Trends in the use of opioids at the end of life and the expected effects on hastening death
Humans; Survival Rate; Analgesics; Attitude of Health Personnel; Questionnaires; Euthanasia; Survival Analysis; Risk Assessment; Risk Factors; decision making; Administration; Oral; Opioid/administration & dosage; Terminal Care/statistics & numerical data; Active/statistics & numerical data/trends; Netherlands/epidemiology; Pain/mortality/prevention & control; Physician's Practice Patterns/statistics & numerical data/trends; Physicians/statistics & numerical data
The aim of our study was to describe trends in opioid use and perceptions of having hastened the end of life of a patient. In 2005, a questionnaire was sent to 6860 physicians in The Netherlands who had attended a death. The response rate was 78%. In 1995 and 2001 similar studies were done. Physicians less often administered opioids with the intention to hasten death in 2005 (3.1% of the non-sudden deaths) than in 2001 and in 1995 (7% and 10%, respectively). Physicians gave similar dosages of opioids in 2005, 2001, and 1995, but physicians in 2005 less often thought that life was actually shortened than in 2001 and 1995 (37% in 2005, 50% in 2001, and 53% in 1995). Of the physicians in 2005 who did think that the life of the patient was shortened by opioids, 94% did not give higher dosages than were, in their own opinion, required for pain and symptom management. Physicians in 2005 more often took hastening death into account when they gave higher dosages of opioids when the patient experienced more severe symptoms and with female patients. In older patients (>or=80 years), physicians took the hastening of death into account more often, but the actual dosages of opioids were lower. These data indicate that physicians in The Netherlands less often thought that death was hastened by opioids and less often gave opioids, with the intention to hasten death in 2005 than in 2001 and 1995.
2009
Rurup ML; Borgsteede SD; van der Heide A; van der Maas PJ; Onwuteaka-Philipsen BD
Journal Of Pain And Symptom Management
2009
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).
Journal Article
<a href="http://doi.org/10.1016/j.jpainsymman.2008.02.010" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2008.02.010</a>
Factors related to the quality of life in adolescents with chronic pain
Child; Cross-Sectional Studies; Female; Humans; Male; Prognosis; Questionnaires; Risk Factors; Psychology; adolescent; PedPal Lit; Chronic disease; quality of life; Netherlands/epidemiology; Pain Measurement; Pain/diagnosis/epidemiology/psychology; Risk Assessment/methods
OBJECTIVE: This study examined the relationships between pain characteristics, psychosocial factors, and quality of life among adolescents with chronic pain that existed for at least 3 months, either recurrently (ie, pain with pain-free intervals) or continuously. METHODS: The authors conducted a cross-sectional study in 194 adolescents aged 12 to 18 years who completed questionnaires on pain, psychosocial factors (ie, vulnerability, reinforcement, modeling, and coping), and quality of life, and also kept a diary about their pain complaints for 3 weeks. RESULTS: Multiple hierarchical regression analysis revealed that psychosocial variables accounted for a significant variance in the adolescents' quality of life, even when controlling for pain characteristics. Analysis of the independent variables showed that pain intensity and vulnerability contributed significantly and uniquely to the variance of most quality-of-life domains. In addition, the authors found that emotion-focused avoidance coping strategies (ie, catastrophizing) strengthened the negative relation between pain intensity and psychological functioning. CONCLUSIONS: In addition to pain, psychosocial factors (vulnerability, reinforcement, modeling, and coping) are strongly associated with quality of life in adolescents with chronic pain. These results may contribute to psychological interventions focused on psychological adaptation in young pain patients to improve their quality of life.
2006
Merlijn VP; Hunfeld JA; van der Wouden JC; Hazebroek-Kampschreur AA; Passchier J; Koes BW
The Clinical Journal Of Pain
2006
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).
Journal Article