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Affiliation(s)
- Miguel Julião
- Cuidados Paliativos, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ULS Amadora/Sintra, Portugal
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2
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Affiliation(s)
- Miguel Julião
- Cuidados Paliativos, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ULS Amadora/Sintra, Portugal
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Hadler RA, Weeks S, Rosa WE, Choate S, Goldshore M, Julião M, Mergler B, Nelson J, Soodalter J, Zhuang C, Chochinov HM. Top Ten Tips Palliative Care Clinicians Should Know About Dignity-Conserving Practice. J Palliat Med 2024; 27:537-544. [PMID: 37831928 DOI: 10.1089/jpm.2023.0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023] Open
Abstract
The acknowledgment and promotion of dignity is commonly viewed as the cornerstone of person-centered care. Although the preservation of dignity is often highlighted as a key tenet of palliative care provision, the concept of dignity and its implications for practice remain nebulous to many clinicians. Dignity in care encompasses a series of theories describing different forms of dignity, the factors that impact them, and strategies to encourage dignity-conserving care. Different modalities and validated instruments of dignity in care have been shown to lessen existential distress at the end of life and promote patient-clinician understanding. It is essential that palliative care clinicians be aware of the impacts of dignity-related distress, how it manifests, and common solutions that can easily be adapted, applied, and integrated into practice settings. Dignity-based constructs can be learned as a component of postgraduate or continuing education. Implemented as a routine component of palliative care, they can provide a means of enhancing patient-clinician relationships, reducing bias, and reinforcing patient agency across the span of serious illness. Palliative care clinicians-often engaging patients, families, and communities in times of serious illness and end of life-wield significant influence on whether dignity is intentionally integrated into the experience of health care delivery. Thus, dignity can be a tangible, actionable, and measurable palliative care goal and outcome. This article, written by a team of palliative care specialists and dignity researchers, offers 10 tips to facilitate the implementation of dignity-centered care in serious illness.
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Affiliation(s)
- Rachel A Hadler
- Department of Anesthesiology, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
- Emory Critical Care Center, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Seth Weeks
- University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - William E Rosa
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Stephanie Choate
- Emory Palliative Care Center, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Matthew Goldshore
- Division of Pediatric General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
| | - Blake Mergler
- Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Judith Nelson
- Division of Supportive Care, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill-Cornell Medical College, New York, New York, USA
| | - Jesse Soodalter
- Division of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Caywin Zhuang
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, University of Manitoba, Winnipeg, Manitoba, Canada
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Julião M, Cruz M. The color purple: Purple urine bag syndrome: Identifying the phenomenon to ease unnecessary anxiety, fear, and distress. Palliat Support Care 2024; 22:424-426. [PMID: 37435644 DOI: 10.1017/s1478951523000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Purple urine bag syndrome (PUBS) is a condition that causes an intense purple discoloration of the urine, predominately in frail, dependent, and bedridden persons who are chronically catheterized and have urinary tract infections. Despite being considered a benign syndrome, PUBS can cause great anxiety, fear, and distress in health professionals, chronically ill persons, and caregivers or family members who provide care. METHODS We report the case of a 98-year-old institutionalized woman with Alzheimer's dementia with a long-term urinary catheter who developed PUBS. RESULTS Although alarming and distressing for the resident and the health-care team, PUBS was resolved by treating the underlying urinary tract infection and applying good genital hygiene and catheter replacement. SIGNIFICANCE OF RESULTS Identifying PUBS and its clinical features and management proved to be significantly helpful in ameliorating the anxiety, fear, and distress around the phenomenon.
