Skip header and navigation

Refine By

9 records – page 1 of 1.

Danish medical schools do not meet international recommendations for teaching palliative medicine.

https://arctichealth.org/en/permalink/ahliterature297870
Source
Dan Med J. 2018 Oct; 65(10):
Publication Type
Journal Article
Date
Oct-2018
Author
Maria Kolind Brask-Thomsen
Bodil Abild Jespersen
Mogens Grønvold
Per Sjøgren
Mette Asbjoern Neergaard
Author Affiliation
mettneer@rm.dk.
Source
Dan Med J. 2018 Oct; 65(10):
Date
Oct-2018
Language
English
Publication Type
Journal Article
Keywords
Curriculum
Denmark
Education, Medical - standards
Humans
Palliative Care
Schools, Medical - standards
Surveys and Questionnaires
Abstract
Denmark has been ranked low regarding the extent of teaching in palliative care (PC) at medical schools although the Danish Health Authority recommends that all doctors have basic knowledge of PC. The aim of this study was to investigate the contents of and time spent on teaching in PC at the four Danish medical schools and to compare results with recommendations from the European Association of Palliative Care (EAPC).
Data were collected by examining university curricula, course catalogues, etc., using search words based on recommendations from the Palliative Education Assessment Tool and by a questionnaire survey among the university employees responsible for semesters or courses in Danish medical schools.
Teaching in palliative medicine at Danish medical schools is generally sparse and mainly deals with pain management and general aspects of PC. Compared to European recommendations, teaching in, e.g., ethics, spirituality, teamwork and self-reflection is lacking. Furthermore, PC training does not reach the recommended minimum of 40 hours, and examinations in PC are not held. As from the autumn of 2017, the University of Southern Denmark has offered a course that expands teaching in PC and thereby improves compliance with EAPC recommendations; the remaining three medical schools do not, to our knowledge, have any specific plans to increase the extent of teaching activities in palliative medicine.
Teaching in palliative medicine is sparse at all four medical schools in Denmark and should be strengthened to meet Danish as well as European recommendations.
No funding was used for this study.
not relevant.
PubMed ID
30269748 View in PubMed
Less detail

The impact of "modern telecommunication" in palliative care--the views of the professionals.

https://arctichealth.org/en/permalink/ahliterature261946
Source
Telemed J E Health. 2014 Jan;20(1):24-31
Publication Type
Article
Date
Jan-2014
Author
Mette Asbjoern Neergaard
Jens Erik Warfvinge
Torben Worsøe Jespersen
Frede Olesen
Niels Ejskjaer
Anders Bonde Jensen
Source
Telemed J E Health. 2014 Jan;20(1):24-31
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Denmark
Female
Health Knowledge, Attitudes, Practice
Home Care Services - organization & administration
Humans
Interviews as Topic
Male
Middle Aged
Palliative Care - organization & administration
Patient Care Team - organization & administration
Telemedicine
Abstract
Specialized palliative care teams are typically based in larger hospitals, from where home visits, telephone consultations, and support are given directly to patients and relatives, but also to professionals working on the frontline. One of the challenges is the long distances to the patients' homes. Modern telecommunication may help overcome this, but little is known about the perceived advantages and barriers to palliative care. This study analyzed the views on modern telecommunication from specialized palliative care professionals' perspective.
This descriptive study is based on four semistructured group interviews where 17 health professionals from three different palliative care teams in the Central Denmark Region were interviewed from November 2009 to March 2010.
We found that face-to-face communication is essential. The participants perceived a potentially added communicative value in visual telecommunication but would never let it replace face-to-face communication. Ethical and practical concerns were expressed on the implementation of "modern telecommunication" and in particular strong reservations against permanent telemonitoring in the patient's home.
Our study underlines the necessity of face-to-face contact in optimal palliative care and that home visits were favored. The participants were generally positive toward telecommunication, although reservations and prerequisites were voiced.
PubMed ID
24160901 View in PubMed
Less detail

Randomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer: The Danish Palliative Care Trial.

