Abstract:
:BACKGROUND: Transitions in the location of care and in who provides such care can be extremely stressful for individuals facing death and for those close to them. The objective of this study was to describe the distribution of transitions in care experienced by palliative care patients following admission to a comprehensive palliative care program (PCP). A better understanding of these transitions may aid in reducing unnecessary change, help predict care needs, enhance transitions that improve quality of life, guide health care system communication links and maximize the cost-effective utilization of different care settings and providers. METHODS: Transition and demographic information pertaining to all patients registered in the PCP at the Queen Elizabeth II Health Sciences Centre (QEII), Halifax, Nova Scotia, Canada between January 1, 1998 and December 31, 2002 and who died on or prior to December 31, 2002 was extracted from the PCP database and examined. A transition was defined as either: (1) a change in location of where the patient was cared for by the PCP or, (2) a change in which clinical service provided care. Descriptive analysis provided frequencies and locations of transitions experienced from time of PCP admission to death and during the final two and four weeks of life, an examination of patient movement and a summary of the length of stay spent by patients at each care location. RESULTS: Over the five year period, 3974 adults admitted to the QEII PCP experienced a total of 5903 transitions (Mean 1.5; standard deviation 1.8; median 1). Patients with no transitions (28%) differed significantly from those who had experienced at least one transition with respect to survival time, age, location of death and diagnosis (p < 0.0001). The majority of patients were admitted to the PCP from various acute care units (66%). Although 54% of all transitions were made to the home, only 60% of these moves included care provided by PCP staff. During the last four weeks of life, 47% of patients experienced at least one transition; 36% during the final two weeks of life. Shorter stays in each location were evident when care was actively provided by the PCP. CONCLUSION: A relatively small number of patients under the care of the PCP at the end of life, made several transitions in care setting or service provider. These particular patients need closer scrutiny to understand why such transitions take place so that clinical programs may be designed or modified to minimize the transitions themselves or the impact transitions have on patients and families.
journal_name
BMC Palliat Carejournal_title
BMC palliative careauthors
Burge FI,Lawson B,Critchley P,Maxwell Ddoi
10.1186/1472-684X-4-3keywords:
subject
Has Abstractpub_date
2005-02-22 00:00:00pages
3issue
1issn
1472-684Xpii
1472-684X-4-3journal_volume
4pub_type
杂志文章abstract:BACKGROUND:Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increas...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0132-5
更新日期:2016-07-15 00:00:00
abstract:UNLABELLED: BACKGROUND:The United Kingdom has led the world in the development of children's palliative care. Over the past two decades, the illness trajectories of children with life-limiting conditions have extended with new treatments and better home-based care. Future planning is a critically under-researched aspe...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-12-5
更新日期:2013-02-05 00:00:00
abstract:BACKGROUND:Globally, the number of people who die with dementia is increasing. The importance of a palliative approach in the care of people with dementia is recognised and there are national polices to enhance current care. In the UK implementation of these polices is promoted by the National Institute for Health and ...
journal_title:BMC palliative care
pub_type: 杂志文章,评审
doi:10.1186/s12904-015-0047-6
更新日期:2015-10-19 00:00:00
abstract:BACKGROUND:Palliative and end-of-life care development is hindered by a lack of information about the circumstances surrounding dying in developing and resource-poor countries. Our aims were to develop and obtain face and content validity for a self-administered questionnaire on end-of-life care provision and medical d...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00630-0
更新日期:2020-08-14 00:00:00
abstract:BACKGROUND:Understanding end of life preferences amongst the oldest old is crucial to informing appropriate palliative and end of life care internationally. However, little has been reported in the academic literature about the end of life preferences of people in advanced age, particularly the preferences of indigenou...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0258-0
更新日期:2017-12-19 00:00:00
abstract:BACKGROUND:Previous studies have found that cancer patients undergoing chemotherapy can effectively manage their own symptoms when given tailored advice. This approach, however, may challenge patients with poor performance status and/or emotional distress. Our goal is to test an automated intervention that engages a fr...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-21
更新日期:2011-11-25 00:00:00
abstract:BACKGROUND:Rapid effective responsiveness to patient needs is pivotal to high quality palliative care. Aboriginal and Torres Strait Islander (Indigenous) people are susceptible to life-limiting illnesses at younger ages than other Australians and experience inequity of health service provision. The Palliative Care Outc...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-018-0380-7
更新日期:2018-12-22 00:00:00
abstract:BACKGROUND:Early integration of palliative care concurrently to standard cancer care is associated with several benefits for patients and their caregivers. However, communication barriers on part of the caring physicians often impede a timely referral to palliative care. This study describes the protocol of the evaluat...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00568-3
更新日期:2020-05-12 00:00:00
abstract:BACKGROUND:It has been recognised that more evidence about important aspects of family members' sense of security during palliative care is needed. The objectives of the study was: i) to discover what variables are associated with family members feeling secure during palliative care; ii) to develop a model of family me...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0446-1
更新日期:2019-07-25 00:00:00
abstract:BACKGROUND:Research suggests that there may be bereavement experiences and support needs which are specific to family caregivers providing end of life care (EoLC), although this remains an under-researched area. This paper focuses on themes relating to bereavement which were derived from an analysis of free text survey...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0165-9
更新日期:2016-11-08 00:00:00
abstract:BACKGROUND:Observational studies investigating risk factors in coronavirus disease 2019 (COVID-19) have not considered the confounding effects of advanced care planning, such that a valid picture of risk for elderly, frail and multi-morbid patients is unknown. We aimed to report ceiling of care and cardiopulmonary resu...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-021-00711-8
