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Unbearability of suffering at the end of life: the development of a new measuring device, the SOS-VEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The SOS-V is an instrument for measuring the unbearability of suffering in end-stage cancer patients with good content validity and psychometric properties, which is feasible to be used in practice. This structured instrument makes it possible to identify and study unbearable suffering in a quantitative and patient-oriented way. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - November 3, 2009 Category: Palliative Care Authors: Kees RuijsBregje Onwuteaka-PhilipsenGerrit van der WalAd Kerkhof Source Type: journals

An open-label, 1-year extension study of the long-term safety and efficacy of once-daily OROS(R) hydromorphone in patients with chronic cancer painEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The results of this extension study suggest that long-term repeated dosing with once-daily OROS(R) hydromorphone can be beneficial in the continuing management of persistent, moderate-to-severe cancer pain. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - September 14, 2009 Category: Palliative Care Authors: Magdi HannaAlberto TucaJohn Thipphawong Source Type: journals

GP and nurses' perceptions of how after hours care for people receiving palliative care at home could be improved: a mixed methods studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: While some of the identified gaps can only be met by long term funding and policy change, educational tools for use in training programs in PC for health professionals, which focus on the utilisation of EPC Medicare items in palliative care planning, the development of advance care plans and good communication between members of multidisciplinary teams, which include the GP, may enhance after hours service provision for patients receiving palliative care at home. The role of locums in after PC is an area for further research (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - September 13, 2009 Category: Palliative Care Authors: Heather TanMargaret O'ConnorGail MilesBritt KleinPeter Schattner Source Type: journals

Balloon kyphoplasty in malignant spinal fractures: a systematic review and meta-analysis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: It appears that there is level III evidence showing BKP is a well-tolerated, relatively safe and effective technique that provides early pain relief and improved functional outcomes in patients with painful neoplastic spinal fractures. BKP also provided long-term benefits in terms of pain and disability. However, the methodological quality of the original studies prevents definitive conclusions being drawn. Further investigation into the use of BKP for spinal fractures in cancer patients is warranted. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - September 8, 2009 Category: Palliative Care Authors: Carmen BouzaTeresa Lopez-CuadradoPatricia CedielZuleika Saz-ParkinsonJose Maria Amate Source Type: journals

"Good idea but not feasible" - the views of decision makers and stakeholders towards strategies for better palliative care in Germany: a representative surveyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The reason why potentially meaningful improvement measures are considered to be not very feasible in Germany may be the existence of barriers resulting from the high degree of fragmentation of health care provision and responsibilities. In overcoming these barriers and further improving palliative care it may be helpful that the basic understanding of the palliative care approach seems to be quite homogenous among the different groups. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - July 21, 2009 Category: Palliative Care Authors: Sara LueckmannMareike BehmannSusanne BissonNils Schneider Source Type: journals

The feasibility of a single-blinded fast-track pragmatic randomised controlled trial of a complex intervention for breathlessness in advanced disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: This study adds to the evidence that fast-track randomised controlled trials are feasible and acceptable in evaluations of palliative care interventions for patients with non-malignant conditions. Reasonable response rates and low attrition rates were achieved. Further, with adequate preparation of the research and randomisation teams, clinicians, and responders, and effective liaison with the clinicians, single-blinding proved possible. Methods were identified to reduce unblinding through careful attention to the type of data collected at unblinded measurement points; the content of interviews should be caref...
Source: BMC Palliative Care - Latest articles - July 6, 2009 Category: Palliative Care Authors: Morag FarquharIrene HigginsonPetrea FaganSara Booth Source Type: journals

Provision of palliative care for chronic heart failure inpatients: how much do we need?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: CHF patients with ejection fraction [greater than or equal to]45% also require palliative care. Our conservative criteria suggest a point prevalence of 2.7% of patients having both ejection fraction [less than or equal to]45% and palliative care needs, although this may be a conservative estimate. We present evidence-based referral criteria from the larger multi methods study. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - June 28, 2009 Category: Palliative Care Authors: Richard HardingTeresa BeynonFiona HodsonElaine CoadyMark KinironsLucy SelmanIrene Higginson Source Type: journals