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
- Inválidos do Comércio IPSS, Lisboa, Portugal
| | - Mário Cruz
- Inválidos do Comércio IPSS, Lisboa, Portugal
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisboa, Portugal
- USF Tapada, ACeS Sintra, Sintra, Portugal
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Simões C, Julião M, Calaveiras P, Costa E, Bruera E. Repeated Filling of Elastomeric Pumps for Home-Based Subcutaneous Infusions: A Cost Analysis of 240 Devices. Am J Hosp Palliat Care 2024:10499091241239929. [PMID: 38509692 DOI: 10.1177/10499091241239929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The use of continuous subcutaneous infusion of drugs using the repeated filling of elastomeric infuser pumps (EIP) has gained clinical recognition for palliative care at home. However, to date, there has been a notable absence of research examining the cost implications associated with the repeated EIP filling procedure. We aimed to evaluate the cost associated to the repeated filling of EIP used in a home-based palliative care team. METHODS We conducted an analysis of the cost associated to the repeated filling of 240 EIP (1-day, n = 136; 2-day, n = 102; 7-day, n = 2) (110 patients). RESULTS The refilling procedure led to a reduction in the utilization of 409 devices, resulting in savings of €4.031. EIP refilling did not result in a decrease in the number of home visits, the duration of each visit, the expenses associated with transportation to patients' residences, or the nurse-to-hour cost. CONCLUSION Refilling EIPs reduces costs by reducing the number of devices purchased. No additional cost savings were noted in nursing time, number of home visits and duration, and expenses with transportation. Further cost savings could be realized by training laycarers to refill EIP at home independently. Future research should assess the feasibility of laycarers training programs on performing EIP filling at home.
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Affiliation(s)
- Carolina Simões
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ULS Amadora/Sintra, Portugal
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ULS Amadora/Sintra, Portugal
| | - Patrícia Calaveiras
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ULS Amadora/Sintra, Portugal
| | - Elisabeth Costa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ULS Amadora/Sintra, Portugal
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Julião M, Calaveiras P, Bruera E, de Sousa PF. Subcutaneous Patient-Controlled Analgesia in Home-Based Palliative Care: " It's as Straightforward as Pushing a Button, Right at my Fingertips". J Pain Palliat Care Pharmacother 2024:1-6. [PMID: 38407922 DOI: 10.1080/15360288.2024.2320404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/10/2024] [Indexed: 02/27/2024]
Abstract
Subcutaneous patient-controlled analgesia (SCPCA) in home-based palliative care is a potentially valuable option for providing effective pain relief to some patients, particularly when conventional analgesic approaches prove ineffective or are refused. Our case report illustrates the use of SPCA for the management of breakthrough pain in a patient receiving palliative care at home with no improvement after multiple previous treatments. SCPCA was found to be safe and successful. Future research is essential to explore its precise role, appropriate indications, prescription guidelines, and safety considerations across various palliative care contexts.
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Affiliation(s)
- Miguel Julião
- , Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Patrícia Calaveiras
- , Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Paulo Faria de Sousa
- , Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
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Julião M, Ulrich J, Calaveiras P, Costa E, Lucas I, Faria de Sousa P. Ketamine subcutaneous continuous infusion for non-cancer neuropathic pain at home: a case report. BMJ Support Palliat Care 2024; 13:e902-e907. [PMID: 37433626 DOI: 10.1136/spcare-2023-004437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE Ketamine is a drug that can effectively treat neuropathic pain by blocking the N-methyl-D-aspartate receptor. It has been studied as a supplement to opioids for cancer pain, but its effectiveness for non-cancer pain is still limited. However, despite its usefulness in managing refractory pain, ketamine is not commonly used for home-based palliative care. METHODS A case report of a patient with severe central neuropathic pain who was treated with a subcutaneous continuous infusion of morphine and ketamine at home. RESULTS The introduction of ketamine in the patient's treatment plan effectively controlled pain. Only one possible ketamine side effect was observed and easily treated with pharmacological and non-pharmacological measures. CONCLUSIONS We have found success in using subcutaneous continuous infusion of morphine and ketamine to alleviate severe neuropathic pain in a home setting. We also observed a positive impact on the patient's family members' personal, emotional and relational well-being after ketamine was introduced.
