Journal ArticleAm J Hosp Palliat Care · May 20, 2024
BACKGROUND: Resident physicians experience personal and professional stressors throughout training. These experiences may increase levels of burnout, depression, and grief. Understanding how these stressors impact trainees is essential for improving wellbe ...
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Journal ArticleJ Pain Symptom Manage · April 2024
INTRODUCTION: No prior study has assessed grief and bereavement curriculum in Hospice and Palliative Medicine (HPM) fellowship programs in the United States. METHODS: A 14-item survey was created and distributed to Accreditation Council for Graduate Medica ...
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Journal ArticleJ Grad Med Educ · April 2023
BACKGROUND: Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediat ...
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Journal ArticleNeurocrit Care · June 2022
BACKGROUND: Palliative care has the potential to improve goal-concordant care in severe traumatic brain injury (sTBI). Our primary objective was to illuminate the demographic profiles of patients with sTBI who receive palliative care encounters (PCEs), wit ...
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Journal ArticleAm J Hosp Palliat Care · February 2022
CONTEXT: Healthcare workers often experience grief stemming from the loss of patients under their care. The impact of personal grief on healthcare workers' wellbeing is less well described, particularly for trainees. To better characterize the prevalence a ...
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Journal ArticleAm J Hosp Palliat Care · April 2021
COVID-19 has not only dramatically changed the way we live, it has also impacted how we die and how we grieve. With more and more Americans dying in ICU settings, away from family, and more funerals being held virtually, the pandemic has seriously curtaile ...
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Journal ArticleThe American journal of hospice & palliative care · December 2020
BackgroundHeart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recomm ...
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Journal ArticleJ Palliat Med · August 2020
Palliative care (PC) focuses on caring for the whole person, from birth to death, while managing symptoms and helping to navigate medical complexities. Care does not stop at the time of death, however, as assisting patients, families, and fellow clinicians ...
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Journal ArticleAm J Hosp Palliat Care · February 2020
BACKGROUND: American College of Surgeons recommends palliative care and surgeons collaborate on the care of patients with poor prognoses. These collaborations are done to discuss symptom management and goals of care. However, contemporary practice patterns ...
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Journal ArticleAm Heart J · January 2020
BACKGROUND/OBJECTIVES: The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of ...
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Journal ArticleJ Palliat Med · April 2019
BACKGROUND: Evidence increasingly supports the integration of specialist palliative care (PC) into routine cancer care. A novel, fully integrated PC and medical oncology inpatient service was developed at Duke University Hospital in 2011. OBJECTIVE: To ass ...
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Journal ArticleAm J Hosp Palliat Care · April 2018
IMPORTANCE: Hip fracture in the elderly patients is associated with increased morbidity and mortality. There is great need for advance care planning should a patient fail to rehabilitate or experience an adverse event during or after recovery. This study w ...
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Journal ArticleJ Oncol Pract · September 2017
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partne ...
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Journal ArticleJ Soc Work End Life Palliat Care · 2017
Challenging end-of-life encounters can be stressful and may lead to burnout. Monthly debriefing sessions are led by a physician and clinical social worker (LCSW). Sessions focus on experiences and emotional reactions rather than case details. Themes identi ...
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Chapter · January 1, 2017
Although older patients preferred less aggressive care than younger patients, many older patients wanted cardiopulmonary resuscitation and care focused on life extension. Patients� families and healthcare providers underestimated older patients’ desire for ...
Cite
Journal ArticleConsultant · November 1, 2016
Stimulants have been used for centuries medicinally, recreationally, and to alleviate fatigue. Because of its favorable pharmacokinetics and low abuse potential, methylphenidate became a highly prescribed drug for the treatment of attention-deficit/hyperac ...
Cite
Journal ArticleAm J Hosp Palliat Care · May 20, 2024
BACKGROUND: Resident physicians experience personal and professional stressors throughout training. These experiences may increase levels of burnout, depression, and grief. Understanding how these stressors impact trainees is essential for improving wellbe ...
