End of life care and the approach of death.
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Qurʾān
القرآن6 shownVerses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.
Qur'ān 2:180Arabic sense: الموت, الوصية, موت, وصيه
كُتِبَ عَلَيۡكُمۡ إِذَا حَضَرَ أَحَدَكُمُ ٱلۡمَوۡتُ إِن تَرَكَ خَيۡرًا ٱلۡوَصِيَّةُ لِلۡوَٰلِدَيۡنِ وَٱلۡأَقۡرَبِينَ بِٱلۡمَعۡرُوفِۖ حَقًّا عَلَى ٱلۡمُتَّقِينَ
it is prescribed that he should make a proper bequest to parents and close relatives- a duty incumbent on those who are mindful of God
Qur'ān 5:106Arabic sense: الموت, الوصية, موت, وصيه
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ شَهَٰدَةُ بَيۡنِكُمۡ إِذَا حَضَرَ أَحَدَكُمُ ٱلۡمَوۡتُ حِينَ ٱلۡوَصِيَّةِ ٱثۡنَانِ ذَوَا عَدۡلࣲ مِّنكُمۡ أَوۡ ءَاخَرَانِ مِنۡ غَيۡرِكُمۡ إِنۡ أَنتُمۡ ضَرَبۡتُمۡ فِي ٱلۡأَرۡضِ فَأَصَٰبَتۡكُم مُّصِيبَةُ ٱلۡمَوۡتِۚ تَحۡبِسُونَهُمَا مِنۢ بَعۡدِ ٱلصَّلَوٰةِ فَيُقۡسِمَانِ بِٱللَّهِ إِنِ ٱرۡتَبۡتُمۡ لَا نَشۡتَرِي بِهِۦ ثَمَنࣰ ا وَلَوۡ كَانَ ذَا قُرۡبَىٰ وَلَا نَكۡتُمُ شَهَٰدَةَ ٱللَّهِ إِنَّآ إِذࣰ ا لَّمِنَ ٱلۡأٓثِمِينَ
You who believe, when death approaches any of you, let two just men from among you act as witnesses to the making of a bequest, or two men from another people if you are journeying in the land when death approaches. Keep the two witnesses back after prayer, if you have any doubts, and make them both swear by God, ‘We will not sell our testimony for any price, even if a close relative is involved. We will not hide God’s testimony, for then we should be doing wrong.’
Qur'ān 21:35Arabic sense: الموت, موت | English sense: taste death
كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۗ وَنَبۡلُوكُم بِٱلشَّرِّ وَٱلۡخَيۡرِ فِتۡنَةࣰۖ وَإِلَيۡنَا تُرۡجَعُونَ
Every soul is certain to taste death: We test you all through the bad and the good, and to Us you will all return
Qur'ān 29:57Arabic sense: الموت, موت | English sense: taste death
كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۖ ثُمَّ إِلَيۡنَا تُرۡجَعُونَ
Every soul will taste death, then it is to Us that you will be returned
Qur'ān 3:185Arabic sense: الموت, موت | English sense: taste death
كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۗ وَإِنَّمَا تُوَفَّوۡنَ أُجُورَكُمۡ يَوۡمَ ٱلۡقِيَٰمَةِۖ فَمَن زُحۡزِحَ عَنِ ٱلنَّارِ وَأُدۡخِلَ ٱلۡجَنَّةَ فَقَدۡ فَازَۗ وَمَا ٱلۡحَيَوٰةُ ٱلدُّنۡيَآ إِلَّا مَتَٰعُ ٱلۡغُرُورِ
Every soul will taste death and you will be paid in full only on the Day of Resurrection. Whoever is kept away from the Fire and admitted to the Garden will have triumphed. The present world is only an illusory pleasure
Qur'ān 44:56Arabic sense: الموت, موت | English sense: taste death
لَا يَذُوقُونَ فِيهَا ٱلۡمَوۡتَ إِلَّا ٱلۡمَوۡتَةَ ٱلۡأُولَىٰۖ وَوَقَىٰهُمۡ عَذَابَ ٱلۡجَحِيمِ
After the one death they will taste death no more. God will guard them from the torment of Hell
Research library, full list
751 to 775 of 969Bridging the gaps in palliative care bereavement support: an international perspective.