https://arctichealth.org/en/permalink/ahliterature292263
Source
Palliat Med. 2017 Oct; 31(9):814-824
Publication Type
Comparative Study
Journal Article
Randomized Controlled Trial
Date
Oct-2017
Author
Mogens Groenvold
Morten Aagaard Petersen
Anette Damkier
Mette Asbjoern Neergaard
Jan Bjoern Nielsen
Lise Pedersen
Per Sjøgren
Annette Sand Strömgren
Tove Bahn Vejlgaard
Christian Gluud
Jane Lindschou
Peter Fayers
Irene J Higginson
Anna Thit Johnsen
Author Affiliation
1 The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen NV, Denmark.
Source
Palliat Med. 2017 Oct; 31(9):814-824
Date
Oct-2017
Language
English
Publication Type
Comparative Study
Journal Article
Randomized Controlled Trial
Keywords
Adult
Aged
Aged, 80 and over
Denmark
Female
Humans
Male
Middle Aged
Neoplasms - therapy
Oncology Nursing - standards
Palliative Care - standards
Practice Guidelines as Topic
Quality of Life - psychology
Surveys and Questionnaires
Abstract
Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal.
To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments.
The Danish Palliative Care Trial (DanPaCT) (ClinicalTrials.gov NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone. The planned sample size was 300. At five oncology departments, consecutive patients with advanced cancer were screened for palliative needs. Patients with scores exceeding a predefined threshold for problems with physical, emotional or role function, or nausea/vomiting, pain, dyspnoea or lack of appetite according to the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were eligible. The primary outcome was the change in each patient's primary need (the most severe of the seven QLQ-C30 scales) at 3- and 8-week follow-up (0-100 scale). Five sensitivity analyses were conducted. Secondary outcomes were change in the seven QLQ-C30 scales and survival.
Totally 145 patients were randomised to early specialist palliative care versus 152 to standard care. Early specialist palliative care showed no effect on the primary outcome of change in primary need (-4.9 points (95% confidence interval -11.3 to +1.5 points); p = 0.14). The sensitivity analyses showed similar results. Analyses of the secondary outcomes, including survival, also showed no differences, maybe with the exception of nausea/vomiting where early specialist palliative care might have had a beneficial effect.
We did not observe beneficial or harmful effects of early specialist palliative care, but important beneficial effects cannot be excluded.
PubMed ID
28494643 View in PubMed
Less detail

Shared care in basic level palliative home care: organizational and interpersonal challenges.

https://arctichealth.org/en/permalink/ahliterature141209
Source
J Palliat Med. 2010 Sep;13(9):1071-7
Publication Type
Article
Date
Sep-2010
Author
Mette Asbjoern Neergaard
Frede Olesen
Anders Bonde Jensen
Jens Sondergaard
Author Affiliation
Palliative Team, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. man@alm.au.dk
Source
J Palliat Med. 2010 Sep;13(9):1071-7
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Denmark
Home Care Services - organization & administration
Humans
Interprofessional Relations
Interviews as Topic
Neoplasms - therapy
Palliative Care - organization & administration
Patient Care Team - organization & administration
Quality of Health Care
Terminally ill
Abstract
Little is known about the existing barriers to cooperation among health professionals in basic level palliative care for terminally ill patients with cancer in primary health care.
The aim of this study was to analyze health professionals' views on interprofessional cooperation in basic level palliative home care for terminally ill cancer patients.
This study was a qualitative, descriptive study based on 7 semistructured group interviews conducted in the former Aarhus County, Denmark. Forty-three health professionals (23 family physicians, 5 chief physicians, and 15 home care nurses) were interviewed.
Two main categories of problems were identified: (1) the organization of palliative home care (need for proactive planning from the start of the palliative trajectory, clear distribution of tasks, advancement of more efficient communication pathways, and improved accessibility to all health professionals) and (2) interaction between health professionals (increased knowledge of and respect for the competencies of other health occupations and individuals).
The study indicates problems with respect to both the organization of the basic level palliative home care and the working culture among health professionals. The main issues: distribution of tasks, information exchange, availability, respect, and personal acquaintance are pivotal to improve the delivery of palliative home care, to training in palliative care and warrant future research.
PubMed ID
20799902 View in PubMed
Less detail

Detailed statistical analysis plan for the Danish Palliative Care Trial (DanPaCT).

