Journal of palliative medicine
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Racial and ethnic disparities in health care access and quality are well documented for some minority groups. However, compared to other areas of health care, such as disease prevention, early detection, and curative care, research in disparities in palliative care is limited. Given the rapidly growing population of minority older adults, many of whom will face advanced serious illness, the availability of high-quality palliative care that meets the varied needs of older adults of all races and ethnicities is a priority. This paper reviews existing data on racial and ethnic disparities in use of and quality of palliative care and outlines priorities for future research.
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There are few studies where quality of life (QOL) and contributive factors are assessed in locked-in syndrome (LIS) patients with complete physical and functional disability and dependence on caregivers. ⋯ In our study, QOL in LIS patients was not significantly altered compared to control subjects in MQOL-SIS and in the MCS SF-36 scale; these results match previous studies published in the literature. Several factors may have an impact on QOL in LIS patients, such as family support and patient-computer communication devices; these may have contributed to improve QOL in LIS patients in this study.
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Little regional data exists on the distress of people nearing the end of their lives and their caregivers. ⋯ The practical, physical, emotional, and spiritual needs of people at the end of life in Botswana and their caregivers are not being fully met, with poor overall quality of life among the dying. More research is needed to explore how hospice and home health services and the services of spiritual leaders can be expanded to meet their needs.
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There are few studies specifically focused on the job satisfaction of hospice and palliative nursing assistants (NAs). The goal of this study was to ascertain factors contributing to NAs' job satisfaction and intent to remain with their current employer, garner suggestions for improving NA jobs, and inform hospice and palliative care providers concerned about retaining qualified, satisfied NAs. ⋯ This study found hospice and palliative NAs to be satisfied and committed to their jobs, which most viewed as long-term careers. However, organizations committed to recruitment and retention of committed and satisfied NAs would do well to ensure high-quality NA supervision, include NAs as valued team members, encourage positive work relationships, work to reduce problems identified by NAs as interfering with their work, and continue efforts to increase NA compensation.
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The query, "Isn't there anything more you can do?" represents a classic informational question with an emotional subtext. In our previous work we have emphasized the value of noticing the emotional cue implicit in this question, and responding with an empathic statement. Yet responding explicitly to patients' emotions is not the best initial communication strategy for all patients. In this paper we discuss four different opening communication strategies--verbalize empathy, exchange information, contain chaos, respect searching--for patients who ask, "Isn't there anything more you can do?"