Journal of palliative medicine
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Over the past decade over two-thirds of U.S. hospitals have established palliative care programs. National data on palliative care program staffing and its association with operational outcomes are limited. ⋯ This report demonstrates that operational effectiveness, as measured by staffing and palliative care service penetration, is associated with shorter time to palliative care consultation.
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Comparative Study
Does Diagnosis Make a Difference? Comparing Hospice Care Satisfaction in Matched Cohorts of Heart Failure and Cancer Caregivers.
Half of heart failure patients will die within five years of diagnosis, making them an ideal population for hospice to reach. Yet hospice originated in oncology, and problems have been noted with the enrollment of heart failure patients. Whether caregiver satisfaction, a key quality measure in hospice, differs between heart failure and cancer caregivers is unknown. ⋯ The diagnosis of heart failure, in and of itself, does not appear to make a difference in informal caregiver satisfaction with hospice care. Hospice provides high-quality care for patients, but improvements are needed in caring for the caregiver.
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Many patients with cancer involving the respiratory system suffer from the frequent recurrence of significant, submassive hemoptysis, which may result in invasive procedures, hospital stays, and a reduction in quality of life. Currently, there are no widely accepted noninvasive therapeutic options. Few case studies have looked at the benefit of tranexamic acid (TXA) as a noninvasive therapy in the treatment of hemoptysis. ⋯ Nebulized TXA seems to be a safe, effective, and noninvasive method for controlling, or at least temporizing, hemoptysis in select patients. Nebulized TXA may be useful as a palliative therapy for chronic hemoptysis and as a tool in the acute stabilization of hemoptysis.
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Fulfillment of patient preferences for location of dying is of continued end-of-life care interest. Of those voicing a preference, most prefer home. However the majority of deaths occur in an institutional setting. ⋯ This study identifies elements of primary and integrated care that address the gap between preferred and actual place of care.
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A primary barrier to physician disclosure of terminal prognosis is concern that patients will lose hope. Inpatient palliative care (IPC) teams are especially posed to mediate this barrier, but little is known about patient perceptions and experience of IPC. ⋯ Results suggest that disclosure of a terminal prognosis does not mean loss of patient hope. Instead, hope was redefined on a goal other than cure. Presenting patients with information and increasing their knowledge about care options and resources may facilitate patients in identifying meaningful goals that are better aligned with their prognosis.