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Automated Electronic Health Record Score to Predict Mortality Risk at the US Department of Veterans Affairs Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-04-17 Thomas F. Osborne, Zachary P. Veigulis, Anna Ware, David M. Arreola, Catherine Curtin, Marianne Yeung
BackgroundTerminally ill patients benefit from earlier engagement in palliative care. However, this does not always occur. This project assessed if an already available risk score, the Care Assessment Needs (CAN) score, would be able to identify patients at greatest risk for mortality within 30 days of hospital admission within the Veterans Health Administration (VHA).MethodsThe cohort of this retrospective
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Ketamine Use for Palliative Care in the Austere Environment: Is Ketamine the Path Forward for Palliative Care Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-04-17 John R. Reed, Stephanie K. Parks, Antony Kaniaru, Justin Hefley, Young Yauger, Jeremy V. Edwards, Derrick C. Glymph
The goal of palliative care is to focus on the holistic needs of the patient and their family versus the pathology of the patient’s diagnosis to reduce the stress of illness. U.S. servicemembers deployed to austere environments worldwide have significantly less access to palliative care than in military treatment facilities in the U.S. Preparation for future conflicts introduces the concept of prolonged
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An Analysis of Healthcare Usage & Place of Death in England for All Adults Who Died in 2021/22 Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-04-16 Justine Wiltshire, Jacqueline Grout, Mike Krotosky, Peter Gerry, Peter Ashcroft, Rachael White, Ash Lillis, Adrienne Betteley, Ollie Minton
ObjectiveWe wanted to examine the healthcare use and non-elective activity in the UK population of expected deaths over an 1-year period to highlight and examine the reasons for variation. We did this to identify areas to focus interventions or resources on to reduce unnecessary emergency care use at the end of life.Methods and AnalysisWe assembled a data set of approximately 400 000 adults who died
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Enhancing End-of-Life Care Knowledge Among Older Spanish-Speaking Adults: Results From a Pilot Educational Intervention on Advance Care Planning and Care Options Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-04-16 Susanny J. Beltran, Olga Molina, Reshawna Chapple
BackgroundDisparities in advance care planning (ACP) among older Latinos necessitate targeted interventions to enhance engagement and knowledge in end-of-life care. This study aimed to evaluate the effectiveness of a resource-efficient, culturally tailored educational intervention in improving ACP readiness and knowledge among older Latino adults in the community.MethodsA quasi-experimental pretest-posttest
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Being Seen as a Unique Person is Essential in Palliative Care at Home and Nursing Homes: A Qualitative Study With Patients and Relatives Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-04-06 Katrin Kochems, Everlien de Graaf, Ginette M. Hesselmann, Saskia C. C. M. Teunissen
ContextIncorporation of a palliative care approach is increasingly needed in primary care and nursing home care because most people with a life-limiting illness or frailty live there.ObjectivesTo explore patients’ and relatives’ experiences of palliative care at home and in nursing homes.MethodsGeneric qualitative research in a purposive sample of patients with an estimated life expectancy of <1 year
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A Survey of Jewish Attitudes and Experiences Relating to End-of-Life Care and the “Right to Die” Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-30 Christopher M. Moreman, Ayona Chatterjee
We conducted a survey of Jewish attitudes towards, and experiences with, end-of-life care. Questions fell into three areas: (1) Expectations for Jewish end-of-life care; (2) Experiences with such care; and (3) Attitudes toward the “right to die.” Examining denominational differences in belief in, and adherence to, Halakha (Jewish law), we confirm many expectations described in the literature. We find
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Survey of NCI-Designated Cancer Centers on the Utilization of Palliative Care in Pancreatic Cancer Patients Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-29 Anjali Goyal, Amir Steinberg
Recognized as one of the deadliest cancers, pancreatic cancer underscores an urgent need for palliative care. We surveyed palliative care directors at all 65 National Cancer Institute (NCI) cancer centers to assess the utilization and timing of palliative care involvement in pancreatic cancer patients. 1) Does your palliative care team have a policy to get involved with every pancreatic cancer patient
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New Graduate Nurses’ Approaches to Death and Dying Patients and the Relationship Between Death Anxiety and Death Awareness: A Cross-Sectional Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-27 Merve Tarhan, Pinar Dogan
