The American journal of hospice & palliative care最新文献_第5页

Ethics Roundtable State-Erected Barriers to End-of-Life Care. 伦理圆桌会议国家为生命末期护理设置的障碍。

The American journal of hospice & palliative care Pub Date : 2024-10-04 DOI: 10.1177/10499091241282638

Saima Rashid, Scott P Broyles, Andrew Wampler, Matthew Stolick, Steven J Baumrucker

引用次数: 0

Ketamine for Super-Refractory Status Epilepticus in Palliative Care. A Case Report and Review of the Literature. 氯胺酮在姑息治疗中的超难治性癫痫持续状态。一例病例报告及文献回顾。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-11-20 DOI: 10.1177/10499091231215491

Edward J Dunn, David D Willis

引用次数: 0

Case Series of Akathisia in Palliative Medicine: Patient Perspective and Efficacy of Procyclidine in Diagnosis and Management. 姑息医学中的阿卡西尼症病例系列：病人的视角和普罗环利定在诊断和治疗中的疗效。

The American journal of hospice & palliative care Pub Date : 2024-10-01 DOI: 10.1177/10499091241286052

David Murphy, Senan Maher, Grace Kennedy, Steven Looi, Riana Minogue, Maeve Brassil, Tara McDonnell, Eileen Mannion, Dympna Waldron

{"title":"Case Series of Akathisia in Palliative Medicine: Patient Perspective and Efficacy of Procyclidine in Diagnosis and Management.","authors":"David Murphy, Senan Maher, Grace Kennedy, Steven Looi, Riana Minogue, Maeve Brassil, Tara McDonnell, Eileen Mannion, Dympna Waldron","doi":"10.1177/10499091241286052","DOIUrl":"https://doi.org/10.1177/10499091241286052","url":null,"abstract":"Aims: Akathisia is a disturbing, reversible but under-diagnosed extrapyramidal side effect of medications used in palliative medicine. We assessed patients' subjective experience of akathisia and response to procyclidine, an anticholinergic used to treat extrapyramidal effects. We also aimed to discuss future areas of research and alternatives to akathisia-causing medications.Methods: Suitable patients were retrospectively identified by palliative medicine physicians in a tertiary hospital and a chart review was undertaken. Information gathered included the account of their experience of akathisia, use of inciting medications, treatment, and outcome.Results: 20 patients were identified, 12 females, 8 males. Mean number of days on the inciting drug(s) to onset of akathisia symptoms was 18.1. Mean number of days from commencing inciting drug(s) to diagnosis was 20.9. Patients' descriptions revealed similarities including feeling \"locked in\" and a need to constantly move. One patient described a \"glass coffin\" enclosing her. 16 patients had full response to treatment with procyclidine, 3 had partial response requiring up-titration of dosing, response was not documented in 1.Conclusions: Akathisia is an elusive symptom that can have dramatic reversibility when treated. Lack of recognition causes unnecessary patient suffering. Procyclidine appears to aid diagnosis and be an effective treatment. Protocols to reduce incidence and guide diagnosis and management are proposed. Further studies are required, in which subjective outcome measures are used and medications to treat akathisia are studied. Recognition remains challenging, causing significant distress for palliative patients, for whom quality of life is paramount.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of Critical Glucose Values in Hospice. 安宁疗护中的临界血糖值管理。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-12-21 DOI: 10.1177/10499091231223748

Belal Dakroub, Sandra L DiScala, Christine M Vartan, Maura F Miller, Michael Silverman, Swati Chalavarya

{"title":"Management of Critical Glucose Values in Hospice.","authors":"Belal Dakroub, Sandra L DiScala, Christine M Vartan, Maura F Miller, Michael Silverman, Swati Chalavarya","doi":"10.1177/10499091231223748","DOIUrl":"10.1177/10499091231223748","url":null,"abstract":"Objectives: This quality improvement (QI) project was to lean the process for managing critical high and low glucose levels in the hospice unit and to simplify the pharmacologic options for hypoglycemic management for nursing staff. Methods: The process for developing and refining the recommendations involved a modified Delphi approach with a team of key stakeholders with overlapping expertise in hospice care practice. Recommendations were based on literature review, judgement of experts, and clinical experience. Stakeholders ranked six potential solutions and two were prioritized within the scope of this project. Results: From 1/1/21 - 12/31/21, there were 48 veterans with insulin sliding scale orders in the hospice unit, of which there were six critical values acted on. A standard operating procedure (SOP) for the management of critical glucose values in hospice was developed based on updated processes. In addition, hospice patient specific insulin sliding scale order sets were created and endorsed for utilization and dissemination. Following implementation on 3/1/22, no critical values were found in the hospice unit from 3/1/22 - 6/1/22 during the sustainment period. Conclusions: The implementation of hospice insulin sliding scale order sets and SOP on the management of critical glucose values in hospice reduced the number of critical glucose values.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center. 多休塞特钠在WPB VA HCS社区生活中心预防便秘和阿片类药物引起的便秘中的用药评价

