Browse Items · Pediatric Palliative Care Library

Decisions about life-sustaining treatment. Impact of physicians' behaviors on the family

BACKGROUND: Despite the growing availability of advance directives, most patients in the intensive care unit lack written directives, and, therefore, consultation with families about treatment decisions remains the rule. In the context of decision…

Whose utilities for decision analysis?

The goal of this study was to examine sources of variation in the utilities assigned to health states. The authors selected a common clinical problem, carcinoma of the rectum, and examined the utilities assigned to colostomy, a common outcome of…

Patient-controlled dose regimen of methadone for chronic cancer pain

Fourteen patients with severe cancer pain participated in a trial of methadone given in a fixed dose (10 mg) but at intervals selected by the patients themselves during the loading phase. The aim was to achieve rapid pain relief while avoiding the…

Palliative care for children with cancer--home, hospital, or hospice?

1990

Tags: 1990, Archives of Disease in Childhood, Backlog, Beardsmore S, Child, Goldman A, Home Nursing, Humans, Hunt J, Journal Article, Location Of Death, Neoplasms/therapy, Non-U.S. Gov't, Palliative Care, Patient Care Team, Research Support, Terminal Care

Life threatening illness and hospice care.

A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening…

Fasting associated with decrease in hypothalamic beta-endorphin

In rats that were fasted for 2 to 3 days there was a decline in hypothalamic, but not pituitary, beta-endorphin. There was no change in pituitary or hypothalamic adrenocorticotropin content as a result of fasting. Endogenous opiates may be involved…

Tags: 1980, Animals, Backlog, Corticotropin/metabolism, Endorphins/metabolism, Fasting, Gambert SR, Garthwaite TL, Hagen TC, Hypothalamus/metabolism, Journal Article, Male, Non-U.S. Gov't, Pituitary Gland/metabolism, Pontzer CH, Rats, Research Support, Science, Time Factors

The effects of self-help and psychotherapy intervention on child loss: the limits of recovery

Results of a longitudinal study of the effects of bereaved parents' participation in a self-help group and in psychotherapy are presented. Active self-help group participants evidenced unique changes in attitudes about bereavement. Reasons for lack…

Combat experience and emotional health: impairment and resilience in later life

War's influence on emotional health includes potential psychological gains as well as losses. In a sample of 149 veterans from longitudinal samples at the Institute of Human Development, University of California, Berkeley, this study explores two…

Husbands and wives as caregivers: antecedents of depression and burden

Contrasting predictors of depression among 101 men and 214 women providing care to spouses suffering from Alzheimer's Disease indicated that the sole predictor for husbands was ill health, whereas for wives less emotional investment was also…

Tags: 1989, Alzheimer Disease/psychology, Backlog, Depression, Home Nursing/psychology, Humans, Interviews, Journal Article, Marriage, Mental Health, P.H.S., Pruchno RA, Regression Analysis, Resch NL, Research Support, Sex Factors, The Gerontologist, U.S. Gov't

Elderly psychiatric patient status and caregiver perceptions as predictors of caregiver burden

Relatives of the impaired elderly: correlates of feelings of burden

1980

Tags: 1980, Aged, Bach-Peterson J, Backlog, Dementia/rehabilitation, Guilt, Humans, Journal Article, Life Support Care, P.H.S., Reever KE, Research Support, The Gerontologist, U.S. Gov't, Zarit SH

Psychiatric and physical morbidity effects of caregiving

Existing empirical literature on the prolonged or cumulative consequences of exposure to the stresses of caregiving is reviewed. Specific goals are to identify psychiatric and physical morbidity effects, report the magnitude of those effects,…

On the elicitation of preferences for alternative therapies

We investigated how variations in the way information is presented to patients influence their choices between alternative therapies. Data were presented summarizing the results of surgery and radiation therapy for lung cancer to 238 ambulatory…

The nature of suffering and the goals of medicine

The question of suffering and its relation to organic illness has rarely been addressed in the medical literature. This article offers a description of the nature and causes of suffering in patients undergoing medical treatment. A distinction based…

Tags: 1982, Backlog, Cassel EJ, Disease, Emotions, Holistic Health, Humans, Journal Article, Medical, Non-P.H.S., Pain/psychology, Patients/psychology, Philosophy, Research Support, Sick Role, The New England Journal Of Medicine, Therapeutics, U.S. Gov't

