Abstract:
:Using a decision-making and treatment checklist developed to facilitate the at-home palliative sedation process, we assessed the incidence and efficacy of palliative sedation for end-of-life cancer patients with intractable symptoms who died at home. We retrospectively reviewed the medical records of 370 patients who were followed by a palliative home care team. Twenty-nine of 245 patients (12%) who died at home had received palliative sedation. The mean age of the patients who received palliative sedation was 58 +/- 17 years, and the mean age of the patients who did not receive palliative sedation was 69 +/- 15 years (p = 0.002). No other differences were detected between patients who did or did not receive palliative sedation. The most common indications for palliative sedation were delirium (62%) and dyspnea (14%). Twenty-seven patients (93%) received midazolam for palliative sedation (final mean dose of 74 mg), and two (7%) received levomepromazine (final mean dose of 125 mg). The mean time between palliative sedation initiation and time of death was 2.6 days. In 13 of the cases (45%), the palliative sedation decision was made with the patient and his or her family members, and in another 13 patients (45%), the palliative sedation decision was made only with the patient's family members. We concluded that palliative sedation may be used safely and efficaciously to treat dying cancer patients with refractory symptoms at home.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Alonso-Babarro A,Varela-Cerdeira M,Torres-Vigil I,Rodríguez-Barrientos R,Bruera Edoi
10.1177/0269216309359996subject
Has Abstractpub_date
2010-07-01 00:00:00pages
486-92issue
5eissn
0269-2163issn
1477-030Xpii
0269216309359996journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. AIM:This study aimed to translate, ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311419987
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Palliative care requires a multidisciplinary care team. General practitioners often ask specialised palliative home care teams for support. Working with specialised nurses offers learning opportunities, also called workplace learning. This can be enhanced by the presence of a learning facilitator. OBJECTIVE...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216314560391
更新日期:2015-05-01 00:00:00
abstract::The quality of research, and the resulting quality of evidence available to guide palliative care, is dependent on the ethical decisions underpinning its design, conduct and report. Whilst much has been published debating the ethics of palliative care research, an assessment of the quality and synthesis of the central...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216309352714
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:People with dementia requiring palliative care have multiple needs, which are amplified in long-term care settings. The European Association for Palliative Care White Paper offers recommendations for optimal palliative care in dementia integral for this population, providing useful guidance to inform interve...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319900141
更新日期:2020-04-01 00:00:00
abstract::Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor qua...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216304pm890oa
更新日期:2004-04-01 00:00:00
abstract::Parenteral administration of mixtures of morphine with other drugs has become common practice in palliative care. Such mixtures are sometimes found to be incompatible but compatibility data are scarce. An attempt was made to develop a quick and simple investigation strategy to obtain complete information on the compat...
journal_title:Palliative medicine
pub_type: 指南,杂志文章,实务指引
doi:10.1191/0269216302pm542oa
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Being at peace is important for the quality of life of dying cancer patients, but its features, and the role of the doctor in facilitating peace, are unclear. AIM:We sought to understand the features of a peaceful patient, and patients' preferences regarding the role of the doctor in facilitating a sense of...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314536455
更新日期:2014-10-01 00:00:00
abstract::Vaccum assisted closure (VAC) therapy is a novel method of wound healing using topical negative pressure across the wound bed and containing all exudate within a sealed system. We report the use of VAC therapy to control pain and exudate of a malignant wound. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216306pm1117cr
更新日期:2006-06-01 00:00:00
abstract::We describe training in CBT techniques for 20 palliative care practitioners delivered as 12 days' equivalent teaching plus skills-building supervision over a six month period. Audiotapes of trainees' interactions with patients during their usual work were rated using a specially devised 'Cognitive First Aid' rating sc...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216306071058
更新日期:2006-09-01 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:BACKGROUND:Early palliative care improves quality of life during life-prolonging treatment for patients with cancer, but the role of nurses in facilitating the early involvement of palliative care is unclear. AIM:To conceptualize the psychosocial processes involved in the introduction and provision of palliative care ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319883980
更新日期:2020-02-01 00:00:00
abstract::This is a review of tools that have been developed to assess pain in children, with a brief evaluation of their practicality and validity. There are some suggestions for the direction of future research in the development and use of the scales. ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/026921639701100503
更新日期:1997-09-01 00:00:00
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 ...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216309106315
更新日期:2009-10-01 00:00:00
abstract::The question of whether a coherent tradition in research and research methods (or paradigm) exists in palliative care is explored in this paper through an examination of the discussion and debate surrounding palliative care; attempts at achieving consensus for research through priority setting exercises; and a critica...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/026921639601000304
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Understanding current patterns of functional decline will inform patient care and has health service and resource implications. AIM:This prospective consecutive cohort study aims to map the shape of functional decline trajectories at the end of life by diagnosis. DESIGN:Changes in functional status were me...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319839024
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking. AIM:To evaluate perceived psychological support in relation to end-of...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319888986
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. AIM:To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palli...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318764095
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:In rural settings, relationships between place and self are often stronger than for urban residents, so one may expect that rural people would view dying at home as a major feature of the 'good death'. AIM:To explore the concept of the 'good death' articulated by rural patients with life-limiting illnesses,...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318800613
更新日期:2018-12-01 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::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:BACKGROUND:This case report describes an end-stage cancer patient with intractable neuropathic pain and delirium who was successfully managed during the last 3 weeks of her life with a continuous subcutaneous infusion of dexmedetomidine. CASE PRESENTATION:A 55-year-old woman with locally advanced cervical cancer and u...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314556923
更新日期:2015-03-01 00:00:00
abstract::Morphine, the recommended drug for the management of moderate to severe cancer pain, is metabolized predominantly to the glucuronides morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G). The quantitative clinical importance of these metabolites following the administration of oral morphine is unclear. This s...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm658oa
更新日期:2003-03-01 00:00:00
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journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1086oa
更新日期:2005-12-01 00:00:00
abstract::The history and development of an extra care sheltered housing complex, specifically designed and built for frail, ambulant, cancer patients is reviewed. Consideration is given to diagnosis, length of stay, place of death, family and social background. Problems are highlighted and the need for future research is discu...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639500900309
更新日期:1995-07-01 00:00:00
abstract::This retrospective study examined the influence of a hospital palliative care team on the activity of a local hospice home care team over a four-year period from May 1989 to April 1993 in East Leeds. The increasing referral to death interval observed in home care patients over this period appears to be due to the pres...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800308
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Legacy has been invoked as a means for strengthening human attachments, continuing bonds, and ensuring that individuals will be remembered; however, little is known about the spectrum of approaches to, outcomes associated with, and best practices for legacy interventions. AIM:To systematically review resear...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216321989565
更新日期:2021-01-25 00:00:00
abstract:BACKGROUND:Death anxiety is important but understudied in palliative care. New self-report measurements have been developed, but their interpretation and clinical utility may not be evident. AIM:To inform our understanding of death anxiety in patients with advanced cancer by exploring the relationship between this sel...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316628780
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION:Even though depression has serious and wide-ranging effects on outcomes in palliative care, errors in the identification of depressed patients are common. OBJECTIVES:To examine the clinical validity of widely publicised one- and two-question screening tools for depression in two palliative care settings. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1021oa
更新日期:2005-06-01 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::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