Abstract:
BACKGROUND:Dyspnea is a very distressing symptom present in the vast majority of patients with advanced cancer. There are limited data on the characteristics and correlates of dyspnea in this population. The purpose of this study was to characterize dyspnea, explore the differences between breakthrough and continuous presentations, and to determine factors associated with its intensity. METHODS:Prospective observational study among 70 patients with dyspnea referred to a palliative care service. Dyspnea was assessed using the Edmonton Symptom Assessment System (ESAS, 0-10) and the Oxygen Cost Diagram (OCD). Oximetry, pulmonary function tests, Hospital Anxiety and Depression Scale (HADS), and a detailed systematic evaluation of daily characteristics of dyspnea were performed. Other symptoms were recorded using the ESAS. RESULTS:Of 30 patients, 70 (43%) were female, median age was 58 (range, 28-87), and the most frequent cancer diagnosis were lung (31/70; 44%) and urologic (15/70; 21%). Constant dyspnea occurred in 27 of 70 (39%) patients, with 14 of 70 (20%) presenting breakthrough episodes. Breakthrough-only dyspnea occurred in 43 of 70 (61%). The majority of patients with breakthrough episodes (39/57; 68%) presented fewer than 5 episodes daily, most frequently lasting for less than 10 minutes (50/57; 88%). In univariate analyses ESAS dyspnea was associated with fatigue (p < 0.0001), sleep (p = 0.002), anxiety (p = 0.006), depression (p = 0.01), sensation of well-being (p = 0.03), and with OCD (p = 0.001). In multivariate analysis, ESAS dyspnea was associated with fatigue (p = 0.001), forced expiratory volume (p = 0.004), pain (p = 0.01), and depression (p = 0.03). Dyspnea intensity significantly interfered with activities (general activity, p = 0.01, mood, p = 0.02, walking ability, p = 0.04, normal work p = 0.04, and enjoyment of life, p = 0.01). CONCLUSION:Dyspnea in patients with advanced cancer more frequently had breakthrough characteristics, was of very short duration, and interfered with daily activities.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Reddy SK,Parsons HA,Elsayem A,Palmer JL,Bruera Edoi
10.1089/jpm.2008.0158subject
Has Abstractpub_date
2009-01-01 00:00:00pages
29-36issue
1eissn
1096-6218issn
1557-7740journal_volume
12pub_type
杂志文章abstract::Hospice Uganda was established in Kampala, September 27, 1993. Since then the hospice has served over 3,000 patients with cancer, and referrals of patients with HIV/AIDS are increasing steadily. The concepts of hospice and palliative care are well accepted in Uganda, but the delivery of services has been severely cons...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/10966210252785141
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Persons with cystic fibrosis (CF) experience high morbidity and mortality, yet little is known about their palliative care needs and how clinicians may address these needs. OBJECTIVES:(1) To identify palliative care and advance care planning needs of patients with CF and their families; and (2) to identify ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0259
更新日期:2018-04-01 00:00:00
abstract::Studies examining individuals' preferences reflect a broad consensus that the end of life is a period during which medical care should be different from that in other periods in patients' lives. More specifically, patients, families, and health care providers believe that medical care during this unique period should ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2005.8.s-12
更新日期:2005-01-01 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:: Background: Despite the association between chronic pain and post-traumatic stress disorder (PTSD), little is known about the longitudinal course of pain and PTSD during cancer treatment. Objectives: We examined the prevalence ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0458
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Care team members may have different views on end-of-life care, which may influence perceptions of that care. METHODS:Twenty-seven consecutive deaths at a long-term care facility were identified. A structured interview of primary care team members (physician, nurse, and aide) was administered. The interview...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662101300051889
更新日期:2001-04-01 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:OBJECTIVE:To describe caregivers' reasons for transfer from home hospice to inpatient facilities, preferences for site of care and death, and their experiences during these transfers. DESIGN:Retrospective qualitative analysis of interviews with caregivers of deceased hospice patients who had undergone transfer. SETTI...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.100
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:When identifying patients for palliative care, medical specialists find it necessary to disclose "hidden" patients: the patient's relatives. The issue has been discussed sporadically in Bulgaria; the present study was part of a larger investigation that examined the opinion of medical specialists, patients, ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0333
更新日期:2014-01-01 00:00:00
abstract::In this review we discuss the history of Hospice and Palliative Medicine (HPM) physician education in the United States over the last 20 years, as there has been dramatic growth in our specialty during this time. A Medline literature search was completed and we surveyed leaders in the field of HPM education regarding ...
