Journal of Palliative Care最新文献_第2页

Adherence to Patients' Preferences for Levels of Life-Sustaining Treatment: A 2-Year Follow-Up Study. 坚持患者对维持生命治疗水平的偏好：一项2年随访研究。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-03-28 DOI: 10.1177/08258597251329842

Mette A Smith, Anne C Brøchner, Helene K Nedergaard, Hanne I Jensen

{"title":"Adherence to Patients' Preferences for Levels of Life-Sustaining Treatment: A 2-Year Follow-Up Study.","authors":"Mette A Smith, Anne C Brøchner, Helene K Nedergaard, Hanne I Jensen","doi":"10.1177/08258597251329842","DOIUrl":"https://doi.org/10.1177/08258597251329842","url":null,"abstract":"ObjectiveThere is increasing interest in advance care planning (ACP) and the implementation of various forms of ACP. The purpose of ACP is to define patients' goals and preferences for future medical treatment and care for patients nearing the end of life (EOL). The aim of this study was to investigate adherence to patients' preferences for levels of life-sustaining treatment in emergency situations, as documented in a Danish POLST (Physician Orders for Life-Sustaining Treatment) form.MethodsA retrospective journal review was conducted 2 years after the conversation with the patients about their wishes for treatment and care at EOL. Medical records included electronic hospital records, nursing home records, and general practice records. Patients were assessed nearing EOL and included in the study based on a negative response to the \"surprise.\"ResultsA total of 120 patients and nursing home residents were included in the study. Overall, there were 2148 contacts with the healthcare system, of which 31 were emergency situations, where the patients were not capable of expressing their own wishes. In 4 contacts (12%), the patients (4) received treatment discordant with their wishes, as documented in the POLST form (and medical record).ConclusionsOur study shows that patients assessed nearing EOL are a patient group with many contacts with the healthcare system, and the results indicate that having had an ACP conversation and the wishes documented is useful to avoid unwanted treatment in emergency situations.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251329842"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intrinsic Gratitude's Impact on Professional Trajectory: A Qualitative Interview Study With Palliative Care Team Members. 内在感恩对职业轨迹的影响：对缓和疗护团队成员的质性访谈研究。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-03-18 DOI: 10.1177/08258597251326760

Hui-Ching Weng, Wei-Shu Lai, Duan-Rung Chen

{"title":"Intrinsic Gratitude's Impact on Professional Trajectory: A Qualitative Interview Study With Palliative Care Team Members.","authors":"Hui-Ching Weng, Wei-Shu Lai, Duan-Rung Chen","doi":"10.1177/08258597251326760","DOIUrl":"https://doi.org/10.1177/08258597251326760","url":null,"abstract":"ObjectivesPalliative care is emotionally demanding, yet extrinsic gratitude can improve job satisfaction. While intrinsic gratitude is effective in preventing burnout, the focus of existing research is mainly on extrinsic gratitude received by clinicians. This study aims to examine the role of intrinsic gratitude in clinicians within the emotionally demanding field of palliative care, assessing its impact on professional development and potential for broader community benefit.MethodsUtilizing purposive sampling, we recruited a diverse group of palliative care professionals from 10 hospitals, focusing on full-time staff with at least two years of experience in palliative care. Of the 23 clinicians, 12 (five physicians, six nurses, and one social worker) were recruited because they spontaneously expressed profound gratitude toward others.ResultsTwelve of twenty-three clinicians maintained a positive outlook despite the inherent challenges of their field. Intrinsic gratitude, especially toward team members like nurses, emerged as a pivotal support mechanism. Through its transformative dimensions of empathic engagement, self-elevation, and humility, this gratitude strengthened their professional resilience and trajectory and had a ripple effect on their personal lives, influencing familial relationships and broader societal interactions.ConclusionsThis is the first research focusing on clinicians' spontaneous expressions of gratitude. This study provides new insights into understanding the clinicians' intrinsic gratitude, its impact on their professional trajectory, and harnessing its potential benefits for broader community outreach. Through a reflective process incorporating gratitude, clinicians may be empowered to develop their self-coping mechanisms and nurture inner resilience while caring.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251326760"},"PeriodicalIF":1.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing Person-Centered Care in Advance Care Planning: A Community Health Nurse's Perspective. 在预先护理计划中加强以人为本的护理：社区卫生护士的观点。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-02-24 DOI: 10.1177/08258597251319104

