Abstract:
BACKGROUND:Chronically homeless individuals have high rates of hospitalization and death, and they may benefit from the completion of advance directives. AIM:To determine the rate of advance directive completion using a counselor-guided intervention, identify characteristics associated with advance directive completion, and describe end-of-life care preferences in a group of chronically homeless individuals. DESIGN:Participants completed a survey and were offered an opportunity to complete an advance directive with a trained counselor. PARTICIPANTS:A total of 205 residents of a shelter in Canada for homeless men (89.1% of those approached) participated from April to June 2013. RESULTS:Duration of homelessness was ⩾12 months in 72.8% of participants, and 103 participants (50.2%) chose to complete an advance directive. Socio-demographic characteristics, health status, and health care use were not associated with completion of an advance directive. Participants were more likely to complete an advance directive if they reported thinking about death on a daily basis, believed that thinking about their friends and family was important, or reported knowing their wishes for end-of-life care but not having told anyone about these wishes. Among individuals who completed an advance directive, 61.2% named a substitute decision maker, and 94.1% expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest if there was a chance of returning to their current state of health. CONCLUSION:A counselor-guided intervention can achieve a high rate of advance directive completion among chronically homeless persons. Most participants expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Leung AK,Nayyar D,Sachdeva M,Song J,Hwang SWdoi
10.1177/0269216315575679subject
Has Abstractpub_date
2015-09-01 00:00:00pages
746-55issue
8eissn
0269-2163issn
1477-030Xpii
0269216315575679journal_volume
29pub_type
杂志文章abstract:BACKGROUND:Patients approaching death often have a decreasing oral intake, which can be distressing for relatives. Little is known about the relatives' experiences with and perceptions of oral intake at the end of life. AIM:This study aims to contribute to a more thorough understanding of relatives' concerns regarding...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313477178
更新日期:2013-07-01 00:00:00
abstract::This retrospective clinical study reports on the experience of palliative venting gastrostomy (PVG) in an integrated acute teaching hospital and hospice-based palliative care service over a seven-year period (1989-97). PVG was performed for 51 patients with refractory nausea and vomiting resulting from varying degrees...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216302pm590oa
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:This case report describes an end-stage cancer patient with intractable neuropathic pain and delirium who was successfully managed during the last 3 weeks of her life with a continuous subcutaneous infusion of dexmedetomidine. CASE PRESENTATION:A 55-year-old woman with locally advanced cervical cancer and u...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314556923
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. AIM:We compared characteristics, expressed unmet needs and outco...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316663855
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Depressive disorders are common among cancer patients. Ketamine can quickly relieve depression, and its subcutaneous administration appears to be as effective as and probably safer than its standard intravenous administration. Herein, we report a case verifying the antidepressant effect of a subcutaneous esk...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320910351
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:A prospective cohort study evaluated the performance and acceptability of the cognitive based Mood Evaluation Questionnaire (MEQ) in assessing depressive symptoms over time in patients with advanced cancer. The structured clinical interview for DSM-III-R (SCID) and the single-item interview screening question...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm812oa
更新日期:2003-10-01 00:00:00
abstract::We describe training in CBT techniques for 20 palliative care practitioners delivered as 12 days' equivalent teaching plus skills-building supervision over a six month period. Audiotapes of trainees' interactions with patients during their usual work were rated using a specially devised 'Cognitive First Aid' rating sc...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216306071058
更新日期:2006-09-01 00:00:00
abstract::This study reports the process and results of a psychometric evaluation of a clinical audit tool, the Support Team Assessment Schedule (STAS), used to measure outcomes of palliative care. The STAS was developed in London, UK to audit community palliative care services provided by a support team. The purpose of this st...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921600677786382
更新日期:2000-01-01 00:00:00
abstract::E-technology is increasingly used in oncology to obtain self-reported symptom assessment information from patients, although its potential to provide a clinical monitoring tool in palliative care is relatively unexplored in the UK. This study aimed to evaluate the support provided to lung cancer patients post palliati...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311399489
更新日期:2011-10-01 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:OBJECTIVES:To identify and explore the educational needs of children's hospice doctors in England. DESIGN:A descriptive quantitative and qualitative survey. SETTING:Children's hospices in England. PARTICIPANTS:All children's hospice doctors (n =55) in England were approached, and 35 (65%) consented. INTERVENTIONS:A...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216304pm902oa
