performance, especially among infants.

Objective/hypothesis:: This research examined the prevalence of CCCs and the infant characteristics related to a CCC classification. Read More

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http://journals.sagepub.com/doi/10.1177/1049909119838985
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http://dx.doi.org/10.1177/1049909119838985DOI Listing
April 2019
1 Read

Advanced Heart Failure Treatment Modalities and Hospice Care: The Need for High Level Care Coordination.

Am J Hosp Palliat Care 2019 Mar 28:1049909119838250. Epub 2019 Mar 28.

3 Division of Cardiology, University of Washington School of Medicine, Seattle, WA, USA.

Advanced heart failure therapies such as ventricular assist devices and home inotrope use are becoming more common. Technology advances as well as increased indications for use of such therapies is leading to a higher percentage of patients with end-stage heart failure receiving these therapies at end of life. We present a case of a young man with dilated cardiomyopathy who undergoes advanced cardiac care in the setting of progressively declining cardiac function. Read More

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http://dx.doi.org/10.1177/1049909119838250DOI Listing
March 2019
1 Read

Utilization of Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During Hospitalization: A Population-Based National Study.

Am J Hosp Palliat Care 2019 Mar 28:1049909119838975. Epub 2019 Mar 28.

1 Department of Health Statistics, Second Military Medical University, Shanghai, China.

Objective:: Patients undergoing hematopoietic stem cell transplantation (HSCT) have substantial physical and psychological symptoms. This study aimed to investigate the utilization of palliative care (PC) in patients undergoing HSCT during hospitalization.

Methods:: The 2008-2014 National Inpatient Sample was queried for eligible participants. Read More

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http://dx.doi.org/10.1177/1049909119838975DOI Listing
March 2019
1 Read

Pharmacology Update: Low-Dose Naltrexone as a Possible Nonopioid Modality for Some Chronic, Nonmalignant Pain Syndromes.

Am J Hosp Palliat Care 2019 Mar 27:1049909119838974. Epub 2019 Mar 27.

2 Hospice and Palliative Medicine, Ballad Health System, Kingsport, TN, USA.

Pain can have a devastating effect on the quality of life of patients in palliative medicine. Thus far, majority of research has been centered on opioid-based pain management, with a limited empirical evidence for the use of nonopioid medications in palliative care. However, opioid and nonopioid medications such as nonsteroidal anti-inflammatory drugs have their limitations in the clinical use due to risk of adverse effects, therefore, there is a need for more research to be directed to finding an alternative approach to pain management in comfort care setting. Read More

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http://dx.doi.org/10.1177/1049909119838974DOI Listing
March 2019
3 Reads

Feasibility of Early Application of an Advance Directive at the Time of First-Line Palliative Chemotherapy in Patients With Incurable Cancer: A Prospective Study.

Am J Hosp Palliat Care 2019 Mar 26:1049909119839355. Epub 2019 Mar 26.

2 Department of Medical Oncology and Hematology, Hanil General Hospital, Seoul, Korea.

Context:: This study aimed to evaluate the feasibility of an advance directive (AD) at the time of starting first-line palliative chemotherapy. We investigated changes in emotional distress, quality of life (QoL), and attitudes toward anticancer treatments between before and after AD.

Methods:: Patients with advanced cancer who had just started palliative chemotherapy were prospectively enrolled. Read More

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http://dx.doi.org/10.1177/1049909119839355DOI Listing

Incorporating Older Adults as "Trained Patients" to Teach Advance Care Planning to Third-Year Medical Students.

Am J Hosp Palliat Care 2019 Mar 25:1049909119836394. Epub 2019 Mar 25.

4 Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL, USA.

Background:: Advance care planning (ACP) is a critical component of end-of-life (EoL) care, yet infrequently taught in medical training.

Objective:: We designed a novel curriculum that affords third-year medical students (MS3s) the opportunity to practice EoL care discussions with a trained older adult in the patient's home.

Design:: Volunteers were instructed as trained patients (TPs) to evaluate MS3s interviewing and communication skills. Read More

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http://dx.doi.org/10.1177/1049909119836394DOI Listing
March 2019
1 Read

Medicare Cost at End of Life.

