San FranciscoMental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders.ChicagoMental Health Services: Organized services to provide mental health care.United StatesAdvance Directives: Declarations by patients, made in advance of a situation in which they may be incompetent to decide about their own care, stating their treatment preferences or authorizing a third party to make decisions for them. (Bioethics Thesaurus)Living Wills: Written, witnessed declarations in which persons request that if they become disabled beyond reasonable expectation of recovery, they be allowed to die rather than be kept alive by extraordinary means. (Bioethics Thesaurus)Advance Directive Adherence: Compliance by health personnel or proxies with the stipulations of ADVANCE DIRECTIVES (or similar directives such as RESUSCITATION ORDERS) when patients are unable to direct their own care.Health Physics: The science concerned with problems of radiation protection relevant to reducing or preventing radiation exposure, and the effects of ionizing radiation on humans and their environment.Advance Care Planning: Discussions with patients and/or their representatives about the goals and desired direction of the patient's care, particularly end-of-life care, in the event that the patient is or becomes incompetent to make decisions.United States Dept. of Health and Human Services: A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.Medicine in ArtNational Academy of Sciences (U.S.): A United States organization of distinguished scientists and engineers established for the purpose of investigating and reporting upon any subject of art or science as requested by any department of government. The National Research Council organized by NAS serves as the principal operating agency to stimulate and support research.Institute of Medicine (U.S.): Identifies, for study and analysis, important issues and problems that relate to health and medicine. The Institute initiates and conducts studies of national policy and planning for health care and health-related education and research; it also responds to requests from the federal government and other agencies for studies and advice.Neuropsychology: A branch of psychology which investigates the correlation between experience or behavior and the basic neurophysiological processes. The term neuropsychology stresses the dominant role of the nervous system. It is a more narrowly defined field than physiological psychology or psychophysiology.Academies and Institutes: Organizations representing specialized fields which are accepted as authoritative; may be non-governmental, university or an independent research organization, e.g., National Academy of Sciences, Brookings Institution, etc.Clinical Laboratory Techniques: Techniques used to carry out clinical investigative procedures in the diagnosis and therapy of disease.Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation.American Medical Association: Professional society representing the field of medicine.Right to Die: The right of the patient or the patient's representative to make decisions with regard to the patient's dying.Bibliometrics: The use of statistical methods in the analysis of a body of literature to reveal the historical development of subject fields and patterns of authorship, publication, and use. Formerly called statistical bibliography. (from The ALA Glossary of Library and Information Science, 1983)Publications: Copies of a work or document distributed to the public by sale, rental, lease, or lending. (From ALA Glossary of Library and Information Science, 1983, p181)Peer Review: An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients.Famous PersonsPublishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.Research: Critical and exhaustive investigation or experimentation, having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusions, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories, or laws. (Webster, 3d ed)Biomedical Research: Research that involves the application of the natural sciences, especially biology and physiology, to medicine.Pulmonary Disease, Chronic Obstructive: A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.Dyspnea: Difficult or labored breathing.Hypoventilation: A reduction in the amount of air entering the pulmonary alveoli.Protriptyline: Tricyclic antidepressant similar in action and side effects to IMIPRAMINE. It may produce excitation.Bronchiectasis: Persistent abnormal dilatation of the bronchi.Bronchitis, Chronic: A subcategory of CHRONIC OBSTRUCTIVE PULMONARY DISEASE. The disease is characterized by hypersecretion of mucus accompanied by a chronic (more than 3 months in 2 consecutive years) productive cough. Infectious agents are a major cause of chronic bronchitis.Bronchitis: Inflammation of the large airways in the lung including any part of the BRONCHI, from the PRIMARY BRONCHI to the TERTIARY BRONCHI.AustriaEuthanasia: The act or practice of killing or allowing death from natural causes, for reasons of mercy, i.e., in order to release a person from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)Terminal Care: Medical and nursing care of patients in the terminal stage of an illness.Retirement: The state of being retired from one's position or occupation.BostonSocial Sciences: Disciplines concerned with the interrelationships of individuals in a social environment including social organizations and institutions. Includes Sociology and Anthropology.Gatekeeping: The controlling of access to health services, usually by primary care providers; often used in managed care settings to reduce utilization of expensive services and reduce referrals. (From BIOETHICS Thesaurus, 1999)Formularies as Topic: Works about lists of drugs or collections of recipes, formulas, and prescriptions for the compounding of medicinal preparations. Formularies differ from PHARMACOPOEIAS in that they are less complete, lacking full descriptions of the drugs, their formulations, analytic composition, chemical properties, etc. In hospitals, formularies list all drugs commonly stocked in the hospital pharmacy.Politics: Activities concerned with governmental policies, functions, etc.Sulfoxides: Organic compounds that have the general formula R-SO-R. They are obtained by oxidation of mercaptans (analogous to the ketones). (From Hackh's Chemical Dictionary, 4th ed)South CarolinaPalliative Care: Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)Transsexualism: Severe gender dysphoria, coupled with a persistent desire for the physical characteristics and social roles that connote the opposite biological sex. (APA, DSM-IV, 1994)BerlinAfrican Americans: Persons living in the United States having origins in any of the black groups of Africa.American Heart Association: A voluntary organization concerned with the prevention and treatment of heart and vascular diseases.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.
