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Text
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<a href="http://doi.org/10.1001/archinte.165.4.401" target="_blank" rel="noreferrer">http://doi.org/10.1001/archinte.165.4.401</a>
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Title
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Forgoing treatment at the end of life in 6 European countries
Publisher
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Archives Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
statistics & numerical data Male Middle Aged Physician's Practice Patterns; statistics & numerical data Physician-Patient Relations Questionnaires Refusal to Treat; 80 and over Cause of Death/trends Child Child; Adolescent Adult Aged Aged; Attitudes; Non-U.S. Gov't Retrospective StudiesTerminally Ill Treatment Refusal/statistics & numerical data; PedPal Lit; Practice Humans Infant Life Support Care; Preschool Comparative StudyDecision Making Europe/epidemiology Female Health Knowledge; statistics & numerical data Registries; statistics & numerical data Research Support
Creator
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Bosshard G; Nilstun T; Bilsen J; Norup M; Miccinesi G; van Delden JJ; Faisst K; van der Heide A
Description
An account of the resource
Background: Modern medicine provides unprecedentedopportunities in diagnostics and treatment. However,in some situations at the end of a patient’s life, manyphysicians refrain from using all possible measures to prolonglife. We studied the incidence of different types oftreatment withheld or withdrawn in 6 European countriesand analyzed the main background characteristics.Methods: Between June 2001 and February 2002,samples were obtained from deaths reported to registriesin Belgium, Denmark, Italy, the Netherlands, Sweden,and Switzerland. The reporting physician was thensent a questionnaire about the medical decision-makingprocess that preceded the patient’s death.Results: The incidence of nontreatment decisions,whether or not combined with other end-of-life decisions,varied widely from 6% of all deaths studied in Italyto 41% in Switzerland. Most frequently forgone in everycountry were hydration or nutrition and medication, togetherrepresenting between 62% (Belgium) and 71%(Italy) of all treatments withheld or withdrawn. Forgoingtreatment estimated to prolong life for more than 1month was more common in the Netherlands (10%), Belgium(9%), and Switzerland (8%) than in Denmark (5%),Italy (3%), and Sweden (2%). Relevant determinants oftreatment being withheld rather than withdrawn wereolder age (odds ratio [OR], 1.53; 95% confidence interval[CI], 1.31-1.79), death outside the hospital (death inhospital: OR, 0.80; 95% CI, 0.68-0.93), and greater lifeshorteningeffect (OR, 1.75; 95% CI, 1.27-2.39).Conclusions: In all of the participating countries, lifeprolongingtreatment is withheld or withdrawn at the endof life. Frequencies vary greatly among countries. Lowtechnologyinterventions, such as medication or hydrationor nutrition, are most frequently forgone. In olderpatients and outside the hospital, physicians prefer notto initiate life-prolonging treatment at all rather than stopit later.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/archinte.165.4.401" target="_blank" rel="noreferrer">10.1001/archinte.165.4.401</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
80 and over Cause of Death/trends Child Child
Adolescent Adult Aged Aged
Archives Of Internal Medicine
Attitudes
Backlog
Bilsen J
Bosshard G
Faisst K
Journal Article
Miccinesi G
Nilstun T
Non-U.S. Gov't Retrospective StudiesTerminally Ill Treatment Refusal/statistics & numerical data
Norup M
PedPal Lit
Practice Humans Infant Life Support Care
Preschool Comparative StudyDecision Making Europe/epidemiology Female Health Knowledge
statistics & numerical data Male Middle Aged Physician's Practice Patterns
statistics & numerical data Physician-Patient Relations Questionnaires Refusal to Treat
statistics & numerical data Registries
statistics & numerical data Research Support
van Delden JJ
van der Heide A
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
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URL Address
<a href="http://doi.org/10.1136/jme.2005.011767" target="_blank" rel="noreferrer">http://doi.org/10.1136/jme.2005.011767</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
On the difficulty of neurosurgical end of life decisions
Publisher
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Journal Of Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2006
Subject
The topic of the resource
Adolescent Adult Aged Aged; PedPal Lit; 80 and over Brain Injuries/surgery/therapy Child Child; Preschool Decision Making Ethics Consultation Female Humans Intracranial Hemorrhages/surgery/therapy Male Middle Aged Neurosurgical Procedures/ethics Patient Care Team Prognosis Prospective Studies Withholding Treatment/ethics
Creator
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Schaller C; Kessler M
Description
An account of the resource
OBJECTIVE: To analyse the process of end of life decisions in a neurosurgical environment. METHODS: All 113 neurosurgical patients, who were subject to so called end of life decisions within a one year period were prospectively enrolled in a computerised data bank. Decision pathways according to patient and physician related parameters were assessed. RESULTS: Leading primary diagnoses of the patients were traumatic brain injury and intracranial haemorrhage. Forty-five patients had undergone an emergency neurosurgical operation prior to end of life decision, N = 69 were conservatively treated, which included intracranial pressure recording, or they were not offered neurosurgical care because of futile prognosis. N = 111 died after a median of two (zero to nine) days. Two, in whom the end of life decisions were revised, survived. Clear decisions to terminate further treatment were made by a senior staff member on call being informed by the senior resident on call (27.4%), difficult decisions on the basis of extensive round discussions (71.7%), and very difficult decision by an interdisciplinary ethical consult (0.9%). Decisions were further substantiated by electrophysiological examinations in N = 59. CONCLUSION: End of life decisions are to be considered standard situations for neurosurgeons. These decisions may reach a high rate of "positive" prediction, if substantiated by electrophysiological examinations as well as on the grounds of clinical experience and respect for the assumed will of the patient. The fact that patients may survive following revision of an end of life decision underlines the necessity for repeated reassessment of these decisions. Ethical training for neurosurgeons is to be encouraged.
