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healthcare provider is delivering the news including privacy, sitting, time, and the inclusion of family members. What to say should also be considered, as well as rehearsed. It is important to understand how a patient is receiving the information by asking open ended questions and asking them to repeat what they learned in their own words, which is perception aspect of the framework. The healthcare provider should seek an invitation from the patient to disclose additional information before doing so in order to prevent overwhelming or distressing the patient further. In order to ensure the patient understands what is being told, knowledge must be used. This includes speaking in a way that the patient will understand, using simple words, not being excessively blunt, giving information in small chunks and checking in with the patient to confirm that they understand, and not providing poor information that may not be completely true. In order to alleviate some of a patient's distress it is crucial to be empathetic in the sense of understanding how a patient is feeling and the reactions they are having. This can allow one to change how they are delivering information, allow the patient to have time to process the information, or console them if needed. Connecting with patients is an important step in delivering bad news; maintaining eye contact proves that the healthcare provider is present and the patient and family has their full attention. Furthermore, the provider may make a connection by touching the patients shoulder or hand, giving them a physical connection to know that they are not alone. Finally, it is important to summarize all the information given in order to ensure the patient fully understands and takes away the major points. Additionally, patients who have a clear plan for the future are less likely to feel anxious and uncertain, but it is important to ask people if they are ready for that information before providing them with it.
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team regarding goals and options for care. Often, these conversations occur within the context of family meetings, which are formal meetings between families and the child's multidisciplinary medical team. Prior to the family meeting, providers often meet to discuss the child's overall case, reasonably expected prognosis, and options for care, in addition to clarifying specific roles each provider will take on during the family meeting. During this meeting, the multidisciplinary medical team may also discuss any legal or ethical considerations related to the case. Palliative care providers often facilitate this meeting and help synthesize its outcome for children and their families. Experts in optimized communication, palliative care providers may opt to hold the family meeting in a quiet space where the providers and family can sit and address concerns during a time when all parties are not constrained. Additionally, parents' preferences regarding information exchange with the sick child present should be clarified. If the child's guardians are resistant to disclosing information in front of their child, the child's provider may explore parental concerns on the topic. When excluded from family meetings and moments of challenging information exchange, adolescents, in particular, may have challenges with trusting their medical providers if they feel critical information is being withheld. It is important to follow the child's lead when deciding whether to disclose difficult information. Additionally, including them in these conversations can help the child fully participate in their care and medical decision making. Finally, it is important to prioritize the family's agenda while additionally considering any urgent medical decisions needed to advance the child's care.
145:(WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
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ultimate goals of care. Equally important to consider, families may vary in the level of responsibility they want in this decision-making process. Their preference may range from wanting to be the child's sole decision makers, to partnering with the medical team in a shared decision making model, to advocating for full deferral of decision-making responsibility to the clinician. Palliative care providers clarify a family's preferences and support needs for medical decision making by providing context, information, and options for treatment and medical palliation. In the case of critically ill babies, parents are able to participate more in decision making if they are presented with options to be discussed rather than recommendations by the doctor. Utilizing this style of communication also leads to less conflict with doctors and might help the parents cope better with the eventual outcomes.
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few symptoms assessment tools trialed among older children receiving palliative care include the
Symptom Distress Scale, and the Memorial Symptom Assessment Scale, and Childhood Cancer Stressors Inventory. Quality of life considerations within pediatrics are unique and an important component of symptoms assessment. The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32) is a standardized parent-proxy report which assesses cancer treatment-related symptoms (focusing mainly on pain and nausea). But again, this tool does not comprehensively assess all palliative are symptoms issues. Symptom assessment tools for younger age groups are rarely utilized as they have limited value, especially for infants and young children who are not at a developmental stage where they can articulate symptoms.
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potentially distressing conversations, naming emotions witnessed to create opportunities to discuss complex emotional responses to illness, actively listening, and allowing for invitational silence. The palliative care provider may iteratively assess the child and family's emotional responses and needs during challenging conversations. At times, the medical team may be hesitant to discuss a child's prognosis out of fear of increasing distress. This sentiment is not supported by the literature; among adults, end of life discussions are not associated with increased rates of anxiety or depression. Though this topic is not well studied in pediatric populations, conversations about prognosis have the potential to increase in parental hope and peace of mind.
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When a patient has their needs met then they are more likely to be open to the idea of hospice or treatments outside comfort care. Having a psychosocial assessment allows the medical team to help facilitate a healthy patient-family understanding of adjustment, coping and support. This communication between the medical team and the patients and family can also help facilitate discussions on the process of maintaining and enhancing relationships, finding meaning in the dying process, and achieving a sense of control while confronting and preparing for death. For adults with anxiety, medical evidence in the form of high-quality randomized trials is insufficient to determine the most effective treatment approach to reduce the symptoms of anxiety.
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Strategies for communication are complex as the pediatric palliative care practitioners must facilitate a shared understanding of and consensus for goals of care and therapies available to the sick child amongst multiple medical teams who often have different areas of expertise. Additionally, pediatric palliative care practitioners must assess both the sick child and their family's understanding of complex illness and options for care, and provide accessible, thoughtful education to address knowledge gaps and allow for informed decision making. Finally, practitioners are supporting children and families in the queries, emotional distress, and decision making that ensues from the child's illness.
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with the pediatric patient and their family by first asking the child how they would describe themself and what is important to them, communicating in an age and developmentally cognizant fashion. The provider may then gather similar information from the child's caregivers. Questions practitioners may ask include 'What does the child enjoy doing? What do they most dislike doing? What does a typical day look like for the child?' Other topics potentially addressed by the palliative care provider may also include familial rituals as well as spiritual and religious beliefs, life goals for the child, and the meaning of illness within the broader context of the child and their family's life.
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regarding their child's care. A framework often employed by pediatric palliative care providers is 'ask, tell, ask' where the provider asks the patient and their family for a question to identify their level of comprehension of the situation, and then subsequently supplements the family's knowledge with additional expert knowledge. This information is often conveyed without jargon or euphemism to maintain trust and ensure understanding. Providers iteratively check for comprehension of this knowledge supplementation by asking questions related to previous explanations, as information retention can be challenging when undergoing a stressful experience.
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service, with or without an acute inpatient palliative care unit. Palliative care may also be provided in the dying person's home as a "bridge" program between traditional US home care services and hospice care or provided in long-term care facilities. In contrast over 80% of hospice care in the US is provided at home with the remainder provided to people in long-term care facilities or in free standing hospice residential facilities. In the UK hospice is seen as one part of the speciality of palliative care and no differentiation is made between 'hospice' and 'palliative care'.
751:, poor appetite, difficulty with feeding, and diarrhea. In older children with neurologic and neuromuscular manifestations of disease, there is a high burden of anxiety and depression that correlates with disease progression, increasing disability, and greater dependence on carers. From the caregiver's perspective, families find changes in behavior, reported pain, lack of appetite, changes in appearance, talking to God or angels, breathing changes, weakness, and fatigue to be the most distressing symptoms to witness in their loved ones.
260:). An individual's hospice benefits are not revoked if that individual lives beyond a six-month period. In the United States, in order to be eligible for hospice, patients usually forego treatments aimed at cure, unless they are minors. This is to avoid what is called concurrent care, where two different clinicians are billing for the same service. In 2016 a movement began to extend the reach of concurrent care to adults who were eligible for hospice but not yet emotionally prepared to forego curative treatments.
667:. A commonly held myth is that premature and neonatal infants do not experience pain due to their immature pain pathways, but research demonstrates pain perception in these age groups is equal or greater than that of adults. With this said, some children experiencing intolerable pain present with 'psychomotor inertia', a phenomenon where a child in severe chronic pain presents overly well behaved or depressed. These patients demonstrate behavioral responses consistent with pain relief when titrated with
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resource showing which services were available and grouped them according to their intended purpose and benefit to the patient. They also stated that currently in the UK palliative services are only available to patients with a timeline to death, usually 12 months or less. They found these timelines to often be inaccurate and created barriers to patients accessing appropriate services. They call for a more holistic approach to end of life care which is not restricted by arbitrary timelines.
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different avenues of funding. Over 40% of all dying patients in the United States currently undergo hospice care. Most of the hospice care occurs at a home environment during the last weeks/months of their lives. Of those patients, 86.6% believe their care is "excellent". Hospice's philosophy is that death is a part of life, so it is personal and unique. Caregivers are encouraged to discuss death with the patients and encourage spiritual exploration (if they so wish).
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chronic care, as many people in palliative care lose the ability to swallow. A common alternative route of administration is subcutaneous, as it is less traumatic and less difficult to maintain than intravenous medications. Other routes of administration include sublingual, intramuscular and transdermal. Medications are often managed at home by family or nursing support.
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populations put increasing pressure on existing resources, long-term palliative care for patients' non-communicable, chronic conditions has emerged as a necessary approach to increase these patient's quality of life, through prevention and relief by identifying, assessing, and treating the source of pain and other psychosocial and spiritual problems.
152:. It is provided by an interdisciplinary team which can include physicians, nurses, occupational and physical therapists, psychologists, social workers, chaplains, and dietitians. Palliative care can be provided in a variety of contexts, including hospitals, outpatient, skilled-nursing, and home settings. Although an important part of
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with speech, headache, excess secretions, anemia, pressure area problems, anxiety, fever, and mouth sores. The most common end of life symptoms in children include shortness of breath, cough, fatigue, pain, nausea and vomiting, agitation and anxiety, poor concentration, skin lesions, swelling of the extremities,
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advanced illnesses of a chronic nature. Spiritual beliefs and practices can influence perceptions of pain and distress, as well as quality of life among advanced cancer patients. Spiritual needs are often described in literature as including loving/being loved, forgiveness, and deciphering the meaning of life.
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In the United States, hospice and palliative care represent two different aspects of care with similar philosophies, but with different payment systems and location of services. Palliative care services are most often provided in acute care hospitals organized around an interdisciplinary consultation
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Once the immediate physical pain has been dealt with, it is important to remember to be a compassionate and empathetic caregiver that is there to listen and be there for their patients. Being able to identify the distressing factors in their life other than the pain can help them be more comfortable.
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Palliative care interventions in care homes may contribute to lower discomfort for residents with dementia and to improve family members' views of the quality of care. However, higher quality research is needed to support the benefits of these interventions for older people dying in these facilities.
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Many people with chronic pain are stigmatized and treated as opioid addicts. Patients can build a tolerance to drugs and have to take more and more to manage their pain. The symptoms of chronic pain patients do not show up on scans, so the doctor must go off trust alone. This is the reason that some
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Despite significant progress that has been made to increase access to palliative care within the United States and other countries, many countries have not yet considered palliative care as a public health problem, and therefore do not include it in their public health agenda. Resources and cultural
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child to ascertain these parties' baseline understanding of the child's situation. Assessing for baseline knowledge allows the palliative care provider to identify knowledge gaps and provide education on those topics. Through this process, families can pursue informed, shared medical decision making
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An essential component of a provider's ability to provide individualized palliative care is their ability to obtain an intimate understanding of the child and family's preferences and overall character. On initial consultation, palliative care providers often focus on affirming a caring relationship
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As discussed above, within the field of adult palliative medicine, validated symptoms assessment tools are frequently utilized by providers, but these tools lack essential aspects of children's symptom experience. Within pediatrics, there is not a comprehensive symptoms assessment widely employed. A
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As with palliative care for adults, symptom assessment and management is a critical component of pediatric palliative care as it improves quality of life, gives children and families a sense of control, and prolongs life in some cases. The general approach to assessment and management of distressing
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Physical pain can be managed using pain medications as long as they do not put the patient at further risk for developing or increasing medical diagnoses such as heart problems or difficulty breathing. Patients at the end of life can exhibit many physical symptoms that can cause extreme pain such as
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In the United
Kingdom, Palliative Medicine specialist training is delivered alongside Internal Medicine stage two training over an indicative four years. Entry into Palliative medicine training is possible following successful completion of both a foundation programme and a core training programme.
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Within the realm of pediatric medical care, the palliative care team is tasked with facilitating family-centered communication with children and their families, as well as multidisciplinary pediatric caregiving medical teams to forward coordinated medical management and the child's quality of life.
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Many terminally ill people cannot consume adequate food or drink. Providing medically assisted food or drink to prolong their life and improve the quality of their life is common, however there have been few high quality studies to determine best practices and the effectiveness of these approaches.