Am J Hosp Palliat Care 2019 Mar 18:1049909119836204. Epub 2019 Mar 18.

4 Case-Mix Analytics LLC, Handon, CT, USA.

As the Medicare program struggles to control expenditures, there is increased focus on opportunities to manage patient populations more efficiently and at a lower cost. A major source of expense for the Medicare program is beneficiaries at end of life. Estimates of the percentage of Medicare costs that arise from patients in the last year of life differ, ranging from 13% to 25%, depending on methods and assumptions. Read More

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http://dx.doi.org/10.1177/1049909119836204DOI Listing
March 2019
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The Role of Ultrasound-Guided Therapeutic Thoracentesis in an Outpatient Transitional Care Program: A Case Series.

Am J Hosp Palliat Care 2019 Mar 18:1049909119837517. Epub 2019 Mar 18.

3 Center for Transitional Care, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

Background:: Symptomatic pleural effusions create discomfort and are a frequent cause of hospitalization. Ultrasound-guided thoracentesis is a key palliative intervention to assist in the management of this vulnerable population. Our institution has created a multidisciplinary transitional care program to address the needs of those discharged from the hospital with chronic complex conditions, including symptomatic pleural effusions. Read More

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http://dx.doi.org/10.1177/1049909119837517DOI Listing
March 2019
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How to Talk About Attitudes Toward the End of Life: A Qualitative Study.

Am J Hosp Palliat Care 2019 Mar 14:1049909119836238. Epub 2019 Mar 14.

2 Department of Palliative Medicine, Medical Faculty of the University of Cologne, Köln, Germany.

To individually plan end-of-life care, open communication about a person's preferences and attitudes toward the end of life can facilitate dignity and quality of life in patients and relatives. To improve communication, structured guiding tools might be used as door openers. However, most tools focus on care preferences and decisions without assessing the person's underlying attitudes in detail. Read More

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http://dx.doi.org/10.1177/1049909119836238DOI Listing
March 2019
3 Reads

Impact of Race and Ethnicity on End-of-Life Experiences for Children With Cancer.

Am J Hosp Palliat Care 2019 Mar 13:1049909119836939. Epub 2019 Mar 13.

1 Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Background:: Racial and ethnic disparities in the provision of end-of-life care are well described in the adult oncology literature. However, the impact of racial and ethnic disparities at end of life in the context of pediatric oncology remains poorly understood.

Objective:: To investigate associations between end-of-life experiences and race/ethnicity for pediatric patients with cancer. Read More

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http://dx.doi.org/10.1177/1049909119836939DOI Listing
March 2019
3 Reads

A Qualitative Study of Independent Home Visits by Hospice Fellows: Addressing Gaps in ACGME Milestones by Fostering Reflection and Self-Assessment.

Am J Hosp Palliat Care 2019 Mar 13:1049909119836218. Epub 2019 Mar 13.

1 Cleveland Clinic, Cleveland, OH, USA.

Background:: With the rapid growth in the number of fellowship programs in Hospice and Palliative Medicine (HPM), many are in the process of developing ways to demonstrate that fellows are attaining educational milestones. Reflection and self-assessment are key components of 2 Accreditation Council for Graduate Medical Education (ACGME) competencies, practice-based learning and improvement, and systems-based practice, which have both been historically challenging to learn and assess.

Objective:: This article describes results of a content analysis of narrative data collected from HPM fellows' self-assessments as they performed hospice home visits independently in a new clinical rotation. Read More

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http://dx.doi.org/10.1177/1049909119836218DOI Listing

Initiating End-of-Life Care at the Emergency Department: An Observational Study.

Am J Hosp Palliat Care 2019 Mar 12:1049909119836931. Epub 2019 Mar 12.

1 Emergency Medicine Department, National University Hospital, National University Health System, Singapore, Singapore.

Objective:: Terminally ill patients at their end-of-life (EOL) phase attending the emergency department (ED) may have complex and specialized care needs frequently overlooked by ED physicians. To tailor to the needs of this unique group, the ED in a tertiary hospital implemented an EOL pathway since 2014. The objective of our study is to describe the epidemiological characteristics, symptom burden and management of patients using a protocolized management care bundle. Read More

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http://dx.doi.org/10.1177/1049909119836931DOI Listing
March 2019
1.347 Impact Factor

Effects of a Primary Palliative Care Educational System for Teaching Learners at Different Levels of Training.

Am J Hosp Palliat Care 2019 Mar 7:1049909119834854. Epub 2019 Mar 7.

1 Vanderbilt University Medical Center, The Vanderbilt Clinic, Nashville, TN, USA.

Interest and appreciation for palliative care (PC) has resulted in increased demand for both PC services and education. The PC rotation has been shown to improve PC knowledge in medical students (MS) and internal medicine (IM) residents, and PC specialists stand poised to direct the primary PC education of learners at different levels of training. To concurrently teach learners of different levels of training on a busy PC service, we created an educational system that emphasizes management of learner schedules, organization of teaching activities, faculty development to improve teaching skills, and learner self-evaluation. Read More

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http://dx.doi.org/10.1177/1049909119834854DOI Listing

Effect of Erythropoiesis-Stimulating Agent Therapy in Patients Receiving Palliative Care of Chronic Kidney Disease.

Am J Hosp Palliat Care 2019 Mar 7:1049909119834855. Epub 2019 Mar 7.

1 Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong.

Background:: Despite the increasing use of erythropoiesis-stimulating agent (ESA) in patients receiving dialysis, few studies have examined the benefits of ESA for patients with chronic kidney disease receiving palliative care.

Objective:: We designed a retrospective observational study to evaluate the effect of ESA in treating anemia of renal disease among adult patients receiving palliative care instead of dialysis. The primary objective was to assess whether ESA can reduce the transfusion burden and hospitalization. Read More

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http://dx.doi.org/10.1177/1049909119834855DOI Listing
March 2019
1 Read

Implementing a Palliative Medicine Music Therapy Program: A Quality Improvement Project.

Am J Hosp Palliat Care 2019 Mar 7:1049909119834878. Epub 2019 Mar 7.

2 Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Objectives:: Recent evidence suggests that music therapy, a holistic method of care, potentially is beneficial for symptom management. This quality improvement project aimed to evaluate the effect of music therapy on symptom management and coping skills of patients receiving palliative care and to measure patient satisfaction with the therapy. A secondary aim was to evaluate staff perception of patient outcomes of music therapy services. Read More

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http://journals.sagepub.com/doi/10.1177/1049909119834878
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http://dx.doi.org/10.1177/1049909119834878DOI Listing
March 2019
8 Reads

The Provision of Palliative Care for Noncancer Patients With Advanced Disease: Equity Does Matter.

Am J Hosp Palliat Care 2019 Mar 5:1049909119835225. Epub 2019 Mar 5.

3 Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

According to the World Health Organization, the main mission of palliative care is to optimize the quality of life of patients with serious chronic disease, as well as their caregivers, by providing biopsychosociospiritual care. However, historically, the primary focus of palliative care is on providing care only for cancer diseases. Based on the current literature, it is assumed that palliative care is not provided for many chronic diseases on a regular basis and in many cases, a clinical guideline does not exist for providing palliative care. Read More

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http://dx.doi.org/10.1177/1049909119835225DOI Listing

Stakeholder Perspectives on the Biopsychosocial and Spiritual Realities of Living With ALS: Implications for Palliative Care Teams.

Am J Hosp Palliat Care 2019 Mar 3:1049909119834493. Epub 2019 Mar 3.

1 Deparment of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, Missouri.

Context:: Amyotrophic lateral sclerosis (ALS) is an all-encompassing, life-limiting disease, resulting in the eventual paralysis of all voluntary muscles and concurrent loss of independence. As the disease advances, both patients and their family caregivers develop complex biological, psychological, and social needs, leading to increasing calls for the involvement of palliative care teams in the management of ALS.

