1
40
4
-
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/10.1001/jama.2009.1198" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.2009.1198</a>
Dublin Core
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
Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial
Publisher
An entity responsible for making the resource available
Jama
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Subject
The topic of the resource
Female; Humans; Male; Aged; Middle Aged; Treatment Outcome; Length of Stay; Patient Participation; Affect; Sickness Impact Profile; Patient Education as Topic; Emergency Service; quality of life; Hospital/utilization; Adaptation; Psychological; patient care team; Terminally Ill/psychology; social support; Health Services/utilization; Hospitalization/statistics & numerical data; Intensive Care Units/utilization; Intervention; Interventions; Kaplan-Meiers Estimate; Neoplasms/mortality/nursing/psychology/therapy; Outcomes; Palliative Care/methods
Creator
An entity primarily responsible for making the resource
Bakitas M; Lyons KD; Hegel MT; Balan S; Brokaw FC; Seville J; Hull JG; Li Z; Tosteson TD; Byock IR; Ahles TA
Description
An account of the resource
CONTEXT: There are few randomized controlled trials on the effectiveness of palliative care interventions to improve the care of patients with advanced cancer. OBJECTIVE: To determine the effect of a nursing-led intervention on quality of life, symptom intensity, mood, and resource use in patients with advanced cancer. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial conducted from November 2003 through May 2008 of 322 patients with advanced cancer in a rural, National Cancer Institute-designated comprehensive cancer center in New Hampshire and affiliated outreach clinics and a VA medical center in Vermont. INTERVENTIONS: A multicomponent, psychoeducational intervention (Project ENABLE [Educate, Nurture, Advise, Before Life Ends]) conducted by advanced practice nurses consisting of 4 weekly educational sessions and monthly follow-up sessions until death or study completion (n = 161) vs usual care (n = 161). MAIN OUTCOME MEASURES: Quality of life was measured by the Functional Assessment of Chronic Illness Therapy for Palliative Care (score range, 0-184). Symptom intensity was measured by the Edmonton Symptom Assessment Scale (score range, 0-900). Mood was measured by the Center for Epidemiological Studies Depression Scale (range, 0-60). These measures were assessed at baseline, 1 month, and every 3 months until death or study completion. Intensity of service was measured as the number of days in the hospital and in the intensive care unit (ICU) and the number of emergency department visits recorded in the electronic medical record. RESULTS: A total of 322 participants with cancer of the gastrointestinal tract (41%; 67 in the usual care group vs 66 in the intervention group), lung (36%; 58 vs 59), genitourinary tract (12%; 20 vs 19), and breast (10%; 16 vs 17) were randomized. The estimated treatment effects (intervention minus usual care) for all participants were a mean (SE) of 4.6 (2) for quality of life (P = .02), -27.8 (15) for symptom intensity (P = .06), and -1.8 (0.81) for depressed mood (P = .02). The estimated treatment effects in participants who died during the study were a mean (SE) of 8.6 (3.6) for quality of life (P = .02), -24.2 (20.5) for symptom intensity (P = .24), and -2.7 (1.2) for depressed mood (P = .03). Intensity of service did not differ between the 2 groups. CONCLUSION: Compared with participants receiving usual oncology care, those receiving a nurse-led, palliative care-focused intervention addressing physical, psychosocial, and care coordination provided concurrently with oncology care had higher scores for quality of life and mood, but did not have improvements in symptom intensity scores or reduced days in the hospital or ICU or emergency department visits. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00253383.
2009
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/jama.2009.1198" target="_blank" rel="noreferrer">10.1001/jama.2009.1198</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
2009
Adaptation
Affect
Aged
Ahles TA
Backlog
Bakitas M
Balan S
Brokaw FC
Byock IR
Emergency Service
Female
Health Services/utilization
Hegel MT
Hospital/utilization
Hospitalization/statistics & numerical data
Hull JG
Humans
Intensive Care Units/utilization
Intervention
Interventions
JAMA
Journal Article
Kaplan-Meiers Estimate
Length Of Stay
Li Z
Lyons KD
Male
Middle Aged
Neoplasms/mortality/nursing/psychology/therapy
Outcomes
Palliative Care/methods
Patient Care Team
Patient Education as Topic
Patient Participation
Psychological
Quality Of Life
Seville J
Sickness Impact Profile
Social Support
Terminally Ill/psychology
Tosteson TD
Treatment Outcome
-
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/10.1016/s0885-3924(98)00139-0" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0885-3924(98)00139-0</a>
Dublin Core
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
Conceptual models and the outcomes of caring
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
1999
Creator
An entity primarily responsible for making the resource
Byock IR
Description
An account of the resource
Conceptual models and the taxonomies associated with them are inherent tools of goal-directed activity. Conceptual models partition reality, discerning differences within a phenomenologic continuum; a process that is a fundamental requisite for measurement. This paper presents theoretical observations regarding the influence of conceptual models on goal-directed endeavors and explores specific implications for outcome measurement in palliative care. The dominant model of end-of-life care is the problem-based model of adult medicine. In clinical orientation, hospice and palliative care bear strong similarities to a pediatric and family medical model for early childhood care. This essay examines salient features of a conceptual model for palliative care that draws on a life-cycle or developmental model of human experience in critical transitions and explores application of this model to palliative care. [References: 18]
1999
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0885-3924(98)00139-0" target="_blank" rel="noreferrer">10.1016/s0885-3924(98)00139-0</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
1999
Backlog
Byock IR
Journal Article
Journal of Pain and Symptom Management
-
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/10.7326/0003-4819-132-5-200003070-00012" target="_blank" rel="noreferrer">http://doi.org/10.7326/0003-4819-132-5-200003070-00012</a>
Dublin Core
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
Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids.