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first introduced the term "total pain" to describe the heterogenous nature of pain. This is the idea that a patient's experience of total pain has distinctive roots in the physical, psychological, social and spiritual realm but that they are all still closely linked to one another. Identifying the
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quality of life or increases caregiver burden, through pain and symptom management, identification and support of caregiver needs, and care coordination. Palliative care can be delivered at any stage of illness alongside other treatments with curative or life-prolonging intent and is not restricted
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Palliative care is able to improve healthcare quality in three sectors: Physical and emotional relief, strengthening of patient-physician communication and decision-making, and coordinated continuity of care across various healthcare settings, including hospital, home, and hospice. The overall goal
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Essential to facilitating supportive, clear communication around potentially distressing topics such as prognosis and goals of care for seriously ill pediatric patients is optimizing the setting where this communication will take place and developing informed consensus among the child's caregiving
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As part of developing a shared understanding of a child's illness and character, palliative providers will assess both the child and their family's symbolic and emotional relationship to disease. As both the somatic and psychologic implications of illness can be distressing to children, palliative
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Identify and assess symptoms through history taking (focusing on location, quality, time course, as well as exacerbating and mitigating stimuli). Symptoms assessment in children is uniquely challenging due to communication barriers depending on the child's ability to identify and communicate about
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Medications used in palliative care can be common medications but used for a different indication based on established practices with varying degrees of evidence. Examples include the use of antipsychotic medications, anticonvulsants, and morphine. Routes of administration may differ from acute or
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Cancer Center in Ohio which later expanded to become the training site of the first palliative care clinical and research fellowship as well as the first acute pain and palliative care inpatient unit in the United States. The program evolved into The Harry R. Horvitz Center for
Palliative Medicine
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refers specifically to a benefit provided by the federal government since 1982. Hospice care services and palliative care programs share similar goals of mitigating unpleasant symptoms, controlling pain, optimizing comfort, and addressing psychological distress. Hospice care focuses on comfort and
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In the UK palliative care services offer inpatient care, home care, day care and outpatient services, and work in close partnership with mainstream services. Hospices often house a full range of services and professionals for children and adults. In 2015 the UK's palliative care was ranked as the
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The most common symptoms in children with severe chronic disease appropriate for palliative care consultation are weakness, fatigue, pain, poor appetite, weight loss, agitation, lack of mobility, shortness of breath, nausea and vomiting, constipation, sadness or depression, drowsiness, difficulty
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conditions. Forty million people each year are expected to need palliative care, with approximately 78% of this population living in low and middle income countries. However, only 14% of this population is able to receive this kind of care, with a majority in high-income countries, making this an
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about prescribing could help people manage their symptoms at home. A named professional to support and guide patients and carers through the healthcare system could also improve the experience of care at home at the end of life. A synthesised review looking at palliative care in the UK created a
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A significant role of the pediatric palliative care provider is to help support children, their families, and their caregiving teams through the emotional stress of illness. Communication strategies the palliative care provider may employ in this role are asking for permission when engaging with
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According to the
Clinical Practice Guidelines for Quality Palliative Care, spirituality is a "dynamic and intrinsic aspect of humanity" and has been associated with "an improved quality of life for those with chronic and serious illness", especially for patients who are living with incurable and
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Physicians practicing palliative care do not always receive support from the people they are treating, family members, healthcare professionals or their social peers. More than half of physicians in one survey reported that they have had at least one experience where a patient's family members,
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Medical decision making in a pediatric setting is unique in that it is often the child's legal guardians, not the patient, who ultimately consent for most medical treatments. Yet within a palliative care setting, it is particularly consequential to incorporate the child's preferences within the
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High-certainty evidence supports the finding that implementation of home-based end-of-life care programs may increase the number of adults who will die at home and slightly improve patient satisfaction at a one-month follow-up. The impact of home-based end-of-life care on caregivers, healthcare
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The focus on a person's quality of life has increased greatly since the 1990s. In the United States today, 55% of hospitals with more than 100 beds offer a palliative-care program, and nearly one-fifth of community hospitals have palliative-care programs. A relatively recent development is the
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usually refers to a building or institution that specializes in palliative care. These institutions provide care to patients with end of life and palliative care needs. In the common vernacular outside the United States, hospice care and palliative care are synonymous and are not contingent on
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Evidence supports the efficacy of a palliative care approach in improvement of a person's quality of life. Palliative care's main focus is to improve the quality of life for those with chronic illnesses. It is commonly the case that palliative care is provided at the end of life, but it can be
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Pediatric palliative care practitioners receive specialized training in family-centered, developmental and age-appropriate skills in communication and facilitation of shared decision making; assessment and management of pain and distressing symptoms; advanced knowledge in care coordination of
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Evidence that providing palliative care in tandem with standard oncologic care among patients with advanced cancer is associated with lower rates of depression, increased quality of life, and increased length of survival compared to those receiving standard oncologic care and may even prolong
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With the transition in the population toward lower child mortality and lower death rates, countries around the world are seeing larger elderly populations. In some countries, this means a growing burden on national resources in the shape of social security and health care payments. As aging
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This is a framework that is designed to assist healthcare workers deliver bad news. The acronym stands for: setting, perception, invitation, knowledge, empathy, and summarize/strategy. When giving bad news it is important to consider the setting, which considers the environment in which the
1085:, or being unable to access services due to not receiving a time line from medical professionals. The authors call for a less rigid approach to referrals to palliative care services in order to better support the individual, improve quality of life remaining and provide more holistic care.
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psychological support and curative therapies are not pursued. Under the
Medicare Hospice Benefit, individuals certified by two physicians to have less than six months to live (assuming a typical course) have access to specialized hospice services through various insurance programs (
1158:(NIHR) has addressed these areas of need. Examples highlight inequalities faced by several groups and offers recommendations. These include the need for close partnership between services caring for people with severe mental illness, improved understanding of barriers faced by
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Kathryn Batson et al. "The Effect of a
Therapy Dog on Socialization and Physiological Indicators of Stress in Persons Diagnosed with Alzheimer's Disease" in 'Companion Animals in Human Health' Editors β Cindy C. Wilson and Dennis C. Turner, Sage Publications 1998,
951:; the relief of distressing symptoms; the coordination of interdisciplinary care in diverse settings; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end of life care.
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Pediatric palliative care is family-centered, specialized medical care for children with serious illnesses that focuses on mitigating the physical, emotional, psychosocial, and spiritual suffering associated with illness to ultimately optimize quality of life.
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recommends that patients with advanced cancer should be "referred to interdisciplinary palliative care teams that provide inpatient and outpatient care early in the course of disease, alongside active treatment of their cancer" within eight weeks of diagnosis.
928:, and caregivers. In some countries, additional members of the team may include certified nursing assistants and home healthcare aides, as well as volunteers from the community (largely untrained but some being skilled medical personnel), and housekeepers.
958:, are crucial to the palliative care system. Caregivers and people being treated often form lasting friendships over the course of care. As a consequence caregivers may find themselves under severe emotional and physical strain. Opportunities for caregiver
767:
Many frameworks for communication have been established within the medical literature, but the field of pediatric palliative care is still in relative infancy. Communication considerations and strategies employed in a palliative setting include:
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A review states that by restricting referrals to palliative care only when patients have a definitive time line for death, something that the study found to often be inaccurate, can have negative implications for the patient both when accessing
502:"). Radiation is commonly used with palliative intent to alleviate pain in patients with cancer. As an effect from radiation may take days to weeks to occur, patients dying a short time following their treatment are unlikely to receive benefit.
1134:, talked about the importance of good palliative care, being able to express wishes about the last months of life, and good tuition (nutrition?) and education about end of life care generally. The letter went viral after David Bowie's son
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The establishment of shared knowledge between medical providers, patients, and families is essential when determining palliative goals of care for pediatric patients. Initially, practitioners often elicit information from the patient
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is an additional practice that can further aid alleviating the physical and mental pain from the child and their family. By allowing the caregiving to ensue by other qualified individuals, it allows the family time to rest and renew
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Doctrine of
Catholic Church, as a traditional reference, accepts and supports the use of palliative care. Most of main religions in the world (and the biggest in amount of believers) are concordant with this point of view.
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Varni JW, Katz ER, Seid M, Quiggins DJ, Friedman-Bender A, Castro CM (April 1998). "The
Pediatric Cancer Quality of Life Inventory (PCQL). I. Instrument development, descriptive statistics, and cross-informant variance".
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Dixon KC, Ferris R, Kuhn I, Spathis A, Barclay S (February 2021). "Gypsy, Traveller and Roma experiences, views and needs in palliative and end of life care: a systematic literature review and narrative synthesis".
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Foley P, Hampton J, Hampton A, Hampton R, Oleksy D, Oliver D, et al. (August 2012). "Lesley's story: a case report, and discussion of challenges faced in end-of-life care for progressive neurological disease".
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America's Care of
Serious Illness: A State-by-State Report Card on Access to Palliative Care in Our Nation's Hospitals. Center to Advance Palliative Care and the National Palliative Care Research Center. September
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The selection and use of essential medicines : report of the WHO Expert
Committee, March 2011 (including the 17th WHO model list of essential medicines and the 3rd WHO model list of essential medicines for
607:. A score of 0 indicates absence of the symptom, and a score of 10 indicates the worst possible severity. The instrument can be completed by the patient, with or without assistance, or by nurses and relatives.
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For many patients, end of life care can cause emotional and psychological distress, contributing to their total suffering. An interdisciplinary palliative care team consisting of a mental health professional,
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care practitioners look for opportunities to establish meaning and dignity regarding the child's illness by contextualizing disease within a broader framework of the child's life. Derived from the fields of
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began an Advanced Certification Program for Palliative Care that recognizes hospital inpatient programs demonstrating outstanding care and enhancement of the quality of life for people with serious illness.
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Evidence that palliative care services increase the likelihood of dying at home and reduce symptom burden without impacting on caregiver grief among the vast majority of Americans who prefer to die at home.
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Advances in palliative care have since inspired a dramatic increase in hospital-based palliative care programs. Notable research outcomes forwarding the implementation of palliative care programs include:
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Pritchard M, Burghen E, Srivastava DK, Okuma J, Anderson L, Powell B, et al. (May 2008). "Cancer-related symptoms most concerning to parents during the last week and last day of their child's life".
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attitudes both play significant roles in the acceptance and implementation of palliative care in the health care agenda. A study identified the current gaps in palliative care for people with severe
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Appropriately engaging palliative care providers as a part of patient care improves overall symptom control, quality of life, and family satisfaction of care while reducing overall healthcare costs.
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as with any other medical speciality. Nurses, in the United States and internationally, can receive continuing education credits through Palliative Care specific trainings, such as those offered by
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ThunΓ©-Boyle IC, Stygall JA, Keshtgar MR, Newman SP (July 2006). "Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature".
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are some of the services hospices provide to promote caregiver well-being. Respite may last a few hours up to several days (the latter being done by placing the primary person being cared for in a
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Dy SM, Apostol C, Martinez KA, Aslakson RA (April 2013). "Continuity, coordination, and transitions of care for patients with serious and advanced illness: a systematic review of interventions".
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Most spiritual interventions are subjective and complex. Many have not been well evaluated for their effectiveness, however tools can be used to measure and implement effective spiritual care.
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Ferrell BR, Virani R, Grant M, Rhome A, Malloy P, Bednash G, et al. (February 2005). "Evaluation of the End-of-Life Nursing Education Consortium undergraduate faculty training program".
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Mack JW, Hilden JM, Watterson J, Moore C, Turner B, Grier HE, et al. (December 2005). "Parent and physician perspectives on quality of care at the end of life in children with cancer".
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are other medications that are sometimes prescribed to help alleviate nausea and vomiting, however further research is also required to understand how effective these medications may be.
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for everyone regardless of who they are, where they live or their circumstances, and the need to maximise comfort and wellbeing. Informed and timely conversations are also highlighted.
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McSherry W, Smith J. Spiritual care. In: McSherry W, McSherry R, Watson R, editors. In care in nursing β principles, values and skills. New York: Oxford University Press, 2012;117β31.
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Present treatment options to the family proactively, based on care options and resources available in each of the aforementioned care settings. Ensuing management should anticipate
3624:
Savedra MC, Tesler MD, Holzemer WL, Wilkie DJ, Ward JA (October 1989). "Pain location: validity and reliability of body outline markings by hospitalized children and adolescents".
1428:"Impact of Interdisciplinary Outpatient Specialty Palliative Care on Survival and Quality of Life in Adults With Advanced Cancer: A Meta-Analysis of Randomized Controlled Trials"
5808:
3545:
Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991). "The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients".
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Candy B, Jones L, Varagunam M, Speck P, Tookman A, King M (May 2012). "Spiritual and religious interventions for well-being of adults in the terminal phase of disease".
202:
Palliative care can be initiated in a variety of care settings, including emergency rooms, hospitals, hospice facilities, or at home. For some severe disease processes,
169:
of palliative care is to improve quality of life of individuals with serious illness, any life-threatening condition which either reduces an individual's daily function
6276:"Supporting patient access to medicines in community palliative care: on-line survey of health professionals' practice, perceived effectiveness and influencing factors"
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services people with SMI's faced a number of barriers to accessing timely and appropriate palliative care. They called for a multidisciplinary team approach, including
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5872:
464:, can play important roles in helping people and their families cope using various methods such as counseling, visualization, cognitive methods, drug therapy and
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Over 90% of US hospitals with more than 300 beds have palliative care teams, yet only 17% of rural hospitals with 50 or more beds have palliative care teams.
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1053:, murder or killing" during the last five years. A quarter of them had received similar comments from their own friends or family member, or from a patient.
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Palliative care is appropriate for individuals with serious illnesses across the age spectrum and can be provided as the main goal of care or in tandem with
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6361:"An exploration of the experiences of professionals supporting patients approaching the end of life in medicines management at home. A qualitative study"
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Gauvain-Piquard A, Rodary C, Rezvani A, Serbouti S (June 1999). "The development of the DEGR(R): A scale to assess pain in young children with cancer".
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656:. With this said, children as young as four years of age can indicate the location and severity of pain through visual mapping techniques and metaphors.
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Spirituality is a fundamental component of palliative care. Moreover, hospices where palliative care is administered have usually available chaplains.
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5427:
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Hockenberry-Eaton M, Manteuffel B, Bottomley S (July 1997). "Development of two instruments examining stress and adjustment in children with cancer".
970:
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Garwick AW, Patterson J, Bennett FC, Blum RW (September 1995). "Breaking the news. How families first learn about their child's chronic condition".
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Consider both pharmacologic and non-pharmacologic treatment modalities (education and mental health support, administration of hot and cold packs,
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The Tata Memorial Centre in Mumbai has offered a physician's course in palliative medicine since 2012, the first one of its kind in the country.
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292:
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2587:"The effectiveness and cost-effectiveness of hospital-based specialist palliative care for adults with advanced illness and their caregivers"
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5551:
1584:"A Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition"
989:-approved procedure. More than 50 fellowship programs provide one to two years of specialty training following a primary residency. In the
4836:
671:. Finally, because children behaviorally respond to pain atypically, a playing or sleeping child should not be assumed to be without pain.
4495:"Parents are meaningfully involved in decisions on the care of their critically ill baby when they are given options not recommendations"
2813:
1639:
5350:"In-Home Palliative Care Allows More Patients to Die at Home, Leading to Higher Satisfaction and Lower Acute Care Utilization and Costs"
6812:
4654:
Snethen JA, Broome ME, Knafl K, Deatrick JA, Angst DB (June 2006). "Family patterns of decision-making in pediatric clinical trials".
7153:
978:
384:
Evidence that hospital palliative care consult teams are associated with significant hospital and overall health system cost savings.
