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Biomedical subjects

F I Burge

Publications and source records attributed to F I Burge.

9 recordsLinked to original sources
PubMed1996

Evaluating a palliative care program: methodology and limitations.

The article describes an evaluation of a palliative care service in a regional and tertiary care facility. The service components are described. The four outcomes chosen for evaluation were: (a) symptom relief; (b) satisfaction with care for patients/families; (c) utilization of community resources; (d) good nursing morale and low staff stress. Quality of life was measured using a symptom distress scale; satisfaction using an adapted Kristjanson FAMCARE scale; community resources with opinion and satisfaction surveys; and staff morale and stress with the Maslach Bumout Inventory and Latack's Coping Questionnaire. Results showed that overall symptom distress was reduced. Patients/families were generally satisfied, with some areas needing attention. Physicians were generally satisfied and believed patients/families benefited from the psychosocial support, respite, and education/information. Nurses felt they had the time, energy, resources and support to give quality care.

Community Health Services↗
PubMed1996

Dehydration and provision of fluids in palliative care. What is the evidence?

OBJECTIVE: To provide a clinical review of issues surrounding reduced fluid intake in palliative care patients and a practical approach to care for these patients. DATA SOURCES: Medline was searched from 1980 to 1995 for articles concerning dehydration in dying patients. In addition, the law databases QUICKLAW, WESTLAW, and MEDMAL were searched. STUDY SELECTION: Key papers were included for discussion in relation to the clinical evidence to treat or withhold treatment and to a representative sample of the social, ethical, and legal issues. SYNTHESIS: There is little clinical evidence to guide patients, families, or clinicians in treating with reduced fluid intake during the terminal phase of life. Assisting patients to take fluids as a social or symbolic act is recognized, as is the ethical and legal stance that assisting fluid intake should be thought of as a medical therapy. CONCLUSION: Without sound evidence upon which to base clinical decisions, patients, families, and clinicians are left to balance potential benefits and burdens against the goals of care.

Cultural Characteristics↗
PubMed1993

Dehydration symptoms of palliative care cancer patients.

A cross-sectional survey of inpatient palliative care subjects (n = 52) was performed to determine the severity and distribution of symptoms thought to be associated with dehydration in terminally ill cancer patients and to clarify the association between the severity of these symptoms and commonly used objective measures of dehydration. Each patient rated the severity of seven symptoms using 100-mm visual analogue scales. The symptoms considered were thirst, dry mouth, bad taste, nausea, pleasure in drinking, fatigue, and pain. Associations were sought between these symptoms and predictor variables (fluid intake, plasma osmolality, sodium, and urea) and confounding variables (age, medications, oral disease, and mouth-care regimen). Mean symptom ratings were thirst 53.8 mm, dry mouth 60.0 mm, bad taste 46.6 mm, nausea 24.0 mm, pleasure in drinking 61.6 mm, fatigue 61.8 mm, and pain 33.5 mm. Using multiple-linear regression, no association could be demonstrated between thirst (the principal outcome of interest) and the predictor or confounding variables. Estimates of the study power performed after completion revealed a 76% chance of detecting a 20-mm difference between high and low fluid intake groups. This study provides the first quantitative estimate of the experience of dehydration symptoms in those with advanced cancer. The symptoms appear to be rated moderately severe, but there is no demonstrable association between severity and fluid intake. Further studies with greater statistical power and more accurate hydration assessment would strengthen our understanding of this association.

Cross-Sectional Studies↗
PubMed1989

Palliative care in medical education at McMaster University.

As professionals working within palliative care struggle to find their niche in the academic, administrative and service continuum of patient care, we have a growing desire to share what has been learned with students and colleagues. The opportunities for student physicians to learn the principles and practices of caring for the dying are few. The described curriculum content is dependent on the McMaster philosophy of medical education and the developmental level of the student physician. Areas included are: philosophy of palliative care, communication skills, symptom assessment and control, approach to ethical issues, decision making and interdisciplinary team function. The authors describe the university's current approach in its specific contribution to undergraduate and postgraduate medical education, the continuum throughout those years and an examination of recommendations for the future.

Community Health Services↗