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Norway: development of palliative care.

https://arctichealth.org/en/permalink/ahliterature188544
Source
J Pain Symptom Manage. 2002 Aug;24(2):211-4
Publication Type
Article
Date
Aug-2002
Author
Stein Kaasa
Harald Breivik
Marit Jordhøy
Author Affiliation
Unit for Applied Clinical Research and Palliative Medicine Unit, and Norwegian University of Science and Technology Unit, NTNU, St. Olavs Hospital, Trondheim, Norway.
Source
J Pain Symptom Manage. 2002 Aug;24(2):211-4
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Humans
Norway
Palliative Care - organization & administration
Program Development
PubMed ID
12231148 View in PubMed
Less detail

[Palliative medicine-- research and education in a new specialist field].

https://arctichealth.org/en/permalink/ahliterature171004
Source
Tidsskr Nor Laegeforen. 2006 Jan 26;126(3):333-6
Publication Type
Article
Date
Jan-26-2006
Author
Stein Kaasa
Dagny Faksvåg Haugen
Jan Henrik Rosland
Author Affiliation
Seksjon lindrende behandling, Kreftavdelingen, St. Olavs Hospital og Institutt for kreftforskning og molekylaer medisin, Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet, 7006 Trondheim.
Source
Tidsskr Nor Laegeforen. 2006 Jan 26;126(3):333-6
Date
Jan-26-2006
Language
Norwegian
Publication Type
Article
Keywords
Biomedical research
Clinical Competence
Curriculum
Education, Medical, Graduate
Humans
Norway
Palliative Care
Terminal Care
Abstract
Palliative medicine has developed into a recognised specialty in medicine, calling for a high level of skills as well as evidence-based clinical guidelines. The undergraduate teaching in medical schools in Norway is fragmented in this area, and national minimum standards are needed. At the graduate level, teaching in palliative medicine should be included in all relevant specialties. Doctors who are fully involved in palliative medicine should have a specialised education. Recently, a Nordic Curriculum in Palliative Medicine was developed and a two-year course initiated; 30 doctors have graduated. There is a need for research in palliative care, both on the basic biological level as well as on the clinical level. National and international collaboration is needed in order to reach these goals. Nationally, there are some research groups that perform excellently. However, there is a need to strengthen research in this area. Chairs in palliative medicine will facilitate such a development and are urgently needed in all medical schools.
PubMed ID
16440043 View in PubMed
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Building up research in palliative care: an historical perspective and a case for the future.

https://arctichealth.org/en/permalink/ahliterature176688
Source
Clin Geriatr Med. 2005 Feb;21(1):81-92, viii
Publication Type
Article
Date
Feb-2005
Author
Stein Kaasa
Ola Dale
Author Affiliation
Department of Cancer Research and Molecular Biology, The Norwegian University of Science and Technology, 5th Floor Kreftbygget, 7006 Trondheim, Norway. stein.kaasa@ntnu.no
Source
Clin Geriatr Med. 2005 Feb;21(1):81-92, viii
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Health Services Research - economics - organization & administration
History, 20th Century
Humans
Norway
Palliative Care - economics
Abstract
Palliative care is a young discipline for research, though expert group opinions have been helpful. The lack of extended research programs addressing basic biological mechanisms of patients with advanced disease and short life expectancy nationally and internationally has created an increasingly strong call for research in palliative care. Obstacles and challenges include ethical concerns among the ill, establishment of a research agenda, the number of experienced researchers at the university level, lack of national and international leadership, and funding for palliative care research. Committed individuals have conducted important research, and if their efforts are combined with professional leadership, funding might be secured to establish the programs necessary to address palliative care research nationally and internationally.
PubMed ID
15639039 View in PubMed
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Symptom assessment in palliative medicine.