85:
6041:
4740:"Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment"
1032:
In 2021 the UK's National Palliative and End of Life Care Partnership published their six ambitions for 2021β26. These include fair
5994:"End of life care for people with severe mental illness: Mixed methods systematic review and thematic synthesis (the MENLOC study)"
5599:"End of life care for people with severe mental illness: Mixed methods systematic review and thematic synthesis (the MENLOC study)"
5292:
3873:
Stockman JA (January 2008). "Symptoms Affecting Children With Malignancies During the Last Month of Life: A Nationwide Follow-up".
1107:
and Jeffrey Friedman about terminally ill patients in a San Francisco hospital and features the work of palliative care physician,
998:
700:
of palliative care settings to afford seamless continuity of service provision across health, education, and social care settings.
7419:
6752:
6121:"Estimating the prevalence of chronic conditions in children who die in England, Scotland and Wales: a data linkage cohort study"
1246:
5894:
3025:
Silva RS, Caldeira S, Coelho AN, ApΓ³stolo JL (November 2020). "Forgiveness facilitation in palliative care: a scoping review".
538:
pharmacologic options are suggested to help alleviate these symptoms. For people who do not respond to first-line medications,
6410:
5691:
4529:
2153:
Goldstein P, Walsh D, Horvitz LU (September 1996). "The Cleveland Clinic Foundation Harry R. Horvitz Palliative Care Center".
993:
palliative care has been a full specialty of medicine since 1989 and training is governed by the same regulations through the
663:
of the child. Special attention to the child's behavioral response to exam components, particularly in regards to potentially
7704:
7645:
7359:
6240:
5486:
4867:
4386:
3849:
3703:
3600:
3432:
Buchan EJ, Haywood A, Syrmis W, Good P (December 2023). "Medically assisted hydration for adults receiving palliative care".
2288:"Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers"
1950:
1230:
974:
373:
257:
214:
209:
recommend initiating palliative care at the time of diagnosis or when disease-directed options would not improve a patient's
187:
1901:
7052:
2744:
Saunders C (14 February 1964). "Care of patients suffering from terminal illness at St Joseph's Hospice, Hackney, London".
1756:
1170:
17:
5868:
1163:
742:
After the implementation of therapeutic interventions, involve both the child and family in the reassessment of symptoms.
7602:
5405:
239:
The distinction between palliative care and hospice differs depending on global context. In the United States, the term
7607:
7188:
6530:
5106:
5049:
1829:"A systematic review of communication quality improvement interventions for patients with advanced and serious illness"
1560:
634:
resources available to patients and families; and psychologically supporting children and families through illness and
6193:"Place of death of children and young adults with a life-limiting condition in England: a retrospective cohort study"
5212:"Assessment of status of patients receiving palliative home care and services provided in a rural area-kerala, India"
4422:
2732:
1013:
322:
234:
4251:"Communicating with children and families: from everyday interactions to skill in conveying distressing information"
2239:"Hospice enrollment saves money for Medicare and improves care quality across a number of different lengths-of-stay"
2110:
LeGrand SB, Walsh D, Nelson KA, Davis MP (July 2003). "A syllabus for fellowship education in palliative medicine".
7786:
2080:
1479:
253:
2876:
Kain M, Bennett H, Yi M, Robinson B, James M (August 2020). "30-day mortality following palliative radiotherapy".
542:
may be used, however there have been insufficient clinical trials to assess the effectiveness of this medication.
7806:
7774:
2442:"Advanced Certification for Palliative Care Programs". Joint Commission. 30 April 2014. Retrieved 17 August 2014.
1023:
best in the world "due to comprehensive national policies, the extensive integration of palliative care into the
944:
399:
has been a board certified sub-specialty of medicine in the United States since 2006. Additionally, in 2011, The
396:
230:
6241:"Nurses and pharmacists are key to improving access to end of life medicines for people being cared for at home"
5375:
7515:
7306:
7178:
6612:
5959:"Team work and proactive healthcare could help people with severe mental illness receive good end-of-life care"
5474:
1376:"Association Between Palliative Care and Patient and Caregiver Outcomes: A Systematic Review and Meta-analysis"
982:
95:
4451:
Hinds PS (September 2004). "The hopes and wishes of adolescents with cancer and the nursing care that helps".
7752:
7737:
7475:
1999:
Werner D (31 January 2011). "Communicating About Health: Current Issues and Perspectives, by Athena du Pre".
1977:
947:
was established in 2006 to provide expertise in the care of people with life-limiting, advanced disease, and
446:
6042:"A highly personalised approach to end of life care is needed to help Gypsy, Traveller and Roma communities"
5170:
4885:"End-of-life planning and its relevance for patients' and oncologists' decisions in choosing cancer therapy"
739:
Assess how the child perceives their symptoms (based on personal views) to create individualized care plans.
534:
Nausea and vomiting are common in people who have advanced terminal illness and can cause distress. Several
7727:
7158:
5778:
5383:
1198:
904:
In most countries, hospice care and palliative care is provided by an interdisciplinary team consisting of
830:
What is the meaning of this (illness) experience for you? Do you ever think about why this happened to you?
340:
4227:
Varni JW, Seid M, Kurtin PS (2001). Pediatric Quality of Life Inventory 4.0 Generic Core Scales (Report).
2196:
Morrison RS, Penrod JD, Cassel JB, Caust-Ellenbogen M, Litke A, Spragens L, et al. (September 2008).
7757:
6802:
5050:"Perspectives of Major World Religions regarding Euthanasia and Assisted Suicide: A Comparative Analysis"
4064:
Hinds PS, Quargnenti AG, Wentz TJ (April 1992). "Measuring symptom distress in adolescents with cancer".
1069:, with a point of contact co-ordinating the appropriate support for the individual. They also state that
994:
803:, the palliative care provider may explore the following questions with the sick child and their family:
664:
1045:
palliative-care team, a dedicated health care team that is entirely geared toward palliative treatment.
7836:
6782:
5190:
3522:
3070:"Improving the spiritual dimension of whole person care: reaching national and international consensus"
675:
206:
195:
6274:
Latter S, Campling N, Birtwistle J, Richardson A, Bennett MI, Ewings S, et al. (September 2020).
335:
The field of palliative care grew out of the hospice movement, which is commonly associated with Dame
7801:
7747:
7530:
7470:
7352:
7211:
5026:
3941:
Hilton T, Orr RD, Perkin RM, Ashwal S (May 1993). "End of life care in Duchenne muscular dystrophy".
3826:
369:
142:
2045:
Clark D (May 2007). "From margins to centre: a review of the history of palliative care in cancer".
7866:
7796:
7660:
7399:
7003:
6925:
6920:
6840:
6600:
245:
1876:
344:
7695:
6983:
6957:
6499:
5925:"End of life care: research highlights the importance of conversations and need for equal access"
5469:
Sick to death and not going to take it anymore!: reforming health care for the last years of life
3785:
Wolfe J, Grier HE, Klar N, Levin SB, Ellenbogen JM, Salem-Schatz S, et al. (February 2000).
2384:
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. (August 2010).
2335:
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. (August 2010).
1120:
1025:
457:
360:
5428:"Ambitions for Palliative and End of Life Care: A national framework for local action 2021-2026"
1582:
Ahluwalia SC, Chen C, Raaen L, Motala A, Walling AM, Chamberlin M, et al. (December 2018).
973:; recently this was changed to be done through any of 11 different speciality boards through an
7732:
6575:
6523:
4828:
481:
cause of pain can help guide care for some patients, and impact their quality of life overall.
2805:
1631:
7721:
7622:
7226:
7112:
7085:
7058:
7010:
6964:
6659:
6332:(Plain English summary). National Institute for Health and Care Research. 16 September 2020.
5478:
4932:
O'Leary KJ, Kulkarni N, Landler MP, Jeon J, Hahn KJ, Englert KM, et al. (January 2010).
1550:
1548:
1049:
another physician or another health care professional had characterized their work as being "
780:
Developing a shared understanding of the child's condition with the patient and their family.
6048:(Plain English summary). National Institute for Health and Care Research. 17 December 2021.
5965:(Plain English summary). National Institute for Health and Care Research. 28 February 2022.
5152:
4335:"SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer"
3659:
Anand KJ, Hickey PR (November 1987). "Pain and its effects in the human neonate and fetus".
7823:
7791:
7715:
7409:
7394:
7345:
7246:
7206:
7073:
6887:
6882:
6862:
6797:
6649:
2538:"Interventions for improving palliative care for older people living in nursing care homes"
1374:, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J, et al. (November 2016).
1139:
1099:
728:
724:
660:
465:
304:
203:
141:
illnesses. Within the published literature, many definitions of palliative care exist. The
48:
3166:"Evaluation of spiritual needs of patients with advanced cancer in a palliative care unit"
1545:
845:
Optimizing the environment for effective conversations around prognosis and goals of care.
348:
8:
7699:
7326:
7268:
7251:
6910:
6627:
6417:(Plain English summary). National Institute for Health and Care Research. 26 April 2022.
6326:"Terminally ill patients and their families may need more help to manage their medicines"
5931:(Plain English summary). National Institute for Health and Care Research. 31 March 2022.
5779:"Stream It Or Skip It: 'End Game' On Netflix, A Short Documentary About Dying Gracefully"
4308:
955:
948:
679:
604:
572:
300:
133:, or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing
6247:(Plain English summary). National Institute for Health and Care Research. 15 June 2021.
6162:"Most children with life-limiting conditions still die in hospital, not home or hospice"
5288:
4501:(Plain English summary). National Institute for Health and Care Research. 9 March 2021.
1827:
Fawole OA, Dy SM, Wilson RF, Lau BD, Martinez KA, Apostol CC, et al. (April 2013).
1707:"Integration of primary palliative care into geriatric care from the Indian perspective"
821:
What are the particular things you would like your family to know or remember about you?
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6256:
6217:
6192:
6173:
6145:
6120:
6101:
6057:
6018:
5993:
5992:
Edwards D, Anstey S, Coffey M, Gill P, Mann M, Meudell A, et al. (December 2021).
5974:
5940:
5755:
5738:
5707:
5673:
5623:
5598:
5597:
Edwards D, Anstey S, Coffey M, Gill P, Mann M, Meudell A, et al. (December 2021).
5567:
5528:
5503:
5238:
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5082:
4958:
4933:
4909:
4884:
4764:
4739:
4715:
4690:
4560:
4510:
4476:
4209:
4107:
Collins JJ, Byrnes ME, Dunkel IJ, Lapin J, Nadel T, Thaler HT, et al. (May 2000).
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4002:
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3472:
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3384:
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2024:
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1400:
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1321:
1254:
1188:
1112:
917:
191:
149:
79:
4789:"Communicating about prognosis: ethical responsibilities of pediatricians and parents"
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4108:
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3901:
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2704:
2687:
2058:
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3606:
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3453:
3414:
3365:
3316:
3267:
3236:
3195:
3134:
3099:
3054:
3042:
3002:
2973:"Drug therapy for symptoms associated with anxiety in adult palliative care patients"
2953:
2905:
2893:
2858:
2787:
2728:
2709:
2668:
2616:
2585:
Bajwah S, Oluyase AO, Yi D, Gao W, Evans CJ, Grande G, et al. (September 2020).
2567:
2407:
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2317:
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2219:
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2127:
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2028:
2016:
1946:
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1809:
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1405:
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wait to consult their doctor and endure sometimes years of pain before seeking help.
913:
909:
800:
748:
697:
690:
584:
4738:
Wright AA, Zhang B, Ray A, Mack JW, Trice E, Balboni T, et al. (October 2008).
4691:"Compassionate silence in the patient-clinician encounter: a contemplative approach"
4480:
4213:
4093:
3756:
3574:
3130:
2477:
2139:
1691:
1675:
1617:
1061:(SMI's). They found that due to the lack of resources within both mental health and
363:
in Winnipeg. In 1987, Declan Walsh established a palliative medicine service at the
178:. Historically, palliative care services were focused on individuals with incurable
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3913:
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2553:
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2209:
2182:
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2119:
2054:
2008:
1938:
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1343:
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1292:
1193:
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925:
827:
Are you frightened by all of this? What, in particular, are you most frightened of?
796:
720:
413:
400:
364:
175:
153:
138:
6465:
6452:
6089:
5660:
5647:
4351:
4334:
3336:"Haloperidol for the treatment of nausea and vomiting in palliative care patients"
1162:
communities, the provision of flexible palliative care services for children from
7850:
7566:
7525:
7491:
7316:
7261:
7122:
7107:
7090:
7025:
6969:
6947:
6644:
6590:
6570:
5197:
5177:
3529:
2214:
2197:
2012:
1371:
1183:
969:
In the US, board certification for physicians in palliative care was through the
653:
631:
539:
477:
336:
134:
6136:
5171:
ABMS Establishes New Subspecialty Certificate in Hospice and Palliative Medicine
3803:
3786:
3038:
2198:"Cost savings associated with US hospital palliative care consultation programs"
1476:"What is Palliative Care? | Definition of Palliative Care | Get Palliative Care"
7655:
7640:
7511:
7148:
7102:
6915:
6845:
6664:
6292:
5065:
4528:
Marlow N, Shaw C, Connabeer K, Aladangady N, Gallagher K, Drew P (March 2021).
4077:
3558:
2386:"Early palliative care for patients with metastatic non-small-cell lung cancer"
2337:"Early palliative care for patients with metastatic non-small-cell lung cancer"
2123:
1942:
1723:
1116:
990:
630:
multidisciplinary pediatric caregiving medical teams; referral to hospital and
468:
to address their needs. Palliative pets can play a role in this last category.
356:
6377:
6009:
5614:
5504:"Prevalence of formal accusations of murder and euthanasia against physicians"
4197:
2254:
1844:
7860:
7429:
7414:
7404:
7231:
7020:
7015:
6877:
6817:
6720:
5936:
5895:"Benedict Cumberbatch read out a letter to Bowie by a palliative care doctor"
5397:
5228:
5130:
5073:
4999:
4982:
4755:
4432:
4396:
4333:
Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2 March 2000).
