Search results for "Terminal"
showing 10 items of 364 documents
Palliative Sedation in Patients With Advanced Cancer Followed at Home: A Prospective Study
2014
Abstract Context Home care programs in Italy. Objectives The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. Methods A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. Results A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P = 0.012). The principal reasons to start PS were agitated delirium (n = 20) and dyspnea (n = 4).…
Combined evaluation of resting IGF-I, N-terminal propeptide of type III procollagen (PIIINP) and C-terminal cross-linked telopeptide of type I collag…
2004
To verify whether combined measurements of GH-dependent parameters might be useful in detecting exogenous recombinant GH (rGH) administration in male athletes from different disciplines.Sixty-six athletes (control group) were sampled for the evaluation of resting IGF-I, N-terminal propeptide of type III procollagen (PIIINP) and telopeptide type I collagen (ICTP). Cut-off values (mean + 2 SD) for IGF-I, PIIINP and ICTP were calculated and arbitrary scores (1.5, 2.0) were assigned to abnormal parameters. By using the sum of individual parameter scores, positive (or = 3) or negative (3) scores were obtained. In addition, a subgroup of six athletes was treated for 3 weeks with rGH (0.09 IU/kg b…
Aggressive Pharmacological Treatment for Reversing Malignant Bowel Obstruction
2004
Early and intensive pharmacological treatment not only may reduce gastrointestinal symptoms but also reverse malignant bowel obstruction. Fifteen consecutive advanced cancer patients with inoperable bowel obstruction received a combination of drugs including metoclopramide, octreotide, dexamethasone and an initial bolus of amidotrizoato. Recovery of intestinal transit was reported within 1-5 days in fourteen patients, who continued this treatment without presenting symptoms of bowel obstruction until death. This case series establishes that the combination of propulsive and antisecretive agents can act synergistically to allow a fast recovery of bowel transit without inducing unpleasant col…
Spirituality in patients with advanced illness: The role of symptom control, resilience and social network.
2015
In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end o…
Palliative Care Patients’ Quality of Dying and Circumstances of Death—Comparison of Informal Caregivers’ and Health-Care Professionals’ Estimates
2018
Background: Patient-reported outcomes are usually considered to be the gold standard assessment. However, for the assessment of quality of dying and death, ratings of informal caregivers (ICGs) or health-care professionals (HCPs) must be considered for ethical and methodological reasons. This article aims to present results of ICGs’ and HCPs’ estimates of the questionnaire, quality of dying and death (QoDD) on patients who died in PCUs and to compare the level of agreement of both ratings/raters. Methods: The parent validation study to this analysis assessed the ICG and HCP versions of the QoDD. Descriptive statistics are presented for each item in both versions. T tests for the estimation …
End-of-life situations in cardiology: a qualitative study of physicians' and nurses' experience in a large university hospital.
2018
IF 2.335 (2-year Impact Factor); International audience; Background: rofessional societies call for integration of end-of-life discussions early in the trajectory of heart failure, yet it remains unclear where current practices stand in relation to these recommendations. We sought to describe the perceptions and attitudes of caregivers in cardiology regarding end-of-life situations.Methods: e performed a qualitative study using semi-directive interviews in the cardiology department of a university teaching hospital in France. Physicians, nurses and nurses’ aides working full-time in the department at the time of the study were eligible. Participants were asked to describe how they experienc…
Factors influencing place of death in Germany.
2011
Abstract Context Knowledge about factors influencing the place of death may be very useful for the planning of public health strategies to improve the situation of terminally ill patients. Objectives The aim of our study was to determine where people died in the German federal state of Rhineland-Palatinate in 2008. We further wanted to detect which factors had an influence on the place of death. Methods Our cross-sectional survey was based on a random sample of 5000 inhabitants of Rhineland-Palatinate who had died between May 25, 2008 and August 24, 2008. Relatives of these randomly drawn deceased persons were interviewed by means of a written survey. Results After removing duplicates, 4967…
Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey
2018
Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied …
Assessing Somatic, Psychosocial, and Spiritual Distress of Patients with Advanced Cancer
2012
Objective: For adequate distress assessment in palliative care, we developed a screening evaluation tool. Methods: Proven methods of scale construction led to a 53-item pilot form of the Advanced Cancer Patients’ Distress Scale (ACPDS). We used Hornheide Questionnaire (HQ), Palliative Outcome Scale (POS), and Minimal Documentation System (MIDOS) for validation. Advanced cancer patients (N = 168) from 3 centers for palliative medicine (aged 23-89, 51% female) filled out the questionnaire. Results: With a principal component analysis (PCA), we extracted 5 distress scales (emotional reactions/physical restrictions, communication deficits, negative social reactions, pain, and gastrointestinal s…
Dying in Germany--unfulfilled needs of relatives in different care settings.
2012
Abstract Context The integration of family members in the dying process and the recognition of their special needs are important factors for the development of high-quality palliative care. Objectives This study aimed to explore important needs and personal experiences of relatives at the end of life, and to detect differences in these needs and experiences for various care settings. Methods Our cross-sectional survey was based on a random sampling of 5000 inhabitants of Rhineland-Palatinate (Germany) who died between May 25 and August 24, 2008. Relatives of these randomly drawn deceased persons were interviewed by a written survey. Results A total of 1378 questionnaires were completed (res…