Abstract:
BACKGROUND:Over the last 20 years, multiple interventions to better integrate palliative care and intensive care unit (ICU) care have been evaluated. This systematic review summarizes these studies and their outcomes. METHODS:We searched MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and the Web of Science; performed a search of articles published by opinion leaders in the field; and reviewed hand-search articles as of August 13, 2012. The terms "palliative care" and "intensive care unit" were mapped to MeSH subject headings and "exploded." We included trials of adult patients that evaluated an ICU intervention and addressed Robert Wood Johnson group-identified domains of high-quality end-of-life care in the ICU. We excluded case series, editorials, and review articles. We compared two types of interventions, integrative and consultative, focusing on the outcomes of patient and family satisfaction, mortality, and ICU and hospital length of stay (LOS), because these were most prevalent among studies. RESULTS:Our search strategy yielded 3328 references, of which we included 37 publications detailing 30 unique interventions. Interventions and outcome measures were heterogeneous, and many studies were underpowered and/or subject to multiple biases. Most of the interventions resulted in a decrease in hospital and ICU LOS. Few interventions significantly affected satisfaction. With one exception, the interventions decreased or had no effect on mortality. There was no evidence of harm from any intervention. CONCLUSIONS:Heterogeneity of interventions made comparison of ICU-based palliative care interventions difficult. However, existing evidence suggests proactive palliative care in the ICU, using either consultative or integrative palliative care interventions, decrease hospital and ICU LOS, do not affect satisfaction, and either decrease or do not affect mortality.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Aslakson R,Cheng J,Vollenweider D,Galusca D,Smith TJ,Pronovost PJdoi
10.1089/jpm.2013.0409subject
Has Abstractpub_date
2014-02-01 00:00:00pages
219-35issue
2eissn
1096-6218issn
1557-7740journal_volume
17pub_type
杂志文章,评审abstract::This paper provides an evidence-based review of the principles underlying palliative care for heart failure (HF), including its pathogenesis, staging, assessment, prognosis, and treatment. Approaches to advanced care planning, symptom management, hospice eligibility, home inotropic infusions, device management and imp...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.9988
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:In the United States, the American Indian and Alaska Native (AI/AN) population is aging and the leading causes of death for those 55 and older are chronic diseases such as cancer, heart disease, and the complications of diabetes. Since 1955, the federally directed Indian Health Service, along with Tribal gov...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2004.7.830
更新日期:2004-12-01 00:00:00
abstract:INTRODUCTION:In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospital...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0241
更新日期:2008-07-01 00:00:00
abstract:: Background: Failure to initiate discussions about patients' values and goals in serious illness remains a common problem. Many clinicians are inadequately trained for these discussions. Objective: Evaluate whether a novel train...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0334
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:Little is known about young caregivers of people with advanced life-limiting illness. Better understanding of the needs and characteristics of these young caregivers can inform development of palliative care and other support services. METHODS:A population-based analysis of caregivers was performed from pilote...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0004
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) and palliative care (PC) organizations recommend early PC to improve the quality of life of patients living with HF. OBJECTIVE:We conducted a two-phase formative evaluation study to translate a cancer-focused concurrent PC intervention into one that would be appropriate for rural-dwelling...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0680
更新日期:2014-09-01 00:00:00
abstract::Although the widespread implementation of hospice in the United States has led to tremendous advances in the care of the dying, there has been no widely accepted psychological theory to drive needs assessment and intervention design for the patient and family. The humanistic psychology of Abraham Maslow, especially hi...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.1120
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Outpatient palliative care (PC) has been shown to positively impact quality of life and decrease healthcare utilization, but there are limited data describing what activities render these benefits. OBJECTIVE:Describe the topics addressed by an outpatient PC team during scheduled visits. DESIGN:Longitudinal...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0441
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The study of how the quality of pediatric end-of-life care varies across systems of health care delivery and financing is hampered by lack of methods to adjust for the probability of death in populations of ill children. OBJECTIVE:To develop a prognostication models using administratively available data to ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2008.0206
更新日期:2009-02-01 00:00:00
abstract::Louisiana State Penitentiary (Angola) has a large population of aging men serving long sentences with little hope of reprieve. Eighty-five percent of the 5108 inmates currently incarcerated at Angola are expected to die there. The prison, in partnership with University Hospital Community Hospice in New Orleans, has cr...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662102760269797
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:The provision of complementary therapy in palliative care is rare in Canadian hospitals. An Ontario hospital's palliative care unit developed a complementary therapy pilot project within the interdisciplinary team to explore potential benefits. Massage, aromatherapy, Reiki, and Therapeutic Touch™ were provid...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0295
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:This study describes the process and population involved in pediatric advance care planning at one Midwest medical center. The outcomes and the parents' perceptions of this planning are also discussed. METHODS:Pediatric patients with advance directives were identified from ethics consultations records. Infor...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.766
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice. OBJECTIVE:Our aim was to review advance care planning for children with l...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0374
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Actions in preparation for death and talks about death between advanced cancer patients and their families are considered essential to achieve a good death. However, little is known about the prevalence of such actions compared with talks and their association with bereaved families' psychological morbidity....
