The American Journal of Hospice and Palliative CareThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

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29 records returned

Review Article: Goals of Care Toward the End of Life: A Structured Literature Review.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Goals of care are often mentioned as an important component of end-of-life discussions, but there are diverse assessments regarding the type and number of goals that should be considered. To address this lack of consensus, we searched MEDLINE (1967-2007) for relevant articles and identified the number, phrasing, and type of goals they addressed. An iterative process of categorization resulted in a list of 6 practical, comprehensive goals: (1) be cured, (2) live longer, (3) improve or maintain function/quality of life/ independence, (4) be comfortable, (5) achieve life goals, and (6) provide support for family/caregiver...
Source: The American Journal of Hospice and Palliative Care - December 26, 2008 Category: Palliative Care Authors: Kaldjian LC, Curtis AE, Shinkunas LA, Cannon KT Tags: Am J Hosp Palliat Care Source Type: journals

Malignant Irreversible Intestinal Obstruction : The Powerful Association of Octreotide to Corticosteroids, Antiemetics, and Analgesics.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the case of malignant intestinal obstruction, surgery often carries important mortality and morbidity risks, and feasibility is neither realistic nor reasonable. A total of 4 clinical cases of intestinal obstruction caused by advanced gastrointestinal cancers in their terminal phase are described. The association of analgesics, corticosteroids, antiemetics, and octreotide was effective to relieve symptoms of intestinal obstruction for the remaining lifetime. The insertion of a nasogastric tube was avoided in 3 of 4 cases. Death occurred 51, 56, and 64 days after clinical and radiological diagnosis of irreversible in...
Source: The American Journal of Hospice and Palliative Care - December 16, 2008 Category: Palliative Care Authors: Zulian GB, Weber C Tags: Am J Hosp Palliat Care Source Type: journals

The Meaning of the Music: The Role of Music in Palliative Care Music Therapy as Perceived by Bereaved Caregivers of Advanced Cancer Patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, the role of music in palliative care music therapy is examined and representatively summarized, followed by a review of strategies provided by this author to home hospice patients and their caregivers. The reported perceptions of the meaning of music to 7 bereaved caregivers are presented, including a review of themes and associated narrations that illustrated its significance. The caregivers described these aspects of music in sessions to have memorable and lasting effects as follows: "music is a conduit," "music gets inside us," "live music makes a difference," and "music is love." Findings support the ben...
Source: The American Journal of Hospice and Palliative Care - December 1, 2008 Category: Palliative Care Authors: Magill L Tags: Am J Hosp Palliat Care Source Type: journals

Developing a Pediatric Palliative Care Program: Addressing the Lack of Baseline Expenditure Information.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aims to estimate predicted health care expenditures for Medicaid-eligible infants and children across several health service categories. Across these categories, infants and children were predicted to spend about US$110 000 and US$62 000 at the end of life, respectively. About 5% of infants and 8% of children incurred hospice expenditures. Results from the multivariate models suggest that black, non-Hispanic children are less likely than white, non-Hispanic children to use hospice care. Baseline expenditure information from this study can be used to develop integrated pediatric palliative care models. Our findin...
Source: The American Journal of Hospice and Palliative Care - December 1, 2008 Category: Palliative Care Authors: Knapp CA, Thompson LA, Vogel WB, Madden VL, Shenkman EA Tags: Am J Hosp Palliat Care Source Type: journals

Imagine You Are Dying: Would You Be Interested in Having a Hospice Palliative Care Volunteer?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A community sample of 100 adults was asked to imagine that they had been recently diagnosed with a life-threatening illness. After reading about the services provided by hospice palliative care volunteers, participants were asked whether they would choose to have a volunteer help them and to give a reason for their answer. Eighty-nine of the 100 participants indicated that they would use the help of a volunteer. The most commonly given reasons for utilizing a volunteer included for the general support they provide, help with practical things, and lack of family nearby; reasons given for declining the services of a volu...
Source: The American Journal of Hospice and Palliative Care - December 1, 2008 Category: Palliative Care Authors: Claxton-Oldfield S, Gosselin N, Claxton-Oldfield J Tags: Am J Hosp Palliat Care Source Type: journals

