Wednesday 9 April 2008

New library book

Now in stock:

Palliative care : the nursing role. 2nd edition 2005 edited by Jean Lugton and Rosemary McIntyre.

Shelved at 616.994 LUG

Paediatric palliative care

Paediatric palliative care.

Lancet 8 Mar 2008, vol. 371, no. 9615, p. 786
Publication type
Editorial.

Paediatric palliative care: challenges and emerging ideas.

Lancet, 8 Mar 2008, vol. 371, no. 9615, p. 852-64, 170 refs
Liben-Stephen, Papadatou-Danai, Wolfe-Joanne.
Author affiliation
The Montreal Children's Hospital of the McGill University Health Center, Montreal, Quebec, Canada.
Abstract
Paediatric palliative care is an emerging subspecialty that focuses on achieving the best possible quality of life for children with life-threatening conditions and their families. To achieve this goal, the individuals working in this field need to: clearly define the population served; better understand the needs of children with life- threatening conditions and their families; develop an approach that will be appropriate across different communities; provide care that responds adequately to suffering; advance strategies that support caregivers and health-care providers; and promote needed change by cultivating educational programmes. Despite these challenges, advances in paediatric palliative care have been achieved in a short period of time; we expect far greater progress as the field becomes more formalised and research networks are established. Grant ID: 5 K07 CA 096746, Acronym: CA, Agency: United States NCI.

Palliative care for critically ill older adults: dimensions of nursing advocacy.

Palliative care for critically ill older adults: dimensions of nursing advocacy.

Critical care nursing quarterly, Jan-Mar 2008, vol. 31, no. 1, p. 19-23
Dawson-Katherine-A.
Author affiliation
Center for Palliative Care, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA. kadawson9@aol.com.
Abstract
Overall, critical care nursing and medical teams are inadequately prepared to deliver palliative care for the critically ill geriatric patient. Conversations with nursing and medical providers caring for the frail elderly within an intensive care unit often reveal feelings of concern for overtreatment of patients when hope for improvement has diminished. Decline of critically ill elders regularly results in conflicts and disagreements surrounding care directives among patient, family, nursing, and specialty service teams. Uncertainty shrouds the care goals as the patient declines within a critical care setting. Nursing and medical providers caring for the critically ill elderly population often waver anxiously between aggressive verses palliative care measures and are troubled by ethical dilemmas of doing more harm than good. Collaborative, interdisciplinary practice in the face of such dilemmas offers an interactive and practical approach that promotes clinical excellence and improves quality of care for the critically ill. This article defines palliative care, discusses the complexities of caring for the critically ill older adult, and suggests recommendations for nursing practice.
Descriptors

Facilitating good process in primary palliative care: does the Gold Standards Framework enable quality performance?

Facilitating good process in primary palliative care: does the Gold Standards Framework enable quality performance?

Family practice, Oct 2007 (epub: 04 Aug 2007), vol. 24, no. 5, p. 486-94
Munday-Daniel, Mahmood-Kashifa, Dale-Jeremy, King-Nigel.
Author affiliation
Warwick Medical School, University of Warwick, Coventry, UK. d.munday @warwick.ac.uk.
Abstract
BACKGROUND: Palliative care is an important, complex aspect of primary care, requiring a multidisciplinary approach. The Gold Standards Framework (GSF), a programme used by over 3,000 UK practices, aims to facilitate high-quality palliative care through the introduction of systematic clinical and organizational processes. Quality payments for palliative care are available to UK practices which maintain registers and hold multidisciplinary meetings. OBJECTIVES: To explore the effectiveness and sustainability of the implementation of GSF at practice level. METHODS: The study followed a qualitative comparative case study design using in-depth interviews and observational data with 15 practices participating in GSF, from three areas differing in socio-geography. Semi-structured interviews (total 45) with GPs, community nurses and practice managers were supplemented by observation of practice meetings and systems, to provide contextual insights. Transcribed interviews were analysed using a thematic matrix approach and comparisons were made within and between practices. Practices were identified on a continuum of performance (high, medium and minimal) according to the evidence of functioning in palliative care-related activity. RESULTS: Considerable variation existed between practices in both the extent of palliative care-related processes and the effectiveness of inter- professional communication. High-performing practices displayed a clear-shared purpose for palliative care with effective communication, whereas minimal performing practices demonstrated little utilization of basic GSF processes and deficiencies in inter- professional communication. CONCLUSION: Effective palliative care requires good team relationships and robust processes. While GSF can enable such improvements, quality measures focusing on processes alone are inadequate to distinguish good practice, questioning the effectiveness of current quality measures in UK general practice.

Trials in palliative treatment--have the goal posts been moved?

Trials in palliative treatment--have the goal posts been moved?

The lancet oncology, Mar 2008, vol. 9, no. 3, p. 186-7

Kirkbride-Peter, Tannock-Ian-F.
Author affiliation
Weston Park Hospital, Sheffield, UK. Peter.Kirkbride@sth.nhs.uk.
Publication type
Letter.

