Journal of palliative medicine
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Background: Nurses who provide person-centered care even after death must possess essential competencies to perform their duties effectively. Therefore, it is imperative to develop educational programs to enhance the capabilities of new nurses in care after death. Objective: To develop a care after-death mentoring program that includes an augmented reality (AR) end-of-life experience for new nurses and to describe its effectiveness. ⋯ Results: Significant improvements were observed in both comfort during bereavement/end-of-life care and compassion competency (t = -8.43, p < 0.001; t = -4.90, p < 0.001). Conclusions: This study demonstrated enhancements in participants' comfort levels regarding bereavement and end-of-life care, as well as their ability to exhibit compassion after participating in the program. Consequently, it was confirmed that simulation-based care after-death mentoring education utilizing an AR app helped enhance the capabilities of new nurses.
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Background: Malignant ascites (MA) represents 10% of all causes of ascites and is associated with a poor prognosis. The PleurX tunneled peritoneal catheter is a device that allows the management of MA at home in a palliative care context (renamed AscitX catheter for this work). The objective of this study was to analyze real-world data of AscitX use for cancer patients with MA, to describe complications associated with the insertion of this device, and to identify factors influencing patient outcomes. ⋯ Regarding post-catheter end-of-life management, 41% of the patients died at home. Conclusions: AscitX catheter safety appears to be acceptable and most of the palliative care patients included in our study died at home. We identified CT-diagnosed portal hypertension as associated with better prognosis, as well as the absence of diuretic treatment.
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This case discussion describes the use of an expanded interdisciplinary palliative care team structure that integrated art therapy and narrative therapy to meet the needs of a woman with a history of chronic pain and Burkitt lymphoma, who had received quadruple amputation due to complications of treatment. The concurrent interventions of art therapy, narrative therapy, and traditional palliative care consultation services resulted in high-quality, trauma-informed care, contributing to effective psychosocial coping and enhanced total pain management. The addition of expressive therapeutic modalities to inpatient palliative care consultation requires close collaboration and may be particularly valuable when addressing complex needs in the setting of prolonged hospitalizations.
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Objective: Medication management in home hospice is challenging for family caregivers (FCGs). We tested a patient-centered medication review and FCG support program delivered by hospice staff called "Shared Medication PLanning In (SiMPLIfy) Home Hospice." Methods: A pilot cluster-randomized trial at two U. S. home hospice agencies measured the primary outcome of reduction in Medication Regimen Complexity Index (MRCI) (range 0 [no medications]-no upper limit) and secondary outcome of Family Caregiver Medication Administration Hassle Scale (FCMAHS) (range 0 [no hassle-120 [greatest hassle]). ⋯ FCMAHS differed between spousal and nonspousal FCGs (p = 0.12). Conclusion: A clinician-FCG-patient communication program in home hospice is feasible and may reduce medication complexity. SiMPLIfy has the potential to reduce polypharmacy.