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal
| | - João Ulrich
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal
| | - Patrícia Calaveiras
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal
| | - Elisabeth Costa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal
| | - Isabel Lucas
- Equipa Comunitária de Suporte em Cuidados Paliativos Ametista, ACES Alentejo Central, Alentejo, Portugal
| | - Paulo Faria de Sousa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal
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Julião M, Calaveiras P, Costa E, Runa D, Johnston B, Bruera E. Refractory lower limb edema in cancer: subcutaneous drainage. BMJ Support Palliat Care 2024; 13:e939-e941. [PMID: 35589122 DOI: 10.1136/bmjspcare-2022-003721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACeS Sintra, Sintra, Portugal
| | - Patrícia Calaveiras
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACeS Sintra, Sintra, Portugal
| | - Elisabeth Costa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACeS Sintra, Sintra, Portugal
| | - Daniela Runa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACeS Sintra, Sintra, Portugal
| | | | - Eduardo Bruera
- Palliative Care & Rehabilitation Medicine, UT M. D. Anderson Cancer Center, Houston, Texas, USA
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Paiva BSR, Mingardi M, de Almeida LF, de Camargos MG, Valentino TCDO, Julião M, Paiva CE. Go Wish card game-exploring end-of-life wishes of patients in oncology palliative care: a qualitative study. Ann Palliat Med 2024; 13:31-41. [PMID: 38073298 DOI: 10.21037/apm-23-381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/13/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Among the methods that promote quality of life and care, discussing and remembering end-of-life (EOL) wishes for future care may contribute to decision-making about care and the promotion of a good death. Our aim was to investigate the most significant EOL desires among Brazilian cancer patients receiving palliative care (PC). METHODS This was an exploratory, descriptive, and qualitative study conducted in a Palliative Care Oncology Unit. Fifteen patients played the Go Wish card game (GWCG), choosing and categorizing cards into themes as very important, more or less important, and not important at all. The ten most important cards were discussed, and categories were defined for each card. Cards with the highest frequencies of choice were described. Patients were also asked, "What did playing the cards mean to you?". All data were analyzed using Bardin's content analysis and generated a word cloud to interpret the participants' narratives. RESULTS Out of the 36 cards, card 19, "I want my family and friends close to me", was the most frequently chosen. Out of the 15 patients studied, only one reported that they initially did not enjoy playing the cards. In this study, the GWCG was effective in fulfilling 90% of the patients' wishes, and this was only possible with the support of the researchers, members of the multi-professional team, and patients' families. CONCLUSIONS The use of the GWCG in the oncology PC setting made an important contribution to open discussions about patients' values and preferences, as well as being an easy-to-use, understandable, and flexible tool. Prioritizing the fulfillment of patients' wishes was one of the main strengths of this study. Our study suggests working with these wishes as a framework for person-centered care.
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Affiliation(s)
- Bianca Sakamoto Ribeiro Paiva
- Oncology Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Mirella Mingardi
- Oncology Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Laura Fiacadori de Almeida
- Oncology Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Mayara Goulart de Camargos
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Clinical Hospital of the Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Talita Caroline de Oliveira Valentino
- Oncology Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Miguel Julião
- Sintra's Community Palliative Care Support Team, Sintra, Portugal
| | - Carlos Eduardo Paiva
- Oncology Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, São Paulo, Brazil; Breast and Gynecology Division, Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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Julião M. Come and See the Yellow Bird, Dear! J Palliat Med 2023; 26:1427. [PMID: 37788473 DOI: 10.1089/jpm.2023.0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
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Julião M, Bruera E, Silva C, Calado J, Cruz M, Vaz M, Paiva BSR. "Mãos de Conforto" (Hands of Comfort): A novel non-pharmacological intervention to ease agitation in elderly persons with dementia. Palliat Support Care 2023; 21:946-952. [PMID: 36788747 DOI: 10.1017/s147895152300007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Behavioral symptoms associated with dementia, such as agitation, are frequent and associated with well-known negative consequences for patients, their carers, and their environment. Pharmacological treatments for agitation using sedatives and antipsychotics are known to have several undesirable side effects and modest efficacy. Non-pharmacological alternatives are recommended as first-line options for agitation in persons with dementia with few side effects, but there is limited evidence of efficacy. We developed a novel and simple non-pharmacological alternative for agitation in dementia residents based on a Brazilian intervention using warm water surgical gloves used in patients with COVID-19 in intensive care units during the pandemic. We coined it "Mãos de Conforto" - Hands of Comfort. We report a series of 7 cases in 3 residents with dementia who whore Hands of Comfort.
