Abstract:
CONTEXT:Evidence-based resource allocation is receiving increasing attention as we strive for equity, transparency, and cost-effectiveness across health care. In the context of finite resources, which of our patients with terminal illness should be prioritized for urgent palliative care? OBJECTIVES:To develop the scoring system for the novel Responding to Urgency of Need in Palliative Care triage tool. METHODS:Online international discrete choice experiment involving palliative care clinicians to establish the relative importance of seven key attributes of palliative care triage identified during an earlier qualitative study. RESULTS:Participants (n = 772) were mainly female (79.9%) with a decade of clinical experience. All attributes contributed significantly (all P-values < 0.001) and independently to clinician assessment of urgency. This study found physical suffering (coefficient 3.45; 95% confidence interval: 3.24 to 3.66) was the most important determinant of urgency, followed by imminent dying (coefficient 1.56; 1.43 to 1.69), psychological suffering (coefficient 1.49; 1.37 to 1.60), caregiver distress (coefficient 1.47; 1.35 to 1.59), discrepancy between care needs and care arrangements (coefficient 1.14; 1.02 to 1.26), mismatch between current and desired site of care (coefficient 0.94; 0.85 to 1.03), and unmet communication needs (coefficient 0.84; 0.76 to 0.92). CONCLUSION:Palliative care triage, which is complex and contextual, has been made more transparent through this discrete choice experiment. The Responding to Urgency of Need in Palliative Care triage tool provides an important step toward evidence-based assessment of priority for palliative care. Further research is underway to determine the validity of the tool in clinical practice and its impact on patient and caregiver outcomes.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Russell B,Vogrin S,Philip J,Hennessy-Anderson N,Collins A,Burchell J,Le B,Brand C,Hudson P,Sundararajan Vdoi
10.1016/j.jpainsymman.2019.08.009subject
Has Abstractpub_date
2020-01-01 00:00:00pages
95-104.e11issue
1eissn
0885-3924issn
1873-6513pii
S0885-3924(19)30455-5journal_volume
59pub_type
杂志文章abstract:CONTEXT:Patients with lung cancer who undergo chemotherapy (CTX) experience multiple symptoms. Evaluation of how these symptoms cluster together and how these symptom clusters change over time are salient questions in symptom clusters research. OBJECTIVES:The purposes of this analysis, in a sample of patients with lun...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.02.002
更新日期:2019-05-01 00:00:00
abstract:CONTEXT:Fatigue is highly prevalent in populations with advanced illness and is often associated with depressed mood. The role of psychostimulant therapy in the treatment of these conditions remains ill defined. OBJECTIVES:To evaluate the response of fatigue and depression in patients with advanced illness to titrated...
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.2011.03.026
更新日期:2012-01-01 00:00:00
abstract:CONTEXT:There are no previously published studies examining opioid doses administered to opioid-tolerant cancer patients during emergency department (ED) encounters. OBJECTIVES:To determine if opioid-tolerant cancer patients presenting with acute pain exacerbations receive adequate initial doses of as needed (PRN) opi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2017.07.013
更新日期:2017-10-01 00:00:00
abstract::Locked-in syndrome (LIS) is a rare neurologic disorder rendering an individual quadriplegic and anarthric with preserved self-awareness and normal if not near-normal cognition. A lesion to the ventral pons causes the classic form of LIS, and patients can typically interact with their environment with eye/eyelid moveme...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2015.10.021
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:We used a quality improvement framework to transform two-day and in-person advanced communication training (ACT) course into a remote ACT (Re-ACT) format to help clinicians improve serious illness conversation (SIC) skills. MEASURES:We assessed the reach, impact, and costs of Re-ACT and compared these measu...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.08.013
更新日期:2021-02-01 00:00:00
abstract::Good policies lay the groundwork for an effective health care system and society. They facilitate the implementation of palliative care programs aimed at providing care for all people in need of these services, and they ensure equitable access to affordable medications and therapies. The lack of good policies can lead...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2007.02.031
更新日期:2007-05-01 00:00:00
abstract::A cross-sectional study was conducted among 249 Chinese cancer patients with multiple diagnoses to validate a Chinese version of the Brief Fatigue Inventory (BFI-C). Cronbach's coefficient alpha was 0.92 for fatigue severity items and 0.90 for fatigue interference items. Construct validity was explored by principal fa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2003.09.008
更新日期:2004-04-01 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:CONTEXT:Although sporadic male predominance in hiccup patients has been reported, the association between gender differences and triggering factors has rarely been evaluated in patients with hiccups. OBJECTIVES:The aim of this study was to investigate whether gender differences exist in hiccup patients by analyzing al...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2015.09.013
更新日期:2016-02-01 00:00:00
abstract:CONTEXT:Many breast cancer patients have unmet informational and psychosocial needs after treatment completion. A psychoeducational intervention may be well suited to support these patients. OBJECTIVES:The purpose of this multicenter randomized controlled trial was to examine the effectiveness of a web-based tailored ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jpainsymman.2017.07.009
更新日期:2017-10-01 00:00:00
abstract:CONTEXT:Over the history of palliative care provision in Ireland, services have predominantly provided care to those with cancer. Previous estimates of palliative care need focused primarily on specialist palliative care and included only a limited number of nonmalignant diseases. OBJECTIVES:The primary aim of this st...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.09.011
更新日期:2015-04-01 00:00:00
abstract::A treatment program was developed involving cognitive and behavioral strategies for the treatment of migraine headaches with adolescents at the Children's Hospital of Eastern Ontario. These techniques include: a headache diary, progressive relaxation techniques, cognitive restructuring, distraction or attention focusi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(89)90007-9
更新日期:1989-09-01 00:00:00
abstract:CONTEXT:Important aspects of the palliative care needs of patients from low- and middle-income countries (LMIC) are largely unexplored. About 44 million of the 56 million annual deaths worldwide occur in developing countries, and it is estimated that more than 33 million of those concerned would benefit from palliative...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.05.023
更新日期:2010-01-01 00:00:00
abstract:CONTEXT:Chronic fatigue (CF) in breast cancer (BC) survivors is multifactorial and may be caused by immune activation triggered by BC or its treatment. In the Neoadjuvant Avastin in Breast Cancer study, BC patients received neoadjuvant chemotherapy (FEC100→taxane) ± bevacizumab, a monoclonal antibody with fatigue as a ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jpainsymman.2016.09.011
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Intensive care unit (ICU) care could be improved by implementation of time-triggered evidence-based interventions including identification of a patient/family medical decision maker, the patient's advance directive status, and cardiopulmonary resuscitation preferences by Day 1; offer of social work and spiri...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.06.012
更新日期:2011-11-01 00:00:00
abstract::The European Association for Palliative Care guidelines for treatment of cancer pain recommend a double dose (DD) of immediate-release morphine at bedtime instead of single doses (SD) repeated every four hours throughout the night. A previous open controlled study reported more side effects after DD than after SD. The...
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.2007.12.016
更新日期:2009-01-01 00:00:00
abstract::The need to treat dehydration in terminally ill patients to minimize symptom distress remains a controversial issue. Hypodermoclysis (HDC) is a simple technique for rehydration that offers many advantages over the intravenous route. In this prospective open study of 100 consecutive patients who died on a palliative ca...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/0885-3924(94)90187-2
更新日期:1994-07-01 00:00:00
abstract::Pain was measured and analgesic treatment examined in 131 children and adolescents, 8-17 years of age, for 5 days after surgery. Analgesic data were converted to 10 mg intramuscular morphine-equivalent doses (IMMSEQ) and were designated appropriate or inappropriate for body weight. Analgesic onset, peak, and duration ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(94)90161-9
更新日期:1994-02-01 00:00:00
abstract::This paper assesses different methods of evaluating pain management. We used the established methods of pain prevalence measurement and the Pain Management Index (PMI) to compare pain management between two groups who might be expected to have different outcomes. We also developed and used a method to assess how quick...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2006.05.024
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.02.015
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
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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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abstract::Several aspects of venipuncture technique were evaluated to assess their relationship to reported pain. Subjects were 514 children aged 5-17 who had venipuncture performed by a technician in a hospital outpatient laboratory. A research assistant timed the duration of venipuncture and then obtained visual analogue pain...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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abstract::Approximately 65% of women report hot flashes (HFs) during or following breast cancer treatment. However, few studies have compared the occurrence of vasomotor symptoms according to the type of adjuvant treatment received, and little is known about other risk factors for HFs among this population. This longitudinal st...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.04.010
更新日期:2009-04-01 00:00:00
abstract::The aim of this study was to evaluate the prevalence, severity, and management of pain in Korean patients with advanced cancer, and to identify the predictors of inadequate management of cancer pain in Korea. From 8 university hospitals, 655 patients with advanced cancer were surveyed. Information concerning analgesic...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
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更新日期:2003-05-01 00:00:00
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
abstract::This study describes a new clinical tool for needs assessment in palliative care: the Problems and Needs in Palliative Care questionnaire (PNPC). It was developed to support the provision of care tailored to the specific demands of patients, which only can be provided when their needs are clearly identified. To test v...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
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更新日期:2004-10-01 00:00:00
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2013.04.011
更新日期:2014-03-01 00:00:00
abstract::As more individuals are being treated for cancer with high-dose therapy and autologous stem cell rescue (ASCR), there is growing interest in treatment side effects and their impact on quality of life. The primary aim of this study was to determine if the severity of fatigue and its impact on quality of life is signifi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(99)00007-x
更新日期:1999-05-01 00:00:00
abstract:CONTEXT:Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID. OBJECTIVES:To describe MAID cli...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
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更新日期:2020-08-21 00:00:00