The American journal of hospice & palliative care
-
Am J Hosp Palliat Care · Apr 2018
Physicians Perceptions of Shared Decision-Making in Neonatal and Pediatric Critical Care.
Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. ⋯ Due to power imbalances, families' values and preferences may not be integrated in decisions or families may be excluded from discussions about goals of care. We suggest that a systematic approach to identify parental preferences and needs for decisional roles and information may reduce variability in parental involvement.
-
Am J Hosp Palliat Care · Mar 2018
Factors Associated With End-of-Life Planning in Huntington Disease.
Knowledge of one's gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample. ⋯ Health-care providers should develop specific interventions early in the disease process to increase ADs in this population.
-
Am J Hosp Palliat Care · Mar 2018
Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians.
Family conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present. ⋯ Pediatric ICU physicians spend more time giving medical information, whereas the PC team more commonly offers emotional support. The addition of the PC team to ICU family conferences may provide a balanced approach to communication.
-
Am J Hosp Palliat Care · Mar 2018
ReviewToward Mentoring in Palliative Social Work: A Narrative Review of Mentoring Programs in Social Work.
Mentoring by an experienced practitioner enhances professional well-being, promotes resilience, and provides a means of addressing poor job satisfaction and high burnout rates among medical social workers. This is a crucial source of support for social workers working in fields with high risk of compassion fatigue and burnout like palliative care. Implementing such a program, however, is hindered by differences in understanding and application of mentoring practice. ⋯ Common themes in prevailing mentoring practices help identify key elements for the design of an effective mentoring program in medical social work. We conclude with a discussion of the implications of these findings upon clinical practice in palliative care and on sustaining such a program.
-
Am J Hosp Palliat Care · Mar 2018
Pilot Study of an Interprofessional Palliative Care Curriculum: Course Content and Participant-Reported Learning Gains.
The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines recommend that palliative care clinicians work together as interprofessional teams. We created and piloted a 9-month curriculum that focused on 3 related domains: (1) patient-centered, narrative communication skills; (2) interprofessional team practice; and (3) metrics and systems integration. The multifaceted curriculum was delivered through 16 webinars, 8 online modules, 4 in-person workshops, reflective skill practice, written reflections, and small group online discussions. ⋯ This curriculum demonstrated success in increasing perceived skills for interprofessional palliative care clinicians in advanced communication, team practice, and metrics and system integration.