Palliative care for older people - Exploring the views of doctors and nurses from different fields in GermanyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: General practitioners are the central health professionals in the delivery of palliative care for older people. They should however be encouraged to involve specialized services such as palliative care teams where necessary. With the German health care reform of 2007, a legal framework has been created that allows for this. As far as its realization is concerned, it must be ensured that the spotlight remains on the needs of the patients and not on policy conflicts and rivalries between health care professionals. Older people might particularly benefit if "talking" medicine and time-consuming care were properly...
Source: BMC Palliative Care - Latest articles - June 22, 2009 Category: Palliative Care Authors: Torben BruecknerMartin SchumacherNils Schneider Source Type: journals

Dying, death and bereavement: a qualitative study of the views of carers of people with heart failure in the UK.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionOur findings suggest that an absence of discussion about end of life care wishes with family members or health professionals is a barrier to advance care planning. Carers' perceptions about prioritising making the dying person comfortable can be in conflict with doctors' decisions to treat. Whilst carers report a range of strategies adopted in response to bereavement there is a need for continued support for vulnerable carers after the death of the person with HF. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - June 15, 2009 Category: Palliative Care Authors: Neil SmallSarah BarnesMerryn GottSheila PayneChris ParkerDavid SeamarkSalah Gariballa Source Type: journals

Assessing the feasibility, acceptability and potential effectiveness of Dignity Therapy for people with advanced cancer referred to a hospital-based palliative care team: Study protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionDignity Therapy is brief, can be delivered at the bedside and may help both patients and their families. This detailed exploratory research shows if it is feasible to offer Dignity Therapy to patients with advanced cancer, many of whom are likely to be in the terminal stage of their illness, whether it is acceptable to them and their families, if it is likely to be effective, and determine whether a Phase III RCT is desirable. Trial registration: Current Controlled Clinical Trials: ISRCTN29868352 (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - May 16, 2009 Category: Palliative Care Authors: Sue Hall, Polly Edmonds, Richard Harding, Harvey Chochinov and Irene J Higginson Source Type: journals

Measuring the diffusion of palliative care in long-term care facilities – a death censusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The profile of patients with access to palliative care must become more diversified. Among other recommendations, equal access to opiates in nursing homes and in home health services, palliative care at an earlier stage and the systematic use of symptom management scales when resorting to opiates have to become of prime concern. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - January 16, 2009 Category: Palliative Care Authors: Sophie Paroz and Brigitte Santos-Eggimann Source Type: journals

General practitioners' use and experiences of palliative care services: a survey in south east EnglandEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: A large number of GPs were happy with the service provision of the palliative care services in this area. They suggested that 3 out of 4 terminally ill patients needed specialist input. Views of services were largely positive, and reasons for non referral were unrelated to previous experience of the specialist services. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - November 5, 2008 Category: Palliative Care Authors: Sabrina Bajwah and Irene J Higginson Source Type: journals

Prevalence of distressing symptoms in hospitalised patients on medical wards: A cross-sectional studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: More than one third of the patients in a Department of Internal Medicine were defined as palliative, and the majority of the patients in this palliative group reported severe symptoms. There is a need for skills in symptom control on medical wards. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - September 23, 2008 Category: Palliative Care Authors: Katrin Ruth Sigurdardottir and Dagny Faksvåg Haugen Source Type: journals

Caregivers' active role in palliative home care – to encourage or to dissuade? A qualitative descriptive studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The results from this study identified important issues whenever spouses take an active part in medical treatment and physical care of critically ill patients in palliative care. The results question the previous research that active involvement of family care givers could be harmful and add preconditions to a positive outcome. More research into these preconditions is needed. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - September 16, 2008 Category: Palliative Care Authors: Anna Weibull, Frede Olesen and Mette Asbjoern Neergaard Source Type: journals

