Abstract:
PURPOSE:To evaluate the perception of attending physicians, medical residents, and undergraduate medical students about death and dying, the end of life (EoL), and palliative care (PC) during training and clinical practice, highlighting knowledge gaps, and the changes needed in medical school curricula. METHOD:Cross-sectional study of 12 attending physicians, residents, and undergraduate medical students randomly selected from a single teaching hospital in São Paulo, Brazil, 2018. Semi-structured interviews were conducted, transcripts were coded in depth, and categorizing analysis was carried out. RESULTS:Three topical categories were recognized: Negative feelings about death and the EoL, importance of PC, and gaps in curricular structure hindering preparedness for PC and EoL communication. Besides differing perspectives depending on their years of experience, all participants strongly endorsed that the current medical school curriculum does not train and support physicians to handle EoL and PC. CONCLUSIONS:Medical education plays a fundamental role in the development of knowledge and skills on death, dying, and PC. Such practices should extend throughout the course and be continuously improved after graduates move to clinical practice.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Corradi MLG,Duim E,Rodrigues CISdoi
10.1177/0825859720923435subject
Has Abstractpub_date
2020-05-10 00:00:00pages
825859720923435eissn
0825-8597issn
2369-5293pub_type
杂志文章abstract::This paper addresses the music therapy process specific to one subgroup of the general population identified as having terminal illness. This subgroup includes individuals who are impoverished, homeless, and do not have someone to provide them with care at the end of life. Based upon her clinical work at Malachi House...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract::This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life car...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:10.1177/0825859719851483
更新日期:2020-04-01 00:00:00
abstract::Doctor-patient communication is a quintessential part of medical care. Yet, several factors challenge its effectiveness. The author, a third year Pediatrics resident, explores the ways medical education creates distance between doctors' and patients' ability to achieve mutual understanding in the clinical setting and ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718795438
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by pa...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718769099
更新日期:2018-07-01 00:00:00
abstract::This paper presents an overview of a qualitative study of six recently discharged hospice patients, who had experienced at least two episodes of inpatient palliative care and who were interviewed about their experience of care. The resulting data formed a representation--the Circle of Care--with a central theme being ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::In 1992, 82.2% of deaths in Alberta occurred in acute care hospitals or continuing care facilities. This paper outlines the end-of-life care of adult inpatients who died that year in four such facilities (n = 137). CPR was an infrequent end-of-life treatment modality (2.9%), in stark contrast to the extensive use of o...
journal_title:Journal of palliative care
pub_type: 杂志文章,多中心研究
doi:
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Little is known about current practice in using the anticonvulsant gabapentin in the management of cancer-related neuropathic pain. OBJECTIVES:The main objective of this study was to describe the pattern of gabapentin use as an adjuvant analgesic for cancer-related neuropathic pain in patients admitted to a...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract::Inpatient palliative care consultation has been demonstrated to improve quality of life as well as decrease hospital readmissions, intensive care unit transfers, and hospital costs for people with a life limiting illness. The clinical teaching units (CTUs) at London Health Sciences Centre (LHSC) routinely admit patien...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718781363
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The use of chemotherapy at the end of life in advanced cancer patients has increased and end of life care has become increasingly aggressive. The aim of this study is to evaluate patients receiving chemotherapy in the last 3 months of life and the aggressiveness of end-of-life support of these...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720946505
更新日期:2020-08-06 00:00:00
abstract:AIM:The aim of this study was to evaluate the utility of the Edmonton Symptom Assessment System (ESAS-r) Scale on a tertiary palliative care unit. METHOD:There were 92 admitted patients who participated in the study; the scale was administered to those able to participate on day 1 (n = 35, 38 percent), on day 4 (n = 2...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/082585971503100107
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Socioeconomic disparities in home death have been noted in the literature. Home-based palliative care increases access to home death and has been suggested as a means to decrease these disparities. AIM:Our study examines the association between socioeconomic status and other demographic factors on place of ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719855020
更新日期:2020-07-01 00:00:00
abstract::Historically, health and social care professionals have described their lack of competence and confidence in many aspects of palliative care, and have recognized the need for increased educational opportunities, where new skills can be acquired and existing knowledge consolidated. Redressing these omissions has led to...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Advance care planning is not well implemented in Belgian hospital practice. In order to obtain successful implementation, implementation theory states that the adopters should be involved in the implementation process. This information can serve as a basis for creating better implementation strategies. AIM:...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720938583
更新日期:2020-10-01 00:00:00
