Journal of palliative medicine
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Background: Advance care planning (ACP) is underutilized among those with advanced cancer, leading to the potential of not receiving goal-concordant care. Objectives: To understand the experience of patients in creating a video declaration (ViDec) of their ACP preferences and their family member/caregivers' perceptions after viewing their ViDec. Design: Qualitative study among patients and family members/caregivers. ⋯ Recommendations to improve the ViDec process included providing structured prompts to patients. Conclusions: These case studies highlight the potential high-perceived usefulness of ViDecs across patients and caregivers. ViDecs have the potential to improve care among patients with advanced cancer.
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Case Reports
Assessing SPACES in Patients with Chronic Obstructive Pulmonary Disease Helps Identify Unmet Needs.
Environmental factors contribute to the symptom burden for patients with chronic obstructive pulmonary disease, particularly in the Appalachian region where prevalence of the disease is higher. These regions are especially vulnerable because of poor air quality, exposure to organic toxic dust, and higher percentage of smokers. Using an innovative approach to assess the home environmental impact, SPACES (Spend, Primary Place, Assessment, Changes, Equipment, and Synergy), palliative care providers may uncover factors contributing to the symptom burden that might otherwise be missed. We present a case of a 68-year-old woman living in Appalachia with several environmental factors that contributed to her symptom burden while reducing the healing home environment.