2006
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1136/jme.2005.011767" target="_blank" rel="noreferrer">10.1136/jme.2005.011767</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2006
80 and over Brain Injuries/surgery/therapy Child Child
Adolescent Adult Aged Aged
Backlog
Journal Article
Journal of Medical Ethics
Kessler M
PedPal Lit
Preschool Decision Making Ethics Consultation Female Humans Intracranial Hemorrhages/surgery/therapy Male Middle Aged Neurosurgical Procedures/ethics Patient Care Team Prognosis Prospective Studies Withholding Treatment/ethics
Schaller C
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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URL Address
<a href="http://doi.org/10.1016/j.jpainsymman.2004.09.002" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2004.09.002</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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A comparison between telephone and bedside consultations given by palliative care consultation teams in the Netherlands: results from a two-year nationwide registration
Publisher
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Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
patient care team; Adolescent Adult Aged Aged; PedPal Lit; methods; 80 and over Child Child; methods Male Middle Aged Netherlands Palliative Care/; Preschool Comparative Study Female Humans Interviews/; Referral and Consultation Registries; Telephone
Creator
An entity primarily responsible for making the resource
Schrijnemaekers V; Courtens A; Kuin A; van der Linden B; Vernooij-Dassen M; van Zuylen L; van den Beuken M
Identifier
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<a href="http://doi.org/10.1016/j.jpainsymman.2004.09.002" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2004.09.002</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2005
2005
80 and over Child Child
Adolescent Adult Aged Aged
Backlog
Courtens A
Journal Article
Journal of Pain and Symptom Management
Kuin A
Methods
methods Male Middle Aged Netherlands Palliative Care/
Patient Care Team
PedPal Lit
Preschool Comparative Study Female Humans Interviews/
Referral and Consultation Registries
Schrijnemaekers V
Telephone
van den Beuken M
van der Linden B
van Zuylen L
Vernooij-Dassen M
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1023/b:qure.0000018486.91360.00" target="_blank" rel="noreferrer">http://doi.org/10.1023/b:qure.0000018486.91360.00</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group
Publisher
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Quality of Life Research
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
quality of life; Psychological; Adolescent Adult Aged Aged; PedPal Lit; 80 and over Child Comparative Study Cross-Cultural Comparison Cross-Sectional Studies Female Humans Male Middle Aged Psychometrics/; 830). Sick and well respondents were sampled from the general population; and to test its main psychometric properties. The WHOQOL-BREF is a 26-item version of the WHOQOL-100 assessment. Its psychometric properties were analysed using cross-sectional data obtained from a survey of adults carried out in 23 countries (n = 11; as reflected by its four domains: physical; as well as from hospital; clinical settings and clinical trials. Using data from the WHOQOL-BREF field trials; cross-culturally valid assessment of QOL; discriminant validity and construct validity through confirmatory factor analysis; indicate that the WHOQOL-BREF has good to excellent psychometric properties of reliability and performs well in preliminary tests of validity. These results indicate that overall; instrumentation; item-total correlations; rehabilitation and primary care settings; serving patients with physical and mental disorders and with respect to quotas of important socio-demographic variables. The WHOQOL-BREF self-assessment was completed; Sickness Impact Profile World Health Organization%X Quality of life (QOL) assessments that are easily administered and which do not impose a great burden on the respondent are needed for use in large epidemiological surveys; social and environment.; the objectives of this work are to examine the performance of the WHOQOL-BREF as an integrated instrument; the WHOQOL-BREF is a sound; together with socio-demographic and health status questions. Analyses of internal consistency
Creator
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Skevington SM; Lotfy M; O'Connell KA
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1023/b:qure.0000018486.91360.00" target="_blank" rel="noreferrer">10.1023/b:qure.0000018486.91360.00</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2004
2004
80 and over Child Comparative Study Cross-Cultural Comparison Cross-Sectional Studies Female Humans Male Middle Aged Psychometrics/
830). Sick and well respondents were sampled from the general population
Adolescent Adult Aged Aged
and to test its main psychometric properties. The WHOQOL-BREF is a 26-item version of the WHOQOL-100 assessment. Its psychometric properties were analysed using cross-sectional data obtained from a survey of adults carried out in 23 countries (n = 11
as reflected by its four domains: physical
as well as from hospital
Backlog
clinical settings and clinical trials. Using data from the WHOQOL-BREF field trials
cross-culturally valid assessment of QOL
discriminant validity and construct validity through confirmatory factor analysis
indicate that the WHOQOL-BREF has good to excellent psychometric properties of reliability and performs well in preliminary tests of validity. These results indicate that overall
instrumentation
item-total correlations
Journal Article
Lotfy M
O'Connell KA
PedPal Lit
Psychological
Quality Of Life
Quality of Life Research
rehabilitation and primary care settings
serving patients with physical and mental disorders and with respect to quotas of important socio-demographic variables. The WHOQOL-BREF self-assessment was completed
Sickness Impact Profile World Health Organization%X Quality of life (QOL) assessments that are easily administered and which do not impose a great burden on the respondent are needed for use in large epidemiological surveys
Skevington SM
social and environment.
the objectives of this work are to examine the performance of the WHOQOL-BREF as an integrated instrument
the WHOQOL-BREF is a sound
together with socio-demographic and health status questions. Analyses of internal consistency