Autonomy, liberalism and advance care planning. (1/32)
The justification for advance directives is grounded in the notion that they extend patient autonomy into future states of incompetency through patient participation in decision making about end-of-life care. Four objections challenge the necessity and sufficiency of individual autonomy, perceived to be a defining feature of liberal philosophical theory, as a basis of advance care planning. These objections are that the liberal concept of autonomy (i) implies a misconception of the individual self, (ii) entails the denial of values of social justice, (iii) does not account for justifiable acts of paternalism, and (iv) does not account for the importance of personal relationships in the advance care planning process. The last objection is especially pertinent in light of recent empirical research highlighting the importance of personal relationships in advance care planning. This article examines these four objections to autonomy, and the liberal theoretical framework with which it is associated, in order to re-evaluate the philosophical basis of advance care planning. We argue that liberal autonomy (i) is not a misconceived concept as critics assume, (ii) does not entail the denial of values of social justice, (iii) can account for justifiable acts of paternalism, though it (iv) is not the best account of the value of personal relationships that arise in advance care planning. In conclusion, we suggest that liberalism is a necessary component of a theoretical framework for advance care planning but that it needs to be supplemented with theories that focus explicitly on the significance of personal relationships. (+info)Decisions to treat or not to treat pneumonia in demented psychogeriatric nursing home patients: development of a guideline. (2/32)
Non-treatment decisions concerning demented patients are complex: in addition to issues concerning the health of patients, ethical and legal issues are involved. This paper describes a method for the development of a guideline that clarifies the steps to be taken in the decision making process whether to forgo curative treatment of pneumonia in psychogeriatric nursing home patients. The method of development consisted of seven steps. Step 1 was a literature study from which ethical, juridical and medical factors concerning the patient's health and prognosis were identified. In step 2, a questionnaire was sent to 26 nursing home physicians to determine the relative importance of these factors in clinical practice. In a meeting of nine experienced physicians (step 3), the factors identified in step 2 were confirmed by most of these professionals. To prevent the final guideline being too directive, a concept guideline that included ethical and legal aspects was designed in the form of a "checklist of considerations" (step 4). Experts in the fields of nursing home medicine, ethics and law reviewed and commented on the concept guideline (step 5). The accordingly adapted "checklist of considerations" was tested in a pilot study (step 6), after which all experts endorsed the checklist (step 7). The resulting "checklist of considerations" structures the decision making process according to three primary domains: medical aspects, patient's autonomy, and patient's best interest (see annex at end of paper). (+info)Physicians's reports on the impact of living wills at the end of life in Japan. (3/32)
CONTEXT: A growing number of Japanese people have completed advance directives, especially living wills, even though there is no legislation recognising such documents and little empirical research on their impact on clinical care at the end of life in Japan. OBJECTIVES: To investigate physicians' attitudes about living wills and their experiences with patients who had completed a living will and later died. DESIGN: Self administered survey and qualitative study using open question and content analysis. SETTING: Japan. PARTICIPANTS: Physicians known to have cared for a patient who had presented a living will prior to death. MEASUREMENTS: The physician's response to receiving a living will, communication about the living will, the impact of the living will on clinical care, demographics, and their opinion on advance directives, especially living wills. MAIN RESULTS: Fifty five per cent of respondents approved of advance directives in general, and 34% had more opportunities to communicate with a patient and his/her family after receiving the living will. Sixty nine per cent of the physicians who received a living will did not, however, change their course of therapy as a consequence of receiving the living wills. Based on the analysis, we identified three areas of concern in the comments on living wills: (1) concerns relative to patients, physicians, and families; (2) social context, and (3) clinical and administrative concerns. The physicians raised various topics for discussion; they tended to describe the issues from a clinical perspective. CONCLUSIONS: Our identified areas of concern should prove helpful in better understanding the clinical and ethical implications of living wills in Japan. (+info)Adherence to advance directives in critical care decision making: vignette study. (4/32)
OBJECTIVE: To explore health professionals' decision making in a critical care scenario when there is an advance directive. DESIGN: Qualitative study. SETTING: Scotland. PARTICIPANTS: Interviewees (n = 12) comprising general practitioners, hospital specialists, and nurses, and six focus groups (n = 34 participants) comprising general practitioners, geriatricians (consultants and specialist registrars), hospital nurses, and hospice nurses. RESULTS: When presented with an advance directive that applied to the same hypothetical scenario, health professionals came to divergent conclusions as to the "right thing to do." Arguments opposing treatment centred on the supremacy of autonomy as an ethical principle. Other arguments were that the decision to treat was consistent with the terms of the advance directive, or that, notwithstanding the advance directive, the patient's quality of life was sufficient to warrant treatment. CONCLUSION: Advance directives are open to widely varying interpretation. Some of this variability is related to the ambiguity of the directive's terminology whereas some is related to the willingness of health professionals to make subjective value judgments concerning quality of life. (+info)Respecting end-of-life treatment preferences. (5/32)
Most patients eventually must face the process of planning for their future medical care. However, few Americans have a living will or a durable power of attorney for health care. Although advance directives provide a legal basis for physicians to carry out treatment using a health care proxy or a living will, they also should reflect the patient's values and preferences. Family physicians are in a position to integrate medical knowledge, individual values, and cultural influences into end-of-life care. Family physicians can best respect the autonomy of patients by allowing the patient and family to prospectively identify relevant health care preferences, by sustaining an ongoing discussion about end-of-life preferences, and by abiding by the decisions their patients have made. (+info)Living wills and the Mental Capacity Act: a postal questionnaire survey of UK geriatricians. (6/32)
