Journal of palliative medicine
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Multicenter Study
Impact of Immigrant Status on Aggressive Medical Care Counter to Patients' Values Near Death among Advanced Cancer Patients.
Little is known about disparities in end-of-life (EoL) care between U.S. immigrants and nonimmigrants. ⋯ Immigrant, as compared with nonimmigrant, advanced cancer patients are not only more likely to receive aggressive EoL care, but also more likely to receive care counter to their wishes. These findings indicate potential disparities in, rather than differences in preference for, aggressive care and a need for further investigation into potential causes of these disparities.
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Multicenter Study
Bereavement Challenges and Their Relationship to Physical and Psychological Adjustment to Loss.
The psychosocial challenges confronted by bereaved survivors may contribute to poor bereavement adjustment. Measures of the challenges of bereavement are limited. This study is a preliminary examination of the factor structure of a new measure of bereavement challenges and their relationships to quality of life and mental illness in bereaved cancer caregivers. This measure was designed to identify intervention targets to reduce the likelihood of prolonged grief. ⋯ Assessing the challenges associated with bereavement is important to understanding barriers to bereaved individuals' adjustment. The five factors of the BCS point to potential targets for clinical intervention. Additional research on the BCS is needed, including validation in larger more diverse samples, and confirmation that reduction of these challenges is associated with less psychiatric morbidity and, specifically, symptoms of prolonged grief.
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Multicenter Study
Associations between Mild Cognitive Dysfunction and End-of-Life Outcomes in Patients with Advanced Cancer.
Cognitive function of patients with advanced cancer is frequently compromised. ⋯ Patient cognitive screening scores were associated with EoL outcomes. Rather than avoid patients who are cognitively impaired, oncologists should consider ACP with them.
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Multicenter Study Observational Study
Distress Due to Prognostic Uncertainty in Palliative Care: Frequency, Distribution, and Outcomes among Hospitalized Patients with Advanced Cancer.
Prognostic uncertainty is common in advanced cancer and frequently addressed during palliative care consultation, yet we know little about its impact on quality of life (QOL). ⋯ Prognostic uncertainty is a prevalent source of distress among hospitalized patients with advanced cancer at the time of initial palliative care consultation. Distress from prognostic uncertainty is associated with lower levels of preconsultation QOL and with greater pre-post consultation improvement in the QOL.
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Multicenter Study
Pharmacovigilance in Hospice/Palliative Care: Net Effect of Haloperidol for Nausea or Vomiting.
Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. ⋯ Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms.