Abstract：
: Background: Although community-based serious-illness care (CBSC) is an innovative care model, it is unclear to what extent CBSC addresses palliative care needs, particularly for those patients near death. Objectives: To evaluate palliative care services of a CBSC program. Design: Retrospective chart reviews. Setting/Subjects: Patients enrolled in a CBSC program in central North Carolina. Measurement: Descriptive statistics of palliative care needs and services, such as symptom management, psychosocial support, and advance care planning (ACP), for survivors and decedents. Results: Patients were seen in an 18-month time frame (n = 159). Mean enrollment in the program was 261.1 days (standard deviation 180.6). Patients' average age was 70 years, 56% were female, and 33% were black. Patients' most frequent comorbidities were dementia (32%), heart failure (32%), and diabetes (28%). Fifty patients (31%) died during the study period. Clinicians most frequently screened for pain (70%), constipation (57%), and dyspnea (57%). Of those screened positive, clinicians most frequently treated pain (92%), anxiety (84%), and constipation (83%). Among the 54% who screened positive for psychosocial distress, 82% received support. Clinicians screened 22% for spiritual needs; 4% received spiritual care. Among decedents, 66% were enrolled in hospice; 14% died in in-hospital. Decedents were more likely than survivors to have ACP (34% vs. 18%, p = 0.03) and a primary goal of comfort (40% vs. 12%, p < 0.01). Conclusions: A CBSC program provided palliative care services comparable with other home-based palliative care programs. Although the CBSC program does not address all domains of palliative care, it provided most with symptom management, psychosocial support, and ACP.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Ernecoff NC,Hanson LC,Fox AL,Daaleman TP,Kistler CEdoi
10.1089/jpm.2019.0174subject
Has Abstractpub_date
2020-05-01 00:00:00pages
692-697issue
5eissn
1096-6218issn
1557-7740journal_volume
23pub_type
杂志文章abstract：: Background: Despite positive outcomes associated with specialist palliative care (PC) in diverse medical populations, little research has investigated specialist PC in surgical ones. Although cancer surgery is predominantly safe, operations can be extensive and unpredictab...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1089/jpm.2019.0130
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVES:Continuity, coordination, and transitions of care are key to high-quality medical care for patients with serious and advanced illness. We conducted a systematic review to evaluate the impact of interventions targeting these areas in this population. METHODS:We searched PubMed, CINAHL, PsycINFO, Cochrane, an...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1089/jpm.2012.0317
更新日期：2013-04-01 00:00:00
abstract：: Background: Aggressive care at the end of life (EOL) is a persistent issue for patients with stage IV nonsmall cell lung cancer (NSCLC). We evaluated the use of concurrent care (CC) with hospice care and cancer-directed treatment simultaneously within the Veteran's Health ...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2019.0485
更新日期：2020-08-01 00:00:00
abstract：: Background: Although there is growing evidence that close reading of literature and reflective writing can improve providers' appreciation of the patient experience, foster physician development, and combat burnout, there has been less work on the experience of reading lit...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2020.0078
更新日期：2020-08-19 00:00:00
abstract：: Background: The COVID-19 pandemic has created an environment in which existence is more fragile and existential fears or terror rises in people. Objective: Managing existential terror calls for being mature about mortality, som...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2020.0263
更新日期：2020-06-17 00:00:00
abstract：BACKGROUND:Living at home is an important factor for maintaining high quality of life among patients. Many studies have discussed parameters associated with place of death, but no studies have yet clarified which factors influence the length of stay at home during the end of life. OBJECTIVE:The aim of this study was t...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2016.0455
更新日期：2017-08-01 00:00:00
abstract：:It has frequently been claimed that palliative care (PC) consultation services reduce hospital length of stay (LOS). We review 12 published studies comparing patients receiving PC or similar intervention and patients receiving usual care with regard to average total hospital LOS. None of the six observational studies ...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,评审
doi：10.1089/jpm.2009.0379
更新日期：2010-06-01 00:00:00
abstract：PURPOSE:Rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors and negatively impacts quality of life. This single-institution study sought to explore how rash is currently managed outside a clinical trial setting and to further characterize general clinical aspects of this rash. MET...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2010.0258
更新日期：2011-02-01 00:00:00
abstract：BACKGROUND:Advanced cancer can erode patients' wellbeing. Narrative interventions have improved patients' wellbeing, but might not be feasible for widespread implementation. OBJECTIVES:(1) Test the effects of miLivingStory, a telephone-based life review and illness narrative intervention with online resources and soci...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,随机对照试验
doi：10.1089/jpm.2017.0007
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Key to high-quality care of dying hospice patients at home is whether the hospice provides adequate training so the caregiver can safely care for the patient. OBJECTIVE:The study objective was to develop and validate a survey of hospice training for caregivers to ensure safe, high-quality care in the home s...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2015.0185
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Antibiotic administration is frequent in terminal patients with cancer, yet the effects on survival are still under debate. OBJECTIVE:The aim of this study was to examine the status of infection and the benefit/burden of antibiotic administration on the survival of terminal patients with cancer with infecti...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2012.0634
更新日期：2013-11-01 00:00:00
abstract：: Background: There are substantial disparities in distribution of palliative care (PC) services within Latin America, with Bolivia historically lagging behind neighboring countries in PC metrics. Comprehensive data on PC in Bolivia were last collected in 2012 through the La...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2020.0169
更新日期：2020-09-21 00:00:00
abstract：INTRODUCTION:The World Health Organization (WHO) explicitly recommends the integration of palliative care (PC) early in the disease trajectory as part of the WHO definition of PC. Our comprehensive cancer center decided: (1) to include this recommendation in the administrative directives for principles of cancer care a...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2010.0016