OBJECTIVE: To determine geriatricians' experience of and views on living wills, National Health Service Trusts' support of advance end-of-life health care planning and geriatricians' views on related legal changes in the Mental Capacity Act. DESIGN: Anonymous postal questionnaire survey of all 1,426 British Geriatrics Society members in England, Wales and Northern Ireland. RESULTS: A total of 842 (59%) questionnaires were returned. Of 811 geriatricians, 454 (56%) had cared for patients with living wills. Of the 280 who cared for patients when the living will had come into effect, 108 (39%) had changed treatment because of the living will and 84 (78%) of those felt that decisions had been easier to make. Living wills not already in effect made discussions with patients [171 of 178 (96%)] and families [135 of 178 (76%)] easier. Of 779 geriatricians, 713 (92%) saw advantages of older people using living wills; 467 of these also expressed concerns. Only 16 (2%) geriatricians who had concerns said that there were no advantages. A total of 214 (27%) were aware that their Trust had a form to help with discussions about cardiopulmonary resuscitation. Fewer [126 of 781 (16%)] were aware of a Trust policy on living wills. The proposal, in the Mental Capacity Bill, for advance refusals of treatment was supported by 59% (476 of 801), yet the proposal for a lasting power of attorney (LPA) covering health care was only supported by 47% (382 of 806). CONCLUSION: Many geriatricians have positive experiences of caring for patients with living wills. Despite recognising potential problems, most geriatricians support the use of living wills by older people. However, most believe that their Trust does not have a policy to support advance health care planning. Geriatricians have reservations about LPAs covering health care. (+info)Perioperative do-not-resuscitate orders--doing 'nothing' when 'something' can be done. (7/32)
Cardiopulmonary resuscitation (CPR) has the ability to reverse premature death. It can also prolong terminal illness, increase discomfort and consume enormous resources. Despite the desire to respect patient autonomy, there are many reasons why withholding CPR may be complicated in the perioperative setting. This review outlines these factors in order to offer practical suggestions and to provoke discussion among perioperative care providers. Although originally described for witnessed intraoperative arrests, closed chest cardiac massage quickly became universal practice, and a legal imperative in many hospitals. Concerns were raised by both health care workers and patient groups; this eventually led to the creation of the do-not-resuscitate (DNR) order. However, legal precedents and ethical interpretations dictated that patients were expected to receive full resuscitation unless there was explicit documentation to the contrary. In short, CPR became the only medical intervention that required an order to prevent it from being performed. Before the 1990s, patients routinely had pre-existing DNR orders suspended during the perioperative period. Several articles criticized this widespread practice, and the policy of 'required reconsideration' was proposed. Despite this, many practical issues have hindered widespread observance of DNR orders for surgical patients, including concerns related to the DNR order itself and difficulties related to the nature of the operating room environment. This review outlines the origins of the DNR order, and how it currently affects the patient presenting for surgery with a pre-existing DNR order. There are many obstacles yet to overcome, but several practical strategies exist to aid health care workers and patients alike. (+info)Content of advance directives for individuals with advanced dementia. (8/32)
(+info)... advance directive adherence MeSH N05.715.360.335 --- evaluation studies MeSH N05.715.360.395 --- guideline adherence MeSH ...
Unlike advance directives, a POLST summarizes the patients' wishes in the form of medical orders. An advance directive is a ... POLST more accurately conveys end-of-life preferences and yields higher adherence by medical professionals." The National ... To designate a health care surrogate, patients must use an advance directive. An advance directive allows you to generally ... One difference between a POLST form and an advance directive is that the POLST form is designed to be actionable throughout an ...
... advance directive adherence MeSH N04.761.337 --- guideline adherence MeSH N04.761.380 --- medical audit MeSH N04.761.380.100 ... advance care planning MeSH N04.590.233.624.124.050 --- advance directives MeSH N04.590.233.624.124.050.500 --- living wills ...
Exit worked for the acceptance of the living will (Advance health care directive), initially advocating a living will using a ... Exit uses the Carver Model of Policy Governance in the running of its affairs to ensure strict adherence to its aims. Exit ... Exit highlights both the benefits and shortcomings of advance health care directives and has sought to establish proper ... Docker, Chris (20 August 1999). "Problems with advance refusals". British Medical Journal. McLean, Sheila (1996). Contemporary ...
They may have previously prepared a power of attorney and advance directives to provide guidance if they are unable to ... Self-reported noncompliance with adherence to a medication schedule was reported by a striking one-third of the participants. ... The care of older people in the UK has been advanced by the implementation of the National Service Frameworks for Older People ... George Day published the Diseases of Advanced Life in 1849, one of the first publications on the subject of geriatric medicine ...
Refusal to close or delay in closing the accounts; Non-adherence to the fair practices code as adopted by the bank; and ... Any other matter relating to the violation of the directives issued by the Reserve Bank in relation to banking or other ... other than loans and advances) promised in writing by a bank or its direct selling agents; Delays, non-credit of proceeds to ... Non-adherence by the bank or its subsidiaries to the instructions of Reserve Bank on ATM/debit card operations or credit card ...
It captured the city of Krakow, reached the Vistula River and advanced as far as Lvov. During the campaign in Poland, he was ... This only strengthened Busch's resolve to follow Hitler's directives without question. By mid-June, the 700,000 troops of Army ... In the meantime, Busch became depressed after his sacking which effectively came about because of his adherence to Hitler's ... He was replaced by Generalfeldmarschall Walter Model who managed to stop the advance of the Red Army but only after they had ...
p.28 "Influence of adherence to treatment and response of cholesterol on mortality in the coronary drug project". N. Engl. J. ... In 1964, the World Medical Association issued the Declaration of Helsinki,[3] which specifically limited its directives to ... and codes of practice have been gradually developed as a response to advances in scientific medicine. The Nuremberg Code, which ... Gallagher, E. J.; Viscoli, C. M.; Horwitz, R. I. (1993). "The relationship of treatment adherence to the risk of death after ...
Estimated adherence rates are difficult to measure (see below); there is, however, evidence that adherence could be improved by ... Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and ... Doctor-centered consultations are generally directive, with the patient answering questions and playing less of a role in ... Advanced credentialing in the US as a clinical health psychologist is provided through the American Board of Professional ...
On the organization's website, ZFA claims to take a revolutionary step in the Zionist world by combining a faithful adherence ... That means pressuring members of Knesset from different parties to advance legislation against accepting foreign money or ... they also believe that Israel must obey the directives of foreign governments, which often demand such concessions. While ...
