Articles: caregivers.
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Multicenter Study Comparative Study
Cardiometabolic effects in caregivers of nursing home placement and death of their spouse with Alzheimer's disease.
To test the hypothesis that cardiometabolic risk is attenuated when caregivers are relieved of caregiving stress when the caregiving recipient transitions out of the home. ⋯ High cardiometabolic risk in caregivers decreased to the level of that of noncaregivers within 3 months of death of the spouse with AD, although placement, a transition in the course of dementia caregiving, did not benefit cardiovascular health in highly distressed caregivers.
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Critical care medicine · Aug 2011
Multicenter Study Comparative StudyConstructing the illness narrative: a grounded theory exploring patients' and relatives' use of intensive care diaries.
After a stay in the intensive care unit, patients risk experiencing delusional memories, memory loss, and symptoms of posttraumatic stress. Since the 1990s, diaries have been kept for intensive care unit patients to help fill in memory gaps, aid psychosocial recovery, and improve health-related quality of life. More insight is needed into the application of diaries. The aim of our study was to explore how patients and relatives use diaries in the context of the illness trajectory. ⋯ Intensive care diaries are useful to patients as well as their relatives. Patients need to construct their illness narrative, and diaries are among the sources they use. The patients' project was to combine various sources of information in a process of information acquisition, narration, and evolving insight progressing toward recovery. The relatives supported the patients' project and also supported themselves by using the diary to uphold their own healing process. We recommend intensive care diaries as a low-technology, low-cost rehabilitative intervention for patients and relatives to help bridge the span from intensive care to recovery.
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Whereas most studies have focused on euthanasia and physician-assisted suicide, few have dealt comprehensively with other critical interventions administered at the end of life. We surveyed cancer patients, family caregivers, oncologists and members of the general public to determine their attitudes toward such interventions. ⋯ Although the various participant groups shared the same attitude toward futile and ameliorative end-of-life care (the withdrawal of futile life-sustaining treatment and the use of active pain control), oncologists had a more negative attitude than those in the other groups toward the active ending of life (euthanasia and physician-assisted suicide).
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To examine family member's perceptions of decision-making and outcomes of feeding tubes. ⋯ Based on the perceptions of bereaved family members, important opportunities exist to improve decision-making in feeding tube insertion.
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Randomized Controlled Trial Multicenter Study
Improving hospice outcomes through systematic assessment: a clinical trial.
Systematic assessment is vital to palliative care, but documentation confirming completion of systematic assessment in hospice settings is often inadequate or absent. ⋯ Systematic assessment of depression is needed in hospice patients. No caregiver variables changed, which may indicate a need for a focus on caregivers.