BackgroundOne of the challenges experienced by new graduate nurses during the transition into practice is caring for dying patients. This study aimed to determine new graduate nurses’ approaches to death and dying patients and the relationship between death anxiety and death awareness.MethodsThis descriptive, cross-sectional study was conducted with 226 new graduate nurses in Istanbul, Türkiye. A personal
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Facts to Snacks. Evaluating the Effectiveness of Bite-Sized Animations in Teaching Palliative Care to Medical Students Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-23 Kai Lin Megan Chua, Jin Qi Valerie Chan, Laurence Lean Chin Tan, James Alvin Low
BackgroundCurrent palliative care training in medical school is inadequate in preparing doctors to provide quality palliative care. Little attention is paid to determining effective methods of training.ObjectiveTo assess the use of bite-sized animations in improving the confidence, knowledge and attitudes of medical students towards palliative care.MethodsA mixed methods cohort study was adopted for
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Repeated Filling of Elastomeric Pumps for Home-Based Subcutaneous Infusions: A Cost Analysis of 240 Devices Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-21 Carolina Simões, Miguel Julião, Patrícia Calaveiras, Elisabeth Costa, Eduardo Bruera
BackgroundThe use of continuous subcutaneous infusion of drugs using the repeated filling of elastomeric infuser pumps (EIP) has gained clinical recognition for palliative care at home. However, to date, there has been a notable absence of research examining the cost implications associated with the repeated EIP filling procedure. We aimed to evaluate the cost associated to the repeated filling of
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Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-20 Letteria Consolo, Daniele Rusconi, Stella Colombo, Ilaria Basile, Tiziana Campa, Daniele Pezzera, Salvatore Benenati, Augusto Caraceni, Maura Lusignani
IntroductionElectronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their
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Embracing Inclusivity in Hospice Care: A Case Study in Supporting HIV Patients Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-20 Jeff Clyde G. Corpuz
Despite the growing prevalence of human immunodeficiency virus (HIV) and acquired immunodefiency syndrome (AIDS) in the Philippines and the psychosocial challenges it engenders, there remains a dearth of research on the intersection of HIV and hospice care. Stigma and discrimination further compound the challenges of providing inclusive hospice care to HIV patients in the country. Drawing upon the
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Music Therapy Intervention to Reduce Symptom Burden in Hospice Patients: A Descriptive Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-19 Madison H. Estell, Kevin J. Whitford, Angela M. Ulrich, Brianna E. Larsen, Christina Wood, Maureen L. Bigelow, Travis J. Dockter, Kimberly L. Schoonover, Amy J. Stelpflug, Jacob J. Strand, Monica P. Walton, Maria I. Lapid
Background: Music therapy (MT) offers benefits of improved symptom relief and quality of life at the end of life, but its impact on hospice patients and caregivers needs more research. Objective: To assess the impact of MT intervention on symptom burden and well-being of hospice patients and caregivers. Methods: A total of 18 hospice patients, selected based on scores ≥4 on the revised Edmonton Symptom
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Prevalence and Characteristics of Pathological Fractures in Patients Referred to Specialist Palliative Care: A Retrospective Study From India Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-18 Jyothsna Kuriakose, Sumith Surendran, Jayita K. Deodhar, Prasun P, Rutula N. Sonawane, Prarthna Jayaseelan
Background: Prevalence of pathological fractures in palliative care is less studied. This study aimed to determine the annual prevalence of pathological fractures and describe the characteristics and treatments in patients with pathological fractures referred to a specialist palliative care clinic in a tertiary care cancer center in India. Methods: Data of adult cancer patients newly referred to the
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Health Care Worker Education for Palliative Care in Africa: Narrative Review Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-14 Claire Beecher, David Holmes
The demand for palliative care for terminally ill patients is rising globally. This review examines the potential of health worker education to enhance palliative care in Africa. A search of PubMed yielded 32 relevant articles published in English from 2013 to 2023 focused on African countries with WHO-categorized palliative care development and health care worker training. The findings underscore