Effectiveness of an Integrated Ward-based Program in Preparing Medical Students to Care for Patients at the End of Life.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Integrating end-of-life care training into the clinical years of medical school has been promoted to enhance education in this area. To assess the effectiveness of an end-of-life care exercise integrated into clinical clerkships, we compared the level of preparedness in end-of-life care reported by students who did or did not complete the exercise. A greater proportion of students who completed the exercise compared with those who did not felt prepared in end-of-life care [50.7% (39/77) vs 35.6% (64/180); P = .02]. Among 5 domains of skills examined, significant differences were seen in interviewing/communicating (3.7 ...
Source: The American Journal of Hospice and Palliative Care - October 27, 2008 Category: Palliative Care Authors: Ellman MS, Rosenbaum JR, Cherlin E, Bia M Tags: Am J Hosp Palliat Care Source Type: journals

Hospitalization Pattern in a Hospital-based Palliative Care Program: An Example From Saudi Arabia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The few palliative care programs available to date in Saudi Arabia are largely hospital-based. Subacute palliative care models have not been developed yet. This retrospective review was conducted to assess the patterns and outcomes of hospital-based palliative care unit admissions in the absence of subacute palliative care models. We reviewed 759 eligible palliative care unit admissions related to 629 cancer patients during a 4-year period. Of all admissions, 66% were hospitalized through the emergency room. The average hospital stay was 24 days. The majority (86%) of patients died in-hospital. These results suggest th...
Source: The American Journal of Hospice and Palliative Care - October 22, 2008 Category: Palliative Care Authors: Alsirafy SA, Hassan AA, Al-Shahri MZ Tags: Am J Hosp Palliat Care Source Type: journals

Advance Directives in Nursing Home Residents Aged >= 65 Years: United States 2004.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This report defines documentation of advance directives in a nationally representative survey of US nursing home residents aged >/=65 years in 2004, as well as advance directive use in relation to demographic factors and receipt of specialty services including hospice/palliative care. In 2004, advance directives were documented in 69.9% of US nursing home residents aged >/=65 years and in 93.6% of residents receiving hospice/palliative care. Documentation of advance directives increased substantially between 1996 and 2004 and is nearly universal among residents receiving hospice/palliative care services. However in 2...
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Resnick HE, Schuur JD, Heineman J, Stone R, Weissman JS Tags: Am J Hosp Palliat Care Source Type: journals

Pilot Testing of a Question Prompt Sheet to Encourage Family Caregivers of Cancer Patients and Physicians to Discuss End-of-life Issues.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Family members of patients with advanced illness have many questions. Unfortunately, several barriers prevent caregivers from discussing their questions with the physicians caring for the patient. Although question prompt sheets can be helpful in overcoming barriers to communication, few have been developed for family caregivers. The goal of this study, therefore, was to develop and test the acceptability and feasibility of a short question prompt sheet designed to encourage discussions about end-of-life concerns in an outpatient palliative care clinic. Our results demonstrated that caregivers wanted to discuss a varie...
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Hebert RS, Schulz R, Copeland VC, Arnold RM Tags: Am J Hosp Palliat Care Source Type: journals

Making the Healing Difference: Guilt and Regret.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18843135 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Cox J Tags: Am J Hosp Palliat Care Source Type: journals

Assessing Advance Directives in the Homebound Elderly.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We studied the prevalence of specific barriers that prevent indigent homebound older adults from obtaining advance directives and tested the effectiveness of clinical reminders for lowering the number of clients without advance directives. Case managers interviewed 1569 clients to determine whether they had an advance directive. All 530 clients without advance directives were contacted 3 months later to determine if advance directives had been obtained. Clients who still did not have advance directives were asked to list 1 or more reasons they did not have advance directives. About 57.8% of the barriers identified may ...
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Golden AG, Corvea MH, Dang S, Llorente M, Silverman MA Tags: Am J Hosp Palliat Care Source Type: journals

Evidence-based Medicine: Show Me the Evidence!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18843137 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Rousseau P Tags: Am J Hosp Palliat Care Source Type: journals

Long-term Silicone Urinary Catheter Is a Simpler Alternative to Radical Bilateral Percutaneous Nephrostomy for Palliation of Malignant Vesicouterine Fistula.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18843138 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Gupta D, Sharma SK, Khurana H, Mishra S, Bhatnagar S Tags: Am J Hosp Palliat Care Source Type: journals

Word Choices of Advanced Cancer Pain Patients: Frequency of Nociceptive and Neuropathic Pain.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study provided evidence that advanced cancer patients select words that describe nociceptive and neuropathic pain types. PMID: 18843139 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - October 8, 2008 Category: Palliative Care Authors: Dobratz MC Tags: Am J Hosp Palliat Care Source Type: journals

Telehospice Acceptance Among Providers: A Multidisciplinary Comparison.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study measured telehospice acceptance in a national sample of hospice professionals from various disciplines (N = 160). Results indicate that acceptance was moderately high overall, although significant differences existed among individuals from different disciplines, with nurses and administrators generally indicating higher levels of acceptance than social workers and chaplains. Findings demonstrate that telehospice interventions will likely be more readily accepted by nursing and administrative staff members, while those employees who address primarily psychosocial issues may be reluctant to use such technology. ...
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Washington KT, Demiris G, Oliver DP, Day M Tags: Am J Hosp Palliat Care Source Type: journals

Pain Management Practices by Internal Medicine Residents - A Comparison Before and After Educational and Institutional Interventions.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We aimed to improve internal medicine residents' deficiencies in pain management and evaluate the effectiveness of our intervention, which included an interactive conference series, e-mail vignettes, and didactic sessions. An anonymous survey was administered at the beginning and at the end of an academic year, before and after the intervention, respectively. We analyzed 65 preintervention and 63 postintervention surveys. Self-perception of competency in pain management increased from 40% to 60% (P = .02). Perception of adequacy of training increased from 38.5% to 55.6% (P = .05). Opioid conversion skills improved by 2...
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Scott E, Borate U, Heitner S, Chaitowitz M, Tester W, Eiger G Tags: Am J Hosp Palliat Care Source Type: journals

Comorbidities in a Cancer Patient: Problems in Pain Management and Palliation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pain management and palliation face a great challenge with inclusion of the palliation teams from the earliest phases of diagnosis. The presented case report highlights that early inclusion of pain and palliative physicians in patient care demands comprehensive evaluation of the symptoms by the palliative physicians with possibly curable comorbid conditions requiring active and aggressive curative management. In summary, it is crucial for the treating palliative physician to be more proactive in the management of comorbid treatable conditions in a patient who may be an established case of advanced stage cancer. PMI...
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Bhatnagar S, Das SC, Khurana H, Gupta D, Mishra S Tags: Am J Hosp Palliat Care Source Type: journals

The Use of Pediatric Advance Directives: A Tool for Palliative Care Physicians.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although laws such as the Patient Self-Determination Act encourage individuals to address their end-of-life treatment preferences using advance directives, the wishes of children have traditionally been ignored or, perhaps even worse, overruled. Given that there is a substantial body of research indicating that children are capable of making mature decisions when faced with terminal illness, the author proposes granting minors, especially older minors, the right to participate in making end-of-life decisions. Children who complete advance directives benefit in multiple ways. Adopting this approach could benefit patient...
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Zinner SE Tags: Am J Hosp Palliat Care Source Type: journals

Management of Patients with ICDs at the End of Life (EOL): A Qualitative Study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions. Improving the end of life care for patients with implantable cardioverter defibrillators will require additional physician education and increased commitment by subspecialists to deactivation discussions. PMID: 18812618 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Kelley AS, Mehta SS, Reid MC Tags: Am J Hosp Palliat Care Source Type: journals

End-of-Life Care Curricula in Undergraduate Medical Education: A Comparison of Allopathic and Osteopathic Medical Schools.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
End-of-life care curricula in osteopathic medical schools were compared with allopathic school offerings. An 8question online survey of undergraduate medical education administrators at all United States osteopathic medical schools (n = 26) and 26 allopathic schools geographically closest to them was conducted in 2007. Responses from 80% (n = 21) of osteopathic schools and 77% (n = 20) of allopathic schools revealed that both osteopathic and allopathic medical schools offered end-oflife care education. Of note is that 71% of the osteopathic medical school respondents had a course that concentrates on end-of-life care c...
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Rothman MD, Gugliucci MR Tags: Am J Hosp Palliat Care Source Type: journals

