scholarly journals End-of-Life Care in the Curriculum: A National Study of Medical Education Deans

2004 ◽  
Vol 79 (8) ◽  
pp. 760-768 ◽  
Author(s):  
Amy M. Sullivan ◽  
Anne G. Warren ◽  
Matthew D. Lakoma ◽  
Karen R. Liaw ◽  
David Hwang ◽  
...  
Keyword(s):  
Medical Education ◽  
End Of Life ◽  
End Of Life Care ◽  
National Study ◽  
Life Care ◽  
Education Deans

scholarly journals CAREGIVER BURDEN, BENEFIT, AND PERCEPTIONS OF END-OF-LIFE CARE QUALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S668-S668
Author(s):  
Elizabeth A Luth ◽  
Teja Pristavec
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Hospice Care ◽  
Quality Care ◽  
Care Quality ◽  
National Study ◽  
Life Care ◽  
Care Needs ◽  
Caregiving Burden ◽  
High Burden

Abstract End-of-life care quality (EOLCQ) gauges our success in providing quality care to dying individuals. EOLQC measures rely on reports from bereaved family members who provide care for dying loved ones, but analyses seldom account for how caregivers’ experiences influence their EOLCQ perceptions. Caregivers frequently experience burden, which is linked to poor health outcomes and may negatively bias EOLCQ reports. Individuals may also perceive caregiving benefits that can offset deleterious burden effects, but potentially encourage overly positive EOLCQ perceptions. This paper links National Study of Caregivers (2011) and National Health and Aging Trends Study (2011-2016) data, using regression analysis and a sample of 380 EOL caregivers to examine how caregiving burden and benefits perceptions shape and moderate EOLCQ reports. Caregiving burden is unrelated to EOLCQ in adjusted models. Benefits are associated with marginally greater odds of being informed about the dying person’s condition and reporting their personal care needs were met. Burden and benefits moderate these two measures. Despite benefits, low burden caregivers report they were informed about the dying person’s condition with 90% probability. Regardless of burden, high benefits caregivers report the same with 90% probability. Low burden and benefits caregivers report met care needs with 90% probability. High burden and benefits caregivers have 90% probability of such reports. Given these reports are used in formal hospice care evaluations by CMS, additional research should explore why caregiving burden and benefit are associated with some EOLCQ measures and why individuals reporting high burden and benefits provide more positive EOLCQ appraisals.

scholarly journals Palliative and End of Life Care in Undergraduate Medical Education: A Survey of New Zealand Medical Schools

2021 ◽  
Author(s):  
Lis Heath ◽  
Richard Egan ◽  
Ella Iosua ◽  
Robert Walker ◽  
Jean Ross ◽  
...  
Keyword(s):  
Medical Education ◽  
New Zealand ◽  
End Of Life ◽  
Undergraduate Medical Education ◽  
End Of Life Care ◽  
Medical Schools ◽  
Learning Opportunities ◽  
Clinical Learning ◽  
Life Care ◽  
Teaching Assessment

Abstract Background: In New Zealand, 34% of deaths occur in the hospital setting where junior doctors are at the frontline of patient care. The death rate in New Zealand is expected to double by 2068 due to the aging population, but many studies report that graduates feel unprepared to care for people near the end of life and find this to be one of the most stressful parts of their work. International guidelines recommend that palliative and end of life care should be a mandatory component of undergraduate medical education, yet teaching varies widely and remains optional in many countries. Little is known about how medical students in New Zealand learn about this important area of clinical practice. The purpose of this study was to investigate the organisation, structure and provision of formal teaching, assessment and clinical learning opportunities in palliative and end of life care for undergraduate medical students in New Zealand.Methods: Quantitative descriptive, cross-sectional survey of module conveners in New Zealand medical schools.Results: Palliative and end of life care is included in undergraduate teaching in all medical schools. However, there are gaps in content, minimal formal assessment and limited contact with specialist palliative care services. Lack of teaching staff and pressure on curriculum time are the main barriers to further curriculum development.Conclusions: This article reports the findings of the first national survey of formal teaching, assessment and clinical learning opportunities in palliative and end of life care in undergraduate medical education in New Zealand. There has been significant progress towards integrating this content into the curriculum, although further development is needed to address barriers and maximise learning opportunities to ensure graduates are as well prepared as possible.