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Is This a Deceased Loved One That I See Before Me or Am I Only Dreaming? Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-06 Stephen Claxton-Oldfield
This article makes a case for examining dying person’s visions during wakefulness and their dreams during sleep as separate and unique phenomena. The reason being that the mode of experience, for example, being visited by a deceased loved one while awake and conscious vs having a deceased loved one appear in a dream while asleep, may have a different impact on the dying person. A better understanding
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Managing End of Life Care for the Critically Ill: A Novel Program to Deliver Bedside Critical Care Without Transfer to the Intensive Care Unit Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-04 Kathryn Bass, Rohit Gupta, Celia Wells, Samantha Ortiz Muriel, Anna Hackett, Sanam Ahmed, Roopa Kohli-Seth
Background: Navigating medical care at the end of life can be a challenging experience for patients. There are also significant resource burdens, including intensive care unit (ICU) admissions, accompanying terminal illness. For actively dying patients, developing a care plan based on patient goals and delivering care at the bedside can enhance patient well-being, avoid inappropriate transfers or interventions
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The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students’ Knowledge, Attitudes, and Emotions Toward End-of-Life Patients Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-03-04 Betül Çakmak, Bahar Inkaya
BackgroundSufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it.AimThis study aimed to examine the effect of a repeated standardized patient-based
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An Insight Into the Experiences of Malaysian Patients With Advanced Cancer and Their Preferences in End-of-Life Care: A Qualitative Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-23 Iris Chung, Shiao-Yen Khoo, Lee Lan Low
Background: Preferences of patients with advanced cancer are well studied in Western countries but less so in Asian communities where end-of-life discussions can be seen as taboo. This may lead to patients receiving care that is incongruent with their wishes as their disease progress. It is important for healthcare providers to have a better understanding of patients’ experiences and preferences especially
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Exploring Palliative Care Needs Among Patients With Cancer and Non-Cancer Serious Chronic Diseases: A Comparison Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-22 Malek Alnajar, Muhammad Darawad, Wejdan Khater, Rashed Alshahwan, Sultan Mosleh, Basema Nofal, Maysoon Abdalrahim
BackgroundPalliative care (PC) is integral to improving the quality of life and mitigating suffering for individuals with serious illnesses. This interdisciplinary-led study aims to comprehensively evaluate the prevalence of distressing problems and unmet needs among both cancer and non-cancer chronic disease patients and explore their need for PC.MethodsA cross-sectional, comparative, and multicenter
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Mental Health Service Integration in Hospice Organizations: A National Survey of Hospice Clinicians and Medical Leadership Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-21 Catherine Lowenthal, Maureen Ekwebelem, Mary E. Callahan, Katherine Pike, Samuel Weisblatt, Milagros Silva, Angela L. Novas, Amy S. Tucci, M. Carrington Reid, Daniel Shalev
Background: Unmet mental health needs are associated with a range of negative consequences for individuals at the end of life. Despite the high prevalence of mental health needs among individuals enrolled in hospice, there is a paucity of data describing mental health service integration in hospices in the United States. Objectives: 1. To identify patterns of mental health service integration in hospice
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A Mixed Methods Analysis of Standardized Documentation of Serious Illness Conversations Within an Electronic Health Record Module During Hospitalization Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-09 Myrna Katalina Serna, Catherine Yoon, Julie Fiskio, Joshua R. Lakin, Jeffrey L. Schnipper, Anuj K. Dalal
BackgroundAnalysis of documented Serious Illness Conversations (SICs) in the inpatient setting can help clinicians align management to address patient and caregiver needs.MethodsWe conducted a mixed methods analysis of the first instance of standardized documentation of a SIC within a structured module among hospitalized general medicine patients from 2018 to 2019. Percentage of documentations that
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Perceptions on Use of Opioids in Palliative Care of Dyspnoea in Patients with Fibrotic interstitial lung disease and Chronic Obstructive Pulmonary Disease: A Qualitative Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-08 Camilla Yde Hvelplund, Birgit Refsgaard, Elisabeth Bendstrup