How useful are systematic reviews for informing palliative care practice? Survey of 25 Cochrane systematic reviewsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Cochrane reviews in palliative care are well performed, but fail to provide good evidence for clinical practice because the primary studies are few in number, small, clinically heterogeneous, and of poor quality and external validity. They are useful in highlighting the weakness of the evidence base and problems in performing trials in palliative care. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - August 20, 2008 Category: Palliative Care Authors: Bee Wee, Gina Hadley and Sheena Derry Source Type: journals

Emergency calls and need for emergency care in patients looked after by a palliative care team: Retrospective interview study with bereaved relativesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Emergency calls were more likely to occur if the patients were not being attended by our palliative care team. Because of the lack of correlation between MCS-12 and the number of emergency calls, the MCS-12 cannot indicate that acutely stressful situations triggered the calls. However, we conclude that special palliative care programs can reduce psychosocial strain in family caregivers. Therefore, the number of emergency calls may be reduced and this fact allows more palliative patients to die at home. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - August 12, 2008 Category: Palliative Care Authors: Christoph H.R. Wiese, Andrea Vossen-Wellmann, Hannah C. Morgenthal, Aron F. Popov, Bernhard M. Graf and Gerd G. Hanekop Source Type: journals

A reliability and validity study of the palliative performance scaleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The results of the reliability study demonstrated that PPS is a reliable tool. The validity study found that most experts did not feel a need to further modify PPS and, only two experts requested that some performance status measures be defined more clearly. Areas of PPS use include prognostication, disease monitoring, care planning, hospital resource allocation, clinical teaching and research. PPS is also a good communication tool between palliative care workers. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - August 4, 2008 Category: Palliative Care Authors: Francis Ho, Francis Lau, Michael G Downing and Mary Lesperance Source Type: journals

Efficacy of a training intervention on the quality of practitioners' decision support for patients deciding about place of care at the end of life: A randomized control trial: Study protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aims to determine whether the quality of clinicians' decision support can be improved with a brief, theory-based, skills-building intervention.TheoryThe Ottawa Decision Support Framework (ODSF) guides an evidence based, practical approach to assist clinicians in providing high-quality decision support. The ODSF proposes that decisional needs [personal uncertainty, knowledge, values clarity, support, personal characteristics] strongly influence the quality of decisions patients make. Clinicians can improve decision quality by providing decision support to address decisional needs [clarify decisional needs, provid...
Source: BMC Palliative Care - Latest articles - April 30, 2008 Category: Palliative Care Authors: Mary Ann Murray, Annette O'Connor, Dawn Stacey and Keith G Wilson Source Type: journals

Efficacy of a Training Intervention on the Quality of Practitioners' Decision Support for Patients Deciding about Place of Care at the End of-Life: A Randomized Control Trial: Study ProtocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aims to determine whether the quality of clinicians' decision support can be improved with a brief, theory-based, skills-building intervention. Theory: The Ottawa Decision Support Framework (ODSF) guides an evidence based, practical approach to assist clinicians in providing quality decision support. The ODSF proposes that decisional needs [uncertainty, knowledge, values clarity, support, personal characteristics] strongly influence the quality of decisions patients make. Clinicians can improve the quality of those decisions by providing decision support to address decisional needs [clarify decisional needs, pr...
Source: BMC Palliative Care - Latest articles - April 30, 2008 Category: Palliative Care Authors: Mary Ann Murray, Annette O'Connor, Dawn Stacey and Keith G. Wilson Source Type: journals