A review of palliative care policies and bereavement support practices in the United States, Canada, United Kingdom, Australia, and Japan demonstrated 4 challenges: questions over providing universal versus targeted support; a lack of clear evidence driving service delivery; informal or no risk assessment; and limited or no evaluation of services. Bridging the gaps between the policy and practice of palliative care bereavement support requires acknowledging the challenges of medical and public health models, improving bereavement need assessment processes, enhancing the role of primary care providers, and extending research to provide an evidence-base for interventions.
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Use of radiation therapy in the last 30 days of life among a large population-based cohort of elderly patients in the United States.
Purpose: Our goal was to evaluate use and associated costs of radiation therapy (RT) in the last month of life among those dying of cancer.
Methods: We used the Surveillance, Epidemiology, and End Results (SEER) -Medicare linked databases to analyze claims data for 202,299 patients dying as a result of lung, breast, prostate, colorectal, and pancreas cancers from 2000 to 2007. Logistic regression modeling was used to conduct adjusted analyses of potential impacts of demographic, health services, and treatment-related variables on receipt of RT and treatment with greater than 10 days of RT. Costs were calculated in 2009 dollars.
Results: Among the 15,287 patients (7.6%) who received RT in the last month of life, its use was associated with nonclinical factors such as race, gender, income, and hospice care. Of these patients, 2,721 (17.8%) received more than 10 days of treatment. Nonclinic…
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Creatureliness priming reduces aggression and support for war.
Terror management theory (TMT) posits that humans distance themselves from, or elevate themselves above, other animals as a way of denying their mortality. The present studies assessed whether the salience of aggressive tendencies that humans share with other animals make thoughts of death salient and whether depicting human aggression as animalistic can mitigate aggressive behaviour and support for aggression. In Study 1, participants primed with human-animal similarities (i.e., human creatureliness) exhibited elevated death-thought accessibility (DTA) after hitting a punching bag. In Studies 2a and 2b, creatureliness priming caused participants to hit a punching bag with less frequency, perceived force, and comfort. In Study 3, participants primed to view violence as animalistic exhibited increased DTA and reported less support for war against Iran. These studies suggest that portrayin…
matched on Attitude to Death (mesh), Existentialism (mesh)
Pilot test of a three-station palliative care observed structured clinical examination for multidisciplinary trainees.
Developing effective communication and symptom assessment skills is an important component of palliative care training for advance practice nurses (APNs) and other health care providers. The purpose of this project was to develop and pilot test a three-station palliative care Observed Structured Clinical Examination (OSCE) for APN students and physician fellows. Three stations included discussing goals of care, breaking bad news, and assessing delirium. Measures included the Interpersonal Skills Tool, Station Checklists, the OSCE Evaluation Tool, and a focus group to solicit learners' perspectives about the experience. Findings showed that learners evaluated the exercise as appropriate for their level of training and that standardized patients were convincing and provided helpful feedback. Learner self-evaluation means were significantly lower than those of standardized patient or facult…
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Miyasaki JM, Long J, Mancini D, Moro E, Fox SH, Lang AE, Marras C, Chen R, Strafella A, Arshinoff R, Ghoche R, Hui J (2012)MEDLINE-indexed journal, not yet read by usParkinsonism & related disorders89 citations Palliative care for advanced Parkinson disease: an interdisciplinary clinic and new scale, the ESAS-PD.
Unlabelled: Palliative care provides a holistic approach to symptom relief using a multidisciplinary team approach to enhance quality of life throughout the entire course of a particular illness. The care team consists of movement disorders neurologist, a palliative care physician, a wound care nurse, a spiritual counselor and a care coordinator. Palliative care concepts were applied to a group of advanced Parkinson disease (PD) patients in a dedicated Palliative Care Clinic.
