Publications by authors named "Renee Maciejewski"
Futile or potentially inappropriate care (futile/PIC) for dying inpatients leads to negative outcomes for patients and clinicians. In the setting of rising end-of-life health care costs and increasing physician burnout, it is important to understand the causes of futile/PIC, how it impacts on care and relates to burnout. Examine causes of futile/PIC, determine whether clinicians report compensatory or avoidant behaviors as a result of such care and assess whether these behaviors are associated with burnout.
View Article and Find Full Text PDFContext: Stability of patients' treatment preferences has important implications for decisions about concurrent and future treatment.
Objectives: To examine the stability of treatment preferences and correlates among patients with advanced cancer.
Methods: In this cohort, 104 patients with metastatic cancer, progression after at least one chemotherapy regimen, and an oncologist-estimated life expectancy of six or fewer months participated in structured interviews after clinical visits in which patients' recent scan results were discussed.
Article Synopsis
- Caring for patients at the end of life in the ICU can lead to emotional distress and burnout among nurses, but the specific factors contributing to this distress are not well understood.
- A study involving 100 nurses revealed that factors such as patients' suffering, loss of dignity, and overall quality of death significantly influenced nurses' emotional distress.
- Additionally, family dynamics, including fears about death and unrealistic expectations, were also identified as contributors to nurses' emotional challenges, suggesting that improving patient care and family support may benefit nurses' well-being.
Context: Patients with advanced cancer often overestimate their time left to live. Those who have heightened awareness of their cognitive and physical deficits at the end of life may have a better prognostic understanding.
Objectives: We sought to investigate the extent to which patients' self-reports of physical well-being and cognitive function were associated with prognostic understanding.
Realistic illness understanding is essential to an advanced cancer patient's ability to make informed medical decisions at the end of life. This study sought to determine whether advanced cancer patients better understood the late stage of their cancer if an oncologist, compared to other members of the care team, was present to discuss their scan results. Data were derived from a multi-institutional, longitudinal cohort study of patients recruited between 2010 and 2015.
View Article and Find Full Text PDFContext: Deaths in the intensive care unit (ICU) are increasingly common in the U.S., yet little is known about patients' experiences at the end of life in the ICU.
View Article and Find Full Text PDFContext: For patients with metastatic cancer and limited life expectancy, potential benefits of chemotherapy must be balanced against harms to quality of life near death and increased out-of-pocket costs of care.
Objectives: To evaluate the association between chemotherapy use by patients with Stage IV pancreatic cancer and health care use and Medicare and out-of-pocket costs in the last 30 days of life.
Methods: We conducted a retrospective cohort study of 3825 patients aged 66 years or older when diagnosed with Stage IV pancreatic cancer in 2006-2011, using the linked Surveillance, Epidemiology, and End Results-Medicare data.