BackgroundMany patients with chronic obstructive pulmonary disease and fibrotic interstitial lung disease suffer from severe dyspnea and reduced quality of life, despite receiving optimal disease-modifying treatment for their illness. Studies have suggested that these patients may benefit from treatment with low-dose opioids. However, many patients decline opioid treatment. This has led to patients
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Promising Impact of Telenovela Intervention for Caregivers of Hospice Patients: A Pilot Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-07 Dulce M. Cruz-Oliver, Gabrielle E. Milner, Kelsea Mensh, Marielle Bugayong, Marcela D. Blinka, Nowella Durkin, Martha Abshire Saylor, Chakra Budhathoki, Debra Parker Oliver
BackgroundHospice family caregivers (HFCGs) support the needs of their loved ones but are at risk of developing distress and anxiety. NOVELA is a four-chapter telenovela-style educational video to support topics related to hospice caregiving. Telehealth visits are scheduled in 4 weekly sessions consisting of a chapter and subsequent discussion with an interventionist. This feasibility pilot study tested
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Knowledge and Attitude of the General Public Toward Palliative Care in Jordan: A Cross-Sectional Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-07 Ahmad A. Altarifi, Mohammed Baker, Kenda Abedal-Kareem, Abdullah Abu-Ishqair, Zaina AbuMelhim, Salman Abu Shetayyah, Khader A. Almhdawi
Palliative care is directed to relieve the symptoms of serious and life-threatening illnesses. Unfortunately, it’s usually provided lately in the disease course in developing countries due to a lack of awareness about its concept, which deprives many patients of its benefits. This study aims to investigate the knowledge and attitude of the Jordanian general public toward palliative care. A cross-sectional
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Differences in Attitudes and Barriers Towards Advance Care Planning Amongst Ischemic Heart Disease Patients: A Cross-Sectional Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-07 Alyssa Ng, Athena Ming-Gui Khoo, Jerrald Lau, Chermaine Ang, Hui-Wen Sim, Ker-Kan Tan
ObjectivesPerceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. This cross-sectional study assessed awareness and intentions regarding ACP in individuals with Ischemic Heart Disease, both before and after an Acute
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Cultural Advocacy for Indigenous Individuals With Serious Illness Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-02-02 Jeanna A Ford, Constance Dahlin
Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. Given the
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Opioid Management Review Committee: Fostering Interdisciplinary Education and Support Amid the Ongoing US Opioid Overdose Crisis Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-31 Kyle Neale, Renato V. Samala, Ruth Lagman, Patricia B. Mullan, Laura Shoemaker
BackgroundOver the past two decades, pain and suffering caused by the U.S. opioid crisis have resulted in significant morbidity, policy reforms and healthcare resource strain, and affected healthcare providers’ efforts to manage their patients’ pain. In 2017, Cleveland Clinic’s Department of Palliative and Supportive Care established their Opioid Management Review Committee (OMRC), which focuses on
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A Survey of State Correctional Health Care Providers on Advance Care Planning: Opportunity for Collaboration With Corrections Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-27 Susan O’Conner-Von, Rebecca Shlafer, Paul Galchutt, Sara Kettering, Ali Bouterse, Rebecca Freese, Patricia Berry
Prison populations are rapidly aging. Persons in prison age quicker and suffer more chronic illness and disability than their nonincarcerated peers, posing challenges to caring for prisoners who are chronically ill and dying. The goal of our study was to describe state prisons’ practices and policies addressing persons in prison with advanced chronic and life limiting illness through a national web-based
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Parkinson’s Disease Carepartners’ Perceptions of the Challenges and Rewards of Caregiving Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-24 Sandhya Seshadri, Angela Contento, Kei Sugiura, Maryann Abendroth, Zachary Macchi, Benzi M. Kluger
BackgroundMultiple debilitating symptoms and the progressive nature of Parkinson’s disease (PD) affect carepartners’ quality of life. Although, there is abundant knowledge on caregiver burden there is limited knowledge on PD carepartners’ perceptions of caregiving.AimTo understand family members’ perception of their role, and of the challenges and rewards of PD caregiving.MethodUsing a qualitative
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Compassionate Presence in Seriously Ill Cancer Patients Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-20 M. Renz, C. Gloggner, D. Bueche, U. Renz
