Under-diagnosis of pain by primary physicians and late referral to a palliative care team 英文参考文献.docVIP

下载本文档

3
0
约3.57万字
约 9页
2017-05-16 发布于上海
举报
版权申诉

Under-diagnosis of pain by primary physicians and late referral to a palliative care team 英文参考文献.doc

1、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。。
2、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
3、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。
4、该文档为VIP文档，如果想要下载，成为VIP会员后，下载免费。
5、成为VIP后，下载本文档将扣除1次下载权益。下载后，不支持退款、换文档。如有疑问请联系我们。
6、成为VIP后，您将拥有八大权益，权益包括：VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
7、VIP文档为合作方或网友上传，每下载1次，网站将根据用户上传文档的质量评分、类型等，对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档

Under-diagnosis of pain by primary physicians and late referral to a palliative care team 英文参考文献

Akashietal.BMCPalliativeCare2012,11:7 /1472-684X/11/7 RESEARCH ARTICLE OpenAccess Under-diagnosisofpainbyprimaryphysicians andlatereferraltoapalliativecareteam MasakoAkashi2*,EijiYano2andEtsukoAruga1 Abstract Background:Under-diagnosisofpainisaseriousproblemincancercare.Accuratepainassessmentbyphysicians mayformthebasisofeffectivecare.Theaimofthisstudyistoexaminetheassociationbetweenlatereferraltoa PalliativeCareTeam(PCT)afteradmissionandtheunder-diagnosisofpainbyprimaryphysicians. Methods:ThisretrospectivestudywasperformedintheTeikyoUniversityteaching-hospitalforaperiodof 20months.Weinvestigatedtriadscomposedof213adultcancerinpatientswhohadcoexistingmoderateor severepainattheinitialPCTconsultation,77primaryphysicians,and4palliativecarephysicians.Theoutcomeof thepresentstudywastheunder-diagnosisofpainbyprimaryphysicianswithroutinelyself-completedstandard formatchecklists.Thechecklistsincludedcoexistingpaindocumentedindependentlybyprimaryandpalliativecare physiciansatthetimeoftheinitialPCTconsultation.Under-diagnosisofpainwasdefinedasexistingpain diagnosedbythepalliativecarephysiciansonly.LatereferraltoPCTsafteradmissionwasdefinedasareferralto thePCTat≥20daysafteradmission.Becausethetwogroupsdisplayedsignificantlydifferentregardingthe distributionsofthedurationfromadmissiontoreferraltoPCTs,weused20daysasthecut-offpointfor“late referral.” Results:Accuratepainassessmentwasobservedin192triads,whereas21triadsdisplayedunder-diagnosisofpain byprimaryphysicians.Under-diagnosisofpainbyprimaryphysicianswasassociatedwithalongerduration betweenadmissionandinitialPCTconsultation,comparedwithaccuratepainassessment(25daysversus4days, p0.0001).Afteradjustingforpotentialconfoundingfactors,under-diagnosisofpainbytheprimaryphysicianswas significantlyassociatedwithlate(20ormoredays)referraltoaPCT(adjustedoddsratio,2.91;95%confidence interval,1.27?6.71).Otherfactorssignificantlyassociatedwithunder-diagnosisofpainwerecoexistingdeliriumand casemanagementbyphysicianswith6yearsofclinical