Jean Kutner

..Hospice, which provides a multidisciplinary approach to care at the end of life, can assist Mrs H and her family in making decisions that are consistent with her goals...

..Despite the physical, emotional and spiritual demands of working with end-of-life patients and their families, being open and willing to face these challenges can lead to positive growth and increased meaning for all involved...

..The goal of this qualitative study was to understand caregivers' needs to inform the feasibility, structure, and content of a telephone-based counseling intervention...

..Small studies of variable quality suggest that massage therapy may relieve pain and other symptoms...

..Issues of recruitment, retention and training should be accounted for in hospice-based research study design and budgeting...

..Patient involvement in preventing inpatient medication errors is predicated upon patient knowledge of their medications. However, there is little published on the accuracy of patient knowledge or understanding of their hospital medications...

..approximately 4% to 17% of all adult strokes have onset in the hospital. Previous research indicates significant in-hospital evaluation delays and lower adherence to some measures of quality care compared to out-of-hospital strokes...

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..This study was designed to determine if physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators (ICDs) are regionally associated with ICD use...

..The purpose of this study was to describe quality of life (QOL) and psychosocial and spiritual issues among patients receiving hospice care...

..A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer...

..Variation in medication use may suggest areas for best practices or quality improvement in medication use in end-of-life care...

..The persistence of significant symptom distress, particularly due to pain, argues for the need for enhanced evidence to guide care provided in the last days and weeks of life...

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..This conclusion provides a unique opportunity for hospices to collaborate with healthcare educational institutions and to influence the work force of the future...

..These nurses endorsed multiple barriers contributing to unrelieved symptom distress in patients receiving hospice care. Interventions to improve symptom management in hospice may need to account for these differing barrier patterns...

..Improved release planning, coordination between the medical, mental health and criminal justice systems may reduce the risk of poor health outcomes for this population...

..Little is known about symptoms and their burden in outpatients with chronic heart failure. Diverse symptoms may be associated with poor heart failure-related quality of life, and depression may be related to increased symptoms...

..Timeliness of care is 1 of 6 dimensions of quality identified in Crossing the Quality Chasm. We compared patient and physician perceptions of appropriate timing of visits for common medical problems...

..Given this favorable view, variations in the use and content of written materials may signify an opportunity to decrease symptom distress in hospice through the implementation of evidence-based symptom management resources...

..Little is known about hospices' readiness to meet this new mandate...

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..Increased patient education about the range of conditions appropriate for care in the PCP office and more availability of office appointments could potentially decrease the ED usage by patients with low-acuity problems...

..This care is complementary to contemporary heart failure care and can be provided concurrently at any point during the illness based on patient and caregiver needs...

..Confusion is common among ill patients and has broad consequences for their care and well-being. The prevalence of confusion in hospice patients is unknown...

..In this equal access system, minority patients were at least as likely or more likely to have important aspects of end-of-life care addressed compared with white patients...

..Although physical distress is a component of suffering, other determinants likely play a role. This study attempted to elucidate these other components in an effort to understand the nature of suffering better...

..Little guidance is available for health care providers who try to communicate with patients and their families in a culturally sensitive way about end-of-life care...

..Clinics serving a large population of Spanish-speaking patients can enhance patient satisfaction by avoiding the use of untrained interpreters, such as family or ad hoc interpreters...

..Pharmaceutical costs varied by patient setting, but long-acting opioids and continuous-infusion delivery systems were the two most significant contributors. A variety of mechanisms were employed to control drug costs...

..DESCRIPTION: Clerkship directors identified a lack of exposure to end-of-life issues and hospice care as gaps in our third-year medical student curriculum. This curriculum was implemented to address these deficiencies...

..Medical care at the end of life remains poor. One approach to improving end-of-life care is through education of medical trainees. However, evidence regarding the structure of an ideal educational intervention is sparse...

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..The goal of this study was to evaluate the feasibility of this strategy for identifying hospice patients who are interested in research participation...

..Barriers to providing optimal palliative care in rural communities are not well understood...

..Analyses will determine the independent influence of the intervention (a series of massage therapy sessions) on the identified outcomes (pain, physical and emotional symptom distress, quality of life). ..