End of life care and the approach of death.
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326 to 350 of 969Anticipated regret and organ donor registration: A randomized controlled trial.
Objective: To test whether simply asking people to rate the extent to which they anticipate feeling regret for not registering as an organ donor after death increases subsequent verified organ donor registration.
Method: There were 14,509 members of the general public (both registered and nonregistered donors) randomly allocated to 1 of 4 arms, each receiving different questionnaires. The no-questionnaire control (NQC) arm received a survey measuring demographics and whether or not they were registered organ donors. The questionnaire control (QC) arm completed the NQC questions plus questions regarding affective attitudes and intention to register as an organ donor. The theory of planned behavior (TPB) questionnaire arm received the QC questionnaire, plus additional items measuring TPB variables. The anticipated regret (AR) arm received the TPB questionnaire, plus 2 additional items meas…
matched on Attitude to Death (mesh)
Embodied terror management: interpersonal touch alleviates existential concerns among individuals with low self-esteem.
Individuals with low (rather than high) self-esteem often struggle with existential concerns. In the present research, we examined whether these existential concerns may be alleviated by seemingly trivial experiences of both real and simulated interpersonal touch. A brief touch on the shoulder by a female experimenter led individuals with low self-esteem to experience less death anxiety (Study 1) and more social connectedness after a death reminder (Study 2). Reminding individuals with low self-esteem of death increased their desire for touch, as indicated by higher value estimates of a teddy bear, a toy animal that simulates interpersonal touch (Study 3). Finally, holding a teddy bear (vs. a cardboard box) led individuals with low self-esteem to respond to a death reminder with less defensive ethnocentrism (Study 4). Individuals with high self-esteem were unaffected by touch (Studies 1-…
matched on Attitude to Death (mesh)
Effects of mortality salience and perceived vulnerability on HIV testing intentions and behaviour.
Objective: Research indicates that death thoughts that occur in response to health threats affect subsequent health behaviour. The present study examined the effects of mortality salience on HIV testing.
Design: After reading an article that was intended to make them perceive that they had high or low vulnerability to HIV, participants wrote about death or an aversive control topic. Participants then indicated their intentions to get tested for HIV and were given the opportunity to take an HIV test at the end of the study.
Results: Results showed that mortality salience increased testing behaviour among participants who were made to feel vulnerable to HIV, but decreased testing behaviour among participants who were not made to feel vulnerable to HIV infection.
Conclusion: This research suggests that HIV prevention programmes must carefully consider how the association many people make be…
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Taylor LD (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usDeath studies1 citations Death and television: terror management theory and themes of law and justice on television.
Based on terror management theory, it was hypothesized that media choices may be affected by the salience of death-related thoughts. Three experiments with samples of undergraduate students were conducted to investigate whether such a process would affect preferences for law and justice television programming. In the first experiment (n = 132), individuals for whom mortality had been made salient through experimental induction preferred more programs with law and justice themes than individuals for whom mortality had not been made salient. In the second experiment (n = 761), this effect was observed regardless of trust in law enforcement and only for participants induced to think about death, not those induced to think about pain. In the third experiment (n = 163), participants for whom mortality was salient who watched a crime drama that showed justice being carried out showed a diminis…
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Factors associated with outcome of cognitive-behavioural therapy for complicated grief: a preliminary study.
Complicated grief (CG), also called prolonged grief disorder, is a debilitating condition that can develop following a loss. There is growing evidence that cognitive-behavioural interventions are efficacious in the treatment of CG. The present preliminary study used data from 43 patients with CG who were randomly assigned to cognitive-behavioural therapy in an earlier treatment trial to explore (a) predictors of outcome of cognitive-behavioural therapy for CG and (b) the relationship between symptom improvement and changes in loss-related negative cognitions and avoidance behaviours. Analyses showed that worse treatment outcome was associated with lower education attainment, loss of a partner/child (instead of some other relative), early treatment discontinuation, less patient motivation and more severe CG symptoms at pre-treatment. As predicted, stronger reduction in CG severity was sig…
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Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU.