Use of a Cybex NORM dynamometer to assess muscle function in patients with thoracic cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: For patients with non-small cell lung cancer or mesothelioma, the Cybex NORM dynamometer provides an acceptable and reliable method of assessing muscle strength and work done. Muscle function appears to be relatively well preserved in this group and it appears feasible to explore interventions which aim to maintain or even improve this. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - April 10, 2008 Category: Palliative Care Authors: Andrew Wilcock, Matthew Maddocks, Mary Lewis, Paul Howard, Jacky Frisby, Sarah Bell, Bisharat El Khoury, Cathann Manderson, Helen Evans and Simon Mockett Source Type: journals

Information from physicians and retention of information by patients - Obstacles to the awareness of patients of progressing disease when life is near to an endEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: To optimize the care of patients who wish to be informed and aware during their disease, it is important that the health care staff recognizes potential obstacles to the awareness of patients in order to minimize such obstacles. The physicians could improve their communication with patients with life-threatening diseases, and avoid having a narrow focus on the treatment calendar. The patients could be encouraged to have a more proactive attitude in their communication with their physician. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - February 28, 2008 Category: Palliative Care Authors: Lena Hoff and Goran Hermeren Source Type: journals

Palliative care for cancer patients in a primary health care setting - Bereaved relatives' experience. A qualitative group interview studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Relatives experience insufficient palliative care mainly due to organizational and cultural problems among professionals. Palliative care in primary care in general needs improvement and attention should be drawn to the "professionalization" of the relatives and the need to strike a balance between their needs, wishes and resources in end-of-life care and bereavement. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - January 15, 2008 Category: Palliative Care Authors: Mette Asbjoern Neergaard, Frede Olesen, Anders Bonde Jensen and Jens Sondergaard Source Type: journals

The attitudes of brain cancer patients and their caregivers towards death and dying: a qualitative studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Several important themes underlie the experiences of brain cancer patients and their caregivers. It is important to consider these when managing these patients and to respect not only their autonomy but also the complex interpersonal toll that a malignant diagnosis can have. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - November 8, 2007 Category: Palliative Care Authors: Nir Lipsman, Abby Skanda, Jonathan Kimmelman and Mark Bernstein Source Type: journals

The PAMINO-project: evaluating a primary care based educational program to improve the quality of life of palliative patients [ISRCTN78021852]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionAlthough participating physicians value the increase in knowledge they receive from PAMINO, the effects on patients remain unclear. If the evaluation reveals a clear benefit for patients' quality of life, a larger-scale implementation of the program is considered. Trial registration The study was registered at 'current controlled trials (CCT)', registration number: ISRCTN78021852. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - May 29, 2007 Category: Palliative Care Authors: Thomas Rosemann, Katja Hermann, Antje Miksch, Peter Engeser and Joachim Szecsenyi Source Type: journals

Infection rates associated with epidural indwelling catheters for seven days or longer: systematic review and meta-analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The best estimate is that one person in 35 with an epidural catheter in place for 74 days for relief of cancer pain can be expected to have a deep epidural infection, and that about 1 in 500 may die of infection-related causes. This is a most uncertain estimate given the limited nature of the evidence. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - April 4, 2007 Category: Palliative Care Authors: Wilhelm Ruppen, Sheena Derry, Henry J McQuay and R Andrew Moore Source Type: journals

Can cancer patients assess the influence of pain on functions? A randomised, controlled study of the pain interference items in the Brief Pain InventoryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: We observed similar scores in the original BPI interference scores (pain influence on function) compared with the revised BPI interference scores (decreased function in general). This finding might imply that the BPI interference scale measures are partly responded to as more of a global interference measure. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - March 9, 2007 Category: Palliative Care Authors: Guri Stenseth, Mari Bjornes, Stein Kaasa and Pal Klepstad Source Type: journals

In the shadow of bad news – views of patients with acute leukaemia, myeloma or lung cancer about information, from diagnosis to cure or deathEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: To several patients there was an unmet need for information about the progressing disease and the approaching death. To optimize the care of these patients it seems important that the physician is aware of patients' need for information even when the news is bad. Knowing the patient's information strategy could probably function as a key for the physician to communicate with patients on these matters. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - January 24, 2007 Category: Palliative Care Authors: Lena Hoff, Ulf Tidefelt, Lars Thaning and Göran Hermerén Source Type: journals

