Journal of palliative medicine
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Comparative Study
Clinical characteristics of cancer patients referred early to supportive and palliative care.
Palliative care is evolving from end-of-life care to care provided earlier in the disease trajectory. We compared clinical characteristics between patients referred late in the course of their disease (late referrals, LRs) with patients referred earlier (early referrals, ERs). ⋯ ERs had different patient characteristics than LRs, and although ERs experience distress similar to that of LRs, their needs and outcomes differ.
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Limited research in Taiwan and Europe suggest that hope is inversely correlated with certain dimensions of the pain experience. However, the relationship between hope and pain among oncology outpatients in the United States has not been evaluated. The aims of this study were to investigate the relationship between hope and cancer pain, after accounting for key psychological, demographic, and clinical characteristics. ⋯ While an association exists between the patients' experience of pain and levels of hope in this study, adjustment for depression and spiritual well being eliminates the relationship initially observed. Although the causal relationships have yet to be determined, in our study hope had a stronger connection to psycho-spiritual factors, than to pain experiences or severity.
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Quality of end-of-life (EOL) care is gaining increasing attention. However, the relationship between hospital case volume and performance of benchmark quality indicators is not well characterized. The aim of this study was to determine whether hospital case volume affects EOL care for terminal cancer patients. ⋯ The results showed that the case volume of terminally ill cancer patients was associated with several aspects of quality of EOL care.
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Palliative care clinical and educational programs are expanding to meet the needs of seriously ill patients and their families. Multiple reports call for an enhanced palliative care evidence base. ⋯ When compared to 2001-2005, more palliative medicine investigators received NIH funding; and research funding has improved. Nevertheless, additional initiatives to further support palliative care research are needed.