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| 2. |
- Gholiha, Alex, et al.
(författare)
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Stora luckor i journaler vid vård i livets slutskede : Journaluppgifter saknas för data inrapporterade till Palliativregistret
- 2011
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Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 108:16-17, s. 918-921
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Tidskriftsartikel (refereegranskat)abstract
- Dokumentation av vårdåtgärder och bedömningar är väsentlig för en optimal palliativ vård. I denna studie har vi jämfört åtgärder som inrapporterats till Svenska palliativregistret i samband med dödsfall med den befintliga journaldokumentationen. Genom slumpmässigt urval deltog totalt 14 registeraktiva vårdenheter representerande de fem vanligaste enhetstyperna. De tio senaste dödsfallen på varje enhet granskades med fokus på vårdinnehållet sista veckan i livet. Bristfällig journaldokumentation noterades i stor utsträckning (8–76 procent). Behovet av tydliga sökord är stort för att såväl läkares som sjuksköterskors journaldokumentation ska kunna leva upp till modern standard vad gäller palliativa vårdinsatser i livets slutskede.
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| 3. |
- Henoch, Ingela, et al.
(författare)
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The Assessment of Quality of life at the End of Life (AQEL) questionnaire: a brief but comprehensive instrument for use in patients with cancer in palliative care.
- 2010
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Ingår i: Quality of life research. - : Springer Science and Business Media LLC. - 1573-2649 .- 0962-9343. ; 19:5, s. 739-750
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the study was to further validate the Assessment of Quality of life at the End of Life (AQEL) questionnaire, to explore whether conceptually consistent scales could be confirmed and how the instrument relates to other widely used and validated HRQL instruments. METHODS: A total of 106 patients with lung cancer in palliative care completed the 20-item AQEL, the EORTC QLQ-C30, Hospital Anxiety and Depression Scale (HADS), Sense of Coherence (SOC-13) and Social Support Survey (SSS). Construct validity of the AQEL was tested by multitrait scaling, principal components analysis, inter-scale correlations and known-groups comparisons. RESULTS: Five scales were supported by multitrait scaling: Basic function, Activity, Emotional function, Cognitive function and Existential needs, with satisfactory (>.7) internal consistency for the latter three and intermediate (>.5) for the remaining two. A Social support scale was supported by principal components analysis, but exhibited a low internal consistency. Items on health care issues and physical symptoms worked best as individual items. Expected correlations with other instruments were found for all scales. Activity was sensitive to different levels of functioning as defined by performance status. CONCLUSIONS: This study provided some evidence for the validity of the AQEL and its feasibility in patients with cancer in palliative care.
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| 4. |
- Lind, Susanne, 1962-, et al.
(författare)
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Quality indicators for palliative and end of life care : a review of Swedish policy documents
- 2013
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Ingår i: BMJ Supportive & Palliative Care. - : BMJ Publishing Group Ltd. - 2045-435X .- 2045-4368. ; 3:2, s. 174-180
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Tidskriftsartikel (refereegranskat)abstract
- Background All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.Methods We reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.Results We found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and ‘The care and nursing of the elderly’. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.Conclusions In the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.
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| 5. |
- Lind, Susanne, 1962-, et al.
(författare)
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Quality indicators for palliative and end of life care : a review of Swedish policy documents
- 2013
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Ingår i: BMJ Supportive & Palliative Care. - : BMJ. - 2045-435X .- 2045-4368. ; 3:2, s. 174-180
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.METHODS: We reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.RESULTS: We found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and 'The care and nursing of the elderly'. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.CONCLUSIONS: In the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.
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| 7. |
- Lundquist, Gunilla, et al.
(författare)
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Information of imminent death or not : does it make a difference?
- 2011
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Ingår i: Journal of Clinical Oncology. - Orlando, FL : Grune & Stratton. - 0732-183X .- 1527-7755. ; 29:29, s. 3927-3931
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study examines whether end-of-life care for patients with cancer who were informed about imminent death differs from care for those patients with cancer who were not informed. Patients and Methods: This study included all cancer deaths between 2006 and 2008 for which the patient did not lose his or her decision-making capacities until hours or days before death (N=13,818). These patients were taken from a national quality register for end-of-life care. The majority of the patients—91% (n=12,609) —had been given information about imminent death; 9% (n=1,209) had not been informed. Because of the difference in sample size, a matching procedure was performed to minimize bias. This resulted in a comparison of 1,191 informed and 1,191 uniformed patients. Nonparametric methods were used for statistical analyses. Results: Informed patients significantly more often had parenteral drugs prescribed as needed (ie, PRN), had his or her family informed, died in his or her preferred place, and had family who were offered bereavement support. There was no difference in symptom control (ie, pain, anxiety, confusion, nausea, and respiratory tract secretions) between the groups. Conclusion: Providing information of imminent death to a patient with cancer at the end of life does not seem to increase pain or anxiety, but it does seem to be associated with improved care and to increase the likelihood of fulfilling the principles of a good death.