journal_title:Journal of palliative medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1089/jpm.2012.0436
更新日期:2013-03-01 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:Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE:The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of p...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0286
更新日期:2017-02-01 00:00:00
abstract:: Background: Many older adults with serious illness who depend on others for care have symptoms that are difficult to manage. Supporting caregivers in symptom assessment (SA) may reduce suffering. Objective: Pilot an SA-Toolkit ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0103
更新日期:2020-12-01 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: Depression is common in the oncology patient population. Little data exist on the impact of depression on health care utilization. Objectives: We evaluated the prevalence of depression and the relationship between d...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0329
更新日期:2021-01-21 00:00:00
abstract:BACKGROUND:Cancer and its treatment can significantly affect appearance and body integrity. A number of studies have explored the impact of cancer and its treatment on body image, primarily in head and neck and breast cancer. The aim of this pilot study was to examine the construct of body image dissatisfaction and its...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0588
更新日期:2015-02-01 00:00:00
abstract:: Objective: To systematically capture patient- and family-centered data to understand variability and opportunities in end-of-life care delivery across settings in an integrated health care delivery system. Background: Improving...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0265
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Percutaneous stenting is established in the palliation of malignant biliary obstruction. We examined the indications, success rate, complications, and long-term postoperative course of patients undergoing this procedure. METHODS:All patients undergoing percutaneous transhepatic cholangiography (PTC) and m...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0205
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Millions of older adults require Medicaid-funded home care, referred to as In-Home Supportive Services (IHSS). Many of these individuals experience serious illness, disability, and common symptoms such as pain and shortness of breath. OBJECTIVE:To explore whether and how to integrate symptom assessment into...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0704
更新日期:2018-10-01 00:00:00
abstract:: Background: Although there is growing evidence that close reading of literature and reflective writing can improve providers' appreciation of the patient experience, foster physician development, and combat burnout, there has been less work on the experience of reading lit...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0078
更新日期:2020-08-19 00:00:00
abstract::Relief of adverse events induced by chemotherapy is an important issue for patients, especially those with a poor prognosis, such as with pancreatic cancer. There are no reports of the relationship between gastroesophageal reflux disease (GERD) and chemotherapy, so we investigated the incidence of chemotherapy-induced...
journal_title:Journal of palliative medicine
pub_type: 临床试验,杂志文章
doi:10.1089/jpm.2009.0404
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:To review studies that used direct observation (i.e., videotaping or audiotaping) methods in palliative/end-of-life care communication research. DESIGN:Descriptive thematic analysis. SETTING:Multinational studies were conducted in both the outpatient and inpatient setting. MEASUREMENTS:Extensive bibliogra...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2009.0388
更新日期:2010-05-01 00:00:00
abstract::The need for palliative care for patients with end-stage renal disease (ESRD) is increasingly recognized. Patients starting renal replacement therapy are now elderly, with a median age of 65 years, and with multiple comorbid conditions. Quality of life is often poor and with advance care planning, patients can be enab...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0033
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:In hospitals, where care is focused on cure and life prolongation, impending death is often recognized too late. Physician awareness of impending death is a prerequisite for communication with patients and relatives about dying in hospital and providing care that adequately addresses patients' needs. OBJECT...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0203
更新日期:2014-11-01 00:00:00
abstract::For most families, the preferred location of death for their child is home, yet most children still die in the hospital. Many children with life-threatening and life-limiting illness are medically dependent on technology, and palliative transport can serve as a bridge from the intensive care unit to the family's home ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0301
更新日期:2019-04-01 00:00:00
abstract:: Background: Systematic measurement of conversational features in the natural clinical setting is essential to better understand, disseminate, and incentivize high quality serious illness communication. Advances in machine-learning (ML) classification of human speech offer ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0270
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors and negatively impacts quality of life. This single-institution study sought to explore how rash is currently managed outside a clinical trial setting and to further characterize general clinical aspects of this rash. MET...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0258
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND AND AIM:Consensus has been reached on the need to integrate palliative care in the follow-up examinations of chronic obstructive pulmonary disease (COPD) patients. We analyzed the survival from the initiation of follow-up by a palliative home care team (PHCT) and described the needs and end-of-life process. ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0363
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND/AIM:Palliative care services (PCS) are recommended to enhance quality of care for hospitalized patients. METHODS:We evaluated the attitudes of liver transplant (LT) providers and perceived barriers to PCS for their patients by conducting a web-based survey of intensive care unit nurses, postgraduate year 1 ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0002
更新日期:2016-08-01 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