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The Congress of Vienna.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19788767 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Breitbart W Tags: Palliat Support Care Source Type: journals

Reappraisal in the eighth life cycle stage: a theoretical psychoeducational intervention in elderly patients with cancer.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Elderly patients with cancer face unique physical and psychiatric challenges in coping with their illness. Optimal psychosocial therapy for older cancer patients requires recognizing certain enhanced psychological capacities such as coping better with illness, which is associated with older age. This strength can be combined with the most appropriate cognitive coping strategies to develop a model intervention. This paper describes such a model, which integrates Erik Erikson's eighth and final psychosocial developmental life stage, in which the task is to achieve ego integrity (equanimity) or to experience despair (sadn...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Holland J, Poppito S, Nelson C, Weiss T, Greenstein M, Martin A, Thirakul P, Roth A Tags: Palliat Support Care Source Type: journals

Adjusting to pancreatic cancer: perspectives from first-degree relatives.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: The combination of a difficult early diagnosis, few treatment options, and high mortality rate could make the experience of pancreatic cancer different from the experience of other cancers, both for patients and families. To design effective interventions for families with a diagnosis of pancreatic cancer, there is need for a model of family members' adjustment to cancer that is specific to these unique aspects of pancreatic cancer. METHOD: Trained clinical interviewers and a genetic counselor conducted phone interviews with 22 first-degree relatives-parents, siblings, and offspring-from a pool of participat...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Petrin K, Bowen DJ, Alfano CM, Bennett R Tags: Palliat Support Care Source Type: journals

Quality of life measures (EORTC QLQ-C30 and SF-36) as predictors of survival in palliative colorectal and lung cancer patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study assessed whether better prediction is achieved using generic (SF-36) HRQoL measures or cancer-specific (EORTC QLQ-C30) measures that include symptoms. METHOD: Fifty-four lung and 46 colorectal patients comprised the sample. Ninety-four died before study conclusion. EORTC QLQ-C30 and SF-36 scores and demographic and clinical information were collected at baseline. Follow-up was 5 years. Deaths were flagged by the Office of National Statistics. Cox regression survival analyses were conducted. Surviving cases were censored in the analysis. RESULTS: Univariate analyses showed that survival was significantly associat...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Grande GE, Farquhar MC, Barclay SI, Todd CJ Tags: Palliat Support Care Source Type: journals

Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Women with ovarian cancer face a poor prognosis, with prolonged periods of treatment but relatively high levels of physical functioning. Their thoughts and feelings regarding the prospect of dying are complex and have not been adequately studied. Various demographic, medical and psychosocial factors were examined to determine their independent associations with fear of dying and hopelessness in a cross-sectional design. METHOD: Two hundred fifty-four ovarian cancer patients were assessed at the beginning of a new chemotherapy regimen. Separate logistic regressions were performed for worry about dying and los...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Shinn EH, Taylor CL, Kilgore K, Valentine A, Bodurka DC, Kavanagh J, Sood A, Li Y, Basen-Engquist K Tags: Palliat Support Care Source Type: journals

The psychological responses of outpatient breast cancer patients before and during first medical consultation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study used a content analysis of interviews to chronologically examine psychological response of cancer patients seeking medical consultation at three points in time. RESULTS: Patients at the time of their first outpatient breast cancer consultation experience negative feelings before the examination, directly influenced by the suspicion of cancer. These include anxiety and worries, fear, evasion, depression, and impatience. These tendencies do not change at the time of consultation. However, in addition to negative feelings, some people also possess positive feelings, either simultaneously or at a different point in ...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Okazaki S, Iwamitsu Y, Masaru K, Todoroki K, Suzuki S, Yamamoto K, Hagino M, Watanabe M, Miyaoka H Tags: Palliat Support Care Source Type: journals

Development and validation of the Family Decision-Making Self-Efficacy Scale.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Several studies have reported high levels of distress in family members who have made health care decisions for loved ones at the end of life. A method is needed to assess the readiness of family members to take on this important role. Therefore, the purpose of this study was to develop and validate a scale to measure family member confidence in making decisions with (conscious patient scenario) and for (unconscious patient scenario) a terminally ill loved one. METHODS: On the basis of a survey of family members of patients with amyotrophic lateral sclerosis (ALS) enriched by in-depth interviews guided by Se...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Nolan MT, Hughes MT, Kub J, Terry PB, Astrow A, Thompson RE, Clawson L, Texeira K, Sulmasy DP Tags: Palliat Support Care Source Type: journals

