Abstract:
BACKGROUND:End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. AIM:To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. DESIGN:Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire. Participants were classified as insufficient or sufficient implantable cardioverter defibrillator knowledge and the two groups were compared. SETTING/PARTICIPANTS:Implantable cardioverter defibrillator recipients ( n = 270, mean age 61 ± 14 years; 73% male) were recruited from cardiology and implantable cardioverter defibrillator clinics attached to two tertiary hospitals in Melbourne, Australia, and two in Kentucky, the United States. RESULTS:Participants with insufficient implantable cardioverter defibrillator knowledge ( n = 77, 29%) were significantly older (mean age 66 vs 60 years, p = 0.001), less likely to be Caucasian (77% vs 87%, p = 0.047), less likely to have received implantable cardioverter defibrillator shocks (26% vs 40%, p = 0.031), and more likely to have indications of mild cognitive impairment (Montreal Cognitive Assessment score <24: 44% vs 16%, p < 0.001). Insufficient implantable cardioverter defibrillator knowledge was associated with attitudes suggesting unwillingness to discuss implantable cardioverter defibrillator deactivation, even during the last days towards end of life ( p < 0.05). CONCLUSION:Implantable cardioverter defibrillator recipients, especially those who are older or have mild cognitive impairment, often have limited knowledge about implantable cardioverter defibrillator deactivation. This study identified several potential teachable moments throughout the patients' treatment trajectory. An interdisciplinary approach is required to ensure that discussions about implantable cardioverter defibrillator deactivation issues are initiated at appropriate time points, with family members ideally also included.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
McEvedy SM,Cameron J,Lugg E,Miller J,Haedtke C,Hammash M,Biddle MJ,Lee KS,Mariani JA,Ski CF,Thompson DR,Chung ML,Moser DKdoi
10.1177/0269216317718438subject
Has Abstractpub_date
2018-01-01 00:00:00pages
156-163issue
1eissn
0269-2163issn
1477-030Xjournal_volume
32pub_type
杂志文章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::The quality of research, and the resulting quality of evidence available to guide palliative care, is dependent on the ethical decisions underpinning its design, conduct and report. Whilst much has been published debating the ethics of palliative care research, an assessment of the quality and synthesis of the central...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216309352714
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Specialist palliative care (SPC) services in Ireland are well developed by international standards. However, standardized information on all patients of SPC services is not collected so the proportion of patients seen with a noncancer diagnosis is just an estimate at 5%. AIMS:To describe Irish SPC services'...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216307084609
更新日期:2008-01-01 00:00:00
abstract::Cyclizine is an antihistamine, which is frequently used to manage nausea and vomiting in cancer patients. Antihistamines can be drugs of misuse/abuse, and the article describes four cancer patients who developed such problems after receiving parenteral cyclizine within the inpatient unit of a cancer centre. The articl...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216308094337
更新日期:2008-10-01 00:00:00
abstract::This retrospective study examined the influence of a hospital palliative care team on the activity of a local hospice home care team over a four-year period from May 1989 to April 1993 in East Leeds. The increasing referral to death interval observed in home care patients over this period appears to be due to the pres...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800308
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Of deaths in high-income countries, 75% are caused by progressive advanced chronic conditions. Palliative care needs to be extended from terminal cancer to these patients. However, direct measurement of the prevalence of people in need of palliative care in the population has not been attempted. AIM:Determi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313518266
更新日期:2014-04-01 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::This study looked at the efficacy of drug treatment in managing death rattle in a 30-bedded specialist palliative care unit. The study was conducted in two phases. In the first, patients received hyoscine hydrobromide as the antimuscarinic; glycopyrrolate was used in the second phase. The patients in the two phases we...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章
doi:10.1191/026921601678320313
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311408993
更新日期:2012-04-01 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:Little is known about the attitudes of healthcare professional students' perceived competence and confidence in treating those with dementia who are at the end of life. AIM:To explore the attitudes of final year medical, nursing and pharmacy students towards people with dementia and to evaluate their percei...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313483661
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Policy guidance and bioethical literature urge the involvement of adolescents in decisions about their healthcare. It is uncertain how roles and expectations of adolescents, parents and healthcare professionals influence decision-making and to what extent this is considered in guidance. AIMS:To identify rec...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216316648072
更新日期:2016-12-01 00:00:00
abstract::To be able to distinguish end-stage palliative sedation from euthanasia without having to refer to intentions that are difficult to verify, physicians must be able to manage palliative sedation appropriately (i.e., see that death is not hastened as a result of disproportionate medication). In the present study, we ass...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308091867