Sublingual absorption of selected opioid analgesics

Ongoing interest in the improvement of pain management with opioid analgesics had led to the investigation of sublingual opioid absorption. The present report determined the percent absorption of selected opioid analgesics from the oral cavity of…

Death of a child at home or in the hospital: subsequent psychological adjustment of the family

Twenty-four families who had participated in a Home Care Program for children terminally ill with cancer and 13 families of similar children who had died in the hospital completed inventories on parent and sibling personality as well as family…

Effects of framing and level of probability on patients' preferences for cancer chemotherapy

Although most clinicians agree that patients should be informed about treatment alternatives, little is known about the way patients perceive probabilistic information about treatment outcomes and how it influences the choices they make. The purpose…

The nature of opioid responsiveness and its implications for neuropathic pain: new hypotheses derived from studies of opioid infusions

In recent years, the observation that the response of patients to opioid drugs may be influenced by properties inherent in the pain or pain syndrome, such as its pathophysiology, has evolved into the belief that certain types of pain, e.g.,…

Diphosphonates: history and mechanisms of action

The history of diphosphonates began with studies of inorganic pyrophosphate. This compound was found to occur in many biological fluids and inhibited the precipitation of calcium phosphates. It also slowed the transformation of amorphous calcium…

The assessment of values in laryngeal cancer: reliability of measurement methods

Although quantitative estimates of patients' attitudes toward the relative importance of different aspects of health are of great potential usefulness in medical decision making, there is little information about the stability of such values over…

Beta-endorphin disregulation in autistic and self-injurious behavior: a neurodevelopmental hypothesis

Peptides derived from pro-opiomelanocortin (POMC) influence neurodevelopmental processes. Earlier studies indicated that MSH/ACTH compounds improved behavioral efficiency in retarded individuals. Recent studies have shown that opiate blockers reduce…

Tags: 1988, Adult, Autistic Disorder/drug therapy/physiopathology, Backlog, beta-Endorphin/blood/physiology, Clinical Trials, Comparative Study, Developmental Disabilities/drug therapy/physiopathology, Homeostasis, Humans, Journal Article, Male, Naloxone/therapeutic use, Naltrexone/diagnostic use, Non-U.S. Gov't, Research Support, Sandman CA, Synapse (new York, N.Y.)

The 2002 Schering Lecture. Children's cancer symptom experiences: keeping the spirit alive in children and their families

Despite the finding that each child and family experienced cancer in their own unique way, they all shared the need to maintain a sense of spirit. Just as the suffering united the families, so too did their sense of spirit. Talk of the spirit is not…

The Role of Social Support in Coping with Daily Pain among Patients with Rheumatoid Arthritis

Using a daily process methodology, the current study examined the role of social support in coping and pain severity among patients with rheumatoid arthritis (RA). Seventy-three adults with RA completed a structured record twice daily for one week on…

Mapping the journey of cancer patients through the health care system. Part 2: Methodological approaches and basic findings

This is the second in a series of articles from a line of research whose intent was to construct a complete history of interactions with the health care system. This paper provides details of the methods developed to collect and collate the scattered…

Mapping the journey of cancer patients through health care system. Part 1: developing the research question

This is the first in a series of articles relating results from research which constructed a complete history of interactions with the health care system from available data sources for all patients diagnosed in 1990 with primary breast, colorectal,…

Antiepileptic drug therapy for adults: when to initiate and how to choose

Although antiepileptic drugs (AEDs) are commonly used to control and prevent seizures, their long-term use carries a considerable risk of morbidity. The decision to start AEDs is made once the risks of further seizures outweigh the risks of…

Clinical spectrum, morbidity, and mortality in 113 pediatric patients with mitochondrial disease

OBJECTIVES: The aim of this study was to elucidate the frequency of major clinical manifestations in children with mitochondrial disease and establish their clinical course, prognosis, and rates of survival depending on their clinical features.…

Hospital staff and family perspectives regarding quality of pediatric palliative care.