Validation of the Demoralization Scale in an Irish advanced cancer sample.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article presents a validation study of the Demoralization Scale, a 24-item, 5-point response questionnaire developed by Kissane et al. in 2004 to assess demoralization in advanced cancer patients. METHOD: One hundred Irish inpatients with advanced palliative cancer completed the Demoralization Scale and measures of depression, hopelessness, quality of life, and personal hopefulness. RESULTS: Principal component analysis of the Demoralization Scale yielded four similar factors found by Kissane et al. (2004), namely, loss of meaning, dysphoria, disheartenment, and sense of failure. A new factor, the hopelessness factor,...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Mullane M, Dooley B, Tiernan E, Bates U Tags: Palliat Support Care Source Type: journals

Attitudes of Quebec doctors toward sedation at the end of life: an exploratory study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: The induction of sedation at the end of life is a much debated practice and not very documented. The goal of this study was to explore the practice from both a clinical and ethical point of view. METHODS: Data were collected through semistructured interviews with 19 Quebec physicians working in palliative care. RESULTS: Doctors' first priority was their patients, not patients' families. Clinically, the therapeutic aim of sedation was strictly to relieve suffering on the part of the patient. Ethically, getting the patient's consent was imperative. The family's consent was only required in cases of incapacity....
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Blondeau D, Dumont S, Roy L, Martineau I Tags: Palliat Support Care Source Type: journals

Perspectives on palliative care in Lebanon: knowledge, attitudes, and practices of medical and nursing specialties.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Our objective was to determine the knowledge, attitudes, and practices of physicians and nurses on Palliative Care (PC) in Lebanon, across specialties. METHOD: We performed a cross-sectional descriptive survey using a self-administered questionnaire; the total number of completed and returned questionnaires was 868, giving a 23% response rate, including 74.31% nurses (645) and 25.69% physicians (223). RESULTS: Significant differences were found between medical and surgical nurses and physicians concerning their perceptions of patients' and families' outbursts, concerns, and questions. Knowledge scores were s...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Abu-Saad Huijer H, Dimassi H, Abboud S Tags: Palliat Support Care Source Type: journals

International comparison study on the primary concerns of terminally ill cancer patients in short-term life review interviews among Japanese, Koreans, and Americans.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: The aim of this study was to investigate the primary concerns of terminally ill cancer patients in a Short-Term Life Review among Japanese, Koreans, and Americans to develop intervention programs to be tailored to patients in other countries. METHOD: Twenty Japanese, 16 Korean, and 7 American terminally ill cancer patients who were in the hospice wards of general Christian hospitals in each country participated in this study. Medical staff members (nurses, social workers, clinical psychologists) performed Short-Term Life Review Interviews with each patient. Patients reviewed their lives in the first session,...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Ando M, Morita T, Ahn SH, Marquez-Wong F, Ide S Tags: Palliat Support Care Source Type: journals

Providing care and sharing expertise: reflections of nurse-specialists in palliative home care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study explored the experiences, perspectives, and reflections of five nurse-specialists in palliative home care, whose dual role includes caring for patients in their daily practice as well as sharing their knowledge, skills, expertise, and experiences with other home care nurses in the community. METHODS: A qualitative research design, incorporating face-to-face semistructured interviews, was used. Interviews were based on open-ended questions such as: "What is your experience in providing palliative home care to patients and their families? How do you feel about sharing your expertise and experiences with home care ...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Arnaert A, Wainwright M Tags: Palliat Support Care Source Type: journals

Hope in palliative care: an integrative review.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this review is to describe the current status of research on hope in palliative care. METHODS: Integrative review was conducted to determine current knowledge on the topic. CINAHL and PubMed MEDLINE databases were used to find the articles relevant to this review. The data consisted of 34 articles on hope and palliative care published in peer-reviewed journals. A qualitative approach utilizing content analysis was used in this review. RESULTS: There are at least two overarching themes of patients' hope in the palliative context: "living with hope" and "hoping for something" which however are not separate c...
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Kylmä J, Duggleby W, Cooper D, Molander G Tags: Palliat Support Care Source Type: journals

Complications.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19788780 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - August 31, 2009 Category: Palliative Care Authors: Rousseau P Tags: Palliat Support Care Source Type: journals

