Abstract:
BACKGROUND:The WHO definitions of palliative care have been adopted in Denmark and implemented in The National Guidelines from 1999, but service developments have been very slow and not according to the recommendations. Attitudes to palliative care of Danish doctors and nurses may in part account for this. OBJECTIVE:To assess the attitudes to issues related to palliative care of doctors and nurses in a Danish county hospital and the related primary care services. DESIGN:Cross-sectional survey using a mailed, self-administered questionnaire answered anonymously. PARTICIPANTS:Nurses and doctors employed in a county hospital in Denmark, homecare nurses and general practitioners from the related primary care services. OUTCOME MEASURES:The responses from the groups were compared by chi2 statistics (where ordinal variables with chi2 for trend). Data were analysed using SPSS 10.0. RESULTS:347 responded, response rate 76%. Eighty-one per cent of all respondents were currently caring for terminally ill patient(s), 94% had done so within the last six months. Hospital doctors see more terminally ill patients than GPs (P = 0.002). Comparison of doctors (both hospital and GPs) with nurses showed that nurses were more likely to definitely agree that palliative/terminal care was a rewarding part of their work (61% 'definitely agree' versus 30%), and they were less likely to prefer to leave care of these patients to others (4% 'definitely/probably agree' versus 9%). Nurses reflected more on existential matters (80% 'definitely/probably agree' versus 63%) and were more likely to agree that dealing with a dying patient made them aware of their own feelings regarding death (97% 'definitely/probably agree' versus 80%). Only 7% of all respondents reported 'being an active member of a religious community'. Ninety-two per cent of all respondents agreed that doctors play a key role in reducing the suffering of dying patients, but 59% of nurses versus 9% of doctors 'definitely/probably agree' that 'it is primarily the task of nurses to deal with patients reactions to death'. There were significant differences between hospital doctors and GPs, with the former less likely to agree that palliative and terminal illness is rewarding, more likely to leave care of dying patients to others, and more likely to 'probably' or 'definitely agree' that it is more satisfying to work with patients who will improve. Home care nurses reflected more on existential matters than their hospital colleagues, and were more likely to 'definitely agree' that palliative/terminal care is rewarding. Differences between groups seemed to be due to profession (doctor versus nurse) and setting (hospital versus community) rather than age or gender. CONCLUSION:These findings suggest that in Denmark nurses demonstrate more positive attitudes to the care of palliative/terminally ill patients than doctors, and that attitudes amongst doctors and nurses working in the community are more positive than those of the colleagues in hospitals. There is currently little education in the principles and practice of palliative care in Denmark. These findings will inform the development of appropriate palliative care education for doctors and nurses working both in the hospital and in the community in Denmark. They also raise the possibility that part of the inertia in the development of palliative care in Denmark is related to the lack of education and, in particular, to the need of support for doctors and nurses providing terminal care so they are enabled to be more reflective on the care they currently provide. There is evidence that education in palliative care can change health professionals' attitudes to palliative and terminal care, and this now needs to be investigated in Denmark.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Vejlgaard T,Addington-Hall JMdoi
10.1191/0269216305pm988oasubject
Has Abstractpub_date
2005-03-01 00:00:00pages
119-27issue
2eissn
0269-2163issn
1477-030Xjournal_volume
19pub_type
杂志文章abstract:BACKGROUND:Cytochrome P450 3A is the most relevant drug-metabolizing enzyme in humans as it is involved in the elimination of 50% of marketed drugs. Nothing is known about the activity of cytochrome P450 3A in palliative care patients who have complicated symptoms often associated with a terminal illness. AIM:In order...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319843629
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:No systematic meta-analysis is available on the prevalence of cancer patients' accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. AIM:To examine the prevalence of advanced/terminal cancer patients' accurate pro...
journal_title:Palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1177/0269216316663976
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:It is often suggested that terminally ill patients favour end-of-life care at home. Yet, it is unclear how these preferences are formed, if the process is similar for patients and family caregivers, and if there are discrepancies between preferences for place of care and place of death. Understanding these n...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319845794
更新日期:2019-07-01 00:00:00
abstract::Philip J Larkin, Fliss Murtagh, Heather Richardson, Myra Bluebond Langner and Sheila Payne (2016) Collaboration: Securing a future for palliative care research. Palliative Medicine, September 2016 30:8 709-710, doi: 10.1177/0269216316661970. ...