abstract::This study measures the proportion of cancer patients in Ontario, Canada, with intensive care unit (ICU) admissions, emergency room (ER) visits, or chemotherapy in the last two weeks of life. We used the Ontario Cancer Registry to identify a cohort of cancer patients who died in 2001. These cases were then linked to a...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to characterize the strategies and psychosocial conditions that influence how resilient people live in the face of advanced cancer. METHODS:Grounded theory interviews and a survey of 10 resilient people with advanced cancer were collected and analyzed. FINDINGS:Personal assets - including p...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2013-07-01 00:00:00
abstract::Current definitions of "symptom burden" are largely derived from clinicians, and there are many variations in the way the term is used, defined, and operationalized. The aim of this study was to explore patient perceptions of symptom burden in the context of advanced and incurable disease. A group of 58 cancer patient...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2012-07-01 00:00:00
abstract::There has been little research into pressure ulcer prevention and treatment in hospices. In this study, interviews with hospice directors of clinical services and direct-care nurses were analyzed using qualitative methods. Several general themes were found. Both pressure ulcer prevention and treatment can be painful t...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2003-04-01 00:00:00
abstract::Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at t...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2012-04-01 00:00:00
abstract::There may be quantitatively more cancer in the developing world, Africa included, than in the developed world. Unlike in the developed world, cancer patients in Africa present for treatment at a late stage and therefore most of them have pain. Yet, the most commonly used modality for treatment of the cancer pain is dr...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract::Health care workers often perceive a conflict between autonomy and beneficence when dealing with clients living at risk in the community. Respect for personal freedom and the desire to help and protect vulnerable people frequently appear to demand opposite interventions. The assessment of decision-making capacity is a...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:1998-04-01 00:00:00
abstract:INTRODUCTION:Health system restructuring combined with the preferences of many terminally ill care recipients and their caregivers has led to an increase in home-based palliative care, yet many care recipients die within institutional settings such as hospitals. This study sought to determine the place of death and its...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Patients with advanced chronic obstructive pulmonary disease (COPD) have a significant symptom burden despite maximal medical therapy, yet few are referred for concomitant palliative care. OBJECTIVE:To evaluate the utilization and impact of palliative care on the location of death and to identify clinical v...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719851486
更新日期:2019-07-02 00:00:00
abstract::With increasing trends towards home care of children with even the most complex conditions and care requirements, respite becomes critical in improving the quality of life for terminally ill children and their families. This article reports on the respite component of an evaluation project that examined the effect of ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::In Spain, there is a general tendency to conceal the prognosis from a terminally ill patient. We conducted grounded-theory-based, phenomenological, qualitative research on this using a final sample of 42 in-depth interviews with doctors and nurses from different fields. We found that most health professionals believe ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract::With recent changes in health care there is greater emphasis on providing care at home, including the support of families to enable more home deaths. Since a home death may not be practical or desirable in every family situation, there is a need for an objective way to assess the viability of a home death in each indi...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::Daily care involving proximity with a malodorous patient in the terminal stage of cancer has often proved difficult for the caregiver. Whatever the cause of the primary cancer, three sources of noxious odor can exist or coexist: necrosis, superinfection, and perspiration and/or discharge. The proposed treatment calls ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::A strong and often polarized debate has taken place during recent years concerning the consequences of dehydration in the terminally ill patient. When a patient has a severely restricted oral intake or is found to be dehydrated, the decision to administer fluids should be individualized and made on the basis of a care...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:1998-07-01 00:00:00
abstract:AIM:The aim of this study was to characterize the attitudes of older adults on an inpatient palliative care unit toward complementary and alternative medicine (CAM) therapies. METHODS:A consecutive sample of 33 inpatients (61 to 98 years old) completed a questionnaire that examined their attitudes toward CAM to determ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::Professional caregivers for cancer patients are at high risk for work-related stress, but it is not clear how this relates to exposure to death and dying, and to professional satisfaction. This study compares work-related stress and staff satisfaction on an academic acute palliative care unit (PCU) with that on a medi...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:There is a growing movement to increase palliative care consults from the emergency department (ED) to reduce healthcare costs and improve quality of life. The surprise question is a screening tool that emergency medicine physicians may be able to use towards achieving this goal. OBJECTIVE:The objectives of...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719866698
更新日期:2020-10-01 00:00:00