Kamran Munawar

引用次数: 0

Electronic Health Records and Family Satisfaction in the ICU: Communication, Care Processes, and Decision-Making. ICU的电子健康记录和家庭满意度：沟通、护理过程和决策。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-02-24 DOI: 10.1177/08258597251320713

Vivian Wuerges de Aquino, Kawoana Trautman Vianna, Marcio Manozzo Boniatti, Mellina da Silva Terres

{"title":"Electronic Health Records and Family Satisfaction in the ICU: Communication, Care Processes, and Decision-Making.","authors":"Vivian Wuerges de Aquino, Kawoana Trautman Vianna, Marcio Manozzo Boniatti, Mellina da Silva Terres","doi":"10.1177/08258597251320713","DOIUrl":"https://doi.org/10.1177/08258597251320713","url":null,"abstract":"Objectives: To evaluate electronic health records and explore associations with the satisfaction of families of critically ill patients. Methods: Exploratory cohort study. Included 94 patients with severe chronic illnesses or chronic critical illness who were admitted to the ICU and their family members. Family satisfaction was assessed using the Family Satisfaction ICU (FS-ICU 24) questionnaire, through the FS-ICU Care score (perception of care itself), FS-ICU Decision Making score (perception of decision-making), and FS-ICU Total score, and queried about the use of a room suitable for communication. Electronic health records were analyzed for elements of communication with family members, care processes, and decision-making. Results: The scores were FS-ICU Care 91.1 (76.8-98.0), FS-ICU DM 90.0 (77.5-97.5), and FS-ICU total 90.7 (78.0-97.0). In 17 (18.1%) of the medical records, there was a documented family meeting within the first 72 hours, and in 9.6%, there was documentation of communication about functionality, wishes and values, and consultation for palliative care. The use of a suitable room for communication was reported as \"never\" or \"rarely\" by 45 (47.8%) of the family members. There was a trend towards greater satisfaction with social support and lower satisfaction among family members of deceased patients, with 9 (25.8%) of these family members feeling that the patient was uncomfortable before death, and the records of meetings and communication of poor prognosis were associated with a lower perception of discomfort (P < .05). Conclusions: The satisfaction of family members of critically ill patients was high and was not significantly associated with the documentation deficiencies found. Deficiencies in communication appear to have influenced the perception of family members. Various perspectives are necessary for analyzing the care provided to patients and families in the ICU.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251320713"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regional Priorities in Palliative Care Research: Adapting the Delphi Technique for the Philippines. 姑息治疗研究的区域优先事项：菲律宾采用德尔菲技术。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-02-20 DOI: 10.1177/08258597241301134

John Patrick C Toledo

引用次数: 0

The Heart of the Matter: Exploring a Veteran's Wish for Pacemaker Deactivation. 问题的核心：探索退伍军人对心脏起搏器停用的愿望。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-02-02 DOI: 10.1177/08258597251318069

Jordana L Meyerson, Jeffrey M Kowaleski, McKenzie R McClelland

引用次数: 0

The Effect of Life Activity Levels of Palliative Care Patients on the Caregivers' Perception of Caregivers Burden. 姑息治疗患者生活活动水平对照顾者负担感知的影响。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-15 DOI: 10.1177/08258597241309728