Study protocol: delayed intervention randomised controlled trial within the Medical Research Council (MRC) Framework to assess the effectiveness of a new palliative care serviceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report here a novel protocol for the evaluation of a new palliative care service in this context.Methods/DesignUsing the MRC Framework for the Evaluation of Complex Interventions we modelled a new palliative care and neurology service for patients severely affected by Multiple Sclerosis (MS). We conducted qualitative interviews with patients, families and staff, plus a literature review to model and pilot the service. Then we designed a delayed intervention randomised controlled trial to test its effectiveness as part of phase II of the MRC framework. Inclusion criteria for the trial were patients identified by referrin...
Source: BMC Palliative Care - Latest articles - October 2, 2006 Category: Palliative Care Authors: Irene J Higginson, Bella Vivat, Eli Silber, Tariq Saleem, Rachel Burman, Sam Hart and Polly Edmonds Source Type: journals

Factors associated with multiple transitions in care during the end of life following enrollment in a comprehensive palliative care programEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Our data suggest there is some variation in the number of transitions associated with the demographics and diagnoses of patients. Associations with gender and age require further exploration as does the contribution of caregiver supports and symptom issues. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - May 30, 2006 Category: Palliative Care Authors: Beverley Lawson, Frederick I Burge, Patrick Critchley and Paul McIntyre Source Type: journals

Validity of measures of pain and symptoms in HIV/AIDS infected households in resources poor settings: results from the Dominican Republic and CambodiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The results of the study suggest that the selected measures can usefully be incorporated into population-based surveys and evaluation tools needed to monitor palliative care and used in settings with high HIV/AIDS prevalence. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - March 20, 2006 Category: Palliative Care Authors: Gregory Pappas, R Cameron Wolf, Guy Morineau and Richard Harding Source Type: journals

A study of home deaths in Japan from 1951 to 2002Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The pattern of the place of death has not only been determined by social and demographic characteristics of the decedent, but also associated with the medical service in the community. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - March 9, 2006 Category: Palliative Care Authors: Limin Yang, Naoko Sakamoto and Eiji Marui Source Type: journals

The pattern of symptoms in patients receiving home based care in Bangwe, Malawi : a descriptive studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Symptoms which are alleviated by simple treatments are common. The patients in whom symptoms recur need a responsive home based care service. Population based estimates of incidence and duration of disease and the visit work load allow an assessment of home based care needs in an urban setting in Africa. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - February 10, 2006 Category: Palliative Care Authors: Cameron Bowie, Linda Kalilane, Paul Cleary and Claire Bowie Source Type: journals

The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice [ISRCTN81117481]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The AKPS is a useful modification of the KPS that is more appropriate for clinical settings that include multiple venues of care such as palliative care. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - November 12, 2005 Category: Palliative Care Authors: Amy P Abernethy, Tania Shelby-James, Belinda S Fazekas, David Woods and David C Currow Source Type: journals

Patterns and predictors of place of cancer death for the oldest oldEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The finding of rising proportions of cancer deaths in institutions with increasing age suggests a need to ensure that appropriate high quality care is available to this growing section of the population. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - October 8, 2005 Category: Palliative Care Authors: Anna Lock and Irene Higginson Source Type: journals

Acupuncture for dyspnea in advanced cancer: a randomized, placebo-controlled pilot trial [ISRCTN89462491]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The acupuncture technique used in this trial is unlikely to have effects on dyspnea importantly larger than placebo for patients with advanced cancer. (Source: BMC Palliative Care - Latest articles)
Source: BMC Palliative Care - Latest articles - August 18, 2005 Category: Palliative Care Authors: Andrew J Vickers, Marc B Feinstein, Gary E Deng and Barrie R Cassileth Source Type: journals