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Palliative & Supportive Care

Rachel D Zordan, Melanie L Bell, Melanie Price, Cheryl Remedios, Elizabeth Lobb, Christopher Hall, Peter Hudson
ContextThe short-term impact of prolonged grief disorder (PGD) following bereavement is well documented. The longer term sequelae of PGD however are poorly understood, possibly unrecognized, and may be incorrectly attributed to other mental health disorders and hence undertreated. OBJECTIVES: The aims of this study were to prospectively evaluate the prevalence of PGD three years post bereavement and to examine the predictors of long-term PGD in a population-based cohort of bereaved cancer caregivers...
February 15, 2019: Palliative & Supportive Care
Daisuke Fujisawa, Jennifer S Temel, Joseph A Greer, Areej El-Jawahri, Lara Traeger, Jamie M Jacobs, Stacy Cutrono, William F Pirl
OBJECTIVE: Wearable devices such as a wrist actigraph may have a potential to objectively estimate patients' functioning and may supplement performance status (PS). This proof-of-concept study aimed to evaluate whether actigraphy data are significantly associated with patients' functioning and are predictive of their survival in patients with metastatic non-small cell lung cancer. METHOD: We collected actigraphy data for a three-day period in ambulatory patients with stage IV non-small cell lung cancer...
February 11, 2019: Palliative & Supportive Care
Kelsey B White, Patricia E Murphy, Jane Jeuland, George Fitchett
BACKGROUND: The prevalence of burnout and distress among palliative care professionals has received much attention since research suggests it negatively impacts the quality of care. Although limited, research suggests low levels of burnout or distress among healthcare chaplains; however, there has been no research among chaplains working in specific clinical contexts, including palliative care. OBJECTIVE: This study explored the distress, self-care, and debriefing practices of chaplains working in palliative care...
February 11, 2019: Palliative & Supportive Care
Gary L Stein, Cathy Berkman, Bonnie Pollak
OBJECTIVE: Palliative social workers have taken steps to increase the numbers of social workers trained and competent to deliver effective psychosocial palliative care. Despite these developments, masters of social work (MSW) programs have only begun to develop curricula preparing students for entry-level practice. This study sought to determine the type and extent of content areas included in MSW courses dedicated to palliative care or with content related to palliative care practice...
February 4, 2019: Palliative & Supportive Care
Yong Tang
OBJECTIVE: Family caregivers (FCs) in China provide hospice care to terminally ill cancer patients; however, few studies have been conducted in China on caregiver burden and bereavement experiences as a process that continues over time. The purpose of this study was to identify the main elements of caring and bereavement experiences for FCs caring for patients diagnosed with terminal cancer. METHOD: Twenty in-depth qualitative semistructured interviews were conducted with FCs providing care in a hospice unit in Shenzhen, Southern China...
January 31, 2019: Palliative & Supportive Care
David B Bekelman, Christopher E Knoepke, Carolyn Turvey
OBJECTIVE: In seriously ill cardiac patients, several psychotherapy efficacy studies demonstrate little to no reduction in depression or improvement in quality of life, and little is known about how to improve psychotherapies to best address the range of patient needs. An interpersonal and behavioral activation psychotherapy was a key component of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) multisite randomized clinical trial. Although depressive symptoms did improve in the CASA trial, questions remain about how best to tailor psychotherapies to the needs of seriously ill patient populations...
January 31, 2019: Palliative & Supportive Care
Aldis H Petriceks
No abstract text is available yet for this article.
January 31, 2019: Palliative & Supportive Care
Sriram Yennurajalingam, Srikanth Reddy Barla, Joseph Arthur, Gary B Chisholm, Eduardo Bruera
No abstract text is available yet for this article.
