Palliative medicine in a United States cancer center: A prospective study

Cowan, John D.; Walsh, Declan; Homsi, Jade

doi:10.1177/104990910201900408

Cited by 21 publications

(17 citation statements)

References 36 publications

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“…17 The list includes 49 of the most frequently occurring standardized symptoms of previous prevalence studies. [18][19][20][21][22] Anxiety and depressed mood were primarily assessed by means of the HADS; 8 the Dutch translation has been validated. 23 The HADS is a simple, sensitive, and specific screening tool for psychiatric disorders in hospitalized patients avoiding the inclusion of somatic symptoms.…”

Section: Methodsmentioning

confidence: 99%

Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients

et al. 2007

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Section: Methodsmentioning

confidence: 99%

Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients

et al. 2007

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“…In 46 studies, (part of) the aim of the study had been to determine the prevalence of pain in cancer patients. This had not been a primary goal in the other eight studies [11,13,49,65,71,73,75,82,84]. One study looked at unmet needs, one described the experiences of a palliative care programme, two compared usual care with intensive care, one was on the influence of demographic and disease specific variables on pain and one compared differences in symptoms between cancer and noncancer patients.…”

Section: General Characteristicsmentioning

confidence: 99%

Prevalence of pain in patients with cancer: a systematic review of the past 40 years

Everdingen

Rijke

Kessels³

et al. 2007

Annals of Oncology

1,622

859

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Background: Despite the abundant literature on this topic, accurate prevalence estimates of pain in cancer patients are not available. We investigated the prevalence of pain in cancer patients according to the different disease stages and types of cancer.Patients and methods: A systematic review of the literature was conducted. An instrument especially designed for judging prevalence studies on their methodological quality was used. Methodologically acceptable articles were used in the meta-analyses.Results: Fifty-two studies were used in the meta-analysis. Pooled prevalence rates of pain were calculated for four subgroups: (i) studies including patients after curative treatment, 33% [95% confidence interval (CI) 21% to 46%]; (ii) studies including patients under anticancer treatment: 59% (CI 44% to 73%); (iii) studies including patients characterised as advanced/metastatic/terminal disease, 64% (CI 58% to 69%) and (iii) studies including patients at all disease stages, 53% (CI 43% to 63%). Of the patients with pain more than one-third graded their pain as moderate or severe. Pooled prevalence of pain was >50% in all cancer types with the highest prevalence in head/neck cancer patients (70%; 95% CI 51% to 88%). Conclusion:Despite the clear World Health Organisation recommendations, cancer pain still is a major problem.

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“…In other countries, the prevalence of pain at the end of life is very variable, from 40% for the State of Virginia in 2005, 22 57% for Hong-Kong, 23 65% for Japan, 24 64% for London, 25 67% for Italy 26 and up to 73% for the State of Ohio in 2002. 27 If our figures are well below the international average, this is due to the fact that in the studies quoted above it was the patients who assessed their pain (self-assessment), while in our study it was the caregivers who were questioned (hetero-assessment). It can be feared that pain is under-estimated by caregivers as can be seen from the prospective studies by Oi-Ling et al 23 in Hong-Kong, and Nekolaichuk et al 28 for Canada.…”

Section: Discussionmentioning

confidence: 55%

Return home at the end of life: Patients’ vulnerability and risk factors

Vassal¹,

Coz

Hervé

et al. 2011

Palliat Med

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Although most of the people in good health questioned about the subject said they would like to die at home, in the western world between 60 and 80% of deaths occur in hospital. Most authors consider that the indispensable conditions for a return home are the patient's desire and presence of the family and caregivers with the appropriate skills. The assessment of other factors predictive of a return home is inadequate. The aim of this study is to clarify how the return home is influenced by the vulnerability of the patient at the end of life, and by that of the family and caregivers. We carried out a multicentric, observational, prospective, exhaustive and longitudinal epidemiological study (three months follow-up), including 146 patients hospitalized at the end of their life and desiring to return home. For these patients the caregivers respected their freedom to choose to die at home in over half the cases (56%). Their overall vulnerability (personal, family context and caregivers) had a significant influence on the return home. This overall vulnerability was in fact identified as applying in 40% of the clinical situations, and made the possibility of a return home 50% less likely.

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Palliative medicine in a United States cancer center: A prospective study

Abstract: Multiple recommendations were made with most patients surviving long enough potentially to benefit. Consultation in palliative medicine is a sophisticated intervention involving considerable acuity and complexity of care.

Cited by 21 publications

References 36 publications

Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients

Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients

Prevalence of pain in patients with cancer: a systematic review of the past 40 years

Return home at the end of life: Patients’ vulnerability and risk factors

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