Background: Compassion is a relational response to patients’ suffering. Palliative care focuses not only on skills but also on compassion. Nevertheless, incorporated patient perspectives are largely missing from existing research. Aim: Our mixed-method exploratory study in a major Swiss cancer center sought to better understand compassionate presence, its benefits and challenges for patients and providers
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Resident and Caregiver Dyads Talk About Death and Dying in Assisted Living: A Typology of Communication Behaviors Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-20 Ann E. Vandenberg, Alexis A. Bender, Candace L. Kemp, Molly M. Perkins
BackgroundIn the U.S., assisted living (AL) is increasingly a site of death, and anxiety about dying has been identified in long-term care residents and their caregivers. Communication about death and dying is associated with better quality of life and care at end of life (EOL).ObjectiveTo understand communication behaviors used by AL residents and their informal caregivers (i.e., family members or
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Clinical Experiences of Perinatal Palliative Care After a Stillbirth: A Narrative Therapy for Grief Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-20 Yanhua Liu, Xiaolin Yang, Xiaoxiong Zhu, Xiaoling Tian, Zhifen Yang
Narrative care for families suffering from perinatal loss is rarely provided by medical institutions in China Mainland. However, with the advancement of the Chinese narrative medicine theory and practice, the clinical significance of narrative care has been increasingly recognized. Based on the principles of Chinese narrative medicine, this narrative case study described traumatic narrative foreclosures
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Undergraduate Students’ Attitudes Towards Medical Assistance in Dying for Mental Illness Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-20 Stephen Claxton-Oldfield, Emma Mackley
Seventy-one undergraduate students took part in a study examining their attitudes toward medical assistance in dying (MAiD) for mental illness. More than half (52%) of the students did not know that a change to Canada’s MAiD law will allow people with a mental illness as their sole underlying condition to request a medically assisted death next spring (ie, March, 2024). Less than a one-third (28%)
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Impact of Visitor Restrictions on the Pain and Psychological Wellbeing of Palliative Care Patients: A Cohort Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-19 Yiran Tu, Mark Tacey, Jaclyn Yoong
Aim: Palliative care patients with advanced or life-threatening illnesses in hospital during the COVID-19 pandemic are likely to be affected by visitor restrictions (VR). We aimed to explore the impact of VR on patients’ levels of physical pain and psychological distress. Design: Retrospective cohort study comparing two cohorts of patients admitted to a palliative care unit in a major metropolitan
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The Impact of Hospice Care Structures on Care Processes: A Retrospective Cohort Study Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-18 Everlien de Graaf, Matthew Grant, Frederieke van der Baan, Marieke Ausems, Carlo Leget, Saskia Teunissen
Background: Palliative care is subject to substantial variations in care, which may be shaped through adapting the organisational structures through which care is provided. Whilst the goal of these structures is to improve patient care, there is a lack of evidence regarding their effect on care processes and patient outcomes. Aims: This study aims to describe the relationship between care structures
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Pediatric Oncology Hospice: A Comprehensive Review Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-16 Ali Tafazoli, Katharine Cronin-Wood
Pediatric hospice is a new terminology in current medical literature. Implementation of pediatric hospice care in oncology setting is a vast but subspecialized field of research and practice. However, it is accompanied by substantial uncertainties, shortages and unexplored sections. The lack of globally established definitions, principles, and guidelines in this field has adversely impacted the quality
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Caring for Patients Requiring Venous Arterial Extracorporeal Membrane Oxygenation: Can Upstream Palliative Care Make a Difference? Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-10 Katie Stevens, Samuel R. Anandan, Husneara Rahman, Sima Parikh, An Gao Leung, Andrea Benintendi, Katlynn M. Van Ogtrop, Alyssa Stancavage, Christopher J. Magalee, Frank Manetta, Christina Saikus, Santiago Lopez
ObjectivePalliative care consultation is relevant for patients requiring Venous-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO); however, evidence is limited to support its value. For this population, we compared length of stay (LOS) (primary outcome), operational metrics and goals of care (GOC) frequency before and after a collaboration between cardiothoracic (CT) surgery and Geriatrics and
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Uncovering Patient and Caregiver Goals for Goal-Concordant Care in Kidney Therapy Decisions Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-10 Ramya Sampath, Sandhya Seshadri, Tramanh Phan, Rebecca Allen, Paul R. Duberstein, Fahad Saeed
ContextIn kidney therapy (KT) decisions, goal-concordant decision-making is recognized to be important, yet alignment with patients' goals during dialysis initiation is not always achieved.ObjectivesTo explore older patients’ and caregivers’ hopes, goals, and fears related to KT and communication of these elements with members of their health care team.MethodsThe study included patients aged ≥75 years
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Screening for End-of-Life in Acute Hospitals: A Cross-Sectional Survey Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-10 Timothy To, Paul Hakendorf, David C Currow
BackgroundPatients are frequently admitted to hospital in the last year of life. Actively recognising patients at this stage gives the opportunity to plan future care.MethodsWe performed a cross-sectional survey of all acute medical and surgical inpatients at one tertiary hospital. Two simple screening tools, the indicators for a palliative approach and the surprise question identified a group of patients
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Integrating Frailty Assessment to Enhance Care in Cancer Patients with Borderline Eastern Cooperative Oncology Group Performance Status Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-06 Chih-Chung Hsu, Yu-Shin Hung, Shao-Ming Yu, Shun-Wen Hsueh, Wen-Chi Chou
BackgroundThe (ECOG) performance status (PS) is commonly used to evaluate the functional ability of patients undergoing antitumor therapy. An ECOG PS of 2, indicating patients capable of self-care but restricted strenuous activity, can complicate treatment decisions owing to concerns regarding treatment-related toxicity. We investigated whether frailty assessment could help discriminate treatment tolerance
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The Perspective of Cancer Patients in Palliative Care on Unmet Needs: A Qualitative Synthesis Using Meta-Ethnography Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-05 Ilaria Basile, Letteria Consolo, Daniele Rusconi, Laura Arba, Flavia Rampichini, Augusto Caraceni, Maura Lusignani
BackgroundAs cancer patients approach the end of life, their needs become more complex, increasing the demand for palliative care. Advanced-stage cancer patients encounter increasing unmet psychological, physical, autonomy, and communication needs, reflecting the difference between patients’ perceived requirements and the support from health care professionals. The objective of this study was to synthesize
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Long-Term Impact of the End-of-Life Care Nursing Education Consortium on Knowledge, Attitudes, and Practice (KAP) of Indian Nurses Working in Non-Palliative Care Settings: A KAP-GAP Analysis Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2024-01-03 Mayank Gupta, Gegal Pruthi, Karamjot Singh
Background: The End-of-life Care Nursing Education Consortium (ELNEC) program aims to equip nurses with knowledge and skills in palliative and end-of-life care. While this program improves knowledge and attitudes of Indian nurses regarding palliative care and end-of-life care, its long-term impact on their knowledge, attitude, and clinical practice remains unknown. This study aims to assess ELNEC’s
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Advance Care Planning in Patients with Suspected or Proven COVID: Are We Meeting Our Own Standards? Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-30 Oyungerel Byambasuren,Jananee Myooran,Aishah Virk,Rida Hanna,Onur Tanglay,Sarah Younan,Nikk Moore,Paul Middleton,Danielle Ní Chróinín
OBJECTIVE Given the importance of advance care planning (ACP) in the context of a pandemic, we aimed to assess current adherence to local policy recommending ACP in all hospitalised adult patients with suspected or proven COVID-19 at Liverpool Hospital, Sydney, Australia. DESIGN A retrospective cohort study. SETTING A tertiary referral and teaching hospital. PARTICIPANTS A select sample of adult patients
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Aggressive End-of-Life Treatments Among Inpatients With Cancer and Non-cancer Diseases Using a Japanese National Claims Database. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-29 Shintaro Togashi,Kento Masukawa,Maho Aoyama,Kazuki Sato,Mitsunori Miyashita
To describe aggressive treatments at end-of-life among inpatients with cancer and non-cancer diseases and to evaluate factors associated with these treatments using the Japanese national database (NDB). We conducted a retrospective cohort study among inpatients aged ≥ 20 years who died between 2012 and 2015 using a sampling dataset of NDB. The outcome was the proportion of aggressive treatments in
