ELDVs are commonly experienced phenomena during the dying process, characterized by a consistent sense of realism and marked emotional significance. These dreams/visions may be a profound source of potential meaning and comfort for the dying, and therefore warrant clinical attention and further research.

These findings indicate that for children with special health care needs, enrollment in a multidisciplinary aerodigestive clinic may improve health care outcomes by decreasing technical direct cost by 70% and significantly decreasing patient hospital days by an estimated 1 week per year. Furthermore, coordinated aerodigestive care in a medical home setting may lower health care expenditures from a systems-based perspective.

End-of-life dreams and visions (ELDVs) are well documented throughout history and across cultures with impact on the dying person and their loved ones having profound meaning. Published studies on ELDVs are primarily based on surveys or interviews with clinicians or families of dead persons. This study uniquely examined patient dreams and visions from their personal perspective. This article reports the qualitative findings from dreams and visions of 63 hospice patients. Inductive content analysis was used to examine the content and subjective significance of ELDVs. Six categories emerged: comforting presence, preparing to go, watching or engaging with the deceased, loved ones waiting, distressing experiences, and unfinished business.

between self-care and number of comorbidities (r ¼ À0.253; P ¼ 0.03) was found; those with fewer comorbidities reported better self-care maintenance (P ¼ 0.04) and management (P ¼ 0.03). Narrative revealed the most challenging practices were diet adherence, symptom monitoring, and differentiating symptoms. Multiple comorbidities influenced self-care by shaping how individuals: 1) prioritized self-care and 2) integrated multiple self-care instructions. Subjects felt ill-prepared to carry out self-care and lacked self-efficacy within the context of another condition (''is the heart.mostly I just wait to see if it passes or not''). As a result of fragmented self-care instructions (''.diabetic nurse didn't mention salt''), individuals selected one set of instructions, most often those in which they felt most confident (''.the diabetes diet.that I can do.''). Overall, self-care confidence and number of comorbidities explained 21.7% of variance in self-care management (P < 0.01) and 10.4% of variance in self-care maintenance (P < 0.01). Conclusion.Multiple comorbidities result in disintegrated prioritization of HF self-care.Implications for research, policy, or practice. Multiple comorbid conditions should trigger referral to palliative care to support prioritization/ integration of HF self-care with other disease protocols.