Abstract:
:Comprehensive palliative care programs are often implemented on a community level, and to evaluate such interventions, randomization by cluster (community) may be the only feasible method. In trials randomizing individual subjects, the importance of proper concealment has been stressed. In cluster randomized trials, however, concealment of individual patient allocation is often impossible. The following risk of selection bias has been given little attention. In the present study, comparing palliative care to conventional care, community health care districts were defined as clusters and randomized. The patients' treatment assignment was determined by the allocation of the cluster in which they resided, and hence predictable by their address. A biased selection based on practical considerations related to patients' diagnoses and hospital departments was suspected. To explore this, cancer diagnoses were grouped according to local tradition for sharing of treatment responsibility among hospital departments. A significant difference between trial arms in distribution of these groups was revealed and strongly supported our suspicion. The finding carries an important message to future researchers: when using cluster randomization, any evidence of selection bias should be carefully checked and reported.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Jordhøy MS,Fayers PM,Ahlner-Elmqvist M,Kaasa Sdoi
10.1191/0269216302pm523oasubject
Has Abstractpub_date
2002-01-01 00:00:00pages
43-9issue
1eissn
0269-2163issn
1477-030Xjournal_volume
16pub_type
临床试验,杂志文章,随机对照试验abstract::Prospective controlled clinical trials provide the highest level of evidence in palliative care. Both parallel and crossover studies have unique advantages and disadvantages. Excellent knowledge of the patient population, interventions and endpoints are useful in choosing the most appropriate trial. Open pilot studies...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576275
更新日期:2001-05-01 00:00:00
abstract::Back pain resulting from spinal instability in metastatic bone disease can be difficult to alleviate by pharmacological methods and surgical intervention is frequently required. This paper discusses the treatment options with three illustrative case reports. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639300700311
更新日期:1993-01-01 00:00:00
abstract::In this paper we review the challenges facing the delivery of research in end-of-life care in the UK and internationally as health policies begin to focus on improving care. These include the problems of terminology in this field of enquiry and the lack of emphasis on clinical studies relating to the medical aspects o...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216310366064
更新日期:2010-07-01 00:00:00
abstract::The Research Network of the European Association for Palliative Care (EAPC) performed a survey of 3030 cancer patients from 143 palliative care centres in 21 European countries. The survey addressed pain intensity and the use of non-opioid analgesics, adjuvant analgesics and opioids. Patients were treated with analges...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/0269216305pm1054oa
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:To review current understanding of the knowledge and information needs of informal caregivers in palliative settings. DATA SOURCES:Seven electronic databases were searched for the period January 1994--November 2006: Medline, CINAHL, PsychINFO, Embase, Ovid, Zetoc and Pubmed using a meta-search engine (Metal...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216307085343
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Care relationships are crucial in tailoring the end-of-life care of a person with intellectual disabilities (ID) to their needs. Yet, almost all studies on end-of-life care for people with ID have been conducted among caregivers. The views of people with ID about care relationships at the end of life have no...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316640421
更新日期:2016-07-01 00:00:00
abstract:INTRODUCTION:Even though depression has serious and wide-ranging effects on outcomes in palliative care, errors in the identification of depressed patients are common. OBJECTIVES:To examine the clinical validity of widely publicised one- and two-question screening tools for depression in two palliative care settings. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1021oa
更新日期:2005-06-01 00:00:00
abstract::Open pulmonary tuberculosis has been increasingly seen in HIV-infected patients in this hospice. Multidrug-resistant tuberculosis is a new and serious threat and two cases have occurred in our hospice in the past two years. This infection poses a health risk to staff, patients, relatives and volunteers. Palliative car...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639701100607
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:A normal vitamin D status is required for bones and muscles to maintain their function and structure, but it also contributes to the functional integrity of other multiple physiologic systems in the body. AIM:To assess the relationship of Vitamin D deficiency with health-related quality-of-life issues, fati...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315601954
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Bisphosphonates and denosumab are well-established therapies to reduce the frequency and severity of skeletal-related events in patients with bone metastasis. However, the analgesic effect of these medications on bone pain is uncertain. AIM:To identify, critically appraise and synthesize existing evidence t...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216316639793
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Previous findings implicated rumination (recurrent dwelling on abstract concerns) in elevated psychological distress in palliative patients. We hypothesised that reducing rumination may be important in addressing psychological distress in palliative care. AIM:This study tested the prediction that a brief gu...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216311414757
更新日期:2012-04-01 00:00:00
abstract::In an increasingly secular age in which society no longer offers a code of behaviour for those who are bereaved as in Victorian times, the majority of people do not seek support from church-based rituals of remembrance. Most hospices provide religious Services of Remembrance and Thanksgiving or non-faith remembrance g...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309103803