Full textLink to itemCite
Journal ArticleJ Pain Symptom Manage · April 2024
INTRODUCTION: No prior study has assessed grief and bereavement curriculum in Hospice and Palliative Medicine (HPM) fellowship programs in the United States. METHODS: A 14-item survey was created and distributed to Accreditation Council for Graduate Medica ...
Full textLink to itemCite
Journal ArticleJ Grad Med Educ · April 2023
BACKGROUND: Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediat ...
Full textOpen AccessLink to itemCite
Journal ArticleNeurocrit Care · June 2022
BACKGROUND: Palliative care has the potential to improve goal-concordant care in severe traumatic brain injury (sTBI). Our primary objective was to illuminate the demographic profiles of patients with sTBI who receive palliative care encounters (PCEs), wit ...
Full textOpen AccessLink to itemCite
Journal ArticleAm J Hosp Palliat Care · February 2022
CONTEXT: Healthcare workers often experience grief stemming from the loss of patients under their care. The impact of personal grief on healthcare workers' wellbeing is less well described, particularly for trainees. To better characterize the prevalence a ...
Full textLink to itemCite
Journal ArticleAm J Hosp Palliat Care · April 2021
COVID-19 has not only dramatically changed the way we live, it has also impacted how we die and how we grieve. With more and more Americans dying in ICU settings, away from family, and more funerals being held virtually, the pandemic has seriously curtaile ...
Full textLink to itemCite
Journal ArticleThe American journal of hospice & palliative care · December 2020
BackgroundHeart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recomm ...
Full textCite
Journal ArticleJ Palliat Med · August 2020
Palliative care (PC) focuses on caring for the whole person, from birth to death, while managing symptoms and helping to navigate medical complexities. Care does not stop at the time of death, however, as assisting patients, families, and fellow clinicians ...
Full textLink to itemCite
Journal ArticleAm J Hosp Palliat Care · February 2020
BACKGROUND: American College of Surgeons recommends palliative care and surgeons collaborate on the care of patients with poor prognoses. These collaborations are done to discuss symptom management and goals of care. However, contemporary practice patterns ...
Full textLink to itemCite
Journal ArticleAm Heart J · January 2020
BACKGROUND/OBJECTIVES: The extent to which individual knowledge, preferences, and priorities explain lower use of invasive cardiac care among older vs. younger adults presenting with acute coronary syndrome (ACS) is unknown. We directly surveyed a group of ...
Full textLink to itemCite
Journal ArticleJ Palliat Med · April 2019
BACKGROUND: Evidence increasingly supports the integration of specialist palliative care (PC) into routine cancer care. A novel, fully integrated PC and medical oncology inpatient service was developed at Duke University Hospital in 2011. OBJECTIVE: To ass ...
Full textLink to itemCite
Journal ArticleAm J Hosp Palliat Care · April 2018
IMPORTANCE: Hip fracture in the elderly patients is associated with increased morbidity and mortality. There is great need for advance care planning should a patient fail to rehabilitate or experience an adverse event during or after recovery. This study w ...
Full textOpen AccessLink to itemCite
Journal ArticleJ Oncol Pract · September 2017
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partne ...
Full textLink to itemCite
Journal ArticleJ Soc Work End Life Palliat Care · 2017
Challenging end-of-life encounters can be stressful and may lead to burnout. Monthly debriefing sessions are led by a physician and clinical social worker (LCSW). Sessions focus on experiences and emotional reactions rather than case details. Themes identi ...
Full textLink to itemCite
Chapter · January 1, 2017
Although older patients preferred less aggressive care than younger patients, many older patients wanted cardiopulmonary resuscitation and care focused on life extension. Patients� families and healthcare providers underestimated older patients’ desire for ...
Cite
Journal ArticleConsultant · November 1, 2016
Stimulants have been used for centuries medicinally, recreationally, and to alleviate fatigue. Because of its favorable pharmacokinetics and low abuse potential, methylphenidate became a highly prescribed drug for the treatment of attention-deficit/hyperac ...
