Are there racial differences in attitudes toward hospice care? A study of hospice-eligible patients at the Visiting Nurse Service of New York.

Research on African American and white attitudes, perceptions, and knowledge of hospice care has focused predominantly on patients and providers in institutions and community-based care settings. Little is known about patients receiving home health services, despite growing trends toward noninstitutional care in the United States. This study of home health clients who are eligible for hospice, but not currently receiving it, found few differences between racial groups with regard to attitudes about end-of-life care. An alarming proportion of African American and white home health clients held erroneous ideas about hospice care and had not discussed this option with their providers. These findings suggest that increased referrals to home-based hospice care among home health clients depend on the availability and professional dissemination of accurate, spiritually sensitive information.

Subcutaneous emphysema: an uncommon presentation of enterocutaneous fistula.

Patients with advanced cancer often develop enterocutaneous fistulae. The enterocutaneous fistulae usually develop from gastrointestinal malignancies. We describe a case report of a patient with schwannoma of the ovarian cyst wall who developed enterocutaneous fistula but presented with subcutaneous emphysema.