https://arctichealth.org/en/permalink/ahliterature128037
Source
Tidsskr Nor Laegeforen. 2012 Jan 10;132(1):18-9
Publication Type
Article
Date
Jan-10-2012
Author
Irmelin Bergh
Nina Aass
Dagny Faksvåg Haugen
Stein Kaasa
Marianne Jensen Hjermstad
Author Affiliation
Regional Centre of Excellence in Palliative Care, South-Eastern Norway Regional Health Authority, Oslo University Hospital, Norway.
Source
Tidsskr Nor Laegeforen. 2012 Jan 10;132(1):18-9
Date
Jan-10-2012
Language
English
Norwegian
Publication Type
Article
Keywords
Humans
Norway
Palliative Care - standards
Practice Guidelines as Topic
Self Report
Severity of Illness Index
Sickness Impact Profile
Terminal Care - standards
United States
PubMed ID
22240824 View in PubMed
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[The specialist field of palliative medicine]

https://arctichealth.org/en/permalink/ahliterature16501
Source
Tidsskr Nor Laegeforen. 2006 Jan 26;126(3):326-8
Publication Type
Article
Date
Jan-26-2006
Author
Stein Kaasa
Dagny Faksvåg Haugen
Author Affiliation
Seksjon lindrende behandling, Kreftavdelingen, St. Olavs Hospital og Institutt for kreftforskning og molekylaer medisin, Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet, 7006 Trondheim.
Source
Tidsskr Nor Laegeforen. 2006 Jan 26;126(3):326-8
Date
Jan-26-2006
Language
Norwegian
Publication Type
Article
Keywords
English Abstract
Hospices
Humans
Length of Stay
Norway
Palliative Care - organization & administration - standards
Patient care team
Quality of Life
Specialties, Medical
Terminal Care - organization & administration - standards
Abstract
Palliative medicine means caring for patients with incurable disease and short life expectancy, or, with the British definition, "the study and management of patients with active, progressive, far advanced disease, for whom the prognosis is limited and the focus of care is the quality of life". Palliative medicine is more than care for the dying. Today palliative medicine is regarded as integral to the treatment pathway for all patients with incurable disease. Up to now, mostly cancer patients have been offered specialist palliative care, but the international trend is to include other patient groups, especially patients with degenerative neurological disease and advanced cardiac and pulmonary disease. Palliative medicine is characterized by a focus not primarily on disease control but rather on symptom relief, social support, spiritual care, and maintenance of physical and psychological functioning and wellbeing. To reach these goals, a multi-professional approach is needed, and the doctor in charge must be highly qualified clinically and academically and willing and able to cooperate with colleagues and other healthcare professionals.
PubMed ID
16440041 View in PubMed
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Attitudes towards, and wishes for, euthanasia in advanced cancer patients at a palliative medicine unit.

https://arctichealth.org/en/permalink/ahliterature16705
Source
Palliat Med. 2005 Sep;19(6):454-60
Publication Type
Article
Date
Sep-2005
Author
Sissel Johansen
Jacob Chr Hølen
Stein Kaasa
Håvard Jon Loge
Lars Johan Materstvedt
Author Affiliation
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Source
Palliat Med. 2005 Sep;19(6):454-60
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Attitude to Death
Euthanasia - psychology
Female
Humans
Male
Middle Aged
Neoplasms - psychology
Norway
Palliative Care - psychology
Questionnaires
Research Support, Non-U.S. Gov't
Suicide, Assisted - psychology
Terminally Ill - psychology
Abstract
BACKGROUND: Most studies on attitudes towards euthanasia and physician-assisted suicide (PAS) have been conducted in healthy populations. The aim of this study is to explore and describe attitudes towards, and wishes for, euthanasia/PAS in cancer patients with short life expectancy. METHOD: Semi-structured interviews with 18 cancer patients with a life expectancy of less than nine months. All patients were recruited from an inpatient palliative medicine unit. RESULTS: Patients holding a positive attitude towards euthanasia/PAS do not necessarily want euthanasia/PAS for themselves. Wishes are different from requests for euthanasia/PAS. Fear of future pain and a painful death were the main reasons given for a possible wish for euthanasia/PAS. Worries about minimal quality of life and lack of hope also contributed to such thoughts. Wishes for euthanasia/PAS were hypothetical; they were future oriented and with a prerequisite that intense pain, lack of quality of life and/or hope had to be present. Additionally, wishes were fluctuating and ambivalent. CONCLUSION: The wish to die in these patients does not seem to be constant. Rather, this wish is more appropriately seen as an ambivalent and fluctuating mental 'solution' for the future. Health care providers should be aware of this when responding to utterances regarding euthanasia/PAS.
PubMed ID
16218157 View in PubMed
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Measuring quality of palliative care: psychometric properties of the FAMCARE Scale.

