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Palliative care is treating symptoms of a condition rather than treating the underlying disease itself. Palliative care aims to achieve the best quality of life for patients and their families. [...]

2024 FEB 10 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Digestive System Diseases and Conditions - Gastric [...]

Objective: To examine the associations of primary care physician (PCP) care continuity with cancer-specific survival and end-of-life care intensity. Data Sources: Surveillance, epidemiology, and end results linked to Medicare claims data from 2001 to 2015. Study Design: Cox proportional hazards models with mixed effects and hierarchical generalized logistic models were used to examine the associations of PCP care continuity with cancer-specific survival and end-of-life care intensity, respectively. PCP care continuity, defined as having visited the predominant PCP (who saw the patient most frequently before diagnosis) within 6 months of diagnosis. Data Extraction Methods: We identified Medicare patients diagnosed at age 66.5-94 years with stage-III or IV poor-prognosis cancer during 2001-2012 and followed them up until 2015. Patients who died within 6 months after diagnosis were excluded. Principal Findings: Primary study cohort consisted of 85,467 patients (median survival 22 months), 71.7% of whom had PCP care continuity. Patients with PCP care continuity tended to be older, married, nonblack, non-Hispanic, and to have fewer comorbid conditions (p < 0.001 for all). Patients with PCP care continuity had lower cancer-specific mortality (adjusted hazard ratio: 0.93; 95% confidence interval [CI]: 0.91 to 0.95; p = 0.001) than did those without PCP care continuity. Findings of the 2001-2003 cohorts (nearly all of whom died by 2015) show no associations of overall end-of-life care intensity measures with PCP care continuity (adjusted marginal effects: 0.005; 95% CI: -0.016 to 0.026; p = 0.264). Conclusions: Among Medicare beneficiaries with advanced poor-prognosis cancer, PCP continuity was associated with modestly improved survival without raising overall aggressive end-of-life care. KEYWORDS cancer/oncology, care continuity, end of life, primary care physician, prospective cohort study, survival analysis What is known on this topic * End-of-life care for patients diagnosed with advanced cancer is often aggressive, without aligned patient preferences. * Continuity of primary care physician (PCP) care may facilitate information exchange and patient-centered decision making across PCPs, cancer specialists, and other care providers. * Among older persons with cancer, continuity with their primary care physician has been expected to improve survival and reduce the intensity of end-of-life care, but evidence to date has been inconclusive. What this study adds * Medicare beneficiaries with stage-III or IV poor-prognosis cancer have a modest survival benefits but no associations with aggressive end-of-life care from following up with their predominant PCPs within 6 months following diagnosis. * Efforts to improve PCP continuity of care over time may benefit patients with poor-prognosis cancer without increasing their end-of-life care burdens., 1 | INTRODUCTION With the increasing number of cancer survivors,1 smooth care transition before and after cancer diagnosis becomes vital for patients' long-term survival.2,3 Continuity of care with one's primary [...]

Various factors impact end-of-life (EOL) for older adults. This period is more complex for older adults with severe and persistent mental illness (SPMI). The current article aims to explore a non-exhaustive list of person-level and environmental factors that may impact EOL for older adults with SPMI. [Journal of Gerontological Nursing, 48(3), 11–16.], Severe and persistent mental illness (SPMI) affects approximately 4% of the U.S. population and refers to chronic and debilitating psychiatric disorders, such as schizophrenia, major depression, and bipolar disorder (Donald [...]

Cancer in a pet is one of the most devastating and confusing diagnoses pet parents can receive. Often unexpected, it leaves clients reeling and overwhelmed by the choice of treatments. [...]

Byline: Daniela. Parra-Tanoux, Maria. Dussan-Vargas, Martha. Escandon Painful-blind eye (PBE) is a challenging and debilitating condition that greatly affects the quality of life of patients. Although PBE can result from [...]

