Journal of palliative medicine
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Randomized Controlled Trial
A Longitudinal Examination of Quality of Life of Older Adults with Complicated Grief Receiving Accelerated Resolution Therapy.
Objective: To examine the effect of Accelerated Resolution Therapy (ART) on the quality of life (QOL) of older adults with complicated grief (CG) over time. Design: Subanalysis of a randomized controlled trial. Setting/Subject: Older adult, former caregivers were recruited from a large hospice in the southeastern United States to be treated with ART for CG. ⋯ Both the intervention (11%, p = 0.013) and time (7.8%, growth curve p = 0.014) contributed significantly. Conclusion: There was a significant large effect of ART on CG. This study supports concurrent improved patient-related outcome-QOL.
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Background: During the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City, COVID-19 hospitalization was associated with high mortality. It is unknown how palliative care was utilized in this context. Objectives: To describe the frequency of palliative care consultation and its association with end-of-life care for deceased patients with COVID-19. ⋯ Palliative care consultation was associated with fewer invasive procedures (0, IQR 0-2, vs. 2, IQR 0-3, p < 0.01), less mechanical ventilation (32 patients, 29.9% vs. 65 patients, 67.7%, p < 0.01), and fewer ICU admissions (33 patients, 30.8% vs. 69 patients, 71.9%, p < 0.01). Palliative care was associated with shorter ICU stays (0 days, IQR 0-4, vs. 4 days, IQR 0-12, p < 0.01), whereas hospital stays did not differ significantly (8 days, IQR 5-12.5, vs. 10 days, IQR 5-16.3, p = 0.15). Conclusion: Palliative care was consulted for roughly half of deceased patients with COVID-19 and those patients were less likely to undergo invasive procedures or life-sustaining treatments and spent less time in the ICU at the end of life.
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Multicenter Study Observational Study
Hydration Volume Is Associated with Development of Death Rattle in Patients with Abdominal Cancer.
Background: Death rattle occurs frequently in dying patients with malignancies. The association the between hydration volume and death rattle development is controversial. Design and Setting: A secondary analysis using data from two multicenter prospective observational studies, including a total of 471 consecutive advanced cancer patients. ⋯ The prevalence of death rattle was significantly higher in those receiving artificial hydration >500 mL/day than those receiving ≤500 mL/day (23.1% vs. 13.6%, respectively; adjusted odds ratio: 2.56; 95% confidence interval: 1.37-4.80; p = 0.0036). Conclusion: The hydration volume might be associated with death rattle development in patients with abdominal malignancies. Volume reduction may alleviate or prevent death rattle.