Journal of palliative medicine
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Randomized Controlled Trial Comparative Study
Association between Physician Trainee Self-Assessments in Discussing Religion and Spirituality and Their Patients' Reports.
Effective physician communication at the end-of-life is a cornerstone to providing patient-centered palliative care. Educational programs in physician communication often rely on self-assessments of physician knowledge and attitudes and seldom provide patients' reports. Thus, it is unclear whether physician self-assessments are associated with patient perspectives. ⋯ Physician trainee self-assessments may be a valid surrogate for patient ratings of quality with respect to religious/spiritual communication. This specific domain of physician-patient communication should receive further investigation as our finding contrasts with reports of more general measures of physician-patient end-of-life communication.
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Randomized Controlled Trial Comparative Study
Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.
Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. ⋯ Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.
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Randomized Controlled Trial
A qualitative exploration of the experiences of people living alone and receiving community-based palliative care.
It is projected that in Australia there will be between 28% and 48% of palliative care patients living alone by the year 2031. As such, it will become increasingly important to provide appropriate home-based care in order to support these patients to be cared for and die at home. ⋯ The practice implications for working with people close to death who are living alone are that supports and assistance may be needed to maintain social networks and also a sense of independence.
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Randomized Controlled Trial Multicenter Study
Feasibility and acceptability of a collaborative care intervention to improve symptoms and quality of life in chronic heart failure: mixed methods pilot trial.
People with chronic heart failure (HF) suffer from numerous symptoms that worsen quality of life. The CASA (Collaborative Care to Alleviate Symptoms and Adjust to Illness) intervention was designed to improve symptoms and quality of life by integrating palliative and psychosocial care into chronic care. ⋯ The CASA intervention was feasible based on participant enrollment, cohort retention, implementation of medical recommendations, minimal missing data, and acceptability. Several intervention changes were made based on participant feedback.
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Randomized Controlled Trial
Assessing palliative care unit inpatients for residential aged care placement: is it worth it?
Increasing demand for palliative care unit (PCU) admissions has led to a stronger focus on discharge planning. This has resulted in shorter inpatient length of stays (LOS), and stable patients not requiring specialist palliative care services being referred for placement in residential aged care facilities (RACFs). The process of placement is time-consuming and can be distressing to patients and families, so RACF placement should only be proposed in patients whose prognosis is relatively good (i.e., weeks to months). ⋯ Over one-third of all patients died before discharge to an RACF could take place. The rate of death before discharge was higher among patients who had cancer. Patients suffering from NCSLC need to be more carefully selected for placement as only one-third of these patients survived to discharge.