3859:
3713:
3610:
3385:"Droperidol for treatment of nausea and vomiting in palliative care patients"
2020:
1519:
1338:
1143:
1074:
1058:
1033:
921:
453:
352:
183:
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4788:
4632:
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4579:
2889:
1391:
1169:
Other research suggests that giving nurses and pharmacists easier access to
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7576:
7551:
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7236:
7221:
7047:
6772:
6622:
6607:
6553:
6474:
6396:
6311:
6226:
6154:
6097:
6027:
5764:
5669:
5632:
5537:
5502:
Goldstein NE, Cohen LM, Arnold RM, Goy E, Arons S, Ganzini L (March 2012).
5335:
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959:
876:
732:
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708:
620:
499:
440:
5739:"Acknowledging stigma: Its presence in patient care and medical education"
5519:
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4949:
4706:
4316:
4205:
4169:
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2939:
2853:
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2402:
2385:
2353:
2336:
2174:
1804:
1795:
1029:, a strong hospice movement, and deep community engagement on the issue".
160:
helpful for a person of any stage of illness that is critical or any age.
7368:
7095:
7040:
6937:
6792:
6767:
6585:
6359:
Wilson E, Caswell G, Latif A, Anderson C, Faull C, Pollock K (May 2020).
4530:"End-of-life decisions in neonatal care: a conversation analytical study"
2806:"Palliative care β shortness of breath: MedlinePlus Medical Encyclopedia"
1443:
1127:
1104:
932:
There are two core training programmes for Palliative Medicine training:
712:
543:
6337:
6252:
6169:
6053:
5970:
5563:
5023:"Magisterial teaching on end-of-life issues - Texas Catholic Conference"
4506:
1475:
985:) in the United States through four medical specialty boards through an
182:, but this framework is now applied to other diseases, including severe
91:
UK: Certificate of Completion of Specialist Training (4 years full-time)
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6757:
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6737:
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6715:
6705:
6453:"Timely community palliative and end-of-life care: a realist synthesis"
6422:
5809:"How This Doctor Is Bringing Human Connection Back to End-of-Life Care"
5703:
5648:"Timely community palliative and end-of-life care: a realist synthesis"
5376:"Quality of Death Index 2015: Ranking palliative care across the world"
4900:
4858:
du Pre A (2017). "Social Support, Family Caregivers, and End of Life".
4232:
3840:
3471:
Good P, Richard R, Syrmis W, Jenkins-Marsh S, Stephens J (April 2014).
2536:
Hall S, Kolliakou A, Petkova H, Froggatt K, Higginson IJ (March 2011).
2469:
2237:
Kelley AS, Deb P, Du Q, Aldridge Carlson MD, Morrison RS (March 2013).
2166:
1557:"Clinical Practice Guidelines for Quality Palliative Care, 4th edition"
1159:
1097:
Palliative care was the subject of the 2018 Netflix short documentary,
1050:
977:-approved procedure. Additionally, board certification is available to
600:
592:
547:
535:
491:
137:
and mitigating suffering among people with serious, complex, and often
4667:
4244:
4242:
3770:
Committee on Bioethics (August 2000). "Palliative Care for Children".
3231:
3214:
2286:
Gomes B, Calanzani N, Curiale V, McCrone P, Higginson IJ (June 2013).
368:
which was designated as an international demonstration project by the
156:, palliative care is not limited to individuals near the end of life.
7581:
7465:
7256:
6998:
6993:
6857:
6835:
6710:
6674:
4883:
Saraiya B, Bodnar-Deren S, Leventhal E, Leventhal H (December 2008).
4882:
1933:
Sibson K, Craig F, Goldman A (2005). "Palliative Care for Children".
1281:"Palliative Care: the World Health Organization's global perspective"
1108:
905:
872:
616:
436:
210:
27:
Area of healthcare that focuses on relieving and preventing suffering
4147:
4025:"A different perspective to approaching cancer symptoms in children"
3726:
2195:
1370:
7501:
7455:
7445:
6762:
6539:
4239:
3787:"Symptoms and suffering at the end of life in children with cancer"
1632:"Heart failure β palliative care: MedlinePlus Medical Encyclopedia"
1066:
668:
596:
495:
461:
249:
112:
60:
6451:
Petrova M, Wong G, Kuhn I, Wellwood I, Barclay S (December 2021).
6273:
5646:
Petrova M, Wong G, Kuhn I, Wellwood I, Barclay S (December 2021).
2636:
1969:
987:
American Osteopathic Association Bureau of Osteopathic Specialists
7665:
7561:
7450:
7241:
6701:
6669:
6562:
4983:"Palliative care in India: Situation assessment and future scope"
4862:. New York, New York: Oxford University Press. pp. 208β209.
3698:(2nd ed.). Philadelphia: Lippincott Williams & Wilkins.
3473:"Medically assisted nutrition for adult palliative care patients"
2637:
Shepperd S, Gonçalves-Bradley DC, Straus SE, Wee B (March 2021).
1426:
Hoerger M, Wayser GR, Schwing G, Suzuki A, Perry LM (June 2019).
704:
683:
652:
symptoms. Thus, both the child and caregivers should provide the
641:
588:
264:
5552:"How to improve end-of-life care for people with mental illness"
3116:
7496:
6503:
5839:"Thank you letter to David Bowie from a palliative care doctor"
3975:
2454:"Tackling the Challenges of Clinical Trials in Palliative Care"
1902:"Medicare Care Choices Model (MCCM): The First Two Years | CMS"
1555:
National Consensus Project for Quality Palliative Care (2018).
792:
Establishing meaning and dignity regarding the child's illness.
773:
Developing supportive relationships with patients and families.
689:
Anticipate symptoms based on the typical disease course of the
580:
179:
116:
7337:
4931:
3470:
647:
symptoms in children by a palliative care team is as follows:
4689:
Back AL, Bauer-Wu SM, Rushton CH, Halifax J (December 2009).
4527:
2383:
2334:
1503:"Palliative care in India: current progress and future needs"
1322:"Palliative care in India: current progress and future needs"
1278:
1138:
shared it. The letter was subsequently read out by the actor
635:
291:
deal primarily with the United States and do not represent a
5352:. Agency for Healthcare Research and Quality. 3 April 2013.
4934:"Hospitalized patients' understanding of their plan of care"
4537:
Archives of Disease in Childhood. Fetal and Neonatal Edition
3287:"Levomepromazine for nausea and vomiting in palliative care"
3215:"Concept Analysis of Spirituality: An Evolutionary Approach"
2688:"Existential painβan entity, a provocation, or a challenge?"
2535:
2285:
6508:
4860:
Communicating About Health: Current Issues and Perspectives
4294:
3623:
3024:
2236:
1279:
SepΓΊlveda C, Marlin A, Yoshida T, Ullrich A (August 2002).
1225:. American Association of Hospice and Palliative Medicine.
758:
576:
6411:"End of life care should not wait for prediction of death"
6358:
5692:"End of life care should not wait for prediction of death"
4688:
4653:
3383:
Storrar J, Hitchens M, Platt T, Dorman S (November 2014).
3382:
3067:
2763:
1660:
1425:
899:
3825:
2685:
1781:
376:
as an Integrated Center of Oncology and Palliative Care.
224:
6190:
5843:
British Medical Journal Supportive & Palliative Care
4618:
4106:
3544:
3253:
3068:
Puchalski CM, Vitillo R, Hull SK, Reller N (June 2014).
1581:
1077:
needs to be included in the training for professionals.
6450:
5991:
5645:
5596:
5501:
5313:
4332:
3431:
2109:
2081:"Why Quality of Life Matters, Even in Your Final Hours"
1757:"Hospice and Palliative Medicine Specialty Description"
494:(dry mouth), nausea and vomiting, constipation, fever,
6191:
Gibson-Smith D, Jarvis SW, Fraser LK (December 2020).
6118:
6074:
4019:
3769:
3212:
3163:
2686:
Strang P, Strang S, Hultborn R, ArnΓ©r S (March 2004).
7834:
5737:
Dubin RE, Kaplan A, Graves L, Ng VK (December 2017).
5289:"American Academy of Hospice and Palliative Medicine"
4182:
4109:"The measurement of symptoms in children with cancer"
3940:
2875:
2764:
Rome RB, Luminais HH, Bourgeois DA, Blais CM (2011).
2152:
2112:
The American Journal of Hospice & Palliative Care
943:
In the United States, the physician sub-specialty of
359:
became the director of a new "terminal care" unit at
5435:
National Palliative and End of Life Care Partnership
4063:
3693:
939:
Acute Care Common Stem - Internal Medicine (ACCS-IM)
5736:
5209:
4417:(2nd ed.). New York: Oxford University Press.
3784:
2970:
2451:
5466:
5287:American Academy of Hospice, Palliative Medicine.
5264:. American Osteopathic Association. Archived from
4737:
3590:
3333:
2834:
2584:
1932:
575:(VAS) ranging from 0β10, indicating the levels of
4980:
4415:The nature of suffering and the goals of medicine
4379:Dignity therapy : final words for final days
4372:
4370:
3899:
3164:Vilalta A, Valls J, Porta J, ViΓ±as J (May 2014).
2878:Journal of Medical Imaging and Radiation Oncology
2837:"Comfort Care for Patients Dying in the Hospital"
1826:
1500:
1319:
1007:
971:American Board of Hospice and Palliative Medicine
498:, and excessive oral and pharyngeal secretions ("
7858:
6119:Hardelid P, Dattani N, Gilbert R (August 2014).
5157:Joint Royal College of Physicians Training Board
4297:Archives of Pediatrics & Adolescent Medicine
3284:
2766:"The role of palliative care at the end of life"
2632:
2630:
1704:
1501:Khosla D, Patel FD, Sharma SC (September 2012).
1320:Khosla D, Patel FD, Sharma SC (September 2012).
1274:
1272:
1216:
1214:
806:What gives your life meaning, worth, or purpose?
505:
5455:Center to Advance Palliative Care, www.capc.org
5153:"Specialist Training in Palliative Medicine UK"
5047:
4408:
4406:
4290:
4288:
4286:
4226:
3532:from Cancer Care Ontario. Revised 2005 February
3213:Weathers E, McCarthy G, Coffey A (April 2016).
2639:"Hospital at home: home-based end-of-life care"
1156:National Institute for Health and Care Research
824:When was the last time you laughed really hard?
427:staff, and health service costs are uncertain.
5985:
5180:, 6 October 2006, Retrieved 11 September 2010.
4367:
2921:
2917:
2915:
1937:. Blackwell Publishing Ltd. pp. 295β316.
1928:
1926:
1924:
1922:
1575:
642:Symptoms assessment and management of children
567:One instrument used in palliative care is the
430:
407:
7353:
6524:
6112:
5639:
5590:
5210:Thayyil J, Cherumanalil JM (September 2012).
4446:
4444:
4442:
3586:
3584:
3540:
3538:
2627:
2508:Caresearch: Palliative care knowledge network
2040:
2038:
1705:Atreya S, Sinha A, Kumar R (September 2022).
1269:
1211:
966:or inpatient hospice unit for several days).
490:dyspnea (or difficulty breathing), coughing,
289:The examples and perspective in this section
5464:
5107:"Jewish medical ethics and end-of-life care"
4403:
4283:
3285:Cox L, Darvill E, Dorman S (November 2015).
2971:Salt S, Mulvaney CA, Preston NJ (May 2017).
2869:
2835:Blinderman CD, Billings JA (December 2015).
2759:
2757:
2755:
2531:
2529:
1421:
1419:
866:
610:
5104:
4176:
3658:
3595:(2nd ed.). Malden, MA: Blackwell Pub.
3477:The Cochrane Database of Systematic Reviews
3434:The Cochrane Database of Systematic Reviews
3389:The Cochrane Database of Systematic Reviews
3340:The Cochrane Database of Systematic Reviews
3291:The Cochrane Database of Systematic Reviews
3256:The Cochrane Database of Systematic Reviews
3159:
3157:
3020:
3018:
3016:
2977:The Cochrane Database of Systematic Reviews
2912:
2643:The Cochrane Database of Systematic Reviews
2591:The Cochrane Database of Systematic Reviews
2542:The Cochrane Database of Systematic Reviews
2292:The Cochrane Database of Systematic Reviews
1919:
1711:Journal of Family Medicine and Primary Care
1494:
128:
7360:
7346:
6813:Reproductive endocrinology and infertility
6531:
6517:
5869:"David Bowie's son shares powerful letter"
5200:, 2011, p. 2, Retrieved 11 September 2010.
4439:
4023:, Degner LF, Yanofsky R (September 2003).
3900:Drake R, Frost J, Collins JJ (July 2003).
3696:Pain in infants, children, and adolescents
3581:
3535:
3518:
3516:
3334:Murray-Brown F, Dorman S (November 2015).
2035:
1313:
836:Assessing preferences for decision making.
553:
307:, or create a new section, as appropriate.
7154:Bachelor of Medicine, Bachelor of Surgery
6464:
6386:
6376:
6301:
6291:
6216:
6144:
6017:
5754:
5659:
5622:
5527:
5237:
5227:
5081:
4998:
4957:
4908:
4804:
4786:
4763:
4714:
4595:
4577:
4376:
4350:
4266:
4124:
4040:
3917:
3839:
3802:
3523:Edmonton Symptom Assessment System (ESAS)
3496:
3408:
3359:
3310:
3230:
3189:
3093:
2996:
2947:
2852:
2781:
2752:
2703:
2662:
2610:
2561:
2526:
2401:
2352:
2311:
2262:
2213:
1852:
1803:
1732:
1722:
1599:
1528:
1518:
1451:
1416:
1399:
1347:
1337:
1296:
1220:
460:, as well as spiritual support such as a
323:Learn how and when to remove this message
86:Bachelor of Medicine, Bachelor of Surgery
4328:
4326:
4248:
3872:
3694:Schechter N, Berde CB, Yaster M (2003).
