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A Canadian survey of issues in cancer pain management.

https://arctichealth.org/en/permalink/ahliterature207065
Source
J Pain Symptom Manage. 1997 Dec;14(6):332-42
Publication Type
Article
Date
Dec-1997
Author
N. MacDonald
H P Findlay
E. Bruera
D. Dudgeon
J. Kramer
Author Affiliation
Cancer Ethics Programme, Clinical Research Institute of Montreal, Quebec, Canada.
Source
J Pain Symptom Manage. 1997 Dec;14(6):332-42
Date
Dec-1997
Language
English
Publication Type
Article
Keywords
Canada
Data Collection
Humans
Neoplasms - therapy
Palliative Care
Abstract
We report the analysis of a cancer management survey mailed to a representative group of health professionals in 1994. The goals of the study were to gather information on cancer pain treatment practices, and to obtain health professional views on obstacles to ideal pain management. The survey, designed by a working party of pharmacists, nurses and physicians, was distributed to 14,628 physicians. A total of 2,686 physicians responded to the survey, including 39% of medical or radiation oncologists, and 18.19% of physicians who listed their primary interest as Family Medicine. Reflecting the modest emphasis placed on palliative care and cancer pain management in the current Canadian milieu, 67% of physicians rated their past teaching experience as only "fair" or "poor." Lack of exposure to pain education was reflected in the response to a series of hypothetical case scenarios exploring physician choices in managing severe cancer pain. For example, in the initial management of a cancer patient with severe pain, 50% of physicians would not use a strong opioid in the absence of other contraindications to opioid use. A wide variety of analgesics and non-pharmacologic techniques is available to Canadian physicians to assist patients with pain. Few physicians identified the unavailability of analgesics or analgesic techniques as limiting factors in pain management. We conclude that greater emphasis should be placed on pain education in our training programmes. We suggest that further surveys of this type, sponsored by our provincial colleges and medical organizations, can provide feedback which will enhance the adherence by Canadian physicians to published guidelines for pain management.
PubMed ID
9409098 View in PubMed
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The Canadian Palliative Care Undergraduate Curriculum.

https://arctichealth.org/en/permalink/ahliterature222526
Source
J Cancer Educ. 1993;8(3):197-201
Publication Type
Article
Date
1993
Author
N. MacDonald
B. Mount
W. Boston
J F Scott
Author Affiliation
Alberta Cancer Foundation, University of Alberta, Edmonton, Canada.
Source
J Cancer Educ. 1993;8(3):197-201
Date
1993
Language
English
Publication Type
Article
Keywords
Canada
Curriculum
Education, Medical, Undergraduate
Humans
Palliative Care
Professional Staff Committees
Abstract
In 1988 the deans of 12 (out of 16) Canadian medical schools appointed representatives to a Canadian Palliative Care Curriculum Committee. The Committee has subsequently published the Canadian Palliative Care Curriculum which outlines specific goals and objectives for palliative care instruction in undergraduate medical teaching. The Curriculum covers 22 different topics, including 13 symptoms and 9 psychosocial issues. The Canadian Curriculum Committee continues to meet and is now considering other national educational initiatives in palliative care.
PubMed ID
7506051 View in PubMed
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Research--a neglected area of palliative care.

https://arctichealth.org/en/permalink/ahliterature225005
Source
J Palliat Care. 1992;8(1):54-8
Publication Type
Article
Date
1992
Author
N. MacDonald
Author Affiliation
Department of Medicine, University of Alberta, Edmonton, Canada.
Source
J Palliat Care. 1992;8(1):54-8
Date
1992
Language
English
Publication Type
Article
Keywords
Canada
Hospices - standards
Humans
Palliative Care - standards
Research - economics - organization & administration - standards
PubMed ID
1374795 View in PubMed
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Limits to multidisciplinary education.

https://arctichealth.org/en/permalink/ahliterature213475
Source
J Palliat Care. 1996;12(2):6
Publication Type
Article
Date
1996

Ontario palliative care statement: a template for the rest of Canada.