The spiritual domain of palliative care: who should be "spiritual care professionals"?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19538795 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Breitbart W Tags: Palliat Support Care Source Type: journals

Challenges of illness in metastatic breast cancer: a low-income African American perspective.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Disparities in breast cancer survival and treatment for African American and low income women are well documented, yet poorly understood. As care for women with metastatic breast cancer (MBC) evolves to a chronic care model, any inequities in optimal treatment and management of symptoms must also be identified and eliminated. The purpose of this study was to explore how race and income status influence women's experiences with MBC, particularly the management of symptoms, by describing the perceived challenges and barriers to achieving optimal symptom management among women with MBC and exploring whether the...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Rosenzweig MQ, Wiehagen T, Brufsky A, Arnold R Tags: Palliat Support Care Source Type: journals

Caring for a person in advanced illness and suffering from breathlessness at home: threats and resources.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Little is known about the factors that mediate the caregiving experience of informal carers at home, which could inform about ways of supporting them in their caregiving role. Our objective was to investigate the caring experience of carers for patients with an advanced progressive illness (chronic obstructive pulmonary disease [COPD], heart failure, cancer, or motor neuron diseases [MND]), who suffer from breathlessness. METHODS: A purposive sample of 15 carers was selected. They were recruited via the patients they cared for (who suffered from COPD, cancer, MND, or heart failure) from the hospital and the ...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Gysels MH, Higginson IJ Tags: Palliat Support Care Source Type: journals

Techniques for framing questions in conducting family meetings in palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Family therapy has developed several approaches to framing questions within family meetings, but few of these techniques have been adapted for palliative care. We focus on the application of questioning techniques from systemic family therapy to palliative care. More specifically, we describe and give examples of the model of asking questions developed by Karl Tomm (1988) through its application in Family Focused Grief Therapy (FFGT), a preventive intervention delivered to high-risk families during palliative care and bereavement. METHODS: First, the type of questions used across the course of therapy is exp...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Dumont I, Kissane D Tags: Palliat Support Care Source Type: journals

Conducting family meetings in palliative care: themes, techniques, and preliminary evaluation of a communication skills module.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: To develop a communication skills training module for health care professionals about how to conduct a family meeting in palliative care and to evaluate the module in terms of participant self-efficacy and satisfaction. METHODS: Forty multispecialty health care professionals from the New York metropolitan area attended a communication skills training module at a Comprehensive Cancer Center about how to conduct a family meeting in oncology. The modular content was based on the Comskil model and current literature in the field. RESULTS: Based on a retrospective pre-post measure, participants reported a signifi...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Gueguen JA, Bylund CL, Brown RF, Levin TT, Kissane DW Tags: Palliat Support Care Source Type: journals

Patients' views on decision making in advanced cancer.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: To explore patients' understanding of decision making in the treatment of advanced cancer and to determine the factors they believe important to these processes in their care. METHODS: Surveys were distributed to consecutive outpatients with advanced malignancy attending a comprehensive cancer treatment center. RESULTS: Patients believed that the medical condition (94%), their doctors' experience (81%), and the medical literature (73%) are the most important factors for decisions made in their care. They also value their relationship with the doctor (63%) and their own (the patients') values (63%), and just ...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Philip J, Gold M, Schwarz M, Komesaroff P Tags: Palliat Support Care Source Type: journals

Strength through adversity: bereaved cancer carers' accounts of rewards and personal growth from caring.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Many studies have identified negative and distressing consequences experienced by informal cancer carers, but less attention has been given to positive and beneficial aspects of caring. This qualitative study examined the positive aspects of caring as subjectively constructed by bereaved informal cancer carers, a group of individuals who are in a position to make sense of their caring experiences as a coherent whole. METHOD: Twenty-three bereaved informal cancer carers were interviewed, and their accounts were analyzed using a thematic analytical approach from a phenomenological perspective. RESULTS: The par...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Wong WK, Ussher J, Perz J Tags: Palliat Support Care Source Type: journals

