Abstract:
BACKGROUND:Hospitalizations in patients with metastatic cancer occur commonly at the end of life but have not been well-described in individuals with metastatic breast cancer. AIM:To describe the reasons for admission and frequency of palliative care and hospice utilization in hospitalized patients with metastatic breast cancer. DESIGN:This was a retrospective chart review of patients who had their first hospitalization with a diagnosis of metastatic breast cancer between 1 January 2009 and 31 December 2010. To standardize follow-up time, we collected data for 3 years post the index hospitalization. SETTING/PARTICIPANTS:We identified 123 consecutive patients who were hospitalized for the first time with a diagnosis of metastatic breast cancer at a single, tertiary care center. RESULTS:Uncontrolled symptoms accounted for half (50%, 62/123) of index admissions. The majority of patients died during the follow-up period (76%, 94/123), and the median time from index admission to death was 6 months (range: 0-34 months). Approximately half (53%, 50/94) died in the hospital or within 14 days of last hospital discharge, and less than one-third (29%, 27/94) were referred to hospice after their last hospitalization. The inpatient palliative care team evaluated 57% (54/94) of those who died at least once during an admission, but only 17% (16/94) of patients attended an outpatient palliative care appointment. CONCLUSIONS:Hospitalized patients with metastatic breast cancer are commonly admitted for uncontrolled symptoms and have a poor prognosis. However, only a minority receive outpatient palliative care or are referred to hospice during their last hospitalization prior to death.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Shin JA,Parkes A,El-Jawahri A,Traeger L,Knight H,Gallagher ER,Temel JSdoi
10.1177/0269216316637238subject
Has Abstractpub_date
2016-10-01 00:00:00pages
854-61issue
9eissn
0269-2163issn
1477-030Xpii
0269216316637238journal_volume
30pub_type
杂志文章abstract::The high prevalence of pain and other symptoms throughout the HIV disease trajectory, the need for management of side effects related to antiretroviral therapy, the continuing incidence of cancers and new emerging co-morbidities as a result of extended life expectancy under new therapeutic regimes, and the ongoing nee...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216305pm1005oa
更新日期:2005-04-01 00:00:00
abstract::Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdo...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216309106893
更新日期:2009-12-01 00:00:00
abstract::It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576176
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:The global prevalence of dementia is set to rise to almost 65 million people by 2030, providing policy makers and practitioners with significant challenges, not least within the realms of end-of-life care. The international literature would suggest that people with dementia may benefit from palliative forms ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311423443
更新日期:2012-10-01 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:In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/0269216305pm1002oa
更新日期:2005-04-01 00:00:00
abstract:STUDY OBJECTIVE:The Italian Survey of the Dying of Cancer (ISDOC) was undertaken to evaluate the experiences of Italian people dying from cancer during their last three months of life in all settings of care. STUDY DESIGN:A two-stage probability sample was used to estimate end-of-life outcomes of about 160 000 Italian...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1086oa
更新日期:2005-12-01 00:00:00
abstract::The presence of cognitive impairment in patients who are receiving hospice care can affect numerous practical, ethical and legal aspects of their healthcare. A number of factors can contribute to cognitive impairment in these patients. Prevalence rates of cognitive impairment vary widely, but it remains under-recognis...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308096907
更新日期:2008-10-01 00:00:00
abstract::This paper reviews the experience of managing 31 patients with severe dysphagia in motor neurone disease. Thirteen patients were fed nasogastrically and the remaining 18 were managed conservatively without a nasogastric tube. The introduction of nasogastric feeding led to the development of new problems in some patien...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800108
更新日期:1994-01-01 00:00:00
abstract::Attitudes to companion animals were surveyed among 50 patients and staff at a day care hospice. Dog visits were welcomed by all but two. Of the 37 patients studied, only seven had a companion animal, often their closest companion. Many more would like to keep an animal, but were prevented by age, frailty or accommodat...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639601000410
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:The WHO definitions of palliative care have been adopted in Denmark and implemented in The National Guidelines from 1999, but service developments have been very slow and not according to the recommendations. Attitudes to palliative care of Danish doctors and nurses may in part account for this. OBJECTIVE:T...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm988oa
更新日期:2005-03-01 00:00:00
abstract::Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understan...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216311399663
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, ...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216315588007
更新日期:2016-01-01 00:00:00
abstract::The McGill Quality of Life Questionnaire (MQOL) is a widely used tool that has been specifically developed to measure the quality of life of patients facing a life-threatening illness. Preferably, a self-report instrument has an equal number of items worded positively and negatively. However, all the psychological sca...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308094519
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. AIM:To explore the experiences of senior medical and nursing staff regarding the challenges a...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315573000
更新日期:2015-04-01 00:00:00
abstract::The purpose of this study is to analyze French general practitioners' attitudes toward prescribing opiate painkillers for dying patients and compare them with their attitudes toward making frequent home visits. One hundred and fifteen general practitioners indicated the acceptability of prescribing opiates in 48 scena...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309107012
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To explore the experiences of people involved in UK palliative care day services (PCDS) and identify the important outcomes of this service. METHODS:Focus groups were carried out separately with patients, informal carers and volunteers from four purposively selected palliative care day units and with day un...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm942oa
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Early palliative care improves quality of life during life-prolonging treatment for patients with cancer, but the role of nurses in facilitating the early involvement of palliative care is unclear. AIM:To conceptualize the psychosocial processes involved in the introduction and provision of palliative care ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319883980
更新日期:2020-02-01 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::In an era of ever increasing emphasis on cost-effectiveness of health care, and with the introduction of the internal market, there is now an urgent need for information on the costs and quality of palliative care. This paper highlights the complexities involved in acquiring and measuring such information and discusse...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800402
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Terminal illness not only causes physical suffering but also spiritual distress. Spiritual care has been widely implemented by healthcare professionals to assist patients coping with spiritual distress. However, the effects of spiritual care need to be clear. AIM:To evaluate the effects of spiritual care on...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318772267
更新日期:2018-07-01 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
abstract:BACKGROUND:Home-based care coordination and support programs for people with advanced illness work alongside usual care to promote personal care goals, which usually include a preference for home-based end-of-life care. More research is needed to confirm the efficacy of these programs, especially when disseminated on a...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317711824
更新日期:2018-02-01 00:00:00
abstract::This paper presents a qualitative study exploring the meaning of 'dignity' to patients, relatives and professionals. It examines the impact of advanced illness and treatment and the issues pertinent to caring for dignity. Depth interviews were conducted with eight patients, six relatives and seven members of the multi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm699oa
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. AIM:To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gap...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216314531999
更新日期:2014-10-01 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:BACKGROUND:Telehealth technologies are an emerging resource opening up the possibility of greater support if they have utility for patients, carers and clinicians. They may also help to meet health systems' imperatives for improved service delivery within current budgets. Clinicians' experiences and attitudes play a ke...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315600113
更新日期:2016-04-01 00:00:00
abstract::Despite the lack of clear benefits of feeding via gastrostomy tube in dementia patients, its use has been increasing. The views of health professionals, patients and their carers differ widely about the perceived benefits, which makes decision-making difficult and stressful. The palliative care approach of facilitatin...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216306071796
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Care relationships are crucial in tailoring the end-of-life care of a person with intellectual disabilities (ID) to their needs. Yet, almost all studies on end-of-life care for people with ID have been conducted among caregivers. The views of people with ID about care relationships at the end of life have no...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316640421
更新日期:2016-07-01 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