BACKGROUND: Development of a pediatric palliative care program was preceded by a needs assessment that included a staff survey and family interviews regarding improving pediatric palliative care. METHODS: Four hundred forty-six staff members and…

Circumstances surrounding the deaths of hospitalized children: opportunities for pediatric palliative care.

OBJECTIVES: Little is known regarding the assessment and treatment of symptoms during end-of-life (EOL) care for children. This study was conducted to describe the circumstances surrounding the deaths of hospitalized terminally ill children,…

Health services use and health care expenditures for children with disabilities

OBJECTIVE: To examine health care utilization and expenditure patterns for children with disabilities. METHODS: Secondary data analysis was conducted of the 1999 and 2000 editions of the Medical Expenditure Panel Survey (MEPS), a nationally…

Long-term safety and efficacy of risperidone for the treatment of disruptive behavior disorders in children with subaverage IQs

OBJECTIVE: The objective of this study was to investigate the long-term safety and efficacy of risperidone in disruptive behavior disorders in children with subaverage IQs. Disruptive behavior disorders were defined as oppositional defiant disorder,…

Where do children with complex chronic conditions die? Patterns in Washington State, 1980-1998

OBJECTIVE: Little is known about factors that influence whether children with chronic conditions die at home. We sought to test whether deaths attributable to underlying complex chronic conditions (CCCs) were increasingly occurring at home and to…

Process mapping as a tool for home health network analysis

Process mapping is a qualitative tool that allows service providers, policy makers, researchers, and other concerned stakeholders to get a "bird's eye view" of a home health care organizational network or a very focused, in-depth view of a component…

The effect of inpatient hospice units on hospice use post-admission

The objective of this study was to determine whether having a hospice unit within the hospital increases the proportion of terminally ill patients who use hospice services (including home, nursing home, or inpatient hospice) post-admission. Using…

Experiences of families in which a child has a prolonged terminal illness: modifying factors.

A significant proportion of children requiring palliative care have neurodegenerative life-threatening illnesses (NLTIs). While most of their care is provided at home by their families over many years, there is a paucity of research examining…

Tags: 2002, Backlog, Child, Communication, Family, Female, Humans, International Journal of Palliative Nursing, Journal Article, Longitudinal Studies, Male, Neurodegenerative Diseases/nursing, Non-U.S. Gov't, Parents/psychology, Research Support, Steele R, Terminal Care/psychology

Immune mechanisms in pain control

2002

Tags: 2002, Analgesics, Anesthesia & Analgesia, Animals, Backlog, Cellular/physiology, Endorphins/metabolism, Humans, Immune System/physiology, Immunity, Journal Article, Machelska H, Non-U.S. Gov't, Opioid/pharmacology, Opioid/physiology, Pain/drug therapy/immunology/pathology, Receptors, Research Support, Stein C

Mothers' perceptions of benefit following pediatric stem cell transplantation: a longitudinal investigation of the roles of optimism, medical risk, and sociodemographic resources

BACKGROUND: This longitudinal study investigated the course and predictors of benefit finding among 144 mothers of children undergoing hematopoietic stem cell transplantation (HSCT), a severely stressful and life-threatening medical procedure.…

Systematic review of bisphosphonates for hypercalcaemia of malignancy

BACKGROUND: Bisphosphonates are the treatment of choice for hypercalcaemia of malignancy (HCM) but there is no consensus regarding which drug or dose should be given. We designed a systematic review to investigate the efficacy of bisphosphonates in…

Tags: 2004, Backlog, Broadley KE, Diphosphonates/therapeutic use, Edmonds PM, Humans, Hypercalcemia/drug therapy, Journal Article, Neoplasms/complications, Non-U.S. Gov't, Palliative Medicine, Patel S, Randomized Controlled Trials, Research Support, Ross JR, Saunders Y, Steering Group, Treatment Outcome

Goal setting as a measure of outcome in palliative care

Setting goals and assessing outcomes are essential elements in palliative care. This paper describes a multiprofessional project, conducted under the auspices of clinical audit, which attempted to evaluate important outcomes of care. Over a six-month…

Differences in understanding of specialist palliative care amongst service providers and commissioners in South London

This paper describes a study that sought to identify service providers' and commissioners' understanding of specialist palliative care within the context of changing service provision in one area of South London. Using a formative evaluation…

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