Articles: palliative-care.
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Discussing difficult and personal topics is not new to those practicing palliative care. Specialty-level consultation is often sought to facilitate complex and uncomfortable conversations on death and dying. Palliative care (PC) providers focus on patient and family needs through the lens of whole-person care. ⋯ PC providers are recognized communication experts, although current curricula offer little training on how to incorporate discussions regarding this important aspect of personhood. Using case discussions, we offer strategies for examining sexuality and incorporating sex-positive interventions into practice. By highlighting how sexuality and PC intersect, we hope to foster a community of interdisciplinary PC providers who practice what we have termed sex-positive palliative care.
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Background: Much end-of-life care is provided in hospital, yet little is known about the delivery of palliative care during end-of-life hospitalizations. Objectives: To characterize the level of palliative care involvement across hospitalizations in the last year of life. Methods: A population-based retrospective cohort study of adults in Ontario, Canada, who died between April 1, 2012, and March 31, 2017, and had at least one acute care hospitalization in their last year of life. ⋯ Most hospitalizations with palliative care involvement (85.6%) occurred in the two months before death. Compared to patients who received no inpatient palliative care, patients who received a high level of palliative care involvement tended to be younger, died of cancer, resided in urban or lower income neighborhoods, and had fewer chronic conditions. Discussion: While many hospitalizations occurred in the last year of life, the majority did not involve palliative care, and very few had a high level of palliative care involvement.
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J Pain Symptom Manage · Jul 2021
Narrative Approach to Goals of Care Discussions: Adapting the 3-Act Model Training to an Online Format.
The three-Act Model, a narrative approach to goals of care (GOC) discussions centered on patients' individual stories, has proven to be effective as measured by objective skill improvement among medical trainees. This study describes the adaptation of the in-person curriculum to a streamlined, online format, in the setting of the Covid19 pandemic. We hypothesized that high levels of skill proficiency and learner satisfaction observed in previous in-person cohorts would be sustained amongst trainees in the online setting. ⋯ After completing the adapted online three-Act Model training, nearly all learners were scored to be proficient in GOC communication skills and reported high satisfaction with the online curriculum. Achieving high quality more efficiently represents genuine educational value. Further, these online teaching results show that the three-Act Model training can be delivered to geographically distanced learners.
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Since the amendments to the Regulation of Patients' Rights in May 2014, the concept of euthanasia and the validity of the decisions taken towards the end of life have been protected by the "Regulation Amending the Regulation of Patients' Rights." This research study was carried out using a triple Likert scale to record the opinions of patients, who were staying at the University Hospital, and doctors and nurses on the issues of the "euthanasia ban" and "taking personal decisions and requests into an account." ⋯ It was found that more than half of the doctors, nurses, and patients expressed that it is important for a patient to have the right to make decisions regarding his/her own life. FNx01This was presented as an Oral Presentation at the 7th National Congress of Ethics and Medical Law on March 21, 2017.