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Ecology of End-of-life Medical Care for Advanced Cancer Patients in China. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-28 Fei Yang,Anli Leng,Jun Jing,Mary Miller,Bee Wee
AIMS Cancer is a leading cause of death worldwide. Approximately 30% of global cancer-related deaths occur in mainland China. However, there is a paucity of information regarding the end-of-life care-seeking behavior of patients with advanced cancer in China. Our study was to investigate end-of-life care-seeking behavior and to quantify the association between sociodemographic characteristics and the
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End-of-Life Medical Decisions: The Link Between Sociodemographic Characteristics and Treatment Preferences. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-26 Ashley Shayya,Yuchi Young
INTRODUCTION Advance directives (ADs) promote patient autonomy in end-of-life (EOL) care, including an individual's EOL medical treatment preferences. This study aims to better understand preferences regarding EOL medical treatment among community-dwelling adults (18 and older) residing in the United States and examine the association between sociodemographic characteristics and EOL medical treatment
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Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-24 Wesley Faulkner,Sandra DiScala,Christine Vartan,Belal Dakroub,Michael Silverman,Mythili Bharadwaj
INTRODUCTION Docusate sodium's efficacy is widely debated. Several studies on opioid induced constipation (OIC) concluded that docusate sodium vs either placebo or in combination with sennosides provided no benefit. OBJECTIVE This medication use evaluation aimed to investigate constipation treatment trends within the West Palm Beach VA Healthcare System Community Living Center, and to assess the therapeutic
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The Determinants of Inpatient Palliative Care Use in Patients With Pancreatic Cancer. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-22 Osayande Osagiede,Kapil Nayar,Massimo Raimondo,Vivek Kumbhari,Frank J Lukens
INTRODUCTION Symptom burden management is a major goal of pancreatic cancer care given that most patients are diagnosed late. Early palliative care is recommended in addition to concurrent active treatment; however, disparities exist. We sought to determine the factors associated with inpatient palliative treatment among pancreatic cancer patients and compare treatment outcomes in terms of mortality
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Elevating Home Health Aide Input in Co-Creation of COVID-19 Vaccine Messaging. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-22 Hillary D Lum,Stacy Fischer,Kate Ytell,Laura Scherer,Sean T O'Leary,Ronit Elk,Susan Hurley,Karla T Washington,Matthew DeCamp
Home health aides (HHAs) care for patients highly vulnerable to COVID-19 and are disproportionately women from minority communities that have been adversely impacted by COVID-19. Yet, direct care workers are less likely to be vaccinated against COVID-19 compared to others. As the pandemic evolves, interest in vaccination may decrease suggesting the need for relevant vaccine messaging to HHAs. Objectives:
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Estimating the Impact of Hospice Care on Key Patient-Family Care Outcomes Using a Nationwide U.S. Probability Sample. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-21 John G Cagle,Peiyuan Zhang,Sarah Clem
Hospice is touted as an exemplary model for end-of-life care. However, there is little generalizable evidence estimating benefits of hospice at the national level. Using a national population-based probability sample of U.S. adults with weights applied (data collected Spring/Summer 2015), we conducted six logistic regression models to evaluate linkages between hospice involvement and end-of-life outcomes
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Ketamine for Super-Refractory Status Epilepticus in Palliative Care. A Case Report and Review of the Literature. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-20 Edward J Dunn,David D Willis
We report a case of super refractory status epilepticus uncontrolled by multiple anti-seizure medications in an individual with acute liver failure due to hepatic cirrhosis and an obstructive ileocecal mass plus multiple bilateral lung lesions presumed to be metastatic. A ketamine infusion was initiated late in his hospitalization which eliminated the convulsive seizures in less than an hour. The abatement
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Referrals to Palliative Care Services for Hospitalised COVID-19 Patients: A Systematic Literature Review. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-17 Rolf A H Snijders,Linda Brom,Sami O Simons,Simone M C H Langenberg,Yvette M van der Linden,Natasja J H Raijmakers
BACKGROUND The increase in the incidence of the coronavirus disease 2019 (COVID-19) led to more hospital admissions and deaths, and coincided with an increased need for palliative care. The new circumstances required palliative care services to be flexible and to develop response strategies. AIM To synthesise studies including COVID-19 patients to gain insight into how many patients were referred to