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-11-24 DOI: 10.1177/10499091231218390

Wesley Faulkner, Sandra DiScala, Christine Vartan, Belal Dakroub, Michael Silverman, Mythili Bharadwaj

{"title":"Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center.","authors":"Wesley Faulkner, Sandra DiScala, Christine Vartan, Belal Dakroub, Michael Silverman, Mythili Bharadwaj","doi":"10.1177/10499091231218390","DOIUrl":"10.1177/10499091231218390","url":null,"abstract":"Introduction: Docusate sodium's efficacy is widely debated. Several studies on opioid induced constipation (OIC) concluded that docusate sodium vs either placebo or in combination with sennosides provided no benefit.Objective: This medication use evaluation aimed to investigate constipation treatment trends within the West Palm Beach VA Healthcare System Community Living Center, and to assess the therapeutic effectiveness of docusate sodium.Methods: This was a retrospective review of data extracted from April 1, 2022, to September 30, 2022. Patients were included if they had oral orders for docusate sodium, sennosides, lactulose, and/or polyethylene glycol. Patients without active bowel regimen medications were excluded. Requirements for rescue constipation medication was evaluated.Results: A total of 98 patients were reviewed. Docusate sodium was used in 43% (n = 42/98) of patients. Rescue medications were needed in 58% (n = 22/38) of patients receiving oral docusate sodium. 52% (n = 29/56) of patients without docusate sodium required rescue medications. For OIC treatment, when docusate sodium was added to other bowel regimens, 59% (n = 17/29) of patients needed a rescue medication, while 66% (n = 19/29) of patients without docusate sodium required a rescue medication. Patients on morphine were given the greatest quantity of rescue constipation medications (73%, n = 16/22).Conclusion: Oral docusate sodium did not reduce the requirement for rescue constipation medications in the WPB VAHCS CLC population. When evaluating constipation treatment, docusate sodium may supply minimal benefit and could be identified as nonessential for deprescribing efforts. Morphine was the most constipating opioid used in this patient population, requiring more aggressive bowel regimens.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Screening for End-of-Life in Acute Hospitals: A Cross-Sectional Survey. 急症医院的临终筛查：一项横断面调查。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2024-01-09 DOI: 10.1177/10499091231226299

Timothy To, Paul Hakendorf, David C Currow

引用次数: 0

Profile of Antimicrobial Consumption in Patients Assisted by a Palliative Care Team During the COVID-19 Pandemic in Brazil. 巴西COVID-19大流行期间由姑息治疗小组协助的患者抗微生物药物使用概况

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-11-11 DOI: 10.1177/10499091231215432

Tulio L Correa, Matheus Ac Quitete, Clara Rs do Nascimento, Rafaela P Carbone, Ricardo T de Carvalho, Juraci A Rocha

{"title":"Profile of Antimicrobial Consumption in Patients Assisted by a Palliative Care Team During the COVID-19 Pandemic in Brazil.","authors":"Tulio L Correa, Matheus Ac Quitete, Clara Rs do Nascimento, Rafaela P Carbone, Ricardo T de Carvalho, Juraci A Rocha","doi":"10.1177/10499091231215432","DOIUrl":"10.1177/10499091231215432","url":null,"abstract":"Background: This study aimed to evaluate the profile of antimicrobial consumption in patients assisted by a palliative care (PC) team during the COVID-19 pandemic.Methods: A retrospective observational study was conducted in a quaternary hospital. Patients assisted by the PC team in 2020 were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records.Results: A total of 181 patients were included in the study, of whom 93.4% had used antimicrobials and 24.3% had had COVID-19. COVID-19 patients were more likely to receive at least one course of antimicrobial therapy. Patients who received polytherapy in the first course of treatment were more likely to die and to be still receiving antimicrobials at death. There was no significant difference in the length of hospital stay, new hospitalization in 12 months, nor the time to death among patients who received monotherapy or polytherapy during the first course of antimicrobial therapy.Conclusions: There was a large amount of PC patients receiving antimicrobial therapy during the COVID-19 pandemic. SARS-CoV-2-positive patients were more likely to receive antimicrobial therapy.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89721488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

e-PainSupport: A Digital Pain Management Application for Home Hospice Care. e-PainSupport:用于家庭临终关怀的数字疼痛管理应用程序。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-10-28 DOI: 10.1177/10499091231211493

