Abstract:
:Past efforts in the palliative and end-of-life care field have been laudably directed at increasing the cultural competence of providers and institutions and improving outreach to multicultural communities. Today, however, we face new challenges with regard to racial, cultural, and ethnic factors at the end of life. We now have documented evidence of disparities in almost every area of health care. In addition, breakthroughs in genomics research, including "race-based therapeutics," have redefined the meaning of our human differences. These trends, unfolding in an increasingly polarized post-9/11 world, greatly challenge our understanding of concepts of race, culture, and ethnicity. By definition, when considering these concepts, our focus shifts from the individual to that of group membership. In turn, this suggests using a population-based or epidemiological approach, which at once reveals inequalities and inequities in mortality patterns across diverse groups. Understanding and serving the needs of specific populations requires us to apply a framework of equity and to consider strategies to eliminate disparities. These include identifying sources of bias and discrimination in health care; enhancing the collection of racial, ethnic, and other demographic data; and increasing the representation of a range of diverse population groups in well designed qualitative and quantitative research. Using an epidemiological framework does not suggest, however, that we lose sight of dying individuals and their families. At the end of life, an individualized approach to care with a focus on quality is paramount for any patient, regardless of racial, ethnic, or cultural background.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Crawley LMdoi
10.1089/jpm.2005.8.s-58subject
Has Abstractpub_date
2005-01-01 00:00:00pages
S58-69eissn
1096-6218issn
1557-7740journal_volume
8 Suppl 1pub_type
杂志文章,评审abstract:BACKGROUND:Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0097
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Research on the effectiveness of evidence-based practices in the treatment of depression and anxiety with palliative care populations is primarily limited to individuals having specific conditions such as cancer. OBJECTIVE:This meta-analysis examined the effect of psychotherapy on depression and anxiety amo...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1089/jpm.2017.0576
更新日期:2018-07-01 00:00:00
abstract::Achieving the best quality of life for patients and their families when a disease becomes progressive and no longer remains responsive to curative therapy is the primary goal of palliative care. A comprehensive care plan focusing on control of physical symptoms as well as psychological, social, and spiritual issues th...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.9.391
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:There is heightened emphasis on teaching end-of-life (EOL) care in the medical school curriculum, but a relative paucity of tools focused on assessing key attitudinal changes due to curricula. OBJECTIVE:We sought to evaluate the responsiveness of two validated measures of relevant attitudes to changes cause...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.975
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:In advanced dementia, many difficult decisions may arise as the disease progresses, including whether to use feeding by tube. Several recent articles question the benefit of percutaneous endoscopic gastrostomy (PEG) tube placement in persons with advanced dementia. However, patients with advanced dementia are...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103322654767
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to clarify how physicians should interpret the answer "neither" to the single-question interview, "Are you depressed or not?" PATIENTS AND METHODS:Two hundred fifty-one patients with cancer were studied. The patients were directly interviewed, choosing one answer among these three:...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.861
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Patients' and families' evaluations of health care, including palliative care, are widely used as performance measures. Survey scores may be affected by nonresponse bias, resulting in inaccurate performance evaluation. OBJECTIVES:Our aim was to examine nonresponse bias for the mailed version of the Departme...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0050
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To explore how staff recognize that a resident is dying and to present a typology of comfort measures. DESIGN:Exploratory, descriptive study involving qualitative methods and semistructured in-depth interviews with staff members of one nursing home. SETTING:A 120-bed nursing home that is part of a continuum...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0053
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Many patients with cancer involving the respiratory system suffer from the frequent recurrence of significant, submassive hemoptysis, which may result in invasive procedures, hospital stays, and a reduction in quality of life. Currently, there are no widely accepted noninvasive therapeutic options. Few case ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0167
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:In 1997, a biweekly, 18-month Palliative Care Seminar Series was started at Mount Sinai School of Medicine as a way to explore participants' beliefs about palliative care and to instill the knowledge, skills, and attitudes needed to improve care at the end of life. The goal of this study was to examine the effe...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662102320135234
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Increasing numbers of patients are living with multiple, chronic medical conditions and functional impairments that leave them homebound. Home-based primary and palliative care (HBPC) programs provide access to health care services for this vulnerable population. Homebound patients have high symptom burden u...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0546
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Nurses play an integral role in providing care for patients with end of life (EOL) symptoms refractory to conventional treatments and that may necessitate palliative sedation (PS). A paucity of research on nurses' attitudes, knowledge, and experience with PS exists, despite nurses being instrumental in evalu...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0336