3154:
3013:
2743:
2452:Currow D, Agar MR, Abernethy AP (2011).
1964:
1962:
1039:
999:End-of-Life Nursing Education Consortium
759:Communication with children and families
731:) when addressing distressing symptoms.
5189:American Board of Medical Specialties,
5169:American Board of Medical Specialties,
4412:
3513:
2924:"Palliative Care for the Seriously Ill"
900:Certification and training for services
809:Where do you find strength and support?
355:coined the term "palliative care". and
14:
7859:
4857:
4113:Journal of Pain and Symptom Management
4029:Journal of Pain and Symptom Management
3906:Journal of Pain and Symptom Management
2922:Kelley AS, Morrison RS (August 2015).
2692:Journal of Pain and Symptom Management
1998:
1588:Journal of Pain and Symptom Management
1285:Journal of Pain and Symptom Management
1126:In 2016, an open letter to the singer
1111:. The film's executive producers were
529:
225:Palliative care vis-Γ -vis hospice care
199:important sector to pay attention to.
7705:Artificial intelligence in healthcare
7341:
6512:
5905:from the original on 28 December 2021
5875:from the original on 28 December 2021
5849:from the original on 28 December 2021
5398:"UK end-of-life care 'best in world'"
4981:Kar SS, Subitha L, Iswarya S (2015).
4450:
4323:
4150:Journal of Pediatric Oncology Nursing
4066:Journal of Pediatric Oncology Nursing
3834:. Geneva: World Health Organization.
3591:Faull C, Carter Y, Daniels L (2005).
2514:from the original on 20 February 2011
2044:
1959:
1563:from the original on 23 December 2019
1130:written by a palliative care doctor,
975:American Board of Medical Specialties
562:
374:European Society for Medical Oncology
215:American Society of Clinical Oncology
188:chronic obstructive pulmonary disease
7292:
7053:Physical medicine and rehabilitation
6457:BMJ Supportive & Palliative Care
6078:BMJ Supportive & Palliative Care
5652:BMJ Supportive & Palliative Care
4309:10.1001/archpedi.1995.02170220057008
2484:from the original on 11 January 2012
1833:Journal of General Internal Medicine
1763:from the original on 27 October 2020
343:for the terminally ill in 1967, and
275:
263:Outside the United States, the term
7302:
5191:ABMS Guide to Physician Specialties
4578:Mack JW, Grier HE (February 2004).
4381:. Oxford: Oxford University Press.
3791:The New England Journal of Medicine
3661:The New England Journal of Medicine
2928:The New England Journal of Medicine
2841:The New England Journal of Medicine
2390:The New England Journal of Medicine
2341:The New England Journal of Medicine
1247:"WHO Definition of Palliative Care"
24:
7780:reform debate in the United States
7189:Medical Scientist Training Program
5789:from the original on 30 April 2019
5408:from the original on 11 April 2020
5356:from the original on 14 March 2020
5295:from the original on 23 April 2014
5262:"Specialties & Subspecialties"
5048:Grove G, Lovell M, Best M (2022).
4787:Mack JW, Joffe S (February 2014).
3862:. WHO technical report series;965.
1642:from the original on 3 August 2019
25:
7883:
7807:(Category Health care by country)
6493:
5819:from the original on 26 June 2020
5578:from the original on 23 June 2022
5386:from the original on 17 June 2020
5216:Indian Journal of Palliative Care
2705:10.1016/j.jpainsymman.2003.07.003
2091:from the original on 29 June 2021
1980:from the original on 21 June 2020
1601:10.1016/j.jpainsymman.2018.09.008
1507:Indian Journal of Palliative Care
1326:Indian Journal of Palliative Care
1014:Hospice care in the United States
815:How do you like to be thought of?
674:Identify the place of treatment (
569:Edmonton Symptom Assessment Scale
235:Hospice care in the United States
7844:
7819:
7818:
7321:
7311:
7301:
7291:
7282:
7281:
6444:
6403:
6352:
6318:
6267:
6233:
6209:10.1136/archdischild-2020-319700
6197:Archives of Disease in Childhood
6184:
6068:
6034:
5951:
5917:
5887:
5861:
5831:
5801:
5771:
5730:
5718:from the original on 5 July 2022
5684:
5544:
5495:
5458:
5449:
5420:
5368:
5342:
5307:
5280:
5254:
5203:
5183:
5163:
5145:
5098:
4839:from the original on 4 July 2020
4656:Research in Nursing & Health
4549:10.1136/archdischild-2020-319544
3902:"The symptoms of dying children"
3673:10.1097/00132586-198808000-00042
3626:Research in Nursing & Health
2816:from the original on 5 June 2020
1759:. American Medical Association.
1482:from the original on 5 July 2020
571:(ESAS), which consists of eight
484:
347:who published her seminal work "
280:
254:health maintenance organizations
7367:
7322:
5380:The Economist Intelligence Unit
5041:
5025:. 3 August 2023. Archived from
5015:
4974:
4925:
4876:
4851:
4821:
4780:
4731:
4682:
4647:
4612:
4571:
4521:
4487:
4220:
4141:
4100:
4057:
4013:
3969:
3934:
3893:
3866:
3819:
3778:
3763:
3720:
3687:
3652:
3617:
3464:
3425:
3376:
3327:
3278:
3247:
3206:
3145:
3131:10.1016/j.socscimed.2005.11.055
3110:
3061:
2964:
2828:
2798:
2737:
2720:
2679:
2578:
2496:
2445:
2436:
2426:
2377:
2328:
2279:
2230:
2189:
2146:
2103:
2073:
1992:
1894:
1869:
1820:
1775:
1749:
1698:
1676:10.1136/practneurol-2012-000263
1654:
1624:
945:hospice and palliative medicine
936:Internal Medical Training (IMT)
885:
514:
397:Hospice and palliative medicine
231:Hospice and palliative medicine
7516:Academic health science centre
7179:Doctor of Osteopathic Medicine
6613:Oral and maxillofacial surgery
5508:Journal of Palliative Medicine
5475:University of California Press
5316:Journal of Palliative Medicine
5111:Journal of Palliative Medicine
5054:Journal of Religion and Health
4695:Journal of Palliative Medicine
4186:Journal of Behavioral Medicine
3772:American Academy of Pediatrics
3489:10.1002/14651858.CD006274.pub3
3446:10.1002/14651858.CD006273.pub4
3401:10.1002/14651858.CD006938.pub3
3352:10.1002/14651858.CD006271.pub3
3303:10.1002/14651858.CD009420.pub3
3264:10.1002/14651858.CD007544.pub2
3170:Journal of Palliative Medicine
3074:Journal of Palliative Medicine
2989:10.1002/14651858.CD004596.pub3
2655:10.1002/14651858.CD009231.pub3
2603:10.1002/14651858.CD012780.pub2
2554:10.1002/14651858.CD007132.pub2
2304:10.1002/14651858.CD007760.pub2
1784:Journal of Palliative Medicine
1468:
1364:
1239:
1008:Regional variation in services
852:Supporting emotional distress.
801:meaning-centered psychotherapy
476:In the 1960s, hospice pioneer
96:Doctor of Osteopathic medicine
13:
1:
7753:Health information management
7738:health information technology
7476:Health information management
6466:10.1136/bmjspcare-2021-003066
6090:10.1136/bmjspcare-2020-002676
5661:10.1136/bmjspcare-2021-003066
4352:10.1634/theoncologist.5-4-302
4162:10.1016/S1043-4542(97)90054-0
4126:10.1016/S0885-3924(00)00127-5
4042:10.1016/S0885-3924(03)00285-9
3919:10.1016/S0885-3924(03)00202-1
3887:10.1016/S0084-3954(08)70519-0
3119:Social Science & Medicine
2202:Archives of Internal Medicine
2059:10.1016/S1470-2045(07)70138-9
1970:"Hospice Facts & Figures"
1432:Annals of Behavioral Medicine
1298:10.1016/S0885-3924(02)00440-2
1204:
894:
506:Psychosocial pain and anxiety
447:Distress in cancer caregiving
127:(derived from the Latin root
33:Palliative medicine physician
7728:Translational bioinformatics
7159:Bachelor of Medical Sciences
6926:Neurosurgical anesthesiology
6538:
4621:Journal of Clinical Oncology
4584:Journal of Clinical Oncology
3955:10.1016/0887-8994(93)90080-V
2215:10.1001/archinte.168.16.1783
2013:10.1080/10410236.2011.527626
1199:Health Insurance Innovations
1154:Research funded by the UK's
954:Caregivers, both family and
7:
7758:Consumer health informatics
6137:10.1136/bmjopen-2014-005331
3804:10.1056/NEJM200002033420506
3593:Handbook of palliative care
3039:10.11124/JBISRIR-D-19-00286
1935:Handbook of Palliative Care
1177:
1149:
1092:
995:Royal College of Physicians
818:What are you most proud of?
431:Pain, distress, and anxiety
408:Practice of palliative care
303:, discuss the issue on the
10:
7888:
6293:10.1186/s12904-020-00649-3
5066:10.1007/s10943-022-01498-5
4078:10.1177/104345429200900238
3559:10.1177/082585979100700202
3547:Journal of Palliative Care
2124:10.1177/104990910302000410
1943:10.1002/9780470755877.ch15
1724:10.4103/jfmpc.jfmpc_399_22
1171:electronic patient records
1034:access to end of life care
1011:
870:
614:
444:
434:
411:
271:
228:
207:professional organizations
7814:
7768:
7748:Public health informatics
7684:
7661:Electronic health records
7631:
7595:
7539:
7531:Supervised injection site
7484:
7471:Allied health professions
7438:
7375:
7277:
7199:
7137:
6898:
6826:
6781:
6690:
6561:
6546:
6459:: bmjspcareβ2021β003066.
6378:10.1186/s12904-020-0537-z
6084:: bmjspcareβ2020β002676.
6010:10.1177/02692163211037480
5743:Canadian Family Physician
5615:10.1177/02692163211037480
3827:World Health Organization
2255:10.1377/hlthaff.2012.0851
2155:Supportive Care in Cancer
1845:10.1007/s11606-012-2204-4
1223:Primer of Palliative Care
1160:Gypsy, Traveller and Roma
867:Geriatric palliative care
611:Pediatric palliative care
370:World Health Organization
341:St. Christopher's Hospice
143:World Health Organization
104:
71:
66:
54:
42:
37:
7113:Transplantation medicine
7004:Clinical neurophysiology
6921:Obstetric anesthesiology
6841:Interventional radiology
6601:Digestive system surgery
5937:10.3310/collection_49245
5229:10.4103/0973-1075.105693
5176:16 November 2010 at the
5000:10.4103/0019-509x.175578
4987:Indian Journal of Cancer
4756:10.1001/jama.300.14.1665
3729:European Journal of Pain
2504:"Palliative Medications"
1520:10.4103/0973-1075.105683
1339:10.4103/0973-1075.105683
163:
7696:Medical image computing
7646:Artificial intelligence
6984:Intensive care medicine
6958:Mass gathering medicine
6803:Maternalβfetal medicine
6500:Palliative Care Nursing
5105:Kinzbrunner BM (2004).
4938:Mayo Clinic Proceedings
4895:(12 Suppl): 3540β3547.
4806:10.1542/peds.2013-3608E
4633:10.1200/JCO.2005.04.010
4597:10.1200/JCO.2004.04.078
4249:Levetown M (May 2008).
4198:10.1023/a:1018779908502
2890:10.1111/1754-9485.13073
1392:10.1001/jama.2016.16840
1121:Shoshana R. Ungerleider
1026:National Health Service
729:complementary therapies
678:versus local hospital,
554:Hydration and nutrition
361:Saint Boniface Hospital
7733:Translational medicine
6576:Cardiothoracic surgery
5328:10.1089/jpm.2005.8.107
5123:10.1089/jpm.2004.7.558
4465:10.1188/04.ONF.927-934
4453:Oncology Nursing Forum
4268:10.1542/peds.2008-0565
3991:10.1542/peds.2007-2681
3875:Yearbook of Pediatrics
3741:10.1053/eujp.1999.0118
3638:10.1002/nur.4770120506
3027:JBI Evidence Synthesis
1132:Professor Mark Taubert
979:osteopathic physicians
691:hypothesized diagnosis
372:and accredited by the
129:
7722:Computational biology
7623:Universal precautions
7227:Personalized medicine
7086:Reproductive medicine
7011:Occupational medicine
6965:Evolutionary medicine
5520:10.1089/jpm.2011.0234
5465:Lynn, Joanne (2004).
4950:10.4065/mcp.2009.0232
4707:10.1089/jpm.2009.0175
4377:Chochinov HM (2012).
3182:10.1089/jpm.2013.0569
3086:10.1089/jpm.2014.9427
2940:10.1056/nejmra1404684
2854:10.1056/NEJMra1411746
2403:10.1056/NEJMoa1000678
2354:10.1056/NEJMoa1000678
1796:10.1089/jpm.2012.0317
1040:Acceptance and access
412:Further information:
345:Elisabeth KΓΌbler-Ross
7716:Behavior informatics
7247:Traditional medicine
7207:Alternative medicine
7074:Addiction psychiatry
6888:Transfusion medicine
6883:Medical microbiology
6798:Gynecologic oncology
6650:Reproductive surgery
5558:. 28 February 2022.
5196:31 July 2017 at the
4829:"John Hausdorff, MD"
4799:(Suppl 1): S24βS30.
3528:31 July 2017 at the
2047:The Lancet. Oncology
2001:Health Communication
1877:"History of Hospice"
1221:Zhukovsky D (2019).
1140:Benedict Cumberbatch
725:occupational therapy
573:visual analog scales
351:" in 1969. In 1974,
301:improve this section
174:to people receiving
88:(e.g. MBBS or MBChB)
18:Palliative treatment
7700:imaging informatics
7608:Cultural competence
7269:History of medicine
7252:Veterinary medicine
7059:Preventive medicine
6911:Adolescent medicine
6753:Infectious diseases
6365:BMC Palliative Care
6338:10.3310/alert_41179
6280:BMC Palliative Care
6253:10.3310/alert_46494
6170:10.3310/alert_46991
6054:10.3310/alert_48747
5998:Palliative Medicine
5971:10.3310/alert_49015
5871:. 18 January 2016.
