Abstract:
BACKGROUND:While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS:(1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-of-life care and death; (2) to identify the factors affecting decision-making; (3) to consider the implications for clinical practice. DESIGN:Grounded theory study of bereaved parents using semi-structured open-ended interviews following Strauss and Corbin's principles of data collection and analysis. SETTING/PARTICIPANTS:Semi-structured interviews with 36 bereaved parents of 22 children who died at home (n = 9) or in a paediatric hospital (n = 13) in Athens, Greece. RESULTS:(1) Decisions regarding place of care and death were reached in one of four ways: consensus, accommodation, imposition of professional decisions on parents or imposition of parents' decisions without including professionals. (2) Six factors were identified as affecting decisions: awareness of dying, perceived parental caregiving competence, perceived professional competence, parents' view of symptom management, timing of decision-making, and being a 'good parent'. (3) Decisions were clear-cut or shifting. Few parents did not engage in decisions. CONCLUSION:Parents' decisions about place of end-of-life care and death are affected by personal, interpersonal, timing and disease-related factors. Parents are best supported in decision-making when information is presented clearly and honestly with recognition of what acting as 'good parents' means to them, and opportunities to enhance their caregiving competence to care for their child at home, if they choose so.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Papadatou D,Kalliani V,Karakosta E,Liakopoulou P,Bluebond-Langner Mdoi
10.1177/0269216320967547subject
Has Abstractpub_date
2021-01-01 00:00:00pages
219-230issue
1eissn
0269-2163issn
1477-030Xjournal_volume
35pub_type
杂志文章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, pa...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317718438
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:This research examines 2006 population-based data on persons who died in US nursing homes (NHs) and received hospice in the NH. METHODS:We compared dying persons characteristics and lengths of hospice stay in five US states between 1992 and 1996 and in 2006. We also compared characteristics of dying perso...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310389349
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Dementia is a life limiting illness and is becoming a major cause of death in developed countries. Many people with dementia die in nursing homes or long-term residential care settings. Spouse caregivers of people with dementia living in nursing homes find themselves in a position which is difficult to under...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313479685
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). AIM:To test the reliability and acceptabi...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216315613904
更新日期:2016-05-01 00:00:00
abstract:INTRODUCTION:Even though depression has serious and wide-ranging effects on outcomes in palliative care, errors in the identification of depressed patients are common. OBJECTIVES:To examine the clinical validity of widely publicised one- and two-question screening tools for depression in two palliative care settings. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1021oa
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:The global prevalence of dementia is set to rise to almost 65 million people by 2030, providing policy makers and practitioners with significant challenges, not least within the realms of end-of-life care. The international literature would suggest that people with dementia may benefit from palliative forms ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311423443
更新日期:2012-10-01 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:Refractory breathlessness in advanced chronic disease leads to high levels of disability, anxiety and social isolation. These result in high health-resource use, although this is not quantified. AIMS:To measure the cost of care for patients with advanced disease and refractory breathlessness and to identify...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317690994
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. AIM:To explore the experiences of senior medical and nursing staff regarding the challenges a...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315573000
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:This case report describes an end-stage cancer patient with intractable neuropathic pain and delirium who was successfully managed during the last 3 weeks of her life with a continuous subcutaneous infusion of dexmedetomidine. CASE PRESENTATION:A 55-year-old woman with locally advanced cervical cancer and u...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314556923
更新日期:2015-03-01 00:00:00
abstract::The most commonly encountered clinical conditions presenting with cognitive failure (CF) are delirium, dementia and amnestic disorders. Of these, delirium is probably the most prevalent in palliative care, and it is potentially reversible. Thus, improvement in diagnostics seems warranted. The objectives of this review...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216304pm920oa
更新日期:2004-09-01 00:00:00
abstract::The presence of cognitive impairment in patients who are receiving hospice care can affect numerous practical, ethical and legal aspects of their healthcare. A number of factors can contribute to cognitive impairment in these patients. Prevalence rates of cognitive impairment vary widely, but it remains under-recognis...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308096907
更新日期:2008-10-01 00:00:00
abstract::This study reports the process and results of a psychometric evaluation of a clinical audit tool, the Support Team Assessment Schedule (STAS), used to measure outcomes of palliative care. The STAS was developed in London, UK to audit community palliative care services provided by a support team. The purpose of this st...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921600677786382
更新日期:2000-01-01 00:00:00
abstract::To date, the experiences of out-of-hours general practitioners with regard to palliative care patients and their management are yet to be evaluated, since the new General Medical Services contract came into force. In 2007 the National Institute for Health Research highlighted the need to identify factors that improve ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310368580
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:A study designed to explore the experiences of patients with severe chronic obstructive pulmonary disease (COPD) and their carers, particularly with regard to ongoing and palliative care needs. METHODS:The participants were nine men and one woman with severe COPD and the carers of eight of the men, in East ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216304pm928oa
更新日期:2004-10-01 00:00:00
abstract::We determined the relationship between symptom severity and distress for multiple cancer symptoms, and examined patient demographic influences on severity and distress in advanced cancer. A Cochran-Armitage trend test determined whether symptom distress increased with severity. Chi-square, Fisher's exact test and logi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309356380
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Bisphosphonates are the treatment of choice for hypercalcaemia of malignancy (HCM) but there is no consensus regarding which drug or dose should be given. We designed a systematic review to investigate the efficacy of bisphosphonates in the treatment of HCM. METHODS:We identified randomized controlled trial...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216304pm914ra
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Being at peace is important for the quality of life of dying cancer patients, but its features, and the role of the doctor in facilitating peace, are unclear. AIM:We sought to understand the features of a peaceful patient, and patients' preferences regarding the role of the doctor in facilitating a sense of...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216314536455
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The Surprise Question ("Would I be surprised if this patient were to die within the next 12 months?") is widely used to identify palliative patients, though with low predictive value. To improve timely identification of palliative care needs, we propose an additional Surprise Question ("Would I be surprised ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320986720
更新日期:2021-01-11 00:00:00
abstract::Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdo...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216309106893
更新日期:2009-12-01 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::Clinical trials in palliative care involve multiple issues relating to patient populations, interventions and endpoints. Careful data collection and analysis of variables are vital for good clinical research in this complex area. ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601668441770
更新日期:2001-03-01 00:00:00
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journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317740274
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The WHO definitions of palliative care have been adopted in Denmark and implemented in The National Guidelines from 1999, but service developments have been very slow and not according to the recommendations. Attitudes to palliative care of Danish doctors and nurses may in part account for this. OBJECTIVE:T...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm988oa
更新日期:2005-03-01 00:00:00
abstract::Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understan...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216311399663
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Patients approaching death often have a decreasing oral intake, which can be distressing for relatives. Little is known about the relatives' experiences with and perceptions of oral intake at the end of life. AIM:This study aims to contribute to a more thorough understanding of relatives' concerns regarding...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313477178
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Legacy has been invoked as a means for strengthening human attachments, continuing bonds, and ensuring that individuals will be remembered; however, little is known about the spectrum of approaches to, outcomes associated with, and best practices for legacy interventions. AIM:To systematically review resear...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216321989565
更新日期:2021-01-25 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::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:A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. AIM:To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317701891
更新日期:2017-12-01 00:00:00