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Rehospitalizations are prevalent and associated with decreased quality of life. Although hospice has been advocated to reduce rehospitalizations, it is not known how area-level hospice utilization patterns affect rehospitalization risk. OBJECTIVES:The study objective was to examine the association between h...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0395
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Although most hospice care occurs in the home, a growing number of patients utilize inpatient hospice settings. An inpatient hospice stay requires one or more transitions in care settings, although little is known about these transitions. OBJECTIVE/DESIGN:Using ethnographic methods, this study examined the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0359
更新日期:2014-04-01 00:00:00
abstract:: Background: Specialized home-based palliative care (HPC) services aim at reducing the number of visits to emergency departments (EDs) and hospitalizations at end of life. In addition, it offers patients the possibility to die at home. Objective: ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0639
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Substantial agreement has been achieved on research priorities in palliative care over the past 15 years, as evidenced by consensus conferences and systematic reviews. Despite the presence of a widely endorsed research agenda, however, addressing the gaps in scientific knowledge has progressed slowly, sugges...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0589
更新日期:2014-07-01 00:00:00
abstract:: Background: Pharmacovigilance studies in hospice/palliative care provide extra information to improve medication safety. Combination controlled release oxycodone-naloxone offers an alternative opioid with less risk of opioid-induced constipation. O...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0226
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The optimal treatment of malignant ascites (MA) and feasibility of the management with free drainage remain unclear. OBJECTIVE:To study the success of drainage, complications, and survival after paracentesis or insertion of an indwelling tunneled catheter (TC) for the MA performed on a day-case basis. DESI...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0616
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Standardized approaches for assessing and classifying cancer pain are required to improve treatment of patients with complex pain profiles. The Edmonton Classification System for Cancer Pain (ECS-CP) offers a starting point for the evolution of a standardized international classification system for cancer pa...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2012.0390
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medicatio...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0578
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Over the last 20 years, multiple interventions to better integrate palliative care and intensive care unit (ICU) care have been evaluated. This systematic review summarizes these studies and their outcomes. METHODS:We searched MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2013.0409
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Actions in preparation for death and talks about death between advanced cancer patients and their families are considered essential to achieve a good death. However, little is known about the prevalence of such actions compared with talks and their association with bereaved families' psychological morbidity....
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0267
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The Palliative Performance Scale (PPS) is a tool that is widely used to predict end of life. In Ontario, Canada, the PPS is used to mark the terminal phase of life and eligibility for terminal care. OBJECTIVE:The aim of this retrospective study was to confirm that a PPS level of 40% can be used as a marker ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0645
更新日期:2015-01-01 00:00:00
abstract::Generalized severe junctional epidermolysis bullosa is a rare mechanobullous skin disorder that is uniformly fatal. We present the case of an infant who received palliative pain management and ultimately proportionate palliative sedation. However, because of the extent of the patient's skin disease, we were unable to ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0054
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Response bias in end of life research is important though not well understood. OBJECTIVES:To compare consenting advanced cancer patient participants and refusers in observational end of life research. We hypothesized that, compared with refusers, consenters would: 1) have a stronger belief in personal gain ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.115
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:End-of-life care quality deficiencies have in part been linked to inadequate physician skill in the technical and communication domains of palliative care. Yet few studies have examined physicians' perspectives regarding their experiences caring for patients approaching the end of life. OBJECTIVE:To underst...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.291
更新日期:2005-04-01 00:00:00
abstract::Celiac plexus block (CPB) has been widely used as a treatment option for chronic intractable abdominal pain resulting from intra-abdominal malignancies as well as benign conditions. Complications resulting from CPB have been long reported and include diarrhea, back pain, paraplegia, postural hypotension, pneumothorax,...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0530
更新日期:2021-01-04 00:00:00
abstract::This paper provides an evidence-based review of the principles underlying palliative care for heart failure (HF), including its pathogenesis, staging, assessment, prognosis, and treatment. Approaches to advanced care planning, symptom management, hospice eligibility, home inotropic infusions, device management and imp...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.9988
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Hospice provides intensive end-of-life care to patients and their families delivered by an interdisciplinary team of nurses, aides, chaplains, social workers, and physicians. Significant gaps remain about how team members respond to diverse needs of patients and families, especially in the last week of life....
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0198
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Entrustable professional activities (EPAs) are routine tasks considered essential to a professional practice. An EPA can serve as a performance-based outcome that a clinical supervisor would progressively entrust a learner to perform. OBJECTIVE:Our aim was to identify, develop, and validate a set of EPAs fo...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0392
更新日期:2015-08-01 00:00:00