Methods: A modified Edmonton Symptom Assessment System Scale for PD (ESAS-PD) was developed and applied to 65 PD patients at their initial consultation and following recommended interventions. Scores were compared to those of metastatic cancer patients reported in the palliative care literature.
Results: The ESAS-PD scores significantly improved after the interventions (56 and 40 respectively, p = 0.0001). The most …
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Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis.
Background: A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services.
Methods: All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation - Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person's home postcode, and stratified by socio-economic disadvantage.
Results: This study covered July - December 2…
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Motor Neurone Disease family carers' experiences of caring, palliative care and bereavement: an exploratory qualitative study.
Background: Motor Neurone Disease (MND) is a neurodegenerative disease with a sudden onset, a rapid progression, a profile of complex disabilities and fatal consequences. Caring for a person with MND is an unremitting commitment, yet little research has examined the experiences and needs of carers for palliative care and bereavement care.
Aim: This study explored the experiences of MND family carers, both during their time as carers and following bereavement. Particular attention was paid to the carers' prolonged grief status and to the implications for service delivery, including palliative care.
Design: A qualitative approach consisted of interviews with 16 bereaved family carers. The Prolonged Grief tool (PG-13) measured the carers' prolonged grief.
Setting/participants: sixteen family carers participated in the study, between one and four years after the death of their spouse from MN…
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Price A, Goodwin L, Rayner L, Shaw E, Hansford P, Sykes N, Monroe B, Higginson I, Hotopf M, Lee W (2012)MEDLINE-indexed journal, not yet read by usJournal of pain and symptom management28 citations Illness perceptions, adjustment to illness, and depression in a palliative care population.
Context: Representations of illness have been studied in several populations, but research is limited in palliative care.
Objectives: To describe illness representations in a population with advanced disease receiving palliative care and to examine the relationship between illness perceptions, adaptive coping, and depression.
Methods: A cross-sectional survey of 301 consecutive eligible patients recruited from a palliative care service in south London, U.K. Measures used included the Brief Illness Perception Questionnaire (Brief IPQ), the Mental Adjustment to Cancer (MAC) Scale, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9.
Results: Scores were not normally distributed for most questions on the Brief IPQ. The correlations found between items on the Brief IPQ were understandable in the context of advanced disease. MAC helplessness-hopelessness and fig…
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Existential experiences and needs related to induced abortion in a group of Swedish women: a quantitative investigation.
Objective: To investigate the prevalence of existential experiences and needs among women who have requested an induced abortion.
Methods: A questionnaire was used to collect information from 499 women who had requested an induced abortion. A principle component analysis resulted in three components of existential experiences and needs: existential thoughts, existential practices, and humanisation of the foetus. These components were analysed in relation to background data and other data from the questionnaire.
Results: Existential experiences and needs were common. For 61% of women existential thoughts about life and death, meaning and morality were related to the abortion experience. Almost 50% of women reported a need for special acts in relation to the abortion; 67% of women thought of the pregnancy in terms of a child. A higher presence of existential components correlated to diffic…
matched on Attitude to Death (mesh), Existentialism (mesh)
Spirituality and spiritual caring: nurses' perspectives and practice in palliative and acute care environments.
Aims and objectives: Identify and compare spiritual caring practice by palliative care and acute care registered nurses (RNs), determine any correlation between nurses' spiritual perspective and their spiritual caring, and to investigate perceived barriers to spiritual caring.
Background: Over the past decade there has been growing interest in spiritual caring in nursing. Professional nursing bodies have proposed spirituality and spiritual caring as an integral component of holistic nursing.
Design: Cross sectional study.
Methods: Palliative care RNs (n = 42) from one community palliative care service and three hospices, and acute care RNs (n = 50) from three major acute care hospitals all in metropolitan Sydney, Australia completed a research questionnaire. Two validated tools and a demographic survey were used to collect data. These tools measured spiritual perspectives including salie…
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Complicated grief and need for professional support in family caregivers of cancer patients in palliative care: a longitudinal cohort study.
