Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2022
Observational StudySuccess of a community-based delivery at recruiting individuals from underserved communities for an observational cohort study of an advance care planning intervention.
Underserved and minority populations are often reluctant to engage in advance care planning and/or research often due to distrust in healthcare and/or research institutions. ⋯ Use of the community-based delivery model successfully engaged undeserved communities in a research-based advance care planning related community outreach event. This model may be useful for overcoming underserved and minority populations' skepticism and distrust of healthcare and research that is a common barrier to progress in health agendas, especially advance care planning.
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J Pain Symptom Manage · Feb 2022
Balancing Work and Hospice Caregiving-A Closer Look at Burden, Preparedness, and Mental Health.
Navigating end-of-life is stressful and many caregivers feel unprepared for caregiving tasks. Being employed may further increase caregiver burden. ⋯ To better support employed caregivers, hospice team members should be ready to address concerns about finances, daily schedule changes, and family support and screen for preparedness for caregiving. Developing strategies to help employed hospice caregivers feel more prepared may mitigate adverse mental health outcomes.
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J Pain Symptom Manage · Feb 2022
Advance Care Planning Documentation and Intensity of Care at the End of Life for Adults with Congestive Heart Failure, Chronic Kidney Disease, and Both Illnesses.
Heart failure (HF) and chronic kidney disease (CKD) are associated with high morbidity and mortality, especially in combination, yet little is known about the impact of these conditions together on end-of-life care. ⋯ Decedents with both HF and CKD had more ACP documentation and received more intensive end-of-life care than those with only 1 condition. These findings suggest that patients with co-existing HF and CKD may benefit from interventions to ensure care received aligns with their goals.
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J Pain Symptom Manage · Feb 2022
ReviewInterventions to Improve Prognostic Understanding in Advanced Stages of Life-Limiting Illness: A Systematic Review.
Among patients with advanced life-limiting illness, an inaccurate understanding of prognosis is common and associated with negative outcomes. Recent years have seen an emergence of new interventions tested for their potential to improve prognostic understanding. However, this literature has yet to be synthesized. ⋯ Prognostic understanding interventions hold the potential to improve patient understanding and thus informed decision making, but limitations exist. Future research should examine why many patients receiving intervention may continue to maintain inaccurate perceptions, and identify which intervention components can best enhance informed, value-consistent decision making.