Abstract:
:The high prevalence of pain and other symptoms throughout the HIV disease trajectory, the need for management of side effects related to antiretroviral therapy, the continuing incidence of cancers and new emerging co-morbidities as a result of extended life expectancy under new therapeutic regimes, and the ongoing need for terminal care all prove the curative versus palliative dichotomy to be inappropriate. Although there is evidence for both need and effectiveness of palliative care in HIV patient care, access is often poor and care less than optimal. This review aimed to identify evidence of barriers and inequalities in HIV palliative care in order to inform policy and service development. Biomedical databases were searched using a specific strategy, and evidence extracted into the barrier and inequity categories of patient, clinician, service and disease factors. A model of the barriers and inequalities is presented from the evidence. Recommendations are made from the evidence for promoting access and outcomes through integrated palliative care from diagnosis to end-of-life, alongside antiretroviral therapy when initiated. Service responses that have attempted to increase access to palliative care are presented.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Harding R,Easterbrook P,Higginson IJ,Karus D,Raveis VH,Marconi Kdoi
10.1191/0269216305pm1005oasubject
Has Abstractpub_date
2005-04-01 00:00:00pages
251-8issue
3eissn
0269-2163issn
1477-030Xjournal_volume
19pub_type
杂志文章,评审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::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::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::Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311402713
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Refractory breathlessness in advanced chronic disease leads to high levels of disability, anxiety and social isolation. These result in high health-resource use, although this is not quantified. AIMS:To measure the cost of care for patients with advanced disease and refractory breathlessness and to identify...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317690994
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Bisphosphonates are the treatment of choice for hypercalcaemia of malignancy (HCM) but there is no consensus regarding which drug or dose should be given. We designed a systematic review to investigate the efficacy of bisphosphonates in the treatment of HCM. METHODS:We identified randomized controlled trial...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216304pm914ra
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:To explore the experiences of people involved in UK palliative care day services (PCDS) and identify the important outcomes of this service. METHODS:Focus groups were carried out separately with patients, informal carers and volunteers from four purposively selected palliative care day units and with day un...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm942oa
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. AIM:This study aimed to translate, ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311419987
更新日期:2012-10-01 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
abstract::The aim of this study is to synthesize knowledge about the process of shared decision-making (SDM) in palliative care. Medline, EMBASE, CINAHL, PsychInfo, Web of Science were searched with core concepts: shared decisions, patient participation in decision-making, and palliative care. Titles and abstracts were screened...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216310389348
更新日期:2011-04-01 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::Clinical trials in palliative care involve multiple issues relating to patient populations, interventions and endpoints. Careful data collection and analysis of variables are vital for good clinical research in this complex area. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601668441770
更新日期:2001-03-01 00:00:00
abstract::A survey of all district health authorities in England was conducted in order to describe current patterns of needs assessment and contract setting for palliative care services. Outcome measures included the completion of needs assessments in the past five years, the type of data used for needs assessment, and recomme...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639500900403
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:in community studies the prevalence of depression is higher in women than men; however, in palliative care settings this relationship is usually less strong, absent or reversed. AIM:to identify reasons for excess depression among men receiving palliative care. DESIGN:cross-sectional study. SETTING/PARTICI...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311416035
更新日期:2012-07-01 00:00:00
abstract::Dysphagia is a common and distressing problem in motor neurone disease. This paper examines some of the strategies available for managing patients with dysphagia, and illustrates these with four contrasting case histories. The factors which influence the decision making process in patients with dysphagia are also disc...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216393007004S08
更新日期:1993-01-01 00:00:00
abstract::This study reports UK doctors' opinions about legalisation of medically assisted dying (euthanasia and physician-assisted suicide), comparing this with the UK general public. A postal survey of 3733 UK medical practitioners was done. The majority of UK doctors are opposed to legalisation, contrasting with the UK gener...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308102041
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Benzodiazepines are widely used in palliative care, but few studies have attempted to study their use. AIM:To determine the frequency and nature of benzodiazepine prescribing in a palliative care setting. METHOD:The notes of a consecutive series of 100 patients who had died or been discharged from the hosp...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216306pm1151oa
更新日期:2006-06-01 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:BACKGROUND:Informal carers play a key supportive role for patients with chronic obstructive pulmonary disease. However, caring can have a considerable impact on health and wellbeing. Carers may have unidentified support needs that could be a target for intervention. Literature on the support needs of informal carers ha...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320939243
更新日期:2020-12-01 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:The evidence supporting pharmacological treatment of death rattle is poor; yet, anticholinergic drugs feature in end-of-life care pathways and guidelines worldwide as a treatment option. AIM:This qualitative arm of a wider study aimed to explore important issues which health-care professionals associated wi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312464407
更新日期:2013-09-01 00:00:00
abstract::As part of a large multicentre study on palliative care units in Italy, carried out between 1 January and 30 June 1995, we describe the place, circumstances and 'quality of death' of patients admitted to home palliative care. Data presented refer to 401 patients (67% of the 601 patients randomly selected for evaluatio...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/026921699669863369
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The perspectives of patients and relatives are important in the improvement of the quality of health care. However, the quality of end-of-life care has not been systematically evaluated in Scandinavia. AIM:To develop or adapt and subsequently validate a questionnaire assessing the quality of end-of-life car...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317740274
更新日期:2018-04-01 00:00:00
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::Using a decision-making and treatment checklist developed to facilitate the at-home palliative sedation process, we assessed the incidence and efficacy of palliative sedation for end-of-life cancer patients with intractable symptoms who died at home. We retrospectively reviewed the medical records of 370 patients who ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309359996
更新日期:2010-07-01 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:BACKGROUND:Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. AIM:We compared characteristics, expressed unmet needs and outco...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316663855
更新日期:2017-05-01 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: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::Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor qua...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216304pm890oa
更新日期:2004-04-01 00:00:00