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Little is known about the impact of methicillin-resistant Staphylococcus aureus in palliative care settings. To date, the clinical impact of methicillin-resistant Staphylococcus aureus in palliative care is unknown. AIM:To determine prevalence and incidence of methicillin-resistant Staphylococcus aureus col...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315595158
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Burn units are intensive care facilities specialized in the treatment of patients with severe burns. As burn injuries have a major impact in physical, psychosocial, and spiritual health, palliative care can be a strengthening component of integrated care. AIM:To review and appraise the existing evidence abo...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319862160
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Palliative care requires a multidisciplinary care team. General practitioners often ask specialised palliative home care teams for support. Working with specialised nurses offers learning opportunities, also called workplace learning. This can be enhanced by the presence of a learning facilitator. OBJECTIVE...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216314560391
更新日期:2015-05-01 00:00:00
abstract::The most commonly encountered clinical conditions presenting with cognitive failure (CF) are delirium, dementia and amnestic disorders. Of these, delirium is probably the most prevalent in palliative care, and it is potentially reversible. Thus, improvement in diagnostics seems warranted. The objectives of this review...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216304pm920oa
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Population ageing will lead to more deaths with an uncertain trajectory. Identifying patients at risk of dying could facilitate more effective care planning. AIM:To determine whether screening for likely death within 12 months is more effective using screening tools or intuition. DESIGN:Randomised controll...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216317698621
更新日期:2018-02-01 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:Previous findings implicated rumination (recurrent dwelling on abstract concerns) in elevated psychological distress in palliative patients. We hypothesised that reducing rumination may be important in addressing psychological distress in palliative care. AIM:This study tested the prediction that a brief gu...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216311414757
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. AIM:This study aimed to translate, ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311419987
更新日期:2012-10-01 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:BACKGROUND:No systematic meta-analysis is available on the prevalence of cancer patients' accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. AIM:To examine the prevalence of advanced/terminal cancer patients' accurate pro...
journal_title:Palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1177/0269216316663976
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS:(1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-o...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320967547
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. AIM:To ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320963941
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:in community studies the prevalence of depression is higher in women than men; however, in palliative care settings this relationship is usually less strong, absent or reversed. AIM:to identify reasons for excess depression among men receiving palliative care. DESIGN:cross-sectional study. SETTING/PARTICI...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311416035
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:While there have been some studies looking at the impact on quality of life of patients with idiopathic pulmonary fibrosis, to date no qualitative research looking at the specialist palliative needs of these patients has been conducted. AIM:This study aims to explore the specialist palliative care needs of ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313497226
更新日期:2013-10-01 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:Bereavement support is a key component of palliative care, with different types of support recommended according to need. Previous reviews have typically focused on specialised interventions and have not considered more generic forms of support, drawing on different research methodologies. AIM:To review the...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320920533
更新日期:2020-07-01 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::Prospective controlled clinical trials provide the highest level of evidence in palliative care. Both parallel and crossover studies have unique advantages and disadvantages. Excellent knowledge of the patient population, interventions and endpoints are useful in choosing the most appropriate trial. Open pilot studies...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576275
更新日期:2001-05-01 00:00:00
abstract::This is a review of tools that have been developed to assess pain in children, with a brief evaluation of their practicality and validity. There are some suggestions for the direction of future research in the development and use of the scales. ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/026921639701100503
更新日期:1997-09-01 00:00:00