Abstract:
BACKGROUND:Under-diagnosis of pain is a serious problem in cancer care. Accurate pain assessment by physicians may form the basis of effective care. The aim of this study is to examine the association between late referral to a Palliative Care Team (PCT) after admission and the under-diagnosis of pain by primary physicians. METHODS:This retrospective study was performed in the Teikyo University teaching-hospital for a period of 20 months. We investigated triads composed of 213 adult cancer inpatients who had coexisting moderate or severe pain at the initial PCT consultation, 77 primary physicians, and 4 palliative care physicians. The outcome of the present study was the under-diagnosis of pain by primary physicians with routinely self-completed standard format checklists. The checklists included coexisting pain documented independently by primary and palliative care physicians at the time of the initial PCT consultation. Under-diagnosis of pain was defined as existing pain diagnosed by the palliative care physicians only. Late referral to PCTs after admission was defined as a referral to the PCT at ≥20 days after admission. Because the two groups displayed significantly different regarding the distributions of the duration from admission to referral to PCTs, we used 20 days as the cut-off point for "late referral." RESULTS:Accurate pain assessment was observed in 192 triads, whereas 21 triads displayed under-diagnosis of pain by primary physicians. Under-diagnosis of pain by primary physicians was associated with a longer duration between admission and initial PCT consultation, compared with accurate pain assessment (25 days versus 4 days, p < 0.0001). After adjusting for potential confounding factors, under-diagnosis of pain by the primary physicians was significantly associated with late (20 or more days) referral to a PCT (adjusted odds ratio, 2.91; 95% confidence interval, 1.27 - 6.71). Other factors significantly associated with under-diagnosis of pain were coexisting delirium and case management by physicians with < 6 years of clinical experience. CONCLUSIONS:Under-diagnosis of pain by primary physicians was associated with late referral to PCTs. Shortening the duration from admission to referral to PCTs, and increasing physicians' awareness of palliative care may improve pain management for cancer patients.
journal_name
BMC Palliat Carejournal_title
BMC palliative careauthors
Akashi M,Yano E,Aruga Edoi
10.1186/1472-684X-11-7subject
Has Abstractpub_date
2012-06-07 00:00:00pages
7issn
1472-684Xpii
1472-684X-11-7journal_volume
11pub_type
杂志文章abstract:BACKGROUND:Little is known about palliative care professionals' attitudes towards guidelines. In 2015, the German Association for Palliative Medicine (DGP) published an evidence based guideline for palliative care in adults with incurable cancer. Before publication we conducted a national survey among members of the DG...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0187-y
更新日期:2017-03-21 00:00:00
abstract:BACKGROUND:Over the past ten years there has been an increasing focus on the need for improving the experience of end of life care. A number of policy initiatives have been introduced to develop approaches to discussing and documenting individual preferences for end of life care, in particular preferred place to die. ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-18
更新日期:2011-11-04 00:00:00
abstract:BACKGROUND:More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a child...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0189-9
更新日期:2017-02-13 00:00:00
abstract:BACKGROUND:According to common practice based on a generally agreed interpretation of Icelandic law on the rights of patients, health care professionals cannot discuss prognosis and treatment with a patient's family without that patient's consent. This limitation poses ethical problems, because research has shown that,...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-8
更新日期:2014-03-11 00:00:00
abstract:BACKGROUND:Many people with advanced dementia live in residential aged care homes. Care home staff need the knowledge and skills to provide high-quality end-of-life (EOL) dementia care. However, several studies have found EOL dementia care to be suboptimal, and care staff have reported they would benefit from training ...
journal_title:BMC palliative care
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12904-019-0474-x
更新日期:2019-10-23 00:00:00
abstract:BACKGROUND:Advanced cancer patients experience considerable symptoms, problems, and needs. Early referral of these patients to specialised palliative care (SPC) could improve their symptoms and problems.The Danish Palliative Care Trial (DanPaCT) investigates whether patients with metastatic cancer, who report palliativ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-12-37
更新日期:2013-10-24 00:00:00
abstract:BACKGROUND:To determine the feasibility and acceptability of lower limb neuromuscular electrical stimulation (NMES) as a home-based exercise therapy in patients with cancer who could not attend hospital-based exercise training. METHODS:A single-arm prospective pilot study of NMES, applied daily to both quadriceps musc...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-23
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Spiritual care is frequently cited as a key component of hospice care in Taiwanese healthcare and beyond. The aim of this research is to gauge physicians and nurses' self-reported perspectives and clinical practices on the roles of their professions in addressing spiritual care in an inpatient palliative car...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00608-y
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The leading cause of death among young children in southern Africa is complications due to HIV infection and, in South Africa, over a third of all deaths of children younger than five are associated with HIV infection. There is a great and urgent need for children's palliative care in Africa, whether HIV-rel...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0114-7
更新日期:2016-04-09 00:00:00
abstract:BACKGROUND:Empirical knowledge around palliative care provision and needs of people with intellectual disabilities is extremely limited, as is the availability of research resources, including expertise and funding. This paper describes a consultation process that sought to develop an agenda for research priorities for...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0108-5
更新日期:2016-03-24 00:00:00
abstract:BACKGROUND:Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increas...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0132-5
更新日期:2016-07-15 00:00:00
abstract:BACKGROUND:Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0462-1
更新日期:2019-09-10 00:00:00
