Journal of palliative medicine
-
Multimodal curricular assessment after adding standardized patient (SP) actor-based simulation to an advance care planning (ACP) facilitator training course and development of a formative feedback tool. ⋯ Learner feedback and self-assessment suggest that actor-based simulation contributed to improved confidence in conducting ACP. The mini-CEX observation form is adequate for formative feedback, with further testing needed to make judgments of competence.
-
Increasing longevity for Inuit living in Nunavik, northern Quebec, has resulted in heightened rates of cancers and chronic diseases necessitating complex treatments. Consequently, end-of-life (EOL) care, once the domain of Inuit families and communities, has come to include professionalized healthcare providers with varying degrees of awareness of factors to consider in providing care to Inuit populations. ⋯ Building a sustainable model of EOL care requires respectful collaboration among governing structures, healthcare institutions, and community members. It must centrally value local knowledge and initiatives. To ensure Inuit families and patients are supported throughout the dying process, future initiatives must centrally include local stakeholders in both the design and evaluation of any changes to the current healthcare system.
-
While effective communication is important in the care of seriously ill patients, little is known about communication challenges faced by healthcare providers serving U.S. patients of South Asian origin, one of the fastest growing demographic groups in the United States. ⋯ While providers should avoid stereotyping patients, an awareness of common challenges and adoption of recommended strategies to address these challenges may enhance the provision of culturally responsive person-centered services for seriously ill South Asian patients and their families receiving care in the United States.
-
Methadone has been associated with lower overall survival (OS) in patients with chronic pain. There are no data available on the association of methadone with OS in cancer patients. ⋯ We observed no significant difference in OS in cancer patients in methadone group compared to other opioids.