Background: Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members.
Methods: Families of patients dying in the ICU or within 30 h of ICU discharge in 11 hospitals previously participated in a randomized trial. In the current study, we assessed these families for symptoms of posttraumatic stress disorder (PTSD) and depression with follow-up surveys. Outcomes included validated measures of PTSD (PTSD Checklist) and depressive (Patient Health Questionnaire) symptoms. Predictors included family member mental-health history, involvement in decision making, and demographics.
Results: Surveys were completed by 226 families. Response rate was 46% in the original randomized trial and 82% in this study. Prevalence (95% CI) of PTSD and depressive symptoms we…
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Prevalence and severity of college student bereavement examined in a randomly selected sample.
The authors used stratified random sampling to assess the prevalence and severity of bereavement in college undergraduates, providing an advance over findings that emerge from convenience sampling methods or from anecdotal observations. Prior research using convenience sampling indicated that 22% to 30% of college students are within 12 months of having experienced the death of a family member or friend. Using an ethnically diverse sample from a private, Midwestern university, 118 randomly selected students answered demographic and life experience questions and indicated whether a family member or friend had died within the last 24 months. Those who reported experiencing such a loss also completed the PG-13, a questionnaire used to assess prolonged grief disorder. Results indicated that 30% of the sample was within 12 months of experiencing a loss and 39% was within 24 months of experien…
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Adjusting to death: the effects of mortality salience and self-esteem on psychological well-being, growth motivation, and maladaptive behavior.
This research builds on terror management theory to examine the relationships among self-esteem, death cognition, and psychological adjustment. Self-esteem was measured (Studies 1-2, 4-8) or manipulated (Study 3), and thoughts of death were manipulated (Studies 1-3, 5-8) or measured (Study 4). Subsequently, satisfaction with life (Study 1), subjective vitality (Study 2), meaning in life (Studies 3-5), positive and negative affect (Studies 1, 4, 5), exploration (Study 6), state anxiety (Study 7), and social avoidance (Study 8) were assessed. Death-related cognition (a) decreased satisfaction with life, subjective vitality, meaning in life, and exploration; (b) increased negative affect and state anxiety; and (c) exacerbated social avoidance for individuals with low self-esteem but not for those with high self-esteem. These effects occurred only when death thoughts were outside of focal at…
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Gries CJ, White DB, Truog RD, Dubois J, Cosio CC, Dhanani S, Chan KM, Corris P, Dark J, Fulda G, Glazier AK, Higgins R, Love R, Mason DP, Nakagawa TA, Shapiro R, Shemie S, Tracy MF, Travaline JM, Valapour M, West L, Zaas D, Halpern SD, American Thoracic Society Health Policy Committee (2013)guidelineMEDLINE-indexed journal, not yet read by usAmerican journal of respiratory and critical care medicine98 citations An official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: ethical and policy considerations in organ donation after circulatory determination of death.
Rationale: Donation after circulatory determination of death (DCDD) has the potential to increase the number of organs available for transplantation. Because consent and management of potential donors must occur before death, DCDD raises unique ethical and policy issues.
Objectives: To develop an ethics and health policy statement on adult and pediatric DCDD relevant to critical care and transplantation stakeholders.
Methods: A multidisciplinary panel of stakeholders was convened to develop an ethics and health policy statement. The panel consisted of representatives from the American Thoracic Society, Society of Critical Care Medicine, International Society for Heart and Lung Transplantation, Association of Organ Procurement Organizations, and the United Network of Organ Sharing. The panel reviewed the literature, discussed important ethics and health policy considerations, and develope…
matched on Terminal Care (mesh), end of life (text)
Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine.
Background: These recommendations have been developed to improve the care of intensive care unit (ICU) patients during the dying process. The recommendations build on those published in 2003 and highlight recent developments in the field from a U.S. perspective. They do not use an evidence grading system because most of the recommendations are based on ethical and legal principles that are not derived from empirically based evidence.