A feasibility study of a two-session home-based cognitive behavioral therapy-insomnia intervention for bereaved family caregivers.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: In 2008 over two million family caregivers will become bereaved. The vast majority of these caregivers have provided 'round-the-clock care for a period ranging from months to years. Bereaved family caregivers report insomnia symptoms that persist beyond 1 year, longer than what is seen in bereaved noncaregivers, placing them at increased risk of depression and complicated grief. Despite some rewarding elements, caregiving is a stressful and exhausting role that often requires the caregiver to restructure his or her life around the needs of the patient. Once the patient dies, the structure is lost. Cognitive ...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Carter PA, Mikan SQ, Simpson C Tags: Palliat Support Care Source Type: journals

Fatigue in relatives of palliative patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study has a descriptive, comparative, and cross-sectional design. The sample consisted of relatives of all patients cared for in palliative care settings in Uppsala County during a specific day. Relatives completed a questionnaire consisting of the Multidimensional Fatique Inventory (MFI-20) and questions from the Karolinska Sleepiness Scale (KSS) and Karolinska Sleep questionnaire (KSQ). RESULTS: Relatives (n = 56) scored high on every dimension on the MFI-20 scale. Two significant negative correlations were found to exist between age and fatigue, with younger relatives reporting more mental fatigue (p < .01) and ...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Carlsson ME Tags: Palliat Support Care Source Type: journals

Using the differential from complete blood counts as a biomarker of fatigue in advanced non-small-cell lung cancer: an exploratory analysis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Fatigue is currently recognized as an undertreated symptom in cancer. To date the association between fatigue and inflammatory activation has not been examined in patients with advanced cancer. Our exploratory investigation considered whether variations in routinely available hematological parameters relate to the severity of fatigue reports. METHODS: Fatigue, white blood cell differential, and hemoglobin concentration were assessed in 44 Stage IIIb and IV non-small-cell lung cancer (NSCLC) patients. Days of survival and the relative timing of treatment discontinuation were also recorded. Relationships betwe...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Paddison JS, Temel JS, Fricchione GL, Pirl WF Tags: Palliat Support Care Source Type: journals

Effect of music therapy on oncologic staff bystanders: a substantive grounded theory.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Oncologic work can be satisfying but also stressful, as staff support patients and families through harsh treatment effects, uncertain illness trajectories, and occasional death. Although formal support programs are available, no research on the effects of staff witnessing patients' supportive therapies exists. This research examines staff responses to witnessing patient-focused music therapy (MT) programs in two comprehensive cancer centers. METHOD: In Study 1, staff were invited to anonymously complete an open-ended questionnaire asking about the relevance of a music therapy program for patients and visito...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: O'Callaghan C, Magill L Tags: Palliat Support Care Source Type: journals

Cancer patients' reluctance to discuss psychological distress with their physicians was not associated with underrecognition of depression by physicians: a preliminary study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: To investigate the association between cancer patients' reluctance for emotional disclosure to their physician and underrecognition of depression by physicians. METHODS: Randomly selected ambulatory patients with lung cancer were evaluated by the Hospital Depression and Anxiety Scale (HADS), and those with scores over the validated cutoff value for adjustment disorder or major depressive disorder were included in this analysis. The data set included the responses to the 13-item questionnaire to assess four possible concerns of patients in relation to emotional disclosure to the treating physician ("no percei...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Okuyama T, Endo C, Seto T, Kato M, Seki N, Akechi T, Furukawa TA, Eguchi K, Hosaka T Tags: Palliat Support Care Source Type: journals

Palliative care: a need for a family systems approach.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article highlights the importance of caring for a family when one member has a life-threatening illness, and describes the applicability of Family Systems Theory and its major tenets to the palliative cancer population. METHODS: A MedLine and CINAHL search of Family Systems Theory related papers was conducted. RESULTS: Research studies that have been done fail to capture the view of the entire family system, often limiting the perspectives of the family to one single member. The concepts of holism, balance, boundaries, and hierarchal subsystems must be addressed in the care of any family, including those who have a fa...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Mehta A, Cohen SR, Chan LS Tags: Palliat Support Care Source Type: journals

Staff grief and support systems for Japanese health care professionals working in palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article is a literature report on grief issues for health care professionals, undertaken to identify Japanese nurses' grief experience when they work in palliative care units. Health care professionals' grief experience and its impact have not been well understood or identified as a significant issue in Japan. METHODS: Published articles relating to this study were searched using electronic catalogues such as CINAHL and PsycINFO, books, and research publications. Key words used for the search were "grief," "palliative care," "nurse," "staff support," and "Japan." Both English and Japanese were used for the literature ...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Shimoinaba K, O'Connor M, Lee S, Greaves J Tags: Palliat Support Care Source Type: journals