Objectives: There is little research on complicated grief (CG) in family caregivers in palliative care. The aim of the study was to assess the levels of complicated grief and depression in family caregivers after the death of a relative with cancer, to identify their need for support, to compare the palliative team staff's risk assessment of the relatives' grief reaction with measured levels of CG and depression, and to assess the use of bereavement support.
Methods: All 114 eligible family caregivers to deceased patients treated in a palliative care unit in the year 2006 were asked to participate in the study, and 87 (77%) accepted. The participants completed a postal questionnaire 2, 6, 13, and 18 months after the loss measuring complicated grief (Inventory of Complicated Grief, Revised), depression (Beck's Depression Inventory II), and their use of bereavement services. The palliative…
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Discussing life story, forgiveness, heritage, and legacy with patients with life-limiting illnesses.
Aim: To explore the perceptions that individuals with life-limiting illnesses have about their lives, both positive and negative, and their messages to future generations.
Methods: A preparation and life completion intervention (Outlook) was assessed for acceptability and feasibility in an Australian palliative care setting. This paper reports a qualitative analysis of the participants' responses to the intervention. The intervention sessions were audiotaped, transcribed, and analysed using interpretative phenomenological analysis.
Results: Eleven participants were recruited from inpatient and outpatient hospital and hospice settings. Three overarching themes were identified: life review, current situation, and legacy/principles.
Conclusions: The intervention provided insights into individual palliative care patients' sense of self, views of their current situation, hopes, and how they w…
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The symptom burden of patients with hematological malignancy: a cross-sectional observational study.
Context: Current literature suggests that contact with specialist palliative care for patients diagnosed with hematological malignancy is infrequent. As part of an investigation into patterns of care, the symptom profile of this patient group required elucidation.
Objectives: The purpose of this study was to determine the patterns of symptoms and level of distress in patients diagnosed with a hematological malignancy.
Methods: One hundred eighty patients diagnosed with a hematological malignancy attending a tertiary referral hospital completed the Memorial Symptom Assessment Scale-Short Form. Comparisons were made to published symptom prevalence studies of those with nonhematological malignancies.
Results: Patients with hematological malignancy had a considerable physical and psychological symptom burden, with an overall mean of 8.8 (± 5.9) symptoms. The mean number of symptoms was signi…
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I control therefore I am: effects of mortality salience on control attributions.
Terror Management Theory posits that when individuals are faced with their own mortality, they use several defense mechanisms to reduce the existential anxiety caused by the thought of their own death. In this paper, we examined one such mechanism: Control attributions. To do so, we ran an experiment (n = 140) in which we manipulated mortality salience and type of failure (relevant vs. irrelevant consequences) with which participants were faced. Participants were then instructed to evaluate the possible causes of their failure. The results indicated that participants assigned to the mortality salience condition, compared to those assigned to the control group, were more prone to making controllable attributions. That is, even in situations in which individuals are motivated to avoid responsibility (i.e., a relevant failure), mortality salience increased perceived controllability. These r…
matched on Attitude to Death (mesh), Existentialism (mesh)
Spirituality, distress, depression, anxiety, and quality of life in patients with advanced cancer.
Objective: To study the influence of spiritual well being (Sp WB) on symptoms of distress, depression, and other dimensions of quality of life in advanced cancer patients receiving palliative care.
Materials and methods: The study was cross-sectional in nature. Fifty patients with advanced cancer from a hospice were assessed with the following instruments: the visual analog scale for pain (VAP), M.D. Anderson symptom inventory (MDASI), Hospital Anxiety Depression Scale (HADS), Functional assessment of cancer therapy-Palliative Care (FACT-pal), and Functional assessment of chronic illness therapy-spiritual well-being (FACIT-sp). We studied the correlations between spirituality and other variables on these scales.
Results: Depression and anxiety were negatively correlated with spiritual well-being (Sp WB). Sp WB was significantly correlated with fatigue (r = -0.423, P = 0.002), symptom dis…
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How parents of children receiving pediatric palliative care use religion, spirituality, or life philosophy in tough times.
