Abstract:
BACKGROUND:Antibiotic administration is frequent in terminal patients with cancer, yet the effects on survival are still under debate. OBJECTIVE:The aim of this study was to examine the status of infection and the benefit/burden of antibiotic administration on the survival of terminal patients with cancer with infection. DESIGN:A prospective observational study. SETTING/SUBJECTS:We studied 799 patients with terminal cancer who were admitted to a palliative care unit in Taiwan between January 2008 and the end of April 2010. Survival was calculated from the first day of admission to the day of death in the palliative care unit or under home care. MEASUREMENTS:A specially designed assessment tool was used daily to evaluate clinical conditions. Afterwards, it was analyzed at different time points in a weekly team meeting. Multivariate Cox proportional hazard analyses were used to examine the benefit/burden of antibiotic administration on survival. RESULTS:Four hundred fifty-five patients were diagnosed as having at least one episode of infection after first admission. A total of 295 of the 378 (78.0%) with infection received antibiotic treatment upon admission. Multivariate Cox proportional hazard analyses showed that antibiotic administration was related to improved survival for patients who were still alive 1 week after admission (hazard ratio: 0.66, 95% confidence interfal [CI]: 0.46-0.95). However, antibiotics would be a hazard to patients' survival if used in the time 2 days prior to death (hazard ratio: 1.54, 95% CI: 1.22-1.94). CONCLUSIONS:The results suggest that with good communication between patients, families, and medical staff, withdrawal of antibiotics should be considered if signs of death appear, in order to avoid unnecessary risks. The possible benefit of prolonged survival should be in line with the goal of care, and also take into account preparing the patient for a dignified death.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Chih AH,Lee LT,Cheng SY,Yao CA,Hu WY,Chen CY,Chiu TYdoi
10.1089/jpm.2012.0634subject
Has Abstractpub_date
2013-11-01 00:00:00pages
1417-22issue
11eissn
1096-6218issn
1557-7740journal_volume
16pub_type
杂志文章abstract:OBJECTIVE:In advanced dementia, many difficult decisions may arise as the disease progresses, including whether to use feeding by tube. Several recent articles question the benefit of percutaneous endoscopic gastrostomy (PEG) tube placement in persons with advanced dementia. However, patients with advanced dementia are...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103322654767
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Although most hospice care occurs in the home, a growing number of patients utilize inpatient hospice settings. An inpatient hospice stay requires one or more transitions in care settings, although little is known about these transitions. OBJECTIVE/DESIGN:Using ethnographic methods, this study examined the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0359
更新日期:2014-04-01 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::Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliative care may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0069
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Dyspnea is a very distressing symptom present in the vast majority of patients with advanced cancer. There are limited data on the characteristics and correlates of dyspnea in this population. The purpose of this study was to characterize dyspnea, explore the differences between breakthrough and continuous p...
journal_title:Journal of palliative medicine
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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...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0178
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Little is known about the composition, availability, integration, communication, perceived barriers, and work load of pediatric palliative care (PPC) providers serving children and adolescents with cancer. OBJECTIVE:To summarize the structure and services of programs to better understand successes and gaps ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0405
更新日期:2018-04-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.9.391
更新日期:2006-04-01 00:00:00
abstract::Stroke is a leading cause of disability and mortality worldwide. Recent advances in stroke care now enable patients with severe ischemic stroke owing to large vessel occlusion to safely undergo endovascular thrombectomy (EVT) up to 24 hours since their time of last known well, with the goal of improving functional out...