Absolute adherence to traditional Rabbinic authorities and procedure; Caution and conservatism; Independence from any other ... The Sanhedrin Initiative seeks to empower Jews to perform national mitzvot that thanks to technological advances and/or ... that it is the only authorized national institution to deal with the legal aspects of warfare and to give policy directives to ...
While these limits are voluntary, adherence has been mandated for the purposes of accreditation, though lack of adherence to ... Similar concerns have arisen in Europe, where the Working Time Directive limits doctors to 48 hours per week averaged out over ... Residency as an opportunity for advanced training in a medical or surgical specialty evolved in the late 19th century from ... For all ACGME accredited programs since 2007, there was a call for adherence to ethical principles. In a survey of more than ...
... the adherence to the Napoleonic principles in the face of technological advances such as the long-range infantry breechloader ... He recognised the need to delegate control to subordinate commanders and to issue directives rather than specific orders. ... School of Advanced Air and Space Studies. AAP-6(V) NATO Glossary of Terms and Definitions British Defence Doctrine, Edition 3, ... Technological advances also had a huge influence on strategy: aerial reconnaissance, artillery techniques, poison gas, the ...
The EU Council Directive 96/96/EC of 20 December 1996 mandates all member states to carry out periodic safety and emission ... The actual inspection can be carried out one month in advance of that date and up to four months after the date indicated on ... In Russia all vehicles must pass a periodic inspection ensuring their road worthiness that includes the adherence to the ... In August 2005 the Turkish government decided to introduce a vehicle inspection scheme following the directive 96/96/EC of the ...
Practitioners of CLI do not claim it does not influence nor that it is "non-directive". They acknowledge that the interviewer's ... Furthermore, a systematic application of a 'cleanness rating' protocol provides a quantitive measure of adherence to interview ... Advances in Developing Human Resources, 17(3):321-336. https://doi.org/10.1177/1523422315587897 Cairns-Lee, H. (2017) An ... "non-directive therapy". There has been growing use of Clean Interviewing. While it is ideally suited to research (especially ...
4. Directive 2011/85/EU: On requirements for budgetary frameworks of the Member States. The directive shall be implemented by ... creating in advance a "strong budgetary governance and a watertight system of monitoring and surveillance" in the Eurozone, ... where the implementation funding would be paid by the CCI fund conditional on strict adherence to a prior signed "contractual ... "COUNCIL DIRECTIVE 2011/85/EU of 8 November 2011: On requirements for budgetary frameworks of the Member States". Official ...
The directive further instructs that all nonnuclear munitions and missiles must be labeled with placards clearly stating that ... "there has been an erosion of adherence to weapons-handling standards at Minot Air Force Base and at Barksdale Air Force Base" ... including the AGM-129 Advanced Cruise Missile. The AGM-129 was fielded in 1987 as a stealthy cruise missile platform to deliver ... In the Army and Air Force, this term includes a 'significant incident' as defined in DoD Directive 5100.52". In response to the ...
Advance health care directive, durable power of attorney, etc.). In addition to developing standards for financial advisors and ... Adherence to a fee-only standard is strict: NAPFA members cannot accept compensation in any form from any source other than ... Also, unlike other financial planners, NAPFA members are required to clearly disclose the fee in advance. However, NAPFA ...
... to then issue directives in any of these areas of labour policy. Member states must comply with these directives; however, what ... In this case, investors rewarded adherence to the code, as a sign of corporate citizenship. On the other hand, consumers can ... Such factors included rising labour costs in the north, advances in transportation and communication technologies, the ... While these directives allow for labour concerns to be brought above the national level, the presence of philosophical ...
In directive 92/61/EEC of 30 June 1992 relating to the type-approval of two or three-wheel motor vehicles, it is referred to as ... The adherence to "styling aerodynamics" (as opposed to measurably improved aerodynamics) and ergonomic considerations have ... 7, p. 51, ISSN 0011-4286 Coyner, Dale (2007), The Essential Guide to Motorcycle Travel: Tips, Technology, Advanced Techniques, ... Since then most other manufacturers have followed, in order to comply with EC directives that explicitly state that the values ...
In December 1940 Hitler began sending out vague preliminary directives to senior generals on how the war was to be conducted, ... Hitler was well aware that this order was illegal, but personally absolved in advance any soldiers who violated international ... the adherence of the enemy to the principles of humanity or international law is not to be counted upon. In particular it can ...
Fini departed from party's majority line on stem cell research, end of life issues, advance health care directive and ... The document stressed the adherence of the party to the values and the platform of the European People's Party (EPP), its ...
After a few initial salvos, the infantry was to advance quickly for a bayonet charge. The Prussian cavalry was to attack as a ... He accomplished this by means of directives stating his intentions, rather than detailed orders, and he was willing to accept ... During a constitutional crisis in 1819, Frederick William III recognized Prussia's adherence to the anti-revolutionary Carlsbad ... In the actual event of the first world war; on the Western Front, the German advance stalled into trench warfare after the ...
Moreover, facing a German military advance, Lenin and Trotsky were forced to enter into the Treaty of Brest-Litovsk,[15] which ... Stalin's adherence to the collective security line was purely conditional.[54] Britain and France believed that war could still ... followed five weeks thereafter by Hitler's issuance of a secret directive "to take up the Russian problem, to think about war ... both the UK and US showed understanding that the buffer zone was necessary to keep Hitler from advancing for some time, ...
Written] directives on that will follow as soon as the basic elements of the army's plan for the operation have been submitted ... The official record in the DNB therefore corrected his words to remove any reference to "adherence" by other states, but ... asked why the Assembly had not been consulted in advance and whether the pact involved Bulgaria in war. They were ignored. The ... Nonetheless, within the week the Hungarian government had sent out formal notice of its "spiritual adherence" to the pact. In ...
The Sixtieth Year Building: This is a building that is planned to be used for Dhammakaya meditation at an advanced level.[342] ... but instead four directives were given for the temple to improve itself: setting up an Abhidhamma school, more focus on ... vipassana meditation, and strict adherence to the rules of the Vinaya and regulations of the Sangha Council. Despite this, the ...
Usually, advance directives pertain to medical care at the end of life. But a 1991 federal law has given impetus to mental ... Psychiatric Advance Directives. One way to establish a persons preferences regarding future treatment, should the person ... Swanson J, Swartz M, Ferron J, et al: Psychiatric advance directives among public mental health consumers in five U.S. cities: ... Across the sites, only 4 to 13 percent of participants had completed a psychiatric advance directive; however, between 66 and ...
Fagerlin, A., Ditto, P.H., Hawkins, N.A., Schneider, C.E., and Smucker, W.D. (2002). The use of advance directives in end-of- ... Liu, L.L., and Park, D.C. (2004). Aging and medical adherence: The use of automatic processes to achieve effortful things. ... Why dont emergency department patients have advance directives? Academic Emergency Medicine, 6, 1054-1060. ... Madeau, A., and McArdle, J.J. (Eds.). (in press). Contemporary advances in psychometrics. Mahwah, NJ: Lawrence Erlbaum. ...
Adherence to "No Transfer to Hospital" Advance Directives Among Nursing Home Residents. ...
Department of Health and Human Services Literature Review on Advance Directives Anne Wilkinson, Ph.D., Neil Wenger, M.D., M.P.H ... Thompson T, Barbour R, Schwartz L. Adherence to advance directives in critical care decision making: vignette study. Bmj. Nov 1 ... HISTORY OF ADVANCE DIRECTIVES/ADVANCE CARE PLANNING. IV. ETHICAL ISSUES IN ADVANCE DIRECTIVES AND ADVANCE CARE PLANNING. V. ... Advance Directives and Advance Care Planning: Report to Congress Advance Directives and Advance Care Planning for People with ...
As importantly, once advance directives are signed, these documents must become part of the patients health record and must ... "Influence of Adherence to Treatment and Response of Cholesterol on Mortality in the Coronary Drug Project." N Engl J Med 1980; ... Discuss the use of advance directives - both living wills and durable powers of attorney for health care - with patients and ... Discuss the use of advance directives - both living wills and durable powers of attorney for health care - with patients and ...
... adherence? or compliance) adj3 ("advance directive" or directive?)) or ((withdraw$ or cessat$ or withhold$) adj3 (treatment? or ... or resuscitation orders/or advance directive adherence/or withholding treatment/or refusal to treat/or refusal to participate/ ... Does advanced age matter in outcomes after out-of-hospital cardiac arrest in community-dwelling adults? Acad Emerg Med. 2000;7( ... In view of the increasing evidence that advanced age is not associated with worse outcome for cardiovascular procedures (e.g., ...
Advance directives are not in effect until you are no longer able to express your wishes. What the bill is doing is making sure ... Tying reimbursement to adherence to certain standards is a tricky issue. But if were going to have the discussion, lets have ... Same with advance directives.. As long as people like that lady get air time without proper rebuttal (in fact, as long as ... Heres the thing: advance directives are for the time when you can no longer make your own decisions. By definition, that means ...
2007). "An advance directive redesigned to meet the literacy level of most adults: a randomized trial." Patient Educ Couns 69(1 ... Adherence: Adherence is the ability to stick with a health behavior and is important predictor of health outcomes. ... 2007). "Developing a parsimonious model for predicting completion of advance directives." J Nurs Scholarsh 39(2): 165-71. ... 2005). "Effects of a treatment adherence enhancement program on health literacy, patient-provider relationships, and adherence ...
5. Advance care planning. Advance directives are another form of a patient response. By implementing advance directives using ... Without learning why a patient is not taking a prescribed drug, a clinician has little chance of achieving adherence. Patient ... Pre-visit summaries are patient responses to a set of questions sent to a patient in advance of a visit. The questions are ... Advancing Technologies in the Treatment of Sleep Disorders. Jennifer E. Landis - March 8, 2018 ...
Medication Preferences and Adherence Among Individuals With Severe Mental Illness and Psychiatric Advance Directives Wilder, ... Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among ... Overriding Psychiatric Advance Directives: Factors Associated With Psychiatrists Decisions to Preempt Patients Advance ... Advance Directives; Patients; Neurosciences and Mental Health Therapies; Third Party Consent; Right to Refuse Treatment; ...
Heffner JE, Fahy B, Hilling L, Barbieri C. Outcomes of advance directive education of pulmonary rehabilitation patients. Am J ... 8.2.18 adherence to recommended treatment modalities 8.2.19 physician support available to patient 8.2.20 availability of ... 2.13 advance care planning(60,61) 2.14 travel issues(62) 2.15 recreation/leisure activities(63) 2.16 stress management 2.17 ... Adherence in cardiac and pulmonary rehabilitation. J Cardiopulm Rehabil 1995;15(6):420-423. ...
Although advance directives provide a legal basis for physicians to carry out treatment using a health care proxy or a living ... retrospective study25 reported an increase in prevalence and adherence after a large community-based advance directive program ... Advanced directives do not need to include a do-not-resuscitate (DNR) order, and the patient does not need an advanced ... Advanced directives do not need to include a do-not-resuscitate (DNR) order, and the patient does not need an advanced ...
EHRs (e.g., demographics, problem list, medication list, allergies, advance directives). 11-18%. 9-15%. 1%. ---. 29-41%. 25-38% ... Goals of care--rehabilitation, skilled nursing, monitoring, respite, palliation, reduce hospital visits/adherence, stabilize ... Advance Directives. *Preferences for CPR, ventilator support, enteral/ parenteral feeding, hydration, diaysis ... Payers Advance Directives Support (persons/family) Functional Status Problems Family History Social History Alerts Medications ...
Demonstrate effective communication skills when developing and carry out advance directives, facilitating family meetings, ... patient/family education, eliciting the patients illness story, cross-cultural skills and facilitating treatment adherence. ...
Improved communication may also increase the use of advanced directives.. Honoring culturally appropriate requests for truth ... Spiritual support, encouraging and respecting prayer and adherence to cultural traditions, which help many patients and ... If the person had an advance directive or power of attorney for health care instrument the matter would be easy to solve -- ... Advanced life support, early resuscitation at the time of injury and the ability to prevent the cessation of respiration has ...
It is unclear if advance directives (living wills) are associated with end-of-life expenditures and treatments.Objective: To ... Treatment Adherence. *United States Preventive Services Task Force. *Urology. *Users Guide to the Medical Literature ... Advance Directives and Cost SavingsGreater Clarity and Perpetual Confusion. Scott D. Halpern, MD, PhD; Ezekiel J. Emanuel, MD, ... Advance Directives and Cost SavingsGreater Clarity and Perpetual Confusion. Arch Intern Med. 2012;172(3):266-268. doi:10.1001/ ...
... situations with advanced directives, and the treatment of communicable diseases. 3.11.4 Release of medical records will only be ... Adherence to applicable informed consent regulations and standards of the local jurisdiction must be maintained. Informed ... Adherence to the FederaL Controlled Substances Act and the State Pharmacy Act and compliance with NeCHC Standards; and n. ... and an emergency response kit in order to provide any and all interventions described by Advanced Cardiac Life Support (ACLS) ...
... of patients have completed an advance directive, and these completed advance directives are usually limited to preferences with ... adherence to this standard should be measured and tracked. Finally, the proportion of patients completing a POLST/MOLST or ... Opening the black box: How do physicians communicate about advance directives? Ann Intern Med 129: 441-449, 1998pmid:9735081. ... The effects of providing chronic hemodialysis patients written material on advance directives. Am J Kidney Dis 22: 413-418, ...
... advance directive adherence MeSH N05.715.360.335 --- evaluation studies MeSH N05.715.360.395 --- guideline adherence MeSH ...
Unlike advance directives, a POLST summarizes the patients wishes in the form of medical orders. An advance directive is a ... POLST more accurately conveys end-of-life preferences and yields higher adherence by medical professionals." The National ... To designate a health care surrogate, patients must use an advance directive. An advance directive allows you to generally ... One difference between a POLST form and an advance directive is that the POLST form is designed to be actionable throughout an ...
Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?. de Boer, M. E., Dröes, R. M ... Advance directives in dementia: issues of validity and effectiveness. de Boer, M. E., Hertogh, C. M. P. M., Dröes, R. M., ... Advanced Theory of Mind from childhood to adolescence. Scheeren, A. M., Begeer, S. & Koot, H. M., 2010.. Research output: ... Advance purchase discounts versus clearance sales. Watanabe, M. & Moller, M., 2010, In : Economic Journal. 120, 547, p. 1125- ...
Referring patients to meal-delivery programs and advance directive preparation services. Some chronic conditions addressed by ... Monitoring medication adherence. *Assessing the patients daily living activities and cognitive, behavioral and social support ...
Specifically, plans will include motivational interviewing strategies, psychiatric advanced directives, and collaborative, ... The population of focus for proposed program is comprised of adult clients in Travis County who are persistently non-adherence ... and support each SR-AOT consumer to complete a Psychiatric Advanced Directive as a ward against future periods of instability. ... of program enrollees will have a Psychiatric Advance Directive, [2] following 1 year of services, clients will demonstrate ...
6.BMJ - Adherence to advance directives in critical care decision making: vignette study ... 38.Expert Rev Anticancer Ther - von Hippel-Lindau disease: recent advances and therapeutic perspectives ... 83.NEJM - Rethinking the Role of Tube Feeding in Patients with Advanced Dementia ...
Grant RL, Piotto L: Benets of Adopting Standardized ICS There are four major types of advance directives. Parenteral nutrition ... Ultrasound allows for SMR staging, recognition of the anal sphincter tone, overfeeding, or poor adherence to the Acutely Ill ...
Palliative careMedicationClinicalPatientsPatient'sPsychiatric advance diCompletionPreferencesDurable power ofChronicDrug interactionsAcutePhysiciansPOLSTTreatmentsCognitiveGeriatricsTraumaEnsuring patientHealthcareCare PlanningDecisions2017HealthInformed consentPhysicianFormFamilySensoryIncludeRequiresWrittenFormsDataLegislationSupportResearch
- This course will address how race, ethnicity, and culture impact issues of dying, including attitudes toward death, death rituals, grieving and bereavement, advance directives, and palliative care to ensure that culturally responsive care is provided at the end of life. (netce.com)
- Reducing Disparities in the Quality of Palliative Care for Older African Americans through Improved Advance Care Planning (Subaward). (sc.edu)
- In 2017 M eier and M organ [ 7 ], in describing their work at the Center to Advance Palliative Care, suggested a more comprehensive definition of palliative care as: "…specialized medical care for people with serious illnesses… focused on providing patients with relief from the symptoms, pain, and stress of a serious illness… to improve quality of life for both the patient and the family. (ersjournals.com)
- End-of-life decision making may include advance directives such as living wills and health care proxies, palliative care or hospice programs, and choices about life sustaining technologies such as ventilators, feeding tubes, defibrillation, and others. (jeffreymlevinemd.com)
- The comprehensive geriatric assessment provides an avenue for oncologists to discuss advance directives and the role of palliative care measures early in an ambulatory setting. (ascopost.com)
- Predictors of medication adherence in the elderly. (nap.edu)
- An advanced medication administration experience to promote students' knowledge acquisition in the skill of administering medications. (duq.edu)
- Preliminary data with a prevalence of medication adherence is withdrawn before significant numbers of 1% and semen. (secureserver.net)
- A new analysis indicates that not obtaining a medication the first time it is prescribed-called initial medication non-adherence-is common among patients within the Catalan health system in Spain. (news-medical.net)
- Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541. (harvard.edu)
- We review the current literature on nurse-initiated protocols, validated emergency department clinical scoring systems, and the merging of the two to create Advanced Nursing Directives (ANDs). (hindawi.com)