When cancerophobia and denial lead to death.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: The belief that cancer inevitably leads to a dreadful and painful death is widespread. This may contribute to society's cancerophobia and denial with subsequent frequent delays in seeking medical attention and treatment for suspected cancer. Cancerophobia is an active behavior of fear of cancer that can lead to repeated medical examination without giving full reassurance to the patient. Denial is a mechanism of defense that usually helps the patient to cope with painful, threatening, overwhelming, or awkward thoughts. When it turns out to be ineffective and pathological, it can cause either delay or avoidanc...
Source: Palliative and Supportive Care - May 31, 2009 Category: Palliative Care Authors: Reich M, Gaudron C, Penel N Tags: Palliat Support Care Source Type: journals

Palliative care as a human right.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19006585 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Breitbart W Tags: Palliat Support Care Source Type: journals

The relationship between hope and pain in a sample of hospitalized oncology patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACTObjective:The aims of this study were to describe hope in a sample of hospitalized oncology patients in pain and to determine if various demographic, clinical, and pain characteristics were related to hope. In addition, the individual item and total Herth Hope Index (HHI) scores for these oncology inpatients with pain were compared with those from the general Norwegian population.Method:Oncology inpatients in pain (n = 225) were recruited from the Norwegian Radium Hospital. The research instruments included the HHI, the Brief Pain Inventory (BPI), and the European Organization for Research and Treatment of Canc...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Utne I, Miaskowski C, Bjordal K, Paul SM, Jakobsen G, Rustøen T Tags: Palliat Support Care Source Type: journals

A pilot study of transformation, attributed meanings to the illness, and spiritual well-being for terminally ill cancer patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACTObjective:The present study investigated what types of transformation terminally ill cancer patients experienced from diagnosis until the terminal stage, what meanings terminally ill cancer patients attributed to their illness, and whether or not those who attributed positive meaning to their illness achieved high levels of spiritual well-being as a preliminary study.Method:Ten terminally ill cancer patients in the hospice wards of two general hospitals participated. A clinical psychologist conducted a semistructured interview with the patients individually for about 60 min. Patients completed the FACIT-Sp and ...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Ando M, Morita T, Lee V, Okamoto T Tags: Palliat Support Care Source Type: journals

How do-not-resuscitate orders are utilized in cancer patients: Timing relative to death and communication-training implications.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this study was to determine DNR utilization patterns and whether their use is increasing.Methods:A retrospective database analysis (2000-2005) of DNR data for 206,437 patients, the entire patient population at Memorial Sloan-Kettering Cancer Center (MSKCC), was performed.Results:The hospital recorded, on average, 4,167 deaths/year. In 2005, 86% of inpatient deaths had a DNR, a 3% increase since 2000 (p < .01). For patients who died outside the institution (e.g., hospice), 52% had a DNR, a 24% increase over 6 years (p < .00001). Adult inpatients signed 53% of DNRs but 34% were signed by surrogates. Th...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Levin TT, Li Y, Weiner JS, Lewis F, Bartell A, Piercy J, Kissane DW Tags: Palliat Support Care Source Type: journals

Palliative care at home: Carers and medication management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACTObjective:The decision to receive palliative care at home brings with it the complexity of managing a medication regime. Effective symptom control is often directly linked to medication management and relies on access to medications at all times. In home-based palliative care practice, polypropylene syringes of medications may be drawn up and left in clients' domestic refrigerators for subcutaneous administration by carers to provide immediate relief for symptoms such as pain and nausea. However, although there has been some discussion in the literature about the need for ready access to medications for symptom...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Anderson BA, Kralik D Tags: Palliat Support Care Source Type: journals

Barriers to hospice enrollment among lung cancer patients: A survey of family members and physicians.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACTObjective:Most patients diagnosed with lung cancer present with advanced stage disease and have a poor chance of long-term survival. Despite the advantages of hospice care for lung cancer patients, many are enrolled late in the course of their illness or not at all. We sought to identify reasons for this pattern.Method:A list of perceived barriers to hospice enrollment was generated and used to create two self-administered surveys, one for physicians and one for caregivers. After focus group testing, the finalized instruments were mailed to physicians in South Carolina and to caregivers of lung cancer patients ...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Ford DW, Nietert PJ, Zapka J, Zoller JS, Silvestri GA Tags: Palliat Support Care Source Type: journals

Attitudes of Iranian nurses toward caring for dying patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACTObjective:To examine the attitudes of Iranian nurses toward caring for dying patients.Methods:Nurses' attitudes toward death and caring for dying patients were examined by using two types of questionnaires: the Death Attitude Profile-Revised (DAP-R) and Frommelt's Attitude towards Caring for Dying Patients (FATCOD), both with a demographic survey.Results:The results showed that most respondents are likely to view death as a natural part of life and also as a gateway to the afterlife. The majority reported that they are likely to provide care and emotional support for the people who are dying and their families,...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Iranmanesh S, Dargahi H, Abbaszadeh A Tags: Palliat Support Care Source Type: journals

Colchicine mouth washings to improve oral mucositis in patients with hematological malignancies: A clinical trial.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study was a one-arm, nonrandomized clinical trial that used a historical control group. Patients were included in the study from the first day of mucositis and followed up until discharge. Patients received 2 mg colchicine mouthwashes daily for 5 days or saline solution. OM was assessed once daily until symptom resolution, using the WHO grading scale of 0-4 and a visual analogue scale. We determined that at least 40 patients in the colchicine group would be needed to detect a 20% difference in the duration of OM between Groups A and B, with a 95% confidence level and a power of 80%.Results:82 patients were included in...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Garavito AA, Cardona AF, Reveiz L, Ospina E, Yepes A, Ospina V Tags: Palliat Support Care Source Type: journals

Depression in women with metastatic breast cancer: A review of the literature.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACTObjective:The aim of this article is to review the available literature on depression in women with metastatic breast cancer in terms of prevalence, potential risk factors, and consequences, as well as pharmacological and psychological interventions.Method:An extensive review of the literature was conducted.Results:The prevalence of depression appears to be especially elevated in patients with advanced cancer. Many demographic, medical, and psychosocial factors may increase the risk that women will develop depressive symptoms during the course of their illness. Despite the fact that depression appears to be ass...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Caplette-Gingras A, Savard J Tags: Palliat Support Care Source Type: journals

Recognition, reflection, and role models: Critical elements in education about care in medicine.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article addresses how we teach medical students the art of caring for the person rather than simply treating the disease-a question particularly relevant to end-of-life care where, in addition to the physical needs, attention to the psychosocial, emotional, and spiritual needs of the patient is paramount. Following an overview of what it is to care and why it is important that patients feel cared for, we investigate how we learn to care and develop caring human relationships, describing the development and display of empathy in adulthood and the developmental impact of human interaction.Results:We outline evidence of ...
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Janssen AL, Macleod RD, Walker ST Tags: Palliat Support Care Source Type: journals

The dying patient: The right to know versus the duty to be aware.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19006595 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Authors: Pery S, Wein S Tags: Palliat Support Care Source Type: journals

Clinical update: literature abstracts.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Authors: PMID: 19006596 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - November 15, 2008 Category: Palliative Care Tags: Palliat Support Care Source Type: journals

Thoughts on the goals of psychosocial palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 18662413 [PubMed - in process] (Source: Palliative and Supportive Care)
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Breitbart W Tags: Palliat Support Care Source Type: journals

The geriatric depression scale in palliative care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: This research examined the psychometric properties of previously published short forms of the Geriatric Depression Scale (GDS) in patients receiving palliative care. It also uses the full form of the GDS to examine the prevalence of nonsomatic symptoms of depression in palliative patients. METHOD: Participants were 84 patients with advanced cancer attending palliative care outpatient clinics. Scores for short forms of the GDS were derived from administering the original 30-item scale. Patients also completed the single item numerical analogue scale for depression from the Edmonton Symptom Assessment System a...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Crawford GB, Robinson JA Tags: Palliat Support Care Source Type: journals

Psychiatric disorders and background characteristics of cancer patients' family members referred to psychiatric consultation service at National Cancer Center Hospitals in Japan.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Psychological distress of cancer patients' family members is treated by psychiatric consultation service for outpatients at National Cancer Center Hospitals in Japan. The purpose of this study was to identify psychiatric disorders and explore background characteristics of cancer patients' family members referred to psychiatric consultation service, so that we could better understand current utilization of this psychiatric consultation service for cancer patients' family members. METHODS: A retrospective descriptive study using clinical practice data obtained for 5 years (from January 2000 to December 2004) w...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Asai M, Akechi T, Nakano T, Shimizu K, Umezawa S, Akizuki N, Uchitomi Y Tags: Palliat Support Care Source Type: journals

