End-of-life discussions: The top 5 things to talk about with patients and their families
2014-11-03
(Press-News.org) What are the most important things for health care teams to talk about in end-of-life discussions with patients in hospital and their families? A new study published in CMAJ (Canadian Medical Association Journal) asked older patients and their families for their top priorities and found gaps between what patients would like and the care they actually receive.
"Our findings could be used to identify important opportunities to improve end-of-life communication and decision-making in the hospital setting," states Dr. John You, lead author of the study and associate professor of medicine, and clinical epidemiology and biostatistics at McMaster University, and a staff physician at Hamilton Health Sciences, Hamilton, Ontario.
Current guidelines list 11 key elements for health care providers to discuss regarding end-of-life care, although these are based mainly on expert opinion and not on patient and family feedback.
A team of researchers with backgrounds in general internal medicine, critical care medicine and palliative care surveyed 233 older adults in hospital with serious illnesses and 205 family members about the importance of the 11 guideline-recommended elements of end-of-life care. The patients had been admitted to 9 hospitals in British Columbia, Alberta, Ontario and Quebec.
Top 5 things to discuss in end-of-life care, according to patients and families:
preferences of care in event of life-threatening illness
patient values
prognosis of illness
fears or concerns
additional questions regarding care.
"However, we found that these elements are infrequently discussed and that concordance between preferred and prescribed goals of care is low," state the authors.
Patients reported that of the 11 key elements, an average of only 1.4 had been discussed with the health care team within the first few days after admission to hospital. The more elements of care that physicians discussed with patients, the higher the satisfaction patients and their families reported about care received.
"Our results suggest that concordance between preferences and prescribed goals of care, as well as satisfaction with end-of-life communication, increase with the number of elements discussed," write the authors.
They hope that their findings will help improve end-of-life care for patients in hospital.
The authors have previously published a related guide in CMAJ called "Just Ask" to help physicians initiate end-of-life discussions with patients and their families.
INFORMATION:
ELSE PRESS RELEASES FROM THIS DATE:
2014-11-03
Symptoms of mental illness in children and adolescents do not appear to be increasing, according to a large study of Canadian youth published in CMAJ (Canadian Medical Association Journal)
"Popular media tends to perpetuate the idea that the prevalence of mental disorders is increasing," writes Dr. Ian Colman, Canada Research Chair in Mental Health Epidemiology and associate professor at the University of Ottawa, Ottawa, Ontario, with coauthors. "However, research supporting this position has been inconsistent."
Dr. Colman and colleagues sought to better understand ...
2014-11-03
Pro-life Americans are less likely to hear about the abortions women they know have had than are pro-choice Americans, a New York University study shows. The findings, which appear in the journal Sociological Science, point to a previously unexplored divide on the abortion issue: differences in perceptions of those we associate with.
"Americans who are opposed to abortion are less likely to hear that their sister, mother, or friend had an abortion than their pro-choice peers," says Sarah K. Cowan, an assistant professor in NYU's Department of Sociology and the study's ...
2014-11-03
Ever walked into a hotel room and smelled old cigarette smoke? While the last smoker may have left the room hours or even days ago, the lingering odors—resulting from noxious residue that clings to walls, carpets, furniture, or dust particles—are thanks to thirdhand smoke.
Scientists at the U.S. Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab), who have made important findings on the dangers of thirdhand smoke and how it adsorbs strongly onto indoor surfaces, have published a new study assessing the health effects of thirdhand smoke ...
2014-11-03
A new study of emergency department patients in 18 countries, made available online today by the scientific journal Addiction, shows that the risk of injury caused by acute alcohol consumption is higher for women compared with men. While the risk of injury is similar for both men and women up to three 'standard' drinks (containing 16 ml or 12.8 g of pure ethanol), the risk then increases more rapidly for women, becoming twice the risk to men around 15 drinks and three times the risk to men around 30 drinks. In this study the drinks were reportedly consumed within six ...
2014-11-03
CHICAGO --- If you want to avoid chronic back pain, put out the cigarette. A new Northwestern Medicine® study has found that smokers are three times more likely than nonsmokers to develop chronic back pain, and dropping the habit may cut your chances of developing this often debilitating condition.
"Smoking affects the brain," said Bogdan Petre, lead author of the study and a technical scientist at Northwestern University Feinberg School of Medicine. "We found that it affects the way the brain responds to back pain and seems to make individuals less resilient to an ...
2014-11-03
For the first time, researchers have shown that practising mindfulness meditation or being involved in a support group has a positive physical impact at the cellular level in breast cancer survivors.
A group working out of Alberta Health Services' Tom Baker Cancer Centre and the University of Calgary Department of Oncology has demonstrated that telomeres – protein complexes at the end of chromosomes – maintain their length in breast cancer survivors who practise meditation or are involved in support groups, while they shorten in a comparison group without ...
2014-11-03
Introducing competing "biosimilar" versions of complex biologic drugs used to treat illnesses such as cancer and rheumatoid arthritis could cut spending on biologics in the United States by $44 billion over the next decade, according to new analysis from the RAND Corporation.
While biologics have advanced medical treatment for many conditions, they often are expensive and patient copays for some biologics can be several thousand dollars per year. In 2011, eight of the top 20 drugs in the United States in terms of sales were biologics and the annual spending on the drugs ...
2014-11-03
BOSTON—New research reports that preoperative pain and depressive symptoms in older adults place them at greater risk of delirium following surgery. According to the findings published today in The Lancet Psychiatry journal, both pain and depression are independent and interactive risk factors for delirium, suggesting a cumulative effect.
Individuals with delirium experience a sharp decline in attention and mental function. Older adults are especially susceptible to delirium following surgery, occurring in up to 51% of surgical patients 65 and older. Moreover, depression ...
2014-11-03
Clemson researchers find that blending movement and computer programming supports girls in building computational thinking skills, according to an ongoing study funded by the National Science Foundation and emerging technology report published in journal Technology, Learning and Knowledge.
Even with increasing demands for computationally savvy workers, there is a lack of representation among women in science, technology, engineering and mathematics fields (STEM), the researchers say.
"We want more diverse faces around the table, helping to come up with technological ...
2014-11-03
Aging is the most significant and universal risk factor for developing neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS) and Alzheimer's, Parkinson's and Huntington's diseases. This risk increases disproportionately with age, but no one really knows why.
Now a team of scientists from Northwestern University, Proteostasis Therapeutics, Inc. and Harvard University has uncovered some clues. The researchers are the first to find that the quality of protective genes called molecular chaperones declines dramatically in the brains of older humans, both ...
LAST 30 PRESS RELEASES:
[Press-News.org] End-of-life discussions: The top 5 things to talk about with patients and their families