Publisher
An entity responsible for making the resource available
Annals Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Humans; Male; United States; Consensus; Treatment Refusal; Aged; Intention; Fluid Therapy; Morals; Food; Suicide; Non-U.S. Gov't; Professional Patient Relationship; Research Support; patient care team; Death and Euthanasia; Psychological; Stress; Ethics; Assisted; Hypnotics and Sedatives/administration & dosage; Double Effect; Palliative Care/legislation & jurisprudence/methods
Creator
An entity primarily responsible for making the resource
Quill TE; Byock IR; Panel ACP-ASIMEnd-of-Life Care Consensus
Description
An account of the resource
When provided by a skilled, multidisciplinary team, palliative care is highly effective at addressing the physical, psychological, social, and spiritual needs of dying patients and their families. However, some patients who have witnessed harsh death want reassurance that they can escape if their suffering becomes intolerable. In addition, a small percentage of terminally ill patients receiving comprehensive care reach a point at which their suffering becomes severe and unacceptable despite unrestrained palliative efforts; some of these patients request that death be hastened. This paper presents terminal sedation and voluntary refusal of hydration and nutrition as potential last resorts that can be used to address the needs of such patients. These two practices allow clinicians to address a much wider range of intractable end-of-life suffering than physician-assisted suicide (even if it were legal) and can also provide alternatives for patients, families, and clinicians who are morally opposed to physician-assisted suicide. This paper will define the two practices, distinguish them from more standard palliative care interventions and from physician-assisted suicide, illustrate them with a real clinical scenario, provide potential guidelines and practicalities, and explore their moral and legal status. Although medicine cannot sanitize dying or provide perfect answers for all challenging end-of-life clinical problems, terminal sedation and voluntary refusal of hydration and nutrition substantially increase patients' choices at this inherently challenging time.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.7326/0003-4819-132-5-200003070-00012" target="_blank" rel="noreferrer">10.7326/0003-4819-132-5-200003070-00012</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
2000
Aged
Annals Of Internal Medicine
Assisted
Backlog
Byock IR
Consensus
Death and Euthanasia
Double Effect
Ethics
Fluid Therapy
Food
Humans
Hypnotics and Sedatives/administration & dosage
Intention
Journal Article
Male
Morals
Non-U.S. Gov't
Palliative Care/legislation & jurisprudence/methods
Panel ACP-ASIMEnd-of-Life Care Consensus
Patient Care Team
Professional Patient Relationship
Psychological
Quill TE
Research Support
Stress
Suicide
Treatment Refusal
United States
-
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/10.1017/S147895150999040X" target="_blank" rel="noreferrer">http://doi.org/10.1017/S147895150999040X</a>
Dublin Core
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
Seriously ill patients' discussions of preparation and life completion: an intervention to assist with transition at the end of life
Publisher
An entity responsible for making the resource available
Palliative & Supportive Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Subject
The topic of the resource
Intervention; Interventions
Creator
An entity primarily responsible for making the resource
Steinhauser KE; Alexander SC; Byock IR; George LK; Tulsky JA
Description
An account of the resource
OBJECTIVE:Patients approaching the end of life not only face challenges to physical well-being but also threats to emotional and spiritual integrity. Yet, identifying appropriate, effective, and brief interventions to address those concerns has proven elusive. We developed an intervention based on life review and emotional disclosure literatures and conducted a pilot study to determine feasibility and acceptability. This article presents qualitative intervention responses.METHOD:We conducted a three-armed randomized control trial to evaluate the effects of preparation and life completion discussion on health outcomes in patients with advanced serious illness. Hospice-eligible subjects were randomly assigned to one of three groups: (1) intervention (life completion discussion intervention), (2) attention control (relaxation meditation), and control (no intervention). Subjects in the intervention arm met with a facilitator three times. Session 1 focused on life story, Session 2 on forgiveness, and Session 3, on heritage and legacy.RESULTS:Eighteen subjects participated in the pilot intervention interviews. Subjects from a range of socioeconomic backgrounds completed the intervention with equal facility. Results from Session 1 demonstrate narrative responses participants gave as they reconnected with previous life roles, values, and accomplishments. The second session illustrated reflections of choices one might have made differently and exploration of forgiveness offered and sought. Content from the first and second sessions laid the foundation for discussing Session 3's lessons learned and heritage and legacy. Responses are summarized to assist clinicians in anticipating life review content that may improve overall quality of life at the end of life.SIGNIFICANCE OF RESULTS:Discussions of life completion may improve important health outcomes for patients at the end of life. This intervention may provide a brief, standardized, and transportable means for improving the quality of life of patients with advanced serious illness.
2009
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1017/S147895150999040X" target="_blank" rel="noreferrer">10.1017/S147895150999040X</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
2009
Alexander SC
Backlog
Byock IR
George LK
Intervention
Interventions
Journal Article
Palliative & Supportive Care
Steinhauser KE
Tulsky JA