Abstract:
CONTEXT:Standardized outcomes that define successful advance care planning (ACP) are lacking. OBJECTIVE:The objective of this study was to create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. METHODS:This study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from five international ACP conferences to identify initial ACP outcome constructs. In five Delphi rounds, we asked panelists to rate patient-centered outcomes on a seven-point "not-at-all" to "extremely important" scale. We calculated means and analyzed panelists' input to finalize an Organizing Framework and outcome rankings. RESULTS:Organizing Framework outcome domains included process (e.g., attitudes), actions (e.g., discussions), quality of care (e.g., satisfaction), and health care (e.g., utilization). The top five outcomes included 1) care consistent with goals, mean 6.71 (±SD 0.04); 2) surrogate designation, 6.55 (0.45); 3) surrogate documentation, 6.50 (0.11); 4) discussions with surrogates, 6.40 (0.19); and 5) documents and recorded wishes are accessible when needed 6.27 (0.11). Advance directive documentation was ranked 10th, 6.01 (0.21). Panelists raised caution about whether "care consistent with goals" can be reliably measured. CONCLUSION:A large, multidisciplinary Delphi panel developed an Organizing Framework and rated the importance of ACP outcome constructs. Top rated outcomes should be used to evaluate the success of ACP initiatives. More research is needed to create reliable and valid measurement tools for the highest rated outcomes, particularly "care consistent with goals."
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Sudore RL,Heyland DK,Lum HD,Rietjens JAC,Korfage IJ,Ritchie CS,Hanson LC,Meier DE,Pantilat SZ,Lorenz K,Howard M,Green MJ,Simon JE,Feuz MA,You JJdoi
10.1016/j.jpainsymman.2017.08.025subject
Has Abstractpub_date
2018-02-01 00:00:00pages
245-255.e8issue
2eissn
0885-3924issn
1873-6513pii
S0885-3924(17)30431-1journal_volume
55pub_type
共识发展会议,杂志文章abstract::Thoracentesis plays an important role in cancer patients with symptomatic effusions, although its effect is short-lived and symptoms recur in almost all patients. Early video-thoracoscopic surgical pleurodesis may provide added benefit to a group of patients with advanced cancer presenting with symptomatic malignant p...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpainsymman.2005.01.015
更新日期:2005-07-01 00:00:00
abstract::The purpose of this study was to describe hospice social workers' perceptions of cases where hospice patients or their family members expressed a desire to hasten the patient's death. Surveys were mailed to hospice social workers (n=212) in two Southeastern states. Response rate was 36%. Of the 73 respondents, 56.2% h...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2003.10.010
更新日期:2004-06-01 00:00:00
abstract::Radiotherapy is an indispensable modality in the palliation of cancer. All palliative care programs should be acquainted with its indications and have a close working relationship with a radiation oncology department. The technical aspects of the subject may be intimidating to many staff and patients, and departments ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/0885-3924(91)90030-8
更新日期:1991-08-01 00:00:00
abstract::The authors report the data from two studies on the use of controlled-release morphine sulphate tablets for cancer pain relief. This preparation allows just two administrations per day, in comparison with immediate release oral aqueous morphine solution. The first study, a randomized trial carried out on 70 patients s...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0885-3924(89)90005-5
更新日期:1989-09-01 00:00:00
abstract::Perception of discomfort in dying patients is a risk factor for distress and bereavement among relatives. This study determined the perception of discomfort, the frequency of observed behaviors, and their association among relatives and among nurses who care for unresponsive dying patients. Sixty unresponsive dying pa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(03)00286-0
更新日期:2003-09-01 00:00:00
abstract::Data on pain prevalence and severity were collected prospectively from advanced cancer patients as an integral part of two service evaluations. Six multidisciplinary palliative care teams working in Ireland formed the basis of one study and five teams based in the South of England were included in the second. A total ...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究,评审
doi:10.1016/S0885-3924(97)00006-7
更新日期:1997-07-01 00:00:00
abstract:CONTEXT:Oxaliplatin-induced peripheral neuropathy (OIPN) is a dose-limiting toxicity of oxaliplatin and affects most colorectal cancer patients. OIPN is commonly evaluated by patient symptom report, using scales to reflect impairment. They do not discriminate between unique grouping of symptoms and signs, which impedes...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2017.07.033
更新日期:2017-11-01 00:00:00
abstract:CONTEXT:The prevalence of neuropathic pain in patients with cancer pain has been estimated to be around 40%. Neuropathic pain may be caused by tumor invasion and is considered as mixed nociceptive-neuropathic pain, or caused by an anticancer treatment and considered as purely neuropathic pain. The use of adjuvant analg...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2012.10.230
更新日期:2013-10-01 00:00:00
abstract:CONTEXT:Recent analyses of Medicare data show decreases over time in intensity of end-of-life care. Few studies exist regarding trends in intensity of end-of-life care for those under 65 years of age. OBJECTIVES:To examine recent temporal trends in place of death, and both hospital and intensive care unit (ICU) utiliz...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.08.032
更新日期:2018-01-01 00:00:00
abstract:CONTEXT:The Centers for Medicare & Medicaid Services have elected to include a bereaved family member survey in public reporting of hospice quality data as mandated in the Affordable Care Act. However, it is not known what time point after death offers the most reliable responses. OBJECTIVES:To examine the stability o...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2015.01.006
更新日期:2015-07-01 00:00:00
abstract:CONTEXT:Both maintaining hope and preparing for the patient's death are important for families of terminally ill cancer patients. OBJECTIVES:The primary aim of this study was to clarify the level of the family's achievement of maintaining hope and preparing for death and the professional's behavior related to their ev...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.05.014
更新日期:2013-05-01 00:00:00
abstract::Palliative care services provided to patients and families vary substantially across hospices. Literature suggests regulation can act as a standardizing force in health care delivery. However, little is known about the effect of regulation on the delivery of palliative care in hospice and whether its effect differs fo...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.09.014