Is distraction less effective when pain is threatening? An experimental investigation with the cold pressor task.

Is distraction less effective when pain is threatening? An experimental investigation with the cold pressor task.

European journal of pain, Jan 2008 vol. 12, no. 1 p. 60-7
Van-Damme-Stefaan, Crombez-Geert, Van-Nieuwenborgh-De-Wever-Kathleen, Goubert-Liesbet.
Author affiliation
Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
Abstract
Distraction is a commonly used strategy to control pain. However there is doubt about its effectiveness as a clinical tool, and results from both experimental and clinical studies remain inconclusive. Recent theoretical advancements suggest that distraction of attention may be less effective when pain is threatening. The aim of the present study was to experimentally investigate this hypothesis. Pain-free volunteers (N=101) participated in a cold pressor test. Half of the participants simultaneously performed a cognitive distraction task, the other half did not. The threat value of the pain was manipulated by means of verbal information. The results showed that distraction resulted in less attention to the pain and lower pain ratings once the cold pressor procedure was halted. The hypothesis that the effectiveness of distraction is modulated by the threat value of pain could not be confirmed. However, threatening information increased catastrophic thoughts and anxiety, and interfered with performance on the distraction task. These findings suggest that caution is required in using distraction as a pain control strategy when the threat value is high, because fearful appraisal of pain is associated with less engagement in distraction tasks.

Supportive care in cancer Jan 2008 vol. 16, no. 1

Effect of hydromorphone on ventilation in palliative care patients with dyspnea.

p. 93-9
Clemens-Katri-Elina, Klaschik-Eberhard.
Author affiliation
Department of Anaesthesiology, Intensive Care Medicine, Palliative Medicine and Pain Therapy, Malteser Hospital Bonn/Rhein-Sieg, Von- Hompesch-Strasse 1, Bonn, Germany. katri-elena.clemens@malteser.de.
Abstract
GOALS: This study assessed the effect of hydromorphone treatment on ventilation and the intensity of dyspnea in palliative care patients. The assessments measured changes in peripheral oxygen saturation (SaO (2)), transcutaneous arterial pressure of carbon dioxide (tcpaCO(2)), respiratory rate (f), and pulse frequency (PF) during the titration phase with hydromorphone for symptomatic therapy of dyspnea. The aims of the study were to verify the efficacy of hydromorphone for the management of dyspnea and assess its effect on ventilation. MATERIALS AND METHODS: Fourteen patients admitted to our palliative care unit were included in this prospective, nonrandomized trial. At admission, all patients suffered from dyspnea. TcpaCO(2), SaO(2), and PF were measured transcutaneously by means of a SenTec Digital Monitor (Sen Tec AG, Switzerland). MAIN RESULTS: As early as 30 min after the first hydromorphone application, mean respiratory rate decreased from 38.8 +/- 4.9 breaths/min (range 30.0-45.0 breaths/min) to 34.6 +/- 4.2 breaths/min (29.0-41.0 breaths/min); after 120 min to 29.0 +/- 3.1 breaths/min (range 24.0-33.0 breaths/min) (p = 0.001). The other monitored respiratory parameter, however, showed no significant changes. A significant improvement was shown in the intensity of dyspnea (numeric rating scale 0-10: 5.2 +/- 1.5 (4-8)/6.4 +/- 2.1 (4-10) vs 1.1 +/- 0.9 (0-3)/2.3 +/- 1.3 (1-5); p = 0.001). CONCLUSIONS: Neither was there a significant decrease in SaO(2) nor a significant increase in tcpaCO(2) after the initial hydromorphone application, i.e., there was no hydromorphone-induced respiratory depression. The first hydromorphone application, however, resulted in a significant decrease in the intensity of dyspnea and respiratory rate.
Clinical-Trial

Palliative care needs of cancer outpatients receiving chemotherapy: an audit of a clinical screening project.

