A5051898008- Palliative Care and End-of-Life Issues
- Patient Dignity and Privacy
- Geriatric Care and Nursing Homes
- Family and Patient Care in Intensive Care Units
- Childhood Cancer Survivors' Quality of Life
- Grief, Bereavement, and Mental Health
- Chronic Disease Management Strategies
- Patient-Provider Communication in Healthcare
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Decision-Making and Restraints
- Dialysis and Renal Disease Management
- Sepsis Diagnosis and Treatment
- COVID-19 Clinical Research Studies
- Dementia and Cognitive Impairment Research
- Frailty in Older Adults
- Healthcare Policy and Management
- Intensive Care Unit Cognitive Disorders
- Religion, Spirituality, and Psychology
- Ethics in medical practice
- COVID-19 and healthcare impacts
- Complex Systems and Decision Making
- Cancer survivorship and care
- Ethics and Legal Issues in Pediatric Healthcare
- Health and Medical Research Impacts
- Circadian rhythm and melatonin
RAND Corporation
2022-2025
University of Pittsburgh Medical Center
2024
University of Pittsburgh
2012-2023
Bruyère
2022
University of North Carolina at Chapel Hill
2016-2021
Public Health Department
2016
National Institutes of Health
2016
Institute of Medical Ethics
2015
<h3>Importance</h3> Misperceptions about prognosis by individuals making decisions for incapacitated critically ill patients (surrogates) are common and often attributed to poor comprehension of medical information. <h3>Objective</h3> To determine the prevalence factors related physician-surrogate discordance in intensive care units (ICUs). <h3>Design, Setting, Participants</h3> Mixed-methods study comprising quantitative surveys qualitative interviews conducted 4 ICUs at a major US center...
Little is known about whether clinicians and surrogate decision makers follow recommended strategies for shared making by incorporating intensive care unit (ICU) patients' values preferences into treatment decisions.To determine how often surrogates exchange information previously expressed deliberate plan based on these factors during conferences prognosis goals of incapacitated ICU patients.A secondary analysis a prospective, multicenter cohort study audiorecorded clinician-family between...
Although many patients and their families view religion or spirituality as an important consideration near the end of life, little is known about extent to which religious spiritual considerations arise during goals-of-care conversations in intensive care unit.To determine how frequently surrogate decision makers health professionals discuss family meetings unit characterize respond such statements by surrogates.A multicenter prospective cohort study was conducted between October 8, 2009,...
Rationale: Surrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit (ICU) clinicians should discuss prognosis, and existing expert opinion–based recommendations give only general guidance that has not been validated with surrogate decision makers.Objective: To determine the perspectives key stakeholders regarding prognostic information be conveyed in critical illness.Methods: This was a multicenter study...
To date, research and promotion regarding advance care planning (ACP) has targeted those with serious illness or the elderly, thereby ignoring healthy young adults. The purpose of this study was to explore adults' knowledge, attitudes, preferences medical decision-making. Further, we aimed understand potential role public health encourage population-based ACP.Between February 2007 April 2007, conducted six focus groups comprising 56 adults ages 18-30. Topics explored included (1) baseline...
Nursing home (NH) residents with dementia experience high rates of intensive treatment near the end life. Limited research examines whether is concordant goals care (GOC).We analyzed data from GOC trial to describe family decision makers' preferred and perceptions goal-concordant for NH late-stage We compared subsequent orders when families chose a primary goal comfort versus other goals.We performed secondary analysis baseline 9-month decision-maker interviews chart reviews.A total 302...
Objectives: Optimistic expectations about prognosis by surrogate decision-makers in ICUs are common, but there few data the causes and clinical consequences. Our objective was to determine of optimistic among surrogates whether it is associated with more use life support at end life. Design: Prospective, multicenter cohort study from 2009 2012. Setting: Twelve multiple regions United States. Subjects: The physicians 275 incapacitated ICU patients high risk death. Interventions: None....
Compared with the general Medicare population, patients ESKD have worse quality metrics for end-of-life care, including a higher percentage experiencing hospitalizations and in-hospital deaths lower referred to hospice. We developed Concurrent Hospice Dialysis Program in which may receive palliative dialysis alongside hospice services. The aims improve access care and, ultimately, experiences of patients, caregivers, clinicians.
Abstract Background Returning home from the hospital for palliative‐focused care is a common transition, but process can be emotionally distressing and logistically challenging patients caregivers. While interventions exist to aid in none have been developed partnership with Objective To undergo initial stages of codesign create an intervention (Advancing Care Experience receiving Palliative as they Transition Home [ACEPATH]) improve experience hospital‐to‐home transitions adult palliative...
Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts conflict management improve outcomes, but little known about what differences styles may explain the benefit. We used simulation to examine potential how palliative specialists manage with surrogates treatment decisions ICUs compared intensivists.Subjects participated a high-fidelity of an In this simulation, medical actor portrayed maker during ICU family meeting who refuses...