American Journal of Hospice and Palliative Medicine This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Adjusting Bowel Regimens When Prescribing Opioids in Women Receiving Palliative Care in the Acute Care Setting
In palliative medicine, constipation is the third most common symptom after pain and anorexia, causing some patients to discontinue opioid therapy. Women experience higher incidence of constipation than men. The prevalence of infrequent bowel movements (<3 times/wk) and adherence to an established bowel regimen among women receiving opioids were studied. Referral to the palliative care team decreased the prevalence of infrequent bowel movements from 72% to 45%, and algorithm adherence increased from 38% to 78%. Education of oncology nurses decreased the prevalence of infrequent bowel movements among patients with cancer...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Gonzales, L. K., Delmastro, M. A., Boyd, D. M., Sterling, M. L., Aube, P. A., Le, R. N., Traucht, L., Quinal, L. R., Georges, J. M., Glaser, D. N. Tags: Original Articles Source Type: research

Emergency Department Visits at the End of Life of Patients With Terminal Cancer: Pattern, Causes, and Avoidability
Frequent emergency department visits (EDVs) by patients with terminal cancer indicates aggressive care. The pattern and causes of EDVs in 154 patients with terminal cancer were investigated. The EDVs that started during working hours and ended by home discharge were considered avoidable. During the last 3 months of life, 77% of patients had at least 1 EDV. In total, 309 EDVs were analyzed. The EDVs occurred out of hour in 67%, extended for an average of 3.6 hours, and ended by hospitalization in 52%. The most common chief complaints were pain (46%), dyspnea (13%), and vomiting (12%). The EDVs were considered avoidable in 1...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Alsirafy, S. A., Raheem, A. A., Al-Zahrani, A. S., Mohammed, A. A., Sherisher, M. A., El-Kashif, A. T., Ghanem, H. M. Tags: Original Articles Source Type: research

Trends in Engagement in Advance Care Planning Behaviors and the Role of Socioeconomic Status
We investigated the trends in advance care planning (ACP) between 2002 and 2010 and whether socioeconomic status explained such trends. We conducted a pooled regression analysis of Health and Retirement Study data from 6052 proxies of deceased individuals. We studied 3 ACP behaviors, discussing end-of-life (EOL) care preferences, providing written EOL care instructions, and appointing a durable power of attorney for health care (DPAHC). ACP increased by 12% to 23% every 2 years from 2002 to 2010. Higher household income increased the odds of having a DPAHC. Education was not associated with ACP. Socioeconomic status alone ...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Khosla, N., Curl, A. L., Washington, K. T. Tags: Original Articles Source Type: research

"It Just Consumes Your Life": Quality of Life for Informal Caregivers of Diverse Older Adults With Late-Life Disability
In conclusion, informal caregivers take on a huge burden in enabling older adults to age in the community. These caregivers need more support in maintaining their QoL. (Source: American Journal of Hospice and Palliative Medicine)
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Thai, J. N., Barnhart, C. E., Cagle, J., Smith, A. K. Tags: Original Articles Source Type: research

Commonly Prescribed Medications Among Patients in Hospice Care for Chronic Obstructive Pulmonary Disease
The objectives of this study were to evaluate medications being prescribed to patients with end-stage COPD, compared to recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, and to determine which medications were provided by the hospice organization. Methods: We retrospectively reviewed our database for medications pertaining to COPD management as stated in the GOLD criteria or those used for symptoms associated with end of life. Results: A total of 745 patients met inclusion criteria, and approximately 63% were prescribed opioids. Prescribing rates for oxygen, short-actin...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Afrane, M., Sera, L., Holmes, H. M., McPherson, M. L. Tags: Original Articles Source Type: research

Lymphedema Characteristics and the Efficacy of Complex Decongestive Physiotherapy in Malignant Lymphedema
The aim of this study is to identify the lymphedema characteristics and the efficacy of complex decongestive physiotherapy (CDP) in 29 patients with malignant lymphedema. After CDP, total decreased volume of lymphedema was 306 mL, percentage of excess volume (PEV) changed from 43.4% to 22.7%, and lymphedema severity improved from severe to moderate status. The CDP efficacy-percentage reduction in excess volume (PREV) was 46.6%. The stage of lymphedema (P = .004), range of motion (P < .001), pain, heaviness, and tension scores (P < .001) were significantly improved after CDP. This shows that CDP is efficacious and use...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Liao, S.-F. Tags: Original Articles Source Type: research

Medication Needs Vary for Terminally Ill Vietnam Era Veterans With and Without a Diagnosis of PTSD
This retrospective pilot study aims to evaluate the clinical impact of palliative care in the treatment of terminally ill Vietnam Veterans with a history of posttraumatic stress disorder (PTSD) versus those without PTSD, as it pertains to medications for symptom control at the end of life (EOL). Active prescriptions for benzodiazepines, hypnotics, antidepressants, and antipsychotic medications at the EOL were recorded. During EOL care, 28 (72%) participants with PTSD used these medications versus 55 (40%) of the non-PTSD participants (P = .0005). There was significant correlation between a lifetime diagnosis of PTSD with a...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Kelley-Cook, E., Nguyen, G., Lee, S., Edwards, T. M., Sanchez-Reilly, S. Tags: Original Articles Source Type: research