Uncovering Beliefs and Barriers: Staff Attitudes Related to Advance Directives.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although the 1990 Patient Self-determination Act was enacted to insure that patients' wishes regarding advance directives were known and respected, it has had little impact in quality or aggressiveness of care for patients nearing death. The purpose of this descriptive study was to explore staff attitudes related to Advance Directives. A short survey was distributed to 650 hospital, home care, hospice, assisted living, and long term professional and staff members. Analysis was completed on 413 surveys (return rate 63.3%). Findings suggest that although staff members believe that Advance Directives are an important tool...
Source: The American Journal of Hospice and Palliative Care - September 23, 2008 Category: Palliative Care Authors: Bergman-Evans B, Kuhnel L, McNitt D, Myers S Tags: Am J Hosp Palliat Care Source Type: journals

Empathy.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18768424 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Rousseau P Tags: Am J Hosp Palliat Care Source Type: journals

Intravenous morphine can avoid distressing constipation associated with oral morphine: a retrospective analysis of our experience in 11 patients in the palliative care in-patient unit.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Morphine is the preferred strong opioid analgesic. Most of the adverse effects, such as daytime drowsiness, dizziness, mental clouding, and effects on cognitive and psychomotor function or nausea and vomiting, usually resolve with time. The main continuing adverse effect of morphine is constipation, and prophylactic use of laxative is almost always required. We are presenting retrospective data of 11 patients admitted in our palliative care unit over the past 5 months for new (not yet received any opioid analgesic in any form) and severe cancer pain management. It was found that none of the patients was having constipa...
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Mazumdar A, Mishra S, Bhatnagar S, Gupta D Tags: Am J Hosp Palliat Care Source Type: journals

Shackled: the challenge of caring for an incarcerated patient.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hospice care for inmates is widely recognized as an important way of providing efficient, cost-effective palliative care to a growing number of dying inmates. The case presented here is of a 34-year-old inmate who was admitted to a tertiary-care hospital for diagnostic tests and treatment of non-small cell lung cancer. While he was in the hospital, his clinical status rapidly deteriorated and it was clear that palliative care was most appropriate. Prison restrictions prevented the health care team from sharing the patient's clinical status with his family. He was forbidden many interventions that would have improved hi...
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Courtwright A, Raphael-Grimm T, Collichio F Tags: Am J Hosp Palliat Care Source Type: journals

Beyond the urns.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18768427 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Wyatt T Tags: Am J Hosp Palliat Care Source Type: journals

Give me.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18768428 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Wyatt T Tags: Am J Hosp Palliat Care Source Type: journals

Nocturne.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18768429 [PubMed - in process] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Wyatt T Tags: Am J Hosp Palliat Care Source Type: journals

Review Article: End-of-Life Care for Old People: A Review of the Literature.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The aim of this study was to make an inventory of various aspects of end-of-life care of the old people. An additional aim was to illuminate gaps in existing knowledge. A systematic literature review focusing on intervention studies was carried out. Three concepts were of special interest: end-of-life care, palliative care, and terminal care. The result encompassed 29 studies, and the articles were grouped together under 4 headings: education and support for close relatives, education and support for staff, education and support for patients, and articles dealing with care planning. The result highlights the need for f...
Source: The American Journal of Hospice and Palliative Care - August 1, 2008 Category: Palliative Care Authors: Agren Bolmsjo I Tags: Am J Hosp Palliat Care Source Type: journals

Palliative Care in Japan: Current Status and a Nationwide Challenge to Improve Palliative Care by the Cancer Control Act and the Outreach Palliative Care Trial of Integrated Regional Model (OPTIM) Study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the current status and the problems of palliative care in Japan and introduces the OPTIM study. Although the number of palliative care services is increasing, empirical evidence shows the quality of life of cancer patients is still inadequate. The OPTIM study is an intervention trial targeting 4 areas across Japan. Primary end points are quality of care reported by patients as well as the bereaved family, number of patients who received specialized palliative care services, and place of death. The interventions are comprehensively designed to cover all areas identified by the national task force. The O...
Source: The American Journal of Hospice and Palliative Care - July 3, 2008 Category: Palliative Care Authors: Yamagishi A, Morita T, Miyashita M, Akizuki N, Kizawa Y, Shirahige Y, Akiyama M, Hirai K, Kudo T, Yamaguchi T, Fukushima A, Eguchi K Tags: Am J Hosp Palliat Care Source Type: journals