Abstract:
:Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care program in the prior year, with a median of 3 referrals (interquartile range 2, 6). Factors associated with referral included working at KP between 10 and 20 years as compared to <10 years [Odds ratio [OR] 6.29 (95% confidence interval [CI] 1.38, 28.6)] and having personal experience with palliative care [OR 2.13 (95% CI 0.95, 4.976)]. None of the beliefs scales was associated with referral. Physician characteristics other than their beliefs about palliative care played a significant role in determining referral. Palliative care programs should aim to increase their visibility in the outpatient setting to increase referrals by primary care physicians. Tools that help physicians identify seriously ill patients who could benefit from palliative care may also serve to increase appropriate referrals.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Ahluwalia SC,Fried TRdoi
10.1177/0269216309106315subject
Has Abstractpub_date
2009-10-01 00:00:00pages
608-15issue
7eissn
0269-2163issn
1477-030Xpii
0269216309106315journal_volume
23pub_type
杂志文章,多中心研究abstract:BACKGROUND:Little is known about the attitudes of healthcare professional students' perceived competence and confidence in treating those with dementia who are at the end of life. AIM:To explore the attitudes of final year medical, nursing and pharmacy students towards people with dementia and to evaluate their percei...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313483661
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Patients with advanced cancer often have to make difficult decisions, such as how much to spend on moderately life-extending treatments. This and other end-of-life decisions are also influenced by their informal caregivers. Understanding the relative value that patients and their caregivers place on various ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315578803
更新日期:2015-10-01 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:BACKGROUND:Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. AIM:Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. DES...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216313487569
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM:To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual mod...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319840275
更新日期:2019-06-01 00:00:00
abstract::This paper reviews a number of studies relating to religion and coping with chronic illness, emphasizing those aspects relevant to palliative care. After pointing out that religious and existential needs are common in chronic illness, a critical examination is made of those studies which purport to demonstrate associa...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/026921639701100405
更新日期:1997-07-01 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:BACKGROUND AND AIMS:Palliative medicine is not recognized as a medical specialty in any of the five Nordic countries, but there is a great need for physicians with specialty qualifications to serve on an increasing number of palliative care services. The Associations for Palliative Medicine in the five countries agreed...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216307087320
更新日期:2008-04-01 00:00:00
abstract::Chronic cough is a distressing symptom experienced by approximately 37% of patients with advanced cancer. Palliation of chronic nonproductive cough should always first address the underlying cause but in some patients chronic, nonproductive cough persists and antitussive agents are required. Opioids are the gold stand...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921698672930910
更新日期:1998-01-01 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:Hospitalizations in patients with metastatic cancer occur commonly at the end of life but have not been well-described in individuals with metastatic breast cancer. AIM:To describe the reasons for admission and frequency of palliative care and hospice utilization in hospitalized patients with metastatic bre...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316637238
更新日期:2016-10-01 00:00:00
abstract::Back pain resulting from spinal instability in metastatic bone disease can be difficult to alleviate by pharmacological methods and surgical intervention is frequently required. This paper discusses the treatment options with three illustrative case reports. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639300700311
更新日期:1993-01-01 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::The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care specialists regarding communication with the terminally ill in Europe, S...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/026921600674582192
更新日期:2000-07-01 00:00:00
abstract::Objective of this study is to examine physicians' practices regarding information disclosure to terminally ill patients and to their relatives, without informing the patient. A questionnaire had been sent to a random sample of 3014 Belgian physicians from different specialties frequently involved in end-of-life care. ...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308102043
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. AIM:To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gap...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216314531999
更新日期:2014-10-01 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::This paper is a secondary observation of a larger pilot study. The Assessing Caregivers for Team Intervention via Video Encounters intervention project enabled caregiver participation in hospice interdisciplinary team meetings. This paper used the team observation scale to assess the impact of caregiver involvement on...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216309352066
更新日期:2010-03-01 00:00:00
abstract::Prospective controlled clinical trials provide the highest level of evidence in palliative care. Both parallel and crossover studies have unique advantages and disadvantages. Excellent knowledge of the patient population, interventions and endpoints are useful in choosing the most appropriate trial. Open pilot studies...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576275
更新日期:2001-05-01 00:00:00
abstract::Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216307081940
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Family caregivers in palliative care often report feeling insufficiently prepared to handle the caregiver role. Preparedness has been confirmed as a variable that may actually protect family caregiver well-being. Preparedness refers to how ready family caregivers perceive they are for the tasks and demands i...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313486954
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:A study designed to explore the experiences of patients with severe chronic obstructive pulmonary disease (COPD) and their carers, particularly with regard to ongoing and palliative care needs. METHODS:The participants were nine men and one woman with severe COPD and the carers of eight of the men, in East ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216304pm928oa
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311408993
更新日期:2012-04-01 00:00:00
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 nee...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216305pm1005oa
更新日期:2005-04-01 00:00:00
abstract::The amount and quality of information and awareness in cancer patients' is a topic frequently debated, but few studies have focussed on terminal patients. This is the objective of the present study that involved two different palliative home-care units in Italy, which recruited 550 terminal cancer patients. Data from ...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308100772
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:The Gold Standards Framework (GSF) was developed to improve the delivery of palliative care in general practice. AIM:The aim of the study was to evaluate the first phase of GSF in terms of its acceptability to primary care teams, effectiveness in changing practice and professionals' views on the consequence...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216306072501
更新日期:2007-01-01 00:00:00
abstract::Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understan...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216311399663
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/0269216305pm1002oa
更新日期:2005-04-01 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::It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576176
更新日期:2001-05-01 00:00:00