Objective:: The purpose of this study was to generate a rich description of the realities of living with ALS, equipping palliative care teams with an in-depth understanding of the experiences and needs of patients with ALS and their family caregivers. Read More

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http://dx.doi.org/10.1177/1049909119834493DOI Listing
March 2019
10 Reads

Subjective and Objective Assessment of Taste and Smell Sensation in Advanced Cancer.

Am J Hosp Palliat Care 2019 Mar 3:1049909119832836. Epub 2019 Mar 3.

1 School of Medicine, Trinity College Dublin, Dublin, Ireland.

Context:: Taste and smell abnormalities (TSA) occur throughout the cancer trajectory regardless of cancer primary site and contribute to cancer-associated malnutrition. TSA etiology is poorly understood. Tumor-related inflammation is a possible cause. Read More

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Cancer Communication Outside of the Physician-Patient Relationship: The Experience of Communicating and Understanding the Meaning of Prognosis.

Am J Hosp Palliat Care 2019 Feb 28:1049909119832811. Epub 2019 Feb 28.

1 Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.

Research Question:: How does the process of engagement and integration of sources of information outside patient-physician interaction affect how individuals with cancer interpret their treatment experience and prognosis?

Background:: Studies of patient-physician communication of prognosis in oncology highlight areas where misunderstanding occurs: understanding consequences of treatment, likelihood of treatment success, probability of cure, status/progression of illness, and prognosis. Theories proposing mechanisms that underlie this discrepancy cannot account for all instances of misunderstanding, including when complete and direct physician disclosure occurs. Prior research focused on patient-physician communication event(s) and immediate antecedents and consequences. Read More

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http://dx.doi.org/10.1177/1049909119832811DOI Listing
February 2019

Assessing Relationships Between Muslim Physicians' Religiosity and End-of-Life Health-Care Attitudes and Treatment Recommendations: An Exploratory National Survey.

Am J Hosp Palliat Care 2019 Feb 27:1049909119833335. Epub 2019 Feb 27.

1 Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA.

Background:: Research demonstrates that the attitudes of religious physicians toward end-of-life care treatment can differ substantially from their nonreligious colleagues. While there are various religious perspectives regarding treatment near the end of life, the attitudes of Muslim physicians in this area are largely unknown.

Objective:: This article attempts to fill in this gap by presenting American Muslim physician attitudes toward end-of-life care decision-making and by examining associations between physician religiosity and these attitudes. Read More

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http://dx.doi.org/10.1177/1049909119833335DOI Listing
February 2019

Addressing Educational Needs in Managing Complex Pain in Cancer Populations: Evaluation of APAM: An Online Educational Intervention for Nurses.

Am J Hosp Palliat Care 2019 Feb 27:1049909119832819. Epub 2019 Feb 27.

1 de Souza Institute, University Health Network, Toronto, Ontario, Canada.

Context:: Cancer-related pain is associated with significant suffering and is one of the most challenging symptoms to manage. Studies indicate that front-line clinicians often lack the knowledge on best practices in cancer pain management.

Objectives:: The current project, a quality improvement (QI) initiative, evaluated the outcome of an online educational intervention for nurses on complex cancer pain management. Read More

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http://dx.doi.org/10.1177/1049909119832819DOI Listing
February 2019

Outcomes of an Integrated Urology-Palliative Care Clinic for Patients With Advanced Urological Cancers: Maintenance of Quality of Life and Satisfaction and High Rate of Hospice Utilization Through End of Life.

Am J Hosp Palliat Care 2019 Feb 26:1049909119833663. Epub 2019 Feb 26.

1 Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, CA, USA.

Introduction:: Systematic integration of palliative care in a surgical setting is important, but has yet to be achieved. Despite evidence of early palliative care improving patients' quality of life, hospice utilization remains low. Through an integrated palliative care-urology clinic, we aim to assess the effect of early outpatient palliative care on hospice utilization, health-related quality of life (HRQOL) and satisfaction in patients with advanced urological cancers. Read More

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http://dx.doi.org/10.1177/1049909119833663DOI Listing
February 2019
2 Reads

The Ethics of Prioritizing Access to Palliative Care: A Qualitative Study.

Am J Hosp Palliat Care 2019 Feb 25:1049909119833333. Epub 2019 Feb 25.

3 Department of Medicine, University of Melbourne, Victoria, Australia.

Objective:: This article sought to explore ethical issues associated with prioritization decisions in palliative care.

Methods:: As part of a broader series of studies of triage in palliative care, this qualitative substudy was conducted via semi-structured focus groups and individual interviews. Transcripts were subjected to thematic analysis. Read More

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http://dx.doi.org/10.1177/1049909119833333DOI Listing
February 2019
13 Reads

Twelve-Step Programs and Spiritual Support at the End of Life.

Am J Hosp Palliat Care 2019 Feb 25:1049909119832809. Epub 2019 Feb 25.

2 Department of Psychiatry, University of Vermont, Burlington, VT, USA.

Experts estimate that over 25 million Americans are in recovery from addiction to alcohol and other drugs. Many will be confronted with a serious progressive illness necessitating palliative care or hospice services. In current literature, substance use disorder has mostly been examined in relation to appropriate symptom assessment and management, opioid risk screening, and controlled substance prescribing practices. Read More

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http://dx.doi.org/10.1177/1049909119832809DOI Listing
February 2019
1 Read

TeleHospice: A Community-Engaged Model for Utilizing Mobile Tablets to Enhance Rural Hospice Care.

Am J Hosp Palliat Care 2019 Feb 25:1049909119829458. Epub 2019 Feb 25.

4 Hospice Services and Palliative Care of Northwest Kansas, Inc, Phillipsburg, KS, USA.

Background:: In rural communities, providing hospice care can be a challenge. Hospice personnel sometimes travel great distances to reach patients, resulting in difficulty maintaining access, quality, cost-effectiveness, and safety. In 1998, the University of Kansas Medical Center piloted the country's first TeleHospice (TH) service. Read More

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http://dx.doi.org/10.1177/1049909119829458DOI Listing
February 2019

Patient Perspectives on Advance Care Planning via a Patient Portal.

Am J Hosp Palliat Care 2019 Feb 25:1049909119832820. Epub 2019 Feb 25.

1 Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.

Background:: Patient portals can offer patients an opportunity to engage in the advance care planning (ACP) process outside of clinical visits.

Objective:: To describe patient perspectives on use of patient portal-based ACP tools.

Design:: Interviews with patients who used portal-based ACP tools. Read More

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http://dx.doi.org/10.1177/1049909119832820DOI Listing
February 2019

Palliative Care in Myocardial Infarction: Patient Characteristics and Trends of Service Utilization in a National Inpatient Sample.

Am J Hosp Palliat Care 2019 Feb 25:1049909119832818. Epub 2019 Feb 25.

1 Department of Medicine-Unity Hospital, Rochester Regional Health, Rochester, NY, USA.

Introduction:: Myocardial infarction (MI) remains a leading cause of mortality. Palliative care (PC) has recently expanded in scope to include noncancer-related conditions. There is little data available regarding the use of PC in critical MI patients. Read More

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http://dx.doi.org/10.1177/1049909119832818DOI Listing
February 2019
2 Reads

Opioids for Relief of Dyspnea Immediately Before Death in Patients With Noncancer Disease: A Case Series Study.

Authors:
Maki Murakami

Am J Hosp Palliat Care 2019 Feb 25:1049909119832816. Epub 2019 Feb 25.

1 Department of Palliative Care, The Salvation Army Kiyose Hospital, Tokyo, Japan.

Background:: Dyspnea is commonly found in most conditions among patients with progressive noncancer disease.

Objective:: To clarify the effectiveness and safety of opioid administration for the treatment of dyspnea immediately before death in patients with noncancer disease.