https://arctichealth.org/en/permalink/ahliterature221455
Source
CMAJ. 1993 Mar 15;148(6):891-6
Publication Type
Article
Date
Mar-15-1993
Author
N. MacDonald
Source
CMAJ. 1993 Mar 15;148(6):891-6
Date
Mar-15-1993
Language
English
French
Publication Type
Article
Keywords
Humans
Ontario
Palliative Care - standards
Practice Guidelines as Topic
Societies, Medical
Terminal Care - standards
Notes
Cites: Eur J Cancer. 1990;26(11-12):1133-62149995
Cites: Br J Cancer. 1988 Jan;57(1):109-123348942
Cites: Am J Med. 1990 Sep;89(3):357-622393038
Cites: J Palliat Care. 1992 Spring;8(1):38-421583567
Cites: Hastings Cent Rep. 1991 May-Jun;21(3):suppl 11-61885291
Cites: Eur J Cancer. 1991;27(11):1448-531720635
Comment On: CMAJ. 1993 Mar 15;148(6):933-67680601
PubMed ID
7680600 View in PubMed
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Palliative care--a passing fad? Understanding and responding to the signs of the times.

https://arctichealth.org/en/permalink/ahliterature219580
Source
J Palliat Care. 1994;10(1):5-7
Publication Type
Article
Date
1994

A pilot survey of medical students' perspectives on their educational exposure to palliative care in two Canadian universities.

https://arctichealth.org/en/permalink/ahliterature189306
Source
J Palliat Med. 2002 Jun;5(3):353-61
Publication Type
Article
Date
Jun-2002
Author
Doreen Oneschuk
N. MacDonald
Sean Bagshaw
N. Mayo
H. Jung
J. Hanson
Author Affiliation
Tertiary Palliative Care Unit, Grey Nuns Hospital, Edmonton, Alberta, Canada. doneschu@cha.ab.ca
Source
J Palliat Med. 2002 Jun;5(3):353-61
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - mortality
Breast Neoplasms - therapy
Canada
Curriculum
Female
Humans
Hypertension - diagnosis - therapy
Male
Palliative Care
Pilot Projects
Students, Medical
Abstract
Graduating medical students from the class of 1999 from McGill University and the University of Alberta completed a self-administered, anonymous, pilot survey to determine students' perspectives on how their educational experience in common palliative care topics contrasted with their educational experience in the diagnosis and management of hypertension, non palliative aspects of breast cancer, and patients dying of acquired immune deficiency syndrome (AIDS).
A Likert scale ranging from "excellent," scored 1, "very poor," scored 5, was used. Students also estimated the number of hours they spent, during their training, in operating rooms, on home visits to terminally ill patients, and in interprofessional teaching.
Sixty of 114 (53%) students from McGill University, and 53 of 110 (48%) students from the University of Alberta responded to the survey. The mean ratings of education experience in the various topics for both universities combined were as follows: hypertension, 2.03; breast cancer, 2.33; cancer pain, 3.42; communicating with dying patients, 3.32; and caring for patients with AIDS, 4.15. The average number of hours spent in the operating room, on home visits to terminally patients, and in interprofessional teaching for both universities combined were 155 hours, 4.2 hours, and 16 hours, respectively. Of the responding students from both universities 83% favored increased palliative care teaching.
Despite the disproportionate number of hours spent in operating rooms compared to palliative care community exposure, only two students, one from each university, favored shortening surgical rotations to allow for increased time for palliative care education. Recommendations, including increasing palliative care education during clinical clerkships, are provided to improve medical students' perceptions of their educational experiences in palliative care education.
PubMed ID
12133241 View in PubMed
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Ethics of palliative care in the context of limited resources: an essay on the need for attitudinal change.

