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 on only 10 occasions. Systemic side effects secondary to the infusion were reported 75 times and were generally readily reversed. Myoclonus was seen in 11% of our patients at dose rates as low as 60-90 ME mg/h. Adjuvant therapies were not used as frequently as might be warranted. We believe that narcotic infusions, particularly subcutaneous ones, are safe and effective. Further prospective trials are needed to clarify how they should be combined with other therapies to control cancer pain that is poorly responsive to narcotics, and to better understand the etiology and management of serious side effects.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Ferris FD,Kerr IG,De Angelis C,Sone M,Hume Ssubject
Has Abstractpub_date
1990-07-01 00:00:00pages
51-9issue
2eissn
0825-8597issn
2369-5293journal_volume
6pub_type
杂志文章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::The essential mandate of medicine is the relief of suffering. However, the quest for an integrated model towards a conceptualization of suffering is still ongoing and empirical studies are few. Qualitative inquiry using 31 in-depth interviews and content analysis was carried out between 1999 and 2001 in 26 patients di...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2004-04-01 00:00:00
abstract::Emergency department (ED) use is a quality-of-care indicator for community-based end-of-life (EOL) care. This study examined ED use by EOL home care clients. The sample included all EOL home care clients who received care from one community care access centre in Ontario, Canada. Information on health was gathered usin...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2011-10-01 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::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::Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn't be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718777325
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by pa...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718769099
更新日期:2018-07-01 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::Historically, health and social care professionals have described their lack of competence and confidence in many aspects of palliative care, and have recognized the need for increased educational opportunities, where new skills can be acquired and existing knowledge consolidated. Redressing these omissions has led to...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2001-07-01 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::Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and disability worldwide. For many patients, maximal therapy for COPD produces only modest relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality, patients w...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Although religiousness is a strong predictor of attitudes towards physician-assisted suicide (PAS), Oregon hospice chaplains express wide variation in their opposition to or support for legalized PAS. We explored factors associated with chaplains' views on PAS. METHODS:A mailed survey to chaplains from 51 O...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00
abstract::Although the consequences of prolonged lying on a hard surface are as old as the human race, publications on this subject are scarce. This is due to the fact that a decubitus ulcer never occurs in isolation but is nearly always a complication of some other condition. The term "decubitus" was already used by Hildnaus i...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVE:This study aimed to characterize the strategies and psychosocial conditions that influence how resilient people live in the face of advanced cancer. METHODS:Grounded theory interviews and a survey of 10 resilient people with advanced cancer were collected and analyzed. FINDINGS:Personal assets - including p...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2013-07-01 00:00:00
abstract::Inpatient palliative care consultation has been demonstrated to improve quality of life as well as decrease hospital readmissions, intensive care unit transfers, and hospital costs for people with a life limiting illness. The clinical teaching units (CTUs) at London Health Sciences Centre (LHSC) routinely admit patien...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718781363
更新日期:2018-10-01 00:00:00
abstract::Daily care involving proximity with a malodorous patient in the terminal stage of cancer has often proved difficult for the caregiver. Whatever the cause of the primary cancer, three sources of noxious odor can exist or coexist: necrosis, superinfection, and perspiration and/or discharge. The proposed treatment calls ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::A strong and often polarized debate has taken place during recent years concerning the consequences of dehydration in the terminally ill patient. When a patient has a severely restricted oral intake or is found to be dehydrated, the decision to administer fluids should be individualized and made on the basis of a care...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:1998-07-01 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::This retrospective study compared 100 consecutive non-cancer (NC) patients referred to a palliative care consult team (PCT) in a Swiss university hospital to 506 cancer (C) patients referred during the same period. The frequencies of reported symptoms were similar in both groups. The main reasons for referral in the N...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2009-07-01 00:00:00
abstract::This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life car...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:10.1177/0825859719851483
更新日期:2020-04-01 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::With recent changes in health care there is greater emphasis on providing care at home, including the support of families to enable more home deaths. Since a home death may not be practical or desirable in every family situation, there is a need for an objective way to assess the viability of a home death in each indi...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::Health care workers often perceive a conflict between autonomy and beneficence when dealing with clients living at risk in the community. Respect for personal freedom and the desire to help and protect vulnerable people frequently appear to demand opposite interventions. The assessment of decision-making capacity is a...
journal_title:Journal of palliative care
pub_type: 杂志文章,评审
doi:
更新日期:1998-04-01 00:00:00
abstract::Despite very little confirming evidence, one of the most pervasive beliefs about dying is that terminally ill people receive a great deal of health care in the last few days, weeks, or months of life. A secondary analysis of 1992/93 through 1996/97 Alberta inpatient hospital abstracts data was undertaken to explore an...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Despite the central role of hospice in end-of-life care, little is known about the proportion of terminally ill patients referred for hospice and the physician factors associated with hospice referral. METHODS:Cross-sectional data from a self-administered survey of 231 physicians were used to estimate the p...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND::Following the Supreme Court of Canada's Carter Decision, medical assistance in dying (MAID) became possible with individual court orders in February 2016. Subsequently, on June 17, 2016, legislation was passed that eliminated the need for court orders, essentially making physicians the arbiters of these req...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718812446
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Socioeconomic disparities in home death have been noted in the literature. Home-based palliative care increases access to home death and has been suggested as a means to decrease these disparities. AIM:Our study examines the association between socioeconomic status and other demographic factors on place of ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719855020
更新日期:2020-07-01 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::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