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0267
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To describe caregivers' reasons for transfer from home hospice to inpatient facilities, preferences for site of care and death, and their experiences during these transfers. DESIGN:Retrospective qualitative analysis of interviews with caregivers of deceased hospice patients who had undergone transfer. SETTI...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.100
更新日期:2006-02-01 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
abstract:BACKGROUND:After prenatal diagnosis of lethal fetal abnormality (LFA), some couples choose to continue the pregnancy rather than opt for termination of the pregnancy. This may result in the requirement for neonatal palliative care, which in France is prescribed by the Leonetti Law. These rare situations raise various q...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2014.0023
更新日期:2014-08-01 00:00:00
abstract::Organ donation is generally accepted within the medical profession as a beneficial practice with demand continuing to exceed supply. For patients who are dying from cancer opportunities for organ donation are generally limited to eye donation. Between July 1, 2006 and 30 June 2007 over 2000 deaths occurred in nine pal...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0213
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The Palliative Performance Scale (PPS) is a tool that is widely used to predict end of life. In Ontario, Canada, the PPS is used to mark the terminal phase of life and eligibility for terminal care. OBJECTIVE:The aim of this retrospective study was to confirm that a PPS level of 40% can be used as a marker ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0645
更新日期:2015-01-01 00:00:00
abstract::Continuing the momentum of geriatric palliative medicine research achieved during the past decade requires a focus on research methods priorities that span the continuum of research from small pilot studies testing new interventions to large multisite studies evaluating implementation of proven interventions and model...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.9492
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Percutaneous cervical cordotomy (PCC) is a well recognized but infrequently performed procedure for the relief of unilateral intractable pain from malignancy. There is a paucity of data regarding efficacy and safety of PCC. OBJECTIVES:The study's objectives were to demonstrate the efficacy and safety of PCC...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0027
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:To determine the effects of thalidomide and placebo on anorexia-cachexia and its related symptoms, body composition, resting metabolic rate, and serum cytokines and their receptors in patients with advanced cancer. METHODS:Included in the study were patients with advanced cancer with weight loss greater tha...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2012.0146
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:As the United States braces for full implementation of health care reform, the eyes of the nation are on Medicaid. The large number of newly eligible Medicaid beneficiaries may challenge health care resources and ultimately impact quality of care. This is a special concern among current Medicaid beneficiarie...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0099
更新日期:2013-11-01 00:00:00
abstract:: Background: The COVID-19 pandemic has created an environment in which existence is more fragile and existential fears or terror rises in people. Objective: Managing existential terror calls for being mature about mortality, som...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0263
更新日期:2020-06-17 00:00:00
abstract:BACKGROUND:Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure. OBJECTIVE:To assess quantitatively the effectiveness of adding methadone to another opioid for moderate to severe cancer-related pain. DESIGN:All outpa...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0335
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:For the better part of 100 years, acetaminophen (or paracetamol as it is known outside of the United States) has been a common first-line analgesic in pediatrics and is typically well tolerated with minimal side effects. Its use as an anti-pyretic is also well-documented and thus it is used broadly for sympt...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0117
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Hospice provides intensive end-of-life care to patients and their families delivered by an interdisciplinary team of nurses, aides, chaplains, social workers, and physicians. Significant gaps remain about how team members respond to diverse needs of patients and families, especially in the last week of life....
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0198
更新日期:2016-05-01 00:00:00
abstract:: Background: End-of-life (EOL) care in neonatal intensive care units (NICUs) can vary depending on religious beliefs of health care providers and families as well as the sociocultural environment. Although guidelines exist for EOL care in NICUs, most are based on Western st...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2018.0304
更新日期:2019-07-01 00:00:00
abstract:CONTEXT:Family members often lack the knowledge of patients' values and preferences needed to function well as surrogate decision-makers. OBJECTIVE:To determine whether differences in values and preferences for the advance care planning process may be reasons family members are inadequately informed to act as surrogat...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662101753381629
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Pain, not responsive to opioid analgesics, remains a problem for patients with chronic and cancer pain as well as their families, and clinicians. Opioid antagonists have various uses in pain and palliative care. Their use in the reversal of tolerance and hyperalgesia remains at the basic science level and ha...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.1250
更新日期:2006-12-01 00:00:00