Abstract:
:To date, the experiences of out-of-hours general practitioners with regard to palliative care patients and their management are yet to be evaluated, since the new General Medical Services contract came into force. In 2007 the National Institute for Health Research highlighted the need to identify factors that improve and hinder the delivery of optimum palliative out-of-hours care. By interviewing general practitioners who work out-of-hours shifts, this project explored factors influencing confidence in dealing with symptom control and palliative care provision outside regular working hours. Face-to-face semi-structured interviews were conducted with nine out-of-hours general practitioners employed by Serco. Interviews were conducted by a specialist doctor in palliative care who had in the past worked as an out-of-hours general practitioner. Interviews were analysed using Interpretative Phenomenological Analysis. General practitioners expressed concerns relating to constraints within the system provided by the private company-owned out-of-hours provider. Data from interviews was thematically very rich and brought out many different subject areas, some similar to previous interviews, some different. Sub-themes related to the process-driven aspects of working in out-of-hours: * Motivation, * Time-pressure constraints and continuity, * The out-of-hours doctor within the domain of palliative care, * Isolation within system. General practitioners stated that their motivation was mainly financial. There was clear concern about the lack of continuity, and inadequacy of notes and follow-up, and there was a demonstrated need for more learning on the topic of palliative care. Pressure from the out-of-hours provider to see more patients was felt to be oppositional with the need to spend adequate time with this vulnerable patient group. General practitioners felt as unwanted strangers who were viewed with suspicion by patients and carers in palliative care situations. It was clear that most of the doctors interviewed felt a strong sense of isolation when working out-of-hours shifts, and some felt less inclined to contact specialist palliative care services.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Taubert M,Nelson Adoi
10.1177/0269216310368580subject
Has Abstractpub_date
2010-07-01 00:00:00pages
501-9issue
5eissn
0269-2163issn
1477-030Xpii
0269216310368580journal_volume
24pub_type
杂志文章abstract:BACKGROUND:As end-of-life (EoL) care expands across Europe and the world, service developments are increasingly studied. The sociocultural context in which such changes take place, however, is often neglected in research. AIM:To explore sociocultural factors in EoL care in Belgium as represented by the literature. DE...
journal_title:Palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1177/0269216311429619
更新日期:2013-02-01 00:00:00
abstract::Existential distress has been recognized as a source of suffering for oncology patients. This study focusses on existential issues and coping mechanisms of a unique culturally diverse Jewish/Middle Eastern oncology population. A qualitative assessment of 40 patients with advanced cancer was undertaken through an inter...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1038oa
更新日期:2005-07-01 00:00:00
abstract::The Research Network of the European Association for Palliative Care (EAPC) performed a survey of 3030 cancer patients from 143 palliative care centres in 21 European countries. The survey addressed pain intensity and the use of non-opioid analgesics, adjuvant analgesics and opioids. Patients were treated with analges...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/0269216305pm1054oa
更新日期:2005-09-01 00:00:00
abstract::Although anecdotal reports suggest nebulized lignocaine may help breathlessness in patients with cancer this has not been examined formally. We report a pilot study comparing nebulized lignocaine 100 mg and 200 mg with saline in six patients with cancer who were breathless at rest. Nebulized lignocaine was well tolera...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800106
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Psychological distress is highly prevalent among patients with metastatic colorectal cancer. AIMS:To perform an economic evaluation of a combined screening and treatment program targeting psychological distress in patients with metastatic colorectal cancer in comparison with usual care. DESIGN:Societal cos...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320913463
更新日期:2020-07-01 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::Using Grounded Theory, this study examines the experience of 19 palliative care chaplains in counselling dying people. Taking a broad-based definition of counselling, and using unstructured individual interviews and group work, the study aimed to understand how palliative care chaplains work with patients at the point...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310380297
更新日期:2011-01-01 00:00:00
abstract::Place of death is at times suggested as an outcome for palliative care services. This study aimed to describe longitudinal preferences for place of care and place of death over time for patients and their caregivers. Longitudinal paired data of patient/caregiver dyads from a prospective unblinded cluster randomised co...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216308092287
更新日期:2008-10-01 00:00:00
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 ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309359996
更新日期:2010-07-01 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:STUDY OBJECTIVE:The Italian Survey of the Dying of Cancer (ISDOC) was undertaken to evaluate the experiences of Italian people dying from cancer during their last three months of life in all settings of care. STUDY DESIGN:A two-stage probability sample was used to estimate end-of-life outcomes of about 160 000 Italian...
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::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:The primary goal of palliative care is to optimize the quality of life (QOL) of people living with a life-threatening illness and that of their families. While there have been important advances in measurement of the QOL of palliative care patients, little attention has been paid to the QOL of their carers (...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216306072764
更新日期:2006-12-01 00:00:00
abstract:PURPOSE/OBJECTIVE:Patients with cancer or symptoms referable to cancer therapy were offered acupuncture as potential palliation of their symptoms. This paper describes the physical integration of the discipline into the Oncology Clinic, and patient perspectives on its availability and efficacy. PATIENTS AND METHODS:Be...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216302pm540oa
更新日期:2002-05-01 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::This study examines how frequently and for what indications sedatives are prescribed in a hospital support team and in a hospice. We also looked at the survival of sedated patients from the date of admission and from the start of sedation. Overall 26% of patients were prescribed sedatives in order to sedate them (31% ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639701100208
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. AIM:(1) To as...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313483185
更新日期:2013-07-01 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::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:The complexity of end-of-life care, represented by a large number of units caring for dying patients, different types of organizations and difficulties in identification and prognostication, signifies the importance of finding ways to measure the quality of end-of-life care. AIM:To establish, test and manag...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311414758
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:The WHO definitions of palliative care have been adopted in Denmark and implemented in The National Guidelines from 1999, but service developments have been very slow and not according to the recommendations. Attitudes to palliative care of Danish doctors and nurses may in part account for this. OBJECTIVE:T...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm988oa
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Benzodiazepines are widely used in palliative care, but few studies have attempted to study their use. AIM:To determine the frequency and nature of benzodiazepine prescribing in a palliative care setting. METHOD:The notes of a consecutive series of 100 patients who had died or been discharged from the hosp...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216306pm1151oa
更新日期:2006-06-01 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::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:End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. AIM:To examine associations among implantable cardioverter defibrillator knowledge, pa...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317718438
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The evidence supporting pharmacological treatment of death rattle is poor; yet, anticholinergic drugs feature in end-of-life care pathways and guidelines worldwide as a treatment option. AIM:This qualitative arm of a wider study aimed to explore important issues which health-care professionals associated wi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312464407
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The Surprise Question ("Would I be surprised if this patient were to die within the next 12 months?") is widely used to identify palliative patients, though with low predictive value. To improve timely identification of palliative care needs, we propose an additional Surprise Question ("Would I be surprised ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320986720
更新日期:2021-01-11 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: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:Dementia is a life limiting illness and is becoming a major cause of death in developed countries. Many people with dementia die in nursing homes or long-term residential care settings. Spouse caregivers of people with dementia living in nursing homes find themselves in a position which is difficult to under...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313479685
更新日期:2013-07-01 00:00:00