January 31, 2019: Palliative & Supportive Care
Gabrielle Silver, Chani Traube
OBJECTIVE: Delirium is a frequent and severe complication of serious pediatric illness. Development of a nonpharmacologic approach to prevent pediatric delirium may improve short- and long-term outcomes in children and their families. In this brief report, we describe the development of a quality improvement project designed to methodically promote the family member's engagement, comforting, and orienting activities with their critically ill child to decrease delirium rates. METHOD: We created a developmentally specific Delirium Prevention Toolkit for families...
January 31, 2019: Palliative & Supportive Care
Hideki Onishi, Mayumi Ishida, Nozomu Uchida, Takao Takahashi, Daisuke Furuya, Yasuhiro Ebihara, Izumi Sato, Tatsuo Akechi
OBJECTIVE: Thiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer; however, TD has not been recognized in the family caregivers of cancer patients to date. METHOD: From a series of cancer patient caregivers, we reported an aged family caregiver who developed TD while caring for the cancer patient.ResultThe caregiver was a 90-year-old male. He had been accompanying his wife, who was diagnosed with colon cancer 4 years previously, on hospital visits as the primary caregiver, but because of psychological issues, he was recommended to visit the psycho-oncology department's "caregiver's clinic" for a consultation...
January 30, 2019: Palliative & Supportive Care
Kaori Ichihara, Sayako Ouchi, Sachiko Okayama, Fukiko Kinoshita, Mitsunori Miyashita, Tatsuya Morita, Keiko Tamura
OBJECTIVE: To obtain preliminary knowledge to design a randomized controlled trial to clarify the effects of spiritual care using the Spiritual Pain Assessment Sheet (SpiPas). METHOD: The study was designed as a nonrandomized controlled trial. The study took place between January 2015 and July 2015 in a hematology and oncology ward and two palliative care units in Japan. Among 54 eligible patients with advanced cancer, 46 were recruited (24 in the control group vs...
January 26, 2019: Palliative & Supportive Care
Wendy G Lichtenthal, Corinne Catarozoli, Melissa Masterson, Elizabeth Slivjak, Elizabeth Schofield, Kailey E Roberts, Robert A Neimeyer, Lori Wiener, Holly G Prigerson, David W Kissane, Yuelin Li, William Breitbart
OBJECTIVE: To determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer. METHOD: Parents who lost a child to cancer and who were between six months and six years after loss and reporting elevated levels of prolonged grief were enrolled in open trials of MCGT, a manualized, one-on-one cognitive-behavioral-existential intervention that used psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy...
January 26, 2019: Palliative & Supportive Care
Piret Paal, Cornelia Brandst├Âtter, Stefan Lorenzl, Philip Larkin, Frank Elsner
OBJECTIVE: Palliative care training at basic, intermediate, and specialist levels, recommended by the World Health Organization (WHO), is challenging to access in resource-poor countries and regions. Providing support in this regard would seem a moral imperative for all countries with established palliative care education systems and a strong resource base. In collaboration with WHO European Office and European Association for Palliative Care, this paper looks into the educational requirements in palliative care at postgraduate level within Europe...
January 26, 2019: Palliative & Supportive Care
Lauren Miller-Lewis, Jennifer Tieman, Deb Rawlings, Christine Sanderson, Deborah Parker
OBJECTIVE: Understanding factors that are associated with more adaptive death attitudes and competencies can inspire future health-promoting palliative care strategies and inform approaches to training and development for health professionals. The potential importance of meaning, purpose, quality, and values in life for promoting adaptive death attitudes has been highlighted, but there is limited research in this area, particularly in relation to death competence. The purpose of this cross-sectional study was to develop an understanding of demographic and life-related factors associated with perceived death competence, such as meaning in life and quality of life...