p. 101-7
Morita-Tatsuya, Fujimoto-Koji, Namba-Miki, Sasaki-Naoko, Ito-Tomoko, Yamada-Chika, Ohba-Arisa, Hiroyoshi-Motoki, Niwa-Hiroshi, Yamada- Takeshi, Noda-Tsuneo.
Author affiliation
Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, 3453 Mikatabara-cho, Hamamatsu, Shizuoka, Japan. tmorita@sis.seirei.or.jp.
Abstract
PURPOSE: Although more and more cancer patients are receiving chemotherapy in outpatient settings in their advanced stage and could have a broad range of palliative care needs, referral to the specialized palliative care service is often delayed. The primary aim of this study is to explore the usefulness of a combined intervention for cancer patients in identifying patients with under-recognized palliative care needs and referring them to the specialized palliative care service. The intervention consisted of (1) introducing the specialized palliative care service when starting chemotherapy, (2) using screening tools, and (3) providing on-demand specialized palliative care service. MATERIALS AND METHODS: All cancer patients newly starting chemotherapy with primary tumor sites of the lung, gastrointestine, pancreas, bile duct, breast, ovary, and uterus were included. As routine practice, at the first instruction about chemotherapy, pharmacists provided information about the role of the specialized palliative care service using a pamphlet and handed out screening questionnaires. Screening questionnaires were distributed at every hospital visit. Treating physicians and/or nurses checked the questionnaire before examining the patients. The patients were referred to the palliative care team, if (1) the patients voluntarily wished for the specialized palliative care service or (2) the treating physicians clinically determined that, on the basis of the screening results, the patients had physical or psychological needs appropriate for referral to the specialized palliative care service. The screening questionnaire included an open-ended question about their greatest concerns, the severity of 11 physical symptoms, overall quality-of-life, the distress thermometer, help for information about the treatment and decision-making, economic problems, nutrition, daily activities, and wish for help from the specialized palliative care service. RESULTS: Of 211 patients who newly started chemotherapy, 5 patients refused to complete the questionnaire (compliance rate, 98%). We obtained 1,000 questionnaires from 206 patients. The percentages of missing values ranged from 2.7% to 7.0%. Of 206 patients, 38 (18%) were referred to the palliative care team due to newly recognized problems, in addition to 10 patients with problems well-recognized by primary physicians. The total percentage of patients receiving specialized palliative care service was thus 23% of all patients. Frequently identified problems were oral problems (20%), insomnia (20%), help with information and decision-making (16%), psychological distress defined as the distress thermometer (14%), severe fatigue (9.0%), and severe appetite loss (8.8%). As a whole, problems were identified in half of all questionnaires. CONCLUSION: The combined intervention of introducing the specialized palliative care service, using screening tools and providing on-demand specialized palliative care service, was feasible as part of the routine clinical practice for all cancer patients starting chemotherapy. It might be useful in identifying patients with under-recognized palliative care needs and referring them to the specialized palliative care service at the appropriate
time.

Needs of developing the skills of palliative care at the oncology ward: an audit of symptoms among 203 consecutive cancer patients in Finland.

p. 3-8
Salminen-E, Clemens-K-E, Syrjaenen-K, Salmenoja-H.
Author affiliation
Department of Oncology and Radiotherapy, Turku University Hospital, P.O. Box 52, Savitehtaankatu 1, Turku, Finland. eeva.salminen @tyks.fi.
Abstract
BACKGROUND: To clarify the prevalence and severity of the symptoms, 203 consecutive patients with breast, prostate and other cancers treated mainly for palliation were surveyed. MATERIALS AND METHODS: The series includes 116 men and 87 women with the mean age of 65 years (range 27-86 years). The patients filled-up the Edmonton Symptom Assessment System (ESAS) questionnaire with 11 items describing cancer-related symptoms in the visual analogue scale (VAS) . RESULTS: Altogether, 98% of the patients reported at least 1 of the 10 symptoms. There was a significant difference in the score frequencies between the 10 symptoms (p = 0.0001), fatigue receiving the highest frequency (50.8%) of the high scores. Fatigue was also the single most frequent symptom reported by 86.3% of the patients, followed by pain at effort (71.5%), sleeplessness (71.1%) and depression (59.0%). The most disturbing syndrome was pain (n = 48, 23.9%), followed by fatigue (n = 28, 13.9%), depression (9.5%) and dyspnoea (6.0%). Altogether, 75% had more than 5 symptoms and 10% reported all 10 symptoms. The total number of symptoms was not significantly associated with sex (p = 0.781) or age (p = 0.062), but it was associated with the diagnostic group; patients with breast cancer (n = 41) and those with prostate cancer (n = 44) reported fewer symptoms than the patients with other cancers (n = 116)(p = 0.023, Kruskal-Wallis). CONCLUSIONS: Symptoms related to cancer are common among patients treated with palliative indication, but if not specifically surveyed, may remain un-detected and un-treated. ESAS as a clinical tool brings more symptoms to the attention of the physicians and helps in getting a comprehensive insight into the patient's problems.

American journal of hospice & palliative care, 2007 Dec-2008 Jan, vol. 24, no. 6

Core competencies in palliative care for surgeons: interpersonal and communication skills.

The American journal of hospice & palliative care, 2007 Dec-2008 Jan, vol. 24, no. 6, p. 499-507, 59 refs
Bradley-Ciaran-T, Brasel-Karen-J.
Author affiliation
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. cbradley@mcw.edu.
Abstract
Surgeons are an important part of the multidisciplinary approach to the care of terminally ill and dying patients. Some surgical residencies have recognized the need to incorporate palliative care- related topics into graduate surgical education. One core competency of utmost importance to palliative care is the effective use of interpersonal and communication skills. Four areas of surgical practice are identified where these communication skills are important: during preoperative counseling, when presenting a devastating diagnosis or poor prognosis, when discussing error, and when discussing death. Case examples and recommendations for the appropriate words and actions to use in these scenarios are offered. It is important for both surgeons in practice and those in training to achieve proficiency with these communication skills.
Journal-Article, Review.

