Care of the Patient Nearing the End of Life in the Neurointensive Care Unit.

Background: Neurologically critically ill patients present with unique disease trajectories, prognostic uncertainties, and challenges to end-of-life (EOL) care. Acute brain injuries place these patients at risk for underrecognized symptoms and unmet EOL management needs, which can negatively affect their quality of care and lead to complicated grief in surviving loved ones. To care for patients nearing the EOL in the neurointensive care unit, health care clinicians must consider neuroanatomic localization, barriers to symptom assessment and management, unique aspects of the dying process, and EOL management needs.

Opening a Donor Management Center.

In the United States alone, more than 100,000 people are waiting for a lifesaving organ transplant. In response to the growing need for viable organs to transplant, donor management centers have opened to provide care to brain-dead organ donors prior to the organ procurement operation. This article describes donor management center operations, details the opening of one such unit, and describes the results and lessons learned.

End-Of-Life Symptoms and Symptom Management in Older Adults With Stroke Versus Cancer.

Little is known about the end-of-life (EOL) experience in older adults with stroke or how similar the EOL experience is in older adults with stroke when compared to those with cancer. We utilized data from the National Health and Aging Trends Study (NHATS) to compare symptoms, symptom management, and overall rating of care in the last month of life between older adults diagnosed with stroke and those diagnosed with cancer. Logistic regression was used to examine the associations between diagnosis and symptom prevalence, symptom management, and overall care quality, adjusting for care intensity, place of death, and demographic covariates.

Psychometric Testing of a Composite Score for Job Satisfaction of Newly Licensed Registered Nurses.

Inconsistent scaling and inadequate psychometrics on job satisfaction, organizational commitment, and intent to leave among nurses have resulted in studies using a single question to measure these outcomes. Our aim was to psychometrically test a composite measure. The scales for these variables in the Newly Licensed Registered Nurse Survey (NLRNS) and National Sample Survey of Registered Nurses were re-coded into a composite measure.

Advances in Treatment and Health-Related Quality of Life: A Cohort Study of Older Adult Survivors of Breast Cancer.

Objectives: To determine whether there are differences in the health-related quality of life (HRQOL) of older adult survivors of breast cancer (BC) diagnosed in different time periods and to gain insight into whether advances in BC treatment have improved HRQOL.

Sample & Setting: Three cohorts of older adult survivors of BC diagnosed before 1995, from 1996 to 2005, and from 2006 to 2015 were examined using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey linked databases.

Methods & Variables: HRQOL was measured using the Veterans RAND 12-Item Health Survey.

End-of-Life Symptoms in Adult Patients With Stroke in the Last Two Years of Life: An Integrative Review.

Background: Stroke is a leading cause of death globally, yet End-of-Life (EOL) symptoms and their management in these patients are not well understood.

Purpose: This integrative review aims to critique and synthesize research on EOL symptoms and symptom management in adult patients with stroke in the last 2 years of life in all settings.

Methods: The Whittemore and Knafl integrative review methodology guided this review.

Correlates of Health-Related Quality of Life in a National Sample of Older Adult, Long-Term Survivors of Colorectal Cancer.

Background: Most survivors of colorectal cancer (CRC) are older adults who are at high risk of experiencing adverse effects and decreased health-related quality of life (HRQOL) related to cancer and its treatments.

Objective: This study aimed to describe HRQOL and the demographic and clinical factors associated with HRQOL among older adult, long-term survivors of CRC.

Methods: A sample of older adult, long-term survivors of CRC (N = 14 458) from the Surveillance Epidemiology and End Results-Medicare Health Outcomes Survey dataset was selected.

School Shooters: Patterns of Adverse Childhood Experiences, Bullying, and Social Media.

Introduction: Since 2013 there have been at least 421 recorded incidents of gunfire on school grounds METHOD: This study used a critical review of national and local media news reports of 25 American male school shooter cases from 2013 to 2019.

Results: Approximately 88% of school shooters had at least one social media account, and 76% posted disturbing content of guns and threatening messages. Over 72% of shooters had at least one reported adverse childhood experience, and 60% reported being bullied in-person or online DISCUSSION: Professionals who work with adolescents are front-line providers who routinely assess student safety.

Impact of Exposure to Patient Death or Near Death on Compassion Fatigue in Pediatric Intensive Care Nurses.

Background: Compassion fatigue affects up to 40% of health care professionals who work in intensive care settings. Frequent exposure to the death of patients, particularly children, may put nurses at risk for compassion fatigue, but the relation between these is unclear among those working in pediatric intensive care units.

Objectives: To examine the relationship between exposure to the death or near death of a pediatric patient and compassion fatigue, specifically the outcomes of compassion satisfaction, burnout, and secondary traumatic stress.

End-of-life Health-Care Utilization Patterns Among Chronically Ill Older Adults.

Patients with chronic illness are associated with high health-care utilization and this is exacerbated in the end of life, when health-care utilization and costs are highest. Complex Care Management (CCM) is a model of care developed to reduce health-care utilization, while improving patient outcomes. We aimed to examine the relationship between health-care utilization patterns and patient characteristics over time in a sample of older adults enrolled in CCM over the last 2 years of life.

Advance Care Planning Outcomes in African Americans: An Empirical Look at the Trust Variable.

Context: Racial disparities in rates of hospice use, a marker of quality of end-of-life (EOL) care, have been a long-standing problem. Although distrust has been cited as a main reason for the preference of intensive EOL care among African Americans, the role of trust has not been closely analyzed in predicting EOL care in the context of advance care planning (ACP) outcomes.

Objectives: The goal of this review was to empirically examine the role of trust in ACP outcomes.