The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Jan 2008
Nurse views of the adequacy of decision making and nurse distress regarding artificial hydration for terminally ill cancer patients: a nationwide survey.
We evaluated nurse views on the adequacy of decision-making discussion among nurses and physicians regarding artificial hydration for terminally ill cancer patients and nurse distress arising from artificial hydration issues, as well as factors related to this distress. A self-administered questionnaire consisting of 4 questions about nurse views of discussions regarding artificial hydration and 6 questions about nurse distress arising from artificial hydration issues was distributed in participating institutions in October 2002 and returned by mail. A total of 3328 responses (79%) were analyzed. ⋯ Furthermore, 48% of oncology nurses and 47% of PCU nurses experienced distress arising from disagreements among medical practitioners about withholding artificial hydration, whereas 44% and 43% experienced distress about medical practitioners refusing artificial hydration, respectively. Discussion among care providers regarding artificial hydration is insufficient, particularly in general wards. Medical practitioners caring for terminally ill cancer patients should engage in greater discussion among patient-centered teams and facilitate individualized decision making.
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Am J Hosp Palliat Care · Jan 2008
ReviewWhen there is nothing left to do, there is everything left to do.
Circle of Life Hospice in Reno, Nevada is not only a special place for patients and their families to find peace through a sense of meaning and purpose at the end of their life but is also an important place for staff to take care of each other as they take care of those who are dying. The Circle of Life Hospice provides a unique opportunity to examine carefully the power of providing an outlet for hospice staff to process their grief and offer support for one another so that they can continue to give the "everything that there is to do to" to their patients.
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Am J Hosp Palliat Care · Jan 2008
ReviewCore competencies in palliative care for surgeons: interpersonal and communication skills.
Surgeons are an important part of the multidisciplinary approach to the care of terminally ill and dying patients. Some surgical residencies have recognized the need to incorporate palliative care-related topics into graduate surgical education. ⋯ Case examples and recommendations for the appropriate words and actions to use in these scenarios are offered. It is important for both surgeons in practice and those in training to achieve proficiency with these communication skills.
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Am J Hosp Palliat Care · Jan 2008
Comparative StudyCharacteristics of patients receiving hospice care at home versus in nursing homes: results from the National Home and Hospice Care Survey and the National Nursing Home Survey.
This study examined 1170 deceased home hospice patients from the 1998 National Home and Hospice Care Survey and 617 deceased nursing home hospice patients from the 1997 and 1999 National Nursing Home Surveys. T tests and Bonferroni adjustments for multiple comparisons were performed to assess differences in characteristics of patients receiving hospice care at home versus in nursing homes. We found that the nursing home hospice population differs significantly from the home hospice population in the United States. Nursing home hospice patients were more likely to be older, have Medicaid as their primary payment source, have dementia and other noncancer primary diagnosis, and receive dietary/nutrition service, medication management, and physician services than home hospice patients.