Elif Tuğba Uygun, Aylin Özakgül

{"title":"The Effect of Life Activity Levels of Palliative Care Patients on the Caregivers' Perception of Caregivers Burden.","authors":"Elif Tuğba Uygun, Aylin Özakgül","doi":"10.1177/08258597241309728","DOIUrl":"https://doi.org/10.1177/08258597241309728","url":null,"abstract":"Objective(s): Studies show the effects of dependent patients' caregivers on the caregiving burden. Knowing the effects of maintenance of movement, especially in life activities, on the factors affecting the caregiving burden is important for the quality of care, ensuring that the caregiver's capacity is preserved. Methods: This descriptive and cross-sectional study research was carried out to determine the effect of life activity levels of palliative care patients on the care burden of caregivers. The number of individuals to be sampled was calculated according to the sample formula with a known population. The sample of the consisted of 108 patients and their caregivers in a district state hospital between June and December 2022. Data were collected using the Barthel Index of Patient Activities of Daily Living (ADL) and Caregiver Burden Scale. Descriptive statistical methods, quantitative data analyses, and correlation analyses were used in the analysis of the data. Results: The average age for patient was 78.13 ± 10.25 and for caregivers was 54.64 ± 13.22 years. Barthel ADL Index score of the patients was 35.05, and 38% of the patients were completely dependent. Caregiver Burden Scale scores was 50.80, and 76.8% of the caregivers had moderate caregiver burden. Patients with increasing age, with diabetes mellitus and dementia diagnosis, not using glasses, or having urinary catheters and gastrostomy tubes had lower activity levels. The caregiver burden of caregivers was higher in those who spent 3 to 4 h for daily patient care, who had sleep problems, who thought that their health deteriorated compared to those who did not. It was determined that as the patients' ability to perform their daily activities decreased, the caregiver burden increased (r = -0.417; P < .01). Conclusions: It might be recommended that nurses can implement the nursing interventions completely and severely dependent patients' caregivers psychological and social support.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597241309728"},"PeriodicalIF":1.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterizing Difficulties and Management of Sleep Disturbances in a Tertiary Palliative Care Unit-A Retrospective Review. 在三级姑息治疗单元中，睡眠障碍的特点、困难和管理——一项回顾性回顾。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-15 DOI: 10.1177/08258597241309723

Jennifer Schacter, Jana Pilkey

{"title":"Characterizing Difficulties and Management of Sleep Disturbances in a Tertiary Palliative Care Unit-A Retrospective Review.","authors":"Jennifer Schacter, Jana Pilkey","doi":"10.1177/08258597241309723","DOIUrl":"https://doi.org/10.1177/08258597241309723","url":null,"abstract":"Objective: Difficulty sleeping is common in palliative care, however often unrecognized by palliative care physicians. This retrospective review aims to gain a better understanding of the causes and treatment of sleeping disturbances in a tertiary palliative care unit. Methods: This study included 200 palliative care inpatients admitted between January 1, 2015, and August 31, 2020. Patients with sleep disturbances were placed into 3 subgroups: insomnia, delirium, and those with an unclear diagnosis. These categories were analyzed by bivariate analysis (ANOVA, Kruskal-Wallis) to determine statistical significance. Results: A total of 156 (78%) patients had symptoms suggestive of sleep disturbance and 163 (81.5%) patients were prescribed a sedative for sleep disturbance. Most patients were prescribed lorazepam (52 [26%]), followed by haloperidol (47 [23.5%]), and zopiclone (33 [16.5%]). Benzodiazepine and zopiclone prescribing decreased over time, while antipsychotic prescribing remained stable. When analyzed according to the most likely cause of the sleep disturbance, patients with insomnia had a higher Palliative Performance Score (P < .035) and were more likely to have a previous medical history of insomnia (P < .0003) than those with delirium. Both insomnia and delirium were quickly diagnosed but patients with unclear sleep disturbances took longer to recognize and treat. Conclusion: These results suggest that sleep disturbances are common at the end of life and can be challenging to categorize. Using specific criteria may be helpful in differentiating insomnia versus delirium and ultimately lead to more consistent approaches to management.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597241309723"},"PeriodicalIF":1.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Practice Guidelines on Palliative Sedation Around the World: A Systematic Review. 全球姑息镇静临床实践指南：系统回顾。