Predictors of Intention to Refer to Pediatric Palliative or Hospice Care
The purpose of this descriptive correlational study was to determine whether nurse characteristics, level of comfort with care of the dying, and spirituality predict intention to refer and timing of referral to pediatric palliative/hospice care. The Behavioral Model of Health Services Use served as the framework for this study. Data were collected from 105 pediatric nurses recruited from 7 patient units of one pediatric hospital. Regression analysis revealed several nurse factors (practice unit, years of experience, age, race/ethnicity) that predicted intent to refer and timing of referral to pediatric palliative/hospice c...
Source: American Journal of Hospice and Palliative Medicine - June 25, 2016 Category: Palliative Care Authors: Conner, N. E., Uddin, N. Tags: Original Articles Source Type: research

Therapeutic Education in Improving Cancer Pain Management: A Synthesis of Available Studies
This literature review aims to synthesize available studies and to update findings in order to obtain a current, comprehensive estimate of the benefits of pain education. Forty-four original articles obtained from the PubMed database were analyzed to investigate which protocols could be most effective in improving pain management. Recent studies indicate a growing interest in evaluating patients’ skills and attitudes; these include satisfaction with cancer pain treatment, patient-reported improvement, and patient participation—all of which could be dependable benchmarks for evaluating the effectiveness of educa...
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Prevost, V., Delorme, C., Grach, M.-C., Chvetzoff, G., Hureau, M. Tags: Review Article Source Type: research

The Prevalence of Neuropathic Pain in Terminally Ill Patients With Cancer Admitted to a Palliative Care Unit: A Prospective Observational Study
Conclusion: The prevalence of NP in terminally ill patients with cancer in Japanese palliative care units was 18.6%. (Source: American Journal of Hospice and Palliative Medicine)
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Harada, S., Tamura, F., Ota, S. Tags: Original Articles Source Type: research

Improving Palliative Care Team Meetings: Structure, Inclusion, and "Team Care"
Increasing demands on palliative care teams point to the need for continuous improvement to ensure teams are working collaboratively and efficiently. This quality improvement initiative focused on improving interprofessional team meeting efficiency and subsequently patient care. Meeting start and end times improved from a mean of approximately 9 and 6 minutes late in the baseline period, respectively, to a mean of 4.4 minutes late (start time) and ending early in our sustainability phase. Mean team satisfaction improved from 2.4 to 4.5 on a 5-point Likert-type scale. The improvement initiative clarified communication about...
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Brennan, C. W., Kelly, B., Skarf, L. M., Tellem, R., Dunn, K. M., Poswolsky, S. Tags: Original Articles Source Type: research

Predictors of Preference for Hospice Care Among Diverse Older Adults
Conclusions: Uncertainties about hospice among African Americans may contribute to disparities in utilization. Efforts to improve access to hospice should consider pre-existing preferences for end-of-life care and account for the complex demographic, social, and cultural factors that help shape these preferences. (Source: American Journal of Hospice and Palliative Medicine)
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Cagle, J. G., LaMantia, M. A., Williams, S. W., Pek, J., Edwards, L. J. Tags: Original Articles Source Type: research

The Influence of Nursing Unit Characteristics on RN Vacancies in Specialized Hospice and Palliative Care
The nursing shortage is projected to intensify in the United States. Organizations providing specialized hospice and palliative care will be particularly hard hit. The purpose of our study was to examine the influence of the nursing unit on registered nurse (RN) vacancies and test the moderating role of recruitment strategies in perinatal hospices. We estimated the association between the nursing unit and RN vacancies and tested the interaction effects of recruitment strategies (signing bonus and recruitment bonus). Our findings showed that increasing RN unit size and nursing leadership directly affected vacancies and that...
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Lindley, L. C., Mixer, S. J., Cozad, M. J. Tags: Original Articles Source Type: research

Building New Teams for Late Life Care: Lessons From LifeCourse
This article details team development within a longitudinal cohort study designed to bring team-based, whole person care early in the course of serious illness. The primary innovation of this approach is the use of nonclinically trained care guides who support patients and family members by focusing care around what matters most to patients, linking to resources, collaborating with other providers, and offering continuity through care transitions. By describing the development of this team, we document the kinds of questions others may ask during the process of team creation. (Source: American Journal of Hospice and Palliative Medicine)
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Schellinger, S., Cain, C. L., Shibrowski, K., Elumba, D., Rosenberg, E. Tags: Original Articles Source Type: research

Distress Reduction for Palliative Care Patients and Families With 5-Minute Mindful Breathing: A Pilot Study
A pilot study was conducted to evaluate the efficacy of 5-minute mindful breathing in distress reduction. Twenty palliative care patients and family caregivers with a distress score ≥4 measured by the Distress Thermometer were recruited and randomly assigned to mindful breathing or "listening" (being listened to). Median distress reductions after 5 minutes were 2.5 for the mindful breathing group and 1.0 for the listening group. A significantly larger reduction in the distress score was observed in the mindful breathing group (Mann-Whitney U test: U = 8.0, n1 = n2 = 10, mean rank1 = 6.30, mean rank2 = 14.70, z = –...
Source: American Journal of Hospice and Palliative Medicine - June 1, 2016 Category: Palliative Care Authors: Beng, T. S., Ahmad, F., Loong, L. C., Chin, L. E., Zainal, N. Z., Guan, N. C., Ann, Y. H., Li, L. M., Meng, C. B. C. Tags: Original Articles Source Type: research