MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The American Journal of Hospice and Palliative Care' source. Thu, 09 Feb 2012 21:56:55 +0100 http://www.medworm.com/index.php?rid=5674722&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310021%26dopt%3DAbstract Authors: Pierce DM, Shipstone E Abstract Neuropathic pain in a common problem encountered in palliative care. When neuropathic pain is diagnosed, appropriate treatment is important in limiting the severe psychosocial impairment that can ensue with undertreated pain. Proper evaluation of the patient to clarify the type of pain experienced is the first step to determine appropriate management. Tapentadol is an oral mu-opioid receptor agonist and a noradrenaline reuptake inhibitor developed by Ortho-McNeil Janssen Pharmaceuticals and approved by the Food and Drug Administration in November 2008 for the treatment of moderate-to-severe acute pain in adult patients and for chronic pain in August 2011 in an extended release form. Tapentadol has been studied for use in nociceptive pain but... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674722 Sun, 05 Feb 2012 05:00:00 +0100 5674722 http://www.medworm.com/index.php?rid=5674721&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310022%26dopt%3DAbstract CONCLUSIONS: Volunteers see their role as becoming increasingly formalized partly as a response to increasing administrative demands on hospice nurses. The willingness of volunteers to take on new roles is variable. For volunteers to feel secure and valued and working relationships to remain strong, the process of how boundaries between paid and unpaid workers are negotiated needs to be transparent. PMID: 22310022 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674721 Sun, 05 Feb 2012 05:00:00 +0100 5674721 http://www.medworm.com/index.php?rid=5674720&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310023%26dopt%3DAbstract Authors: Salmany SS, Koopmans SM, Treish IM, Jaber RE, Telfah S, Tuffaha HW Abstract The medication assessment tool for cancer pain management (MAT-CP) measures the quality of medication use in relation to guidelines. The original MAT-CP was reviewed, modified and tested at a comprehensive cancer center in Jordan. The tool comprised 30 criteria covering six different aspects of pain management. Seventy patients were included, males 41 (59%), females 29 (41%), mean age 49 (range, 20-79) years. The overall level of adherence to guidelines was 78% with good inter-rater reliability (κ= 0.899). The tool's implementation showed opportunities for improvement in pain management at our institution. The MAT-CP was revised and validated for the first time outside Europe. This tool can be rou... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674720 Sun, 05 Feb 2012 05:00:00 +0100 5674720 http://www.medworm.com/index.php?rid=5674719&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310024%26dopt%3DAbstract In this study, we investigated patient's meaning attribution to pain in hospice and pain therapy unit, using a qualitative approach: narrative-based medicine. The data presented here were related to patients (n = 17) hospitalized in Rimini Hospice (Italy). These data were compared to those of patients (n = 21) with noncancer pain (control sample). The interviews were then analyzed according to the technique of thematic narrative analysis. The results of our research identified a differential process in pain processing in relationship to the meaning that the patient attributed to pain. The thematic analysis of the interviews allowed the inductive construction of a specific network of pain dimensions, which were summarized in "the pain chronogram." PMID: 22310024 [PubMed - as supplied by... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674719 Sun, 05 Feb 2012 05:00:00 +0100 5674719 http://www.medworm.com/index.php?rid=5674718&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310025%26dopt%3DAbstract Conclusion: Significantly lower hospital costs and in-hospital deaths with higher hospice discharges were observed in integrative palliative care compared to consultative palliative care, but these findings were diminished with the presence of advance directives. PMID: 22310025 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674718 Sun, 05 Feb 2012 05:00:00 +0100 5674718 http://www.medworm.com/index.php?rid=5674717&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310705%26dopt%3DAbstract Authors: Enck RE PMID: 22310705 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674717 Wed, 01 Feb 2012 05:00:00 +0100 5674717 http://www.medworm.com/index.php?rid=5674716&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22310706%26dopt%3DAbstract Authors: Benkel I, Wijk H, Molander U PMID: 22310706 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5674716 Wed, 01 Feb 2012 05:00:00 +0100 5674716 http://www.medworm.com/index.php?rid=5596994&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22241456%26dopt%3DAbstract Authors: Nenner F, Meeter RM PMID: 22241456 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5596994 Thu, 12 Jan 2012 05:00:00 +0100 5596994 http://www.medworm.com/index.php?rid=5596993&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22241457%26dopt%3DAbstract Authors: Malpas PJ, Cooper L Abstract The decision to deactivate a pacemaker in a pacing-dependent patient is troubling for some health professionals who may regard such interventions as hastening death and therefore ethically impermissible. This may be especially concerning in situations where a patient is unable to clearly state what their preferences may be and the decision-were it to be made-will almost certainly result in the patient's immediate death. In this discussion, we reflect on some of the ethical aspects that arise when JP, a 75-year-old woman who is pacing dependent, suffers a significant brain injury, and the family request that her pacemaker be deactivated. Taking into account the clinical reality of her situation, the united wishes and loving concern of her husban... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5596993 Thu, 12 Jan 2012 05:00:00 +0100 5596993 http://www.medworm.com/index.php?rid=5596992&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22241458%26dopt%3DAbstract Authors: Muniz da Costa Vargens O, Berterö C Abstract The purpose of this study was, using secondary analysis on data collected from previous empirical studies, to focus on improving the quality of life due to the new possibilities for living after a cancer diagnosis. No matter how long or short the life will be, quality of life in palliative care is about "living in the best way" until death. The data analysis identified 4 main themes; death as a main concern, reevaluating life, living a normal life with support, and living until death. The key message is that the patients are living until they die. Palliative care should facilitate and support the patients in their new life situation in order to sustain their quality of life. They are still alive-living until death. PMID: 22... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5596992 Thu, 12 Jan 2012 05:00:00 +0100 5596992 http://www.medworm.com/index.php?rid=5596991&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22241459%26dopt%3DAbstract In this study, we investigated caregiver's death representation in hospice. The results presented here are a further analysis of the data collected in our previous study, concerning the evaluation of the caregiver in hospice. The data analysis of 24 caregivers of patients hospitalized in Rimini Hospice (Italy) underlined that caregivers avoiding death representation of the patient admitted to hospice had fewer protective factors (52.3%) and more risk factors (47.7%) than caregivers nonavoiding (66.5% and 33.5%, respectively). Caregivers avoiding death representation, moreover, experienced a greater distress (58%) than those nonavoiding (42%). PMID: 22241459 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5596991 Thu, 12 Jan 2012 05:00:00 +0100 5596991 http://www.medworm.com/index.php?rid=5596990&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22241460%26dopt%3DAbstract Authors: Claxton-Oldfield S, Claxton-Oldfield J Abstract Forty-one hospice palliative care volunteers (from 6 community- and 3 hospital-based programs) participated in informal group discussions regarding (1) what aspects of their work provide them with the most (and least) satisfaction; (2) why they continue to volunteer; and (3) why they might stop. In 5 of the 9 programs, volunteers said that feeling appreciated by the patients/families they support gave them great satisfaction. Boundary issues and/or role ambiguities were among the least satisfying aspects of their work, mentioned by volunteers in 4 programs. Volunteers in all 9 programs mentioned that they continue to volunteer because it makes a difference/helps others/meets a need in other people's lives. Among the reasons g... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5596990 Thu, 12 Jan 2012 05:00:00 +0100 5596990 http://www.medworm.com/index.php?rid=5596989&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22241461%26dopt%3DAbstract Authors: Baumrucker SJ, Stolick M, Mingle P, Oertli KA, Morris GM, Vandekieft G PMID: 22241461 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5596989 Thu, 12 Jan 2012 05:00:00 +0100 5596989 http://www.medworm.com/index.php?rid=5577408&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218915%26dopt%3DAbstract Authors: Zaghloul HA, Murillo JR Abstract Chemotherapy treatment options are limited for patients with castration-resistant prostate cancer (CRPC). The purpose of this study is to report treatment use and adverse effects (AEs) within the last three months of life in patients with CRPC. Of the 88 patients identified, 32% received treatment within 3 months of death, and documented AEs occurred in 25% of patients. Of those, neutropenia (18.3%), nausea/vomiting (18.3%), and febrile neutropenia (13.6%) were the most frequent. Results of this study show high treatment utility towards the end-of-life in patients with CRPC, with one fourth of patients experiencing AEs. Attention to health-related quality of life becomes increasingly important as new treatments appear to have small impact o... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5577408 Wed, 04 Jan 2012 05:00:00 +0100 5577408 http://www.medworm.com/index.php?rid=5577407&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218916%26dopt%3DAbstract Conclusion: Antimicrobial use was common among patients with advanced cancer. Even after transition to comfort care, more than one third of patients remained on antimicrobials. The risks and burdens of antimicrobials should be carefully examined when comfort is the stated goal. PMID: 22218916 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5577407 Wed, 04 Jan 2012 05:00:00 +0100 5577407 http://www.medworm.com/index.php?rid=5577406&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218917%26dopt%3DAbstract Authors: Trombley K, Brennan MR, Thomas L, Kline M Abstract A group of palliative care nurses wanted to investigate the phenomenon they were witnessing in their end-of-life patients. There was a rapid onset of skin change characterized by bruising on various parts of the body in these patients. Traditionally they were described as pressure ulcers. However, the skin changes did not progress as typical pressure ulcers and warranted more investigation. PMID: 22218917 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5577406 Wed, 04 Jan 2012 05:00:00 +0100 5577406 http://www.medworm.com/index.php?rid=5577405&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218918%26dopt%3DAbstract Authors: Latuga NM, Wahler RG, Monte SV Abstract Symptom management at the end of life relies heavily on medications. For this reason, pharmacists are an ideal addition to the interdisciplinary hospice team (IDT). The aim of this study is to characterize the utilization of pharmacists in hospices from the hospice administrator and pharmacist perspectives and to determine the impact utilization has on per diem medication requirement and costs. Surveys were sent to 2824 hospice administrators and 658 pharmacists to obtain their perceptions on what clinical, administrative, and dispensing services were being performed. Responses were returned by 9.4% of administrators and 12.6% of pharmacists. The majority of administrators and pharmacists reported a mix of clinical, administrative, a... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5577405 Wed, 04 Jan 2012 05:00:00 +0100 5577405 http://www.medworm.com/index.php?rid=5577404&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218919%26dopt%3DAbstract Authors: Singh B, Singh J Abstract The number of annual implantable cardioverter defibrillator (ICD) implants has substantially increased over the last 5 years and is expected to grow rapidly. Implantable cardioverter defibrillators have a proven mortality benefit by terminating the life-threatening arrhythmias, even near end of life. In patients with moderate/severe symptomatic heart failure, enough clinical literature representing mortality benefits has been published, but limited numbers of studies have reviewed the dwindling risk-benefit profile near end of life, studying quality of life (QoL)/psychosocial impact. Criteria outlining either continued use or deactivation policy/procedures near end of life have not been clearly defined and/or largely implemented, which in turn req... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5577404 Wed, 04 Jan 2012 05:00:00 +0100 5577404 http://www.medworm.com/index.php?rid=5558914&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22207713%26dopt%3DAbstract This study examined the role of burnout and connectedness in the job demands-resources (JD-R) model among palliative care volunteers. It was hypothesized that (a) exhaustion mediates the relationship between demands and depression, and between demands and retention; (b) cynicism mediates the relationship between resources and retention; and (c) connectedness mediates the relationship between resources and retention. Hypotheses were tested in 2 separate analyses: structural equation modeling (SEM) and path analyses. The first was based on volunteer self-reports (N = 204), while the second analysis concerned matched data from volunteers and their family members (N = 99). While strong support was found for cynicism and connectedness as mediators in both types of analyses, this was not altoget... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5558914 Wed, 28 Dec 2011 05:00:00 +0100 5558914 http://www.medworm.com/index.php?rid=5558913&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22207714%26dopt%3DAbstract Authors: Parker GD, Smith T, Corzine M, Mitchell G, Schrader S, Hayslip B, Fanning L Abstract Due to the rapid influx of Palliative care and Hospice services over the last decade, there has been an increase in the number of medical professionals interacting with terminal patients. One of the challenges with this growth becomes how to integrate these services into already busy practices along with providing physicians the education and tools they need to provide quality care. While there is no shortage of articles focusing on the educational needs of physicians related to end of life care, less is known about the level of anxiety physicians feel about interacting with dying patients and their families. PMID: 22207714 [PubMed - as supplied by publisher] (Source: The American Jour... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5558913 Wed, 28 Dec 2011 05:00:00 +0100 5558913 http://www.medworm.com/index.php?rid=5530374&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22174315%26dopt%3DAbstract Authors: Bui T Abstract The widening gap between the demand for palliative care services and the supply of trained palliative care professionals has resulted in considerable end-of-life distress for patients. Without formal training in palliative medicine and end-of-life symptom management, physicians in the United States are less equipped to competently address seriously ill and dying patients' medical, emotional, and spiritual needs. Recent attempts within graduate medical education training deliberately seek to prepare a critical mass of physicians as the new hospice and palliative medicine workforce in the United States. In addition, healthcare reform proposals may re-define the National Health Service Corps (NHSC) post-graduate training over the next five years and the Hospice... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530374 Thu, 15 Dec 2011 05:00:00 +0100 5530374 http://www.medworm.com/index.php?rid=5530373&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22174316%26dopt%3DAbstract Authors: Forman WB Abstract In this case report and review of the literature, transient global amnesia (TGA) is discussed. A 72-year-old physician presented to the emergency department with sudden loss of memory. In particular, he was unable to recall recent events. Other neurological examination was intact. The loss of recent memory was completely resolved, during the next 4 hours. This event (TGA) must be distinguished from other neurological events such as transient ischemic attacks, seizures, and cerebral vascular events. A literature review suggested that TGA is related to an acute loss of function in the temporal lobe. It is important for palliative medicine physicians to have this unusual syndrome in their differential diagnosis, as this cause of memory loss must be separate... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530373 Thu, 15 Dec 2011 05:00:00 +0100 5530373 http://www.medworm.com/index.php?rid=5530379&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22144657%26dopt%3DAbstract This article reviews the current use of methylphenidate for symptom management with a critical look at the evidence base for its efficacy in the conditions described. PMID: 22144657 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530379 Sun, 04 Dec 2011 05:00:00 +0100 5530379 http://www.medworm.com/index.php?rid=5530378&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22144658%26dopt%3DAbstract Authors: Wittenberg-Lyles E, Shaunfield S, Parker Oliver D, Demiris G, Schneider G Abstract Although hospice volunteer programs contribute to patient care, little is known about their utilization and adaptation of technology. A survey was posted to the Hospice Volunteer Association Web site to assess technology use among volunteer coordinators and volunteers. Results revealed that participants have access to computers, Internet, and e-mail at the hospice agency and routinely use cellular phones and e-mail. Despite the use of technology, communication problems with volunteers hindered the coordinator's ability to manage scheduling, training, and volunteer assignments for patient care. Coordinators and volunteers felt comfortable utilizing technology but were less comfortable using t... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530378 Sun, 04 Dec 2011 05:00:00 +0100 5530378 http://www.medworm.com/index.php?rid=5530377&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22144659%26dopt%3DAbstract Authors: June A, Segal DL, Klebe K, Watts LK Abstract The aim of the present study was to explore end-of-life health care attitudes among younger and older sexually diverse women. Self-identified lesbian and heterosexual older women as well as lesbian and heterosexual middle-aged women were recruited. Results indicated that lesbian women held significantly more positive beliefs about hospice services and the role of alternative medicines in health care. No differences among sexual orientation were found for comfort discussing pain management but heterosexual women reported a significantly greater desire for life-sustaining treatments in the event of an incurable disease and severe life-limiting conditions (eg, feeding tube, life support, no brain response). Additionally, as expecte... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530377 Sun, 04 Dec 2011 05:00:00 +0100 5530377 http://www.medworm.com/index.php?rid=5530376&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22144660%26dopt%3DAbstract Authors: Lindenfelser KJ, Hense C, McFerran K Abstract Research into the value of music therapy in pediatric palliative care (PPC) has identified quality of life as one area of improvement for families caring for a child in the terminal stages of a life-threatening illness. This small-scale investigation collected data in a multisite, international study including Minnesota, USA, and Melbourne, Australia. An exploratory mixed method design used the qualitative data collected through interviews with parents to interpret results from the PedsQL Family Impact Module of overall parental quality of life. Parents described music therapy as resulting in physical improvements of their child by providing comfort and stimulation. They also valued the positive experiences shared by the family... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530376 Sun, 04 Dec 2011 05:00:00 +0100 5530376 http://www.medworm.com/index.php?rid=5530375&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22144661%26dopt%3DAbstract Authors: Olsen ML, Havyer RD, Smith TJ, Swetz KM Abstract In the modern age of advanced surgical techniques and pharmacologic management, bacterial spinal infections (SIs) can be managed (either eradicated or suppressed) in many hosts. However, the optimal management of SIs may be limited by patient comorbidities, which do not allow for surgical management, or limited by antimicrobial options due to side effects, toxicities, or emerging drug resistance. In these settings, frank and honest discussion regarding risks and benefits of treatment should be pursued, including that the SI may be a terminal illness. In this case series, we present 3 patients who had bacterial SIs whose treatments were limited by the above-mentioned factors. Furthermore, each case presented challenges regard... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5530375 Sun, 04 Dec 2011 05:00:00 +0100 5530375 http://www.medworm.com/index.php?rid=5438286&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22104044%26dopt%3DAbstract We report a case of massive pulmonary embolism in a 63-year-old female caregiver of her terminally ill husband. Venous thromboembolism in family caregivers is a rare but a serious problem. Increased awareness and implementation of policies and guidelines to decrease potentially preventable venous thromboembolism are vital to help prevent unnecessary death, to increase patient safety, and to contain rising costs in health care. PMID: 22104044 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5438286 Mon, 21 Nov 2011 05:00:00 +0100 5438286 http://www.medworm.com/index.php?rid=5438285&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22104045%26dopt%3DAbstract Authors: Wohleber AM, McKitrick DS, Davis SE Abstract Research in palliative care and hospice populations is important for improving quality of care, quality of life, and provider understanding of individuals at the end of life. However, this research involves many potential challenges. This review seeks to inform and assist researchers targeting to design studies targeting hospice and palliative care patients by presenting a thorough review of the published literature. This review covers English-language articles published from 1990 through 2009 listed in the PsycInfo, Medline, or CINAHL research databases under relevant keywords. Articles on pediatric hospice were not included. Issues discussed include study design, informed consent, and recruitment for participants. Synthesized ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5438285 Mon, 21 Nov 2011 05:00:00 +0100 5438285 http://www.medworm.com/index.php?rid=5438284&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22104046%26dopt%3DAbstract This study aimed to evaluate potential changes in spirituality over the course of radiation therapy (RT). Patients and Materials: The Functional Assessment of Chronic Illness Therapy-Spiritual questionnaire measuring spiritual well-being and quality of life (QOL) was administered to adult patients undergoing RT. Scores were compared using student t tests and chi-square analysis. Results: Despite statistically significant declines in QOL measures such as physical well-being (P < .001) and overall well-being (P < .001), no significant changes were noted in spirituality for all comers. A significant increase in the Sp-12 spirituality measure (P = .001) was noted in patients with breast cancer, independent of age, gender, and purpose of treatment. Sp-12 scores were positively correlated ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5438284 Mon, 21 Nov 2011 05:00:00 +0100 5438284 http://www.medworm.com/index.php?rid=5438287&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22096204%26dopt%3DAbstract CONCLUSIONS: Family therapists working with culturally diverse families need to pay thoughtful attention to ethnic issues as they strive to support them during palliative care and bereavement. PMID: 22096204 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5438287 Thu, 17 Nov 2011 05:00:00 +0100 5438287 http://www.medworm.com/index.php?rid=5438288&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22089523%26dopt%3DAbstract Authors: Upadhyay SP, Mallick PN Abstract Cancer pain remains undertreated and a significant number of patients with cancer pain die from severe untreated pain. With increasing survival rate in cancer, the prevalence of cancer pain is also increasing in number. Though majority of patients with cancer pain can be effectively treated with conventional medical management, still a significant portion of patients required some form of interventional pain management techniques. Among the interventional techniques, intrathecal drug delivery is increasingly used in cancer pain management. Our objective of this article is to review literatures and clinical studies on intrathecal drug delivery system (IDDS) in cancer pain management and to provide updates on its use, precautions, contraindic... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5438288 Tue, 15 Nov 2011 05:00:00 +0100 5438288 http://www.medworm.com/index.php?rid=5417476&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22072640%26dopt%3DAbstract Authors: Conner NE Abstract The purpose of this prospective, correlational study was to examine the differential ability of demographic variables, beliefs, and values about end-of-life, spirituality, and social relationships to predict hospice use among blacks. The framework for this study was the Behavioral Model of Health Services Use. Data were collected from 104 terminally ill black men and women recruited from 6 inpatient and outpatient settings. Only 34% of the individuals participated in hospice services. Chi-square, sequential, and stepwise logistic regressions revealed that the best predictive model consisted of presence of a caregiver, having a religious affiliation, and male gender. Together these factors predicted 13.7% to 19% of hospice use among blacks. Health care pr... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5417476 Tue, 08 Nov 2011 05:00:00 +0100 5417476 http://www.medworm.com/index.php?rid=5417480&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22057207%26dopt%3DAbstract Authors: Wiwanitkit S, Wiwanitkit V PMID: 22057207 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5417480 Thu, 03 Nov 2011 04:00:00 +0100 5417480 http://www.medworm.com/index.php?rid=5417479&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22057208%26dopt%3DAbstract Authors: Carter BS, Swan R Abstract A 1-day training event for pediatric residents with interdisciplinary staff was held, which was modeled after the Initiative for Pediatric Palliative Care (IPPC). Training included relational communication, cultural humility, pain-symptom management, family-centered care, team problem solving, and strategic planning using didactic, small group, and plenary platforms. Two bereaved parents were co-learners and trainers. Twenty-six interdisciplinary staff participated. A positive impact was measured in new knowledge gained, value in collaborative learning with health care professionals and families, and ability to work with professionals outside participants' own unit. Confidence to advocate for improved pediatric palliative care was also noted. The... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5417479 Thu, 03 Nov 2011 04:00:00 +0100 5417479 http://www.medworm.com/index.php?rid=5417478&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22057209%26dopt%3DAbstract CONCLUSIONS: QOL deteriorated with few differences between home and the PCU patients. PMID: 22057209 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5417478 Thu, 03 Nov 2011 04:00:00 +0100 5417478 http://www.medworm.com/index.php?rid=5417477&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22057210%26dopt%3DAbstract Authors: Escobar Pinzón LC, Claus M, Zepf KI, Fischbeck S, Martin W Abstract Investigations have shown that symptom prevalence varies according to the place of death. We sought to assess the symptom prevalence of chronically ill people in Germany and how this prevalence differs depending on the place of death. We sent questionnaires to 5000 bereaved people in Rhineland-Palatinate (Germany), whose relatives died between May 25 and August 24, 2008. In all, 3832 questionnaires were delivered and 1378 completed (response 36.0%). Most decedents had moderate-to-severe weakness (94.5%), fatigue (93.5%), need for help in daily activities (87.9%), and appetite loss (87.4%). Pain and dyspnea were most severe in hospitals; fatigue, confusion/disorientation, and problems with wound care in nu... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5417477 Thu, 03 Nov 2011 04:00:00 +0100 5417477 http://www.medworm.com/index.php?rid=5378267&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22025746%26dopt%3DAbstract Authors: Ramey SJ, Chin SH Abstract Patients with cancer represent the largest group of hospice users, making this population critically important in hospice research studies. Despite the potential benefits of hospice, many studies have noted lower levels of utilization among African Americans. The goal of this literature review was to determine whether this disparity exists within this population of patients with cancer. The largest studies focusing on multiple cancers found lower hospice use among African American patients with cancer. Disparities also existed after entry into hospice. Age, gender, geographic location, preference for aggressive care, and knowledge of hospice influenced hospice use by these patients. Since African American patients with cancer evidently use hospic... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5378267 Sun, 23 Oct 2011 04:00:00 +0100 5378267 http://www.medworm.com/index.php?rid=5378268&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22009291%26dopt%3DAbstract Authors: Baumrucker SJ, Stolick M, Morris GM, Stilin L, Vandekieft G, Mingle P, Oertli KA PMID: 22009291 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5378268 Tue, 18 Oct 2011 04:00:00 +0100 5378268 http://www.medworm.com/index.php?rid=5325108&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998438%26dopt%3DAbstract Authors: Birocco N, Guillame C, Storto S, Ritorto G, Catino C, Gir N, Balestra L, Tealdi G, Orecchia C, De Vito G, Giaretto L, Donadio M, Bertetto O, Schena M, Ciuffreda L Abstract Reiki is a system of natural healing techniques administered by laying of hands and transferring energy from the Reiki practitioner to the recipient. We investigated the role of Reiki in the management of anxiety, pain and global wellness in cancer patients. Building on the results of a pilot project conducted between 2003 and 2005 by a volunteer association at our hospital, a wider, 3-year study was conducted at the same center. The volunteer Reiki practitioners received 2 years of theory and practical training. The study population was 118 patients (67 women and 51 men; mean age, 55 years) with cancer ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325108 Thu, 13 Oct 2011 04:00:00 +0100 5325108 http://www.medworm.com/index.php?rid=5325107&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998439%26dopt%3DAbstract Authors: Zama IN, Edgar M Abstract Refractory ascites causes significant distress to patients and can be managed in various ways. In hospice patients where the goal of care is to preserve comfort and foster better quality of life, diuretics should be tried first; however, in resistant cases, home-based paracentesis should be entertained. Home-based paracentesis is a safe and simple procedure that can be done blindly, if done under standard precautions there is minimal associated risk of bleeding, infection or perforation and no need for pre or post-laboratory testing or the correction of high international normalization ratio or thrombocytopenia. Home-based paracentesis is cost effective, provides immediate symptomatic relief, good patient and caregiver satisfaction and obviates th... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325107 Thu, 13 Oct 2011 04:00:00 +0100 5325107 http://www.medworm.com/index.php?rid=5325106&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998440%26dopt%3DAbstract Authors: Munn JC Abstract We used qualitative methods (13 homogenous focus groups of residents, bereaved family members, licensed staff, paraprofessional staff, and social workers) to examine the components of a good death in a long-term care (LTC). Hospice involvement as beneficial to end-of-life care emerged as a naturally occurring theme and hospice was deemed as expert in all groups. Participants indicated some barriers to hospice involvement as well as difficulties in collaboration between facility staff and hospice personnel. When viewed within the context of existing literature, these data suggest that a new model of hospice care in which hospice staff serve as expert consultants may be appropriate. This model that recognizes and optimizes the experience of both the facility... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325106 Thu, 13 Oct 2011 04:00:00 +0100 5325106 http://www.medworm.com/index.php?rid=5325105&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998441%26dopt%3DAbstract Authors: Lagman R, Soriano MA Abstract The need to ascertain appropriate decision-making capacity is greatest when dealing with refusals of lifesaving or life-prolonging treatment. This may be complicated by delirium, concurrent depression, metabolic disturbances or significant symptom burden, family conflicts, and social issues. This is a case of a 48-year-old patient with a long-standing history of a symptomatic pan-invasive pituitary adenoma who refused life-prolonging treatment. Ultimately, a patient must be able to understand the information given to him, evaluate the consequences of the options presented, deliberate on these options based on his values, communicate this choice, and maintain consistency overtime. These refusals of treatment may fluctuate with time and intensit... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325105 Thu, 13 Oct 2011 04:00:00 +0100 5325105 http://www.medworm.com/index.php?rid=5325104&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998442%26dopt%3DAbstract Authors: Alexander CS, Memiah P, Henley YB, Kaiza-Kangalawe A, Shumbusho AJ, Obiefune M, Enejoh V, Stanis-Ezeobi W, Eze C, Odion E, Akpenna D, Effiong A, Miriti K, Aduda S, Oko J, Melaku GD, Baribwira C, Umutesi H, Shimabale M, Mugisa E, Amoroso A Abstract To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both prevention and cure. Over 35% of eligible persons have been successfully treated. Initial legislation cited palliative care as an essential aspect of this plan but overall health strengthening became critical to sustainability of programing ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325104 Thu, 13 Oct 2011 04:00:00 +0100 5325104 http://www.medworm.com/index.php?rid=5325103&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998443%26dopt%3DAbstract We present a challenging case of HOA in a patient with nonsmall cell lung cancer and review specific therapies for management of HOA-related pain. PMID: 21998443 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325103 Thu, 13 Oct 2011 04:00:00 +0100 5325103 http://www.medworm.com/index.php?rid=5325102&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998444%26dopt%3DAbstract Authors: Foley G, Timonen V, Hardiman O Abstract People with amyotrophic lateral sclerosis (ALS) frequently express dissatisfaction with services. Patient satisfaction with services in ALS care is not always measured and service user perspectives are not usually included when evaluating the outcomes of care. There is a lack of consensus on what constitutes satisfaction for patients in ALS care. To date, health care professionals' conceptualization of outcomes in ALS care has excluded measures of patient satisfaction with services. Exploring the context of the ALS service user experience of care will identify a conceptual framework that will include the domains of satisfaction with care for patients with ALS. An instrument that draws on the ALS patient perspective of services, devel... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325102 Thu, 13 Oct 2011 04:00:00 +0100 5325102 http://www.medworm.com/index.php?rid=5325101&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998445%26dopt%3DAbstract This article will review the pharmacology, pharmacokinetics, and current uses of haloperidol in palliative medicine. There will be an examination of the evidence base for the use of haloperidol in palliative medicine. PMID: 21998445 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325101 Thu, 13 Oct 2011 04:00:00 +0100 5325101 http://www.medworm.com/index.php?rid=5325100&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21998446%26dopt%3DAbstract Authors: Lavenburg P, Bernt FM Abstract We surveyed volunteers from 8 hospices in the Delaware Valley regarding training, perceived needs, and role satisfaction. Results were consistent with previous studies: satisfaction with preservice training and with volunteering was very high; respondents reported feeling very prepared and confident about doing hospice work as a result of their volunteer training. In addition, longer volunteer preservice training was associated with higher levels of overall satisfaction with training; levels of volunteer satisfaction and fulfillment tended to be lower during the first year of volunteering; and participation in volunteer support teams was associated with finding volunteer work rewarding and with feeling a part of the hospice team. Implications... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5325100 Thu, 13 Oct 2011 04:00:00 +0100 5325100 http://www.medworm.com/index.php?rid=5216392&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21908456%26dopt%3DAbstract Authors: Adams J, P C, L D, C F, A M, Smith BJ, Yuen H Abstract Vocalizations during care occur frequently in patients with dementia, and are not uncommon in the palliative setting. Underlying trigger factors may include pain during movement, fear of being turned, startle reflex, attempts at verbal communication, environmental factors such as cold water, and other possible etiologies. A case of a 92 year old female who screamed and called out during bathing is presented. This patient with comorbid dementia and brain lesions did not respond to pre-event pain medication, and became somnolent due to opioid administration for presumed incident pain. A non-pharmacological approach, with a patient-centered focus rather than task orientation, succeeded in extinguishing the vocalizations a... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5216392 Thu, 08 Sep 2011 04:00:00 +0100 5216392 http://www.medworm.com/index.php?rid=5173967&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868425%26dopt%3DAbstract This study explores the referral experience of physicians who refer Latinos to end-of-life care and challenges associated with the referral process. Qualitative data were collected in New Jersey through semistructured, open-ended interviews. Six physicians participated in this study: 1 oncologist, 2 internists, 1 gerontologist, and 2 infectious disease specialists. The study reveals that language barriers, level of family involvement, and generational group of the patient and the family contribute to the complexity of the physician's experience. Physicians' comments evidence the importance of culturally competent training in medical school and continued education on this topic for physicians who did not receive such training. Bilingual bicultural hospice admissions' staff available at the ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173967 Wed, 24 Aug 2011 23:00:00 +0100 5173967 http://www.medworm.com/index.php?rid=5173966&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868426%26dopt%3DAbstract We report a case of a 61 year old female patient with endometrial carcinoma suffering from severe neuropathic pain in her left lower limb. The pain was refractory to highest tolerable doses of oral morphine and neuromodulator drugs, viz. gabapentin and pregabalin. We managed the patient successfully with intrathecal morphine pump reducing the total morphine dose and improving patient comfort and satisfaction. Intrathecal delivery of Morphine ensured better efficacy with fewer side effects. PMID: 21868426 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173966 Wed, 24 Aug 2011 23:00:00 +0100 5173966 http://www.medworm.com/index.php?rid=5173965&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868427%26dopt%3DAbstract Conclusion: Prognostic indicies and communication scripts may better prepare physicians to facilitate end-of-life conversations with MCM patients/families. PMID: 21868427 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173965 Wed, 24 Aug 2011 23:00:00 +0100 5173965 http://www.medworm.com/index.php?rid=5173964&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868428%26dopt%3DAbstract Authors: Deng D, Fu L, Zhao YX, Wu X, Zhang G, Liang C, Xie CH, Zhou YF Abstract To evaluate the relationship between pain and quality of life (QoL) in patients newly admitted to Wuhan Hospice Center, China. A total of 1,634 patients were analyzed in this retrospective study. A Numerical Rating Scale and Chinese-QoL instrument were used to assess pain score and QoL, respectively. Most patients experienced moderate to severe pain, which significantly impaired QoL. The pain was significantly correlated with appetite, mood, sleep, fatigue, pain intensity, daily activity, side effect, general appearance, and support from family. But there was no correlation with support from society, understanding of cancer, or attitude toward treatment. In our study, the relationship between pain and ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173964 Wed, 24 Aug 2011 23:00:00 +0100 5173964 http://www.medworm.com/index.php?rid=5173963&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868429%26dopt%3DAbstract Authors: Hinders D Abstract The number of elderly persons is expected to increase to 55 million by 2020, with the minority population increasing to 12.9 million, yet fewer than 30% of Americans have advance directives in place. Cultural values, religious beliefs, and family support systems are a few of the factors that influence or hinder the completion of advance directives. Health care provider perspectives regarding advance directives vary greatly with health care settings. Many primary care providers are reluctant to initiate conversations regarding advance directives for multiple reasons. Nurse practitioners cover more than 600 million office visits per year in the United States and are in a key position to educate, advocate, and assist in the completion of advance directives.... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173963 Wed, 24 Aug 2011 23:00:00 +0100 5173963 http://www.medworm.com/index.php?rid=5173962&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868430%26dopt%3DAbstract Authors: Campbell CS, Cox JC Abstract Nearly 90% of terminally ill patients who have used Oregon's distinctive death with dignity law to receive a medication to end their lives are enrolled in hospice care programs. In 2009-2010, we conducted a study of the policies developed by Oregon hospices to address patient inquiries and requests for death with dignity. The study examined the stated hospice values and positions and identified the boundaries to participation drawn by the hospice programs to protect personal and programmatic integrity. The boundaries were drawn around 6 key caregiving considerations: (1) language regarding physician-assisted death (PAD); (2) informed decision making by patients; (3) collaboration with physicians; (4) provision of lethal medication; (5) assistan... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173962 Wed, 24 Aug 2011 23:00:00 +0100 5173962 http://www.medworm.com/index.php?rid=5173961&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21868431%26dopt%3DAbstract We present the case of a woman who enrolled in the hospice benefit in order to obtain narcotics. We believe this is a cautionary tale for hospices because of our propensity to enroll patients with minimal corroborating information, in order not to delay symptom management. Also we are philosophically predisposed to believe a patient's self-report of pain and other distressing symptoms. PMID: 21868431 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5173961 Wed, 24 Aug 2011 23:00:00 +0100 5173961 http://www.medworm.com/index.php?rid=5140664&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21840872%26dopt%3DAbstract Authors: Taitel M, Meaux N, Pegus C, Valerian C, Kirkham H Abstract Although most patients with terminal heart failure (HF) prefer to die at home, the majority die in hospitals. To determine the impact of home inotropic support in the place of death among patients with terminal HF, this retrospective study compared the place of death in patients with terminal HF enrolled in an inotropic infusion program to place of death in a national sample of patients with HF. The rate of home death among program participants (64.5%; n = 217) was significantly higher (P < .001) than an age- and sex-adjusted rate of home death in a national sample (35.9%; n = 514 684). Patients with HF participating in home inotropic support can remain at home during the final stage of life and are less likely ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5140664 Wed, 10 Aug 2011 23:00:00 +0100 5140664 http://www.medworm.com/index.php?rid=5095206&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21803784%26dopt%3DAbstract Authors: Soto E, Stewart DR, Mannes AJ, Ruppert SL, Baker K, Zlott D, Handel D, Berger AM Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to be effective not only for its anesthetic properties but also for the analgesic and opiate-sparing effects. However, data on efficacy and safety of oral ketamine for the treatment of neuropathic or cancer pain syndromes is limited with most of the evidence based on small clinical trials and anecdotal experiences. In this review, we will analyze the clinical data on oral ketamine in the palliative care setting. After an extensive search using five major databases, a total of 19 relevant articles were included. No official clinical guidelines for the use of oral ketamine in this patient population were found. Studies on o... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5095206 Thu, 28 Jul 2011 23:00:00 +0100 5095206 http://www.medworm.com/index.php?rid=5095172&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21803785%26dopt%3DAbstract Conclusion: Early identification, intervention, education and coordination of services may help to alleviate caregiver burden, which will improve quality of life for both patient and caregiver. PMID: 21803785 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5095172 Thu, 28 Jul 2011 23:00:00 +0100 5095172 http://www.medworm.com/index.php?rid=5095212&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21784754%26dopt%3DAbstract We present 3 cases of patients with advanced cancer with intractable bone pain whose hospital courses were complicated by severe psychosocial distress and delirium. We also propose an algorithm of multidimensional approach to unrelieved pain and suffering in patients with advanced cancer. PMID: 21784754 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5095212 Thu, 21 Jul 2011 23:00:00 +0100 5095212 http://www.medworm.com/index.php?rid=5048207&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21745832%26dopt%3DAbstract Authors: Mishra S, Bhatnagar S, Nirvani Goyal G, Pratap Singh Rana S, Upadhya SP Neuropathic pain is difficult to diagnose and difficult to treat with certainty. So the aim of the study was to evaluate comparative clinical efficacy of pregabaline with amitriptyline and gabapentin in neuropathic cancer pain. A total of 120 patients with cancer having severe neuropathic cancer pain were enrolled in the study after taking approval from Institutional Ethics Committee and divided in to 4 groups: group AT-amitriptyline, group GB-gabapentin, group PG-pregabalin, and group PL-placebo. Oral morphine was used for rescue analgesic for continued pain. Pain score (Visual Analogue scale) and secondary outcome measures such as intensity of lancinating, dysesthesia, and burning on numerical rating sca... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5048207 Sat, 09 Jul 2011 23:00:00 +0100 5048207 http://www.medworm.com/index.php?rid=5048206&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21745833%26dopt%3DAbstract Conclusion: Palliative sedation is nor slow euthanasia nor an ambivalent practice. It is an intentional medical treatment which is administered in a proportional way when refractory suffering occurs. It occurs in extraordinary situations and at the very end of the dying process. PMID: 21745833 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5048206 Sat, 09 Jul 2011 23:00:00 +0100 5048206 http://www.medworm.com/index.php?rid=5048208&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21737407%26dopt%3DAbstract Authors: Kryworuchko J, Stacey D, Peterson WE, Heyland DK, Graham ID We explored family involvement in decisions about life support interventions in the intensive care unit study using a critical incident technique to focus on specific case exemplars contributed by participants. A total of 6 family members and 9 health care professionals were interviewed. Participants described 2 options (life support or comfort care) and values associated with options: maintaining quality of life, surviving critical illness, minimizing pain and suffering, not being attached to machines, needing adjustment time, and judicious health care resource use. Barriers to involvement included not being offered alternative options; no specific trigger to initiate decision making; dominant influence of profession... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=5048208 Tue, 05 Jul 2011 23:00:00 +0100 5048208 http://www.medworm.com/index.php?rid=4999323&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21727149%26dopt%3DAbstract Authors: Stagg EK, Lazenby M This literature review summarizes the current research on nonpharmacological management of depressive symptoms for patients nearing the end of their lives. Research suggests that major depressive disorder may affect terminally ill adults at a disproportionately high rate. Psychotherapy has not been shown to have consistent benefits among patients in the final months of life. Semi-psychotherapeutic (life review) techniques are likely most effective in patients in the final weeks of life. Non-psychotherapeutic techniques such as hypnotherapy have not been studied sufficiently to be recommended as first-line treatments. Based on the current research, it is our recommendation that psychotherapy be used first-line in patients with approximately 6 months or more ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999323 Sun, 03 Jul 2011 23:00:00 +0100 4999323 http://www.medworm.com/index.php?rid=4999322&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21727150%26dopt%3DAbstract This article concludes with a précis on recommendations for increasing cultural competency in hospice and palliative care for both volunteers and agencies and discusses the top 4 future trends in cultural competency for hospice care. PMID: 21727150 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999322 Sun, 03 Jul 2011 23:00:00 +0100 4999322 http://www.medworm.com/index.php?rid=4999324&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21724679%26dopt%3DAbstract Authors: Legrand SB Hypercalcemia occurs in 10% to 20% of those with advanced cancer. It is considered an oncologic emergency. Presenting symptoms include common gastrointestinal symptoms that may be difficult to differentiate from tumor or treatment-related symptoms. These include nausea, vomiting, and constipation. As levels increase or if development is rapid, neuropsychiatric symptoms such as delirium can develop. Untreated it will lead to coma and death. Current preferred therapies are the bisphosphonate agents, zoledronate and pamidronate with saline rehydration. PMID: 21724679 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999324 Thu, 30 Jun 2011 23:00:00 +0100 4999324 http://www.medworm.com/index.php?rid=4999327&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21712306%26dopt%3DAbstract Authors: Mitra R, Jones S Adjuvant analgesics (co-analgesics) are medications whose primary indication is the management of a medical condition with secondary effects of analgesia. Cancer pain is multifactorial and often involves inflammatory, nociceptive, and neuropathic pain subtypes. Adjuvant analgesics used in conjunction with opioids have been found to be beneficial in the management of many cancer pain syndromes; however, they are currently underutilized. Antidepressants, anticonvulsants, local anesthetics, topical agents, steroids, bisphosphonates, and calcitonin are all adjuvants which have been shown to be effective in the management of cancer pain syndromes. When utilizing analgesic adjuvants in the treatment of cancer pain, providers must take into account the particular sid... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999327 Mon, 27 Jun 2011 23:00:00 +0100 4999327 http://www.medworm.com/index.php?rid=4999326&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21712307%26dopt%3DAbstract Aesthetic Engagements: "Being" in Everyday Life With Advanced Cancer. Am J Hosp Palliat Care. 2011 Jun 28; Authors: la Cour K, Hansen HP Living with advanced cancer can present an overwhelming challenge. It may impact the everyday life of the individual with respect to an array of psychological, physical, social, and existential issues. We focus on ways in which people with advanced cancer experience and use their engagement in daily activities when confronting nearing death. Through a phenomenological analysis based on Heidegger's thinking, we illuminate the complexities of "being toward death" and the human striving for authentic being through engagement in daily living. The main findings demonstrate how sensory experiences support being through an appreciation of everyday ae... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999326 Mon, 27 Jun 2011 23:00:00 +0100 4999326 http://www.medworm.com/index.php?rid=4999325&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21712308%26dopt%3DAbstract Authors: Sanchez Varela AM, Deal AM, Hanson LC, Blatt J, Gold S, Dellon EP Despite improving organization of hospice for children with life-limiting illnesses, services may be underutilized. We asked representatives of all 76 existing North Carolina hospice organizations about barriers to serving children. Representatives of 61 agencies responded (80%). Hospices serving children differed from hospices not serving children on perception of barriers: 1) Lack of pediatric trained staff (8% vs 42%, p = 0.01); 2) lack of pediatrician consultation (23% vs 50%, p = 0.03); 3) lack of pediatric pharmacy (4% vs 32%, p = 0.006), and inconsistent plan of care between pediatrician and hospice (12% vs 47%, p = 0.01). Lack of pediatric referrals (78%) and families wanting to continue curative therapi... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999325 Mon, 27 Jun 2011 23:00:00 +0100 4999325 http://www.medworm.com/index.php?rid=4999328&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697140%26dopt%3DAbstract Authors: Kirkova J, Rybicki L, Walsh D, Aktas A Age, gender, and performance status (PS) are important patient characteristics which might influence to cancer symptom profile. We conducted a secondary analysis of a symptom database to examine any interaction of these factors on symptom prevalence. 