Abstract:
BACKGROUND:Informal caregivers of hospice patients experience multiple stressors that can negatively impact physical, psychological, and emotional health. The goal of this qualitative study was to understand caregivers' needs to inform the feasibility, structure, and content of a telephone-based counseling intervention. METHODS:Focus groups and interviews with 36 former hospice caregivers and 11 hospice staff from 6 hospices were conducted. Interviews and focus groups were audio-recorded, transcribed, and analyzed using a constant comparative approach. RESULTS:Key content areas included coping, emotional support, self-care, logistical issues, and bereavement. Respondents supported telephone-based counseling, appreciating its relative anonymity and convenience. It was recommended that calls be initiated by the counselor, on a weekly basis, and that one counselor be assigned to each caregiver. Hospice staff emphasized the need to coordinate telephone counseling with hospice care, scheduling around and communicating with hospice staff. Most caregivers indicated that they would participate in telephone-based counseling were it available; hospice staff thought that half of caregivers would participate. A pervasive theme was that "there can never be enough support for a caregiver." CONCLUSION:Informal caregivers of hospice patients have support needs that are amenable to telephone-based counseling designed to be complementary to existing hospice services. Based on these qualitative findings, we are pilot-testing a telephone-based cognitive-behavioral stress management program for informal caregivers of hospice patients.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Kutner J,Kilbourn KM,Costenaro A,Lee CA,Nowels C,Vancura JL,Anderson D,Keech TEdoi
10.1089/jpm.2009.0178subject
Has Abstractpub_date
2009-12-01 00:00:00pages
1101-4issue
12eissn
1096-6218issn
1557-7740journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Several methods exist to elicit end-of-life treatment preferences. However, little work has been done to elicit from patients themselves the aspects of treatment decision-making most important to them when making end-of-life treatment decisions. METHODS:Participants consisted of 23 patients, 60 years of age...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103764978489
更新日期:2003-04-01 00:00:00
abstract::Palliating the whole person requires that medicine attend more fully to the phenomenon of existential suffering. The role of social factors, in particular, is often overlooked in attempts to understand why end-of-life suffering does not always respond to physiologic, psychological, and spiritual interventions. Using q...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662104322737223
更新日期:2004-02-01 00:00:00
abstract::Palliative care is an evolving field with extensive studies demonstrating its benefits to patients, families, and the health care system. Many health systems have developed or are developing palliative care programs. The Canadian Society of Palliative Care Physicians (CSPCP) is often asked to recommend how many pallia...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0314
更新日期:2019-11-01 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:: Background: Methadone may play a role in the control of refractory cancer pain in opioid switching, although some cases fail to switch to methadone. Objective: To evaluate the differences in the clinical aspects in switching to...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0490
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Advanced cancer can erode patients' wellbeing. Narrative interventions have improved patients' wellbeing, but might not be feasible for widespread implementation. OBJECTIVES:(1) Test the effects of miLivingStory, a telephone-based life review and illness narrative intervention with online resources and soci...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2017.0007
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Acute hospital readmission of older adults receiving hospice care is not aligned with hospice goals. OBJECTIVE:To identify factors associated with 30-day readmission among older adults newly discharged to hospice. DESIGN/SUBJECTS:Medical record review of 59 patients, 19 readmitted within 30 days and 40 ran...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0224
更新日期:2014-07-01 00:00:00
abstract::Hypercalcemia of malignancy affects 2%-2.8% of cancer patients and is associated with an increased risk of mortality and other symptom-related complications. Standard treatment consists of fluid resuscitation, intravenous bisphosphonates, and calcitonin. Little is known, however, about the benefits of treatment of mal...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0343
更新日期:2020-06-01 00:00:00
abstract:: Background: The number of hospital-based palliative care consultation teams (PCCTs) has increased in Japan, and quality improvement (QI) of PCCTs is an issue. The Japanese Society for Palliative Medicine is building a framework for continuous QI of PCCT activities. ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0236
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To continuously assess overall quality of life (QOL) and disease progression in patients with amyotrophic lateral sclerosis (ALS) at different stages of the disease and compare the results between these two variables. DESIGN/SUBJECTS:Twenty-six patients with ALS were interviewed with a questionnaire to asse...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.304
更新日期:2006-04-01 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:Respiratory signs and symptoms are commonly encountered by physicians who care for cancer patients. Supplemental oxygen (SOx) has long been used for treatment of hypoxic respiratory insufficiency, but data reveal mixed efficacy results. The use and outcome patterns of technologically advanced oxygen delivery...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0005
更新日期:2011-07-01 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: Many patients with serious kidney disease have an elevated symptom burden, high mortality, and poor quality of life. Palliative care has the potential to address these problems, yet nephrology patients frequently lack access to this specialty. ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0647
