Abstract：
:A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236 infants and children who died after hospital admission in Edmonton, Canada between January 1996 and June 1998 met entry criteria. Only children who died after a minimum hospitalization of 24 hours in the case of chronic illness or after a minimum hospitalization of 7 days following an acute event were included. Unanticipated deaths were excluded. Eighty-three percent of children died in intensive care settings (64/77), and 78 % (60/77) were intubated prior to their death. Symptoms were recorded in narrative progress notes. Five of 77 (6%) charts contained specific pain assessment and treatment records. Opioid analgesia was provided in 84 % of all cases (65/77). Six (8 %) patients had do not resuscitate (DNNR) orders preceding final hospital admission and 56/71 (79%) remaining patients had documented discussion resulting in DNR decision during final hospital admission. Median time from DNR to death was < 1 day. Mode of death was withdrawal of therapy in 33/77 (43 %), no cardiopulmonary resuscitation (CPR) in 26/77 (34 %), andfailed CPR in 13/77 (17%). Five children were declared brain dead. In only one case was there evidence in the medical record of the possibility of death being discussed explicitly with the patient. Decision-making regarding end-of-life issues in this pediatric population was deferred very close to the time of death, and only after no remaining curative therapy was available. Acuity of care was very high prior to death. Children are rarely told that they are dying.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
McCallum DE,Byrne P,Bruera Edoi
10.1016/s0885-3924(00)00212-8subject
Has Abstractpub_date
2000-12-01 00:00:00pages
417-23issue
6eissn
0885-3924issn
1873-6513pii
S0885-3924(00)00212-8journal_volume
20pub_type
杂志文章abstract：:Heart failure (HF) experts recommend initiation of continuous inotrope therapy, such as milrinone or dobutamine, for clinically decompensating patients with stage D HF. Although originally intended to serve solely as a bridge to more definitive surgical therapies, more and more patients are receiving inotrope therapy ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
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abstract：:The problem of undertreatment of acute postoperative pain has been documented in many studies. This article reviews this evidence and defines the problem of undertreatment as a group of attitudes about pain treatment that originate with deficiencies in knowledge and skills and lead to the development of inappropriate ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
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abstract：:As more individuals are being treated for cancer with high-dose therapy and autologous stem cell rescue (ASCR), there is growing interest in treatment side effects and their impact on quality of life. The primary aim of this study was to determine if the severity of fatigue and its impact on quality of life is signifi...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(99)00007-x
更新日期：1999-05-01 00:00:00
abstract：CONTEXT:According to the literature, 25%-60% of women treated for breast cancer, regardless of the stage, experience pain. Many risk factors have been suggested, with many possible confounding factors. OBJECTIVES:The aim was to investigate psychosocial, surgical, and medical factors associated with chronic pain by com...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2013.12.239
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究,随机对照试验
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abstract：:Perception of discomfort in dying patients is a risk factor for distress and bereavement among relatives. This study determined the perception of discomfort, the frequency of observed behaviors, and their association among relatives and among nurses who care for unresponsive dying patients. Sixty unresponsive dying pa...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(03)00286-0
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2012.01.010
更新日期：2013-01-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
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journal_title：Journal of pain and symptom management
pub_type： 共识发展会议,杂志文章
doi：10.1016/j.jpainsymman.2013.03.022
更新日期：2014-02-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.02.010
更新日期：2018-06-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.06.012
更新日期：2020-11-01 00:00:00
abstract：:Patient-controlled analgesia (PCA) has been incorporated into the management of chronic pain in cancer patients despite limited evidence of safety and efficacy. Potential benefits of PCA include decreased delay in the administration of opioids from the time requested, rapidity and ease of dose titration, and adaptabil...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2010.11.020
更新日期：2011-08-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2010.04.017
更新日期：2011-01-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.12.364
更新日期：2020-06-01 00:00:00
abstract：CONTEXT:Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. OBJECTIVE:To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COV...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.10.025
更新日期：2021-02-01 00:00:00
abstract：:Our aging population and advances in chronic disease management that prolong the time that patients live with a chronic illness have combined to create an enormous need for improved palliative care research across diverse diseases. In this article, we describe the structure and processes of a National Institutes of He...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.11.013
更新日期：2020-03-01 00:00:00
abstract：:Although pain is an extremely common symptom presenting to primary care physicians, it frequently is not optimally managed. The purpose of this feasibility study was to develop and pilot-test an efficient, rapid assessment and management approach for pain in busy community practices. The intervention utilized the Dart...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0885-3924(01)00301-3
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：
更新日期：1998-02-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2003.04.003
更新日期：2003-12-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2004.09.001
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2004.08.018
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2019.06.009
更新日期：2019-10-01 00:00:00
abstract：:To improve assessment and management of pain in nonverbal older adults with dementia, an effective means of recognizing and evaluating pain in this vulnerable population is needed. The purpose of this review is to critically evaluate the existing tools used for pain assessment in this population to provide recommendat...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2005.07.001
更新日期：2006-02-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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abstract：:Cytokines have a major role in promoting the growth and spread of cancers. Elevated levels of several cytokines have been described in cancer patients. Evidence from animal and human studies suggests that cytokines may contribute to a wide range of symptoms in advanced cancer, including: asthenia, pain, drowsiness, co...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/s0885-3924(00)00199-8
更新日期：2000-09-01 00:00:00
abstract：:Many patients suffer from chronic, intractable neuropathic pain. Despite similar diagnoses and presumed pathophysiologies, symptoms and response to treatment can differ. Monotherapy is only occasionally successful. In this prospective survey, 20 patients with chronic, neuropathic pain not responding to interventional ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(00)00131-7
更新日期：2000-05-01 00:00:00
