The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Jun 2018
Patient and Provider Perspectives on a Mind-Body Program for Grieving Older Adults.
Spousal bereavement in older age is a major stressor associated with an increase in both mental and physical problems. The Stress Management and Resiliency Training: Relaxation Response Resiliency Program (SMART-3RP) is an 8-week multimodal mind-body program that targets stress and has been found efficacious in decreasing the mental and physical manifestations of stress in varied populations. This qualitative study sought to investigate the relevance, credibility, and feasibility of the SMART-3RP in the community. ⋯ Our findings suggest that the SMART-3RP may be helpful in decreasing somatic and psychological distress in older adults who have lost a spouse.
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Am J Hosp Palliat Care · Jun 2018
When and Why Do Neonatal and Pediatric Critical Care Physicians Consult Palliative Care?
Parents of children admitted to neonatal and pediatric intensive care units (ICUs) are at increased risk of experiencing acute and post-traumatic stress disorder. The integration of palliative care may improve child and family outcomes, yet there remains a lack of information about indicators for specialty-level palliative care involvement in this setting. ⋯ Palliative care was most beneficial for families at risk of experiencing communication problems that resulted from organizational factors, including those with long lengths of stay and medical complexity. The ability of palliative care consultants to bridge communication was limited by some of these same organizational factors. Physicians valued the involvement of palliative care consultants when they improved efficiency and promoted harmony. Given the increasing number of children with complex chronic conditions, it is important to support the capacity of ICU clinical teams to provide primary palliative care. We suggest comprehensive system changes and critical care physician training to include topics related to chronic illness and disability.
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Am J Hosp Palliat Care · Jun 2018
Clinical TrialQuality of Life and Compassion Satisfaction in Clinicians: A Pilot Intervention Study for Reducing Compassion Fatigue.
Compassion fatigue (CF) is prevalent in healthcare professionals, particularly in those caring for chronic, acutely ill, and/or those patients who might be moving toward comfort care. Over time, CF can lead to burnout (BO) and secondary traumatic stress and an overall decrease in professional quality of life. In this pilot study, participants completed a resiliency program focused on education about CF and self-awareness of its individualized impact and were expected to develop ongoing self-care practices to prevent/address the untoward effects. ⋯ While the small sample size of this pilot study limits the generalizability of the findings, there were positive effects for CS and BO in participants over time, indicating possible benefits of providing self-care education to healthcare providers. Additional research with a larger sample size is needed to address how healthcare providers might further benefit from resiliency education and interventions to improve professional quality of life.
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Am J Hosp Palliat Care · Jun 2018
Randomized Controlled Trial Multicenter StudyA Randomized Controlled Trial of Strategies to Improve Family Members' Preparedness for Surrogate Decision-Making.
To evaluate 2 strategies for preparing family members for surrogate decision-making. ⋯ The disconnect between confidence and performance raises questions about how to prepare family members to be surrogate decision-makers.
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Am J Hosp Palliat Care · Jun 2018
Impact of Palliative Chemotherapy and Travel Distance on Hospice Referral in Patients With Stage IV Pancreatic Cancer: A Retrospective Analysis Within a Veterans Administration Medical Center.
Metastatic pancreatic ductal adenocarcinoma (mPDAC) has a poor prognosis despite chemotherapy advancements. Although hospice utilization has increased, timing of referral is not always optimal. ⋯ Receipt of palliative chemotherapy and proximity to the treatment center appear to delay referral to hospice in patients with mPDAC. Increasing physician awareness of such factors that may impact the decision to involve hospice is necessary for delivering optimal oncology care.