The Grief of Mothers After the Sudden Unexpected Death of Their Infants.

Unlabelled: : media-1vid110.1542/5741323271001PEDS-VA_2017-3651 BACKGROUND: The loss of a child is associated with elevated grief severity, and sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality in the United States. The diagnosis of prolonged grief disorder (PGD) has gained broader acceptance and use.

Mild cognitive dysfunction of caregivers and its association with care recipients' end-of-life plans and preferences.

Little is known about the association between cognitive dysfunction among informal caregivers and patients' plans and preferences for patients' end of life care. We report on the frequency of cognitive dysfunction among both patients and caregivers and examine associations between caregivers' cognitive screening scores and end of life plans and preferences of patients with advanced cancer. The current sample was derived from a National Cancer Institute- and National Institute of Mental Health-funded study of patients with distant metastasis who had disease progression on at least first-line chemotherapy, and their informal caregivers (n = 550 pairs).

The interactive effect of advanced cancer patient and caregiver prognostic understanding on patients' completion of Do Not Resuscitate orders.

Objective: Advanced cancer patients' prognostic understanding is associated with completion of Do Not Resuscitate (DNR) orders, which often represent engagement in advance care planning (ACP). Given caregivers' critical roles in patient decision-making about ACP and end-of-life care, caregivers' prognostic understanding may have a large additive effect. The present study examined the association between the main and interactive effects of advanced cancer patient and caregiver prognostic understanding on DNR order completion.

Informal Caregiver Challenges for Advanced Cancer Patients During End-of-Life Care in Johannesburg, South Africa and Distinctions Based on Place of Death.

Context: In sub-Saharan Africa, late diagnosis with cancer is common. Many dying patients rely on family members for care; little is known about the challenges African informal caregivers face.

Objectives: To better understand the challenges of informal caregivers at the end of life in South Africa, both at home and in inpatient facilities.

Being present: oncologists' role in promoting advanced cancer patients' illness 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.

Beyond Pain: Nurses' Assessment of Patient Suffering, Dignity, and Dying in the Intensive Care Unit.

Context: 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.

Associations between Mild Cognitive Dysfunction and End-of-Life Outcomes in Patients with Advanced Cancer.

Background: Cognitive function of patients with advanced cancer is frequently compromised.

Objective: To determine the extent that patients' cognitive screening scores was associated with their end-of-life (EoL) treatment preferences, advance care planning (ACP), and care.

Design: Patients were interviewed at baseline and administered a cognitive screen.

Chemotherapy Use, End-of-Life Care, and Costs of Care Among Patients Diagnosed With Stage IV Pancreatic Cancer.

Context: 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.

Bereavement Challenges and Their Relationship to Physical and Psychological Adjustment to Loss.

Objective: The psychosocial challenges confronted by bereaved survivors may contribute to poor bereavement adjustment. Measures of the challenges of bereavement are limited. This study is a preliminary examination of the factor structure of a new measure of bereavement challenges and their relationships to quality of life and mental illness in bereaved cancer caregivers.

Prognostic awareness and communication preferences among caregivers of patients with malignant glioma.

Objective: Malignant glioma (MG) is a devastating neuro-oncologic disease with almost invariably poor prognosis, yet many families facing malignant glioma have poor prognostic awareness (PA), or the awareness of the patient's incurable disease and shortened life expectancy. Accurate PA is associated with favorable medical outcomes at end-of-life for patients and psychosocial outcomes for informal caregivers (ICs) through bereavement. To date, however, no study has specifically examined PA among MG ICs and the information they receive that shapes their awareness.

Educational Intervention to Improve Code Status Discussion Proficiency Among Obstetrics and Gynecology Residents.

Background: Obstetrics and gynecology (OB/GYN) residents receive little formal training in conducting code status discussions (CSDs).

Objective: We piloted an educational intervention to improve resident confidence and competence at conducting CSDs.

Design: The OB/GYN residents at a single institution participated in a 3-part educational program.

Care at End of Life Influences Grief: A Nationwide Long-Term Follow-Up among Young Adults Who Lost a Brother or Sister to Childhood Cancer.

Background: A majority of cancer-bereaved siblings report long-term unresolved grief, thus it is important to identify factors that may contribute to resolving their grief.

Objective: To identify modifiable or avoidable family and care-related factors associated with unresolved grief among siblings two to nine years post loss.

Design: This is a nationwide Swedish postal survey.

Avoidance of Bereavement-Related Stimuli in Chinese Individuals Experiencing Prolonged Grief: Evidence from a Dot-Probe Task.

Attentional bias refers to a preference for (e.g., vigilance) or a shifting away (e.

Prognostic awareness, prognostic communication, and cognitive function in patients with malignant glioma.

Background: Malignant glioma (MG) is a devastating neuro-oncologic disease with almost invariably poor prognosis. Prognostic awareness (PA) is the awareness of incurable disease and shortened life expectancy (LE). Accurate PA is associated with favorable psychological outcomes at the end of life (EoL) for patients with cancer; however, little is known about PA or prognostic communication in MG.

Curative, Life-Extending, and Palliative Chemotherapy: New Outcomes Need New Names.

Imprecise terminology obscures the reasons why a cancer patient might be willing to endure the potential toxicities and side‐effects of treatment. Renaming of the categories of chemotherapy is proposed here to clarify intended definitions.

Advanced cancer caregiving as a risk for major depressive episodes and generalized anxiety disorder.

Objective: Caregivers of advanced cancer patients provide extensive care associated with high levels of caregiver distress. The degree to which cancer caregiving increases caregivers' risk for a psychiatric disorder is unknown. The current study examines whether advanced cancer caregiving poses distinct risks for initial and recurrent major depressive episodes (MDEs) and generalized anxiety disorder (GAD) relative to the general population.

Frequency and Risk Factors for Live Discharge from Hospice.

Objectives: To report frequencies and associated risk factors for 4 distinct causes of live discharge from hospice.

Design: Retrospective cohort study using electronic medical records of hospice patients who received care from a large urban not-for-profit hospice agency in New York City during a 3-year period between 2013 and 2015 (n = 9,190).

Results: Roughly one in five hospice patients were discharged alive (21%; n = 1911).

Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

Background: Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted.

Objective: To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses.

Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma.

Context: Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life are almost invariably a matter of "when," not a matter of "if." Optimizing symptom management and quality of life in later stages of disease is of the utmost priority.

Objectives: To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM.

Continuing Bonds and Bereavement Adjustment Among Bereaved Mainland Chinese.

Given the important role of continuing bonds (CBs) in bereavement adjustment, the aim of this study was to examine the relationship between CBs and bereavement adjustment and identify influences on CB among bereaved mainland Chinese. The Continuing Bonds Scale, Prolonged Grief Questionnaire 13, and Posttraumatic Growth Inventory were administered to 273 bereaved participants. Findings in the current study suggest psychometric validity of the Continuing Bonds Scale in a mainland Chinese sample and confirm that externalized CB is positively associated with severity of grief symptoms, and internalized CB is positively associated with the respondent degree of posttraumatic growth and identifies influences on externalized CB and internalized CB.

Impact of Radiation Therapy on Aggressive Care and Quality of Life Near Death.

Context: Radiation therapy (RT) is used with palliative intent in patients with advanced stage cancer. Prior studies, primarily in patients with poor performance status (PS), suggest that RT is associated with aggressive medical care, which may impact patients' quality of life near death (QoD) adversely.

Objective: This study examines associations between RT use and patients' receipt of aggressive care and QoD based on patients' PS.