1
40
6
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Text
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<a href="http://doi.org/10.1016/j.jpainsymman.2013.08.018" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2013.08.018</a>
Dublin Core
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Title
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Symptoms and problem clusters in cancer and non-cancer patients in specialized palliative care-is there a difference?
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
2014
Subject
The topic of the resource
Female; Humans; Male; Palliative Care; Neoplasms; symptoms; Aged; Inpatients; Germany; cancer; Cluster Analysis; non-cancer; problems
Creator
An entity primarily responsible for making the resource
Stiel S; Matthies Dominik MK; Seuß D; Walsh D; Lindena G; Ostgathe C
Description
An account of the resource
CONTEXT: In clinical practice, some symptoms and problems frequently occur in combination, which may have consequences for symptom management. OBJECTIVES: Facing a growing number of non-cancer patients in palliative care, this study aimed to differentiate symptom clusters in the non-cancer population from those in cancer patients. METHODS: Inpatient data from the German Hospice and Palliative Care Evaluation between 2007 and 2011 were used for a cluster analysis of a 16-item symptom and problem checklist. An agglomerative hierarchical method was chosen. Coefficients from distance matrix ranging between 0 and 1 were calculated to indicate the interrelationship of clustered symptoms. RESULTS: The analysis identified five clusters in cancer patients: 1) nausea and vomiting (d = 0.000); 2) anxiety, tension, and feeling depressed (d = 0.125); 3) wound care and disorientation/confusion (d = 0.229); 4) organization of care and overburdening of family (d = 0.202); and 5) weakness, tiredness, need for assistance with activities of daily living, and loss of appetite (d = 0.207). Five comparable clusters were identified in non-cancer patients: 1) nausea and vomiting (d = 0.000); 2) anxiety, tension, and feeling depressed (d = 0.166); 3) organization of care and overburdening of family (d = 0.187); 4) weakness and need for assistance with activities of daily living (d = 0.139); and 5) tiredness and loss of appetite (d = 0.182). CONCLUSION: As symptom clusters do not significantly differ between cancer and non-cancer patients, specific frequent symptoms in non-cancer patients should be assessed. Identification of symptom clusters may help to target therapies and focus the use of medications to improve patients' quality of life.
2014-07
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jpainsymman.2013.08.018" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2013.08.018</a>
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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
2014
Aged
Backlog
Cancer
Cluster Analysis
Female
Germany
Humans
Inpatients
Journal Article
Journal of Pain and Symptom Management
Lindena G
Male
Matthies Dominik MK
Neoplasms
non-cancer
Ostgathe C
Palliative Care
problems
Seuß D
Stiel S
Symptoms
Walsh D
-
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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Backlog
URL Address
<a href="http://doi.org/10.1177/0269216307077328" target="_blank" rel="noreferrer">http://doi.org/10.1177/0269216307077328</a>
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Title
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Respiratory function during parenteral opioid titration for cancer pain
Publisher
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Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2007
Creator
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Estfan B; Mahmoud F; Shaheen P; Davis MP; Lasheen W; Rivera N; LeGrand SB; Lagman RL; Walsh D; Rybicki L
Description
An account of the resource
BACKGROUND: Respiratory depression is the most feared opioid-related side-effect yet research on the topic is sparse. We evaluated changes in respiratory parameters during parenteral opioid titration for cancer pain to determine if opioid titration was associated with evidence of hypoventilation. The primary outcome measure was to measure changes in end-tidal CO(2) (ET-CO(2)) during opioid titration to pain control. METHODS: Subjects with severe cancer pain admitted for parenteral opioid titration for poorly controlled pain were eligible. Those who were oxygen dependent were excluded. ET-CO(2), O(2) saturation, respiratory rate (RR), and vital signs were monitored daily until pain control was achieved. RESULTS: 30 patients completed the study of which 29 are reported. The mean ET-CO(2) at initial evaluation was 33.39 -/+ 5.0 and 34.79 -/+ 5.7 mmHg at pain control (P =0.14, 95% CI -0.5 to 3.3). None had an ET-CO(2) > or =50 mmHg. All maintained O(2) saturation > or = 92%. RR dropped transiently below 10/minute in two subjects. CONCLUSIONS: Parenteral opioid titration for relief of cancer pain was not associated with respiratory depression as demonstrated by significant changes in ET-CO(2) or oxygen saturation in non-oxygen dependent cancer patients.
2007
Identifier
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<a href="http://doi.org/10.1177/0269216307077328" target="_blank" rel="noreferrer">10.1177/0269216307077328</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
2007
Backlog
Davis MP
Estfan B
Journal Article
Lagman RL
Lasheen W
LeGrand SB
Mahmoud F
Palliative Medicine
Rivera N
Rybicki L
Shaheen P
Walsh D
-
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/10.1177/1049909109338352" target="_blank" rel="noreferrer">http://doi.org/10.1177/1049909109338352</a>
Dublin Core
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Title
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Symptom Variability During Repeated Measurement Among Hospice Patients With Advanced Cancer
Publisher
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The American Journal Of Hospice & Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Creator
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Lasheen W; Walsh D; Hauser K; Gutgsell T; Karafa MT
Description
An account of the resource
Aim: In this prospective study, we explored symptom variability in patients with cancer during repeated measurements. METHODS: Patients with cancer admitted to an inpatient hospice completed a daily questionnaire throughout their admission. The questionnaire consisted of 5 visual analogue scales (VAS) for anxiety, depression, nausea, pain, and sedation and 3 verbal rating scales (VRS) for depression, pain, and vomiting. Data from those who completed 5 consecutive days were used for the primary analysis. We used all available data points to compare VAS and VRS. An index was developed to assess for daily symptom variability. Results/Discussion: A total of 125 hospice inpatients were enrolled; 46 (38%) completed 3 consecutive daily questionnaires and 30 (24%), 5 days. We found (1) a statistically significant decrease in severity of symptoms present on admission, (2) new symptoms developed, (3) consequently overall symptom prevalence on days 1 and 5 appeared unchanged, (4) high daily symptom variability as demonstrated by the variability index and also changing daily symptom interrelationships, (5) demographic characteristics influenced symptom patterns on admission and subsequently, (6) severe pain predicted more frequent and severe symptom burden only on admission, (7) severe depression predicted more frequent and severe symptom burden on admission and thereafter, (8) VAS scores for depression and pain did not correspond with discrete VRS categories (mild, moderate, severe). CONCLUSIONS: (1) Symptom studies in advanced disease while difficult to conduct yield valuable information, (2) symptom relationships changed daily; strict timing of data collection is crucial for data analysis, (3) symptom monitoring following admission is an overlooked measure of risk assessment, (4) symptom prevalence studies alone for treatment follow-up may be misleading, (5) depression is an important predictor of symptoms and need to be more aggressively assessed and treated, (6) demographic characteristics may help identify symptom patterns and better direct treatment, (7) VRS rather than VAS was more reliable for assessing symptoms in hospice cancer patients.
2009
Identifier
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<a href="http://doi.org/10.1177/1049909109338352" target="_blank" rel="noreferrer">10.1177/1049909109338352</a>
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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
Backlog
Gutgsell T
Hauser K
Journal Article
Karafa MT
Lasheen W
The American Journal of Hospice & Palliative Care
Walsh D
-
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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Backlog
URL Address
<a href="http://doi.org/10.1007/s00520-002-0341-8" target="_blank" rel="noreferrer">http://doi.org/10.1007/s00520-002-0341-8</a>
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Title
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The impact of a palliative medicine consultation service in medical oncology.