A National Study of End‐of‐Life Care among Older Veterans with Hearing and Vision Loss

2019 ◽  
Vol 68 (4) ◽  
pp. 817-825
Author(s):  
Joan G. Carpenter ◽  
Mary Ersek ◽  
Francis Nelson ◽  
Daniel Kinder ◽  
Melissa Wachterman ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Vision Loss ◽  
National Study ◽  
Life Care

Do residents need end-of-life care training?

2013 ◽  
Vol 12 (3) ◽  
pp. 195-201 ◽  
Author(s):  
Agata Marszalek Litauska ◽  
Andrzej Kozikowski ◽  
Christian N. Nouryan ◽  
Myriam Kline ◽  
Renee Pekmezaris ◽  
...  
Keyword(s):  
Medical Education ◽  
End Of Life ◽  
End Of Life Care ◽  
Hospice Care ◽  
Comfort Level ◽  
Professional Status ◽  
Life Care ◽  
Hospice Referral ◽  
Care Training ◽  
The Right

AbstractObjective:As medical education evolves, emphasis on chronic care management within the medical curriculum becomes essential. Because of the consistent lack of appropriate end-of-life care training, far too many patients die without the benefits of hospice care. This study explores the association between physician knowledge, training status, and level of comfort with hospice care referral of terminally ill patients.Method:In 2011, anonymous surveys were distributed to physicians in postgraduate years 1, 2, and 3; fellows; hospital attending physicians; specialists; and other healthcare professionals in five hospitals of a large health system in New York. Demographic comparisons were performed using χ2 and Fisher's exact tests. Spearman correlations were calculated to determine if professional status and experience were associated with comfort and knowledge discussing end-of-life topics with terminal patients.Results:The sample consisted of 280 participants (46.7% response rate). Almost a quarter (22%) did not know key hospice referral criteria. Although 88% of respondents felt that knowledge of hospice care is an important competence, 53.2% still relinquished advance directives discussion to emergency room (ER) physicians. Fear of patient/family anger was the most frequently reported hospice referral barrier, although 96% of physicians rarely experienced reprisals. Physician comfort level discussing end-of-life issues and hospice referral was significantly associated with the number of years practicing medicine and professional status.Significance of results:Physicians continue to relinquish end-of-life care to ER staff and palliative care consultants. Exploring unfounded and preconceived fears associated with hospice referral needs to be integrated into the curriculum, to prepare future generations of physicians. Medical education should focus on delivering the right amount of end-of-life care training, at the right time, within the medical school and residency curriculum.

Community prescribing for cancer patients at the end of life: a national study

2021 ◽  
pp. bmjspcare-2021-002952
Author(s):  
Gabrielle Emanuel ◽  
Julia Verne ◽  
Karen Forbes ◽  
Luke Hounsome ◽  
Katherine E Henson
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Best Practice ◽  
Care Home ◽  
Symptom Control ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Service Planning ◽  
National Study ◽  
Life Care

BackgroundGood end-of-life care is essential to ensure dignity and comfort in death. To our knowledge, there has not been a national population-based study in England of community prescribing of all drugs used in end-of-life care for patients with cancer.Methods57 632 people who died from malignant cancer in their own home or in a care home in 2017 in England were included in this study. National routinely collected data were used to examine community prescriptions dispensed for drugs for symptom control and anticipatory prescribing by key sociodemographic factors in the last 4 months of life.Results94% of people who died received drugs to control their symptoms and 65% received anticipatory prescribing. Prescribing increased for the symptom control drug group (53% to 75%) and the anticipatory prescribing group (4% to 52%) over the 4-month period to death.ConclusionsMost individuals who died of cancer in their own home or a care home were dispensed drugs commonly used to control symptoms at the end of life, as recommended by best-practice guidance. Lower prescribing activity was found for those who died in a care home, highlighting a potential need for improved end-of-life service planning.

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