abstract:BACKGROUND:The benefit of palliative chemotherapy (PC) in patients with advanced solid tumors and poor performance status (ECOG-PS) has not been prospectively validated, which makes treatment decision challenging. We aimed to evaluate the overall survival, factors associated with early mortality, and adoption of additi...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0427-4
更新日期:2019-05-20 00:00:00
abstract:BACKGROUND:Laws allowing assisted suicide and euthanasia have been implemented in many locations around the world but some individuals suffering with terminal illness receiving palliative care services are hastening death or die by suicide without assistance. This systematic review aims to summarise evidence of palliat...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0451-4
更新日期:2019-08-31 00:00:00
abstract:BACKGROUND:To understand the status of residents' awareness of and demand for hospice care services in Hangzhou and to provide a reference for promoting the formulation of hospice care-related policies in China. METHODS:A small cross-sectional survey of 519 adults aged over 40 years old living in the rural-urban fring...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00628-8
更新日期:2020-08-17 00:00:00
abstract:BACKGROUND:Palliative and end-of-life care development is hindered by a lack of information about the circumstances surrounding dying in developing and resource-poor countries. Our aims were to develop and obtain face and content validity for a self-administered questionnaire on end-of-life care provision and medical d...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00630-0
更新日期:2020-08-14 00:00:00
abstract:BACKGROUND:The Patient Satisfaction Questionnaire (PSQ) is an assessment tool used to evaluate patients' perspectives of their doctor's communication and interpersonal skills. The present pilot study investigated whether the PSQ could be administered successfully in a hospice inpatient setting and if it is an acceptabl...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-27
更新日期:2014-06-02 00:00:00
abstract:BACKGROUND:The McGill Quality of Life Questionnaire - Expanded (MQOL-E) and the Quality of Life in Life-Threatening Illness-Family Carer/Caregiver version (QOLLTI-F) are developed for use with patients facing the end of life and their family carers, respectively. They are also developed for possible use as companion in...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00549-6
更新日期:2020-03-25 00:00:00
abstract:BACKGROUND:To improve the quality of advance care planning (ACP) in primary care, it is important to understand the frequency of and topics involved in the ACP discussion between patients and their family physicians (FPs). METHODS:A secondary analysis of a previous multicenter cross-sectional observational study was p...
journal_title:BMC palliative care
pub_type: 杂志文章,多中心研究
doi:10.1186/s12904-020-00543-y
更新日期:2020-03-17 00:00:00
abstract::BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent s...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-3-1
更新日期:2004-04-27 00:00:00
abstract:BACKGROUND:One ambition regarding palliative care is that it should be more accessible to patients and families regardless of care setting. Previous studies show many difficulties and shortcomings in the care of patients with palliative care needs in acute care facilities, but also challenges regarding efforts to imple...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0262-4
更新日期:2017-12-28 00:00:00
abstract:BACKGROUND:Even though struggling with similar symptom burden, patients with chronic heart failure (CHF) receive less palliative care than patients suffering from malignant diseases. Researchers have found that this might be related to lack of knowledge about palliative care, insufficient interprofessional communicatio...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0149-9
更新日期:2016-08-15 00:00:00
abstract:BACKGROUND:The Integrated Palliative care Outcome Scale (IPOS) was developed for evaluating essential outcomes for palliative care patients. Our objectives here are to describe the process of a six-phase cross-cultural adaptation of IPOS to French (IPOS-Fr), highlight the difficulties encountered and strategies to solv...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0422-9
更新日期:2019-04-18 00:00:00
abstract:BACKGROUND:Much of what we understand about the design of healthcare systems to support care of the dying comes from our experiences with providing palliative care for dying cancer patients. It is increasingly recognized that in addition to cancer, high quality end of life care should be an integral part of care that i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0076-9
更新日期:2016-01-15 00:00:00
abstract:BACKGROUND:Family members are involved in the care of palliative patients at home and therefore, should be viewed as important sources of information to help clinicians better understand the quality palliative care service patients receive. The objective of the study was to analyse what is valued most by family carers ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0229-5
更新日期:2017-09-06 00:00:00
abstract:BACKGROUND:Children with chronic complex-medical conditions comprise a small minority of children who require substantial healthcare with major implications for hospital utilization and costs in pediatrics. Community-Based Pediatric Palliative Care (CBPPC) provides a holistic approach to patient care that can improve t...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0138-z
更新日期:2016-08-03 00:00:00
abstract:UNLABELLED: BACKGROUND:Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with paren...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-11-21
更新日期:2012-10-30 00:00:00
abstract:BACKGROUND:Being a family carer to a patient nearing the end of their life is a challenging and confronting experience. Studies show that caregiving can have negative consequences on the health of family carers including fatigue, sleep problems, depression, anxiety and burnout. One of the goals of palliative care is to...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-9-17
更新日期:2010-08-05 00:00:00
abstract:BACKGROUND:Overuse of anti-cancer therapy is an important quality-of-care issue. An aggressive approach to treatment can have negative effects on quality of life and cost, but its effect on survival is not well-defined. METHODS:Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified 7,87...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-14
更新日期:2011-09-21 00:00:00
abstract:BACKGROUND:The Palliative Performance Scale (PPS) was first introduced in1996 as a new tool for measurement of performance status in palliative care. PPS has been used in many countries and has been translated into other languages. METHODS:This study evaluated the reliability and validity of PPS. A web-based, case sce...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-10
更新日期:2008-08-04 00:00:00