Nurse views of the adequacy of decision making and nurse distress regarding artificial hydration for terminally ill cancer patients: a nationwide survey.

The American journal of hospice & palliative care, 2007 Dec-2008 Jan (epub: 29 Jun 2007), vol. 24, no. 6, p. 463-9
Author(s)
Miyashita-Mitsunori, Morita-Tatsuya, Shima-Yasuo, Kimura-Rieko, Takahashi-Mikako, Adachi-Isamu.
Author affiliation
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, Japan. miyasita-tky@umin.net.
Abstract
We evaluated nurse views on the adequacy of decision-making discussion among nurses and physicians regarding artificial hydration for terminally ill cancer patients and nurse distress arising from artificial hydration issues, as well as factors related to this distress. A self-administered questionnaire consisting of 4 questions about nurse views of discussions regarding artificial hydration and 6 questions about nurse distress arising from artificial hydration issues was distributed in participating institutions in October 2002 and returned by mail. A total of 3328 responses (79%) were analyzed. Almost half of the nurses felt that discussion of terminal hydration issues was insufficient. Among responses, 39% of oncology nurses and 78% of palliative care unit (PCU) nurses agreed that patients and medical practitioners discuss the issue of artificial hydration adequately, and 49% and 79%, respectively, agreed that medical practitioners discuss the issue of artificial hydration with other physicians adequately. As for distress on behalf of patients and families who refuse artificial hydration, 44% of oncology nurses and 57% of PCU nurses experienced such distress for patients, and 19% and 28% did so for families, respectively. Furthermore, 48% of oncology nurses and 47% of PCU nurses experienced distress arising from disagreements among medical practitioners about withholding artificial hydration, whereas 44% and 43% experienced distress about medical practitioners refusing artificial hydration, respectively. Discussion among care providers regarding artificial hydration is insufficient, particularly in general wards. Medical practitioners caring for terminally ill cancer patients should engage in greater discussion among patient-centered teams and facilitate individualized decision making.

ACT- for pediatric palliative care.

ACT- for pediatric palliative care.

Full text available at ProQuest
Pediatric nursing, Nov-Dec 2007, vol. 33, no. 6, p. 532-4
Calabrese-Carrie-Lynn.
Author affiliation
Children's Hospital of Philadelphia, PA, USA.
Abstract
There are approximately 400,000 children living in America with life- threatening conditions, and every year approximately 55,000 children die. Many of these children suffer at the time of their death due to lack of aggressive symptom management. While curative medicine is always the primary goal of treatment, there may come a time when parents must choose another option of care for their child. Aggressive Comfort Treatment (ACT) is the option that will make the difference in the life and loss of a child. ACT proposes aggressive symptom management with attention to psychosocial and spiritual needs. Allowing the individual and family to have a voice in the dying process, palliation is pursued just as aggressively as cure once was. In support of ACT, the American Academy of Pediatrics (AAP) recommends the development and broad availability of pediatric palliative care services (AAP, 2007). Promoting life enhancement rather than life extension, ACT will have a monumental impact on the care of a dying child.

JAMA 27 Feb 2008, vol. 299, no. 8, p. 888

Guideline for end-of-life care released.

Full text available at American Medical Association
JAMA : the journal of the American Medical Association, {JAMA}, 27 Feb 2008, vol. 299, no. 8, p. 888, ISSN: 1538-3598.
Author(s)
Kuehn-Bridget-M.

Journal of pain and symptom management, Jan 2008, vol. 35, no. 1

Family caregivers' assessment of symptoms in patients with advanced cancer: concordance with patients and factors affecting accuracy.

Journal of pain and symptom management, Jan 2008 (epub: 05 Nov 2007), vol. 35, no. 1, p. 70-82,

McPherson-Christine-J, Wilson-Keith-G, Lobchuk-Michelle-M, Brajtman- Susan.
Author affiliation
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada. christine.mcpherson@uottawa.ca.
Abstract
The purposes of the study were to examine the concordance between patients' and family caregivers' assessments of patients' symptoms, and to identify demographic and psychosocial factors that affect levels of agreement. Sixty-six patients with advanced cancer receiving palliative care, and their primary, informal caregivers assessed patients' symptoms using the Memorial Symptom Assessment Scale (MSAS). Levels of agreement for individual symptoms ranged from poor to excellent (interclass correlation coefficient 0.07-0.75). Analysis of the group means using paired t-tests revealed significant differences for the MSAS subscales (psychological, physical, and general distress index), and for four of the 12 physical symptoms and five of the six psychological symptoms. The magnitude of the observed differences indicated a small to moderate bias for caregivers to overestimate, which was more marked for psychological than for physical symptoms. A number of factors associated with the caregiver (particularly the emotional state, the burden of providing care, and male gender) and the patient (the perception of being a burden to others) were significantly correlated with levels of disparity on some measures. The findings are consistent with the growing body of literature on the validity of proxy respondents' assessments of patients' symptoms.