journal_title:Palliative medicine
pub_type: 杂志文章,已发布勘误
doi:10.1177/0269216316672799
更新日期:2016-12-01 00:00:00
abstract::Increasing emphasis is being placed on the need for advanced care planning (ACP) at the end of life. The Preferred Priorities for Care (PPC) document is a patient-held record promoted by the End of Life Care Strategy as an ACP tool to promote discussion and communication amongst patients, family and health care provid...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311399664
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Approximately one-third of rapid response team consultations involve issues of end-of-life care. We postulate a greater occurrence in patients with a life-limiting illness, in whom the opportunity for advance care planning and palliative care involvement should be offered. AIMS:We aim to review the characte...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216314560802
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:It is necessary to develop palliative care to meet existing and future needs of patients and their families. It is important to include knowledge of patient preferences when developing high-quality palliative care services. Previous reviews have focused on patient preferences with regard to specific componen...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216314557882
更新日期:2015-05-01 00:00:00
abstract::We determined the relationship between symptom severity and distress for multiple cancer symptoms, and examined patient demographic influences on severity and distress in advanced cancer. A Cochran-Armitage trend test determined whether symptom distress increased with severity. Chi-square, Fisher's exact test and logi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309356380
更新日期:2010-04-01 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::Fifty junior residents completed a six-month training period. An anonymous postal questionnaire was sent to collect the residents' opinions on improvements in their knowledge, perception of priorities and usefulness of training. Responses were rated from 5 (a great deal) to 1 (not at all improved). A total of 33 (66%)...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216306pm1158xx
更新日期:2006-07-01 00:00:00
abstract::We investigated the impact of perception of socioeconomic burden on beliefs regarding a patient's autonomy in end-of-life (EOL) decision making. We also sought to identify the characteristics of individuals who advocate patient autonomy and their attitudes toward other EOL issues. A total of 1055 individuals from the ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308099244
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. AIM:To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palli...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318764095
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:A systematic review, undertaken according to an initiative to revise European Association for Palliative Care guidelines on the use of opioids for cancer pain, which aimed to analyse analgesic efficacy and side effects of spinal opioids in adult cancer patients previously treated with systemic opioids. METH...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216310386279
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. AIM:To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317701891
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Burn units are intensive care facilities specialized in the treatment of patients with severe burns. As burn injuries have a major impact in physical, psychosocial, and spiritual health, palliative care can be a strengthening component of integrated care. AIM:To review and appraise the existing evidence abo...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319862160
更新日期:2019-12-01 00:00:00
abstract::To be able to distinguish end-stage palliative sedation from euthanasia without having to refer to intentions that are difficult to verify, physicians must be able to manage palliative sedation appropriately (i.e., see that death is not hastened as a result of disproportionate medication). In the present study, we ass...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308091867
更新日期:2008-07-01 00:00:00
abstract::The purpose of this study is to analyze French general practitioners' attitudes toward prescribing opiate painkillers for dying patients and compare them with their attitudes toward making frequent home visits. One hundred and fifteen general practitioners indicated the acceptability of prescribing opiates in 48 scena...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309107012
更新日期:2010-01-01 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:Intrathecal drug delivery is known to reduce pain in patients where conventional systemic analgesia has been ineffective or intolerable. However, there is little information regarding the effects of intrathecal drug delivery on quality of life and function in those with advanced, incurable cancer. AIM:Retro...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317723777
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Intrathecal drug delivery is known to be effective in alleviating cancer pain in patients for whom the conventional World Health Organization approach has proved insufficient. A multidisciplinary interventional cancer pain service was established in the West of Scotland in 2008 with the aim of providing a sa...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315570514
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Little is known about the impact of methicillin-resistant Staphylococcus aureus in palliative care settings. To date, the clinical impact of methicillin-resistant Staphylococcus aureus in palliative care is unknown. AIM:To determine prevalence and incidence of methicillin-resistant Staphylococcus aureus col...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315595158
更新日期:2016-04-01 00:00:00
abstract::This study looked at the efficacy of drug treatment in managing death rattle in a 30-bedded specialist palliative care unit. The study was conducted in two phases. In the first, patients received hyoscine hydrobromide as the antimuscarinic; glycopyrrolate was used in the second phase. The patients in the two phases we...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章
doi:10.1191/026921601678320313
更新日期:2001-07-01 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::Place of death is at times suggested as an outcome for palliative care services. This study aimed to describe longitudinal preferences for place of care and place of death over time for patients and their caregivers. Longitudinal paired data of patient/caregiver dyads from a prospective unblinded cluster randomised co...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216308092287
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:This research examines 2006 population-based data on persons who died in US nursing homes (NHs) and received hospice in the NH. METHODS:We compared dying persons characteristics and lengths of hospice stay in five US states between 1992 and 1996 and in 2006. We also compared characteristics of dying perso...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310389349
更新日期:2011-06-01 00:00:00
abstract::This paper presents a qualitative study exploring the meaning of 'dignity' to patients, relatives and professionals. It examines the impact of advanced illness and treatment and the issues pertinent to caring for dignity. Depth interviews were conducted with eight patients, six relatives and seven members of the multi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm699oa
更新日期:2003-04-01 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:BACKGROUND:Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, ...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216315588007
更新日期:2016-01-01 00:00:00
abstract::Separate accounts of care were recorded weekly from staff, patients and relatives in a randomised sample of patients with terminal cancer referred to a home care service with readily available beds. Various services were involved but nurses made most contacts, 3.0 visits and 2.4 phone calls weekly, rising sharply in t...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639601000207
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Telehealth technologies are an emerging resource opening up the possibility of greater support if they have utility for patients, carers and clinicians. They may also help to meet health systems' imperatives for improved service delivery within current budgets. Clinicians' experiences and attitudes play a ke...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315600113
更新日期:2016-04-01 00:00:00