Masako Mayahara, JoEllen Wilbur, Louis Fogg, Judith A Paice, Arlene M Miller

{"title":"e-PainSupport: A Digital Pain Management Application for Home Hospice Care.","authors":"Masako Mayahara, JoEllen Wilbur, Louis Fogg, Judith A Paice, Arlene M Miller","doi":"10.1177/10499091231211493","DOIUrl":"10.1177/10499091231211493","url":null,"abstract":"e-PainSupport is a digital pain management application (app) designed to facilitate better pain management in hospice. Early testing revealed caregivers found it was easy to use and successful in communicating patient pain and caregiver administration of analgesics to hospice nurses. However, caregiver knowledge of analgesic management remained low. The purpose of this study was to enhance e-PainSupport by (a) adapting and integrating an evidence-based pain educational intervention; (b) increasing ease of accessing and navigating the app; and (c) facilitating app communication with agency electronic health records (EHRs). An advisory board method, including two key stakeholder groups (an expert panel and a caregiver advisory board), guided the adaptation of an evidence-based pain educational intervention. Further, stakeholders recommended format changes to increase app usability. Study staff worked with four hospice agencies to facilitate app communication with EHRs. While modification to the e-PainSupport app to integrate a pain educational intervention and facilitate usability was successful, EHR integration was challenging. Future evaluation is needed to evaluate the effects of e-PainSupport on pain intensity among home hospice patients.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer. 癌症晚期患者死亡前 24 小时连续心电图监测。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-12-13 DOI: 10.1177/10499091231222184

Ko Sato, Mika Baba, Tatsuya Morita, Kento Masukawa, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Mitsunori Miyashita

{"title":"Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer.","authors":"Ko Sato, Mika Baba, Tatsuya Morita, Kento Masukawa, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Mitsunori Miyashita","doi":"10.1177/10499091231222184","DOIUrl":"10.1177/10499091231222184","url":null,"abstract":"Background: Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking.Objectives: To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death.Methods: In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018.Results: Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group (P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups.Conclusion: While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review. 癌症患者家庭照顾者负担的护理支持:一项范围审查。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-11-14 DOI: 10.1177/10499091231215808

Kohei Kajiwara, Masamitsu Kobayashi, Miharu Morikawa, Yusuke Kanno, Kimiko Nakano, Yoshinobu Matsuda, Yoichi Shimizu, Taichi Shimazu, Jun Kako

{"title":"Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review.","authors":"Kohei Kajiwara, Masamitsu Kobayashi, Miharu Morikawa, Yusuke Kanno, Kimiko Nakano, Yoshinobu Matsuda, Yoichi Shimizu, Taichi Shimazu, Jun Kako","doi":"10.1177/10499091231215808","DOIUrl":"10.1177/10499091231215808","url":null,"abstract":"Purpose: To identify nursing support for caregiver burden in family caregivers of patients with cancer. Methods: This scoping review was guided by Arksey and O'Malley's six-stage scoping review framework. All available published articles from database inception to July 31, 2023 were systematically searched through PubMed, CINAHL, CENTRAL, and Ichushi-Web of the Japan Medical Abstract Society databases with additional relevant studies from the article list. Each key journal was manually searched. Results: Overall, 502 articles were screened, and 34 were finally included. The results of the qualitative thematic analysis were categorized into 7 components of nursing support: psychological and educational support, psychological and educational support using mainly non-face-to-face (Information and Communication Technology), psychological and educational support mainly using non-face-to-face (telephone) methods, mindfulness to support, support aimed at reducing caregiver stress, support for both patients and caregivers, and others. Of the 34 studies, 23 were randomized controlled trials (RCT), and the remaining 11 were non-RCTs. Conclusion: The results of the scoping review categorized nursing support for caregiver burden in the family caregivers of patients with cancer into 7 components. Future research should examine the feasibility of implementing these components.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107593180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0