https://arctichealth.org/en/permalink/ahliterature219569
Source
J Palliat Care. 1994;10(3):39-42
Publication Type
Article
Date
1994
Source
CMAJ. 1998 Jun 30;158(13):1699-701
Publication Type
Article
Date
Jun-30-1998
Author
N. MacDonald
Source
CMAJ. 1998 Jun 30;158(13):1699-701
Date
Jun-30-1998
Language
English
Publication Type
Article
Keywords
Biomedical research
Canada
Cost of Illness
Ethics, Medical
Euthanasia, Active
Health Policy
Home Care Services
Home Nursing
Humans
Neoplasms - mortality - nursing
Palliative Care
Patient care team
Notes
Cites: Ann Intern Med. 1993 Jul 15;119(2):121-68099769
Cites: CMAJ. 1994 Mar 1;150(5):701-88313289
Cites: BMJ. 1995 Apr 29;310(6987):1085-67742666
Cites: Arch Intern Med. 1995 Jun 26;155(12):1265-97778956
Cites: Acad Med. 1991 Jan;66(1):35-81985674
Cites: Arch Phys Med Rehabil. 1988 May;69(5):323-82966616
Cites: J Pain Symptom Manage. 1997 Dec;14(6):332-429409098
Cites: N Engl J Med. 1996 Feb 1;334(5):303-98532027
Cites: West J Med. 1995 Sep;163(3):278-867571592
Cites: Am J Psychiatry. 1995 Aug;152(8):1185-917625468
Comment In: CMAJ. 1998 Jun 30;158(13):1702-49676546
PubMed ID
9676545 View in PubMed
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Palliative care--an essential component of cancer control.

https://arctichealth.org/en/permalink/ahliterature205050
Source
CMAJ. 1998 Jun 30;158(13):1709-16
Publication Type
Article
Date
Jun-30-1998
Author
N. MacDonald
Author Affiliation
Center for Bioethics, Clinical Research Institute of Montreal, Que.
Source
CMAJ. 1998 Jun 30;158(13):1709-16
Date
Jun-30-1998
Language
English
Publication Type
Article
Keywords
Canada
Forecasting
Health Services Accessibility - trends
Health Services Needs and Demand - trends
Humans
Neoplasms - therapy
Oncology Service, Hospital - trends
Palliative Care - trends
Patient Care Team - trends
Terminal Care - trends
Abstract
Unlike in other nations, in Canada palliative care has its origins in university hospitals. It has subsequently developed in a few Canadian schools as an academic discipline closely linked with oncology programs. Although this model is successful, other faculties of medicine and cancer centres have been slow to emulate it. Today, the situation is rapidly changing, and both palliative care and oncology professionals are re-examining the manifest need for collaborative efforts in patient care, research and education. Palliative care must be regarded as an essential component of cancer care, its principles must be applied throughout the course of the illness and, as in other phases of cancer control, palliative care should be regarded as an exercise in prevention--prevention of suffering. This article discusses practical applications that flow from acceptance of these concepts.
Notes
Cites: Br J Cancer. 1995 Feb;71(2):366-707530988
Cites: BMJ. 1995 Jan 14;310(6972):71-27833721
Cites: Pain. 1995 Aug;62(2):155-628545140
Cites: J Med Ethics. 1995 Oct;21(5):259-608558537
Cites: N Engl J Med. 1996 Feb 22;334(8):488-938559201
Cites: Cancer Treat Rev. 1996 Jan;22 Suppl A:3-128625346
Cites: Cancer. 1996 Aug 1;78(3 Suppl):633-88681302
Cites: Cancer. 1996 Nov 15;78(10):2045-88918396
Cites: N Engl J Med. 1996 Dec 12;335(24):1785-918965890
Cites: N Engl J Med. 1997 May 29;336(22):1569-749164814
Cites: Am J Clin Nutr. 1997 Aug;66(2):464S-477S9250134
Cites: J Pain Symptom Manage. 1997 Dec;14(6):332-429409098
Cites: CMAJ. 1998 Jun 30;158(13):1699-7019676545
Cites: Cancer. 1988 Jul 15;62(2):407-112454724
Cites: J Clin Epidemiol. 1991;44(3):313-271705580
Cites: Pain. 1991 Jan;44(1):3-42038486
Cites: Cancer Detect Prev. 1991;15(3):253-51711926
Cites: J Natl Cancer Inst. 1991 Jun 19;83(12):806-72061939
Cites: Cancer. 1992 Sep 15;70(6):1616-241516015
Cites: Pain. 1993 Mar;52(3):259-857681556
Cites: Ann Intern Med. 1993 Jul 15;119(2):121-68099769
Cites: Palliat Med. 1993;7(4 Suppl):65-87505712
Cites: Qual Life Res. 1994 Jun;3(3):183-97920492
Cites: J Pain Symptom Manage. 1995 May;10(4):287-917602179
PubMed ID
9676548 View in PubMed
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10 records – page 1 of 1.