January 22, 2019: Palliative & Supportive Care
Denise Serrano-Eanelli, Emma Fattakhov, Murali Krishna, Jill Embler, Steven Byrne, Claudia DiBlasi, Kaitlyn Ludwigsen, Yasmin Leigh, Hasanat Alamgir
OBJECTIVE: In the United States, approximately 20% patients die annually during a hospitalization with an intensive care unit (ICU) stay. Each year, critical care costs exceed $82 billion, accounting for 13% of all inpatient hospital costs. Treatment of sepsis is listed as the most expensive condition in US hospitals, costing more than $20 billion annually. Electronic Medical Orders for Life-Sustaining Treatment (eMOLST) is a standardized documentation process used in New York State to convey patients' wishes regarding cardiopulmonary resuscitation and other life-sustaining treatments...
January 14, 2019: Palliative & Supportive Care
─░smail Okan, Mustafa Suren, Yalcin Onder, Riza Citil, Secil Akay, Tugce Demir
OBJECTIVE: Grief is intertwined with cultural and religious rituals that are highly appreciated in the quality standards of palliative care. Here, we aimed to investigate whether a cultural mourning ritual, the "First Feast," can be used by palliative care teams to ease the grief response of the deceased patient's relatives. METHOD: A questionnaire with 23 questions about the prevalence of the First Feast tradition, the content, the pros and cons, and whether it would be useful for the grieving relatives of deceased patients was prepared and given to the palliative care patients' relatives...
January 10, 2019: Palliative & Supportive Care
Bethany Russell, Sara Vogrin, Jennifer Philip, Nicole Hennessy-Anderson, Anna Collins, Jodie Burchell, Brian Le, Caroline Brand, Peter Hudson, Vijaya Sundararajan
OBJECTIVE: As referrals to specialist palliative care (PC) grow in volume and diversity, an evidence-based triage method is needed to enable services to manage waiting lists in a transparent, efficient, and equitable manner. Discrete choice experiments (DCEs) have not to date been used among PC clinicians, but may serve as a rigorous and efficient method to explore and inform the complex decision-making involved in PC triage. This article presents the protocol for a novel application of an international DCE as part of a mixed-method research program, ultimately aiming to develop a clinical decision-making tool for PC triage...
January 3, 2019: Palliative & Supportive Care
Carrie Lethborg, David W Kissane, Penelope Schofield
OBJECTIVE: Understanding the way therapy works is a complex undertaking. Historically, such enquiry has been dominated by "outcomes" leading to a lack of discourse about clinical processes. In the cancer setting, identifying clinical process can be even more complex because of the added challenges of an ongoing illness. This study investigated the therapeutic processes used in a meaning-based intervention developed for the advanced cancer setting: Meaning and Purpose therapy...
January 2, 2019: Palliative & Supportive Care
David W Kissane, Carrie Lethborg, Joanne Brooker, Courtney Hempton, Sue Burney, Natasha Michael, Margaret Staples, Tanya Osicka, Merlina Sulistio, Jeremy Shapiro, Hilary Hiscock
OBJECTIVE: Meaning and Purpose (MaP) therapy aims to enhance meaning-based coping through a life review that focuses on the value and worth of the person, key relationships, sources of fulfillment, roles, and future priorities in living life out fully. We sought to test the feasibility and acceptability of a six-session model of MaP therapy against a wait-list control cohort in a pilot study seeking effect sizes on measures of adaptation. METHOD: We randomized patients with advanced cancer to MaP therapy or wait-list control, with measures administered at baseline and after 6-8 weeks...
January 2, 2019: Palliative & Supportive Care
Veronica Cardenas, Yuko Abbott, Jeremy M Hirst, Brent T Mausbach, Suzanne Agarwal, Georgianna Collier, Luke Tran, Geline Tamayo, Anna Downey, Maurice Herring, Scott A Irwin
OBJECTIVE: All accredited cancer institutions are required to screen patients for psychosocial distress. This paper describes the development, implementation, and preliminary outcomes of the University of California San Diego Health Moores Cancer Center Wellbeing Screening Program. METHOD: Essential steps learned in a formal National Cancer Institute-funded training workshop entitled "Implementing Comprehensive Biopsychosocial Screening" were followed to ensure successful program implementation...
January 2, 2019: Palliative & Supportive Care
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