Clinical and demographic characteristics help explain variations in pain at the end of life.

Journal of pain and symptom management, Jan 2008 vol. 35, no. 1, p. 10-9

Strassels-Scott-A, Blough-David-K, Veenstra-David-L, Hazlet-Thomas-K, Sullivan-Sean-D.
Author affiliation
Division of Pharmacy Practice, University of Texas at Austin College of Pharmacy, Austin, Texas, USA. scotts1@mail.utexas.edu.
Abstract
The natural history of pain at the end of life is not well understood. The purpose of this study was to estimate the association between clinical and demographic characteristics and pain in persons who received hospice care in the United States. Data for this study were obtained from a national provider of hospice pharmacy services and included information about the hospice and person receiving hospice care, including geographic location, primary diagnoses, pain intensity, and opioid analgesic use. The data were collected from 2000 to 2004. Worst pain intensity during the previous 24 hours was assessed by the hospice nurse using a 0-10 numeric rating scale (0=none, 10=worst) at an average of 4.1 times per person during hospice care. Regression models were constructed to explain last and average pain scores using data from persons with at least two pain intensity scores. Hospice services were provided to 51,578 persons with at least two pain intensity scores. Of this cohort, 52% were female, 87.5% were Caucasian, and 66.4% had a primary diagnosis of cancer. The mean age at discharge or death was 73.8 years. Patient characteristics accounted for nearly one-third and nearly one-half of the variability in last and average pain scores, respectively. Severe pain on admission and frequency of pain reports were associated with less intense pain. Clinical and demographic characteristics contributed to identifying persons who had severe pain during their hospice admission. These data contribute to understanding pain in persons at the end of life.


Family members' perceived needs for bereavement follow-up.

Journal of pain and symptom management, Jan 2008 vol. 35, no. 1, p. 58-69,
Milberg-Anna, Olsson-Eva-Carin, Jakobsson-Maria, Olsson-Maria, Friedrichsen-Maria.
Author affiliation
Department of Social and Welfare Studies, Linkoeping University, Linkoeping, Sweden. anna.milberg@isv.liu.se.
Abstract
Palliative care does not end with the death of the patient, and many palliative care services offer specific follow-up services for the bereaved. The aims of this study were to quantitate perceived bereavement needs and to qualitatively describe these needs. The study design was cross-sectional and targeted family members three to nine months after the patient's death. Two hundred and forty-eight family members responded (response rate 66%) to a postal questionnaire with Likert-type and open-ended questions. The responses to the open-ended items were analyzed with manifest content analysis, and the quantitative part was analyzed with descriptive statistics. The analysis showed that about half of the family members expressed a need for bereavement follow-up. A majority favored a personal meeting, preferably in their own home, with the staff member who had had the most contact with the patient and the family. The family members wanted to talk about what had happened during the palliative phase (e.g., if the patient had suffered or not), and also about their present situation, their feelings of loneliness, and the future. The follow-up procedure made the family member experience a feeling of being recognized as a person with their own needs and was also valuable with regard to the family members' feelings of guilt. The findings are discussed in relation to narrative theory, meaning- based coping, and the dual process model of coping with bereavement, and designing follow-up procedures.

European Journal of Oncology Nursing, Dec 2007, vol. 11, no. 5

Assessing patients' satisfaction and intensity of pain as outcomes in
the management of cancer-related pain.
European Journal of Oncology Nursing, Dec 2007, vol. 11, no. 5, p.
424-33
Panteli-V, Patistea-E.
Research in Greece on cancer patients' perceptions of pain,
satisfaction with pain relief and the quality of their interpersonal
relationships with nurses. Hospitalised patients completed
questionnaires about the levels of pain experienced, waiting times
for pain medication, satisfaction with nurses' management of pain and
their perceptions and expectations of the nurse-patient relationship.
Gender, occupation and educational level differences were analysed.
40 refs.

Recent articles 7th April 2008

A study of the prevalence of vitamin K deficiency in patients with cancer referred to a hospital palliative care team and its association with abnormal haemostasis
D J Harrington
ISSUE:
2008 ; VOL 61 ; PART 4 (2008-April)
Journal Title:Access
Journal of Clinical Pathology From Publisher (/1998 - /#1975 - /)

From Free Medical Journals . com (/1998 - /Embargo: 1 year)

From Proquest NHS (09/1996 - 12/2003)

From UK PubMed Central (/1947 - 02/2005)
Page:
537 - 540
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[article] [author(s)]

Ethical issues arising from the requirement to sign a consent form in palliative care
I Plu
ISSUE:
2008 ; VOL 34 ; PART 4 (2008-July)
Journal Title:Access
Journal of Medical Ethics From Publisher (/2000 - /)