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Constipation affects many patients receiving long-term opioid therapy for cancer pain. Little is known about the nature of psychological distress and the burden associated with this problem. This information may inform the development of effective treatment strategies and ameliorate distress. AIM:The object...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312450358
更新日期:2013-05-01 00:00:00
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 completio...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315575679
更新日期:2015-09-01 00:00:00
abstract::Little is known about the lived health-care experiences of persons living with palliative stage Parkinson's disease and the family members who care for them. An exploratory phenomenological investigation was adopted to understand participant's lived health-care experiences and the needs flowing from them. Three family...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308100773
更新日期:2009-03-01 00:00:00
abstract::Separate accounts of care were recorded weekly from staff, patients and relatives in a randomised sample of patients with terminal cancer referred to a home care service with readily available beds. Various services were involved but nurses made most contacts, 3.0 visits and 2.4 phone calls weekly, rising sharply in t...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639601000207
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Informal caregivers of people with motor neurone disease (MND) take on an extensive role. Caregivers are at increased risk of experiencing psychological distress and burden, yet, there is a lack of intervention programmes to support them. AIM:The aim of this study was to investigate the feasibility and acce...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317743434
更新日期:2018-04-01 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:BACKGROUND:The primary goal of palliative care is to optimize the quality of life (QOL) of people living with a life-threatening illness and that of their families. While there have been important advances in measurement of the QOL of palliative care patients, little attention has been paid to the QOL of their carers (...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216306072764
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM:To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual mod...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319840275
更新日期:2019-06-01 00:00:00
abstract::The factors related to admission of patients with terminal cancer who had been referred to a reputable home care service were examined in 415 patients referred in a two-year period and in a prospective study of a randomized one in three sample of the 232 adults still alive one week after referral, who were able to con...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/026921639400800303
更新日期:1994-01-01 00:00:00
abstract::Objective of this study is to examine physicians' practices regarding information disclosure to terminally ill patients and to their relatives, without informing the patient. A questionnaire had been sent to a random sample of 3014 Belgian physicians from different specialties frequently involved in end-of-life care. ...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308102043
更新日期:2009-06-01 00:00:00
abstract::This study reports UK doctors' opinions about legalisation of medically assisted dying (euthanasia and physician-assisted suicide), comparing this with the UK general public. A postal survey of 3733 UK medical practitioners was done. The majority of UK doctors are opposed to legalisation, contrasting with the UK gener...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308102041
更新日期:2009-04-01 00:00:00
abstract::The purpose of this study was to further validate a novel instrument to measure satisfaction with end-of-life care, called the Canadian Health Care Evaluation Project (CANHELP) questionnaire. Data were collected by a cross-sectional survey of patients who had advanced, life-limiting illnesses and their family caregive...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310373168
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. AIM:To explore the type and prevalence of bar...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319865414
更新日期:2019-10-01 00:00:00
abstract::Comprehensive palliative care programs are often implemented on a community level, and to evaluate such interventions, randomization by cluster (community) may be the only feasible method. In trials randomizing individual subjects, the importance of proper concealment has been stressed. In cluster randomized trials, h...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1191/0269216302pm523oa
更新日期:2002-01-01 00:00:00
abstract::The relationship between opioid dose, dantron dose, bowel function and physical functioning (measured with the modified Barthel Index) was determined in a sample of 50 inpatients with advanced cancer. Data were collected prospectively from chart review and patient interviews one week after admission to allow for proto...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm773oa
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Patient misunderstandings about prognosis may be related to lack of communication. AIM:This study aimed to examine prognosis discussions held with hospitalized patients for whom palliative care consultations were requested, and if prognosis discussions did not occur, to explore why not. DESIGN:This was a s...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313514126
更新日期:2014-04-01 00:00:00
abstract::This systematic review evaluates the evidence underpinning the provision of palliative day care services (PDS) to determine whether such services have a measurable effect on attendees' wellbeing. The majority of studies reviewed were qualitative and elicited individual perceptions of the benefits PDS. Although it was ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216310381796
更新日期:2011-03-01 00:00:00