Learn More
Morphine and other potent opioids are frequently used in palliative care and pain management. When sustained-release (SR) opioids do not provide adequate background analgesia, additional immediate-release (IR) opioid (e.g. short-acting morphine) may be required to alleviate breakthrough or episodic pain. Despite the frequent use of IR morphine on top of SR(More)
A prospective validation study was conducted in 171 consenting patients from oncology and palliative care outpatient clinics to validate the Distress Thermometer (DT) against the Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire-12 (GHQ-12) and Brief Symptom Inventory-18 (BSI-18) at baseline, four weeks and eight weeks. Receiver(More)
BACKGROUND Increasing numbers of people will die with dementia, many in the acute hospital. It is often not perceived to be a life-limiting illness. AIMS To investigate the prevalence of dementia in older people undergoing emergency medical admission and its effect on outcomes. METHOD Longitudinal cohort study of 617 people (aged over 70). The main(More)
The second edition of the Oxford Textbook of Palliative Medicine is a very good book, better than the first edition, being far more organized and consistent in its style. There is a wealth of information in its 1300 pages demonstrating the diverse nature of the skills needed in palliative care, however, some of the chapters need a degree of expertise to(More)
It is difficult to define continuity of care or study its impact on health outcomes. This study took place in three stages. In stage I we conducted qualitative research with patients, their close relatives and friends, and their key health professionals from which we derived a number of self completion statements about experienced continuity that were(More)
BACKGROUND Higher levels of religious involvement are modestly associated with better health, after taking account of other influences, such as age, sex and social support. However, little account is taken of spiritual beliefs that are not tied to personal or public religious practice. Our objective was to develop a standardized measure of spirituality for(More)
BACKGROUND Reported adverse events (RAEs) are relatively common in the acute hospital and are associated with significant mortality and morbidity. Dementia is increasing in hospital in-patients, however there have been few studies exploring risk factors for RAEs, in particular cognitive impairment and dementia. Our objective was to identify the prevalence(More)
CONTEXT As a multidimensional phenomenon, pain is influenced by various psychological factors. One such factor is catastrophizing, which is associated with higher pain intensity and emotional distress in cancer and noncancer pain. One possibility is that catastrophizing represents a general cognitive style that preferentially supports the processing of(More)
OBJECTIVE To explore the relation between spiritual beliefs and resolution of bereavement. DESIGN Prospective cohort study of people about to be bereaved with follow up continuing for 14 months after the death. SETTING A Marie Curie centre for specialist palliative care in London. PARTICIPANTS 135 relatives and close friends of patients admitted to(More)
BACKGROUND There is increasing interest in improving the quality of care that patients with advanced dementia receive when they are dying. Our understanding of the palliative care needs of these patients and the natural history of advanced disease is limited. Many people with advanced dementia have unplanned emergency admissions to the acute hospital; this(More)