A5013362019- Palliative Care and End-of-Life Issues
- Childhood Cancer Survivors' Quality of Life
- Heart Failure Treatment and Management
- Family and Patient Care in Intensive Care Units
- Patient-Provider Communication in Healthcare
- Grief, Bereavement, and Mental Health
- Geriatric Care and Nursing Homes
- Patient Dignity and Privacy
- Religion, Spirituality, and Psychology
- Cancer survivorship and care
- Cultural Competency in Health Care
- Family Support in Illness
- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Family Caregiving in Mental Illness
- Chronic Disease Management Strategies
- Cardiovascular Health and Disease Prevention
- Health disparities and outcomes
- Dementia and Cognitive Impairment Research
- Ethics in Clinical Research
- Epilepsy research and treatment
- Birth, Development, and Health
- Optimism, Hope, and Well-being
- Healthcare Policy and Management
- Health Systems, Economic Evaluations, Quality of Life
University of Alabama at Birmingham
2016-2025
Deborah Heart and Lung Center
2015
National guidelines recommend early palliative care for patients with advanced heart failure, which disproportionately affects rural and minority populations.To determine the effect of an telehealth intervention over 16 weeks on quality life, mood, global health, pain, resource use failure.A single-blind, vs usual randomized clinical trial was conducted from October 1, 2015, to May 31, 2019, among 415 50 years or older New York Heart Association class III IV failure American College...
Aims Numerous healthcare decisions are faced by persons with advanced cancer from diagnosis to end-of-life. The family caregiver role in these has focused on being a surrogate decision-maker, however, little is known about the caregiver's supporting upstream patient decision-making. We aimed describe roles of caregivers assisting community-dwelling patients decision-making across settings and contexts. Methods Qualitative study using one-on-one, semi-structured interviews metastatic (n = 18)...
<h3>Importance</h3> Family caregivers of persons with advanced heart failure perform numerous daily tasks to assist their relatives and are at high risk for distress poor quality life. <h3>Objective</h3> To determine the effect a nurse-led palliative care telehealth intervention (Educate, Nurture, Advise, Before Life Ends Comprehensive Heart Failure Patients Caregivers [ENABLE CHF-PC]) on life mood family New York Association Class III/IV over 16 weeks. <h3>Design, Setting, Participants</h3>...
Early palliative care (EPC) is recommended but rarely integrated with advanced heart failure (HF) care. We engaged patients and family caregivers to study the feasibility site differences in a two-site EPC trial, ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients Caregivers). conducted an (4/1/14–8/31/15) NYHA Class III/IV HF their academic medical centers northeast southeast U.S. The intervention comprised: 1) in-person outpatient consultation; 2)...
Background The objective of this study was to assess the feasibility, acceptability, and potential efficacy ENABLE (Educate, Nurture, Advise, Before Life Ends) Cornerstone—a lay navigator‐led, early palliative care telehealth intervention for African American/Black and/or rural‐dwelling family caregivers individuals with advanced cancer (ClinicalTrials.gov identifier NCT03464188). Methods This a pilot randomized trial (November 2019 March 2021). Family patients newly diagnosed, stage III/IV,...
Advance care planning (ACP) improves end-of-life for patients and their caregivers. However, only one-third of adults have participated in ACP rates are substantially lower among African Americans than whites. Importantly, many domains where there racial disparities outcomes, including receipt goal-concordant care, hospice use, provider communication. Yet, few studies examined the effectiveness interventions Americans. The objectives reducing quality palliative older through improved advance...
This Viewpoint discusses why health priorities–tailored care, rather than the one-size-fits-all approach, is beneficial for marginalized individuals.
Objectives: Depression is a leading mental health issue affecting elderly individuals worldwide. Previous research widely neglects caregiver emotional stress as probable contributing factor of depression in the elderly. This study investigated chronic life stressor an care recipient using paradigm theoretical foundation.Methods: The relationships between and receiver depressive symptoms, well other social psychological mediation factors, were 2004 wave National Long-Term Care Study (NLTCS)....
Following treatment, breast cancer survivors face challenges participating in valued activities.
Palliative care is specialized medical for people with serious illness that focused on providing relief from symptoms and stress improving the quality of life (QOL) patients their families. To help 6.5 million U.S. adults families affected by heart failure manage high symptom burden, complex decision-making, risk exacerbation death, early integration palliative critical has been recommended numerous professional organizations. However, few trials have tested outpatient community-based models...
Abstract Background Values are broadly understood to have implications for how individuals make decisions and cope with serious illness stressors, yet it remains uncertain patients their family friend caregivers discuss, reflect upon, act on values in the post-left ventricular assist device (LVAD) implantation context. This study aimed explore elicitation experiences of an LVAD post-implantation period. Methods Qualitative descriptive recipients. Socio-demographics patient resource use were...
Occupational performance challenges are common among breast cancer survivors (BCS). In a recent randomized controlled trial (RCT), our rehabilitation intervention catalyzed significantly greater improvements in occupational compared to an education-based control condition. To describe BCS’ activity priorities and examine what short-term goal characteristics (i.e., focus) outcomes attainment, satisfaction) predicted long-term improvement. Post hoc analysis of session data from RCT. Content...
Patients with heart failure benefit from specialty palliative care but are often not evaluated for these services. The lack of standardized screening tools and limited nurse training assessing needs contributing factors. This quality improvement project aimed to improve the identification unmet in patients admitted a progressive unit by implementing nurse-administered tool. nursing staff administered Integrated Palliative Care Outcome Scale (IPOS) number consultations before implementation...
Abstract Objectives To evaluate the cultural acceptability and feasibility of self-directed “My Health Priorities” (MHP) web-based program in older Southern African Americans (AAs) with multiple chronic conditions (MCCs) their family caregivers (FCGs). Design A multi-method formative evaluation study (NIH Stage 1a) to explore patients’ FCGs’ experiences MHP program, a component patient priorities care approach. Interviews were analyzed using constant comparative method thematic analysis....
The disproportionate impact of the COVID-19 pandemic on marginalized communities due to structural racism has led an increased focus diversity, equity, and inclusion in medical literature. To assess pre-pandemic racial ethnic representation among subjects palliative care research, we examined reporting race ethnicity research presented at American Academy Hospice Palliative Medicine Nurses Association State Science (SOS) plenary (2004-2019), as these articles frequently influence patient...
Informal caregivers play a vital role in supporting seriously ill patients. However, informal caregiving is burdensome and can lead to negative health outcomes for the caregiver care recipient. The study’s aim was evaluate relationships among burden, recipient depressive symptomology, race. Guided by social exchange perspective, we examined cross-sectional dyadic data from National Long-Term Care Survey (N = 1279). Using ordinal logistic regression, found that higher caregiver-reported...
Background: Improving family caregiver preparation for surrogate decision making is a critical priority. Objective: Determine parsimonious set of intrapersonal factors associated with caregivers' confidence in future medical decisions their relatives cancer. Methods: Cross-sectional mail survey. Family caregivers Medicare beneficiaries pancreatic, lung, brain, ovarian, head and neck, hematologic, stage IV cancers from communities eight U.S. cancer centers. Participants completed validated...