Abstract:
:Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdom by the Marie Curie Cancer Care 'Delivering Choice Programme'. This article explores perceptions of service users and key stakeholders of palliative care services about problems encountered in journeys between care settings during end-of-life care. This article draws on data from interviews with stakeholders (n = 44), patients (n = 16), carers (n = 19) and bereaved carers (n = 20); and focus groups (n = 9) with specialist nurses. Data were gathered in three areas of the United Kingdom. Data were analysed using a framework approach. Transport problems between care settings emerged as a key theme. Four particular problems were identified: (1) urgent need for transport due to patients' rapidly changing condition; (2) limited time to organise transfers; (3) the management of specialist equipment and (4) the need to clarify the resuscitation status of patients. Partnership working between Ambulance Services and secondary care is required to develop joint protocols of care to ensure timely and safe transportation between care settings of patients, who are near their end of life. Commissioning of services should be responsive to the complexities of patients' needs and those of their families.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Ingleton C,Payne S,Sargeant A,Seymour Jdoi
10.1177/0269216309106893subject
Has Abstractpub_date
2009-12-01 00:00:00pages
723-30issue
8eissn
0269-2163issn
1477-030Xpii
0269216309106893journal_volume
23pub_type
杂志文章,多中心研究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: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::Open pulmonary tuberculosis has been increasingly seen in HIV-infected patients in this hospice. Multidrug-resistant tuberculosis is a new and serious threat and two cases have occurred in our hospice in the past two years. This infection poses a health risk to staff, patients, relatives and volunteers. Palliative car...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639701100607
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Making palliative care accessible to all citizens who are in need of this type of care requires effective policies and education. Moreover, healthcare professionals have an ethical and legal responsibility to ensure quality palliative care. Nevertheless, palliative care has had traditionally a limited emphas...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316639794
更新日期:2016-10-01 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:BACKGROUND:There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. AIM:To explore the type and prevalence of bar...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319865414
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS:(1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-o...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320967547
更新日期:2021-01-01 00:00:00
abstract::This paper reviews the experience of managing 31 patients with severe dysphagia in motor neurone disease. Thirteen patients were fed nasogastrically and the remaining 18 were managed conservatively without a nasogastric tube. The introduction of nasogastric feeding led to the development of new problems in some patien...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800108
更新日期:1994-01-01 00:00:00
abstract::In an era of ever increasing emphasis on cost-effectiveness of health care, and with the introduction of the internal market, there is now an urgent need for information on the costs and quality of palliative care. This paper highlights the complexities involved in acquiring and measuring such information and discusse...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800402
更新日期:1994-10-01 00:00:00
abstract::The purpose of this study is to analyze French general practitioners' attitudes toward prescribing opiate painkillers for dying patients and compare them with their attitudes toward making frequent home visits. One hundred and fifteen general practitioners indicated the acceptability of prescribing opiates in 48 scena...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309107012
更新日期:2010-01-01 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: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::When a person is diagnosed with a severe disease, it seems plausible that existential questions and death anxiety are easily intensified. The aims of this study were to explore whether this is the case, to what extent patients and their next of kin experience death anxiety, and how these experiences are expressed. Fol...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/026921600701536426
更新日期:2000-11-01 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::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:The lack of a clear definition of the palliative care patient hampers the comparison of results across different studies and impedes implementation of research findings in everyday practice. AIM:The aim of this article is to propose minimum characteristics that define a palliative care patient. DESIGN:The ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216311435268
更新日期:2013-03-01 00:00:00
abstract::The purpose of this study was to compare patient and proxy (physician and nurse) assessments of symptoms in advanced cancer patients. The sample consisted of 49 patients with advanced cancer admitted to an acute palliative care unit. Three independent assessments were completed for each patient on two occasions within...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921699675854885
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Bisphosphonates and denosumab are well-established therapies to reduce the frequency and severity of skeletal-related events in patients with bone metastasis. However, the analgesic effect of these medications on bone pain is uncertain. AIM:To identify, critically appraise and synthesize existing evidence t...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216316639793
更新日期:2017-01-01 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:Population ageing will lead to more deaths with an uncertain trajectory. Identifying patients at risk of dying could facilitate more effective care planning. AIM:To determine whether screening for likely death within 12 months is more effective using screening tools or intuition. DESIGN:Randomised controll...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216317698621
更新日期:2018-02-01 00:00:00
abstract::The McGill Quality of Life Questionnaire (MQOL) is a widely used tool that has been specifically developed to measure the quality of life of patients facing a life-threatening illness. Preferably, a self-report instrument has an equal number of items worded positively and negatively. However, all the psychological sca...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308094519
更新日期:2008-09-01 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:Chronic kidney disease palliative care guidelines would benefit from more diverse and objectively defined health status measures. AIM:The aim is to identify high-risk patients from administrative data and facilitate timely and uniform palliative care involvement. DESIGN:It is a retrospective cohort study. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319828602
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Although integrated care for existential suffering is an essential part of palliative care, little is known about its concept and efficacy as perceived by professionals. A questionnaire survey was carried out to 1) explore the underlying structure of psychosocial interventions recommended by specialists, 2) ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm825oa
更新日期:2003-12-01 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::The presence of cognitive impairment in patients who are receiving hospice care can affect numerous practical, ethical and legal aspects of their healthcare. A number of factors can contribute to cognitive impairment in these patients. Prevalence rates of cognitive impairment vary widely, but it remains under-recognis...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308096907
更新日期:2008-10-01 00:00:00
abstract::Comprehensive palliative care programs are often implemented on a community level, and to evaluate such interventions, randomization by cluster (community) may be the only feasible method. In trials randomizing individual subjects, the importance of proper concealment has been stressed. In cluster randomized trials, h...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1191/0269216302pm523oa
更新日期:2002-01-01 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::Attitudes to companion animals were surveyed among 50 patients and staff at a day care hospice. Dog visits were welcomed by all but two. Of the 37 patients studied, only seven had a companion animal, often their closest companion. Many more would like to keep an animal, but were prevented by age, frailty or accommodat...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639601000410
更新日期:1996-10-01 00:00:00
abstract::The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216310386280
更新日期:2011-07-01 00:00:00