Abstract:
: Background: Many patients with serious kidney disease have an elevated symptom burden, high mortality, and poor quality of life. Palliative care has the potential to address these problems, yet nephrology patients frequently lack access to this specialty. Objectives: We describe patient demographics and clinical activities of the first 13 months of an ambulatory kidney palliative care (KPC) program that is integrated within a nephrology practice. Design/Measurements: Utilizing chart abstractions, we characterize the clinic population served, clinical service utilization, visit activities, and symptom burden as assessed using the Integrated Palliative Care Outcome Scale-Renal (IPOS-R), and patient satisfaction. Results: Among the 55 patients served, mean patient age was 72.0 years (standard deviation [SD] = 16.7), 95% had chronic kidney disease stage IV or V, and 46% had a Charlson Comorbidity Index >8. The mean IPOS-R score at initial visit was 16 (range = 0-60; SD = 9.1), with a mean of 7.5 (SD = 3.7) individual physical symptoms (range = 0-15) per patient. Eighty-seven percent of initial visits included an advance care planning conversation, 55.4% included a medication change for symptoms, and 35.5% included a dialysis decision-making conversation. Overall, 96% of patients who returned satisfaction surveys were satisfied with the care they received and viewed the KPC program positively. Conclusions: A model of care that integrates palliative care with nephrology care in the ambulatory setting serves high-risk patients with serious kidney disease. This KPC program can potentially meet documented gaps in care while achieving patient satisfaction. Early findings from this program evaluation indicate opportunities for enhanced patient-centered palliative nephrology care.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Scherer JS,Harwood K,Frydman JL,Moriyama D,Brody AA,Modersitzki F,Blaum CS,Chodosh Jdoi
10.1089/jpm.2018.0647subject
Has Abstractpub_date
2020-02-01 00:00:00pages
259-263issue
2eissn
1096-6218issn
1557-7740journal_volume
23pub_type
杂志文章abstract:BACKGROUND:Nurses and nursing care providers provide the most direct care to patients at end of life. Yet, evidence indicates that many feel ill-prepared for the complexity of palliative care. OBJECTIVE:To review the resources required to ensure adequate education, training, and mentorship for nurses and nursing care ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
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journal_title:Journal of palliative medicine
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journal_title:Journal of palliative medicine
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更新日期:2020-08-01 00:00:00
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更新日期:2014-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2003-04-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2018-07-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2013-11-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0098
更新日期:2008-04-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.20
更新日期:2005-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2020-08-19 00:00:00
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journal_title:Journal of palliative medicine
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更新日期:2006-08-01 00:00:00
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更新日期:2013-08-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2011.0301
更新日期:2012-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
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更新日期:2006-12-01 00:00:00
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更新日期:2013-10-01 00:00:00
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更新日期:2020-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-07-01 00:00:00
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更新日期:2012-06-01 00:00:00
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更新日期:2009-02-01 00:00:00
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更新日期:2013-11-01 00:00:00
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更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-09-01 00:00:00
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