- The process of developing a clinical pathway for children presenting to our pediatric emergency department (PED) with suspected appendicitis will be used to demonstrate the successful integration of validated clinical scoring systems into practice through the use of Advanced Nursing Directives. (hindawi.com)
- Finally, examples of 2 other Advanced Nursing Directives for common clinical PED presentations will be provided. (hindawi.com)
- The purpose of this paper is to review the theoretical constructs behind nurse-driven protocols, the evidence supporting clinical scoring systems, and how the integration of the two form Advanced Nursing Directives (ANDs), which have the potential to significantly improve patient care outcomes, administrative metrics, and overall patient and caregiver satisfaction for children presenting to the ED. (hindawi.com)
- Second, HIV disease may affect the biology of aging, possibly resulting in early manifestations of clinical syndromes generally associated with advanced age. (nih.gov)
- This has contributed to the growth of pharmacy services throughout the region, with advanced clinical practice in countries like Saudi Arabia and the United Arab Emirates. (ajpe.org)
- Some patients who have a representative payee (or a more informal money manager) believe that there is a quid pro quo relationship between their adherence to treatment and their receipt of what they consider to be their money. (jaapl.org)
- Patients should be offered a family-based decision-making plan because some cultures prefer family decision making over the individualist approach inherent in conventional written directives. (aafp.org)
- Patients with chronic and terminal disease, such as acquired immunodeficiency syndrome, cancer, and end-stage lung disease, should be offered advance directives that are specific to their disease. (aafp.org)
- OBJECTIVE: Psychiatric advance directives allow patients with severe mental illness to document their preferences for particular medications. (georgetown.edu)
- POLST represents a significant paradigm change in advance care policy by standardizing provider communications through a plan of care in a portable way, rather than focusing solely on standardizing patients' communications via advance directives. (wikipedia.org)
- Spiritual support, encouraging and respecting prayer and adherence to cultural traditions, which help many patients and families to cope with illness, death, and dying. (blogspot.com)
- The study focuses on the admission of patients with advanced dementia, chest disease or cancer who die within 72 hours of admission to acute hospitals. (springer.com)
- 88% of cases, but no advanced directives were found, and notifications of patients' preferences were found in only 7% of cases. (biomedcentral.com)
- Technological-medical advances regarding terminal illness and end-of-life care have led to an increasing number of situations requiring serious decisions by patients, families and health care providers (e.g., regarding certain life-sustaining measures). (biomedcentral.com)
- Educates patients about patient financial liabilities, employs proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures. (apha.org)
- A basic principal of geriatrics is to discuss advance directives and counsel patients on reasonable end-of-life choices, with the goal of dignity, autonomy, and curtailment of unnecessary suffering. (jeffreymlevinemd.com)
- Because most patients with the test should be provided in adherence. (secureserver.net)
- We investigate whether patients with a PACP or CCP show fewer emergency visits and (involuntary) admissions as compared to patients without a psychiatric advance statement. (biomedcentral.com)
- In addition, the results offer an understanding of the way these advance statements work and whether it is more effective to include a patients' advocate in the process of creating a psychiatric advance statement. (biomedcentral.com)
- Engaging patients and family members is crucial when there are documents specifying physician directives for life-threatening conditions. (healthleadersmedia.com)
- Compared to living wills and durable power of attorney documents, POLST forms have been associated with significantly higher decreased odds of resuscitation attempts in the field and increased odds of out-of-hospital death for patients with "comfort measures only" directives. (healthleadersmedia.com)
- Trying to push society even deeper into the denial of religious conscience, some of the world's most prestigious medical and bioethics journals have published articles arguing that nursing homes should be legally required to withhold spoon feeding from incompetent Alzheimer's patients when the person's written advance directive so instructs. (aoiusa.org)
- Patient response is a new way to ensure that the patient's voice is well heard in creating care plans, in deciding among treatment options, and in advancing the doctor-patient partnership. (healthworkscollective.com)
- Although advance directives provide a legal basis for physicians to carry out treatment using a health care proxy or a living will, they also should reflect the patient's values and preferences. (aafp.org)
- Although clear medical directives were given regarding the patient's care, there was little documentation about the patient's values and how they would influence the medical care she would want. (aafp.org)
- Demonstrate effective communication skills when developing and carry out advance directives, facilitating family meetings, patient/family education, eliciting the patient's illness story, cross-cultural skills and facilitating treatment adherence. (cmich.edu)
- The advance directive can be laid down in binding form (doctors must execute the patient's wishes in any case) or in non-binding form (as statements of wishes to be given due respect, i.e. in case of doubt, doctors are allowed to deviate from the given directives). (biomedcentral.com)
- Advance directives (ADs), written documents that specify personal preferences for future medical care in the event that an individual loses decisional capacity, are a widely recognized tool that may help to protect a patient's autonomy and intentions in such situations (e.g., better alignment between care as preferred and care as received, allowing/disallowing certain life-sustaining measures). (biomedcentral.com)
- Finally, we discuss psychiatric advance directives and explore how these contracts may affect the debate over the practice. (jaapl.org)
- Completion of advance directives (ADs) and power of attorney (POA) documents may protect a person's autonomy in future health care situations when the individual lacks decisional capacity. (biomedcentral.com)
- In a 2006 consensus report, the National Quality Form observed that "compared with other advance directive programs, POLST more accurately conveys end-of-life preferences and yields higher adherence by medical professionals. (wikipedia.org)
- An "Advance directives" is a legally binding document which describes the preferences for and refusals of treatment in advance. (biomedcentral.com)
- Specially trained nurses provided communication with the patient, family, physician, and hospital staff to elicit preferences, facilitate advance care planning, and patient-physician communication. (ascopost.com)
