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 patients with noncurable cancer as well as end-stage heart, lung, liver, or kidney disease. However, the use of inpatient palliative care consultations for CTU patients remains unexamined. We conducted a descriptive study of all patients referred from LHSC CTU from both University and Victoria hospital to inpatient palliative care over a 1-year period from August 2013 to July 2014. The purpose of this study was to characterize the population and identify possible areas for quality improvement. In a 1-year period, 638 patients were referred from CTU to the inpatient palliative care consultation service. Of referrals, 55% died during their admission. Based on data collected, we conclude that many patients are referred early in their admission to CTU and patients are referred for a variety of noncancer diseases, suggesting knowledge and appreciation of the benefit of early palliative care consultation for malignant and nonmalignant disease. However, when further analyzed, there is indication that patients with noncancer diagnoses are referred statistically significantly later than those with a cancer diagnosis. The CTUs are sites of core medical training, and therefore, it is imperative that we model early integration of palliative care in order to continue to improve care of patients at end of life.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Maddison AR,Malik S,Smaggus Adoi
10.1177/0825859718781363subject
Has Abstractpub_date
2018-10-01 00:00:00pages
204-208issue
4eissn
0825-8597issn
2369-5293journal_volume
33pub_type
杂志文章abstract::Emergency department (ED) use is a quality-of-care indicator for community-based end-of-life (EOL) care. This study examined ED use by EOL home care clients. The sample included all EOL home care clients who received care from one community care access centre in Ontario, Canada. Information on health was gathered usin...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Despite the central role of hospice in end-of-life care, little is known about the proportion of terminally ill patients referred for hospice and the physician factors associated with hospice referral. METHODS:Cross-sectional data from a self-administered survey of 231 physicians were used to estimate the p...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Palliative care is one of the newer health specialties and continues to mature. While there has been remarkable progression of clinical skills and education, there has been a lack of focus on palliative care interdisciplinary leadership or development of leadership skills. This article highlights the importance of int...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718791427
更新日期:2018-08-16 00:00:00
abstract::In this paper I have described some of the recent developments in the growth of a patient/survivor movement in Canada. Arguments for the value of increased patient participation include providing a needed balance to the traditional medical perspective, addressing patient needs free from other vested interests, providi...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Morphine and hydromorphone infusions of 6 or more (average 25.75) days in duration were used with increasing frequency (up to 7%) by our oncology inpatients. Eighty-six percent of the 135 inpatients we reviewed realized good pain control with dose rates up to 700 morphine-equivalent (ME) mg/h. Local toxicity occurred ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::The essential mandate of medicine is the relief of suffering. However, the quest for an integrated model towards a conceptualization of suffering is still ongoing and empirical studies are few. Qualitative inquiry using 31 in-depth interviews and content analysis was carried out between 1999 and 2001 in 26 patients di...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Health professionals are expected to support family caregivers of patients requiring palliative care. However, there is a dearth of empirical evidence to help clinicians identify caregivers who might be at risk of poor psychosocial functioning. PURPOSE:This secondary analysis of baseline data from a larger ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2006-10-01 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::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::Informal hospice caregivers play a key role in managing patients' pain at home, but lack of adherence to doctor-prescribed analgesic regimens and medication errors are significant barriers to truly effective pain management. A digital pain diary may improve caregiver management of pain at home; however, most digital p...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859717722466
更新日期:2017-04-01 00:00:00
abstract::Caregivers are often overwhelmed by the strain of terminal caregiving. We wished to better understand the needs of terminal caregivers and to supply a basis for tailoring interventions to them during caregiving and early bereavement. This report provides a profile of 124 bereaved caregivers interviewed within three mo...
journal_title:Journal of palliative care
pub_type: 杂志文章,多中心研究
doi:
更新日期:1999-04-01 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: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:AIM:Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. MATERIALS...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718777375
更新日期:2018-07-01 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::Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn't be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718777325
更新日期:2018-10-01 00:00:00
abstract::The study assessed the components of high-quality HIV palliative care using the multidimensional model of quality assessment developed by Maxwell (4). Data collection consisted of interviews with individual subjects and focus groups. The interviews took place in three London health authorities. Seven service users and...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
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-s...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720923435
更新日期:2020-05-10 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: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::Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and disability worldwide. For many patients, maximal therapy for COPD produces only modest relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality, patients w...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:2005-10-01 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::A survey was conducted to determine what pharmaceutical services are provided to palliative care sites in Australia and Canada, and the pharmacist's role on the interdisciplinary team. Questionnaires were sent to 100 selected sites in each country. Questions pertained to demographics and the level of duties performed....
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::Although the consequences of prolonged lying on a hard surface are as old as the human race, publications on this subject are scarce. This is due to the fact that a decubitus ulcer never occurs in isolation but is nearly always a complication of some other condition. The term "decubitus" was already used by Hildnaus i...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1992-07-01 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: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::In 2006, the Indian Health Service (IHS) and the National Cancer Institute (NCI) collaborated to develop an interdisciplinary palliative training program for health professionals in the Indian health system. Their goal was to improve clinician knowledge and skills in palliative care, to train future trainers, and to i...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2010-04-01 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: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:AIM:By examining clinical parameters associated with survival time and analyzing patients' survival times using prognostic scores, this study aimed to provide helpful information related to the treatment of terminal cancer patients. METHODS:We retrospectively reviewed the medical records of 415 inpatients who died in ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2014-04-01 00:00:00