IF 16.4 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2022-11-28 DOI: 10.1177/08258597221138674

Martyna Tomczyk, Cécile Jaques, Ralf J Jox

{"title":"Clinical Practice Guidelines on Palliative Sedation Around the World: A Systematic Review.","authors":"Martyna Tomczyk, Cécile Jaques, Ralf J Jox","doi":"10.1177/08258597221138674","DOIUrl":"10.1177/08258597221138674","url":null,"abstract":"Objective: The principal aim of this study was to identify, systematically and transparently, clinical practice guidelines (CPGs) on palliative sedation from around the world. Methods: A systematic search was performed using 5 databases, grey literature search tools, citation tracking, and contact with palliative care experts across the world. Current CPGs accredited by an international, national, or regional authority, published in English, German, French, or Italian, were subjected to content analysis. Results: In total, 35 CPGs from 14 countries and 1 international CPG were included in the analysis. The CPGs had diverse formal characteristics. Their thematic scope was difficult to analyze and compare because of differences in the terms and definitions of palliative sedation in those texts. We identified 3 main situations: (1) CPGs with a fully explicit thematic scope; (2) CPGs with a partially explicit thematic scope; and (3) CPGs without an explicit thematic scope. Several CPGs explicitly stated what forms of sedation were excluded from the text. However, this presentation was often confusing. Conclusion: Our review provides several pieces of information that could guide international reflections in this field, and be used to develop or update CPGs at all levels. Efforts should be made to clarify the thematic scope of each CPG on palliative sedation, in order to generate an understanding of the forms of this therapy addressed in the text.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"58-71"},"PeriodicalIF":16.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palliative Care Consultation in the Intensive Care Unit Reduces Hospital Costs: A Cost-Analysis. 重症监护室的姑息治疗咨询降低了医院成本：成本分析。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2022-04-26 DOI: 10.1177/08258597221095986

Tong Han Chung, Linh K Nguyen, Lincy S Lal, J Michael Swint, Yen-Chi L Le, Kathleen R Hanley, Efrain Siller, Cheryl M Chanaud

{"title":"Palliative Care Consultation in the Intensive Care Unit Reduces Hospital Costs: A Cost-Analysis.","authors":"Tong Han Chung, Linh K Nguyen, Lincy S Lal, J Michael Swint, Yen-Chi L Le, Kathleen R Hanley, Efrain Siller, Cheryl M Chanaud","doi":"10.1177/08258597221095986","DOIUrl":"10.1177/08258597221095986","url":null,"abstract":"Background: Palliative care aims to improve or maintain quality of life for patients with life-limiting or life-threatening diseases. Limited research shows that palliative care is associated with reduced intensive care unit length of stay and use of high-cost resources.Methods: This was an observational, non-experimental comparison group study on all patients 18 years or older admitted to any intensive care unit (ICU) at Memorial Hermann - Texas Medical Center for 7 to 30 days from August 2013 to December 2015. Length of stay (LOS) and hospital costs were compared between the treatment group of patients with palliative care in the ICU and the control group of patients with usual care in the ICU. To adjust for confounding of the palliative care consultation on LOS and hospital cost, an inverse probability of treatment weighted method was conducted. Generalized linear models using gamma distribution and log link were estimated. All costs were converted to 2015 US dollars.Results: Mean LOS was 13 days and mean total hospital costs were USD 58,378. In adjusted and weighted analysis, LOS for the treatment group was 8% longer compared to the control group. The mean total hospital cost was estimated to decrease by 21% for the treatment group versus the control group. We found a reduction of USD 33,783 in hospital costs per patient who died in the hospital and reduction of USD 9113 per patient discharged alive.Conclusion: Palliative care consultation was associated with a reduction in the total cost of hospital care for patients with life-limiting or life-threatening diseases.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":"1 1","pages":"3-7"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45777617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0