From Proquest NHS (03/1992 - 12/2003)
Page:
279 - 280
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[article] [author(s)]

Neuropsychiatric complications of commonly used palliative care drugs
N Jackson
ISSUE:
2008 ; VOL 84 ; PART 989 (2008-March)
Journal Title:Access
Postgraduate Medical Journal From Publisher (/1999 - /)

From Free Medical Journals . com (/1999 - /Embargo: 1 year)

From Proquest NHS (02/1999 - 12/2003)
Page:
121 - 126
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[article] [author(s)]

Innovative NP role in rural health palliative care
Cole , M . ; Allenby , A .
ISSUE:
2008 ; VOL 15 ; PART 8
Journal Title:Access
Australian Nursing Journal From EBSCO ( CINAHL with Full Text ) - via Athens (07/1993 - )
From Proquest NHS (02/1998 - 12/2007)
Page:
39-39
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[article] [author(s)]

Palliative Medicine 2008 ; Vol 22 ; Part 2 February

Palliative care : careless use of language undermines our identity
Author(s):
Geoffrey Hanks
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
109 - 110
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[article] [author(s)]

The Edmonton Symptom Assessment System : a 15 - year retrospective review of validation studies ( 1991 - 2006 )
Author(s):
Cheryl Nekolaichuk
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
111 - 122
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[article] [author(s)]

Improving the effectiveness of interventions in palliative care : the potential role of qualitative research in enhancing evidence from randomized controlled trials
Author(s):
Kate Flemming
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
123 - 131
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[article] [author(s)]

How well do current instruments using bereaved relatives` views evaluate care for dying patients ?
Author(s):
CR Mayland
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
133 - 144
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[article] [author(s)]

The effect of the Liverpool Care Pathway for the dying : a multi - centre study
Author(s):
Laetitia Veerbeek
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
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From Proquest NHS (01/1998 - 01/2008)
Page:
145 - 151
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Knowledge and information needs of informal caregivers in palliative care : a qualitative systematic review
Author(s):
Andrea Docherty
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
153 - 171
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Death rattle : its impact on staff and volunteers in palliative care
Author(s):
BL Wee
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
173 - 176
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[article] [author(s)]

Patients' experiences of carcinoma of unknown primary site : dealing with uncertainty
Author(s):
Lucy Boyland
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
177 - 183
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[article] [author(s)]

Access to medications in the community by patients in a palliative setting . A systems analysis
Author(s):
M Lucey
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
185 - 189
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[article] [author(s)]

Opioid withdrawal syndrome on switching from hydromorphone to alfentanil
Author(s):
F McMunnigall
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
191 - 192
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[article] [author(s)]

Does acupressure help reduce nausea and vomiting in palliative care patients ? Pilot study
Author(s):
Paul Perkins
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
Access:
From Proquest NHS (01/1998 - 01/2008)
Page:
193 - 194
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The importance of a word : how to translate `breakthrough`
Author(s):
Jose Antonio Ferraz Gonç ; alves
ISSUE:
2008 ; VOL 22 ; PART 2 (2008-February)
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From Proquest NHS (01/1998 - 01/2008)
Page:
195 - 195
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Critical Care Medicine. 36(4) April 2008

Mularski, Richard A. MD, MSHS, MCR
Institution
The Center for Health Research, Kaiser Permanente Northwest, Pulmonary & Critical Care Medicine, Northwest Permanente, PC, Department of Medicine, Oregon Health & Science University, Portland, OR
Title
The search for a good death-Are there quality insights accessible from medical records? *.[Editorial]
Source
Critical Care Medicine. 36(4):1372-1373, April 2008.

Glavan, Bradford J. MD; Engelberg, Ruth A. PhD; Downey, Lois MA; Curtis, J Randall MD, MPH; Institution
From the Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Washington, Seattle, WA.
Title
Using the medical record to evaluate the quality of end-of-life care in the intensive care unit *.[Article]
Source
Critical Care Medicine. 36(4):1138-1146, April 2008.
Abstract
Rationale: We investigated whether proposed "quality markers" within the medical record are associated with family assessment of the quality of dying and death in the intensive care unit (ICU).Objective: To identify chart-based markers that could be used as measures for improving the quality of end-of-life care.Design: A multicenter study conducting standardized chart abstraction and surveying families of patients who died in the ICU or within 24 hrs of being transferred from an ICU.Setting: ICUs at ten hospitals in the northwest United States.Patients: Overall, 356 patients who died in the ICU or within 24 hrs of transfer from an ICU.Measurements: The 22-item family assessed Quality of Dying and Death (QODD-22) questionnaire and a single item rating of the overall quality of dying and death (QODD-1).Analysis: The associations of chart-based quality markers with QODD scores were tested using Mann-Whitney U tests, Kruskal-Wallis tests, or Spearman's rank-correlation coefficients as appropriate.Results: Higher QODD-22 scores were associated with documentation of a living will (p = .03), absence of cardiopulmonary resuscitation performed in the last hour of life (p = .01), withdrawal of tube feeding (p = .04), family presence at time of death (p = .02), and discussion of the patient's wish to withdraw life support during a family conference (p < .001). Additional correlates with a higher QODD-1 score included use of standardized comfort care orders and occurrence of a family conference (p <= .05).Conclusions: We identified chart-based variables associated with higher QODD scores. These QODD scores could serve as targets for measuring and improving the quality of end-of-life care in the ICU.