The meaning of quality of life: narrations by patients with incurable cancer in palliative home care.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study shows that it is feasible to perform individual interviews with patients approaching death and elucidate the meaning of patients' quality of life in palliative home care. Patients oscillate between being in intense suffering and having breathing space in this suffering, which somewhat opposes the traditional picture of a continuous linear deterioration. Being cared for at home by family caregivers and health care professionals provided a sense of independency and security. Being at home safeguards patients' entire life situation and increases quality of life. PMID: 18662416 [PubMed - in process] (Source: Pal...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Melin-Johansson C, Odling G, Axelsson B, Danielson E Tags: Palliat Support Care Source Type: journals

Quality of life among women after surgery for ovarian cancer.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVES: Difficulties with diagnosis and aggressive, long-term treatment may result in lower quality of life (QOL), including high levels of anxiety, depression, and uncertainty, greater symptom distress, and lower overall QOL among women with avarian cancer. The purpose of this study was to describe demographic, clinical, and other risk factors associated with compromised QOL among women who have undergone surgery for avarian malignancies. METHODS: Subjects were recruited to participate in a clinical trial that tested a specialized nursing intervention addressing psychological and physical care among women post-sur...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Schulman-Green D, Ercolano E, Dowd M, Schwartz P, McCorkle R Tags: Palliat Support Care Source Type: journals

A qualitative study of the experiences of women with metastatic breast cancer.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: My objective was to investigate the experiences of women diagnosed with metastatic breast cancer. METHOD: I did a qualitative study based on interview data. Fourteen women with metastatic breast cancer were recruited into a larger study of online support group use. Participants were interviewed by phone. RESULTS: The women indicated that they experience distress because of concerns about body image, declines in aspects of their sexual lives, and worries about the effect of stress on their illness. The stress that worries these women comes from fear of dying, fear of disease progression and debilitation, the ...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Vilhauer RP Tags: Palliat Support Care Source Type: journals

Hope in adults, ages 20-59, with advanced stage cancer.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVES: The diagnosis of terminal cancer begins one of the most complex and challenging individual experiences of human life that requires multiple coping responses, one of those being hope. There are few studies that provide descriptions of hope over time for adults, ages 20-59, with advanced stage cancer. The purpose of this study was to describe hope as defined and experienced by young and middle age adults with advanced stage cancer. METHODS: This descriptive, longitudinal qualitative research study interviewed 12 hopeful adults with advanced stage cancer once a month for 3 months. RESULTS: By definition, this ...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Reynolds MA Tags: Palliat Support Care Source Type: journals

Caregivers' differing needs across key experiences of the advanced cancer disease trajectory.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study examines a variety of particular needs across a number of more discrete illness-related transition experiences specifically in the advanced cancer disease trajectory. METHODS: One hundred fifty-nine female informal caregivers of people with advanced cancer completed a needs assessment survey. RESULTS: Analyses of these cross-sectional retrospective-report data reveal that cancer caregiver needs vary across specific key experiences occurring within the broader stages of illness identified by current literature. Furthermore, caregivers have unique needs during bereavement. SIGNIFICANCE OF RESULTS: Although the sam...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: DuBenske LL, Wen KY, Gustafson DH, Guarnaccia CA, Cleary JF, Dinauer SK, McTavish FM Tags: Palliat Support Care Source Type: journals

Family health care decision making and self-efficacy with patients with ALS at the end of life.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study compared the preferences of patients with ALS for involving family in health care decisions at the end of life with the actual involvement reported by the family after death. METHODS: A descriptive correlational design with 16 patient-family member dyads was used. Quantitative findings were enriched with in-depth interviews of a subset of five family members following the patient's death. RESULTS: Eighty-seven percent of patients had issued an advance directive. Patients who would opt to make health care decisions independently (i.e., according to the patient's preferences alone) were most likely to have their f...
Source: Palliative and Supportive Care - September 1, 2008 Category: Palliative Care Authors: Nolan MT, Kub J, Hughes MT, Terry PB, Astrow AB, Carbo CA, Thompson RE, Clawson L, Texeira K, Sulmasy DP Tags: Palliat Support Care Source Type: journals