https://arctichealth.org/en/permalink/ahliterature18556
Source
Qual Life Res. 2003 Mar;12(2):167-76
Publication Type
Article
Date
Mar-2003
Author
Gerd Inger Ringdal
Marit S Jordhøy
Stein Kaasa
Author Affiliation
Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. gerd.inger.ringdal@svt.ntnu.no
Source
Qual Life Res. 2003 Mar;12(2):167-76
Date
Mar-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Factor Analysis, Statistical
Family - psychology
Female
Humans
Male
Middle Aged
Neoplasms - drug therapy - psychology
Norway
Palliative Care - standards
Patient satisfaction
Psychometrics
Quality Assurance, Health Care - methods
Research Support, Non-U.S. Gov't
Terminal Care - standards
Abstract
This study measures quality of palliative care in 181 family members (i.e. spouse, child) to cancer victims with terminal disease 1 month after the time of death. The specific aim was to explore the underlying factor structure and dimensionality of the 20 items of the FAMCARE Scale, measuring family satisfaction with health care given to the patient and to them. The results from a factor analysis, a Mokken Scaling Program analysis, and a reliability analysis, showed that 19 out of the 20 items form a strong one-dimensional scale. Since the scale is one-dimensional, the possibility of reducing the number of items should be explored in future research. Our recommendation is to measure satisfaction with care 1-2 months after the death of the patient. One should also explore the possibilities of measuring satisfaction with care prospectively as an integral part of the palliative care program.
PubMed ID
12639063 View in PubMed
Less detail

Depressed patients with incurable cancer: which depressive symptoms do they experience?

https://arctichealth.org/en/permalink/ahliterature259961
Source
Palliat Support Care. 2013 Dec;11(6):491-501
Publication Type
Article
Date
Dec-2013
Author
Elisabeth Brenne
Jon Håvard Loge
Stein Kaasa
Ellen Heitzer
Anne Kari Knudsen
Elisabet Wasteson
Source
Palliat Support Care. 2013 Dec;11(6):491-501
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anxiety - psychology
Depressive Disorder, Major - drug therapy - psychology
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Middle Aged
Neoplasms - complications - psychology
Norway
Palliative Care - methods
Severity of Illness Index
Terminally Ill - psychology
Abstract
Diagnosing depressive disorders in palliative care is challenging because of the overlap between some depressive symptoms and cancer-related symptoms, such as loss of appetite and fatigue. In order to improve future assessment of depression in palliative care, depressive symptoms experienced by patients receiving pharmacological treatment for depression were assessed and compared to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder.
Thirty Norwegian (n = 20) and Austrian (n = 10) patients with advanced cancer were included. Semistructured interviews on symptom experiences were conducted and transcribed verbatim. By the phenomenographic method, patients' symptom experiences were extracted and sorted by headings, first individually and then across patients. The patients subsequently rated 24 symptoms numerically including the DSM-IV depression criteria.
Lowered mood and a diminished motivational drive were prominent and reflected the two main DSM-IV symptom criteria. A relentless focus on their actual situation, restlessness, disrupted sleep, feelings of worthlessness, feelings of guilt, and thoughts of death as a solution were variably experienced. Appetite and weight changes, fatigue and psychomotor retardation were indistinguishable from cancer symptoms. All these symptoms reflected DSM-IV symptom criteria. Some major symptoms occurred that are not present in the DSM-IV symptom criteria: despair, anxiety, and social withdrawal. The numerical ratings of symptoms were mainly in accordance with the findings from the qualitative analysis.
Despair, anxiety, and social withdrawal are common symptoms in depressed patients with incurable cancer, and, therefore, hypothesized as candidate symptom criteria. Other symptom criteria might need adjustment for improvement of relevance in this group of patients.
Notes
Erratum In: Palliat Support Care. 2013 Dec;11(6):535
PubMed ID
23388067 View in PubMed
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The Norwegian Doloplus-2, a tool for behavioural pain assessment: translation and pilot-validation in nursing home patients with cognitive impairment.