Background: How parents of children with life threatening conditions draw upon religion, spirituality, or life philosophy is not empirically well described.
Methods: Participants were parents of children who had enrolled in a prospective cohort study on parental decision-making for children receiving pediatric palliative care. Sixty-four (88%) of the 73 parents interviewed were asked an open-ended question on how religion, spirituality, or life philosophy (RSLP) was helpful in difficult times. Responses were coded and thematically organized utilizing qualitative data analysis methods. Any discrepancies amongst coders regarding codes or themes were resolved through discussion that reached consensus.
Results: Most parents of children receiving palliative care felt that RSLP was important in helping them deal with tough times, and most parents reported either participation in formal religio…
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The frequency and correlates of spiritual distress among patients with advanced cancer admitted to an acute palliative care unit.
Limited research is available on the frequency of spiritual distress and its relationship with physical and emotional distress. We reviewed patients admitted to our acute palliative care unit (APCU) and determined the association between patient characteristics, symptom severity using the Edmonton Symptom Assessment scale (ESAS), and spiritual distress as reported by a chaplain on initial visit. In all, 50 (44%) of 113 patients had spiritual distress. In univariate analysis, patients with spiritual distress were more likely to be younger (odds ratio [OR] = 0.96, P = .004), to have pain (OR = 1.2, P = .010) and depression (OR = 1.24, P = .018) compared to those without spiritual distress. Spiritual distress was associated with age (OR = 0.96, P = .012) and depression (OR = 1.27, P = .020) in multivariate analysis. Our findings support regular spiritual assessment as part of the interdisci…
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Spirituality, religiosity, and spiritual pain in advanced cancer patients.
Context: Spirituality, religiosity, and spiritual pain may affect advanced cancer patients' symptom expression, coping strategies, and quality of life.
Objectives: To examine the prevalence and intensity of spirituality, religiosity, and spiritual pain, and how spiritual pain was associated with symptom expression, coping, and spiritual quality of life.
Methods: We interviewed 100 advanced cancer patients at the M.D. Anderson palliative care outpatient clinic in Houston, TX. Self-rated spirituality, religiosity, and spiritual pain were assessed using numeric rating scales (0=lowest, 10=highest). Patients also completed validated questionnaires assessing symptoms (Edmonton Symptom Assessment Scale [ESAS] and Hospital Anxiety and Depression Scale), coping (Brief COPE and Brief R-COPE), the value attributed by the patient to spirituality/religiosity in coping with cancer (Systems of Belief …
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The palliative care model for emergency department patients with advanced illness.
Background: Large gaps in the delivery of palliative care services exist in the outpatient setting, where there is a failure to address goals of care and to plan for and treat predictable crises. While not originally considered an ideal environment to deliver palliative care services, the emergency department presents a key decision point at which providers set the course for a patient's subsequent trajectory and goals of care. Many patients with serious and life-threatening illness present to emergency departments because symptoms, such as pain or nausea and vomiting, cannot be controlled at home, in an assisted living facility, or in a provider's office. Even for patients in whom goals of care are clear, families often need support for their loved one's physical as well as mental distress. The emergency department is often the only place that can provide needed interventions (e.g., int…
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Bereaved females are more likely to suffer from mood problems even if they do not meet the criteria for prolonged grief.
Purpose: The goal of this study was to describe the gender difference of grief experience and mood distress among caregivers who cared for terminal cancer patients residing in a hospice ward.
Methods: This study recruited 432 caregivers who cared for terminal cancer patients in the hospice ward. Caregivers received telephone interviews 6 months after the patients had died. The Chinese versions of the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Inventory of Complicated Grief (ICG) developed in 1995 by Prigerson et al. were employed to assess the mood distress and grief status.
