Abstract:
:Access to palliative care (PC) is a major need worldwide. Using hospital charts of all patients who died over one year (April 2008-March 2009) in two mid-sized hospitals of a large Canadian city, similar in size and function and operated by the same administrative group, this study examined which patients who could benefit from PC services actually received these services and which ones did not, and compared their care characteristics. A significantly lower proportion (29%) of patients dying in hospital 2 (without a PC unit and reliant on a visiting PC team) was referred to PC services as compared to in hospital 1 (with a PC unit; 68%). This lower referral likelihood was found for all patient groups, even among cancer patients, and remained after controlling for patient mix. Referral was strongly associated with having cancer and younger age. Referral to PC thus seems to depend, at least in part, on the coincidence of being admitted to the right hospital. This finding suggests that establishing PC units or a team of committed PC providers in every hospital could increase referral rates and equity of access to PC services. The relatively lower access for older and non-cancer patients and technology use in hospital PC services require further attention.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Cohen J,Wilson DM,Thurston A,MacLeod R,Deliens Ldoi
10.1177/0269216311408992subject
Has Abstractpub_date
2012-01-01 00:00:00pages
89-94issue
1eissn
0269-2163issn
1477-030Xpii
0269216311408992journal_volume
26pub_type
杂志文章abstract::Cyclizine is an antihistamine, which is frequently used to manage nausea and vomiting in cancer patients. Antihistamines can be drugs of misuse/abuse, and the article describes four cancer patients who developed such problems after receiving parenteral cyclizine within the inpatient unit of a cancer centre. The articl...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216308094337
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:The global prevalence of dementia is set to rise to almost 65 million people by 2030, providing policy makers and practitioners with significant challenges, not least within the realms of end-of-life care. The international literature would suggest that people with dementia may benefit from palliative forms ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311423443
更新日期:2012-10-01 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
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::In this population-based study, we found that parents who are aware that their child will die from a malignancy are more likely to care for their child at home during the child's last month of life compared to parents who are not aware. End-of-life home care was comparable to hospital care for satisfactory pain relief...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216306pm1139oa
更新日期:2006-04-01 00:00:00
abstract::Depression is the most common psychiatric illness in patients with terminal cancer. Depression not only lowers the quality of life for the patients and their families, but patients who are depressed may also have physical symptoms that are difficult to palliate and that improve as their depression is appropriately tre...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm747oa
更新日期:2003-06-01 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: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: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::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::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::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: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::The main focus of palliative care services is to improve patients' quality of life (QOL). The potential value of assessment of QOL in palliative care is being increasingly recognized. The McGill Quality of Life questionnaire (MQOL) is designed specifically for palliative care patients, but its cross-cultural validity ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601680419438
更新日期:2001-09-01 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:ENABLE (Educate, Nurture, Advise Before Life Ends) II was one of the first randomized controlled trials (RCTs) examining the effects of a concurrent oncology palliative care intervention on quality of life, mood, and symptom control for advanced cancer patients and their caregivers. However, little is known ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312445188
更新日期:2013-04-01 00:00:00
abstract::The Association for Palliative Medicine (APM) produced a previous undergraduate palliative medicine syllabus in 1992. This study describes the process of developing the new APM consensus syllabus against the background of changes in medical education and palliative medicine since 1992. The syllabus was derived by mean...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308090769
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:To explore the experiences of people involved in UK palliative care day services (PCDS) and identify the important outcomes of this service. METHODS:Focus groups were carried out separately with patients, informal carers and volunteers from four purposively selected palliative care day units and with day un...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm942oa
更新日期:2005-01-01 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:BACKGROUND:We developed a new single point of access to integrated palliative care, respiratory medicine and physiotherapy: the breathlessness support service for patients with advanced disease and refractory breathlessness. This study aimed to describe patients' experiences of the service and identify the aspects valu...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315600103
更新日期:2016-03-01 00:00:00
abstract::Increasing emphasis is being placed on the need for advanced care planning (ACP) at the end of life. The Preferred Priorities for Care (PPC) document is a patient-held record promoted by the End of Life Care Strategy as an ACP tool to promote discussion and communication amongst patients, family and health care provid...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311399664
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Bisphosphonates are the treatment of choice for hypercalcaemia of malignancy (HCM) but there is no consensus regarding which drug or dose should be given. We designed a systematic review to investigate the efficacy of bisphosphonates in the treatment of HCM. METHODS:We identified randomized controlled trial...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216304pm914ra
更新日期:2004-07-01 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:BACKGROUND:Informal caregivers of people with motor neurone disease (MND) take on an extensive role. Caregivers are at increased risk of experiencing psychological distress and burden, yet, there is a lack of intervention programmes to support them. AIM:The aim of this study was to investigate the feasibility and acce...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317743434
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Patient misunderstandings about prognosis may be related to lack of communication. AIM:This study aimed to examine prognosis discussions held with hospitalized patients for whom palliative care consultations were requested, and if prognosis discussions did not occur, to explore why not. DESIGN:This was a s...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313514126
更新日期:2014-04-01 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: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::Restructuring health care in Canada has emphasized the provision of ambulatory and home-based palliative care. Acquiring economic evidence is critical given this trend and its tremendous demands on family caregivers. The purposes of this study were: 1) to comprehensively assess the societal costs of home-based palliat...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310364877
更新日期:2010-07-01 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:BACKGROUND:It is necessary to develop palliative care to meet existing and future needs of patients and their families. It is important to include knowledge of patient preferences when developing high-quality palliative care services. Previous reviews have focused on patient preferences with regard to specific componen...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216314557882
更新日期:2015-05-01 00:00:00