Methods:: A retrospective case-series study involving 13 consecutive terminally ill patients who were near death and diagnosed with noncancer disease, and had refractory dyspnea and received opioid therapy, was performed. Read More

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http://dx.doi.org/10.1177/1049909119832816DOI Listing
February 2019
1 Read

Surgical Versus Medical Team Assignment and Secondary Palliative Care Services for Patients Dying in a Cardiac Hospital.

Am J Hosp Palliat Care 2019 Apr 13;36(4):316-320. Epub 2018 Dec 13.

2 Cleveland Clinic, Cleveland, OH, USA.

Background:: Secondary palliative care (SPC) provides several benefits for patients with cardiovascular disease, but historically, it has been underutilized in this population. Prior research suggests a low rate of SPC consultation by surgical teams in general, but little is known about how surgical teams utilize SPC in the setting of severe cardiovascular disease.

Aim:: To determine if surgical team assignment affects the probability of SPC for inpatients dying of cardiovascular disease. Read More

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http://dx.doi.org/10.1177/1049909118819462DOI Listing

Impact of Hospice and Palliative Care Service Utilization on All-Cause 30-Day Readmission Rate for Older Adults Hospitalized with Heart Failure.

Am J Hosp Palliat Care 2019 Feb 17:1049909119828712. Epub 2019 Feb 17.

1 Department of Medicine, Washington DC Veterans Affairs Medical Center, Washington, DC, USA.

Background:: Acute decompensated heart failure (HF) is the leading cause for hospital readmission. Large-scale sustainable interventions to reduce readmission rate have not been fully explored or proven effective.

Objective:: We studied the impact of hospice and palliative care service utilization on 30-day all-cause hospital readmissions for patients with HF. Read More

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http://dx.doi.org/10.1177/1049909119828712DOI Listing
February 2019
1.347 Impact Factor

Interprofessional Collaboration Between a Multidisciplinary Palliative Care Team and the Team Pharmacist on Pain Management.

Am J Hosp Palliat Care 2019 Feb 12:1049909119829047. Epub 2019 Feb 12.

2 Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea.

Purpose:: The purpose of the study was to evaluate the impact on pain management by multidisciplinary palliative care team (mPCT) and the team pharmacist.

Methods:: Patients who were admitted to palliative care unit (PCU) for at least 7 days between April 2014 and December 2015 were included. The mPCT consisted of a physician, a pharmacist, nurses, and non-clinical support staff. Read More

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http://dx.doi.org/10.1177/1049909119829047DOI Listing
February 2019
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Oral Hygiene Care in Patients With Advanced Disease: An Essential Measure to Improve Oral Cavity Conditions and Symptom Management.

Am J Hosp Palliat Care 2019 Feb 12:1049909119829411. Epub 2019 Feb 12.

1 Antea Palliative Care Unit, Rome, Italy.

Background:: Oral problems are frequent in palliative care and can cause disabling symptoms such as orofacial pain, dysgeusia, and xerostomia. Even if oral care is an essential aspect of nursing, it is often not considered as a priority, especially when various complex patients' needs have to be managed.

Objective:: The aim of this study was to describe oral conditions and evaluate the impact of standard oral care on symptom control and patient's perceived comfort in a sample of terminally ill patients. Read More

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http://dx.doi.org/10.1177/1049909119829411DOI Listing
February 2019

Trends in Health-Care Utilization at the End of Life Among Patients With Hematologic Malignancies in a Middle-Income Country: Challenges and Opportunities in Brazil.

Am J Hosp Palliat Care 2019 Feb 11:1049909119828086. Epub 2019 Feb 11.

2 Research Laboratory of Intensive Care Medicine, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

Patients with hematologic malignancies (HMs) often receive poor-quality end-of-life care. This study aimed to identify trends in end-of-life care among patients with HM in Brazil. We conducted a retrospective cohort study (2015-2018) of patients who died with HM, using electronic medical records linked to health insurance databank, to evaluate outcomes consistent with health-care resource utilization at the end of life. Read More

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http://dx.doi.org/10.1177/1049909119828086DOI Listing
February 2019
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Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses.

Am J Hosp Palliat Care 2019 Feb 11:1049909119828116. Epub 2019 Feb 11.