更新日期:2008-08-01 00:00:00
abstract::The effect of iontophoretic administration of vincristine in the treatment of postherpetic neuralgia (PHN) was investigated in a prospective, double-blind, placebo-controlled trial. Twenty patients with intercostal or lumbar PHN for more than 6 months that was unresponsive to conventional medical therapy were randomiz...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1999-03-01 00:00:00
abstract:CONTEXT:Pain is common among patients with advanced cancer despite the dissemination of clinical pain care guidelines. OBJECTIVES:We sought to assess the quality of pain care among patients with advanced disease. METHODS:We reviewed the records of 85 adult ambulatory patients with advanced breast, lung, and gastroint...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.06.022
更新日期:2012-06-01 00:00:00
abstract::The Wisconsin Cancer Pain Initiative was established in 1986 to address the various public and professional barriers to cancer pain management. This report discusses the initiative's model for physician education, which includes increasing factual knowledge, legitimizing cancer pain as an important treatment priority,...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(91)90044-5
更新日期:1991-10-01 00:00:00
abstract:CONTEXT:Although idiopathic pulmonary fibrosis (IPF) has worse outcomes compared with most malignancies, patients with IPF receive poor access to optimal palliative care. OBJECTIVES:This study aimed to characterize the practice of pulmonologists regarding palliative care and end-of-life communication for patients with...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.06.012
更新日期:2020-11-01 00:00:00
abstract:CONTEXT:This scoping review maps the existing literature on narrative interventions within a palliative care and end-of-life context. OBJECTIVES:A scoping review was performed to address the following research question: What observational or randomized controlled trials have been performed to evaluate narrative interv...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2019.06.009
更新日期:2019-10-01 00:00:00
abstract:CONTEXT:There is an increasing use of palliative care units (PCUs) for the treatment of terminally ill cancer patients. Thus, it is important to evaluate the care and quality of life of terminally ill cancer patients treated in PCUs so that improvements can be made. Limited research has investigated the quality of dyin...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.04.010
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abstract:CONTEXT:Chinese medicine modalities, including acupuncture and Chinese herbal medicine (CHM), have been used as palliative interventions among cancer patients. More research should be conducted to confirm their effectiveness. OBJECTIVES:The objective of this study was to prioritize Chinese medicine clinical research q...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.08.002
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abstract:CONTEXT:Limited information is available about lung cancer patients' symptoms in the pre- and postoperative periods. OBJECTIVES:Study purposes were to evaluate for changes in symptom occurrence and severity from the preoperative period to five months after surgery and to evaluate for predictors of the occurrence and t...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.11.297
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.09.020
更新日期:2020-02-01 00:00:00
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(99)00038-x
更新日期:1999-08-01 00:00:00
abstract::In 2011, Rwanda's Ministry of Health set a goal of universal access to palliative care by 2020. Toward this audacious egalitarian and humanitarian goal, the Ministry of Health worked with partners to develop palliative care policies and a strategic plan, secure adequate supplies of opioid for the country, initiate pal...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.03.037
更新日期:2018-02-01 00:00:00
abstract::Pruritus is a common opioid side effect and can be so severe that opioid therapy must be modified or abandoned. Antihistamines, opioid antagonists, and propofol have been proposed as treatment options, but none is universally effective. The use of intranasal butorphanol, an opioid agonist-antagonist, for pruritus has ...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/0885-3924(96)00154-6
更新日期:1996-10-01 00:00:00
abstract::Accurate pain assessment is considered essential for effective management of cancer pain. The aim of this study was to evaluate the compliance of hospitalized patients with chronic cancer pain, referred to an inpatient palliative care consultation service, with self-assessment of pain intensity by means of a daily pai...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpainsymman.2004.01.002
更新日期:2004-05-01 00:00:00
abstract:CONTEXT:Dyspnea is one of the most distressing symptoms in patients with cancer, and often worsens with breakthrough episodes on exertion. We hypothesized that fentanyl given prophylactically may alleviate breakthrough dyspnea. OBJECTIVES:To determine the feasibility of conducting a randomized trial of subcutaneous fe...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2013.03.017
更新日期:2014-02-01 00:00:00
abstract::This study was done to examine the level of symptom experience, and symptom variation in relation to demographic and clinical variables, in Korean patients with liver cirrhosis (LC). Symptom experience was measured using a scale developed by the researchers through a literature review on LC. Participants were 129 pati...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2005.08.015
更新日期:2006-04-01 00:00:00
abstract:CONTEXT:Most deaths in intensive care units occur after limitation or withdrawal of life-sustaining therapies. Often these patients require opioids to assuage suffering; yet, little has been documented concerning their use in the medical intensive care unit. OBJECTIVES:To determine the dose and factors influencing the...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2010.10.256
更新日期:2011-07-01 00:00:00
abstract:CONTEXT:Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams. OBJECTIVES:The primary aim of thi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2014.10.010
更新日期:2015-05-01 00:00:00
abstract::The purpose of this study was to evaluate the technical possibilities of placing a catheter near the celiac plexus for performance of a celiac plexus block, and to study the efficacy of repeated neurolytic celiac plexus blocks with alcohol in patients with advanced pancreatic cancer pain resistant to opioid treatment....
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/s0885-3924(01)00338-4
更新日期:2001-11-01 00:00:00