Results: Total scores of BDI, BAI, and ICG were significantly higher in females. Six out of twenty-one items of BDI, lack of satisfaction, crying spells, sleep disturbance, fatigability, somatic preoccupation, and loss of libido, showed significantly higher scores in females. According to BAI,…
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Evaluation of the FICA Tool for Spiritual Assessment.
Context: The National Consensus Project for Quality Palliative Care includes spiritual care as one of the eight clinical practice domains. There are very few standardized spirituality history tools.
Objectives: The purpose of this pilot study was to test the feasibility for the Faith, Importance and Influence, Community, and Address (FICA) Spiritual History Tool in clinical settings. Correlates between the FICA qualitative data and quality of life (QOL) quantitative data also were examined to provide additional insight into spiritual concerns.
Methods: The framework of the FICA tool includes Faith or belief, Importance of spirituality, individual's spiritual Community, and interventions to Address spiritual needs. Patients with solid tumors were recruited from ambulatory clinics of a comprehensive cancer center. Items assessing aspects of spirituality within the Functional Assessment of …
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Going for broke: mortality salience increases risky decision making on the Iowa gambling task.
Research on gambling, and risk taking in general, has focused primarily on approach-related motivations. The current study examined the avoidance of existential anxiety as a possible source of risky decision making and behaviour. The authors hypothesized that participants reminded of their own mortality would consequently make riskier decisions (and therefore perform more poorly) on the Iowa gambling task. Results confirmed this prediction. Implications of the finding that existential concerns undermine efficient decision making are considered.
matched on Attitude to Death (mesh), Existentialism (mesh)
Existential and supportive care needs among patients with chronic kidney disease.
Context: Living with chronic kidney disease (CKD) is associated with spiritual distress and frequently precipitates a search for meaning and hope; yet, very little is known about these patients' spiritual needs.
Objectives: To describe the nature, prevalence, and predictors of spiritual and supportive care needs in CKD.
Methods: Prospective cohort study of 253 CKD patients who completed a seven-item spiritual and seven-item supportive care needs assessment.
Results: Patients reported a mean (standard deviation [SD]) number of 2.9 (2.6) spiritual needs, with 69.1% of patients reporting at least one spiritual need. The mean (SD) number of supportive care needs was 3.5 (2.1), with 91.4% of patients reporting at least one of these needs. Thirty-two percent of the patients had high spiritual needs (defined as reporting ≥5 of the seven needs). Similarly, 37% of the patients reported high suppo…
matched on Terminal Care (mesh)
In their own words: patients and families define high-quality palliative care in the intensive care unit.
Objective: Although the majority of hospital deaths occur in the intensive care unit and virtually all critically ill patients and their families have palliative needs, we know little about how patients and families, the most important "stakeholders," define high-quality intensive care unit palliative care. We conducted this study to obtain their views on important domains of this care.
Design: Qualitative study using focus groups facilitated by a single physician.
Setting: A 20-bed general intensive care unit in a 382-bed community hospital in Oklahoma; 24-bed medical-surgical intensive care unit in a 377-bed tertiary, university hospital in urban California; and eight-bed medical intensive care unit in a 311-bed Veterans' Affairs hospital in a northeastern city.
Patients: Randomly-selected patients with intensive care unit length of stay >=5 days in 2007 to 2008 who survived the intens…
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Disease trajectories and ACT/RCPCH categories in paediatric palliative care.
The objective of this study was to provide a preliminary description of trajectories of life-limiting conditions (LLCs) using qualitative experiential data. Semi-structured interviews were conducted with families of children with LLCs, selected to encompass all Association for Children's Palliative Care (ACT)/Royal College of Paediatrics and Child Health (RCPCH) categories, using a schedule developed from focus groups of professionals. Thirty out of 76 families agreed to participate. Four of these were unsuitable. In nine out of 26 families, their child had died. In eight out of the 26, two individuals were interviewed. Twenty-four mothers, nine fathers, one sibling and two foster-carers were interviewed in total. The interview schedule was developed from data from four themed focus groups, comprising 25 professionals from 14 backgrounds. Thirty-four milestones in five phases were identi…
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