Abstract:
BACKGROUND:A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer. OBJECTIVE:We examined the relative need for palliative care in the two conditions by comparing symptom burden, psychological well-being, and spiritual well-being in heart failure and cancer patients. DESIGN:This was a cross-sectional study. PARTICIPANTS:Sixty outpatients with symptomatic heart failure and 30 outpatients with advanced lung or pancreatic cancer. MEASUREMENTS:Symptom burden (Memorial Symptom Assessment Scale-Short Form), depression symptoms (Geriatric Depression Scale-Short Form), and spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale). MAIN RESULTS:Overall, the heart failure patients and the cancer patients had similar numbers of physical symptoms (9.1 vs. 8.6, p = 0.79), depression scores (3.9 vs. 3.2, p = 0.53), and spiritual well-being (35.9 vs. 39.0, p = 0.31) after adjustment for age, gender, marital status, education, and income. Symptom burden, depression symptoms, and spiritual well-being were also similar among heart failure patients with ejection fraction < or =30, ejection fraction >30, and cancer patients. Heart failure patients with worse heart failure-related health status had a greater number of physical symptoms (13.2 vs. 8.6, p = 0.03), higher depression scores (6.7 vs. 3.2, p = 0.001), and lower spiritual well-being (29.0 vs. 38.9, p < 0.01) than patients with advanced cancer. CONCLUSIONS:Patients with symptomatic heart failure and advanced cancer have similar needs for palliative care as assessed by symptom burden, depression, and spiritual well-being. This implies that heart failure patients, particularly those with more severe heart failure, need the option of palliative care just as cancer patients do.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Bekelman DB,Rumsfeld JS,Havranek EP,Yamashita TE,Hutt E,Gottlieb SH,Dy SM,Kutner JSdoi
10.1007/s11606-009-0931-ysubject
Has Abstractpub_date
2009-05-01 00:00:00pages
592-8issue
5eissn
0884-8734issn
1525-1497journal_volume
24pub_type
杂志文章,多中心研究abstract:BACKGROUND:Differences among hospitals in the use of inpatient consultation may contribute to variation in outcomes and costs for hospitalized patients, but basic epidemiologic data on consultations nationally are lacking. OBJECTIVE:The purpose of the study was to identify physician, hospital, and geographic factors t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3216-7
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To determine the impact of an episode of serious cardiovascular disease on smoking behavior and to identify factors associated with smoking cessation in this setting. DESIGN:Prospective observational study in which smokers admitted to a coronary care unit (CCU) were followed for one year after hospital disch...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02597426
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Inadequate health literacy is prevalent among seniors and is associated with poor health outcomes. At hospital discharge, medications are frequently changed and patients are informed of these changes via their discharge instructions. OBJECTIVES:Explore the association between health literacy and medication ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1886-3
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Colorectal cancer (CRC) screening can be administered through tests with varied characteristics and is a preference-sensitive decision. OBJECTIVE:To assess patient experiences with a Maximum Differences Scaling (MDS) tool for eliciting values about CRC screening test characteristics and determine whether pa...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1318-9
更新日期:2010-07-01 00:00:00
abstract::In 1989, the internal medicine residency training program at St. John's Episcopal Hospital changed from a standard one-in-four on-call system to a night float system of resident on call. Using a confidential questionnaire that assessed the opinions of medical nurses, the nurses were asked which system they preferred, ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599842
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE:To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications whe...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2000.06039.x
更新日期:2000-03-01 00:00:00
abstract::Chronic care facility stay has been shown to be an independent risk factor for venous thromboembolism. Review of the literature, however, reveals a paucity of data addressing the issue of venous thromboembolism in nursing home residents. The purpose of this study was to determine the incidence of venous thromboembolic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2003.21133.x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Consumer-directed health plans are increasingly common, yet little is known about their impact on physician decision-making and preventive service use. OBJECTIVE:To determine how patients' deductible levels and socioeconomic status may affect primary care physicians' recommendations for colorectal cancer sc...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-008-0714-x
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Discharge planning is an important component of hospital care. The Blaylock Risk Assessment Screening Score (BRASS) index is an instrument used to identify patients requiring complex discharge planning. OBJECTIVES:(1) Evaluate the ability of the original BRASS index to predict the risk of complex discharge ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4405-y
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence of hot flashes and health education regarding menopause in African-American and white American women in the late reproductive years. DESIGN:Cross-sectional study. SETTING:Population-based sample recruited through random digit dialing. PARTICIPANTS:The sample was 436 women between ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1999.00294.x
更新日期:1999-02-01 00:00:00
abstract:PURPOSE:To evaluate the acceptance rate and motivation for acceptance of hepatitis B virus (HBV) vaccine among preclinical medical and physician assistant (PA) students in comparison with similar data obtained from resident and staff physicians. METHODS:A cross-sectional survey of all second-year medical and PA studen...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599567
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Despite evidence of inadequate physical examination skills among medical students, teaching these skills has declined. One method of enhancing inspection skills is teaching "visual literacy," the ability to reason physiology and pathophysiology from careful and unbiased observation. OBJECTIVE:To improve stu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-008-0667-0