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Affiliation(s)
- Miguel Julião
- Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
- Inválidos do Comércio IPSS, Lisboa, Portugal
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - José Calado
- Inválidos do Comércio IPSS, Lisboa, Portugal
| | - Mário Cruz
- Inválidos do Comércio IPSS, Lisboa, Portugal
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisboa, Portugal
- USF Tapada, ACeS Sintra, Sintra, Portugal
| | - Marília Vaz
- Inválidos do Comércio IPSS, Lisboa, Portugal
| | - Bianca Sakamoto Ribeiro Paiva
- Research Group on Palliative Care and Health-Related Quality of Life, Barretos Cancer, Hospital - Barretos (SP), São Paulo, Brazil
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Uchida Miwa M, Paiva CE, Ferreira AJS, Julião M, Chochinov HM, Paiva BSR. Translation and cross-cultural adaptation of the Dignity Therapy Question Protocol to Brazilian Portuguese. Palliat Support Care 2023; 21:856-862. [PMID: 37052333 DOI: 10.1017/s147895152300041x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES Dignity therapy (DT) was developed to help patients at their end of life to reframe and give meaning to their illness process. The DT question protocol focuses on personhood and important aspects of the individual's life. This study aimed to translate and culturally adapt the Dignity Therapy Question Protocol (DTQP) to Brazilian Portuguese. METHODS This was a descriptive and methodological study, and cross-cultural adaptation process comprised 4 stages: (1) translation and synthesis of English original version protocol into Brazilian Portuguese, (2) back translation, (3) experts committee, and (4) pretest. RESULTS The Portuguese version of the DTQP - Protocolo de Perguntas sobre Terapia da Dignidade - demonstrated a content validity index of 1 for all equivalences. The initial sample consisted of 41 participants (9 [21.9%] refused to participate and 1 [2.43%] dropped out). The pretest was applied to 30 (73.1%) participants, 15 of them were female and the mean age was 53.4 years. The final version consisted of 10 questions that were approved by the original authors who affirmed that the DTQP Brazilian Portuguese version maintained the original English characteristics. SIGNIFICANCE OF RESULTS The Brazilian cultural adaptation of the DTQP was well understood by patients. It will be very useful in palliative care clinical practice for patients nearing end of life. The adapted version to Brazilian Portuguese will facilitate future studies using the DTQP.
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Affiliation(s)
- Michelle Uchida Miwa
- Palliative Care Unit, Barretos Cancer Hospital, Barretos (SP), Brazil
- Research Group on Palliative Care and Health-Related Quality of Life, Barretos Cancer Hospital, Barretos (SP), Brazil
| | - Carlos Eduardo Paiva
- Research Group on Palliative Care and Health-Related Quality of Life, Barretos Cancer Hospital, Barretos (SP), Brazil
- Department of Clinical Oncology, Breast and Gynecology Division, Barretos Cancer Hospital, Barretos (SP), Brazil
| | - Ana Julia Sucupira Ferreira
- Research Group on Palliative Care and Health-Related Quality of Life, Barretos Cancer Hospital, Barretos (SP), Brazil
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
| | - Harvey Max Chochinov
- Department of Psychiatry, Research Institute of Oncology and Hematology, Cancer Care Manitoba, Manitoba, Canada
| | - Bianca Sakamoto Ribeiro Paiva
- Research Group on Palliative Care and Health-Related Quality of Life, Barretos Cancer Hospital, Barretos (SP), Brazil
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Johnston B, Dönmez CF, Julião M. Effectiveness of dignity therapy in the context of culturally competent care in people with palliative care needs: a systematic review of systematic reviews. Curr Opin Support Palliat Care 2023; 17:186-192. [PMID: 37428208 DOI: 10.1097/spc.0000000000000664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW This review aims to synthesise the evidence from systematic reviews and meta-analyses on the efficacy of dignity therapy (DT) in relation to psychosocial and spiritual outcomes in the context of person-centred and culturally competent care for people with supportive and palliative care needs. RECENT FINDINGS Thirteen reviews were found, including seven conducted by nurses. Most reviews were of high quality, including various study populations such as cancer, motor neurone disease and non-malignant conditions. Six psychosocial and spiritual outcomes were identified: quality of life, anxiety, depression, hopefulness, meaning and purpose in life, and suffering based on the cultural variations in the implementation of DT. SUMMARY DT has a positive impact on anxiety, depression, suffering, and meaning and purpose in life for people with palliative care needs, but the evidence is somewhat conflicted as to whether DT is effective in improving hope, quality of life and spiritual outcomes in the context of culturally competent care. Nurse-led DT seems desirable given its pivotal role when caring for people with palliative care needs. More randomised controlled trials should be conducted for people with different cultural backgrounds to provide person-centred, culturally competent supportive and palliative care.