38 symptoms were assessed in 1000 consecutive patients with advanced cancer. The association of the three demographic factors with each symptom was examined using logistic regression analysis. Eight symptoms were associated with more than one of the three factors. Model-based estimates of symptom prevalence were calculated for 30 groups based on combinations of age, gender, and ECOG PS (0-4). Prevalence differences between various groups >10% were empirically classified as clinically relev... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4999328 Mon, 20 Jun 2011 23:00:00 +0100 4999328 http://www.medworm.com/index.php?rid=4953540&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21685428%26dopt%3DAbstract Authors: Acierno R, Rheingold A, Amstadter A, Kurent J, Amella E, Resnick H, Muzzy W, Lejuez C The development and clinical trial of a 5-session behavioral intervention for complicated bereavement (CB) is presented. We conceptualized CB in terms of Major Depression (MDD) and Post-traumatic Stress Disorder (PTSD) and consequently applied treatment components of Behavioral Activation and Therapeutic Exposure (BA-TE). In order to assure standardization of treatment, control costs, and engage patients, a multi-media, multi-context format was adopted to address avoidance and withdrawal behaviors conceptualized as central pathogenic responses in CB. Participants (N = 26) were assessed before and after BA-TE treatment via structured clinical interview and standardized questionnaires in terms ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4953540 Thu, 16 Jun 2011 23:00:00 +0100 4953540 http://www.medworm.com/index.php?rid=4953541&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21676985%26dopt%3DAbstract Conclusions: The current practice of antimicrobial prescribing, especially for patients who are eminently dying, may need to be reviewed. Initiation of antimicrobial treatment in this group of patients should be based on clear treatment goals and desired outcomes, considering views of patients and families. PMID: 21676985 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4953541 Tue, 14 Jun 2011 23:00:00 +0100 4953541 http://www.medworm.com/index.php?rid=4953542&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21669945%26dopt%3DAbstract Conclusion: Spinal cord stimulation provides an effective, alternative treatment option for select patients with cancer-related pain who have failed conservative treatment. PMID: 21669945 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4953542 Sun, 12 Jun 2011 23:00:00 +0100 4953542 http://www.medworm.com/index.php?rid=4953545&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21665853%26dopt%3DAbstract CONCLUSIONS: HVs are an important part for patient care and fellow education, which provided an opportunity for medication revision and symptom education. PMID: 21665853 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4953545 Thu, 09 Jun 2011 23:00:00 +0100 4953545 http://www.medworm.com/index.php?rid=4953544&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21665854%26dopt%3DAbstract This article attempts to revisit the issues, and the reasons, that may contribute to this. Some guidelines on palliative management in cases of patients suffering from severe dementia exist; the evidence base for these guidelines though is relatively weak. The ethical and legal issues that may influence or impact on the decision to initiate the palliative care pathway in the management of EOL issues for dementia patients in the terminal or end stage of the illness is highlighted. Initiatives by the department of health in England and Wales, and other bodies with interest in dementia issues and palliative care in the United Kingdom to ensure good and acceptable EOL pathways for patients with dementia are mentioned. PMID: 21665854 [PubMed - as supplied by publisher] (Source: The American... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4953544 Thu, 09 Jun 2011 23:00:00 +0100 4953544 http://www.medworm.com/index.php?rid=4953543&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21665855%26dopt%3DAbstract Authors: Carter BS, Wocial LD Over the past 30 years, and increasingly over the past decade, palliative care services characteristically address the complexity of communication, decision making, and management of end-of-life issues for patients and families of all ages. Clinical ethics services have a parallel 30-plus year history in the United States-so much so that some have offered that clinical ethics has "cut its teeth" on issues attendant to the beginning and end of life. The authors propose considerations necessary in determining the appropriateness of consultation with palliative care, clinical ethics, or both, and when either may be necessary but perhaps not sufficient for patient and family management. A resolution for any encountered tension and identification of common or o... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4953543 Thu, 09 Jun 2011 23:00:00 +0100 4953543 http://www.medworm.com/index.php?rid=4904978&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21622488%26dopt%3DAbstract Authors: Enck RE PMID: 21622488 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904978 Tue, 31 May 2011 23:00:00 +0100 4904978 http://www.medworm.com/index.php?rid=4904977&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21636587%26dopt%3DAbstract Conclusion: As the hospice settings become more racially/ethnically diverse, it is essential to attend to the different circumstances and needs of the various groups in providing optimal care. PMID: 21636587 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904977 Tue, 31 May 2011 23:00:00 +0100 4904977 http://www.medworm.com/index.php?rid=4904976&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21636588%26dopt%3DAbstract Authors: Jovanovic M This case study examines the current state of cultural competence in hospice and palliative care in the Greater Toronto Area (GTA). Because of changing demographic trends and ethnic minorities underutilizing hospice palliative care services, this research examined the current state of culturally competent care in a hospice setting, and the challenges to providing culturally competent care in a hospice in the GTA. A case study was conducted with a hospice and included in-depth interviews with 14 hospice volunteers. The findings reveal that volunteers encountered cultural clashes when their level of cultural competency was weak. Second, volunteers revealed there was a lack of adequate cultural competency training with their hospice, and finally, there was a lack of e... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904976 Tue, 31 May 2011 23:00:00 +0100 4904976 http://www.medworm.com/index.php?rid=4904979&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21622486%26dopt%3DAbstract Authors: Ahmed Khan MI, Walsh D, Brito-Dellan N An adjuvant (or co-analgesic) is a drug that in its pharmacological characteristic is not necessarily primarily identified as an analgesic in nature but that has been found in clinical practice to have either an independent analgesic effect or additive analgesic properties when used with opioids. The therapeutic role of adjuvant analgesics (AAs) is to increase the therapeutic index of opioids by a dose-sparing effect, add a unique analgesic action in opioid-resistant pain, or reduce opioid side effects. A notable difference between opioids and AAs is that unlike opioids some AAs are associated with permanent organ toxicity, for example, nonsteroidal anti-inflammatory drugs (NSAIDs) and renal failure. It is impossible to predict in advance... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904979 Wed, 25 May 2011 23:00:00 +0100 4904979 http://www.medworm.com/index.php?rid=4904980&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21613304%26dopt%3DAbstract Authors: Yapp KA Beneficence is a fundamental concept of medicine, which embodies the notion above all, do no harm. While this principle illustrates the health care professional's duty to contribute to the patient's welfare, the principle becomes convoluted when the wishes of the patient directly conflict with that of the physician. The purpose of the study was to determine the degree to which cultural beliefs influence a physician's decision to introduce the concept of hospice to terminally ill patients. This phenomenological study explored the perceptions of 14 physicians practicing medicine in Mercer County, New Jersey. Analysis of the textural data revealed the following 5 themes: (a) physician personal perspectives, (b) physician perspectives on culture, (c) perspectives on hospic... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904980 Tue, 24 May 2011 23:00:00 +0100 4904980 http://www.medworm.com/index.php?rid=4904983&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606122%26dopt%3DAbstract Authors: Ramirez I, Bansal N, Hoffman M Refractory ascites can significantly reduce quality of life in patients with advanced stage ovarian cancer. Paracentesis is a commonly used procedure for the management of refractory ascites. However, there are potential risks associated with paracentesis such as pain, infection, and injury to intra-abdominal organs. In an effort to decrease the number of serial paracentesis, placement of intraperitoneal catheters has been described for the management of intractable ascites. Here we describe a case of metastasis involving a palliative peritoneal catheter in a patient with recurrent ovarian cancer. PMID: 21606122 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904983 Sun, 22 May 2011 23:00:00 +0100 4904983 http://www.medworm.com/index.php?rid=4904982&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606123%26dopt%3DAbstract In conclusion, methylnaltrexone is targeted treatment for the management of opioid-induced constipation. However, there is a percentage of people who fail to respond. The impact of other factors on the problem of constipation requires greater clarification. PMID: 21606123 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904982 Sun, 22 May 2011 23:00:00 +0100 4904982 http://www.medworm.com/index.php?rid=4904981&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606124%26dopt%3DAbstract Authors: York GS, Churchman R, Woodard B, Wainright C, Rau-Foster M Invitations for free-text comments on surveys provide family members of hospice patients an opportunity to ''tell'' their story of the hospice experience and caregiver relationships during the last months of life. These comments are a rich source of data for understanding the complex interpersonal relationships that influence patient/family perceptions of both quality of care and quality of life. Analysis of 438 free-text comments provided by 243 hospice family members revealed 5 emergent caregiver relationship themes: knowledge, skills, and abilities; empathy and compassion; trust and acceptance; communication experience and time spent with caregiver. Findings support the value of free-text comments to explain or add ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4904981 Sun, 22 May 2011 23:00:00 +0100 4904981 http://www.medworm.com/index.php?rid=4854620&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21596732%26dopt%3DAbstract Authors: Johansson AK, Grimby A A Swedish widowhood study revealed that four out of ten widows regarded the pre-loss period more stressful than the post-loss. The present investigation of close relatives to patients dying from cancer (using interviews and the Anticipatory Grief Scale) found that preparatory grief involves much emotional stress, as intense preoccupation with the dying, longing for his/her former personality, loneliness, tearfulness, cognitive dysfunction, irritability, anger and social withdrawal, and a need to talk. Psychological status was bad one by every fifth. However, the relatives mostly stated adjustment and ability to mobilize strength to cope with the situation. The results suggest development of support and guiding programs also for the anticipatory period. ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4854620 Wed, 18 May 2011 23:00:00 +0100 4854620 http://www.medworm.com/index.php?rid=4854613&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21596733%26dopt%3DAbstract Authors: Nenner F PMID: 21596733 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4854613 Wed, 18 May 2011 23:00:00 +0100 4854613 http://www.medworm.com/index.php?rid=4854624&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21576090%26dopt%3DAbstract This report provides nationally representative data on documentation of advance directives (ADs) among home health (HH) and hospice patients. Advance directives were recorded for 29% of HH patients and 90% of hospice discharges. Among HH patients, increasing age and use of assistive devices were associated with greater odds of having an AD, while being Hispanic or black (relative to white) and enrolled in Medicaid decreased the odds of having ADs. Among hospice discharges, being enrolled in Medicare and having 4 or 5 activities of daily living (ADL) limitations were associated with higher odds of ADs while depression, use of emergency services, and being black (relative to White) were associated with lower odds. Even after adjustment for potentially confounding factors, racial differences ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4854624 Sat, 14 May 2011 23:00:00 +0100 4854624 http://www.medworm.com/index.php?rid=4802074&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21546403%26dopt%3DAbstract CONCLUSIONS: Overall satisfaction was high, but there was discordance among different providers. Continuity of care was limited. Age and location of death alone did not significantly affect satisfaction with end-of-life care. Implications of this type of research for improving end of life care at academic centers are discussed. PMID: 21546403 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802074 Wed, 04 May 2011 23:00:00 +0100 4802074 http://www.medworm.com/index.php?rid=4802077&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21527428%26dopt%3DAbstract Authors: Enck RE PMID: 21527428 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802077 Sat, 30 Apr 2011 23:00:00 +0100 4802077 http://www.medworm.com/index.php?rid=4802076&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21527429%26dopt%3DAbstract Authors: Vitrano V, Catania V, Mercadante S The aim of this study was to characterize sexuality attitudes and feelings in a larger sample of patients with advanced cancer in comparison with their previous status before diagnosis. Of the 100 patients randomized, 65 patients answered to all the questions included in the questionnaire. Of these 65, 25 patients were male and 40 were female, with a mean Karnofsky of 58 (range 40-70) and a mean well-being sensation of 5.67 (range 2-10). In all, 60% of patients did not feel to be less attractive after disease, 30% of patients a little, and only 10% very much. Most patients (86.4%) considered important to talk about sexuality and to face such an issue with skilled people. About half of the patients (47%) reported that sexuality was very import... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802076 Sat, 30 Apr 2011 23:00:00 +0100 4802076 http://www.medworm.com/index.php?rid=4802075&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21527430%26dopt%3DAbstract Authors: Nenner F PMID: 21527430 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802075 Sat, 30 Apr 2011 23:00:00 +0100 4802075 http://www.medworm.com/index.php?rid=4802079&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21521709%26dopt%3DAbstract This study suggests that the mailer system and proper education of medical staff have the potential to improve medical waste management, but alternative approaches may be necessary to increase the rate of envelop return. PMID: 21521709 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802079 Mon, 25 Apr 2011 23:00:00 +0100 4802079 http://www.medworm.com/index.php?rid=4802078&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21521710%26dopt%3DAbstract This study aims to provide insight into the role of grandchildren as informal hospice caregivers. It presents 4 cases that highlight the challenges and perceptions of grandchildren who care for a grandparent at the end of life. A researcher met regularly with family caregivers to discuss the problems or challenges during hospice caregiving. Although each caregiver presented unique individual experiences, several themes are common among the family caregivers including fatigue, stress, guilt, and loss of the "grandchild" identity. Grandchildren caregivers often take care of 3 generations (grandparents, parents, and children) and in many cases need additional assistance to help them overcome the challenges associated with managing a household, career, family, and caregiving roles. PMID: 2... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802078 Mon, 25 Apr 2011 23:00:00 +0100 4802078 http://www.medworm.com/index.php?rid=4802080&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21518705%26dopt%3DAbstract This report describes the development of the longitudinal curriculum and provides helpful resources and strategies to guide clinicians and administrators undertaking similar efforts. This is a retrospective, descriptive report based on data collected throughout development of the new curriculum. A Palliative Care Advisory Committee initiated development of curricula in PC. An Office of Palliative Care was established to assess and coordinate offerings. Curriculum transformation was based on best practices. Two cornerstone pieces are highlighted: a mandatory hospice experience and a case based small group discussion prior to graduation. PMID: 21518705 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802080 Sun, 24 Apr 2011 23:00:00 +0100 4802080 http://www.medworm.com/index.php?rid=4802083&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21504998%26dopt%3DAbstract This article poses topical queries on the importance of the palliative care physician exercising a deliberate agenda to persistently refine one's personal framework or beliefs regarding grief. In doing so, it is proposed physicians will engender improved self-knowledge, which will serve to better poise themselves toward being with and purposefully encountering aggrieved others. PMID: 21504998 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802083 Mon, 18 Apr 2011 23:00:00 +0100 4802083 http://www.medworm.com/index.php?rid=4802082&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21504999%26dopt%3DAbstract Authors: Dolan EA Malignant bowel obstruction is common in individuals with intra-abdominal and pelvic malignancies and results in considerable suffering. Treatments target both the resolution of obstruction and symptom management. Emerging procedures include stents placement in the bowel to return patency and newer surgical procedures that are evolving to be less invasive. The use of medical interventions like corticosteroids, alone or in concert with additional drugs, can be utilized to achieve resolution of obstruction. Throughout treatment, it is important to also aggressively treat obstructive symptoms like pain and nausea/vomiting. This can mostly be achieved with medications, but use of venting percutaneous endoscopic gastrostomy (PEG) can also relieve symptoms. Parenteral hydra... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802082 Mon, 18 Apr 2011 23:00:00 +0100 4802082 http://www.medworm.com/index.php?rid=4802081&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21505000%26dopt%3DAbstract Authors: Alsirafy SA, Mousa SM, Brown SM PMID: 21505000 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802081 Mon, 18 Apr 2011 23:00:00 +0100 4802081 http://www.medworm.com/index.php?rid=4802084&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21482556%26dopt%3DAbstract Authors: Weir AB, Brint JM PMID: 21482556 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802084 Sun, 10 Apr 2011 23:00:00 +0100 4802084 http://www.medworm.com/index.php?rid=4802091&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21444324%26dopt%3DAbstract This article provides an evidence-based overview and comparison of cannabis and opioids. Using this foundation, an argument is made for reclassifying cannabis in the context of improving palliative care and reducing opioid-related morbidity. PMID: 21444324 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802091 Wed, 06 Apr 2011 23:00:00 +0100 4802091 http://www.medworm.com/index.php?rid=4802085&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21478176%26dopt%3DAbstract Conclusion: The APCU model is designed for the care of very complex advanced cancer patients. Palliative interventions are given simultaneously with other medical interventions. The APCU is labor intensive and well reimbursed. PMID: 21478176 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802085 Wed, 06 Apr 2011 23:00:00 +0100 4802085 http://www.medworm.com/index.php?rid=4802090&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21454317%26dopt%3DAbstract Conclusion: Black race was associated with higher odds of hospice discussion and referral in a primarily Medicaid population. Additional research is needed to explore variations in physician-patient discussion about hospice among different patient populations. PMID: 21454317 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802090 Tue, 29 Mar 2011 23:00:00 +0100 4802090 http://www.medworm.com/index.php?rid=4802089&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21454318%26dopt%3DAbstract Authors: Liu H, Ruan X PMID: 21454318 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802089 Tue, 29 Mar 2011 23:00:00 +0100 4802089 http://www.medworm.com/index.php?rid=4802088&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21454319%26dopt%3DAbstract This article summarizes the multifactorial nature, numerous predisposing medical risk factors, neuropsychiatric adverse effects of palliative medications, pharmacokinetic changes, and challenges complicating delirium assessment and provides a systematic framework for assessment. The benefits, risks, and patient-specific considerations for treatment selection are also discussed. PMID: 21454319 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802088 Tue, 29 Mar 2011 23:00:00 +0100 4802088 http://www.medworm.com/index.php?rid=4802087&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21454320%26dopt%3DAbstract This article examines Mencken's thoughts on death and dying, Mencken's own death, and the parallels between Mencken's writing and the discipline of Palliative Care. PMID: 21454320 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802087 Tue, 29 Mar 2011 23:00:00 +0100 4802087 http://www.medworm.com/index.php?rid=4802086&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21454321%26dopt%3DAbstract Conclusion: Parents of certain chronically ill children may benefit from routine screening for depression. PMID: 21454321 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4802086 Tue, 29 Mar 2011 23:00:00 +0100 4802086 http://www.medworm.com/index.php?rid=4748366&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21422067%26dopt%3DAbstract Authors: Baumrucker SJ, Licup N PMID: 21422067 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748366 Mon, 21 Mar 2011 00:00:00 +0100 4748366 http://www.medworm.com/index.php?rid=4748333&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21422068%26dopt%3DAbstract Authors: El Toukhy M, Campkin NT Diarrhea is one of the commonest complication following coeliac plexus ablative procedures. It is believed to occur due to inadvertent chemical sympathectomy by the block. For the majority of patients, complications are temporary and self limited. Unfortunately few cases of refractory diarrhea have been reported and some of them proved fatal. The mainstay of therapy is aggressive hydration to restore body fluids and early treatment with antidiarrheal agents. This includes the use of high fiber diet, opioids, anticholinergics, alpha 2 agonists and somatostatin analogues e.g., Octreotide in an attempt to inhibit gut motility and control the diarrhea. We would like to present a case of severe diarrhea following a neurolytic coeliac plexus block using alcoh... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748333 Mon, 21 Mar 2011 00:00:00 +0100 4748333 http://www.medworm.com/index.php?rid=4748321&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21422069%26dopt%3DAbstract Authors: Baumrucker SJ, Stolick M, Mingle P, Vandekieft G, Morris GM, Harrington D, Oertli KA PMID: 21422069 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748321 Mon, 21 Mar 2011 00:00:00 +0100 4748321 http://www.medworm.com/index.php?rid=4748414&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398264%26dopt%3DAbstract Authors: Namendys-Silva SA, Gonzalez-Herrera MO, Herrera-Gomez A Malignancies are becoming increasingly common, especially as the population ages, and patients with cancer are likely to represent an increasing proportion of ICU populations. Advances in oncological and supportive care have led to improved prognosis and extension of survival time in patients with cancer. The National Institute Cancer located in Mexico City has an oncological ICU with 6 beds. During the biennium 2008-2009, 573 patients with cancer were admitted to the ICU. The mean age was 51 ± 16.36 years and 58.6% were women. The length of stay in the ICU was 2 days (interquartile range; 1-5). The 71.6% were surgical patients. The mortality rate was 15.9%. Patients with hemato-oncological cancer had higher ICU mortalit... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748414 Wed, 16 Mar 2011 00:00:00 +0100 4748414 http://www.medworm.com/index.php?rid=4748422&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398261%26dopt%3DAbstract Authors: Ogilvie P PMID: 21398261 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748422 Thu, 10 Mar 2011 00:00:00 +0100 4748422 http://www.medworm.com/index.php?rid=4748419&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398262%26dopt%3DAbstract Authors: Planalp S, Trost MR, Berry P Conversations between hospice volunteers and patients provide patients with emotional and social support, and they are meaningful and satisfying to volunteers. Through questionnaires and interviews, hospice volunteers were asked to describe a meaningful conversation with a patient. Many volunteers stated that all conversations were meaningful. Most, however, were able to describe one specific conversation, though they noted that meaningful conversations cannot be forced and often arise after many interactions. Prominent themes were the meaning of life, experiences and life stories, talk about death and spirituality, discussions of families and relationships, and shared interests. Volunteers expressed appreciation for the opportunity to learn about ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748419 Thu, 10 Mar 2011 00:00:00 +0100 4748419 http://www.medworm.com/index.php?rid=4748417&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398263%26dopt%3DAbstract Authors: Melhado L, Bushy A African Americans over 65 represent 3.5 of the 35.6 million Americans. Morbidity and mortality rates are highest among this group; associated with lack of resources and awareness of health problems. But health needs are the same at end of life, yet care is less than optimal. African Americans are less likely to have advance directives nonetheless desire communication, information, respect, and a trusting doctor-patient relationship. Low health literacy may contribute to this disparity. This scholarly review examines the health literacy in advance care planning and refines concepts of uncertainty in illness theory deriving a model for advance care planning in African Americans. PMID: 21398263 [PubMed - as supplied by publisher] (Source: The American Journ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748417 Thu, 10 Mar 2011 00:00:00 +0100 4748417 http://www.medworm.com/index.php?rid=4748411&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398265%26dopt%3DAbstract Authors: Mahmoud FA, Aktas A, Walsh D, Hullihen B Identification of taste abnormalities can help understand difficulties in nutrition. We evaluated 15 hospice inpatients with advanced cancer for subjective taste changes. The majority had both subjective and objective taste changes. Most thought all food was tasteless followed by loss of sweet sensation and meat aversion. About half of the participants exhibited anorexia and weight loss with decreased energy intake. Both detection and recognition thresholds for these basic tastes were abnormal for the majority of participants. Reduced sensitivity for sweet and salt taste and altered perception for sour predominated in formal taste testing. PMID: 21398265 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice an... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748411 Thu, 10 Mar 2011 00:00:00 +0100 4748411 http://www.medworm.com/index.php?rid=4748408&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398266%26dopt%3DAbstract CONCLUSIONS: Older adults enrolled in PICT with more symptoms may sacrifice QOL for experimental treatment. PMID: 21398266 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748408 Thu, 10 Mar 2011 00:00:00 +0100 4748408 http://www.medworm.com/index.php?rid=4748405&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398267%26dopt%3DAbstract Authors: Alvarez A, Walsh D In Palliative Medicine, symptom management is a clinical priority and one of the key skill sets of the palliative specialist. Symptom control principles have been derived from clinical practice in cancer pain management. They can also be applied to other cancer symptoms, and systematic application will help improve quality of life (QOL). They require a diagnosis of the underlying etiology, individualization of symptom therapy, a systematic approach to management, and therapeutic clarity and simplicity. There are 20 principles that have been identified as helpful to guide the clinical practice of symptom control in advanced cancer. PMID: 21398267 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748405 Thu, 10 Mar 2011 00:00:00 +0100 4748405 http://www.medworm.com/index.php?rid=4748400&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398268%26dopt%3DAbstract In this study, the Edmonton Symptom Assessment Scale (ESAS) has been translated, modified, and tested on content, face, criterion, construct validity, and internal consistency for patients admitted to Flemish palliative care units. These aspects are tested in a descriptive, comparative, longitudinal study based on 3 convenience samples. The first consisted of 8 palliative care experts. The second sample checked the face validity and consisted of 4 patients, 5 family members, and 5 nurses. The last sample involved 23 patients admitted to 3 Flemish palliative care units. Heedful of the "new-wave" vision on validity, the translated and altered ESAS seemed a suitable instrument for the symptom assessment of patients with cancer admitted to a palliative care unit. PMID: 21398268 [PubMed - a... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748400 Thu, 10 Mar 2011 00:00:00 +0100 4748400 http://www.medworm.com/index.php?rid=4748393&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398269%26dopt%3DAbstract Authors: Trivedi DD Dialysis patients are often denied hospice benefits unless they forego dialysis treatments. However, many of those patients might benefit from as-needed dialysis treatments to palliate symptoms of uremia, fluid overload, etc. The current Medicare payment system precludes this "palliative dialysis" except in those few cases where the terminal diagnosis is unrelated to renal failure. As approximately three quarters of all US patients on dialysis have Medicare as their primary insurance, a of review of Medicare policy is suggested, with a goal of creating a new "palliative dialysis" category that would allow patients to receive treatments on a less regular schedule without affecting the quality statistics of the dialysis center.(1). PMID: 21398269 [PubMed - as supp... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748393 Thu, 10 Mar 2011 00:00:00 +0100 4748393 http://www.medworm.com/index.php?rid=4748384&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398270%26dopt%3DAbstract Authors: Clarke GB PMID: 21398270 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748384 Thu, 10 Mar 2011 00:00:00 +0100 4748384 http://www.medworm.com/index.php?rid=4748376&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398271%26dopt%3DAbstract This report provides nationally representative data on policies, storage, and implementation of advance directives (ADs) in home health and hospice (HHH) agencies in the United States using the National Home and Hospice Care Survey. Federally mandated ADs policies were followed in >93% of all agencies. Nearly all agencies stored ADs in a file at the agency, but only half stored them at the patient's residence. Nearly all agencies informed staff about the AD, but only 77% and 72% of home health agencies informed the attending physician and next-of-kin, respectively. Home health and hospice agencies are nearly universally compliant with ADs policies that are required in order to receive Medicare and Medicaid payments, but have much lower rates of adoption of ADs policies beyond federally ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4748376 Thu, 10 Mar 2011 00:00:00 +0100 4748376 http://www.medworm.com/index.php?rid=4577627&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21357206%26dopt%3DAbstract Authors: Enck RE PMID: 21357206 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4577627 Tue, 01 Mar 2011 00:00:00 +0100 4577627 http://www.medworm.com/index.php?rid=4577626&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21357207%26dopt%3DAbstract Authors: Rickabaugh BA PMID: 21357207 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4577626 Tue, 01 Mar 2011 00:00:00 +0100 4577626 http://www.medworm.com/index.php?rid=4523139&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21317130%26dopt%3DAbstract Authors: Schaepe C, Bolmsjo I, Campbell AM Background: Palliative care is not a priority in developing countries. Hospice Africa Uganda (HAU), where nurses complete a course in clinical palliative care, is considered a model for other African countries. Aim: To explore the role of the palliative care nurse specialist (PCNS) in Uganda. METHODS: This ethnographic field study uses observations, interviews, and group interviews. Participants: In total, 20 participants are included in this study. Result: The role of the palliative care nurse specialist is multifaceted. Beyond prescribing drugs, their role is to deliver holistic care. They encounter numerous challenges in their work, but they also have the possibility to improve the quality of the patient's life. PMID: 21317130 [PubMed -... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4523139 Thu, 10 Feb 2011 00:00:00 +0100 4523139 http://www.medworm.com/index.php?rid=4523138&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21317131%26dopt%3DAbstract When to Say "Yes" and When to Say "No": Boundary Issues for Hospice Palliative Care Volunteers. Am J Hosp Palliat Care. 2011 Feb 10; Authors: Claxton-Oldfield S, Gibbon L, Schmidt-Chamberlain K A total of 79 hospice palliative care volunteers from 2 community-based hospice programs responded to a 27-item Boundary Issues Questionnaire that was specifically developed for this study. Volunteers were asked to indicate whether or not they considered each item (eg, "Lend personal belongings to a patient or family," "Agree to be a patient's power of attorney," "Attend/go into a patient's medical appointment") to be something they should not do and to indicate whether or not they have ever done it. On the basis of the volunteers' responses, the authors distinguished between "definite b... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4523138 Thu, 10 Feb 2011 00:00:00 +0100 4523138 http://www.medworm.com/index.php?rid=4523137&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21317132%26dopt%3DAbstract The objective of this retrospective study was to explore trends in hospice utilization among older veterans receiving services at the end of life over a 4-year (2006-2009) time period. Reviewing trends, the number of veterans receiving hospice services increased annually, with 5779 veterans receiving services during 2009, up from 1742 veterans in 2006. The total cost of providing hospice rose dramatically, increasing from $1.98 million in 2006 to $5.91 million in 2009. More funds were spent on younger veterans, with an average of $1.5 million spent on veterans aged 55 to 64 and less than $400,000 spent on veterans aged 85 and older. Findings highlight the growing need and demand for hospice within the VHA to provide end-of-life services. PMID: 21317132 [PubMed - as supplied by publishe... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4523137 Thu, 10 Feb 2011 00:00:00 +0100 4523137 http://www.medworm.com/index.php?rid=4399000&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21247923%26dopt%3DAbstract Authors: Enck RE PMID: 21247923 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4399000 Wed, 26 Jan 2011 16:45:25 +0100 4399000 http://www.medworm.com/index.php?rid=4398999&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21247924%26dopt%3DAbstract This article considers some of the conceptual, practical, and administrative challenges that have been faced in an effort to establish palliative medicine as a discrete field of specialized practice from a US perspective. We also comment on current issues in regard to education and research, and development of comprehensive palliative care programs in the United States. PMID: 21247924 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4398999 Wed, 26 Jan 2011 16:45:19 +0100 4398999 http://www.medworm.com/index.php?rid=4398998&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21247925%26dopt%3DAbstract Authors: Subbiah V PMID: 21247925 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4398998 Wed, 26 Jan 2011 16:45:14 +0100 4398998 http://www.medworm.com/index.php?rid=4398997&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21247926%26dopt%3DAbstract Authors: Muller D PMID: 21247926 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4398997 Wed, 26 Jan 2011 16:45:10 +0100 4398997 http://www.medworm.com/index.php?rid=4398996&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21262760%26dopt%3DAbstract Authors: Brown MV The purpose of this phenomenological study was to examine the coping techniques utilized by hospice volunteers. Individual semi-structured interviews were conducted with 15 hospice volunteers who had at least 1 year of experience, working as a hospice volunteer with direct patient care. The interviews were digitally recorded, transcribed, and analyzed utilizing qualitative research methods. The results indicated the volunteers used problem-focused coping (seeking advice from members of the hospice interdisciplinary team), emotion-focused coping (talking with others, going to funerals), meaning making through appraisal (religious beliefs, downward comparison), and physical techniques (walking, deep breathing). The most significant coping mechanism utilized for the volu... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4398996 Sun, 23 Jan 2011 00:00:00 +0100 4398996 http://www.medworm.com/index.php?rid=4399002&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21242123%26dopt%3DAbstract Conclusion: The benefits of combining scales were best exemplified in participants with dementia. Inconsistencies in the predictive value of specific participant populations are likely due to difference in the illness trajectories of disease processes. PMID: 21242123 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4399002 Sun, 16 Jan 2011 00:00:00 +0100 4399002 http://www.medworm.com/index.php?rid=4399001&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21242124%26dopt%3DAbstract This study aimed to examine the psychological effects of terminal care experience on nursing home staff and analyze the differences between staff who are experienced and those who are inexperienced in providing terminal care. A mailed survey was conducted in 2007.A total of 37% (N = 72) of the participants had experience in terminal care in nursing homes. Analysis of variance (ANOVA) revealed that the professional efficacy (a subscale of the Maslach Burnout Inventory-General Survey [MBI-GS]) and tenure (duration of service) of the experienced staff were significantly higher than those of the inexperienced staff. The high professional efficacy noted among the experienced staff suggests that the provision of terminal care in nursing homes does not necessarily lead to burnout among caregivers... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4399001 Sun, 16 Jan 2011 00:00:00 +0100 4399001 http://www.medworm.com/index.php?rid=4330599&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21208898%26dopt%3DAbstract Authors: Van Dussen D, Culler KL, Cagle JG Research investigating the knowledge and attitudes of diverse older adults about hospice care and end-of-life issues is needed to expand service utilization. This pilot study explored an urban area's perceptions and awareness of hospice through local churches. The sample consisted of 148 adults age 43 and older. Although recruitment efforts resulted in a relatively homogenous sample, findings suggest a lack of knowledge about whether hospice is covered by Medicare, Medicaid, or private insurance. Perceptions of the expense of hospice, however, were not associated with knowledge of coverage. Respondents generally agreed that hospice is important and would recommend its services for their family members. PMID: 21208898 [PubMed - as supplied ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330599 Tue, 04 Jan 2011 00:00:00 +0100 4330599 http://www.medworm.com/index.php?rid=4330598&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21208899%26dopt%3DAbstract Authors: Baumrucker S, Mingle P, Harrington D, Stolick M, Carter GT, Oertli KA PMID: 21208899 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330598 Tue, 04 Jan 2011 00:00:00 +0100 4330598 http://www.medworm.com/index.php?rid=4330601&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21190946%26dopt%3DAbstract In conclusion, a singular element identified as a source of distress in, our study, is that of social network. PMID: 21190946 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330601 Tue, 28 Dec 2010 00:00:00 +0100 4330601 http://www.medworm.com/index.php?rid=4330600&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21190947%26dopt%3DAbstract Authors: Sharma RK, Dy SM Terminally-ill patients and their families often report poor communication and limited understanding of the patient's diagnosis, prognosis, and treatment plan; these deficits can be exacerbated by cross-cultural issues. Although family meetings are frequently recommended to facilitate provider-family communication, a more structured, evidence-based approach to their use may improve outcomes. Drawing on research and guidelines from critical care, palliative care, and cross-cultural communication, we propose a framework for conducting family meetings with consideration for cross-cultural issues. PMID: 21190947 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330600 Tue, 28 Dec 2010 00:00:00 +0100 4330600 http://www.medworm.com/index.php?rid=4330603&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21187290%26dopt%3DAbstract Authors: Bandyopadhyay D, Induru RR Lung cancer is the leading cause of cancer mortality and morbidity. Patients with advanced lung cancer have distressful symptoms like dyspnea. It has severe negative impact on the quality of life. Airway stenting has become widespread for palliation of airway stenosis in patients with metastatic airways disease. Although it provides improvement in symptoms, actual survival benefit is limited with severe potential complications. Appropriate patient selection in terms of site of tumor, type of stent placement is needed to achieve maximum benefit for patients. Here we will discuss 2 patients with advanced lung cancer who received bronchial stent for intractable dyspnea. Although there was dramatic improvement in symptoms and quality of life, both died s... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330603 Sun, 26 Dec 2010 00:00:00 +0100 4330603 http://www.medworm.com/index.php?rid=4330602&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21187291%26dopt%3DAbstract Authors: Rezk Y, Timmins Iii PF, Smith HS Patients with advanced gynecologic malignancies have a multitude of symptoms; pain, nausea, and vomiting, constipation, anorexia, diarrhea, dyspnea, as well as symptoms resulting from intestinal obstruction, hypercalcemia, ascites, and/or ureteral obstruction. Pain is best addressed through a multimodal approach. The optimum palliative management of end-stage malignant intestinal obstruction remains controversial, with no clear guidelines governing the choice of surgical versus medical management. Patient selection for palliative surgery, therefore, should be highly individualized because only carefully selected candidates may derive real benefit from such surgeries. There remains a real need for more emphasis on palliative care education in tr... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330602 Sun, 26 Dec 2010 00:00:00 +0100 4330602 http://www.medworm.com/index.php?rid=4330605&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21156657%26dopt%3DAbstract Conclusion: A prevalence of 0.15% for children with LTC in the MHS population agrees closely with that derived for similar case definitions by other authors among populations of children in other single-payer health care systems (i.e., United Kingdom). The method used here may apply to similar health care systems with ICD 9 codes in a searchable database. PMID: 21156657 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330605 Mon, 13 Dec 2010 00:00:00 +0100 4330605 http://www.medworm.com/index.php?rid=4330604&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21156658%26dopt%3DAbstract CONCLUSIONS: A short, focused intervention can have significant impact on residents' communication skills in the setting of an end-of-life objective structured clinical examination (OSCE). PMID: 21156658 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330604 Mon, 13 Dec 2010 00:00:00 +0100 4330604 http://www.medworm.com/index.php?rid=4330606&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21148160%26dopt%3DAbstract Authors: Kirkova J, Rybicki L, Walsh D, Aktas A, Davis MP, Karafa MT Knowledge of differences in symptom experience between cancer sites may help better understand symptom pathophysiology. A total of 38 symptoms in 796 consecutive patients with advanced cancer were retrospectively analyzed. Symptom prevalence and severity were compared among the 12 primary site groups (PSGs) by the chi-square test. Pairwise comparisons determined which sites differed. Pain, fatigue, weakness, lack of energy, and anorexia had the highest overall prevalence but did not differ among PSGs. The 3 most common neuropsychological symptoms (insomnia, depression, and anxiety) also did not vary among PSGs. Nineteen (50%) symptoms varied significantly between PSGs, in prevalence (17), severity (14), or both (12). ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4330606 Wed, 08 Dec 2010 00:00:00 +0100 4330606 http://www.medworm.com/index.php?rid=4249558&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21131636%26dopt%3DAbstract Authors: Prommer E Dexmedetomidine, is a α(2) adrenergic agonist approved by the Food and Drug administration for sedation and analgesia. A highly potent α(2) adrenergic agonist, it has quick onset of action, with peak effects within 1 hour of administration. It is metabolized in the liver and eliminated in the urine as a glucuronide. Dexmedetomidine is a substrate and inhibitor of cytochrome oxidase 2D6, but clinical evidence of significant drug interactions is lacking. Clinical trials suggest efficacy for the treatment of delirium in the intensive care unit setting with efficacy comparable to haloperidol and benzodiazepines. Dexmedetomidine also has an opioid-sparing action and can act to enhance analgesia. The purpose of this article is to review the pharmacodynamics and pharmacol... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4249558 Fri, 03 Dec 2010 00:00:00 +0100 4249558 http://www.medworm.com/index.php?rid=4165294&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21071435%26dopt%3DAbstract Authors: Mazanec PM, Daly BJ, Townsend A Multiple, complex factors influence end-of-life (EOL) decisions for all persons. In the African American population, these factors include history of disparities and discrimination in health care, which may affect the individual and the family, family system beliefs, values, and practices, and health care system issues. Family dynamics have an especially important role in treatment decisions for loved ones with advanced disease. A family systems framework can guide the clinicians in appreciating care needs and preferences at EOL. Understanding why so many African Americans choose aggressive and often burdensome care, even at the expense of suffering, is important for communication about options at the EOL and the delivery of quality care at the ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4165294 Mon, 15 Nov 2010 12:05:09 +0100 4165294 http://www.medworm.com/index.php?rid=4165295&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21071434%26dopt%3DAbstract Authors: Goldsmith J, Wittenberg-Lyles E, Shaunfield S, Sanchez-Reilly S Limited attention to palliative care communication training is offered to medical students. In this work, we pursued unfolding case responses and what they indicated about student tendencies to use palliative care communication as well as what medical students can learn from their own reflective practice about palliative care. Findings showed an overwhelming trend for students to avoid palliative care communication or inclusion of topics including advance directives, place of care, family support, and dying. Instead, students relied heavily on the SPIKES protocol, communication that was strategically vague and ambiguous, and discussions that centered on specialty care and referral. In reflecting on their own case ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4165295 Wed, 10 Nov 2010 00:00:00 +0100 4165295 http://www.medworm.com/index.php?rid=4151581&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21057139%26dopt%3DAbstract Authors: Clark K, Lam L, Currow D Retrospective analysis of 211 admissions to a palliative care unit was undertaken to explore the relationship between prescribed laxatives and the frequency of documentation of bowel movements. Bivariate analysis flailed to identify relationships between laxatives and the frequency of bowel movements. Relationships were identified between less frequent bowel movements and type and duration of illness phase. Regression analysis identified 2 variables strongly predictive of the frequency with which bowel movements were documented. People in longer illness phases were more likely to have regular bowel movements (Z = 3.02, P = .003). The second significant result was that, even accounting for the short duration of the terminal phase, people who were dying ... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151581 Sun, 07 Nov 2010 00:00:00 +0100 4151581 http://www.medworm.com/index.php?rid=4151580&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21057140%26dopt%3DAbstract This article explores the hyperactive and hypoactive delirium subtypes as well as the pathophysiology of terminal delirium and the theory of acetylcholine deficiency and dopamine excess. The causes for terminal delirium underdiagnosis as well as the causes of terminal delirium itself are identified. The use of the Confusion Assessment Method (CAM) is discussed as a means of delirium diagnosis and the Memorial Delirium Assessment scale (MDAS) is presented as a tool to measure its severity. Lastly, nonpharmacologic and pharmacologic treatment measures are reviewed and an algorithm is presented to assist the clinician in the identification and management of terminal delirium. PMID: 21057140 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151580 Sun, 07 Nov 2010 00:00:00 +0100 4151580 http://www.medworm.com/index.php?rid=4151579&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21057141%26dopt%3DAbstract Authors: Tung EE, Vickers KS, Lackore K, Cabanela R, Hathaway J, Chaudhry R Physicians are often unable to guide patients through the advance care planning (ACP) process due to cost and time constraints. We conducted a retrospective analysis in the primary care setting targeting older adults without an advance medical directive (AMD). An ACP educational packet was sent to intervention patients before their health maintenance examination (HME). Additionally, their physicians had access to a computerized clinical decision support system on AMD completion at the time of the HME. Control participants' physicians had access to the computerized decision support system and traditional resources only. All participants who received the packet were sent a follow-up survey. In all, 21.6% of inter... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151579 Sun, 07 Nov 2010 00:00:00 +0100 4151579 http://www.medworm.com/index.php?rid=4151578&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21057142%26dopt%3DAbstract Conclusion: The incidence of hypoalbuminemia in critically ill patients with cancer admitted to ICU was high. PMID: 21057142 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care) The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151578 Sun, 07 Nov 2010 00:00:00 +0100 4151578 http://www.medworm.com/index.php?rid=4151577&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21057143%26dopt%3DAbstract Authors: Hui D, de la Cruz M, Thorney S, Parsons HA, Delgado-Guay M, Bruera E Limited research is available on the frequency of spiritual distress and its relationship with physical and emotional distress. We reviewed patients admitted to our acute palliative care unit (APCU) and determined the association between patient characteristics, symptom severity using the Edmonton Symptom Assessment scale (ESAS), and spiritual distress as reported by a chaplain on initial visit. In all, 50 (44%) of 113 patients had spiritual distress. In univariate analysis, patients with spiritual distress were more likely to be younger (odds ratio [OR] = 0.96, P = .004), to have pain (OR = 1.2, P = .010) and depression (OR = 1.24, P = .018) compared to those without spiritual distress. Spiritual distress wa... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151577 Sun, 07 Nov 2010 00:00:00 +0100 4151577 http://www.medworm.com/index.php?rid=4151576&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21057144%26dopt%3DAbstract Authors: Schulman-Green D, Ercolano E, Lacoursiere S, Ma T, Lazenby M, McCorkle R Institute of Medicine reports have identified gaps in health care professionals' knowledge of palliative and end-of-life care, recommending improved education. Our purpose was to develop and administer a Web-based survey to identify the educational needs of multidisciplinary health care professionals who provide this care in Connecticut to inform educational initiatives. We developed an 80-item survey and recruited participants through the Internet and in person. Descriptive and correlational statistics were calculated on 602 surveys. Disciplines reported greater agreement on items related to their routine tasks. Reported needs included dealing with cultural and spiritual matters and having supportive res... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151576 Sun, 07 Nov 2010 00:00:00 +0100 4151576 http://www.medworm.com/index.php?rid=4151584&cid=s_37390_78_f&fid=37390&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21051782%26dopt%3DAbstract Authors: Shiroma PR, Geda YE, Mohan A, Richardson J Prevalence of treatable depression is as high as 25% among terminally ill patients. The incidence of antidepressant use was ascertained at the Mayo Hospice Program in Rochester, Minnesota, from June 1, 2007, to December 31, 2008. The 18-month cumulative probability to receive an antidepressant during hospice was estimated at 11.7%. Depression and selective serotonin reuptake inhibitors (SSRIs) were the most common clinical indication and class of antidepressant, respectively. Survival was the main predictor to receive an antidepressant with an odds ratio of 2.71 (95%CI: 1.60-4.60) for each additional day in hospice. Proper diagnostic tools for this population, education about the benefits of antidepressants in palliative care, and cle... The American Journal of Hospice and Palliative Care journals http://www.medworm.com/rss/comments.php?id=4151584 Thu, 04 Nov 2010 00:00:00 +0100 4151584