5845:. 16 January 2016.
5603:Palliative Medicine
5564:10.3310/alert_49015
4507:10.3310/alert_45227
4413:Cassell EJ (2004).
3943:Pediatric Neurology
2770:The Ochsner Journal
1664:Practical Neurology
1166:or deprived areas.
949:catastrophic injury
713:distraction therapy
680:intensive care unit
659:Perform a thorough
605:shortness of breath
530:Nausea and vomiting
213:. For example, the
34:
7686:Health informatics
7461:Healthcare science
7217:Molecular oncology
7174:Doctor of Medicine
7164:Master of Medicine
7081:Radiation oncology
6953:Emergency medicine
6906:Addiction medicine
6873:Clinical chemistry
6868:Clinical pathology
6660:Transplant surgery
6618:Orthopedic surgery
6596:Colorectal surgery
6423:10.3310/post_50369
6159:; Lay summary in:
5815:. 29 August 2018.
5704:10.3310/post_50369
5404:. 6 October 2015.
5382:. 6 October 2015.
4901:10.1002/cncr.23946
4833:pub.hematology.org
4580:"The Day One Talk"
4261:(5): e1441βe1460.
4233:10.1037/t54487-000
3985:(5): e1301βe1309.
2470:10.1007/bf03256842
2167:10.1007/bf01788838
1444:10.1093/abm/kay077
1189:Health care reform
1146:at public events.
1113:Steven Ungerleider
1075:mental health care
918:nursing assistants
812:What inspires you?
563:Symptom assessment
466:relaxation therapy
349:On Death and Dying
192:multiple sclerosis
150:curative treatment
80:Doctor of Medicine
73:Education required
32:
7832:
7831:
7596:Skills / training
7520:Teaching hospital
7335:
7334:
7169:Master of Surgery
7133:
7132:
7118:Tropical medicine
7064:Prison healthcare
6979:Hospital medicine
6943:Disaster medicine
6933:Aviation medicine
6748:Hospital medicine
6655:Surgical oncology
6640:Pediatric surgery
6634:
6581:Endocrine surgery
6004:(10): 1747β1760.
5698:. 26 April 2022.
5609:(10): 1747β1760.
5488:978-0-520-24300-2
5268:on 13 August 2015
4869:978-0-19-027568-6
4750:(14): 1665β1673.
4701:(12): 1113β1117.
4668:10.1002/nur.20130
4627:(36): 9155β9161.
4388:978-0-19-517621-6
3851:978-92-4-120965-6
3705:978-0-7817-2644-3
3667:(21): 1321β1329.
3602:978-0-470-75587-7
3232:10.1111/nuf.12128
3033:(11): 2196β2230.
2847:(26): 2549β2561.
2208:(16): 1783β1790.
1952:978-0-470-75587-7
1386:(20): 2104β2114.
1257:on 4 October 2003
1232:978-1-889296-08-1
1164:ethnic minorities
333:
332:
325:
204:medical specialty
196:neurodegenerative
122:
121:
16:(Redirected from
7879:
7849:
7848:
7847:
7840:
7822:
7821:
7710:Neuroinformatics
7651:Connected health
7362:
7355:
7348:
7339:
7338:
7325:
7324:
7315:
7305:
7304:
7295:
7294:
7285:
7284:
6989:Medical genetics
6974:General practice
6851:Nuclear medicine
6726:Gastroenterology
6682:Vascular surgery
6632:
6559:
6558:
6533:
6526:
6519:
6510:
6509:
6487:
6486:
6468:
6448:
6442:
6441:
6439:
6437:
6407:
6401:
6400:
6390:
6380:
6356:
6350:
6349:
6322:
6316:
6315:
6305:
6295:
6271:
6265:
6264:
6237:
6231:
6230:
6220:
6188:
6182:
6181:
6164:. 20 July 2021.
6158:
6148:
6116:
6110:
6109:
6072:
6066:
6065:
6038:
6032:
6031:
6021:
5989:
5983:
5982:
5955:
5949:
5948:
5921:
5915:
5914:
5912:
5910:
5891:
5885:
5884:
5882:
5880:
5865:
5859:
5858:
5856:
5854:
5835:
5829:
5828:
5826:
5824:
5805:
5799:
5798:
5796:
5794:
5775:
5769:
5768:
5758:
5734:
5728:
5727:
5725:
5723:
5688:
5682:
5681:
5663:
5643:
5637:
5636:
5626:
5594:
5588:
5587:
5585:
5583:
5548:
5542:
5541:
5531:
5499:
5493:
5492:
5472:
5462:
5456:
5453:
5447:
5446:
5444:
5442:
5432:
5424:
5418:
5417:
5415:
5413:
5394:
5393:
5391:
5372:
5366:
5365:
5363:
5361:
5346:
5340:
5339:
5311:
5305:
5304:
5302:
5300:
5284:
5278:
5277:
5275:
5273:
5258:
5252:
5251:
5241:
5231:
5207:
5201:
5187:
5181:
5167:
5161:
5160:
5149:
5143:
5142:
5102:
5096:
5095:
5085:
5060:(6): 4758β4782.
5045:
5039:
5038:
5036:
5034:
5029:on 3 August 2023
5019:
5013:
5012:
5002:
4978:
4972:
4971:
4961:
4929:
4923:
4922:
4912:
4880:
4874:
4873:
4855:
4849:
4848:
4846:
4844:
4825:
4819:
4818:
4808:
4784:
4778:
4777:
4767:
4735:
4729:
4728:
4718:
4686:
4680:
4679:
4651:
4645:
4644:
4616:
4610:
4609:
4599:
4575:
4569:
4568:
4534:
4525:
4519:
4518:
4491:
4485:
4484:
4448:
4437:
4436:
4410:
4401:
4400:
4374:
4365:
4364:
4354:
4330:
4321:
4320:
4292:
4281:
4280:
4270:
4246:
4237:
4236:
4224:
4218:
4217:
4180:
4174:
4173:
4145:
4139:
4138:
4128:
4104:
4098:
4097:
4061:
4055:
4054:
4044:
4017:
4011:
4010:
3973:
3967:
3966:
3938:
3932:
3931:
3921:
3897:
3891:
3890:
3870:
3864:
3863:
3843:
3823:
3817:
3816:
3806:
3782:
3776:
3775:
3767:
3761:
3760:
3724:
3718:
3717:
3691:
3685:
3684:
3656:
3650:
3649:
3621:
3615:
3614:
3588:
3579:
3578:
3542:
3533:
3520:
3511:
3510:
3500:
3468:
3462:
3461:
3452: 10720602.
3440:(12): CD006273.
3429:
3423:
3422:
3412:
3395:(11): CD006938.
3380:
3374:
3373:
3363:
3346:(11): CD006271.
3331:
3325:
3324:
3314:
3297:(11): CD009420.
3282:
3276:
3275:
3251:
3245:
3244:
3234:
3210:
3204:
3203:
3193:
3161:
3152:
3149:
3143:
3142:
3114:
3108:
3107:
3097:
3065:
3059:
3058:
3022:
3011:
3010:
3000:
2968:
2962:
2961:
2951:
2919:
2910:
2909:
2873:
2867:
2866:
2856:
2832:
2826:
2825:
2823:
2821:
2802:
2796:
2795:
2785:
2761:
2750:
2749:
2741:
2735:
2724:
2718:
2717:
2707:
2683:
2677:
2676:
2666:
2634:
2625:
2624:
2614:
2582:
2576:
2575:
2565:
2533:
2524:
2523:
2521:
2519:
2500:
2494:
2493:
2491:
2489:
2449:
2443:
2440:
2434:
2430:
2424:
2423:
2405:
2381:
2375:
2374:
2356:
2332:
2326:
2325:
2315:
2283:
2277:
2276:
2266:
2234:
2228:
2227:
2217:
2193:
2187:
2186:
2150:
2144:
2143:
2107:
2101:
2100:
2098:
2096:
2077:
2071:
2070:
2042:
2033:
2032:
1996:
1990:
1989:
1987:
1985:
1966:
1957:
1956:
1930:
1917:
1916:
1914:
1912:
1898:
1892:
1891:
1889:
1887:
1873:
1867:
1866:
1856:
1824:
1818:
1817:
1807:
1779:
1773:
1772:
1770:
1768:
1753:
1747:
1746:
1736:
1726:
1717:(9): 4913β4918.
1702:
1696:
1695:
1658:
1652:
1651:
1649:
1647:
1628:
1622:
1621:
1603:
1579:
1573:
1572:
1570:
1568:
1552:
1543:
1542:
1532:
1522:
1498:
1492:
1491:
1489:
1487:
1472:
1466:
1465:
1455:
1423:
1414:
1413:
1403:
1368:
1362:
1361:
1351:
1341:
1317:
1311:
1310:
1300:
1276:
1267:
1266:
1264:
1262:
1253:. Archived from
1243:
1237:
1236:
1218:
1194:Health insurance
1083:end of life care
859:SPIKE framework.
721:physical therapy
654:clinical history
603:, and sometimes
414:End-of-life care
401:Joint Commission
365:Cleveland Clinic
328:
321:
317:
314:
308:
284:
283:
276:
258:private insurers
176:end-of-life care
154:end-of-life care
132:
56:Activity sectors
35:
31:
21:
7887:
7886:
7882:
7881:
7880:
7878:
7877:
7876:
7867:Palliative care
7857:
7856:
7855:
7845:
7843:
7835:
7833:
7828:
7810:
7764:
7763:
7762:
7680:
7627:
7591:
7567:Overutilization
7535:
7526:Pharmacy school
7492:Assisted living
7480:
7434:
7371:
7366:
7336:
7331:
7273:
7262:Chief physician
7195:
7140:
7129:
7123:Travel medicine
7108:Sports medicine
7091:Sexual medicine
7031:Palliative care
7026:Pain management
6970:Family medicine
6948:Diving medicine
6894:
6822:
6784:
6777:
6693:
6686:
6645:Plastic surgery
6591:General surgery
6571:Cardiac surgery
6552:
6550:
6542:
6537:
6496:
6491:
6490:
6449:
6445:
6435:
6433:
6409:
6408:
6404:
6357:
6353:
6324:
6323:
6319:
6272:
6268:
6239:
6238:
6234:
6189:
6185:
6160:
6117:
6113:
6073:
6069:
6040:
6039:
6035:
5990:
5986:
5957:
5956:
5952:
5923:
5922:
5918:
5908:
5906:
5901:. 6 June 2016.
5893:
5892:
5888:
5878:
5876:
5867:
5866:
5862:
5852:
5850:
5837:
5836:
5832:
5822:
5820:
5807:
5806:
5802:
5792:
5790:
5777:
5776:
5772:
5749:(12): 906β908.
5735:
5731:
5721:
5719:
5690:
5689:
5685:
5644:
5640:
5595:
5591:
5581:
5579:
5550:
5549:
5545:
5500:
5496:
5489:
5463:
5459:
5454:
5450:
5440:
5438:
5430:
5426:
5425:
5421:
5411:
5409:
5396:
5389:
5387:
5374:
5373:
5369:
5359:
5357:
5348:
5347:
5343:
5312:
5308:
5298:
5296:
5285:
5281:
5271:
5269:
5260:
5259:
5255:
5208:
5204:
5198:Wayback Machine
5188:
5184:
5178:Wayback Machine
5168:
5164:
5151:
5150:
5146:
5103:
5099:
5046:
5042:
5032:
5030:
5021:
5020:
5016:
4979:
4975:
4930:
4926:
4881:
4877:
4870:
4856:
4852:
4842:
4840:
4835:. 1 July 2017.
4827:
4826:
4822:
4785:
4781:
4736:
4732:
4687:
4683:
4652:
4648:
4617:
4613:
4576:
4572:
4532:
4526:
4522:
4493:
4492:
4488:
4449:
4440:
4425:
4411:
4404:
4389:
4375:
4368:
4331:
4324:
4293:
4284:
4247:
4240:
4225:
4221:
4181:
4177:
4146:
4142:
4105:
4101:
4062:
4058:
4018:
4014:
3974:
3970:
3939:
3935:
3898:
3894:
3871:
3867:
3852:
3824:
3820:
3783:
3779:
3768:
3764:
3725:
3721:
3706:
3692:
3688:
3657:
3653:
3622:
3618:
3603:
3589:
3582:
3543:
3536:
3530:Wayback Machine
3521:
3514:
3483:(4): CD006274.
3469:
3465:
3430:
3426:
3381:
3377:
3332:
3328:
3283:
3279:
3258:(5): CD007544.
3252:
3248:
3211:
3207:
3162:
3155:
3150:
3146:
3115:
3111:
3066:
3062:
3023:
3014:
2983:(6): CD004596.
2969:
2965:
2920:
2913:
2874:
2870:
2833:
2829:
2819:
2817:
2810:medlineplus.gov
2804:
2803:
2799:
2762:
2753:
2742:
2738:
2725:
2721:
2684:
2680:
2649:(3): CD009231.
2635:
2628:
2597:(9): CD012780.
2583:
2579:
2548:(3): CD007132.
2534:
2527:
2517:
2515:
2502:
2501:
2497:
2487:
2485:
2450:
2446:
2441:
2437:
2431:
2427:
2382:
2378:
2333:
2329:
2298:(6): CD007760.
2284:
2280:
2235:
2231:
2194:
2190:
2151:
2147:
2108:
2104:
2094:
2092:
2087:. 29 May 2019.
