Abstract:
:When dying patients are young adults or have a contagious disease, nursing staff may feel acutely uncomfortable and the patients may become isolated and alone. Nurses who work in palliative care units (PCU) develop special interactive skills that are generally acknowledged but not clearly defined or understood. Admission of patients with Acquired Immune Deficiency Syndrome (AIDS) to the PCU was expected to provide a unique opportunity for study. The project was an analysis of nurse-patient verbal interactions during physical care for the purpose of understanding communication patterns during the longest usual block of uninterrupted time nurses spend with patients. Included were six terminally ill patients with AIDS in an acute medical unit and nine other patients of differing ages in the medical unit and PCU. Data were tape recordings of up to six hours with each patient, a total of 78 days of taping. These were transcribed and analyzed to examine the content of interactions and communication techniques for identification of themes. The major overall themes were control, well-being, humor, uncertainty, and routines. The process themes identified were validation, problem solving, and therapeutic interaction. A framework for analysis of the relational messages of control was developed and detailed analysis conducted. The most frequent behavior was that of nurses offering control. Nurses and patients took control with approximately the same frequency, and by far the least frequent situation was that of the patient offering control to the nurse. The complexities of dying with a disease such as AIDS have made the care of these patients extremely demanding for all concerned. This analysis will help to delineate the content and process of nurse-patient interaction which is basic to comprehensive care of all patients.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Pepler CJ,Lynch Asubject
Has Abstractpub_date
1991-04-01 00:00:00pages
18-29issue
1eissn
0825-8597issn
2369-5293journal_volume
7pub_type
杂志文章abstract::Comfort care for cancer patients in the terminal stage has been the goal of hospice programs since their inception. Among the many treatment modalities available to homebound patients, transfusions have been little studied for their effects on advanced disease symptoms, particularly for those in the terminal phase. Ou...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Morphine and hydromorphone infusions of 6 or more (average 25.75) days in duration were used with increasing frequency (up to 7%) by our oncology inpatients. Eighty-six percent of the 135 inpatients we reviewed realized good pain control with dose rates up to 700 morphine-equivalent (ME) mg/h. Local toxicity occurred ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::The study assessed the components of high-quality HIV palliative care using the multidimensional model of quality assessment developed by Maxwell (4). Data collection consisted of interviews with individual subjects and focus groups. The interviews took place in three London health authorities. Seven service users and...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::In 2006, the Indian Health Service (IHS) and the National Cancer Institute (NCI) collaborated to develop an interdisciplinary palliative training program for health professionals in the Indian health system. Their goal was to improve clinician knowledge and skills in palliative care, to train future trainers, and to i...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract::Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at t...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Practice guidelines indicate that patients who have months to weeks left to live should not be offered chemotherapy. We examined factors associated with clinician-reported poor performance status as determined by the Palliative Performance Scale (PPS) and subsequent initiation of intravenous (IV) chemotherapy...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2014-10-01 00:00:00
abstract::Professional caregivers for cancer patients are at high risk for work-related stress, but it is not clear how this relates to exposure to death and dying, and to professional satisfaction. This study compares work-related stress and staff satisfaction on an academic acute palliative care unit (PCU) with that on a medi...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:AIM:Physical activity (PA) has a positive effect on the cardiorespiratory fitness, lung cancer symptoms, and quality of life of lung cancer patients. The aim of our study was to identify barriers to, and facilitators of PA in lung cancer patients. METHODS:We collected data from five patients diagnosed with primary, ad...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/082585971503100204
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Palliative, end-of-life care (PEOLC) providers are poorly resourced in addressing the needs of patients with mental health challenges, and the dying experiences of this cohort-particularly those with a comorbid, chronic and persistent mental illness (CPMI)-are poorly documented. We sought to explore the exper...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720951360
更新日期:2020-08-18 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The use of chemotherapy at the end of life in advanced cancer patients has increased and end of life care has become increasingly aggressive. The aim of this study is to evaluate patients receiving chemotherapy in the last 3 months of life and the aggressiveness of end-of-life support of these...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720946505
更新日期:2020-08-06 00:00:00
abstract::COVID-19 has stressed the healthcare system in ways our society has not seen before. Less visibly, elderly patients and their caregivers have been stressed as well, both by the virus and by the public health measures required to slow its spread. After months of isolating, patients with dementia and their caregivers ar...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720984567
更新日期:2021-01-12 00:00:00
abstract:AIM:The aim of this study was to evaluate the utility of the Edmonton Symptom Assessment System (ESAS-r) Scale on a tertiary palliative care unit. METHOD:There were 92 admitted patients who participated in the study; the scale was administered to those able to participate on day 1 (n = 35, 38 percent), on day 4 (n = 2...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/082585971503100107
更新日期:2015-01-01 00:00:00
abstract::This multi-centre study of adjuvant "burst" ketamine in palliative care in-patients documents its effectiveness, duration of pain relief, and adverse effects (AE) profile. Patients received a three-to-five day continuous subcutaneous infusion (CSCI) of ketamine escalated from 100 to 300 to 500 mg/24 hours if required....