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Recent articles 24 March 2008

Pediatric palliative care
Author(s):
Norbert Weidner
ISSUE:
2008 ; VOL 9 ; PART 6 (2008/3)
Journal Title:Access
Current Oncology Reports
Page:
437 - 439
ISSN:
Print: 1523-3790
E-Version: 1534-6269
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Survey of bereavement support provided by Australian palliative care services
Author(s):
Mather , M . A . ; Good , P . D . ; Cavenagh , J . D . ; Ravenscroft , P . J .
ISSUE:
2008 ; VOL 188 ; PART 4
Journal Title:Access
Medical Journal of Australia , The From Free Medical Journals . com (/1996 - /)

From Proquest NHS (01/2004 - /)
Page:
228-230

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The role of opioids in cancer pain: BMJ Learning module

The role of opioids in cancer pain: an up to date guide

What's in this case:
The role of opioids in cancer pain: an up to date guideView user opinions
Target audience:
Foundation programme
International
Hospital doctor
CPDGP
CPDGP trainee
The Royal New Zealand College of General Practitioners
Author: Columba Quigley
Biography:
Columba Quigley is a consultant in palliative medicine, working with both a community based team and a hospital support team. In addition, she works in a hospice, where patients are admitted for terminal care, respite, and control of symptoms. Her research interests include the clinical pharmacology of opioids, pain that is poorly responsive to opioids, and switching opioids. She has written systematic reviews in collaboration with the Cochrane Pain, Palliative, and Supportive Care Group.
Resource provider:
BMJ

http://www.learning.bmj.com/learning/search-result.html?moduleId=5003233

Recent journal articles 17th March

Paediatric palliative care
Author(s):
The Lancet
ISSUE:
2008 ; VOL 371 ; PART 9615
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Lancet , the ( British Edition ) From Proquest NHS (01/1990 - 01/2008Embargo: 60 days)
Page:
786
ISSN:
Print: 0140-6736
E-Version: 1474-547X
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Paediatric palliative care : challenges and emerging ideas
Author(s):
Liben S . ; Papadatou D . ; Wolfe J .
ISSUE:
2008 ; VOL 371 ; PART 9615
Journal Title:Access
Lancet , the ( British Edition ) From Proquest NHS (01/1990 - 01/2008Embargo: 60 days)
Page:
852-864
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Print: 0140-6736
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Doubts over palliative care strategy for children
ISSUE:
2008 ; PART 1711
Journal Title:Access
Community Care From Proquest NHS (12/2003 - /)
Page:
11-12
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Print: 0307-5508
BL Shelfmark:
3363.598000
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Palliative and Supportive Care 2008 ; Vol 6 ; Part 1

Every end entails a beginning
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
1-2
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Estimated longevity and changes in spirituality in the context of advanced congestive heart failure
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
3-11
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The surrogate's experience in authorizing a do not resuscitate order
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
13-19
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End - of - life care in nursing home settings : Do race or age matter ?
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
21-27
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Clinical experience of the modified nurse - assisted screening and psychiatric referral program
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
29-32
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Bereaved parents' perspectives on their needs
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2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
33-41
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Evaluating a bereavement support group
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
43-49
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Clinical evaluation of the Mood and Symptom Questionnaire ( MSQ ) in a day therapy unit in a palliative support centre in the United Kingdom
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
51-59
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Meaning in adjustment to cancer : A model of care
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
61-70
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Development of a hospice formulary for psychotropic medications
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
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71-77
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A case of respiratory akathisia in a cancer patient : A case report
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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Page:
79-81
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DREAMS
ISSUE:
2008 ; VOL 6 ; PART 1 (2008/03/01)
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From Proquest NHS (03/2003 - 03/2003)
Page:
85
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European Journal of Cancer Care Volume 17, Issue 2, March 2008

Guest Editorial
Towards a common purpose: group-format clinical supervision can benefit palliative care
ALUN JONES
pages 105–106

Online cancer education forumAbstract only, please see www.onlinecancereducationforum.com
Cancer-related fatigue
D. LOWRIE, msc, bsc srot, & G. LINDSELL, ba (hons), dipcot
pages 107–107

Articles
Smoking cessation among patients with head and neck cancer: cancer as a ‘teachable moment’
L. SHARP, rn, phd, H. JOHANSSON, ba, K. FAGERSTRÖM, phd & L.E. RUTQVIST, md, phd
pages 114–119

