The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Dec 2010
Hospice utilization and end-of-life care decision making of African Americans.
Multiple, complex factors influence end-of-life (EOL) decisions for all persons. In the African American population, these factors include history of disparities and discrimination in health care, which may affect the individual and the family, family system beliefs, values, and practices, and health care system issues. ⋯ A family systems framework can guide the clinicians in appreciating care needs and preferences at EOL. Understanding why so many African Americans choose aggressive and often burdensome care, even at the expense of suffering, is important for communication about options at the EOL and the delivery of quality care at the EOL.
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Am J Hosp Palliat Care · Nov 2010
Caregiver participation in hospice interdisciplinary team meetings via videophone technology: A pilot study to improve pain management.
This article discusses a pilot study testing a videophone intervention enabling hospice patients and caregivers to remotely participate in interdisciplinary team meetings, with the goal of improving pain management. The aim of this study was to test potential outcome measures and combine the data with qualitative observations to assess the overall feasibility and promise of the intervention. The outcomes evaluated included hospice patient quality of life, caregiver perceptions of pain medications, caregiver quality of life, and caregiver anxiety related to team participation. The pilot study showed that caregiver participation in the care planning process is feasible and may change caregiver perceptions of pain medication, potentially improving pain management for hospice patients.
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Since the publication in 1998 of the articles by the UK Prospective Diabetes Study (UKPDS) group, guidelines for the management and treatment of type II diabetes have been standardized. When applied to an end-of-life population, these international recommendations do not have any scientific justification and go against quality-of-life goals promoted by hospice and palliative care. The aim is to demonstrate this in the current article.
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Am J Hosp Palliat Care · Nov 2010
Symptom burden in hospitalized patients with cancer in kuwait and the need for palliative care.
We conducted this study to describe the symptom burden among hospitalized patients with cancer in a Kuwaiti cancer center. Twenty physical symptoms were assessed in 45 patients with cancer. The majority (82%) of patients had an advanced incurable cancer and 42% were receiving best supportive care only. ⋯ The most common symptoms were pain (82%), weakness/fatigue (80%), anorexia (67%), weight loss (49%), and dyspnea (42%). Pain was the most distressing symptom in 31% of patients, followed by dyspnea (24%) and weakness/fatigue (11%). The high prevalence of advanced disease and the demonstrated high symptom burden mandate the initiation and development of culturally sensitive palliative care models, especially hospital-based ones, to relieve the suffering of patients with cancer in Kuwait.
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This article describes the patients and activities of the Pediatric Palliative Care and Pain Control Clinic of the National Children's Hospital (PPCPCC NCH) in San Jose, Costa Rica Central America, founded in 1990, is the first such clinic in the country. ⋯ The initial analysis enabled us to obtain information and feedback about the work of the PPCPCC. We are now able to understand more fully the needs of pediatric palliative care in Costa Rica such as increasing the coverage of pediatric patients who require palliative care, improving our resources, further defining the criteria for admission of patients to a palliative care program, and developing standards for measuring and recording symptoms besides pain.