Publisher
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Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Female; Humans; Male; Adult; Prognosis; Eligibility Determination; Prospective Studies; Aged; Middle Aged; Resuscitation Orders; Health Status; adolescent; 80 and over; social support; DNAR; hospice care; Pain/dt [Drug Therapy]; Medical Oncology; Neoplasms/th [Therapy]; Palliative Care/ut [Utilization]; referral and consultation; Pain/et [Etiology]; Palliative Care/og [Organization & Administration]
Creator
An entity primarily responsible for making the resource
Homsi J; Walsh D; Nelson KA; LeGrand SB; Davis M; Khawam E; Nouneh C
Description
An account of the resource
This prospective study of consecutive patients describes the palliative medicine consult service in a tertiary level cancer center and its impact on patient care. All inpatients/outpatients referred to the Palliative Medicine Program in a 4-month period were enrolled. Data were collected at the initial consultation using standardized forms with spaces for: reason for the consultation, referring service, demographics and history, ECOG performance status, symptoms, prognosis and diagnostic tests, treatment, and care plan. In all, 240 patients were seen: 79% were referred for symptom management; 53% were referred from medical oncology; and 50% were women. Median patient age was 67 years (range 18-96). Median performance status was 2 (1-4). Most (84%) of the patients had cancer. The cancer sites were: lung in 26% of cases, colorectal in 8%, and breast in 7%. Inpatients accounted for 53% and outpatients, for 47% of the study population. The median number of symptoms per patient was 13 (2-30). The estimated survival was <2 weeks in 15%, 2-8 weeks in 38%, 2-6 months in 37%, and >6 months in 10%. The patients' goals were: improve symptoms for 84%, return home for 55%, and no further admissions for 5%. The support systems named by patients were: family in 89%, friends in 13%, and the community in 5%. Hospice care was discussed at the consultation with 38% of the patients, would have been inappropriate for 31%, was not discussed with 22%, and had been discussed before with 9%. In response to questions about psychosocial care, a caregiver was identified by 78%, a spokesperson by 75%, and durable power of attorney was referred to by 21%. The DNR status was discussed on consult by 57%, had already been discussed with 30%, and was not discussed with 13%. Plan of care foresaw outpatient follow-up for 40%, inpatient follow-up for 32%, and transfer to palliative medicine for 27%. In 39% of cases the consults were considered late referrals. New medications suggested were opioids for 46% of patients, antiemetics for 28%, a bowel regimen for 24%, steroids for 15%, and others for 51%. (1) Palliative medicine consultation involves common complex medical, psychological, and social problems. (2) Complex symptomatology in this population is confirmed. (3) Multiple interventions were suggested even at the initial consultation. (4) Important issues such as DNR (do not resuscitate) status, support system, treatment goals, and eligibility for hospice care had often not been addressed.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1007/s00520-002-0341-8" target="_blank" rel="noreferrer">10.1007/s00520-002-0341-8</a>
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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
2002
80 And Over
Adolescent
Adult
Aged
Backlog
Davis M
DNAR
Eligibility Determination
Female
Health Status
Homsi J
Hospice Care
Humans
Journal Article
Khawam E
LeGrand SB
Male
Medical Oncology
Middle Aged
Nelson KA
Neoplasms/th [therapy]
Nouneh C
Pain/dt [drug Therapy]
Pain/et [Etiology]
Palliative Care/og [Organization & Administration]
Palliative Care/ut [Utilization]
Prognosis
Prospective Studies
Referral And Consultation
Resuscitation Orders
Social Support
Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer
Walsh D
-
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/10.1177/104990910201900512" target="_blank" rel="noreferrer">http://doi.org/10.1177/104990910201900512</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
The efficacy and side effects of continuous infusion intravenous morphine (CIVM) for pain and symptoms due to advanced cancer
Publisher
An entity responsible for making the resource available