更新日期：2010-10-01 00:00:00
abstract：PURPOSE:There have been no studies to date that examine physicians' decisions to withdraw life-sustaining treatment for patients based on their surrogates' financial gain. The authors' objective was to ascertain physician attitudes about withdrawing life-sustaining treatment when financial considerations are involved. ...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2013.0361
更新日期：2014-05-01 00:00:00
abstract：INTRODUCTION:The concept of hope in palliative care is an important and neglected area of research. Amyotrophic lateral sclerosis (ALS), a progressive degenerative motor neuron disease, offers an excellent opportunity to study this construct as the illness is virtually always fatal. Our research explored the meaning of...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2007.0098
更新日期：2008-04-01 00:00:00
abstract：BACKGROUND:Although an interdisciplinary approach is considered best practice for caring for patients at the end of life, or in need of palliative care (PC) services, there is growing tension between healthcare organizations' need to contain costs and the provision of this beneficial, yet resource-intensive service. O...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2015.0398
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:Empirical research suggests that the quality of patient care at the end of life (EOL) is influenced by the effectiveness of the collaboration between the general practitioners (GPs) and hospital physicians (HPs). AIM:To identify possible difficulties and barriers to effective collaboration at the EOL betwee...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2015.0377
更新日期：2016-09-01 00:00:00
abstract：:For most families, the preferred location of death for their child is home, yet most children still die in the hospital. Many children with life-threatening and life-limiting illness are medically dependent on technology, and palliative transport can serve as a bridge from the intensive care unit to the family's home ...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2018.0301
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Transfusion is not an exceptional circumstance in palliative cancer patients (PCPs). This makes it necessary to confront not only medical aspects but also those of infrastructure and ethical issues. On some occasions, literature needs to be consulted to work out the best approach in a patient's particular ca...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,评审
doi：10.1089/jpm.2013.0387
更新日期：2014-01-01 00:00:00
abstract：: Objective: To systematically capture patient- and family-centered data to understand variability and opportunities in end-of-life care delivery across settings in an integrated health care delivery system. Background: Improving...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2019.0265
更新日期：2020-06-01 00:00:00
abstract：OBJECTIVE:It is not known how often physicians use metaphors and analogies, or whether they improve patients' perceptions of their physicians' ability to communicate effectively. Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated w...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2009.0221
更新日期：2010-03-01 00:00:00
abstract：CONTEXT:Research shows an increased symptom burden in young adult (YA) cancer patients compared with their older adult counterpart. OBJECTIVES:The purpose of this study was to identify differences in clinical characteristics and related outcomes between YA and older adult cancer patients admitted for cancer-related pa...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2018.0212
更新日期：2019-03-01 00:00:00
abstract：INTRODUCTION:Methadone (ME) is a highly effective opioid agonist used for difficult pain syndromes. However, in the management of cancer pain with strong opioids, rotation to a different opioid (opioid rotation) may be required because of side effects or poor pain control. Rotation from methadone to another opioid has ...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2007.0285
更新日期：2008-10-01 00:00:00
abstract：: Introduction: The concept of total suffering is well known to palliative care, and it indicates that there are several complex and correlated factors, which contribute to a dynamic and unique experience of one's illness trajectory. Research on terminally ill patients' will...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2019.0137
更新日期：2020-05-01 00:00:00
abstract：BACKGROUND:The Palliative Performance Scale (PPS) is a tool that is widely used to predict end of life. In Ontario, Canada, the PPS is used to mark the terminal phase of life and eligibility for terminal care. OBJECTIVE:The aim of this retrospective study was to confirm that a PPS level of 40% can be used as a marker ...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2013.0645
更新日期：2015-01-01 00:00:00
abstract：PURPOSE:To summarize evidence on conservative, nondialytic management of end-stage renal disease regarding 1) prognosis and 2) symptom burden and quality of life (QOL). METHODS:Medline, Cinahl, and Cochrane were searched for records indexed prior to March 1, 2011. Bibliographies of articles and abstracts from recent m...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,评审
doi：10.1089/jpm.2011.0207
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Palliative chemotherapy is often administered to terminally ill cancer patients to relieve symptoms. Yet, unnecessary use of chemotherapy can worsen patients' quality of life due to treatment-related toxicities. Thus, accurate prediction of survival in terminally ill patients can help clinicians decide on th...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2011.0417
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:The evidence base to support palliative care clinical practice is inadequate and opportunities to improve the palliative care evidence base remain despite the field's rapid growth. OBJECTIVE:To examine current NIH funding of palliative medicine research, changes since our 2013 report, and trends since our 2...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2017.0287
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Standardized approaches for assessing and classifying cancer pain are required to improve treatment of patients with complex pain profiles. The Edmonton Classification System for Cancer Pain (ECS-CP) offers a starting point for the evolution of a standardized international classification system for cancer pa...
journal_title：Journal of palliative medicine
pub_type： 杂志文章,多中心研究
doi：10.1089/jpm.2012.0390
更新日期：2013-05-01 00:00:00
abstract：OBJECTIVE:To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. DESIGN:Electronic health record-based retrospective cohort study. SETTING:Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Compara...
journal_title：Journal of palliative medicine
pub_type： 杂志文章
doi：10.1089/jpm.2013.0631
更新日期：2014-08-01 00:00:00