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Supportive Services at End of Life can Help Reduce Acute Care Services: Observations From the Medicare Care Choices Model. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-16 Patricia Rowan,Danielle Whicher,Marlena Luhr,Lynn Miescier,Keith Kranker,Boyd Gilman
OBJECTIVES This study identifies the mechanisms through which supportive and palliative care services at the end-of-life helped prevent unnecessary use of acute care services. BACKGROUND From 2016 to 2021, the Medicare Care Choices Model (MCCM) tested whether offering Medicare beneficiaries the option to receive supportive and palliative care services through hospice providers, concurrently with treatments
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Palliative Care for the Elderly With Heart Diseases in Tertiary Health care: A Concept Analysis. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-14 Sana Ali,Jane Tyerman
BACKGROUND The increasing incidence of heart failure (HF) in the elderly leads to increased mortality, hospitalization, length of hospital stay, and health care costs. Older adults often face multiple drug treatments, comorbidities, frailty, and cognitive problems, which require early palliative care. However, these patients do not receive adequate palliative care. OBJECTIVE This concept analysis aimed
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Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-14 Kohei Kajiwara,Masamitsu Kobayashi,Miharu Morikawa,Yusuke Kanno,Kimiko Nakano,Yoshinobu Matsuda,Yoichi Shimizu,Taichi Shimazu,Jun Kako
Purpose: To identify nursing support for caregiver burden in family caregivers of patients with cancer. Methods: This scoping review was guided by Arksey and O'Malley's six-stage scoping review framework. All available published articles from database inception to July 31, 2023 were systematically searched through PubMed, CINAHL, CENTRAL, and Ichushi-Web of the Japan Medical Abstract Society databases
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Using Patient-Centered Dissemination and Implementation Frameworks and Strategies in Palliative Care Settings for Improved Quality of Life and Health Outcomes: A Scoping Review. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-13 Lea Sacca,Diana Lobaina,Sara Burgoa,Meera Rao,Vama Jhumkhawala,Sheena M Zapata,Michelle Issac,Suleyki Medina
BACKGROUND There is a need for patient-provider dissemination and implementation frameworks, strategies, and protocols in palliative care settings for a holistic approach when it comes to addressing pain and other distressing symptoms affecting the quality of life, function, and independence of patients with chronic illnesses. The purpose of this scoping review is to explore patient-centered D&I frameworks
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Profile of Antimicrobial Consumption in Patients Assisted by a Palliative Care Team During the COVID-19 Pandemic in Brazil. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-11 Tulio L Correa,Matheus Ac Quitete,Clara Rs do Nascimento,Rafaela P Carbone,Ricardo T de Carvalho,Juraci A Rocha
BACKGROUND This study aimed to evaluate the profile of antimicrobial consumption in patients assisted by a palliative care (PC) team during the COVID-19 pandemic. METHODS A retrospective observational study was conducted in a quaternary hospital. Patients assisted by the PC team in 2020 were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic
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Assessing the Impact of a Hospice and Palliative Medicine Mentored Clinical Shadowing Experience for First-Year Medical and Dental Students: A Pilot Study. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-11 Kirsten G Engel,Lucia R I Millham,Irene M Yeh,Patrick W Malecha,Kate Brizzi,Andrea Wershof Schwartz,Dorothy W Tolchin
Background: All physicians encounter patients with serious illness. Medical students recognize the value of hospice and palliative medicine (HPM) and desire more knowledge and skills in this area. However, both pre-clinical and clinical HPM content are underrepresented within medical school curricula. Objectives: To conduct a pilot study examining the impact of a novel required HPM clinical experience
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Unveiling the Influencers: An Exploration of Factors Determining Advance Directive Completion Among Community-Dwelling Adults. Am. J. Hosp Palliat. Med. (IF 1.9) Pub Date : 2023-11-08 Yuchi Young,Taylor Perre,Ashley Shayya,Virgile Barnes,Thomas O'Grady
INTRODUCTION Advance directives (AdvDirs) align end-of-life care with personal values, averting unnecessary treatments. This study explores factors influencing AdvDir completion. METHODS We conducted a cross-sectional study with community-dwelling adults (n = 166) age range 18-93, using a survey to gather sociodemographics, beliefs, and AdvDir experiences. Multivariate logistic regression quantifies