Principal findings: Family-centered care, which emphasizes the importance of the social structure within which patients are embedded, has emerged as a comprehensive ideal for managing end-of-life care in the ICU. ICU clinicians should be competent in all aspects of this care, including the practical and ethical aspects of withdrawing different modalities of life-sustaining treatment and the use of sedatives, analgesics, and nonpharmacologic approaches to eas…
matched on Terminal Care (mesh), end of life (text)
Shemie SD, Baker AJ, Knoll G, Wall W, Rocker G, Howes D, Davidson J, Pagliarello J, Chambers-Evans J, Cockfield S, Farrell C, Glannon W, Gourlay W, Grant D, Langevin S, Wheelock B, Young K, Dossetor J (2006)guidelineMEDLINE-indexed journal, not yet read by usCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne173 citations National recommendations for donation after cardiocirculatory death in Canada: Donation after cardiocirculatory death in Canada.
These recommendations are the result of a national, multidisciplinary, year-long process to discuss whether and how to proceed with organ donation after cardiocirculatory death (DCD) in Canada. A national forum was held in February 2005 to discuss and develop recommendations on the principles, procedures and practice related to DCD, including ethical and legal considerations. At the forum's conclusion, a strong majority of participants supported proceeding with DCD programs in Canada. The forum also recognized the need to formulate and emphasize core values to guide the development of programs and protocols based on the medical, ethical and legal framework established at this meeting. Although end-of-life care should routinely include the opportunity to donate organs and tissues, the duty of care toward dying patients and their families remains the dominant priority of health care teams.…
matched on Terminal Care (mesh), end of life (text)
Grief in family carers of people living with dementia: A systematic review.
Objectives: Grief research in family carers of people with dementia has increased. We aimed to report the prevalence of pre-death and post-death grief and to synthesize associated factors and the relationship between pre-death factors and post-death grief and services used to manage grief.
Design: (Prospero protocol: CRD42020165071) We systematically reviewed literature from PsycINFO, MEDLINE, CINAHL, and ASSIA until April 2020. Effectiveness of intervention data and studies not written in English were excluded; qualitative studies were additionally excluded during study selection. Study quality was assessed using the Mixed Methods Appraisal Tool. Evidence was narratively summarized.
Participants: Family non-paid carers of somebody with any dementia type.
Measurements: Validated measures of pre-death and/or post-death grief.
Results: We included quantitative data from 55 studies (44 rate…
matched on Palliative Care (keyword)
Effects of Acceptance and Commitment Therapy on health-related outcomes for patients with advanced cancer: A systematic review.
Background: Advanced cancer is an incurable and life-threatening disease that poses a major challenge to patients' psychological and physical well-being. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy for managing health outcomes and inducing health-related behaviour changes. However, the components and modality of Acceptance and Commitment Therapy and its effectiveness on health outcomes for patients with advanced cancer remain unclear.
Objectives: This review aimed to identify the main content, delivery mode, dosage and duration of Acceptance and Commitment Therapy, and to systematically summarise evidence regarding its application in patients with advanced cancer for improving physical and psychological outcomes and health-related quality of life.
Design: Systematic review.
Data sources: PubMed, British Nursing Index, Medline, PsycINFO, EMBASE, CINAHL, Co…
matched on Palliative Care (keyword)
Psychosocial interventions for advanced cancer patients: A systematic review.
Objective: Psychosocial care for advanced cancer encompasses a wide range of interventions that help patients make life-changing decisions, manage debilitating symptoms, confront impending mortality, and improve other patient outcomes. Psychosocial care is becoming increasingly available to advanced cancer patients; however, an overview of the various types of interventions is lacking.
Methods: The current review systematically examined randomised-controlled trials of psychosocial interventions for advanced cancer patients from January 2007 to June 2018. MEDLINE, CINAHL Plus, PsycINFO, and Scopus databases were searched, and a total of 68 studies were included in the review.
Results: We found a range of psychosocial interventions studies and grouped them based on six theoretical/clinical approaches: cognitive behavioural therapy based; meaning enhancing; dignity, life review, and narrati…
matched on Palliative Care (keyword)
Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient.