Efficacy, toxicity and cost analysis for non-platinum triplet (gemcitabine and vinorelbine, followed by docetaxel) vs. platinum-based chemotherapy in IIIB/IV non-small-cell lung cancer: single-institution experience
H. TADA, ms, rn, S. MATSUI, phd, M. KAWAHARA, md, phd, S. HOSOE, md, phd, C. HAMADA, phd & M. FUKUSHIMA, md, phd
pages 120–126

Quality of life and dyadic adjustment in oral cancer patients and their female partners
J. JENEWEIN, md, R.A. ZWAHLEN, md, dmd, D. ZWAHLEN, ma, N. DRABE, md, H. MOERGELI, phd & S. BÜCHI, md
pages 127–135

The economic burden of cancer in Korea in 2002
S.-G. KIM, ms, researcher, M.-I. HAHM, phd, researcher, K.-S. CHOI, phd, researcher, N.-Y. SEUNG, ms, researcher, H.-R. SHIN, md, phd, senior scientist & E.-C. PARK, md, phd, senior scientist
pages 136–144

Preparatory grief, psychological distress and hopelessness in advanced cancer patients
K. MYSTAKIDOU, md, phd, assistant professor in palliative medicine, E. PARPA, ba, ma in clinical psychology, E. TSILIKA, bsc, msc, health psychologist, P. ATHANASOULI, graduate student in psychology, M. PATHIAKI, md, radiotherapist-oncologist, A. GALANOS, bsc, biostatistician, A. PAGOROPOULOU, assistant professor in psychology, & L. VLAHOS, md, phd professor of radiology and director of radiology department
pages 145–151

Bone and total alkaline phosphatase for screening skeletal metastasis in patients with solid tumours
F. SCHINDLER, ms, postgraduate student, P.P. LAJOLO, md, medical oncologist, H. PINCZOWSKI, md, medical oncologist, F.L.A. FONSECA, phd, A. BARBIERI, md, L.H. MASSONETTO, md, F.T. KATTO, md, & A. del GIGLIO, md, facp, medical oncologist
pages 152–156

‘I’m living with a chronic illness, not . . . dying with cancer': a qualitative study of Australian women's self-identified concerns and needs following primary treatment for breast cancer
M. OXLAD, m.psych, phd, research assistant, T.D. WADE, m.psych, phd, associate professor, L. HALLSWORTH, b.psych.(hons), clinical doctorate candidate, & B. KOCZWARA, bm bs, fracp, mbioethics, head of medical oncology
pages 157–166

Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes
N. TSAVARIS, md, C. KOSMAS, md, P. KOPTERIDES, md, M. VADIAKA, md, N. KOSMAS, md, H. SKOPELITIS, md, D. KARADIMA, md, G. KOLLIOKOSTA, md, E. TZIMA, md, D. LOUKERIS, md, E. PAGOUNI, md, E. BATZIOU, md, V. XYLA, md, & C. KOUFOS, md
pages 167–173

Prognostic factors affecting the outcome of early cervical cancer treated with radical hysterectomy and post-operative adjuvant therapy
M.-T. LIU, md, J.-C. HSU, md, W.-S. LIU, md, A.-Y. WANG, phd, W.-T. HUANG, phd, T.-H. CHANG, md, C.-P. PI, md, C.-Y. HUANG, md, C.-C. HUANG, md, P.-H. CHOU, md, & T.-H. CHEN, md
pages 174–181

The patients' account of outcome following primary surgery for oral and oropharyngeal cancer using a ‘quality of life’ questionnaire
S.N. ROGERS, professor, fdsrcs, frcs, md consultant, J. SCOTT, medical student, A. CHAKRABATI, msc, pgde, rgn, rscn, D. LOWE, msc, c.stat. medical statistician
pages 182–188

Assessing informal caregivers' experiences: a qualitative and psychometric evaluation of the Caregiver Reaction Assessment Scale
C. PERSSON, rpt, phd student, A. WENNMAN-LARSEN, rn, phd student, K. SUNDIN, rnt, phd, & P. GUSTAVSSON, bsc, phd
pages 189–199

Anemia in patients with midgut carcinoid, treated with alpha interferon: effects by erythropoietin treatment on the perceived quality of life
G. LARSSON, phd, & E.T. JANSON, associated professor
pages 200–204

Case report
Two patients with tumours presenting as inguino-scrotal masses
N. ZAMPIERI, md, A. CARABAICH, md, M. CORROPPOLO, md, M. CECCHETTO, md, S. BIANCHI, md, P. MARRADI, md & F.S. CAMOGLIO, professor
pages 205–208

Clinical note
Adult T-cell leukaemia and strongyloidiasis
S. KANAZAWA, K. YAMAGUCHI, Y. KINOSHITA, & S. NOMURA
pages 209–210