https://arctichealth.org/en/permalink/ahliterature263177
Source
Trials. 2014;15:376
Publication Type
Article
Date
2014
Author
Anna Thit Johnsen
Morten Aagaard Petersen
Christian Gluud
Jane Lindschou
Peter Fayers
Per Sjøgren
Lise Pedersen
Mette Asbjoern Neergaard
Tove Bahn Vejlgaard
Anette Damkier
Jan Bjoern Nielsen
Annette S Strömgren
Irene J Higginson
Mogens Groenvold
Source
Trials. 2014;15:376
Date
2014
Language
English
Publication Type
Article
Keywords
Bias (epidemiology)
Data Interpretation, Statistical
Denmark
Female
Humans
Male
Neoplasms - complications - diagnosis - psychology - therapy
Palliative Care - statistics & numerical data
Quality of Life
Referral and Consultation - statistics & numerical data
Research Design - statistics & numerical data
Sample Size
Time Factors
Treatment Outcome
Abstract
Advanced cancer patients experience considerable symptoms, problems, and needs. Early referral of these patients to specialized palliative care (SPC) could offer improvements. The Danish Palliative Care Trial (DanPaCT) investigates whether patients with metastatic cancer will benefit from being referred to 'early SPC'. DanPaCT is a multicenter, parallel-group, superiority clinical trial with 1:1 randomization. The planned sample size was 300 patients. The primary data collection for DanPaCT is finished. To prevent outcome reporting bias, selective reporting, and data-driven results, we present a detailed statistical analysis plan (SAP) for DanPaCT here.
This SAP provides detailed descriptions of the statistical analyses of the primary and secondary outcomes in DanPaCT. The primary outcome is the change in the patient's 'primary need'. The 'primary need' is a patient-individualised outcome representing the score of the symptom or problem that had the highest intensity out of seven at baseline assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Secondary outcomes are the seven scales that are represented in the primary outcome, but each scale evaluated individually for all patients, and survival. The detailed description includes chosen significance levels, models for multiple imputations, sensitivity analyses and blinding. In addition, we discuss the patient-individualized primary outcome, blinding, missing data, multiplicity and the risk of bias.
Only few trials have investigated the effects of SPC. To our knowledge DanPaCT is the first trial to investigate screening based 'early SPC' for patients with metastatic cancer from a broad spectrum of cancer diagnosis.
Clinicaltrials.gov identifier: NCT01348048 (May 2011).
Notes
Cites: Am J Public Health. 1996 May;86(5):726-88629727
Cites: J Natl Cancer Inst. 1993 Mar 3;85(5):365-768433390
Cites: J Clin Oncol. 1998 Jan;16(1):139-449440735
Cites: Cancer. 2005 Apr 15;103(8):1747-5515756655
Cites: J Clin Epidemiol. 2008 Jan;61(1):64-7518083463
Cites: BMJ. 2008 Mar 15;336(7644):601-518316340
Cites: Stat Med. 2008 Jul 30;27(17):3227-4618203127
Cites: PLoS One. 2008;3(8):e308118769481
Cites: Int J Epidemiol. 2009 Feb;38(1):276-8618824467
Cites: BMJ. 2009;338:b239319564179
Cites: Qual Life Res. 2009 Aug;18(6):747-5219513815
Cites: BMC Med Res Methodol. 2009;9:8620042080
Cites: N Engl J Med. 2010 Aug 19;363(8):733-4220818875
Cites: PLoS One. 2011;6(10):e2549122028777
Cites: Eur J Cancer. 2012 Jul;48(11):1713-2122418017
Cites: Ann Intern Med. 2012 Sep 18;157(6):429-3822945832
Cites: Stat Med. 2013 Mar 30;32(7):1136-4923112128
Cites: BMC Med Res Methodol. 2014;14:1124456267
Cites: BMC Med Res Methodol. 2014;14:3424588900
Cites: BMJ. 2002 Sep 21;325(7365):652-412242181
Cites: Stat Med. 2002 Oct 15;21(19):2917-3012325108
Cites: Acta Psychiatr Scand. 1983 Jun;67(6):361-706880820
Cites: Qual Life Res. 1996 Dec;5(6):555-678993101
PubMed ID
25257804 View in PubMed
Less detail

Socioeconomic position and place of death of cancer patients.

https://arctichealth.org/en/permalink/ahliterature263305
Source
BMJ Support Palliat Care. 2012 Jun;2(2):133-9
Publication Type
Article
Date
Jun-2012
Author
Mette Asbjoern Neergaard
Anders Bonde Jensen
Ineta Sokolowski
Frede Olesen
Peter Vedsted
Source
BMJ Support Palliat Care. 2012 Jun;2(2):133-9
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cause of Death
Cross-Sectional Studies
Death
Delivery of Health Care - utilization
Denmark - epidemiology
Female
Humans
Income
Male
Middle Aged
Neoplasms - economics - mortality
Palliative Care - economics - organization & administration
Registries
Socioeconomic Factors
Young Adult
Abstract
Most terminally ill patients and relatives prefer care and death to occur at home. However, in many cases patients die in hospital and the question arises whether social inequity in palliative care exists. The aim of this study was to analyse associations between dying at home and demographic and socioeconomic characteristics adjusted for healthcare utilisation among Danish cancer patients.
Population-based, cross-sectional register study in Aarhus County, Denmark. 599 deceased adults who died from cancer from 1 March to 30 November 2006 in a well-defined geographical area were identified. Based on unique personal identifier numbers, socioeconomic data and healthcare utilisation from different registers were retrieved and analysed.
Multivariate analysis showed that dying at home was negatively associated with, first, being either 50-59 (prevalence ratio (PR): 0.67 (95% CI 0.45 to 0.99)) or 70-79 years of age (PR: 0.83 (95% CI 0.70 to 0.99)) compared with being 80 years or above; second, a middle personal income compared with a high income (PR: 0.86 (95% CI 0.75 to 1.00)); and, third, being employed or having a leadership position compared with being unemployed/student/receiving social security (PR: 0.72 (95% CI 0.53 to 0.98)).
The found socioeconomic differences in whether death occurred at home or at institutions indicate that age, income and social class must be taken into account when palliative care services engage in fulfilling preferences of dying at home. This may lead to more equality in the possibility of dying at home, despite differences in socioeconomic level.
PubMed ID
24654054 View in PubMed
Less detail