2079:
2078:
2074:
2043:
2036:
1997:
1993:
1983:
1981:
1968:
1967:
1960:
1953:
1931:
1920:
1910:
1908:
1900:
1899:
1895:
1885:
1883:
1875:
1874:
1870:
1825:
1821:
1780:
1776:
1766:
1764:
1755:
1754:
1750:
1703:
1699:
1659:
1655:
1645:
1643:
1636:medlineplus.gov
1630:
1629:
1625:
1580:
1576:
1566:
1564:
1553:
1546:
1499:
1495:
1485:
1483:
1474:
1473:
1469:
1424:
1417:
1369:
1365:
1318:
1314:
1277:
1270:
1260:
1258:
1245:
1244:
1240:
1233:
1219:
1212:
1207:
1184:Health Advocate
1180:
1152:
1142:and the singer
1095:
1042:
1016:
1010:
902:
897:
888:
879:
869:
797:dignity therapy
761:
665:painful stimuli
644:
623:
613:
599:, sensation of
565:
556:
540:levomepromazine
532:
517:
508:
487:
478:Cicely Saunders
449:
443:
433:
416:
410:
337:Cicely Saunders
329:
318:
312:
309:
298:
285:
281:
274:
237:
227:
166:
135:quality of life
125:Palliative care
109:
107:
74:
57:
45:
44:Occupation type
28:
23:
22:
15:
12:
11:
5:
7885:
7875:
7874:
7869:
7854:
7853:
7830:
7829:
7827:
7826:
7815:
7812:
7811:
7809:
7804:
7799:
7794:
7789:
7787:United Kingdom
7784:
7783:
7782:
7772:
7770:
7766:
7765:
7761:
7760:
7755:
7750:
7745:
7740:
7735:
7730:
7725:
7719:
7713:
7707:
7702:
7692:
7691:
7690:
7688:
7682:
7681:
7679:
7678:
7673:
7668:
7663:
7658:
7656:Digital health
7653:
7648:
7643:
7641:3D bioprinting
7637:
7635:
7629:
7628:
7626:
7625:
7620:
7615:
7610:
7605:
7603:Bedside manner
7599:
7597:
7593:
7592:
7590:
7589:
7584:
7579:
7574:
7569:
7564:
7559:
7554:
7549:
7543:
7541:
7537:
7536:
7534:
7533:
7528:
7523:
7512:Medical school
7509:
7504:
7499:
7494:
7488:
7486:
7482:
7481:
7479:
7478:
7473:
7468:
7463:
7458:
7453:
7448:
7442:
7440:
7436:
7435:
7433:
7432:
7427:
7422:
7417:
7412:
7407:
7402:
7397:
7392:
7387:
7382:
7376:
7373:
7372:
7365:
7364:
7357:
7350:
7342:
7333:
7332:
7330:
7329:
7319:
7309:
7299:
7289:
7278:
7275:
7274:
7272:
7271:
7266:
7265:
7264:
7254:
7249:
7244:
7239:
7234:
7229:
7224:
7219:
7214:
7209:
7203:
7201:
7200:Related topics
7197:
7196:
7194:
7193:
7192:
7191:
7181:
7176:
7171:
7166:
7161:
7156:
7151:
7149:Medical school
7145:
7143:
7135:
7134:
7131:
7130:
7128:
7127:
7126:
7125:
7115:
7110:
7105:
7103:Sleep medicine
7100:
7099:
7098:
7088:
7083:
7078:
7077:
7076:
7066:
7061:
7056:
7050:
7045:
7044:
7043:
7033:
7028:
7023:
7018:
7013:
7008:
7007:
7006:
6996:
6991:
6986:
6981:
6976:
6967:
6962:
6961:
6960:
6950:
6945:
6940:
6935:
6930:
6929:
6928:
6923:
6916:Anesthesiology
6913:
6908:
6902:
6900:
6896:
6895:
6893:
6892:
6891:
6890:
6885:
6880:
6875:
6870:
6865:
6855:
6854:
6853:
6848:
6846:Neuroradiology
6843:
6832:
6830:
6824:
6823:
6821:
6820:
6815:
6810:
6805:
6800:
6795:
6789:
6787:
6783:Obstetrics and
6779:
6778:
6776:
6775:
6770:
6765:
6760:
6755:
6750:
6745:
6740:
6735:
6734:
6733:
6723:
6718:
6713:
6708:
6698:
6696:
6688:
6687:
6685:
6684:
6679:
6678:
6677:
6667:
6665:Trauma surgery
6662:
6657:
6652:
6647:
6642:
6637:
6636:
6635:
6628:Otolaryngology
6625:
6620:
6615:
6610:
6605:
6604:
6603:
6598:
6588:
6583:
6578:
6573:
6567:
6565:
6556:
6554:subspecialties
6544:
6543:
6536:
6535:
6528:
6521:
6513:
6507:
6506:
6495:
6494:External links
6492:
6489:
6488:
6443:
6402:
6351:
6317:
6266:
6232:
6203:(8): 780β785.
6183:
6131:(8): e005331.
6111:
6067:
6033:
5984:
5950:
5916:
5886:
5860:
5830:
5800:
5785:. 7 May 2018.
5770:
5729:
5683:
5638:
5589:
5543:
5514:(3): 334β339.
5494:
5487:
5457:
5448:
5419:
5367:
5341:
5322:(1): 107β114.
5306:
5279:
5253:
5222:(3): 213β218.
5202:
5182:
5162:
5144:
5117:(4): 558β573.
5097:
5040:
5014:
4973:
4924:
4875:
4868:
4850:
4820:
4779:
4730:
4681:
4662:(3): 223β232.
4646:
4611:
4590:(3): 563β566.
4570:
4543:(2): 184β188.
4520:
4486:
4459:(5): 927β934.
4438:
4423:
4402:
4387:
4366:
4345:(4): 302β311.
4339:The Oncologist
4322:
4303:(9): 991β997.
4282:
4238:
4219:
4192:(2): 179β204.
4175:
4156:(3): 178β185.
4140:
4119:(5): 363β377.
4099:
4056:
4035:(3): 800β817.
4012:
3968:
3949:(3): 165β177.
3933:
3912:(1): 594β603.
3892:
3865:
3850:
3818:
3797:(5): 326β333.
3777:
3762:
3735:(2): 165β176.
3719:
3704:
3686:
3651:
3632:(5): 307β314.
3616:
3601:
3580:
3534:
3512:
3463:
3424:
3375:
3326:
3277:
3246:
3205:
3176:(5): 592β600.
3153:
3144:
3125:(1): 151β164.
3109:
3080:(6): 642β656.
3060:
3012:
2963:
2934:(8): 747β755.
2911:
2884:(4): 570β579.
2868:
2827:
2797:
2776:(4): 348β352.
2751:
2746:Nursing Mirror
2736:
2719:
2698:(3): 241β250.
2678:
2626:
2577:
2525:
2495:
2444:
2435:
2425:
2396:(8): 733β742.
2376:
2347:(8): 733β742.
2327:
2278:
2249:(3): 552β561.
2243:Health Affairs
2229:
2188:
2161:(5): 329β333.
2145:
2118:(4): 279β289.
2102:
2072:
2053:(5): 430β438.
2034:
1991:
1958:
1951:
1918:
1893:
1868:
1839:(4): 570β577.
1819:
1805:2027.42/140114
1790:(4): 436β445.
1774:
1748:
1697:
1670:(4): 244β248.
1653:
1623:
1594:(6): 831β870.
1574:
1544:
1513:(3): 149β154.
1493:
1467:
1438:(7): 674β685.
1415:
1372:Kavalieratos D
1363:
1332:(3): 149β154.
1312:
1268:
1238:
1231:
1209:
1208:
1206:
1203:
1202:
1201:
1196:
1191:
1186:
1179:
1176:
1151:
1148:
1117:David C. Ulich
1094:
1091:
1059:mental illness
1041:
1038:
1009:
1006:
991:United Kingdom
941:
940:
937:
922:social workers
901:
898:
896:
893:
887:
884:
868:
865:
864:
863:
856:
849:
841:
840:
833:
832:
831:
828:
825:
822:
819:
816:
813:
810:
807:
789:
777:
760:
757:
744:
743:
740:
737:
701:
694:
687:
672:
657:
643:
640:
612:
609:
564:
561:
555:
552:
531:
528:
516:
513:
507:
504:
486:
483:
432:
429:
409:
406:
393:
392:
388:
385:
357:Paul Henteleff
339:, who founded
331:
330:
295:of the subject
293:worldwide view
288:
286:
279:
273:
270:
226:
223:
165:
162:
120:
119:
110:
105:
102:
101:
100:
99:
92:
89:
83:
75:
72:
69:
68:
64:
63:
58:
55:
52:
51:
46:
43:
40:
39:
26:
9:
6:
4:
3:
2:
7884:
7873:
7870:
7868:
7865:
7864:
7862:
7852:
7842:
7841:
7838:
7825:
7817:
7816:
7813:
7808:
7805:
7803:
7800:
7798:
7795:
7793:
7790:
7788:
7785:
7781:
7778:
7777:
7776:
7775:United States
7773:
7771:
7767:
7759:
7756:
7754:
7751:
7749:
7746:
7744:
7741:
7739:
7736:
7734:
7731:
7729:
7726:
7724:in healthcare
7723:
7720:
7718:in healthcare
7717:
7714:
7712:in healthcare
7711:
7708:
7706:
7703:
7701:
7697:
7694:
7693:
7689:
7687:
7683:
7677:
7674:
7672:
7669:
7667:
7664:
7662:
7659:
7657:
7654:
7652:
7649:
7647:
7644:
7642:
7639:
7638:
7636:
7634:
7630:
7624:
7621:
7619:
7616:
7614:
7611:
7609:
7606:
7604:
7601:
7600:
7598:
7594:
7588:
7585:
7583:
7580:
7578:
7575:
7573:
7570:
7568:
7565:
7563:
7560:
7558:
7555:
7553:
7550:
7548:
7545:
7544:
7542:
7538:
7532:
7529:
7527:
7524:
7521:
7517:
7513:
7510:
7508:
7505:
7503:
7500:
7498:
7495:
7493:
7490:
7489:
7487:
7483:
7477:
7474:
7472:
7469:
7467:
7464:
7462:
7459:
7457:
7454:
7452:
7449:
7447:
7444:
7443:
7441:
7437:
7431:
7428:
7426:
7423:
7421:
7418:
7416:
7413:
7411:
7408:
7406:
7403:
7401:
7398:
7396:
7393:
7391:
7388:
7386:
7383:
7381:
7378:
7377:
7374:
7370:
7363:
7358:
7356:
7351:
7349:
7344:
7343:
7340:
7328:
7320:
7318:
7314:
7310:
7308:
7300:
7298:
7290:
7288:
7280:
7279:
7276:
7270:
7267:
7263:
7260:
7259:
7258:
7255:
7253:
7250:
7248:
7245:
7243:
7240:
7238:
7235:
7233:
7232:Public health
7230:
7228:
7225:
7223:
7220:
7218:
7215:
7213:
7212:Allied health
7210:
7208:
7205:
7204:
7202:
7198:
7190:
7187:
7186:
7185:
7182:
7180:
7177:
7175:
7172:
7170:
7167:
7165:
7162:
7160:
7157:
7155:
7152:
7150:
7147:
7146:
7144:
7142:
7136:
7124:
7121:
7120:
7119:
7116:
7114:
7111:
7109:
7106:
7104:
7101:
7097:
7094:
7093:
7092:
7089:
7087:
7084:
7082:
7079:
7075:
7072:
7071:
7070:
7067:
7065:
7062:
7060:
7057:
7054:
7051:
7049:
7046:
7042:
7039:
7038:
7037:
7034:
7032:
7029:
7027:
7024:
7022:
7021:Oral medicine
7019:
7017:
7016:Ophthalmology
7014:
7012:
7009:
7005:
7002:
7001:
7000:
6997:
6995:
6992:
6990:
6987:
6985:
6982:
6980:
6977:
6975:
6971:
6968:
6966:
6963:
6959:
6956:
6955:
6954:
6951:
6949:
6946:
6944:
6941:
6939:
6936:
6934:
6931:
6927:
6924:
6922:
6919:
6918:
6917:
6914:
6912:
6909:
6907:
6904:
6903:
6901:
6897:
6889:
6886:
6884:
6881:
6879:
6878:Cytopathology
6876:
6874:
6871:
6869:
6866:
6864:
6861:
6860:
6859:
6856:
6852:
6849:
6847:
6844:
6842:
6839:
6838:
6837:
6834:
6833:
6831:
6829:
6825:
6819:
6818:Urogynecology
6816:
6814:
6811:
6809:
6806:
6804:
6801:
6799:
6796:
6794:
6791:
6790:
6788:
6786:
6780:
6774:
6771:
6769:
6766:
6764:
6761:
6759:
6756:
6754:
6751:
6749:
6746:
6744:
6741:
6739:
6736:
6732:
6729:
6728:
6727:
6724:
6722:
6721:Endocrinology
6719:
6717:
6714:
6712:
6709:
6707:
6703:
6700:
6699:
6697:
6695:
6689:
6683:
6680:
6676:
6673:
6672:
6671:
6668:
6666:
6663:
6661:
6658:
6656:
6653:
6651:
6648:
6646:
6643:
6641:
6638:
6631:
6630:
6629:
6626:
6624:
6621:
6619:
6616:
6614:
6611:
6609:
6606:
6602:
6599:
6597:
6594:
6593:
6592:
6589:
6587:
6584:
6582:
6579:
6577:
6574:
6572:
6569:
6568:
6566:
6564:
6560:
6557:
6555:
6549:
6545:
6541:
6534:
6529:
6527:
6522:
6520:
6515:
6514:
6511:
6505:
6501:
6498:
6497:
6484:
6480:
6476:
6472:
6467:
6462:
6458:
6454:
6447:
6432:
6428:
6424:
6420:
6416:
6415:NIHR Evidence
6412:
6406:
6398:
6394:
6389:
6384:
6379:
6374:
6370:
6366:
6362:
6355:
6347:
6343:
6339:
6335:
6331:
6330:NIHR Evidence
6327:
6321:
6313:
6309:
6304:
6299:
6294:
6289:
6285:
6281:
6277:
6270:
6262:
6258:
6254:
6250:
6246:
6245:NIHR Evidence
6242:
6236:
6228:
6224:
6219:
6214:
6210:
6206:
6202:
6198:
6194:
6187:
6179:
6175:
6171:
6167:
6163:
6156:
6152:
6147:
6142:
6138:
6134:
6130:
6126:
6122:
6115:
6107:
6103:
6099:
6095:
6091:
6087:
6083:
6079:
6071:
6063:
6059:
6055:
6051:
6047:
6046:NIHR Evidence
6043:
6037:
6029:
6025:
6020:
6015:
6011:
6007:
6003:
5999:
5995:
5988:
5980:
5976:
5972:
5968:
5964:
5963:NIHR Evidence
5960:
5954:
5946:
5942:
5938:
5934:
5930:
5929:NIHR Evidence
5926:
5920:
5904:
5900:
5896:
5890:
5874:
5870:
5864:
5848:
5844:
5840:
5834:
5818:
5814:
5810:
5804:
5788:
5784:
5780:
5774:
5766:
5762:
5757:
5752:
5748:
5744:
5740:
5733:
5717:
5713:
5709:
5705:
5701:
5697:
5696:NIHR Evidence
5693:
5687:
5679:
5675:
5671:
5667:
5662:
5657:
5653:
5649:
5642:
5634:
5630:
5625:
5620:
5616:
5612:
5608:
5604:
5600:
5593:
5577:
5573:
5569:
5565:
5561:
5557:
5556:NIHR Evidence
5553:
5547:
5539:
5535:
5530:
5525:
5521:
5517:
5513:
5509:
5505:
5498:
5490:
5484:
5480:
5476:
5471:
5470:
5461:
5452:
5436:
5429:
5423:
5407:
5403:
5399:
5385:
5381:
5377:
5371:
5355:
5351:
5345:
5337:
5333:
5329:
5325:
5321:
5317:
5310:
5294:
5291:. Aahpm.org.