Cite
Journal ArticleAm J Cardiol · September 1, 2016
Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of ...
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Journal ArticleHeart Fail Clin · October 2015
Heart failure (HF) is increasingly common in the United States and is associated with a high degree of morbidity and mortality. As patients approach the end of life there is a significant increase in health care resource use. Patients with end-stage HF hav ...
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Journal ArticleJ Palliat Med · March 2013
Family members of intensive care unit (ICU) patients want to be involved in decision making, but they may not be best served by being placed in the position of having to solve problems for which they lack knowledge and skills. This case report presents an ...
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Journal ArticleJAMA Surg · January 2013
OBJECTIVE: To describe the outcomes and the expected postoperative course for patients with do-not-resuscitate (DNR) orders (DNR patients) who undergo emergency surgical management of bowel obstruction. DESIGN: We retrospectively identified all patients wh ...
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Journal ArticleAm J Hosp Palliat Care · February 2012
BACKGROUND: End-of-life care is deemed to be poor in the United States - particularly in large teaching hospitals. Via a brief survey, we examined satisfaction with end-of-life care for those patients who died in our academic medical center from provider a ...
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Chapter · January 1, 2010
Although the world is full of suffering, it is also full of the overcoming of it. – Helen Keller, Optimism (1903) Why focus on the elderly? Geriatric patients are complex, do not fit in the traditional biomedical model, and are underrepresented in cancer r ...
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Journal ArticleJ Am Geriatr Soc · January 2006
The literature has identified significant successes in cardiac resuscitation with the use of automated external defibrillators (AEDs) in public areas. As of September 2004, the Food and Drug Administration has authorized the purchase of these devices by th ...
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Journal ArticleJ Am Geriatr Soc · December 2005
Elderly minorities are more likely to die in inpatient settings than their Caucasian counterparts. It is not known whether this difference is due to cultural preferences for place of death or decreased access to hospice. This analysis examines ethnic diffe ...
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Journal ArticleAnnals of Long-Term Care · July 1, 2004
The percentage of Medicare recipients who die in nursing homes continues to grow. This necessitates skills and competencies in end-of-life care, despite the current scarcity of training in medical and nursing schools. The principles and tenets of Palliativ ...
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Journal ArticleJ Am Geriatr Soc · February 2002
OBJECTIVES: To compare prognostic estimates made by seriously ill hospitalized patients, their surrogates, and their physicians about the patients' activities of daily living (ADLs) 2 months after admission; compare the accuracy of their estimates; and ide ...
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Journal ArticleAm Heart J · July 2001
BACKGROUND: The purpose of this study was to examine the use of post-myocardial infarction (MI) risk stratification in the elderly. Although expert panels have recommended risk stratification after MI, limited data are available on whether patients actuall ...
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Journal ArticleGerontologist · February 2001
PURPOSE: To describe death-related planning and preferences for place of death among well elders in a community characterized by a low rate of hospital deaths. DESIGN AND METHODS: Cross-sectional prevalence survey of independent-living residents (n = 219) ...
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Journal ArticleClinics in Family Practice · January 1, 2001
It is hoped that the reader has an appreciation for what care near the end of life could be, and that it should be viewed as a shift in focus to optimize quality of life and minimize symptoms rather than attempting to cure a disease. Symptom management and ...
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Journal ArticleJ Am Geriatr Soc · October 2000
OBJECTIVE: To determine whether depressive symptoms in older adults are associated with an increased risk for hospitalization. DESIGN: A 6 month cohort study. SETTING: Five counties in the northern Piedmont of North Carolina from the Duke University site o ...
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Journal ArticleJ Am Geriatr Soc · May 2000
OBJECTIVE: To develop and validate a model estimating the survival time of hospitalized persons aged 80 years and older. DESIGN: A prospective cohort study with mortality follow-up using the National Death Index. SETTING: Four teaching hospitals in the US. ...
