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 with COPD do not receive adequate palliative care. One reason these patients may receive poor quality palliative care is that patient-physician communication about palliative and EOL care is unlikely to occur. The purpose of this review is to summarize recent research regarding patient-physician communication about palliative care for patients with COPD. Understanding the barriers to this communication may be an important step to improving communication about EOL care and improving patient-centred outcomes. Two areas that may influence the quality of care received by patients with COPD are also highlighted: 1) the role of depression, a common problem in patients with COPD, in physician-patient communication; and 2) the role of advance care planning in this communication. Further research is needed to develop and test interventions that can enhance patient-physician communication about palliative and EOL care for patients with COPD, and we describe our perspective on a research agenda in each area.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Curtis JR,Engelberg RA,Wenrich MD,Au DHsubject
Has Abstractpub_date
2005-10-01 00:00:00pages
157-64issue
3eissn
0825-8597issn
2369-5293journal_volume
21pub_type
杂志文章,评审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::Palliative care is one of the newer health specialties and continues to mature. While there has been remarkable progression of clinical skills and education, there has been a lack of focus on palliative care interdisciplinary leadership or development of leadership skills. This article highlights the importance of int...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859718791427
更新日期:2018-08-16 00:00:00
abstract:PURPOSE:To evaluate the perception of attending physicians, medical residents, and undergraduate medical students about death and dying, the end of life (EoL), and palliative care (PC) during training and clinical practice, highlighting knowledge gaps, and the changes needed in medical school curricula. METHOD:Cross-s...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859720923435
更新日期:2020-05-10 00:00:00
abstract:BACKGROUND:Little is known about current practice in using the anticonvulsant gabapentin in the management of cancer-related neuropathic pain. OBJECTIVES:The main objective of this study was to describe the pattern of gabapentin use as an adjuvant analgesic for cancer-related neuropathic pain in patients admitted to a...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2003-10-01 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: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: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::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. Admiss...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:AIM:By examining clinical parameters associated with survival time and analyzing patients' survival times using prognostic scores, this study aimed to provide helpful information related to the treatment of terminal cancer patients. METHODS:We retrospectively reviewed the medical records of 415 inpatients who died in ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2014-04-01 00:00:00
abstract::This study measures the proportion of cancer patients in Ontario, Canada, with intensive care unit (ICU) admissions, emergency room (ER) visits, or chemotherapy in the last two weeks of life. We used the Ontario Cancer Registry to identify a cohort of cancer patients who died in 2001. These cases were then linked to a...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2006-04-01 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::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::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::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::There may be quantitatively more cancer in the developing world, Africa included, than in the developed world. Unlike in the developed world, cancer patients in Africa present for treatment at a late stage and therefore most of them have pain. Yet, the most commonly used modality for treatment of the cancer pain is dr...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1989-06-01 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::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::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::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 Regional Palliative Care Unit in Ottawa conducted a retrospective study to determine how satisfied patients and families were with the service the Unit offers. Forty-five primary care providers, bereaved from 6 to 12 months, completed the 64-item semistructured telephone interview in a mean time of 20 minutes. The...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1992-01-01 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: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::The conduct of psychosocial research with palliative care patients or staff presents a major investigative challenge. The fragility of patients and their physical or cognitive limitations severely curtail the types of studies that are possible and the research methods that can be applied. A major limitation is that ra...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:1989-12-01 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::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::This paper presents an overview of a qualitative study of six recently discharged hospice patients, who had experienced at least two episodes of inpatient palliative care and who were interviewed about their experience of care. The resulting data formed a representation--the Circle of Care--with a central theme being ...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:
更新日期:2001-04-01 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::Families of patients are well poised to comment on the end-of-life (EOL) care received by those patients and can provide feedback to care providers and decision makers. To better understand family-member evaluations of the quality of in-patient EOL care, this study draws on qualitative interview data (n = 24) to ident...
journal_title:Journal of palliative care
pub_type: 杂志文章,多中心研究
doi:
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:Little is known about how clinicians perceive prognostic uncertainty. Our study objective was to identify factors that influence how prognostic uncertainty is viewed by physicians, as it relates to their communications with families. DESIGN:Thirty semi-structured interviews with qualitative content analysis...
journal_title:Journal of palliative care
pub_type: 杂志文章
doi:10.1177/0825859719845005
更新日期:2020-01-01 00:00:00