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:While the home is the most common setting for the provision of palliative care in Australia, a common problem encountered here is the inability of patient/carers to manage medications, which can lead to misadventure and hospitalisation. This can be averted through detection and resolution of drug related pro...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-16
更新日期:2011-10-31 00:00:00
abstract:BACKGROUND:Studies have shown that telehealth applications in palliative care are feasible, can improve quality of care, and reduce costs but few studies have focused on user acceptance of current technology applications in palliative care. Furthermore, the perspectives of health administrators have not been explored i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00644-8
更新日期:2020-09-07 00:00:00
abstract:BACKGROUND:Soft tissue sarcomas (STS) account for less than 1% of all malignancies. Approximately 50% of the patients develop metastases with limited survival in the course of their disease. For those patients, palliative treatment aiming at symptom relief and improvement of quality of life is most important. However, ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00702-1
更新日期:2021-01-14 00:00:00
abstract:BACKGROUND:Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0462-1
更新日期:2019-09-10 00:00:00
abstract::BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent s...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-3-1
更新日期:2004-04-27 00:00:00
abstract:BACKGROUND:Research has highlighted the need for improving the implementation of advance care planning (ACP) in nursing homes. We developed a theory-based multicomponent ACP intervention (the ACP+ programme) aimed at supporting nursing home staff with the implementation of ACP into routine nursing home care. We describ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0505-7
更新日期:2020-01-08 00:00:00
abstract:BACKGROUND:Keeping people living with advanced dementia in their usual place of residence is becoming a key governmental goal but to achieve this, family carers and health care professionals must negotiate how to provide optimal care. Previously, we reported a realist analysis of the health care professional perspectiv...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0467-9
更新日期:2019-10-24 00:00:00
abstract:BACKGROUND:Globally the state of palliative care research remains uncertain. Questions remain regarding impact, funding, and research priorities. Building upon previous research, this review examines palliative care research in Ireland and contributes to a wider international debate on the state of palliative care rese...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-018-0364-7
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:Little is known about palliative care professionals' attitudes towards guidelines. In 2015, the German Association for Palliative Medicine (DGP) published an evidence based guideline for palliative care in adults with incurable cancer. Before publication we conducted a national survey among members of the DG...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0187-y
更新日期:2017-03-21 00:00:00
abstract:BACKGROUND:There are many potential benefits to chaplaincy in transforming into a "research-informed" profession. However little is known or has been documented about the roles of chaplains on research teams and as researchers or about the effects of research engagement on chaplains themselves. This report describes th...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-015-0006-2
更新日期:2015-05-02 00:00:00
abstract:BACKGROUND:Much of what we understand about the design of healthcare systems to support care of the dying comes from our experiences with providing palliative care for dying cancer patients. It is increasingly recognized that in addition to cancer, high quality end of life care should be an integral part of care that i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0076-9
更新日期:2016-01-15 00:00:00
abstract:BACKGROUND:The supportive hospice aged residential exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00633-x
更新日期:2020-08-17 00:00:00
abstract:UNLABELLED: BACKGROUND:This study explores with patients, carers and health care professionals if, when and how Advance Care Planning conversations about patients' preferences for place of care (and death) were facilitated and documented. METHODS:The study adopted an exploratory case study design using qualitative in...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-11-15
更新日期:2012-09-17 00:00:00
abstract:BACKGROUND:Confinement to an in-patient hospital ward impairs patients' sense of social support and connectedness. Providing the means, through communication technology, for patients to maintain contact with friends and family can potentially improve well-being at the end of life by minimizing social isolation and faci...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0203-2
更新日期:2017-05-06 00:00:00
abstract:BACKGROUND:Effective integration between hospices, palliative care services and other local health care services to support patients with palliative care needs is an important international priority. A previous model suggests that integration involves a cumulative stepped process of engagement with other organisations ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0250-8
更新日期:2017-11-28 00:00:00
abstract:BACKGROUND:One ambition regarding palliative care is that it should be more accessible to patients and families regardless of care setting. Previous studies show many difficulties and shortcomings in the care of patients with palliative care needs in acute care facilities, but also challenges regarding efforts to imple...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0262-4
更新日期:2017-12-28 00:00:00
abstract:BACKGROUND:In palliative care (PC) patients and relatives (P/R) often show their gratitude to the healthcare professionals (HP) who care for them. HP appreciate these displays of gratitude, although the impact of the same has not been examined in detail. Publications analysed tell personal experiences in which HP say t...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0412-y
更新日期:2019-03-21 00:00:00
abstract:BACKGROUND:Overuse of anti-cancer therapy is an important quality-of-care issue. An aggressive approach to treatment can have negative effects on quality of life and cost, but its effect on survival is not well-defined. METHODS:Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified 7,87...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-14
更新日期:2011-09-21 00:00:00
abstract::Population-based mortality follow-back survey designs have been used to collect information concerning end-of-life care from bereaved family members in several countries. In Canada, this design was recently employed to gather population-based information about the end-of-life care experience among adults in Nova Scoti...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-12-28
更新日期:2013-08-06 00:00:00