The American journal of hospice & palliative care
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As Americans live longer they are likely to suffer from chronic, life-limiting illness. Because there are not enough hospice and palliative medicine (HPM) trained physicians to care for these people, there have been recent calls to increase the number of HPM trained physicians. ⋯ In addition, NPs are not only numerous, they can provide care that is on par with that provided by physicians. Removal of barriers to NP practice and increasing the quality of their palliative care education/training needs to occur in order to make this suggestion a reality.
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Am J Hosp Palliat Care · May 2014
The determinants of patients in a palliative care unit being discharged home in Japan.
In Japan, regarding the place of end-of-life care, many people preferred the home. However, there is a discrepancy between patients' wishes and the actual circumstances. The primary aim of this study was to explore the factors that determine discharge home of patients in a palliative care unit. ⋯ Palliative prognostic index was significantly lower in group 1 than in group 2 (P = .032). Regarding routes of feeding, oral intake was significantly higher in group 1 than in group 2 (P = .043). That is to say, factors determining discharge home of patients may be influenced by the patient's prognosis and the necessity of a feeding device.
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Am J Hosp Palliat Care · May 2014
Factors affecting the place of death among hospice home care cancer patients in Taiwan.
Some patients who receive hospice home care still end up dying in hospital. The significance of the variables possibly affecting the place of death in patients with terminal cancer who received hospice home care was examined. ⋯ For a better hospice care service, it is essential to inquire patients or their relatives on preferred place of death while concerning the influences of other factors.
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Am J Hosp Palliat Care · Mar 2014
ReviewMethods for improving the quality of palliative care delivery: a systematic review.
The effectiveness for improving the outcomes across palliative care domains remains unclear. We conducted a systematic review of different types of quality improvement interventions relevant to palliative care. ⋯ A minority of quality improvement interventions have succeeded in improving the quality of palliative care delivery. More studies are needed on specific quality improvement types, including organizational change and multiple types of interventions.
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Am J Hosp Palliat Care · Mar 2014
Review Case ReportsManagement of intractable hiccups: an illustrative case and review.
Often thought of as a benign and self-limited condition, hiccups can become persistent or intractable, and thus be associated with substantial morbidity and distress. In such cases, an underlying etiology is often present, and may be overlooked. ⋯ Various causes of protracted hiccups have been identified including metabolic abnormalities, central nervous system pathology, malignancy, medications, and disorders attributed to cardiac, pulmonary and gastrointestinal etiologies. We present a case of intractable hiccups in a patient with an advanced hematological malignancy and review specific therapies for the management of persistent hiccups.