Abstract:
BACKGROUND:Observational studies investigating risk factors in coronavirus disease 2019 (COVID-19) have not considered the confounding effects of advanced care planning, such that a valid picture of risk for elderly, frail and multi-morbid patients is unknown. We aimed to report ceiling of care and cardiopulmonary resuscitation (CPR) decisions and their association with demographic and clinical characteristics as well as outcomes during the COVID-19 pandemic. METHODS:Retrospective, observational study conducted between 5th March and 7th May 2020 of all hospitalised patients with COVID-19. Ceiling of care and CPR decisions were documented using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process. Unadjusted and multivariable regression analyses were used to determine factors associated with ceiling of care decisions and death during hospitalisation. RESULTS:A total of 485 patients were included, of whom 409 (84·3%) had a documented ceiling of care; level one for 208 (50·9%), level two for 75 (18·3%) and level three for 126 (30·8%). CPR decisions were documented for 451 (93·0%) of whom 336 (74·5%) were 'not for resuscitation'. Advanced age, frailty, White-European ethnicity, a diagnosis of any co-morbidity and receipt of cardiovascular medications were associated with ceiling of care decisions. In a multivariable model only advanced age (odds 0·89, 0·86-0·93 p < 0·001), frailty (odds 0·48, 0·38-0·60, p < 0·001) and the cumulative number of co-morbidities (odds 0·72, 0·52-1·0, p = 0·048) were independently associated. Death during hospitalisation was independently associated with age, frailty and requirement for level two or three care. CONCLUSION:Ceiling of care decisions were made for the majority of patients during the COVID-19 pandemic, broadly in line with known predictors of poor outcomes in COVID-19, but with a focus on co-morbidities suggesting ICU admission might not be a reliable end-point for observational studies where advanced care planning is routine.
journal_name
BMC Palliat Carejournal_title
BMC palliative careauthors
Straw S,McGinlay M,Drozd M,Slater TA,Cowley A,Kamalathasan S,Maxwell N,Bird RA,Koshy AO,Prica M,Patel PA,Relton SD,Gierula J,Cubbon RM,Kearney MT,Witte KKdoi
10.1186/s12904-021-00711-8subject
Has Abstractpub_date
2021-01-11 00:00:00pages
10issue
1issn
1472-684Xpii
10.1186/s12904-021-00711-8journal_volume
20pub_type
杂志文章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: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:Discrepancies between the information that patients have received and the patients' awareness of their condition have frequently been observed in literature and given a number of different explanations. The chief contribution of this study is that by following patients over time it is possible not only to no...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-2
更新日期:2008-02-28 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:It has been recognised that more evidence about important aspects of family members' sense of security during palliative care is needed. The objectives of the study was: i) to discover what variables are associated with family members feeling secure during palliative care; ii) to develop a model of family me...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0446-1
更新日期:2019-07-25 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:Keeping people living with advanced dementia in their usual place of residence is becoming a key governmental goal but to achieve this, family carers and health care professionals must negotiate how to provide optimal care. Previously, we reported a realist analysis of the health care professional perspectiv...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0467-9
更新日期:2019-10-24 00:00:00
abstract:BACKGROUND:The focus of Specialized Palliative Care (SPC) is to improve care for patients with incurable diseases and their families, which includes the opportunity to make their own choice of place of care and ultimately place of death. The Danish Palliative Care Trial (DOMUS) aims to investigate whether an accelerate...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-44
更新日期:2014-09-09 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: Transitions in the location of care and in who provides such care can be extremely stressful for individuals facing death and for those close to them. The objective of this study was to describe the distribution of transitions in care experienced by palliative care patients following admission to a compreh...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-4-3
更新日期:2005-02-22 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: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: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:Confinement to an in-patient hospital ward impairs patients' sense of social support and connectedness. Providing the means, through communication technology, for patients to maintain contact with friends and family can potentially improve well-being at the end of life by minimizing social isolation and faci...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0203-2
更新日期:2017-05-06 00:00:00
abstract:BACKGROUND:During the last few decades, patients' rights have been reinforced in many countries by acts of law. Measures now include health care proxies to uphold the doctor-patient relationship and advance directives for end-of-life patients. These could be relevant tools as early as the initial diagnosis of haematolo...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-57
更新日期:2014-12-11 00:00:00
abstract:BACKGROUND:Cervical cancer is mostly diagnosed at advanced stages among the majority of women in low-income settings, with palliative care being the only feasible form of care. This study was aimed at investigating palliative care knowledge and access among women with cervical cancer in Harare, Zimbabwe. METHODS:Seque...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-0523-5
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:There is limited population-level research on end-of-life care in Australia that considers health care use and costs across hospital and community sectors. The aim of this study was to quantify health care use and costs in the last 6 months of life in a cohort of elderly Australian decedents and to examine t...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0213-0
更新日期:2017-06-21 00:00:00
abstract:BACKGROUND:More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008/9. The study was undertaken as part of the Irish Hospice Found...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-015-0014-2
更新日期:2015-04-18 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: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:Although spiritual care is a basic element of holistic nursing, nurses' spiritual care knowledge and abilities are often unable to satisfy patients' spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care. DESIGN:A no...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0489-3
更新日期:2019-11-26 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:: Parkinson's disease (PD) is one of the most common neurodegenerative disorders of the elderly population. Few therapeutic options are available for patients with PD requiring palliative care. Treatment of the early stages of PD is entirely different from later stages. During the later stages, the palliative care mode...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-11-20
更新日期:2012-10-25 00:00:00
abstract:BACKGROUND:This paper explores carers' views of dying, death and bereavement for family members who had recently died with heart failure adding to a growing literature on end of life experiences for people with conditions other than cancer. METHODS:Twenty interviews were conducted with bereaved carers of older people ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-8-6
更新日期:2009-06-16 00:00:00
abstract:BACKGROUND:The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-8-20
更新日期:2009-12-30 00:00:00
abstract:UNLABELLED: BACKGROUND:The United Kingdom has led the world in the development of children's palliative care. Over the past two decades, the illness trajectories of children with life-limiting conditions have extended with new treatments and better home-based care. Future planning is a critically under-researched aspe...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-12-5
更新日期:2013-02-05 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:Children show long-term psychological distress if family communication and illness-related information are poor during and after a parent's illness and death. Few psychosocial interventions for families with minor children living with a parent who has a life-threatening illness have been evaluated rigorously...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00551-y
更新日期:2020-04-16 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: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