Abstract
Letter to the Editor
Within psycho-oncology, both palliative medicine clinicians and psychiatrists can focus on symptom management during both curative intent treatment as well as end-of-life care. (page 1326)
Brief Report
Pilot data suggest that consideration be given to employing transplant status as a method of identifying HD patients at risk for greater symptom burden and targeting them for palliative interventions. (page 1459)
Fast Facts and Concepts
#273 Treating Depression after Heart Transplantation (page 1477)
Personal Reflection
“I learned about the concept of ‘No agenda’ from my chaplain colleagues when I was a fellow. They explained it as being open to whatever opened in front of you, going where the patient led.” (page 1482)
Case Discussions in Palliative Medicine
The case of a 17-month-old girl with progressive leukemia who was at the end of her life and whose severe opioid-induced constipation and rectal prolapse were successfully treated with the μ-opioid-receptor antagonist methylnaltrexone. (page 1486)
Recent Literature
(page 1489)
Early Palliative Care in the Emergency Department
The authors describe how early initiation of palliative care consultation in the ED resulted in significantly shorter lengths of stay for patients admitted to the hospital over a four-year period. (page 1362)
“Isn't There Anything More You Can Do?”
In this paper, Tony Back discusses four different opening communication strategies—verbalize empathy, exchange information, contain chaos, respect searching—for patients who ask, “Isn't there anything more you can do?” (page 1429)
Screening for Early Genetic Counseling
Researchers found use of a simple screening tool by oncologists and palliative care clinicians could enable earlier cancer genetic risk assessment for unaffected relatives, improving the potential benefit from targeted screening and intervention. (page 1350)
Teaching Professionalism
In this qualitative study the authors analyzed student reflective writing about a palliative care clinical experience for evidence of learning and growth in students' sense of professionalism. (page 1342)
Assessing Nurse Educators
This study validates a new questionnaire for measuring the impact of End of Life Nursing Education Consortium (ELNEC) workshops on participant readiness to teach the content. (page 1375)
Measuring Caregiver Burden
Chinese researchers adapted a version of the Brief Assessment Scale for Caregivers, a tool measuring positive and negative effects of caregiving, and found it valid and culturally appropriate. (page 1394)
Mindfulness in Bereavement
The authors studied the benefits of Existential Behavioral Therapy, a form of mindfulness in bereavement care. Participants reported improved quality of life through social support, a sense of belonging, and emotional, cognitive, and practical help from others. They also described better self-regulation, including mindfulness, acceptance, focusing on the positive, and future orientation. (page 1410)
Medicaid's Care of Chronically IIl Children
The authors examined the current California Medicaid system and found it appears to provide comprehensive care for children at end of life. However, hospice and home health services were underutilized, and represent an opportunity to improve the quality of end-of-life care while potentially reducing costs or remaining budget neutral. (page 1388)
Measuring Competency in Primary Palliative Care
Japanese researchers share a validated tool for evaluating physicians' knowledge of palliative care as well as educational programs in primary palliative care. (page 1423)
Staff Retention in Hospice
In a national survey of 751 hospice nursing assistants, nearly all were satisfied with their job (96.4%), not at all likely to leave in the next year (83.9%), and not thinking of quitting (98.7%). Predictors of job satisfaction and long-term commitment were team spirit, quality of supervision, pride, and intent not to leave. (page 1356)
Assessing Current Practice in Australia
In a national survey of palliative care physicians in Australia, most doctors supported the use of clinical practice guidelines but reported barriers to coordination of care and access to nonpharmacologic interventions for patients. (page 1403)