https://arctichealth.org/en/permalink/ahliterature173264
Source
Palliat Med. 2005 Jul;19(5):411-7
Publication Type
Article
Date
Jul-2005
Author
Jacob C Hølen
Ingvild Saltvedt
Peter M Fayers
Marit Bjørnnes
Guri Stenseth
Bjørn Hval
Marilène Filbet
Jon Håvard Loge
Stein Kaasa
Author Affiliation
Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, N-7006 Trondheim, Norway. jacob.chr.holen@medisin.ntnu.no
Source
Palliat Med. 2005 Jul;19(5):411-7
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cognition Disorders - nursing - psychology
Dementia - nursing - psychology
Female
Geriatric Assessment - methods
Homes for the Aged
Humans
Male
Middle Aged
Norway
Pain - diagnosis - nursing - psychology
Pain Measurement - methods - nursing
Palliative Care - methods
Patient Compliance - psychology
Pilot Projects
Regression Analysis
Reproducibility of Results
Abstract
Pain assessment is challenging in cognitively impaired (CI) patients due to inadequate self-report skills and observational ratings are an alternative. The Doloplus-2 is developed for pain assessment in the CI and rates somatic, psychomotor and psychosocial behaviours as indicators of pain.
To translate the Doloplus-2 into Norwegian, to test the Doloplus-2 with regard to criterion validity and to obtain the administrators' evaluation of the clinical performance of the Doloplus-2.
Nurses at three nursing homes, in collaboration with two research assistants, administered the Doloplus-2 to 59 patients with dementia. The results were compared against experienced clinicians' pain ratings. Regression analyses were performed to explore each different item's contribution to the total pain score. The administrators also completed a debriefing questionnaire.
The instrument was translated according to international guidelines. Regression analyses demonstrate that the Doloplus-2 score accounts for 62% (R2) of the expert score and that the four most informative items could explain 68% of the expert score. Analyses of the different Doloplus-2 items indicate that facial expressions explain most and social life least of the expert's pain ratings. The administrators reported that Doloplus-2 was helpful and easy to administer, but questioned the validity of the psychosocial domain.
The Norwegian Doloplus-2 demonstrates satisfactory criterion validity and clinical value in this pilot study. However, the content of the instrument needs a general re-evaluation, especially with regard to the psychosocial items.
PubMed ID
16111065 View in PubMed
Less detail

Characterization of patients receiving palliative chemo- and radiotherapy during end of life at a regional cancer center in Norway.

https://arctichealth.org/en/permalink/ahliterature265804
Source
Acta Oncol. 2015 Mar;54(3):395-402
Publication Type
Article
Date
Mar-2015
Author
Malin Anshushaug
Mari Aas Gynnild
Stein Kaasa
Anne Kvikstad
Bjørn H Grønberg
Source
Acta Oncol. 2015 Mar;54(3):395-402
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - therapeutic use
C-Reactive Protein - analysis
Cancer Care Facilities
Child
Female
Humans
Male
Middle Aged
Neoplasms - blood - drug therapy - mortality - radiotherapy
Norway - epidemiology
Palliative Care - statistics & numerical data
Prognosis
Radiotherapy - utilization
Retrospective Studies
Serum Albumin - analysis
Severity of Illness Index
Abstract
Many cancer patients receive chemotherapy and radiotherapy their last 30 days [end of life (EOL)]. The benefit is questionable and side effects are common. The aim of this study was to investigate what characterized the patients who received chemo- and radiotherapy during EOL, knowledge that might be used to improve practice.
Patients dead from cancer in 2005 and 2009 were analyzed. Data were collected from hospital medical records. When performance status (PS) was not stated, PS was estimated from other information in the records. A Glasgow Prognostic Score (GPS) of 0, 1 or 2 was assessed from blood values (CRP and albumin). A higher score is associated with a shorter prognosis.
In total 616 patients died in 2005; 599 in 2009. Among the 723 analyzed, median age was 71; 42% had metastases at diagnosis (synchronous metastases); 53% had PS 2 and 16% PS 3-4 at the start of last cancer therapy. GPS at the start of last cancer therapy was assessable in 70%; of these, 26% had GPS 1 and 35% GPS 2. Overall, 10% received chemotherapy and 8% radiotherapy during EOL. The proportions varied significantly between the different types of cancer. Multivariate analyses revealed that those at age
PubMed ID
25162953 View in PubMed
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13 records – page 1 of 2.