Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2018
Development and Validation of a Family Meeting Assessment Tool (FMAT).
A cornerstone procedure in Palliative Medicine is to perform family meetings. Learning how to lead a family meeting is an important skill for physicians and others who care for patients with serious illnesses and their families. There is limited evidence on how to assess best practice behaviors during end-of-life family meetings. ⋯ Expert-based content, high inter-rater reliability, good internal consistency, and ability to predict educational level provided initial evidence for construct validity for this novel assessment tool.
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J Pain Symptom Manage · Jan 2018
ReviewThe effectiveness of advance care planning in improving end of life outcomes for people with dementia and their carers: A systematic review and critical discussion.
End-of-life care for people with dementia can be poor, involving emergency hospital admissions, burdensome treatments of uncertain value, and undertreatment of pain and other symptoms. Advance care planning (ACP) is identified, in England and elsewhere, as a means of improving end-of-life outcomes for people with dementia and their carers. ⋯ There is a need for more high-quality outcome studies, particularly using randomized designs to control for confounding. These need to be underpinned by sufficient development work and process evaluation to clarify the appropriateness of outcome measures, explore implementation issues and identify "active elements."
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PC-FACS(FastArticleCriticalSummaries for Clinicians inPalliativeCare) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PC-FACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pc-facs@aahpm.org.
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J Pain Symptom Manage · Jan 2018
Temporal trends between 2010 and 2015 in intensity of care at end-of-life for patients with chronic illness: Influence of age under versus over 65 years.
Recent analyses of Medicare data show decreases over time in intensity of end-of-life care. Few studies exist regarding trends in intensity of end-of-life care for those under 65 years of age. ⋯ From 2010 to 2015, we observed a decrease in hospital admissions for all age groups and in ICU admissions for those over 65 years. As there were no changes in the proportion of patients with chronic illness who died at home nor in hospital or ICU LOS in the last 30 days, hospital and ICU admissions in the last 30 days may be a more responsive quality metric than site of death or LOS for palliative care interventions.
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J Pain Symptom Manage · Jan 2018
Development and psychometric properties of a survey to assess barriers to implementing advance care planning in primary care.
Valid and reliable measurement of barriers to advance care planning (ACP) in health care settings can inform the design of robust interventions. ⋯ This questionnaire to assess barriers to ACP discussion from the perspective of family physicians demonstrates preliminary evidence of reliability and validity.