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:There is widespread agreement that the families of hospice patients need to be prepared for the final days of life, yet current practices preparing families are not well described. Examining the gap between family needs and current practice will inform the development of effective preparatory interventions. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314551320
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Dementia is a life limiting illness and is becoming a major cause of death in developed countries. Many people with dementia die in nursing homes or long-term residential care settings. Spouse caregivers of people with dementia living in nursing homes find themselves in a position which is difficult to under...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313479685
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Informal caregivers of people with motor neurone disease (MND) take on an extensive role. Caregivers are at increased risk of experiencing psychological distress and burden, yet, there is a lack of intervention programmes to support them. AIM:The aim of this study was to investigate the feasibility and acce...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317743434
更新日期:2018-04-01 00:00:00
abstract::Despite the lack of clear benefits of feeding via gastrostomy tube in dementia patients, its use has been increasing. The views of health professionals, patients and their carers differ widely about the perceived benefits, which makes decision-making difficult and stressful. The palliative care approach of facilitatin...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216306071796
更新日期:2006-10-01 00:00:00
abstract::Progressive multifocal leukoencephalopathy (PML) is a rare but usually fatal demyelinating disease of the central nervous system in patients who are immunocompromised. It is characterized by rapid neurological deterioration associated with progressive white matter changes on imaging and is confirmed by isolation of th...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216312450932
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311408993
更新日期:2012-04-01 00:00:00
abstract::This paper is a secondary observation of a larger pilot study. The Assessing Caregivers for Team Intervention via Video Encounters intervention project enabled caregiver participation in hospice interdisciplinary team meetings. This paper used the team observation scale to assess the impact of caregiver involvement on...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216309352066
更新日期:2010-03-01 00:00:00
abstract::This paper describes the development and content of palliative care residential workshops for general practitioner/district nurse pairs from the same practice. Pre- and post-testing self-rating scales were completed by the participants of five workshops. A retrospective questionnaire identified perceived effects on pr...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639300700103
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Patient misunderstandings about prognosis may be related to lack of communication. AIM:This study aimed to examine prognosis discussions held with hospitalized patients for whom palliative care consultations were requested, and if prognosis discussions did not occur, to explore why not. DESIGN:This was a s...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313514126
更新日期:2014-04-01 00:00:00
abstract::Although anecdotal reports suggest nebulized lignocaine may help breathlessness in patients with cancer this has not been examined formally. We report a pilot study comparing nebulized lignocaine 100 mg and 200 mg with saline in six patients with cancer who were breathless at rest. Nebulized lignocaine was well tolera...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800106
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. AIM:To ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320963941
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:As end-of-life (EoL) care expands across Europe and the world, service developments are increasingly studied. The sociocultural context in which such changes take place, however, is often neglected in research. AIM:To explore sociocultural factors in EoL care in Belgium as represented by the literature. DE...
journal_title:Palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1177/0269216311429619
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Depressive disorders are common among cancer patients. Ketamine can quickly relieve depression, and its subcutaneous administration appears to be as effective as and probably safer than its standard intravenous administration. Herein, we report a case verifying the antidepressant effect of a subcutaneous esk...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320910351
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Specialist palliative care (SPC) services in Ireland are well developed by international standards. However, standardized information on all patients of SPC services is not collected so the proportion of patients seen with a noncancer diagnosis is just an estimate at 5%. AIMS:To describe Irish SPC services'...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216307084609
更新日期:2008-01-01 00:00:00
abstract::To date, the experiences of out-of-hours general practitioners with regard to palliative care patients and their management are yet to be evaluated, since the new General Medical Services contract came into force. In 2007 the National Institute for Health Research highlighted the need to identify factors that improve ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310368580
更新日期:2010-07-01 00:00:00
abstract::The factors related to admission of patients with terminal cancer who had been referred to a reputable home care service were examined in 415 patients referred in a two-year period and in a prospective study of a randomized one in three sample of the 232 adults still alive one week after referral, who were able to con...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/026921639400800303
更新日期:1994-01-01 00:00:00
abstract::The most commonly encountered clinical conditions presenting with cognitive failure (CF) are delirium, dementia and amnestic disorders. Of these, delirium is probably the most prevalent in palliative care, and it is potentially reversible. Thus, improvement in diagnostics seems warranted. The objectives of this review...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216304pm920oa
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). AIM:To test the reliability and acceptabi...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216315613904
更新日期:2016-05-01 00:00:00