Journal of palliative medicine
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Randomized Controlled Trial
Using Nurse Ratings of Physician Communication in the ICU to Identify Potential Targets for Interventions to Improve End-of-Life Care.
Communication among doctors, nurses, and families contributes to high-quality end-of-life care, but is difficult to improve. ⋯ Several topics of physician-nurse communication, as rated by nurses, were associated with higher nurse-rated quality of dying, whereas one topic, nurses' concerns for patient or family, was associated with poorer ratings. Higher nurse ratings of physician-family communication were uniformly associated with higher quality of dying, highlighting the importance of this communication. Physician support of family decision making was particularly important, suggesting a potential target for interventions to improve end-of-life care.
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Randomized Controlled Trial
A Pilot Feasibility Intervention to Increase Advance Care Planning among African Americans in the Deep South.
Despite growing efforts to facilitate advance care planning (ACP) to decrease health disparities in palliative care, low completion rates of advance directives (AD) have been consistently found among African Americans. ⋯ Feasibility data revealed successful implementation of a brief intervention to increase ACP engagement and willingness to complete an AD among southern African Americans.
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Randomized Controlled Trial Multicenter Study
Gender Differences in Caregiving at End of Life: Implications for Hospice Teams.
Researchers have identified important gender differences in the experience of caring for a family member or friend living with advanced disease; however, trends suggest that these differences may be diminishing over time in response to changing gender roles. In addition, while many studies have found caregiving experiences and outcomes to be poorer among female caregivers, noteworthy exceptions exist. ⋯ Despite changing social expectations, pronounced gender differences persist in caregiving at the end of life.
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Randomized Controlled Trial Multicenter Study
Have We Improved Pain Control in Cancer Patients? A Multicenter Study of Ambulatory and Hospitalized Cancer Patients.
Pain in cancer patients is recognized as a major health problem, yet few studies of both inpatient and outpatient populations have been carried out. ⋯ Pain in cancer patients, both ambulatory and hospitalized, remains a challenge for health care professionals, health administrators, and stakeholders. Our study reveals the high level of pain and distress that cancer patients continue to suffer, a problem that is particularly notable in outpatients due to the intensity and duration of the pain.
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Randomized Controlled Trial Multicenter Study
An Advanced Practice Nurse Coordinated Multidisciplinary Intervention for Patients with Late-Stage Cancer: A Cluster Randomized Trial.
Early palliative care provided through a palliative care consultative service is effective in enhancing patient outcomes. However, it is unknown whether the integration of palliative care as part of routine comprehensive cancer care improves patients' self-reported clinical outcomes. ⋯ In this translational study, we demonstrated that if patients newly diagnosed with late-stage cancer were managed by disease-specific multidisciplinary teams who palliated their symptoms, providing whole-patient care, patient outcomes remained stable or improved.