journal_title:Journal of palliative medicine
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doi:10.1089/jpm.2019.0667
更新日期:2020-05-14 00:00:00
abstract:BACKGROUND:Acupressure is a widely used adjunct for various symptoms in patients with nonchronic kidney disease. However, its role for symptom management in end-stage renal disease (ESRD) populations is not clear. OBJECTIVE:To summarize and critically evaluate the evidence available from randomized clinical trials (RC...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2009.0363
更新日期:2010-07-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2012.0173
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:It is not known how often physicians use metaphors and analogies, or whether they improve patients' perceptions of their physicians' ability to communicate effectively. Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated w...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0221
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of dexmedetomidine infusions in patients with advanced malignancies, advanced heart disease, or after stem cell transplantation (SCT), who during end-of-life care had pain and/or agitation unresponsive to conventional therapies. BACKGROUND:Pediatric patients with intractable advanced m...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0419
更新日期:2017-07-01 00:00:00
abstract::In this review we discuss the history of Hospice and Palliative Medicine (HPM) physician education in the United States over the last 20 years, as there has been dramatic growth in our specialty during this time. A Medline literature search was completed and we surveyed leaders in the field of HPM education regarding ...
journal_title:Journal of palliative medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1089/jpm.2012.0436
更新日期:2013-03-01 00:00:00
abstract:: Background: Lung transplant recipients who experience serious illness could benefit from specialty palliative care (SPC), but evidence suggests that referral has been rare. Objective: Examine the characteristics of post-transpl...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0560
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:In 2011 the Palliative Care Funding Review highlighted concerns about the funding, provision, and quality of care at the end of life. Two years on, an independent review of the Liverpool Care Pathway--prompted by a storm of negative media coverage--has raised concerns around a lack of funding, availability o...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0464
更新日期:2013-12-01 00:00:00
abstract:: Background: This study examines communication profiles and associated attitudes toward health care professionals in interviews with family caregivers of hospitalized patients with confirmed multidrug-resistant organisms (e.g., methicillin-resistant Staphylococcus aureus or...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0027
更新日期:2019-12-01 00:00:00
abstract::This is a retrospective study of the length of survival (LOS) in hospice of patients with cancer treated at a major cancer center compared to other treatment sites. Of 670 patients, the 185 (28%) treated at a major cancer center had unique characteristics, including higher median Palliative Performance Score (PPS) at ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.0071
更新日期:2007-04-01 00:00:00
abstract:: Background: Physical activity in palliative care patients is closely linked to independence, function, carer burden, prognosis, and quality of life. Changes in physical activity can also be related to service provision needs, including requirements for support and prognosi...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0414
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to clarify how physicians should interpret the answer "neither" to the single-question interview, "Are you depressed or not?" PATIENTS AND METHODS:Two hundred fifty-one patients with cancer were studied. The patients were directly interviewed, choosing one answer among these three:...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.861
更新日期:2006-08-01 00:00:00
abstract:: Background: Legacy-making (i.e., a way for patients with terminal illness to create or do something for others as a means of remembrance) is rising in popularity in palliative medicine, although only one study has examined its impact in a pediatric population. ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0329
更新日期:2019-09-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0408
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:Describe the establishment of the palliative care quality network (PCQN) with guidance on how teams can develop similar collaborations. BACKGROUND:In the current healthcare environment, palliative care (PC) teams must be able to demonstrate value and provide efficient care while supporting the clinicians who...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0514
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Black and Hispanic older Americans are less likely than white older Americans to possess advance directives. Understanding the reasons for this racial and ethnic difference is necessary to identify targets for future interventions to improve advance care planning in these populations. METHODS:The aim of the...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0326
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Patients' and families' evaluations of health care, including palliative care, are widely used as performance measures. Survey scores may be affected by nonresponse bias, resulting in inaccurate performance evaluation. OBJECTIVES:Our aim was to examine nonresponse bias for the mailed version of the Departme...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0050
更新日期:2015-10-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0355
更新日期:2010-04-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.492
更新日期:2005-06-01 00:00:00
abstract::Resumen Contexto: La Academia Pontificia de la Vida (PAV) es una institución académica de la Santa Sede (Vaticano) cuyo objetivo es promover una visión católica de la ética biomédica. La PAV invitó a una serie de expertos en Cuidados Paliativos (CP) de todo el mundo, de todas las creencias, a desarrollar recomendacion...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 共识发展会议,杂志文章
doi:10.1089/jpm.2012.0205
更新日期:2013-01-01 00:00:00