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Journal ArticleJ Am Geriatr Soc · May 2000
OBJECTIVES: To review previously published findings about how patient age influenced patterns of care for seriously ill patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). DESIGN: An observ ...
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Journal ArticleJ Am Geriatr Soc · May 2000
OBJECTIVE: To determine the extent to which older or seriously ill inpatients would prefer to have their family and physician make resuscitation decisions for them rather than having their own stated preferences followed if they were unable to decide thems ...
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Journal ArticleJ Am Geriatr Soc · May 2000
OBJECTIVE: To develop a model estimating the probability of a patient aged 80 years or older having functional limitations 2 months and 12 months after being hospitalized. DESIGN: A prospective cohort study. SETTING: Four teaching hospitals in the US. PART ...
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Journal ArticleJournal of the American Geriatrics Society · 2000
OBJECTIVES: To review previously published findings about how patient age influenced patterns of care for seriously ill patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). DESIGN: An observ ...
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Journal ArticleJournal of the American Geriatrics Society · 2000
OBJECTIVE: To develop and validate a model estimating the survival time of hospitalized persons aged 80 years and older. DESIGN: A prospective cohort study with mortality follow-up using the National Death Index. SETTING: Four teaching hospitals in the US. ...
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Journal ArticleAnn Intern Med · November 16, 1999
BACKGROUND: Older age is associated with less aggressive treatment and higher short-term mortality due to serious illness. It is not known whether less aggressive care contributes to this survival disadvantage in elderly persons. OBJECTIVE: To determine th ...
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Journal ArticleAnn Intern Med · January 19, 1999
BACKGROUND: Patient age may influence decisions to withhold life-sustaining treatments, independent of patients' preferences for or ability to benefit from such treatments. Controversy exists about the appropriateness of using age as a criterion for making ...
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Journal ArticleCrit Care Med · December 1997
OBJECTIVE: To determine if body mass Index (BMI = weight [kg]/height [m]2), predictive of mortality in longitudinal epidemiologic studies, was also predictive of mortality in a sample of seriously ill hospitalized subjects. DESIGN: Prospective, multicenter ...
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Journal ArticleJ Am Geriatr Soc · September 1996
OBJECTIVE: To determine the effect of age on hospital resource use for seriously ill adults, and to explore whether age-related differences in resource use are explained by patients' severity of illness and preferences for life-extending care. STUDY DESIGN ...
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Journal ArticleJ Nutr Elder · 1995
There is a traditional belief that the elderly have difficulty coping with dietary change, and therefore have a diminished likelihood of successfully responding to nutritional interventions or restrictions. Using a controlled mild zinc-deficiency feeding s ...
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Journal ArticleAging (Milano) · October 1994
The present study attempts to determine empirically the relationship of measures of functional status to other domains common to geriatric assessment, and to ascertain whether functional status can substitute for other domains of clinical assessment. A com ...
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Journal ArticleJ Am Coll Nutr · October 1994
OBJECTIVE: Suspicions that mild zinc deficiency is common among the elderly cannot be confirmed or refuted because definitive indicators of zinc status are lacking. The goal of this study was to document the clinical responsiveness of parameters of zinc st ...
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Journal ArticleJ Am Geriatr Soc · April 1994
OBJECTIVE: To determine if there is a relationship between body mass index and the ability to perform the usual activities of living in a sample of community-dwelling elderly. DESIGN: Secondary data analysis of The National Health and Nutrition Examination ...
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Journal ArticleInt J Aging Hum Dev · 1994
This study examined the hypothesis that sociodemographic characteristics such as age, education, race, and gender would be predictive of Multidimensional Health Locus of Control Subscale scores in a population-based sample of 342 community dwelling elderly ...
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Journal ArticleEducational Gerontology · January 1, 1993
In an effort to sensitize medical students to the problems of the frail elderly, a simulation experience known as the Aging Game is a required portion of the In troduction to Clinical Medicine course for medical students at Duke University. The immediate p ...
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