Palliative medicine
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Palliative medicine · May 2002
Decision making in terminal care: a survey of finnish doctors' treatment decisions in end-of-life scenarios involving a terminal cancer and a terminal dementia patient.
The physicians' decision-making process in terminal care is complex: medical, ethical, legal and psychological aspects are all involved, particularly in critical situations. Here, a study was made of the association of personal background factors with end-of-life decisions. ⋯ Doctors' end-of-life decisions vary widely according to personal background factors. The findings underline the importance of advance communication, making these decisions in accordance with the patient's wishes.
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Palliative medicine · Mar 2002
Comparative StudyWhich cancer patients are referred to Hospital at Home for palliative care?
Previous research has shown that palliative home care use is influenced by variables such as age, socioeconomic status, presence of an informal carer, diagnosis, and care dependency. However, there is little information on its association with other health service use. This study compared 121 cancer patients referred to Hospital at Home (HAH) for palliative care with a sample of 206 cancer patients not referred who died within the same period. ⋯ Multivariate logistic regression analysis showed HAH referral to be negatively associated with breast and genitourinary cancers and number of noncancer causes recorded on the death certificate. Referral was significantly positively associated with specialist oncology input, Marie Curie nursing, and a late start (close to death) of acute hospital and district nursing care. It is hypothesised that referral to palliative home care is more likely among patients who have had prior contact with cancer services or are most clearly identified as cancer patients, and whose illness progression is manifested by a relatively short but intensive period of care prior to death.
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Palliative medicine · Mar 2002
The current status of bereavement follow-up in hospice and palliative care in Japan.
In order to explore the implementation of bereavement care in hospice/palliative care settings in Japan, a self-administered questionnaire was sent to all 54 government-approved hospice/palliative care units (PCUs) in May of 1999 (recovery rate 93%). Results showed that bereavement follow-up is performed in 37 institutes (74%) and memorial cards and services are most frequently provided. Memorial cards are provided mainly by nurses, and memorial services involve many health care professionals as well as volunteers. ⋯ Two socio-cultural factors possibly affecting bereavement care in Japan, namely, the roles of family and religious (Buddhist) ceremonies were discussed. It was pointed out that the spirit of bereavement care may be embodied in existing religious ceremonies. We conclude that it is necessary to develop bereavement care programmes based on common, basic hospice care tenets while making full use of existing local resources and taking into account regional values.
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Palliative medicine · Mar 2002
ReviewDepression in advanced disease: a systematic review Part 1. Prevalence and case finding.
To identify all literature regarding depression in patients with advanced cancer and among mixed hospice populations, and to summarise the prevalence of depression according to different definitions. ⋯ Depression is a common problem in palliative care settings. The quality of much of the available research is poor, based on small samples of patients with very high nonparticipation rates. The clinical importance of depression is described in subsequent papers.