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Integrating evidence-based innovations (EBIs) into sustained use is challenging; most implementations in health systems fail. Increasing frontline teams' quality improvement (QI) capability may increase the implementation readiness and success of EBI implementation. OBJECTIVES:Develop a QI training program ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06133-1
更新日期:2020-09-08 00:00:00
abstract:BACKGROUND:Business literature has demonstrated the importance of networking and connections in career advancement. This is a little-studied area in academic medicine. OBJECTIVE:To examine predictors of intra-organizational connections, as measured by network reach (the number of first- and second-degree coauthors), a...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3463-7
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Hemophilia A is a rare, sex-linked genetic disorder treated with intravenous administration of factor VIII (FVIII) to prevent bleeding; however, approaches vary across and within countries. Value-of-information (VOI) methods identify situations in which the cost-benefit evidence is sufficient to adopt one tr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2880-3
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:As children with diabetes transition to adulthood, they may be especially vulnerable to diabetic ketoacidosis (DKA). Cross-national comparisons may inform efforts to avoid this complication. OBJECTIVE:To compare DKA hospitalization rates in the USA and Manitoba, Canada, during the vulnerable years known as ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05006-6
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The transfer of critically ill patients from the intensive care unit (ICU) to hospital ward is challenging. Shortcomings in the delivery of care for patients transferred from the ICU have been associated with higher healthcare costs and poor satisfaction with care. Little is known about how hospital ward pro...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-018-4590-8
更新日期:2018-10-01 00:00:00
abstract::Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4030-1
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Post-hospital discharge follow-up appointments are intended to evaluate patients' recovery following a hospitalization, but it is unclear how appointment statuses are associated with readmissions. OBJECTIVE:To examine the association between post-discharge ambulatory follow-up status, (1) having a scheduled...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06569-5
更新日期:2021-01-19 00:00:00
abstract::Because of the financial incentives of prepaid care, the quality of care for Medicare enrollees in Health Maintenance Organizations (HMOs) is a concern. Therefore, the care in 150 newly diagnosed cases of colorectal cancer in eight HMOs was compared with that in 180 similar fee-for-service (FFS) cases. As part of the ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600509
更新日期:1990-03-01 00:00:00
abstract::There is reason for pessimism about the incorporation of prevention into medical education. In addition to what might be called the standard reasons for resistance to prevention, there are at least three other structural barriers: the destabilization of the health care system, the loss of interest in careers in primar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600854
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Patients who leave hospitals against medical advice (AMA) may be at risk for adverse health outcomes. Their decision to leave may not be clearly understood by providers. This study explored providers' experiences with and attitudes toward patients who leave the hospital AMA. OBJECTIVE:To explore providers' ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0728-4
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:The many challenges in health care today create a special need for great leadership. However, traditional criteria for physicians' advancement to leadership positions often regard academic and/or clinical accomplishments rather than the distinctive competencies needed to lead. Furthermore, physicians' traini...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-009-1007-8
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved. DESIGN:Randomized controlled trial conducted between 1995 and 1998. SETTING:Five sites: two teaching hospitals (Madison, Wis, and Chicago, I...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1525-1497.2001.016007435.x
更新日期:2001-07-01 00:00:00
abstract:INTRODUCTION:With the increasing number of women Veterans enrolling in the Veterans Health Administration (VA), there is growing demand for reproductive health services. Little is known regarding the on-site availability of reproductive health services at VA and how this varies by site location and type. OBJECTIVE:To ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-012-2289-9
更新日期:2013-07-01 00:00:00
abstract::Polypharmacy occurs when a medical regimen includes at least one unnecessary medication. Factors that contribute to this problem include: patient characteristics of increasing age, multiple medical problems, therapy expectations, and decisions to self-treat; physician factors such as excessive prescribing; and system ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02600099
更新日期:1993-05-01 00:00:00
abstract:INTRODUCTION:How can residency programs help trainees address conflicting emotions about their professional roles and cultivate a curiosity about their patients' lives beyond their diseases? We drew on the medical humanities to address these challenges by creating an intensive writing workshop for internal medicine res...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00550.x
更新日期:2006-10-01 00:00:00
abstract::To evaluate the performance of serum iron studies as a diagnostic test for iron-deficiency anemia in a county hospital, the authors identified retrospectively all general medicine patients who had had bone-marrow aspirates for the work-up of non-macrocytic anemias from 1978 through 1983. Re-reading a sample of aspirat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596144
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:To address concerns that the Hospital Readmissions Reduction Program (HRRP) unfairly penalized safety net hospitals treating patients with high social and functional risks, Medicare recently modified HRRP to compare hospitals with similar proportions of high-risk, dual-eligible patients ("peer group hospital...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06222-1
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE:To explore the relevance and learning value of clinical vignettes from the SGIM...
journal_title:Journal of general internal medicine
pub_type:
doi:10.1111/j.1525-1497.2006.00596.x
更新日期:2006-11-01 00:00:00