journal_title:Journal of palliative care
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:2010-10-01 00:00:00
abstract::Current definitions of "symptom burden" are largely derived from clinicians, and there are many variations in the way the term is used, defined, and operationalized. The aim of this study was to explore patient perceptions of symptom burden in the context of advanced and incurable disease. A group of 58 cancer patient...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2012-07-01 00:00:00
abstract::There has been little research into pressure ulcer prevention and treatment in hospices. In this study, interviews with hospice directors of clinical services and direct-care nurses were analyzed using qualitative methods. Several general themes were found. Both pressure ulcer prevention and treatment can be painful t...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2003-04-01 00:00:00
abstract::This study used a randomized controlled trial design to investigate the impact of hospice at home (HAH) on caregiver bereavement outcome. Secondary analyses considered the association between bereavement, place of death, and carers' assessment of support. Ninety-six informal carers of patients referred to HAH were sur...
journal_title:Journal of palliative care
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2004-07-01 00:00:00
abstract::This article describes two young, potentially curable patients who chose a course of treatment that ultimately resulted in death. Their choice was in part influenced by the prospect of the disfiguring surgery that would have been required for cure. In the first patient this would have meant massive head and neck surge...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::The principle of double effect is widely used to permit the administration of narcotics and sedatives with the intent to palliate dying patients, even though the administration of these drugs may cause hastening of death. In recent medical literature, this principle's validity has been severely criticized, causing hea...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Advance care planning is not well implemented in Belgian hospital practice. In order to obtain successful implementation, implementation theory states that the adopters should be involved in the implementation process. This information can serve as a basis for creating better implementation strategies. AIM:...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720938583
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:One challenge for those who manage amyotrophic lateral sclerosis (ALS) is to understand patients' needs. AIM:The aim of this study was to examine the needs of Singapore ALS patients from their perspective as well as that of their caregivers and healthcare professionals in order to develop a template for bet...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/082585971503100304
更新日期:2015-01-01 00:00:00
abstract:UNLABELLED:In Poland, medical curricula cover palliative care for adults, not for children. This paper evaluates feedback of students who participated in a pilot pediatric palliative care education program. METHOD:An anonymous questionnaire was designed for the students; they were asked to assess each aspect of the pr...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::In this paper I have described some of the recent developments in the growth of a patient/survivor movement in Canada. Arguments for the value of increased patient participation include providing a needed balance to the traditional medical perspective, addressing patient needs free from other vested interests, providi...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Family care giving is important for the quality of life of terminally ill patients and their family members. Although family caregivers are generally eager to provide palliative care, at some point it may become too demanding, and then volunteers can make a difference. This four-study paper presents the experiences of...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract::Informal hospice caregivers play a key role in managing patients' pain at home, but lack of adherence to doctor-prescribed analgesic regimens and medication errors are significant barriers to truly effective pain management. A digital pain diary may improve caregiver management of pain at home; however, most digital p...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859717722466
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Bleeding occurs with some regularity at the end of life. Patients often endure fatigue, weakness, pain, dyspnea and anxiety. These symptoms are magnified in visually apparent bleeds. Management can be particularly challenging as we attempt to balance therapies with goals of care. Children are at risk for suc...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719883844
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:There is a growing movement to increase palliative care consults from the emergency department (ED) to reduce healthcare costs and improve quality of life. The surprise question is a screening tool that emergency medicine physicians may be able to use towards achieving this goal. OBJECTIVE:The objectives of...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719866698
更新日期:2020-10-01 00:00:00
abstract::Morphine was administered to 56 advanced cancer patients; of that number spinal metastases had induced bone pain in 28 and malignant tumors had induced sciatica in 28. The sciatica was caused in 16 patients by direct invasion of the sacral plexus, in four by lumbar bone metastases, and in eight by pelvic bone metastas...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::Doctor-patient communication is a quintessential part of medical care. Yet, several factors challenge its effectiveness. The author, a third year Pediatrics resident, explores the ways medical education creates distance between doctors' and patients' ability to achieve mutual understanding in the clinical setting and ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718795438
更新日期:2019-01-01 00:00:00
abstract:AIM:Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. MATERIALS...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718777375
更新日期:2018-07-01 00:00:00
abstract::Caregivers are often overwhelmed by the strain of terminal caregiving. We wished to better understand the needs of terminal caregivers and to supply a basis for tailoring interventions to them during caregiving and early bereavement. This report provides a profile of 124 bereaved caregivers interviewed within three mo...
journal_title:Journal of palliative care
pub_type: 杂志文章,多中心研究
doi:
更新日期:1999-04-01 00:00:00