5290:
5283:
5267:
5263:
5257:
5249:
5245:
5240:
5235:
5230:
5225:
5221:
5217:
5213:
5206:
5199:
5195:
5192:
5186:
5179:
5175:
5172:
5166:
5158:
5154:
5148:
5140:
5136:
5132:
5128:
5124:
5120:
5116:
5112:
5108:
5101:
5093:
5089:
5084:
5079:
5075:
5071:
5067:
5063:
5059:
5055:
5051:
5044:
5028:
5024:
5018:
5010:
5006:
5001:
4996:
4993:(1): 99β101.
4992:
4988:
4984:
4977:
4969:
4965:
4960:
4955:
4951:
4947:
4943:
4939:
4935:
4928:
4920:
4916:
4911:
4906:
4902:
4898:
4894:
4890:
4886:
4879:
4871:
4865:
4861:
4854:
4838:
4834:
4830:
4824:
4816:
4812:
4807:
4802:
4798:
4794:
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4783:
4775:
4771:
4766:
4761:
4757:
4753:
4749:
4745:
4741:
4734:
4726:
4722:
4717:
4712:
4708:
4704:
4700:
4696:
4692:
4685:
4677:
4673:
4669:
4665:
4661:
4657:
4650:
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4638:
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4630:
4626:
4622:
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4603:
4598:
4593:
4589:
4585:
4581:
4574:
4566:
4562:
4558:
4554:
4550:
4546:
4542:
4538:
4531:
4524:
4516:
4512:
4508:
4504:
4500:
4499:NIHR Evidence
4496:
4490:
4482:
4478:
4474:
4470:
4466:
4462:
4458:
4454:
4447:
4445:
4443:
4434:
4430:
4426:
4424:1-60256-743-3
4420:
4416:
4409:
4407:
4398:
4394:
4390:
4384:
4380:
4373:
4371:
4362:
4358:
4353:
4348:
4344:
4340:
4336:
4329:
4327:
4318:
4314:
4310:
4306:
4302:
4298:
4291:
4289:
4287:
4278:
4274:
4269:
4264:
4260:
4256:
4252:
4245:
4243:
4234:
4230:
4223:
4215:
4211:
4207:
4203:
4199:
4195:
4191:
4187:
4179:
4171:
4167:
4163:
4159:
4155:
4151:
4144:
4136:
4132:
4127:
4122:
4118:
4114:
4110:
4103:
4095:
4091:
4087:
4083:
4079:
4075:
4071:
4067:
4060:
4052:
4048:
4043:
4038:
4034:
4030:
4026:
4022:
4016:
4008:
4004:
4000:
3996:
3992:
3988:
3984:
3980:
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2733:0-7619-1062-X
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2068:
2064:
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2056:
2052:
2048:
2041:
2039:
2030:
2026:
2022:
2018:
2014:
2010:
2006:
2002:
1995:
1979:
1975:
1971:
1965:
1963:
1954:
1948:
1944:
1940:
1936:
1929:
1927:
1925:
1923:
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1144:Jarvis Cocker
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1122:
1118:
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1106:
1103:by directors
1102:
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976:
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923:
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878:
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842:
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512:
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485:Physical pain
482:
479:
474:
473:
469:
467:
463:
459:
455:
454:social worker
448:
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438:
428:
424:
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402:
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389:
386:
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381:
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366:
362:
358:
354:
353:Balfour Mount
350:
346:
342:
338:
327:
324:
316:
306:
302:
296:
294:
287:
278:
277:
269:
266:
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242:
236:
232:
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219:
216:
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208:
205:
200:
197:
193:
189:
185:
184:heart failure
181:
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172:
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155:
151:
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7743:Telemedicine
7676:Telemedicine
7671:Nanomedicine
7571:
7507:Nursing home
7237:Rural health
7222:Nanomedicine
7030:
6773:Rheumatology
6704: /
6623:Hand surgery
6608:Neurosurgery
6456:
6446:
6434:. Retrieved
6414:
6405:
6368:
6364:
6354:
6329:
6320:
6283:
6279:
6269:
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5928:
5919:
5907:. Retrieved
5899:Wales Online
5898:
5889:
5877:. Retrieved
5863:
5851:. Retrieved
5842:
5833:
5821:. Retrieved
5812:
5803:
5791:. Retrieved
5782:
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5732:
5720:. Retrieved
5695:
5686:
5651:
5641:
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5602:
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5580:. Retrieved
5555:
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5497:
5473:. Berkeley:
5468:
5460:
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5439:. Retrieved
5434:
5422:
5410:. Retrieved
5401:
5388:. Retrieved
5379:
5370:
5358:. Retrieved
5344:
5319:
5315:
5309:
5297:. Retrieved
5282:
5272:23 September
5270:. Retrieved
5266:the original
5256:
5219:
5215:
5205:
5185:
5165:
5156:
5147:
5114:
5110:
5100:
5057:
5053:
5043:
5031:. Retrieved
5027:the original
5017:
4990:
4986:
4976:
4944:(1): 47β52.
4941:
4937:
4927:
4892:
4888:
4878:
4859:
4853:
4841:. Retrieved
4832:
4823:
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4792:
4782:
4747:
4743:
4733:
4698:
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4659:
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4342:
4338:
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4185:
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4149:
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4072:(2): 84β86.
4069:
4065:
4059:
4032:
4028:
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3982:
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3971:
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3732:
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3294:
3290:
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3225:(2): 79β96.
3222:
3218:
3208:
3173:
3169:
3147:
3122:
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3112:
3077:
3073:
3063:
3030:
3026:
2980:
2976:
2966:
2931:
2927:
2881:
2877:
2871:
2844:
2840:
2830:
2818:. Retrieved
2809:
2800:
2773:
2769:
2745:
2739:
2722:
2695:
2691:
2681:
2646:
2642:
2594:
2590:
2580:
2545:
2541:
2516:. Retrieved
2507:
2498:
2486:. Retrieved
2461:
2457:
2447:
2438:
2428:
2393:
2389:
2379:
2344:
2340:
2330:
2295:
2291:
2281:
2246:
2242:
2232:
2205:
2201:
2191:
2158:
2154:
2148:
2115:
2111:
2105:
2093:. Retrieved
2084:
2075:
2050:
2046:
2004:
2000:
1994:
1982:. Retrieved
1973:
1934:
1909:. Retrieved
1905:
1896:
1884:. Retrieved
1880:
1871:
1836:
1832:
1822:
1787:
1783:
1777:
1765:. Retrieved
1751:
1714:
1710:
1700:
1667:
1663:
1656:
1644:. Retrieved
1635:
1626:
1591:
1587:
1577:
1565:. Retrieved
1510:
1506:
1496:
1484:. Retrieved
1470:
1435:
1431:
1383:
1379:
1366:
1329:
1325:
1315:
1291:(2): 91β96.
1288:
1284:
1259:. Retrieved
1255:the original
1250:
1241:
1222:
1168:
1153:
1136:Duncan Jones
1125:
1098:
1096:
1087:
1079:
1055:
1047:
1043:
1031:
1024:
1021:
1017:
1003:
968:
964:nursing home
953:
942:
930:
903:
889:
886:In religions
880:
877:Psychologist
858:
851:
844:
835:
791:
784:
779:
772:
766:
762:
753:
745:
733:Respite care
717:hypnotherapy
709:play therapy
645:
628:
624:
621:Psychologist
579:, activity,
568:
566:
557:
533:
525:
521:
518:
515:Spirituality
509:
500:Death Rattle
488:
475:
471:
470:
450:
441:Psychologist
425:
421:
417:
394:
378:
334:
319:
310:
290:
262:
240:
238:
220:
201:
170:
167:
158:
147:
124:
123:
29:
7802:New Zealand
7557:End-of-life
7439:Professions
7369:Health care
7307:Wikiproject
7096:Venereology
7041:Neonatology
6938:Dermatology
6793:Gynaecology
6785:gynaecology
6768:Pulmonology
6586:Eye surgery
6548:Specialties
5909:30 December
5879:30 December
5853:30 December
5299:21 November
4021:Woodgate RL
3881:: 448β449.
3841:10665/44771
2464:(1): 7β15.
1906:www.cms.gov
1567:18 December
1128:David Bowie
1105:Rob Epstein
1071:end of life
1063:end of life
910:pharmacists
698:transitions
636:bereavement
544:Haloperidol
252:, and most
67:Description
7861:Categories
7769:By country
7633:Technology
7572:Palliative
7400:Philosophy
7390:Guidelines
7069:Psychiatry
7055:(PM&R)
7048:Phlebology
7036:Pediatrics
6863:Anatomical
6828:Diagnostic
6808:Obstetrics
6758:Nephrology
6743:Hematology
6738:Geriatrics
6731:Hepatology
6716:Cardiology
6706:Immunology
6286:(1): 148.
5477:. p.
5437:. May 2021
4793:Pediatrics
4255:Pediatrics
3979:Pediatrics
3553:(2): 6β9.
2518:28 October
2085:The Walrus
2007:(1): 110.
1911:12 January
1886:12 January
1767:22 October
1261:4 December
1205:References
1051:euthanasia
1012:See also:
956:volunteers
906:physicians
895:In society
871:See also:
736:themselves
632:ambulatory
615:See also:
601:well-being
593:drowsiness
585:depression
548:droperidol
536:antiemetic
492:xerostomia
472:Total pain
445:See also:
435:See also:
229:See also:
194:and other
108:employment
94:(US only)
38:Occupation
7797:Australia
7618:Education
7613:Diagnosis
7466:Dentistry
7410:Providers
7385:Equipment
7380:Economics
7257:Physician
7141:education
6999:Neurology
6994:Narcology
6858:Pathology
6836:Radiology
6711:Angiology
6675:Andrology
6483:245013480
6431:249936671
6371:(1): 66.
6346:242429298
6261:241904445
6178:242843746
6106:231992307
6062:245290694
5979:247180312
5945:247873633
5712:249936671
5678:245013480
5572:247180312
5412:8 October
5390:8 October
5131:1096-6218
5074:1573-6571
4565:221788612
4515:242477064
4433:173843216
4397:714030350
4007:207160955
3860:0512-3054
3832:children)
3714:808596673
3611:212125356
3055:221179683
2906:220119083
2458:Pharm Med
2029:143078786
2021:1041-0236
1109:BJ Miller
1001:(ELNEC).
926:chaplains
873:Analgesic
617:Analgesic
458:counselor
437:Analgesic
391:survival.
313:July 2022
305:talk page
211:prognosis
113:Hospitals
106:Fields of
49:Specialty
7851:Medicine
7824:Category
7502:Hospital
7485:Settings
7456:Pharmacy
7446:Medicine
7395:Industry
7287:Category
6763:Oncology
6694:medicine
6692:Internal
6540:Medicine
6475:34887313
6397:32393231
6312:32972414
6227:33355156
6155:25085264
6125:BMJ Open
6098:33619223
6028:34479457
5903:Archived
5873:Archived
5847:Archived
5823:10 April
5817:Archived
5793:10 April
5787:Archived
5765:29237624
5716:Archived
5670:34887313
5633:34479457
5576:Archived
5538:22401355
5441:20 April
5406:Archived
5384:Archived
5354:Archived
5336:15662179
5293:Archived
5248:23440060
5194:Archived
5174:Archived
5139:15353100
5092:35092533
5009:26837989
4968:20042561
4919:19058149
4837:Archived
4815:24488537
4774:18840840
4725:19698026
4676:16676342
4641:16172457
4606:14752081
4557:32943530
4481:46005587
4473:15378093
4361:10964998
4277:18450887
4214:23995360
4135:10869877
4094:34253777
4051:12967729
3999:18450873
3928:12850642
3829:(2012).
3813:10655532
3757:14580922
3749:10700346
3575:26165154
3526:Archived
3507:24760679
3458:38095590
3419:25429434
3370:26524474
3321:26524693
3272:22592721
3241:25644366
3200:24745870
3139:16427173
3104:24842136
3047:32813428
3007:28521070
2958:26287850
2898:32592442
2863:26699170
2820:30 April
2814:Archived
2792:22190887
2748:: viiβx.
2714:15010102
2673:33721912
2621:32996586
2572:21412898
2512:Archived
2482:Archived
2478:34967878
2412:20818875
2363:20818875
2322:23744578
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