Associations between successful palliative trajectories, place of death and GP involvement.

https://arctichealth.org/en/permalink/ahliterature99272
Source
Scand J Prim Health Care. 2010 Sep;28(3):138-45
Publication Type
Article
Date
Sep-2010
Author
Mette Asbjoern Neergaard
Peter Vedsted
Frede Olesen
Ineta Sokolowski
Anders Bonde Jensen
Jens Sondergaard
Author Affiliation
The Palliative Team, Department of Oncology, Aarhus University Hospital, Denmark. man@alm.au.dk
Source
Scand J Prim Health Care. 2010 Sep;28(3):138-45
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Death
Cross-Sectional Studies
Denmark
Family Practice
Female
Home Care Services
House Calls
Humans
Male
Middle Aged
Neoplasms - nursing - psychology - therapy
Palliative Care - manpower - methods
Physician's Role
Physicians, Family - psychology
Professional-Family Relations
Questionnaires
Registries
Retrospective Studies
Terminal Care - manpower - methods
Abstract
OBJECTIVE: General practitioner (GP) involvement may be instrumental in obtaining successful palliative cancer trajectories. The aim of the study was to examine associations between bereaved relatives' evaluation of palliative cancer trajectories, place of death, and GP involvement. DESIGN: Population-based, cross-sectional combined register and questionnaire study. SETTING: The former Aarhus County, Denmark. SUBJECTS: Questionnaire data on GPs' palliative efforts and relatives' evaluations of the palliative trajectories were obtained for 153 cases of deceased cancer patients. MAIN OUTCOME MEASURES: A successful palliative trajectory as evaluated retrospectively by the relatives. RESULTS: Successful palliative trajectories were statistically significantly associated with home death (PR 1.48 (95% CI 1.04; 2.12)). No significant associations were identified between the evaluations of the palliative trajectory at home and GP involvement. "Relative living with patient" (PR 1.75 (95% CI: 0.87; 3.53)) and "GP having contact with relatives" (PR 1.69 (95% CI 0.55; 5.19)) were not significantly associated, but this may be due to the poor number of cases included in the final analysis. CONCLUSION: This study indicates that home death is positively associated with a higher likelihood that bereaved relatives will evaluate the palliative trajectory at home as successful. No specific GP services that were statistically significantly associated with higher satisfaction among relatives could be identified, but contact between GPs and relatives seems important and the impact needs further investigation.
PubMed ID
20698730 View in PubMed
Less detail

Access to outreach specialist palliative care teams among cancer patients in Denmark.

https://arctichealth.org/en/permalink/ahliterature114285
Source
J Palliat Med. 2013 Aug;16(8):951-7
Publication Type
Article
Date
Aug-2013
Author
Mette Asbjoern Neergaard
Anders Bonde Jensen
Frede Olesen
Peter Vedsted
Author Affiliation
The Palliative Team, Aarhus University Hospital, Aarhus, Denmark. mettneer@rm.dk
Source
J Palliat Med. 2013 Aug;16(8):951-7
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Community-Institutional Relations
Cross-Sectional Studies
Denmark
Female
Health Services Accessibility - statistics & numerical data
Humans
Male
Middle Aged
Multivariate Analysis
Neoplasms - physiopathology - therapy
Palliative Care - manpower - organization & administration
Patient Care Team - organization & administration - standards
Registries
Sex Distribution
Socioeconomic Factors
Specialization
Terminal Care - manpower - organization & administration
Young Adult
Abstract
Equal access to end-of-life care is important. However, social inequality has been found in relation to place-of-death. The question is whether social and economic factors play a role in access to specialist palliative care services.
The study analyzed the association between access to outreach specialist palliative care teams (SPCTs) and socioeconomic characteristics of Danish cancer patients who died of their cancer.
The study was a population-based, cross-sectional register study. We identified 599 adults who had died of cancer from March 1 to November 30, 2006, in Aarhus County, Denmark. Data from health registers were retrieved and linked based on the unique personal identifier number.
Multivariate analysis with adjustment for age, gender, and general practitioner (GP) involvement showed a higher probability of contact with an SPCT among immigrants and descendants of immigrants than among people of Danish origin (prevalence ratio [PR]: 1.55; 95% confidence interval (CI): 1.04;2.31) and among married compared to unmarried patients (PR: 1.25; 95% CI: 1.01;1.54). The trends were most marked among women.
We found an association between females, married patients, and female immigrants and their descendants and access to an SPCT in Denmark. However, no association with the examined economic factor was found. Need for specialized health care, which is supposed to be the main reason for access to an SPCT, may be related to economic imbalance; and despite the relative equality found, SPCT access may not be equal for all Danish residents. Further research into social and economic consequences in palliative care services is warranted.
PubMed ID
23631614 View in PubMed
Less detail

Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis? A nation-wide study from the Danish Palliative Care Database (DPD).

https://arctichealth.org/en/permalink/ahliterature282037
Source
BMC Palliat Care. 2017 Mar 23;16(1):21
Publication Type
Article
Date
Mar-23-2017
Author
Mathilde Adsersen
Lau Caspar Thygesen
Anders Bonde Jensen
Mette Asbjoern Neergaard
Per Sjøgren
Mogens Groenvold
Source
BMC Palliat Care. 2017 Mar 23;16(1):21
Date
Mar-23-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Databases, Factual
Denmark - epidemiology
Female
Health Services Accessibility - organization & administration - statistics & numerical data
Hospices
Humans
Male
Middle Aged
Neoplasms - diagnosis - epidemiology - therapy
Palliative Care - organization & administration - statistics & numerical data
Patient Care Team - organization & administration
Registries
Sex Distribution
Sex Factors
Young Adult
Abstract
Specialised palliative care (SPC) takes place in specialised services for patients with complex symptoms and problems. Little is known about what determines the admission of patients to SPC and whether there are differences in relation to institution type. The aims of the study were to investigate whether cancer patients' admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both).
This was a register-based study of adult patients living in Denmark who died from cancer in 2010-2012. Data sources were the Danish Palliative Care Database, Danish Register of Causes of Death and Danish Cancer Registry. The associations between the explanatory variables (sex, age, diagnosis) and admittance to SPC were investigated using logistic regression.
In the study population (N?=?44,548) the overall admittance proportion to SPC was 37%. Higher odds of overall admittance to SPC were found for women (OR?=?1.23; 1.17-1.28), younger patients (
Notes
Cites: Cancer. 2014 May 15;120(10):1572-824549743
Cites: Med Care. 2002 Jan;40(1):73-811748429
Cites: J Palliat Med. 2013 Aug;16(8):951-723631614
Cites: Med Care. 2004 Feb;42(2):116-2214734948
Cites: Intern Med J. 2012 Sep;42(9):1040-224020341
Cites: Palliat Med. 2002 Sep;16(5):403-912380658
Cites: Palliat Med. 2006 Jun;20(4):439-4516875115
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):22-521775345
Cites: Med Care. 2008 Dec;46(12):1203-1119300309
Cites: Palliat Med. 2009 Sep;23(6):491-50119443525
Cites: Eur J Haematol. 2009 Aug;83(2):139-4819284418
Cites: BMC Palliat Care. 2014 Mar 11;13(1):824618410
Cites: J Palliat Med. 2007 Oct;10(5):1146-5217985971
Cites: Eur J Epidemiol. 2014 Aug;29(8):551-824407880
Cites: J Pain Symptom Manage. 2009 May;37(5):884-91219097748
Cites: J Support Oncol. 2013 Sep;11(3):126-3224400392
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):42-521775350
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):26-921775346
Cites: Palliat Med. 2007 Sep;21(6):487-9217846088
Cites: J Palliat Med. 2005 Oct;8(5):1025-3216238515
Cites: J Palliat Care. 2012 Summer;28(2):90-622860381
Cites: Oncologist. 2012;17(12):1574-8023220843
Cites: Palliat Med. 2011 Sep;25(6):630-4121228094
Cites: Age Ageing. 2006 Sep;35(5):469-7616751635
Cites: J Palliat Med. 2014 Feb;17(2):195-924383458
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):30-321775347
Cites: BMC Palliat Care. 2016 May 10;15:4627165411
PubMed ID
28330507 View in PubMed
Less detail

9 records – page 1 of 1.