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| 8. |
- Lundstrom, Staffan, et al.
(författare)
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Developing a national quality register in end-of-life care: The Swedish experience
- 2012
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Ingår i: Palliative Medicine. - : SAGE Publications (UK and US). - 0269-2163 .- 1477-030X. ; 26:4, s. 313-321
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Tidskriftsartikel (refereegranskat)abstract
- Background: The complexity of end-of-life care, represented by a large number of units caring for dying patients, different types of organizations and difficulties in identification and prognostication, signifies the importance of finding ways to measure the quality of end-of-life care. less thanbrgreater than less thanbrgreater thanAim: To establish, test and manage a national quality register for end-of-life care. less thanbrgreater than less thanbrgreater thanDesign: Two questionnaires were developed with an attempt to retrospectively identify important aspects of the care delivered during the last week in life. An internet-based IT platform was created, enabling the physician and/or nurse responsible for the care during the last week in life to register answers online. less thanbrgreater than less thanbrgreater thanSetting: Units caring for dying people, such as hospital wards, home care units, palliative in-patient care units and nursing facilities. less thanbrgreater than less thanbrgreater thanResults: The register received status as a National Quality Register in 2006. More than 30,000 deaths in nursing facilities, hospital wards, palliative in-patient units and private homes were registered during 2010, representing 34% of all deaths in Sweden and 58% of the cancer deaths. less thanbrgreater than less thanbrgreater thanConclusions: We have shown that it is feasible to establish a national quality register in end-of-life care and collect data through a web-based system. Ongoing data analyses will show in what way this initiative can lead to improved quality of life for patients and their families. There is an ongoing process internationally to define relevant outcome measures for quality of care at the end-of-life in different care settings; the registry has a potentially important role in this development.
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| 9. |
- Mahalingam, A. Kannan, et al.
(författare)
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HIV-1 Protease Inhibitors with a Transition-State Mimic Comprising a Tertiary Alcohol : Improved Antiviral Activity in Cells
- 2010
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Ingår i: Journal of Medicinal Chemistry. - : American Chemical Society (ACS). - 0022-2623 .- 1520-4804. ; 53:2, s. 607-615
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Tidskriftsartikel (refereegranskat)abstract
- By a small modification in the core structure of the previously reported series of HIV-1 protease inhibitors that encompasses a tertiary alcohol as part of the transition-state mimicking scaffold, up to 56 times more potent compounds were obtained exhibiting EC50 values down to 3 nM. Three of the inhibitors also displayed excellent activity against selected resistant isolates of HIV-1. The synthesis of 25 new and optically pure HIV-1 protease inhibitors is reported, along with methods for elongation of the inhibitor Pl' side chain using microwave-accelerated, palladium-catalyzed cross-coupling reactions, the biological evaluation, and X-ray data obtained from one of the most potent analogues cocrystallized with both the wild type and the L63P, V82T, 184 V mutant of the HIV-1 protease.
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| 10. |
- Malm, Annika, 1970, et al.
(författare)
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The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms
- 2013
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Ingår i: Water Research. - : Elsevier BV. - 0043-1354 .- 1879-2448. ; 47:13, s. 4474-4484
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Tidskriftsartikel (refereegranskat)abstract
- There are relatively few studies on the association between disturbances in drinking waterservices and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerningGI illness may be a useful source of information. This study investigates if there is anincreased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted inGothenburg, a Swedish city with 0.5 million inhabitants with a surface water source ofdrinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea,vomiting or abdominal pain) were recorded for a three-year period, including also sex, age,and geocoded location of residence. The number of contacts with the HCC in the affectedgeographical areas were recorded during eight periods of disturbances in the water works(e.g. short stops of chlorine dosing), six periods of large disturbances in the distributionnetwork (e.g. pumping station failure or pipe breaks with major consequences), and 818pipe break and leak repairs over a three-year period. For each period of disturbance theobserved number of calls was compared with the number of calls during a control periodwithout disturbances in the same geographical area. In total about 55, 000 calls to the HCCdue to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants andyear, but much higher (>200) for children
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