The American Journal Of Hospice & Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Female; Humans; Male; United States; Pain; Adult; Analgesics; Aged; Middle Aged; 80 and over; retrospective studies; Palliative Care/methods; Infusions; Intravenous; Opioid/administration & dosage/adverse effects; Intractable/drug therapy/etiology; Morphine/administration & Neoplasms/complications
Creator
An entity primarily responsible for making the resource
Glare P; Walsh D; Groh E; Nelson KA
Description
An account of the resource
Morphine is the strong opioid of choice in the management of moderate-to-severe chronic cancer pain. The preferred route of administration is oral, in individually titrated doses, regularly scheduled around the clock We conducted a retrospective study of continuous intravenous morphine (CIVM) in a palliative medicine program in 107 consecutive patients. The results suggest CIVM is an effective, safe, and versatile method of morphine administration when used with a defined protocol. Efficacy was similar to that obtained by others with intravenous morphine sulfate and also for oral morphine. Safety was suggested by the low incidence of dose-limiting side effects, most of which responded to dose reduction. Particularly noteworthy was the flexibility of CIVM with dose reduction in 20 percent.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/104990910201900512" target="_blank" rel="noreferrer">10.1177/104990910201900512</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
2002
80 And Over
Adult
Aged
Analgesics
Backlog
Female
Glare P
Groh E
Humans
Infusions
Intractable/drug therapy/etiology
Intravenous
Journal Article
Male
Middle Aged
Morphine/administration & Neoplasms/complications
Nelson KA
Opioid/administration & dosage/adverse effects
Pain
Palliative Care/methods
Retrospective Studies
The American Journal of Hospice & Palliative Care
United States
Walsh D
-
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/10.1177/1049909111433810" target="_blank" rel="noreferrer">http://doi.org/10.1177/1049909111433810</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
A pilot study of palliative medicine fellows' hospice home visits.
Publisher
An entity responsible for making the resource available
The American Journal Of Hospice & Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2012
Subject
The topic of the resource
Female; Humans; Male; Prospective Studies; Aged; Middle Aged; Pilot Projects; Patient Education as Topic; 80 and over; DNAR; Palliative Care/mt [Methods]; Palliative Care/ma [Manpower]; home care services; hospice care; Physicians; Medication Reconciliation
Creator
An entity primarily responsible for making the resource
Shoemaker LK; Aktas A; Walsh D; Hullihen B; Khan MIA; Russell KM; Davis Mellar P; Lagman R; LeGrand SB
Description
An account of the resource
This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify the indications for physician HVs and the problems addressed during the HV. Data was collected on 58 consecutive patients using a standardized form completed before and after the home visit. More than half of the persons were women. Most were Caucasian. Median age was 75 years; 57% had cancer; 77% were do-not-resuscitate. 76% HV occurred in the home. The median visit duration was 60 minutes; median travel distance and time 25 miles and 42 minutes, respectively. A hospice nurse case manager was present in 95%. The most common issues addressed during HVs were: health education, symptom management, and psychosocial support. Medication review was prominent. Physicians identified previously unreported issues. Symptom control was usually pain, although 27 symptoms were identified. Medications were important; all home visits included drug review and two thirds drug change. Physicians had unique responsibilities and identified important issues in the HV. Physicians provided both education and symptom management. Physician HVs are an important intervention. HVs were important in continuity of care, however, time-consuming, and incurred considerable travel, and professional time and costs.
Identifier
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<a href="http://doi.org/10.1177/1049909111433810" target="_blank" rel="noreferrer">10.1177/1049909111433810</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
2012
80 And Over
Aged
Aktas A
Backlog
Davis Mellar P
DNAR
Female
home care services
Hospice Care
Hullihen B
Humans
Journal Article
Khan MIA
Lagman R
LeGrand SB
Male
Medication Reconciliation
Middle Aged
Palliative Care/ma [manpower]
Palliative Care/mt [methods]
Patient Education as Topic
Physicians
Pilot Projects
Prospective Studies
Russell KM
Shoemaker LK
The American Journal of Hospice & Palliative Care
Walsh D