更新日期:2020-02-01 00:00:00
abstract:: Background: Lack of guidance is highlighted as a barrier to deprescribing in palliative care. Two deprescribing tools exist, but with inclusion and exclusion criteria that limit utility. The tools have not previously been compared directly or used in an unselected palliati...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0225
更新日期:2020-09-29 00:00:00
abstract:OBJECTIVE:We sought to develop and validate a novel palliative medicine needs assessment tool for patients with cancer in the emergency department. METHODS:An expert panel trained in palliative medicine and emergency medicine reviewed and adapted a general palliative medicine symptom assessment tool, the Needs at the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0456
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care. OBJECTIVE:T...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2010.0453
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Palliative care unit (PCU) beds are a limited resource in Canada, so PCU admission is restricted to patients with a short prognosis. Anecdotally, PCUs further restrict admission of patients with noncancer diagnoses out of fear that they will "oversurvive" and reduce bed availability. This raises concerns tha...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0401
更新日期:2012-06-01 00:00:00
abstract:CONTEXT:Unmet spiritual needs have been associated with decreased patient ratings of quality of care, satisfaction, and quality of life. Few instruments exist to measure spiritual needs particularly among non-English speaking patients in the U.S. OBJECTIVE:To develop an internally consistent and reliable Chinese versi...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0131
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Discussions about withdrawal of life-sustaining therapies often include family members of critically ill patients. These conversations should address essential components of the dying process, including expected time to death after withdrawal. OBJECTIVES:The study objective was to aid physician communicatio...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0115
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. OBJECTIVE:To characterize the employment situations of ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0478
更新日期:2017-07-01 00:00:00
abstract:: Background: End-of-life (EOL) care in neonatal intensive care units (NICUs) can vary depending on religious beliefs of health care providers and families as well as the sociocultural environment. Although guidelines exist for EOL care in NICUs, most are based on Western st...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2018.0304
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:Many deaths occur among persons without insurance coverage for hospice care. We examined the patient and agency characteristics associated with receiving unreimbursed hospice care in a national survey. RESULTS:We examined the receipt of unreimbursed care using the 1998 National Home and Hospice Care Survey ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103768253696
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Nurses and nursing care providers provide the most direct care to patients at end of life. Yet, evidence indicates that many feel ill-prepared for the complexity of palliative care. OBJECTIVE:To review the resources required to ensure adequate education, training, and mentorship for nurses and nursing care ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0395
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Inpatient Code Status Discussions (CSDs) are commonly facilitated by resident physicians, despite inadequate training. We studied the efficacy of a CSD communication skills training intervention for internal medicine residents. METHODS:This was a prospective, randomized controlled trial of a multimodality c...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2011.0446
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Exploring preferences for and barriers to quality end-of-life care is essential to improving care for dying individuals. Young adults often are involved or will be involved in decisions about the care of a loved one, and little research has examined opinions about end-of-life care among this population. RES...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2008.0265
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Surgical patients most commonly receive palliative care services within 24-48 hours of death, and reasons for this delay are poorly understood. Research with nonsurgeons suggests that physician characteristics and beliefs about death and dying may contribute to late referral. OBJECTIVE:To describe surgeon p...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0197
更新日期:2019-02-01 00:00:00
abstract:: Background: Delivery of health services in the province of Ontario is organized into 14 Local Health Integration Networks (LHINs), and further into 76 LHIN subregions, making these a natural unit of comparing the regional differences in palliative care receipt among decede...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0573
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Prognostic tools are available to predict if terminally ill cancer patients have days or weeks to live. Tools for predicting the prognosis in ambulatory patients at an earlier stage are lacking. The Number of Risk Factors (NRF) score developed in ambulatory cancer patients receiving palliative radiation ther...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0256
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To describe the growth and outcomes of the Palliative Care Research Cooperative Group (PCRC). BACKGROUND:Despite advances, significant gaps remain in the evidence base to inform care for people with serious illness. To generate this needed evidence and bolster research capacity, the Palliative Care Research ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0138
更新日期:2017-06-01 00:00:00