Abstract
Letter to the Editor
The Australia New Zealand Society of Palliative Medicine (ANZSPM) Clinical Indicators Working Group is committed to the development of a Clinical Indicator (CI) for the care of the dying. (page 1280)
Brief Reports
Given the growing body of evidence and the legal controversy surrounding medical marijuana, it is likely that palliative medicine providers will be faced with questions about its use. The purpose of this survey was to assess the knowledge, experience and views of hospice professionals regarding the medical use of marijuana. (page 1291)
Fast Facts and Concepts
#246: Emergency Department Management of Hospice Patients (page 1345)
#247: Initiating a Hospice Referral from the Emergency Department (page 1346)
Personal Reflection
We are beginning to learn how stroke patients die. Most die after a large stroke and deliberate decision to withhold or withdraw life-sustaining therapies. (page 1348)
Case Discussions in Palliative Medicine
We report the first case of a patient in permanent vegetative state (PVS) who develops paroxysmal sympathetic hyperactivity (sympathetic storm) 8 months after the hypoxic brain injury that lead to PVS. (page 1355)
Book and Media Reviews
(page 1358)
Recent Literature
(page 1359)
Empowering ICU Nurses with Communication Skills
Intensive care unit (ICU) nurses often see patients and families more than any other discipline, but may not formally be involved in family conferences. This study intervention trained 99 ICU nurses in advanced communication skills using didactics and role plays. Later, nearly all nurses expressed greater confidence and less anxiety in participating in family meetings. (page 1325)
Emergency Department Physicians' Views on Palliative Care
In this qualitative study, the authors interviewed 24 emergency medicine physicians about their perspectives on palliative care in the emergency department setting. They asked about their training in and understanding of palliative care, which was often equated with end-of-life care. Most physicians felt palliative care was underrepresented in emergency departments in general. (page 1333)
Parents' Stories: “My Baby Is a Person”
Diagnosis of a lethal fetal diagnosis (LFD) early in pregnancy is devastating for parents. This qualitative descriptive study sought to clarify the experiences and needs of families in order to design perinatal palliative care services. (page 1302)
Identifying the Needs of Heart Failure Patients
Researchers interviewed 33 adults with symptomatic heart failure and their families. The respondents desired early support in adjusting to the illness, relief of symptoms, the involvement of family caregivers, and coordination by a provider who understood their personal and medical issues. (page 1317)
How Do Patients Define “Symptom Burden?”
In this prospective cohort study, patients who rated one or more symptoms on the Edmonton Symptom Assessment Scale at 7 or greater were higher risk of self-defined “burden,” and likely to experience significant impact on physical, emotional, and social functioning. (page 1309)
End-of-Life Care for the Very Old
This retrospective review of medical records of patients who died on an inpatient palliative care unit found that very old people had shorter admissions and lower medication requirements compared to younger patients. (page 1339)