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Affiliation(s)
- Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow
- NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - C Fulya Dönmez
- School of Medicine, Dentistry and Nursing, University of Glasgow
- Fethiye Faculty of Health Sciences, Mugla University, Fethiye, Turkey
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
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Valentino TCDO, Paiva CE, de Oliveira MA, Hui D, Bruera E, Julião M, Paiva BSR. Preference and actual place-of-death in advanced cancer: prospective longitudinal study. BMJ Support Palliat Care 2023:spcare-2023-004299. [PMID: 37402541 DOI: 10.1136/spcare-2023-004299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES To evaluate the preferred place-of-death (PPoD) among patients with advanced cancer over time, and the concordance between preferred and actual place-of-death. METHODS Prospective cohort study. A total of 190 patients with advanced cancer and their caregivers (n=190) were interviewed every 3 months, from study enrolment to 12 months (M0, M1, M2, M3, M4). PPoD data were obtained under four different end-of-life scenarios: (1) severe clinical deterioration without further specification; (2) clinical deterioration suffering from severe symptoms; (3) clinical deterioration receiving home-based visits; and (4) clinical deterioration receiving home-based visits and suffering from severe symptoms. RESULTS Home was the most common PPoD over time among patients in scenarios 1 (n=121, 63.7%; n=77, 68.8%; n=39, 57.4%; n=30, 62.5%; n=23, 60.5%) and 3 (n=147, 77.4%; n=87, 77.7%; n=48, 70.6%; n=36, 75.0%; n=30, 78.9%). PPoD in palliative care unit (PCU) and hospital were most frequent at baseline in scenario 2 (n=79, 41.6%; n=78, 41.1%), followed by hospital over time (n=61, 54.5%; n=45, 66.2%; n=35, 72.9%; n=28, 73.7%). During the curse of illness, 6.3% of patients change their PPoD in at least one of end-of-life scenario. About 49.7%, 30.6% and 19.7% of patients died in PCU, hospital and home, respectively. Living in rural area (OR=4.21), poor health self-perception (OR=4.49) and pain at the last days of life (OR=2.77) were associated with death in PPoD. The overall agreement between last preference and actual place-of-death was 51.0% (k=0.252). CONCLUSION Home death was not the preferred place for a large number of patients when this option was presented within a clinical context scenario. The PPoD and actual place-of-death were depending on the clinical situation.