Bereavement care is considered an integral component of quality end-of-life care endorsed by the palliative care movement. However, few hospitals and health care institutions offer universal bereavement care to all families of patients who die. The current coronavirus disease 2019 pandemic has highlighted this gap and created a sense of urgency, from a public health perspective, for institutions to provide support to bereaved family members. In this article, drawing on the palliative care and bereavement literature, we offer suggestions about how to incorporate palliative care tools and psychological strategies into bereavement care for families during this pandemic.
matched on Palliative Care (mesh), Terminal Care (mesh), Palliative Care (keyword), end of life (text)
Meeting patients' spiritual needs during end-of-life care: A qualitative study of nurses' and healthcare professionals' perceptions of spiritual care training.
Aims and objectives: To explore nurses' and healthcare professionals' perceptions of spiritual care and the impact of spiritual care training on their clinical roles.
Background: Many nurses and healthcare professionals feel unprepared and lack confidence, competence and skills, to recognise, assess and address patients' spiritual issues. Patients with unmet spiritual needs are at increased risk of poorer psychological outcomes, diminished quality of life and reduced sense of spiritual peace. There are implications for patient care if nurses and healthcare professionals cannot attend to patients' spiritual needs.
Design: A qualitative methodology was adopted.
Methods: Recruitment was purposive. A total of 21 generalist and specialist nursing and healthcare professionals from North West and South West England, who undertook spiritual care training between 2015-2017, were recruited. Partic…
matched on Hospice Care (mesh), Terminal Care (mesh), Palliative Care (keyword), end of life (text)
Gratitude at the End of Life: A Promising Lead for Palliative Care.
Background: Numerous studies, conducted largely with non-clinical populations, have shown a significant link between gratitude and psychological dimensions relevant for palliative care (e.g., psychological distress). However, the relevance of gratitude in the context of palliative care needs to be confirmed.
Objectives: We strived to evaluate the association between gratitude and quality of life (QoL), psychological distress, post-traumatic growth, and health status in palliative patients, and to develop an explanatory model for QoL. An ancillary purpose was to identify which life domains patients considered sources of gratitude.
Design: We performed an exploratory and cross-sectional study with palliative patients of the Lausanne University Hospital.
Measurements: We used the Gratitude Questionnaire, the McGill Quality of Life questionnaire revised, the Hospital Anxiety and Depression S…
matched on Palliative Care (mesh), Terminal Care (mesh), Palliative Care (keyword), end of life (text)
The duty of the physician to care for the family in pediatric palliative care: context, communication, and caring.
Pediatric palliative care physicians have an ethical duty to care for the families of children with life-threatening conditions through their illness and bereavement. This duty is predicated on 2 important factors: (1) best interest of the child and (2) nonabandonment. Children exist in the context of a family and therefore excellent care for the child must include attention to the needs of the family, including siblings. The principle of nonabandonment is an important one in pediatric palliative care, as many families report being well cared for during their child's treatment, but feel as if the physicians and team members suddenly disappear after the death of the child. Family-centered care requires frequent, kind, and accurate communication with parents that leads to shared decision-making during treatment, care of parents and siblings during end-of-life, and assistance to the family …
matched on Hospice Care (mesh), Palliative Care (mesh), Palliative Care (keyword), end of life (text)
[The anesthesiologist facing terminality: a survey-based observational study].
Background and objectives: Advances in medicine, including anesthesiology and resuscitation, have made natural death increasingly rare. As a consequence, dysthanasia has become usual in a scenario for which there is not rationale. The present study aimed to assess the level of knowledge of Brazilian anesthesiologists on the principles of dysthanasia and orthothanasia. Thence, we studied the management preferences of these professionals, vis-à-vis those practices, as well as how medical school contributed to addressing death-related issues.
Method: Quantitative approach, prospective and descriptive cohort that included 150 anesthesiologists, members of the Brazilian Society of Anesthesiology, and who were invited to participate by email. An online questionnaire containing 38 questions was prepared by the authors. The study was approved by the Instructional Research Ethics Committee.
