The American journal of hospice & palliative care
-
Am J Hosp Palliat Care · Mar 2020
Multicenter StudyPrevalence and Predictors of Distress, Anxiety, Depression, and Quality of Life in Bereaved Family Caregivers of Patients With Advanced Cancer.
To investigate prevalence and predictors of postloss distress, depressive and anxiety symptoms, and quality of life among bereaved family caregivers of patients with advanced cancer. ⋯ Preloss mental burden showed to be a consistent predictor for postloss burden and should be addressed during palliative care. Future research should examine specific caregiver-directed interventions during specialist palliative care.
-
Am J Hosp Palliat Care · Aug 2019
Multicenter StudyTrauma Surgeon and Palliative Care Physician Attitudes Regarding Goals-of-Care Delineation for Injured Geriatric Patients.
The value of defining goals of care (GoC) for geriatric patients is well known to the palliative care community but is a newer concept for many trauma surgeons. Palliative care specialists and trauma surgeons were surveyed to elicit the specialties' attitudes regarding (1) importance of GoC conversations for injured seniors; (2) confidence in their own specialty's ability to conduct these conversations; and (3) confidence in the ability of the other specialty to do so. ⋯ Both groups believe themselves to conduct GoC discussions for injured seniors better than the other specialty perceived them to do so, which led to disparate views on the optimal leadership of these discussions.
-
Am J Hosp Palliat Care · Mar 2019
Multicenter StudyA Retrospective Chart Review of Transfusion Practices in the Palliative Care Unit Setting.
There remains limited data in the literature on the frequency, clinical utility and effectiveness of transfusions in palliative care, with no randomized controlled trials or clinical practice guidelines on this topic. There are no routinely accepted practices in place for the appropriate transfusion of blood products in this setting. ⋯ Transfusions in the palliative care units were infrequent, symptom targeted, and well tolerated, though the lack of standardized pre/post assessment tools limits any ability to draw conclusions about utility. Patients would benefit from additional research in this area and the development of clinical practice guidelines for transfusions in palliative care.
-
Am J Hosp Palliat Care · Jan 2019
Multicenter StudySeeing the Patient and Family Through: Nurses and Physicians Experiences With Withdrawal of Life-Sustaining Therapy in the ICU.
Withdrawal of life-sustaining therapy at the end of life is a complex phenomenon. Intensive care nurses and physicians are faced with caring for patients and supporting families, as these difficult decisions are made. The purpose of this study was to explore and describe the experience of critical care nurses and physicians participating in the process of withdrawal of life-sustaining therapy. ⋯ The main categories that were inductively derived from the data analysis included from novice to expert, ensuring ethical care, uncertainty to certainty, facilitating the process, and preparing and supporting families. The categories aided in understanding the experiences of nurses and physicians, as they worked individually and together to see patients and families through the entire illness experience, withdrawal of life-sustaining therapy decision-making process and dying process. Understanding the perspectives of health-care providers involved in the withdrawal of life-sustaining therapy process will help other health-care providers who are striving to provide quality care to the dying and to their families.
-
Am J Hosp Palliat Care · Sep 2018
Randomized Controlled Trial Multicenter StudyFamily Caregivers' Characterization of Conversations Following an ACP Event.
Advance care planning (ACP) has been shown to benefit patients and families, yet little is known about how an ACP event impacts communication and conversation about end-of-life treatment wishes and the content of such conversations between patients and family caregivers. ⋯ The ACP events promote conversation regarding quality of life, general wishes at the end of life, and specific medical wishes. Barriers to conversation following ACP were similar to barriers to ACP in general, suggesting that a more intentional focus on addressing these barriers pre- and post-ACP may be necessary to improve communication.