- Adherence to POLST form directives is higher than for living wills and durable power of attorney documents. (healthleadersmedia.com)
- Advances in Chronic Kidney Disease. (elsevier.com)
- Small pilot studies support the appropriateness of engaging adolescents with chronic or life-limiting illnesses in pediatric advance care planning (pACP). (aappublications.org)
- Pharmacologic problems associated with aging, including changes in pharmacokinetics and pharmacodynamics, drug interactions, overmedication, appropriate prescribing and adherence. (southnassau.org)
- 2 , 3 Even with end-of-life planning, the inaccessibility of transferring advance directives from ambulatory to acute care settings is an ongoing problem. (aafp.org)
- The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008). (biomedcentral.com)
- The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. (biomedcentral.com)
- The challenge remains to educate physicians about the nature of advance directives and reasonable choices for care at the end of life. (jeffreymlevinemd.com)
- One difference between a POLST form and an advance directive is that the POLST form is designed to be actionable throughout an entire community. (wikipedia.org)
- Though not usually part of the ED situation, there are starting to be lawsuits when clear advance directives-usually in the form of the orders associated with POLST rather than more vague wishes expressed in other advance directives-are ignored. (healthleadersmedia.com)
- POLST forms have broader scope than CPR directives. (healthleadersmedia.com)
- These directives forbid or severely restrict critical reproductive and end-of-life health care services at Catholic health facilities, including contraception, abortions, fertility treatments, vasectomies, tubal ligations, aid in dying, and advance directives that are contrary to Catholic teachings. (aclu-wa.org)
- Advanced cognitive training for independent and vital elderly study group. (nap.edu)
- Depression reduces quality of life, has a negative impact on adherence, and is known to worsen cognitive function and other MS symptoms such as fatigue and pain. (nationalmssociety.org)
- TUESDAY, Feb. 14, 2017 (HealthDay News) - Quality improvement interventions can increase discussions relating to advanced care planning and the mention of advance directives (ADs) in the electronic medical record (EMR), according to a study published online Feb. 9 in the Journal of the American Geriatrics Society . (physiciansweekly.com)
- The American College of Surgeons Committee on Trauma (ACS COT) fully supports the directives urging social distancing to slow the spread of the COVID-19 virus, and strongly encourages Advanced Trauma Life Support ® (ATLS) sites to cancel courses planned in the near future. (facs.org)
- Advance directives (ADs) or advance health care directives were developed to provide a practical process for ensuring patient autonomy at the end of life. (hhs.gov)
- A living will contains written directives to healthcare providers. (nationalmssociety.org)
- When planning programs to offer advanced care planning to the oldest old, it might be helpful to respond to these specific needs, and also to be sensitive to attitudinal differences in this target group. (biomedcentral.com)
- Adolescents and families who participated in a highly structured advance care planning program facilitated by trained/certified research assistants experienced intense emotions compared with controls and found the experience acceptable, worthwhile, and helpful with 99% attendance at all 3 sessions. (aappublications.org)
- Improved approaches to pediatric advance care planning (pACP) are needed for the ∼400 000 children living in the United States with life-limiting conditions. (aappublications.org)
- The way to enforce your wishes about future medical-care decisions is to make them in advance and place them in a legally enforceable 'advance directive' document. (nationalmssociety.org)
- An advance directive is a document in which a competent person states medical decisions for the future. (nationalmssociety.org)
- Providence is a Catholic health care system that is required to follow the Ethical and Religious Directives (ERDs) promulgated by the United States Conference of Catholic Bishops. (aclu-wa.org)
- Further, adherence to the ERDs increases the likelihood that LGBTQ individuals and their families will face discrimination in seeking to access health care services consistent with their medical needs. (aclu-wa.org)
- As a result, health care practitioners are working to improve patient care by adopting progressive strategies such as nurse-initiated protocols and Advanced Nursing Directives (ANDs). (hindawi.com)
- Advance statements such as crisis plans are rarely used in metal health practices in the Netherlands. (biomedcentral.com)
- The issues of power of attorney , privacy, legal responsibility , advance directives and informed consent must always be considered in geriatric procedure. (thefullwiki.org)
- Previous research has shown that a form of psychiatric advance statement - joint crisis plan - may prevent involuntary admissions, but another study showed no significant results for another form. (biomedcentral.com)
- The question remains which form of psychiatric advance statement may help to prevent crisis situations. (biomedcentral.com)
- If you become incapacitated and you don't have specific advance directives, your family members will generally be deemed the appropriate decision makers. (nationalmssociety.org)
- Demonstrated a clear understanding of the challenges, and approaches to overcoming the challenges, of onboarding new/replacement personnel into the expeditionary environment, to include local command directives, local laws, and NGA processes. (gao.gov)
- This question may include advance directives such as a noninvasive method for at least 12 months after response and discussed with values ranging from a probe with restrictive disease have normal-shaped curves with use of patient progress. (secureserver.net)
- D: Large area of the brain death the oculovestibular reflex requires the most important viruses to consider and implement advance directives early in the SCN5A (sodium channel) gene. (cide.edu)
- See related handout on advance directives , written by the authors of this article. (aafp.org)
- Many standard legal forms for advance directives contain only one of these two types. (nationalmssociety.org)
- A structured questionnaire that included demographic and professional aspects and the Standard Precautions Adherence Scale were used to collect data. (bvsalud.org)
- In 2006 a new advance directive legislation was enacted in Austria. (biomedcentral.com)
- Some adults without ADs/POA perhaps would have completed advance care documents, if they had had received more information and support. (biomedcentral.com)
- Researchers reviewed published research to compare weight loss, adherence, and harms of 11 commercial or proprietary weight loss programs. (eurekalert.org)