Resul…
matched on Terminally Ill (mesh), end of life (text), terminal illness (text)
The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care.
Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alp…
matched on Palliative Care (mesh), Attitude to Death (mesh), Terminally Ill (mesh), end of life (text), terminal illness (text)
A 10-year literature review of family caregiving for motor neurone disease: moving from caregiver burden studies to palliative care interventions.
Background: There is growing awareness that different terminal diseases translate into different family caregiver experiences, and the palliative and supportive care needs of these families are both similar and unique. Family members caring for people with motor neurone disease may experience exceptional strain due to the usually rapid and progressive nature of this terminal illness.
Aim: The purpose of this review is to synthesize contemporary research and provide a comprehensive summary of findings relevant to motor neurone disease family caregivers, as well as highlight some of the suggested interventions to alleviate burden and improve quality of life for this group.
Design: We conducted a comprehensive review of empirical research on family caregiving for people with motor neurone disease in peer-reviewed journals published in English, January 2000-April 2011. Fifty-nine studies met…
matched on Palliative Care (mesh), end of life (text), terminal illness (text)
Advance Care Planning in Asia: A Systematic Narrative Review of Healthcare Professionals' Knowledge, Attitude, and Experience.
Objective: The value of advance care planning (ACP) for patients with life-limiting illnesses is widely recognized but Asian health care professionals' (HCPs') perspectives on ACP have received little systematic attention. We aim to synthesize evidence regarding Asian HCPs' knowledge of, attitudes toward, and experiences with ACP.
Design: Systematic review with narrative synthesis and stepwise thematic analysis.
Setting and participants: HCPs in southern, eastern, and southeastern Asia.
Methods: Studies from inception to September 2019 were identified from English-language searches of Embase, MEDLINE, Web of Science, and Google Scholar with reference-chaining and hand-searching. Two investigators independently screened and assessed the risk of bias in all original studies reporting HCPs' knowledge of, attitudes toward, and experiences with ACP, including their perspectives toward barrier…
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Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review.
Introduction: Advance care planning is a means for patients to communicate their wishes, fears and desires for future health decisions should they lose the ability to consider or communicate these. Despite being supported by governments and healthcare leaders, uptake amongst the general population remains low. Nurses play a crucial role in promoting and engaging with these discussions given their close relationship with patients and families in a range of clinical settings.
Aim: To describe the barriers that nurses and healthcare professionals believe prevent them from exploring advance care planning with their patients.
Method: We carried out a systematic review of peer-reviewed journal articles from the databases MEDLINE, Embase, CINAHL Plus, Web of Science and ProQuest Central, guided by the PRISMA checklist.
Results: Eleven articles were identified: all were self-reporting surveys us…
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Facilitators and Barriers for Advance Care Planning Among Ethnic and Racial Minorities in the U.S.: A Systematic Review of the Current Literature.
Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experiences, (3) cultural values, and (4) spirituality. Socio-demographic factors showed inconsistent findings regarding their association with ACP engagement. Worse health status and knowledge about ACP are common facilitators across ethnic minority groups, whereas mistrust toward the health care system was a barrier only for Blacks. Collectivistic cultural values influenced ACP engagement among Latinos…
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The Effects of Advance Care Planning Interventions on Nursing Home Residents: A Systematic Review.
Background: Advance care planning (ACP) encompasses a process by which people may express and record their values and preferences for care and treatment should they lose the capacity to communicate them in the future. We believe the effects that ACP can have on the nursing home population is distinct from others and sought to gain insight into the outcomes of relevant studies on the topic.
Aim: To identify the effects of ACP interventions on nursing home residents.
Design: Systematic review.
Methods: A comprehensive literature search was conducted using the following 4 electronic databases, Embase, Medline, PsychINFO, and CINAHL, with no limits on year or language. Gray literature search of relevant journals was also performed as was reviewing of the reference lists of all included articles. Inclusion criteria were randomized controlled trials, controlled trials, pre/post study design tr…
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