2 Palliative Home Care Nursing Team, Tuen Mun Hospital, NT, Hong Kong.

Background:: Noncancer patients with life-limiting diseases often receive more intensive level of care in their final days of life, with more cardiopulmonary resuscitation performed and less do-not-resuscitate (DNR) orders in place. Nevertheless, death is still often a taboo across Chinese culture, and ethnic disparities could negatively affect DNR directives completion rates.

Objectives:: We aim to explore whether Chinese noncancer patients are willing to sign their own DNR directives in a palliative specialist clinic, under a multidisciplinary team approach. Read More

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http://dx.doi.org/10.1177/1049909119828116DOI Listing
February 2019
11 Reads
1.347 Impact Factor

Improving End-of-Life Care for Diverse Populations: Communication, Competency, and System Supports.

Am J Hosp Palliat Care 2019 Feb 6:1049909119827933. Epub 2019 Feb 6.

2 Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA.

Background:: While disparities in end-of-life care have been well-documented, explanations for the persistence of disparities are less clear. This study sought to examine diverse perceptions of end-of-life care, especially regarding how medical professionals can better serve all populations.

Objective:: To investigate similarities and differences in end-of-life care preferences, across racial and ethnic groups. Read More

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http://dx.doi.org/10.1177/1049909119827933DOI Listing
February 2019

POLST Registration and Associated Outcomes Among Veterans With Advanced-Stage Lung Cancer.

Am J Hosp Palliat Care 2019 Jan 30:1049909118824543. Epub 2019 Jan 30.

1 Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR, USA.

Introduction:: The Oregon Physicians Orders for Life-Sustaining Treatment (POLST) Program allows patients with advanced illness to document end-of-life (EOL) care preferences. We examined the characteristics and associated EOL care among Veterans with and without a registered POLST.

Methods:: Retrospective, cohort study of advanced-stage (IIIB and IV) patients with lung cancer who were diagnosed between 2008 and 2013 as recorded in the VA Central Cancer Registry. Read More

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http://dx.doi.org/10.1177/1049909118824543DOI Listing
January 2019

Patients' Perspectives on Approaches to Facilitate Completion of Advance Directives.

Am J Hosp Palliat Care 2019 Jan 29:1049909118824548. Epub 2019 Jan 29.

3 Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Background:: Little is understood about the different ways patients complete advance directives (ADs), which is most commonly through lawyers and increasingly using websites.

Objective:: To understand patients' perspectives on different approaches to facilitating AD completion, the value of legal regulation of ADs, and the use of a web-based platform to create an AD.

Design:: Semi-structured interviews with patients. Read More

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http://dx.doi.org/10.1177/1049909118824548DOI Listing
January 2019
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End-of-life Health-Care Utilization Patterns Among Chronically Ill Older Adults.

Am J Hosp Palliat Care 2019 Jan 29:1049909118824962. Epub 2019 Jan 29.

2 University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

Patients with chronic illness are associated with high health-care utilization and this is exacerbated in the end of life, when health-care utilization and costs are highest. Complex Care Management (CCM) is a model of care developed to reduce health-care utilization, while improving patient outcomes. We aimed to examine the relationship between health-care utilization patterns and patient characteristics over time in a sample of older adults enrolled in CCM over the last 2 years of life. Read More

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http://dx.doi.org/10.1177/1049909118824962DOI Listing
January 2019
1.347 Impact Factor

Korean Physicians' Perspectives on Prognostication in Palliative Care: A Qualitative Study.

Am J Hosp Palliat Care 2019 Jan 27:1049909118824542. Epub 2019 Jan 27.

7 Department of Statistics, Dongguk University, Seoul, South Korea.

Background:: Prognostication is an essential component of palliative care for patients with advanced cancer but also poses challenges. Little is known about physicians' perspectives on prognostication and prognostic tools used in palliative care practice in Eastern countries.

Objectives:: To explore Korean physicians' perspectives and experiences with prognostication in their palliative care practices. Read More

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http://dx.doi.org/10.1177/1049909118824542DOI Listing
January 2019