Abstract:
CONTEXT:There is limited research on how community-based long-term care (CBLTC) providers' personal characteristics and attitudes affect their decisions to initiate advance care planning (ACP) conversations with consumers. OBJECTIVES:To examine judgments by CBLTC providers as to whether a consumer was in need of ACP and to compare the relative influence of situational features of the consumer with the influence of personal characteristics of the CBLTC provider. METHODS:Factorial surveys with vignettes with randomly assigned situational features of a hypothetical consumer were obtained from 182 CBLTC providers at three Area Agencies on Aging located in the Midwestern U.S. Measures included the consumer's situational features, such as demographics, diagnosis, pain level, level of functioning, and caregiver involvement. Personal characteristics of the CBLTC provider included demographics, discipline, past experience with ACP, and attitudes toward ACP. RESULTS:Hierarchical linear models indicated that most variability in ACP decisions was the result of differences among CBLTC providers (64%) rather than consumers' situational features. Positive decisions to discuss ACP were associated with consumers who needed assistance with legal issues and had a cancer diagnosis; these variables explained 8% of the vignette level variance. Significant personal characteristics of the CBLTC provider included a nursing background, less direct contact with consumers, past experience with ACP, and positive attitudes toward ACP; these variables explained 41% of the person-level variance. CONCLUSION:This study shows the lack of normative consensus about ACP and highlights the need for consistent educational programs regarding the role of the CBLTC provider in the ACP process.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Baughman KR,Ludwick RE,Merolla DM,Palmisano BR,Hazelett S,Winchell J,Hewit Mdoi
10.1016/j.jpainsymman.2011.03.023subject
Has Abstractpub_date
2012-01-01 00:00:00pages
10-9issue
1eissn
0885-3924issn
1873-6513pii
S0885-3924(11)00273-9journal_volume
43pub_type
杂志文章,多中心研究,随机对照试验abstract::The purposes of this study were 1) to assess and describe the occurrence, frequency, severity, and distress of symptoms reported by Taiwanese pediatric cancer patients who were between 10 and 18 years of age, and 2) to use statistical analysis to determine whether the multiple dimensions (i.e., frequency, severity, or...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.04.023
更新日期:2009-11-01 00:00:00
abstract::Radiotherapy remains the primary treatment of malignant epidural spinal cord compression. Therapeutic success depends on diagnosis before the development of neurological compromise and the prompt initiation of radiotherapy. Radiotherapy alone is effective in over 85% of cases of spinal cord compression that occur in h...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/0885-3924(95)00137-9
更新日期:1996-01-01 00:00:00
abstract:CONTEXT:One palliative care approach that is increasingly being used at home for relieving intolerable suffering in terminally ill patients is continuous sedation until death. Its provision requires a multidisciplinary team approach, with adequate collaboration and communication. However, it is unknown how general prac...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.05.012
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abstract::Pain is a multidimensional phenomenon with physical, psychological, and social components and is a significant problem for 50% of hemodialysis (HD) patients. Failure to treat pain adequately may lead to disruption in many aspects of life. This study examines the relationship between moderate to severe chronic pain and...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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abstract:CONTEXT:Fatigue is highly prevalent in populations with advanced illness and is often associated with depressed mood. The role of psychostimulant therapy in the treatment of these conditions remains ill defined. OBJECTIVES:To evaluate the response of fatigue and depression in patients with advanced illness to titrated...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2011.03.026
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abstract::We evaluated the reliability and validity of the Pediatric Functional Assessment of Cancer Therapy-Childhood Brain Tumor Survivor Questionnaire (pedsFACT-BrS, Version 2). This was specifically directed to patients aged 13 years and older (adolescents). The pedsFACT-BrS was translated and cross-culturally adapted into ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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abstract::This study describes a new clinical tool for needs assessment in palliative care: the Problems and Needs in Palliative Care questionnaire (PNPC). It was developed to support the provision of care tailored to the specific demands of patients, which only can be provided when their needs are clearly identified. To test v...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
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abstract:CONTEXT:Systematic reviews and meta-analyses suggest that community specialist palliative care services (SPCSs) can avoid hospitalizations and enable home deaths. But more information is needed regarding the relative efficacies of different models. Family caregivers highlight home nursing as the most important service,...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
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更新日期:2013-02-01 00:00:00
abstract:CONTEXT:International consensus on indicators is necessary to standardize the global assessment of palliative care (PC) development. OBJECTIVES:To identify the best indicators to assess current national-level PC development. METHODS:Experts in PC development were invited to rate 45 indicators organized by domains of ...
journal_title:Journal of pain and symptom management
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abstract::Neuropathy is common in patients receiving vinca alkaloids, platinum derivatives, or taxanes. This double-blind, randomized, placebo-controlled study assessed the efficacy of low-dose amitriptyline to relieve chemotherapy-induced symptoms in 44 patients (age 20-65 years) who had neuropathic symptoms (numbness, tinglin...
journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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abstract::After years of second-class status, supportive care is increasingly being recognized for its importance. Included in this recognition is a concern for making more explicit the long-held conviction within medicine that no goal can logically be more important than optimal patient functioning and well-being. This effort ...
journal_title:Journal of pain and symptom management
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abstract::Accumulation of active (toxic) metabolites of opioids might explain cases of opioid toxicity when high doses are used for long periods of time. Other mechanisms of late toxicity of opioids may be found at the receptor level. Whatever the cause, a change of opioids using equianalgesic doses can be expected to improve s...
journal_title:Journal of pain and symptom management
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abstract::Treatment of painful episodes in sickle cell disease (SCD) is sometimes complicated by disputes between patients and staff and patient behaviors that raise concerns about analgesic misuse. Those concern-raising behaviors could indicate either drug seeking caused by analgesic dependence or pseudoaddiction caused by und...
journal_title:Journal of pain and symptom management
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abstract::To define changes in sleep and subjective fatigue associated with localized radiation treatment, and to determine their relationship to interleukin-1B (IL-1), we prospectively followed 15 men, none of whom were depressed during 8 wk of radiation treatment for localized prostate cancer. Each patient rated fatigue daily...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/0885-3924(93)90127-h
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abstract::Comparisons of symptom ratings and health-related quality of life between significant others and patients have been the focus of numerous studies during the past decades. Additional studies are needed to assess the discrepancies identified in this work. In the present cross-sectional exploratory study, focus has been ...
journal_title:Journal of pain and symptom management
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abstract:CONTEXT:Conflicts between families and clinicians in pediatric end-of-life (EOL) care cause distress for providers, dissatisfaction for patients' families, and potential suffering for terminally ill children. OBJECTIVES:We hypothesized that family factors might influence clinician decision making in these circumstance...
journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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更新日期:2020-12-24 00:00:00
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
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journal_title:Journal of pain and symptom management
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更新日期:2011-07-01 00:00:00
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of pain and symptom management
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abstract::Cancer patients often experience multiple symptoms concurrently, a phenomenon called symptom clustering. Different symptom clusters have been identified by various symptom assessment tools, as well as by different research methods, but no study has reported whether these identified symptom clusters can be replicated i...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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