The concept of guilt has been studied in the context of caregivers of older adults with advanced dementia, usually describing the feelings a person has of placing a loved one in a long-term care facility; however, little research has been done to understand how nursing home staff and proxies for older adults with dementia describe guilt as a decision-influencer in end-of-life care. For the current study, private, semi-structured interviews were conducted with 158 nursing home staff and 44 proxies in 13 nursing homes across four demographic regions in the United States. Interviews were reviewed and analyzed for how the concept of guilt was perceived as a decision-influencer. Nursing home staff described guilt as an important influencer in why proxies make decisions about end-of-life care. Staff noted that proxies who felt guilty about their relationship with their loved one or lack of time spent at end-of-life tended to be more aggressive in care decisions, whereas no proxies mentioned guilt as an influencer in care decisions. Rather, proxies used language of obligation and commitment to describe why they make decisions. Findings highlight the disconnect between nursing home staff and proxies in what motivates proxies to make end-of-life decisions for loved ones. Nursing home staff should be aware of misconceptions about proxies and work to understand proxies' true rationale and motivations for making care decisions. [Journal of Gerontological Nursing, 48(1), 22–27.], Feelings of guilt are common among family caregivers. Guilt among caregivers of older adults with dementia is a negative feeling resulting from conflict between one's actions and one's internal moral [...]

Background: Access to community palliative and end-of-life care that is patient-centred, culturally sensitive and responsive is not equitable for all people in New Zealand. There is an opportunity to transform primary palliative care through an anticipatory prescribing approach and an interdisciplinary workforce. Research is needed to inform the development of best practice and give confidence to authorised prescribers. Aim: This study aimed to identify the factors influencing anticipatory prescribing in community palliative and end-of-life care. Methodology: A literature search was undertaken of the databases CINAHL Complete, Science Direct, PubMed, Google Scholar, Grey Lit, Open Grey, Mednar and Open Core. Seven relevant primary research studies were selected. A meta-synthesis of the qualitative research was carried out using a critical realist framework. Findings: Three main themes emerged from the reviewed articles to explain the factors influencing anticipatory prescribing in community palliative and end-of-life care, including expertise, teamwork and prioritisation. Expertise had two subthemes, which were knowing when to prescribe and knowing how to prescribe. Conclusions: Developing and maintaining expertise in primary palliative care, developing better interdisciplinary teamwork, and the prioritising of this prescribing practice are the factors underpinning effective anticipatory prescribing in palliative and end-of-life care. There is an ethical responsibility to anticipate the likely deterioration and end-of-life needs of palliative patients, so timely care can be provided and symptoms managed. Anticipatory prescribing should be individualised, approached with an equity lens, and delivered through an interdisciplinary health workforce to effectively meet population needs. KEY WORDS Palliative, end-of-life care, anticipatory prescribing, patient/whanau-centred, interdisciplinary team, community, INTRODUCTION Interdisciplinary teamwork is integral to the philosophy of palliative care (Brown, 2015). The complexities of whole-person care require the complementary approaches of different team members to work together to [...]

2023 APR 15 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Opioids is now available. According to news reporting [...]

2023 APR 8 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on cancer. According to news reporting out of [...]

2023 FEB 11 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on Cancer are discussed in a new report. According to [...]

2023 JAN 14 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on Opioids are presented in a new report. According to [...]

2023 JAN 7 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New study results on cancer have been published. According to news reporting [...]

2022 NOV 12 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Heart Disorders and Diseases - Heart Failure have [...]

2022 OCT 8 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New study results on esophageal cancer have been published. According to news [...]

2022 AUG 6 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on delirium are discussed in a new report. According to [...]

2022 JUL 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on Cancer are presented in a new report. According to [...]

2022 APR 30 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New study results on gallbladder cancer have been published. According to news [...]

2022 APR 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on non-small cell lung cancer. According to news [...]

2022 APR 2 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on Drugs and Therapies - Combined Modality Therapy is the [...]