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Affiliation(s)
| | - Carlos Eduardo Paiva
- GPQual - Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Marco Antonio de Oliveira
- GPQual - Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - David Hui
- Palliative Care, MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Palliative Care & Rehabilitation Medicine, UT M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Lisboa, Portugal
| | - Bianca Sakamoto Ribeiro Paiva
- GPQual - Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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15
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Wu Y, Levis B, Daray FM, Ioannidis JPA, Patten SB, Cuijpers P, Ziegelstein RC, Gilbody S, Fischer FH, Fan S, Sun Y, He C, Krishnan A, Neupane D, Bhandari PM, Negeri Z, Riehm KE, Rice DB, Azar M, Yan XW, Imran M, Chiovitti MJ, Boruff JT, McMillan D, Kloda LA, Markham S, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Al-Adawi S, Beck KR, Beraldi A, Bernstein CN, Boye B, Büel-Drabe N, Bunevicius A, Can C, Carter G, Chen CK, Cheung G, Clover K, Conroy RM, Costa-Requena G, Cukor D, Dabscheck E, De Souza J, Downing M, Feinstein A, Ferentinos PP, Flint AJ, Gallagher P, Gandy M, Grassi L, Härter M, Hernando A, Jackson ML, Jenewein J, Jetté N, Julião M, Kjærgaard M, Köhler S, König HH, Krishna LKR, Lee Y, Löbner M, Loosman WL, Love AW, Löwe B, Malt UF, Marrie RA, Massardo L, Matsuoka Y, Mehnert A, Michopoulos I, Misery L, Nelson CJ, Ng CG, O'Donnell ML, O'Rourke SJ, Öztürk A, Pabst A, Pasco JA, Peceliuniene J, Pintor L, Ponsford JL, Pulido F, Quinn TJ, Reme SE, Reuter K, Riedel-Heller SG, Rooney AG, Sánchez-González R, Saracino RM, Schellekens MPJ, Scherer M, Benedetti A, Thombs BD, Et Al. Comparison of the accuracy of the 7-item HADS Depression subscale and 14-item total HADS for screening for major depression: A systematic review and individual participant data meta-analysis. Psychol Assess 2023; 35:95-114. [PMID: 36689386 DOI: 10.1037/pas0001181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit
| | | | - Simon Gilbody
- Department of Health Sciences, Hull York Medical School, University of York
| | - Felix H Fischer
- Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin
| | - Suiqiong Fan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | | | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | | | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University
| | - Dean McMillan
- Department of Health Sciences, Hull York Medical School, University of York
| | | | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital
| | - Zahinoor Ismail
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary
| | | | | | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Kevin R Beck
- Department of Psychiatry, Singapore General Hospital, Singapore
| | - Anna Beraldi
- kbo Lech-Mangfall-Klinik für Psychatrie, Psychotherapie und Psychsomatik, Garmisch-Partenkirchen
| | | | - Birgitte Boye
- Department of Behavioural Medicine, University of Oslo
| | | | | | - Ceyhun Can
- Adana City Training and Research Hospital
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle
| | - Chih-Ken Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Gary Cheung
- Department of Psychological Medicine, University of Auckland
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle
| | - Ronán M Conroy
- Division of Population Health Sciences, Royal College of Surgeons in Ireland
| | - Gema Costa-Requena
- Department of Psychiatry, Clinical Psychology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Centro de Investigacióo Biomédica en Red de Salud Mental
| | | | | | | | | | | | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens
| | | | | | - Milena Gandy
- The School of Psychological Sciences, Macquarie University
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg, University of Hamburg
| | | | | | - Josef Jenewein
- Department of Medical Psychology and Psychotherapy, Medical University of Graz
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf
| | | | - Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig
| | | | | | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf
| | - Ulrik F Malt
- Department of Research and Education Division of Surgery and Clinical Neuroscience, University of Oslo
| | - Ruth Ann Marrie
- Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
| | - Loreto Massardo
- Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia, Universidad San Sebastián
| | - Yutaka Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens
| | | | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya
| | | | | | | | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig
| | - Julie A Pasco
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University
| | - Jurate Peceliuniene
- Faculty of Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius University
| | - Luis Pintor
- Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer
| | | | | | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow
| | - Silje E Reme
- Department of Psychology, Faculty of Social Sciences, University of Oslo
| | - Katrin Reuter
- Private Practice for Psychotherapy and Psycho-oncology, Freiburg, Baden-Württemberg
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig
| | | | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar
| | - Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | | | - Martin Scherer
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital
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Julião M. In my hands, a glimpse of war. Ann Palliat Med 2023; 12:418-420. [PMID: 36786104 DOI: 10.21037/apm-22-1347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/06/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
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Julião M, Wholihan DJ, Calaveiras P, Costa E, Faria de Sousa P. Energy surge: A deathbed phenomenon that matters. Palliat Support Care 2023; 21:1-5. [PMID: 36700451 DOI: 10.1017/s1478951522001754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Miguel Julião
- Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Sintra, Portugal
| | - Dorothy J Wholihan
- Geriatric Research, Education and Clinical Center, James J. Peters VA Medical Center, New York, NY, USA
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Patrícia Calaveiras
- Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Sintra, Portugal
| | - Elisabeth Costa
- Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Sintra, Portugal
| | - Paulo Faria de Sousa
- Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Sintra, Portugal
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18
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
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19
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Trevizan FB, Paiva CE, Julião M, de Oliveira Valentino TC, Miwa MU, Mingardi M, D'Almeida Preto D, Ciorlia JB, de Angelis Nascimento MS, Kovács MJ, Dadalto L, de Oliveira LC, da Costa Rosa KS, Ribeiro Paiva BS. Comprehension and Decision-Making Capacity Questionnaire About Palliative Care and Advance Care Planning: A Delphi Study. J Palliat Care 2022; 38:41-51. [PMID: 36168276 DOI: 10.1177/08258597221128676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE(S) To develop a questionnaire that assesses the level of comprehension and decision-making capacity of patients with breast cancer about palliative care and advance care planning. Methods: Questionnaire items were based on the scientific literature. Delphi Consensus, a three-round survey with experts (n = 14), evaluated the relevance, clarity, and redundancies of the items. A pretest with breast cancer patients (n = 15) evaluated whether they comprehended each item and identified doubts or discomforts. Results: The initial questionnaire was composed of 38 items. After the Delphi, 18 items were restructured, six were added, and 16 were removed. In the pretest phase, all items with the survey header, guidelines, and Likert model were evaluated. All items accomplished ≥80% cut-off score and were kept as in the original version. The final version of the questionnaire have 28 itens and five domains: determination, responsibility, independence, self-knowledge, and knowledge of reality. Conclusions: This study represents the first step in the development of a questionnaire that may be used in oncology clinical practice. The main findings revealed that Delphi and pretesting increased the quality of the questionnaire, making it compelling to assess breast cancer patients' comprehension and decision-making capacity about PC and ACP.
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Affiliation(s)
- Fulvio Bergamo Trevizan
- GPQual - Research Group on Palliative Care and Quality of Life - 67766Barretos Cancer Hospital, Brazil
| | - Carlos Eduardo Paiva
- GPQual - Research Group on Palliative Care and Quality of Life - 67766Barretos Cancer Hospital, Brazil
| | - Miguel Julião
- Community Support Team in Palliative Care - Sintra, Portugal
| | | | - Michelle Uchida Miwa
- GPQual - Research Group on Palliative Care and Quality of Life - 67766Barretos Cancer Hospital, Brazil
| | - Mirella Mingardi
- GPQual - Research Group on Palliative Care and Quality of Life - 67766Barretos Cancer Hospital, Brazil
| | - Daniel D'Almeida Preto
- GPQual - Research Group on Palliative Care and Quality of Life - 67766Barretos Cancer Hospital, Brazil
| | - Juliana Beraldo Ciorlia
- GPQual - Research Group on Palliative Care and Quality of Life - 67766Barretos Cancer Hospital, Brazil
| | | | - Maria Júlia Kovács
- Department of Psychology of Learning, Development and Personality Psychology in 28133University of São Paulo (USP) - São Paulo, Brazil
| | - Luciana Dadalto
- 241167Newton Paiva University Center - Belo Horizonte, Brazil
| | - Livia Costa de Oliveira
- National Cancer Institute José Alencar Gomes da Silva (INCA) - Palliative Care Unit. Rio de Janeiro, Brazil
| | - Karla Santos da Costa Rosa
- National Cancer Institute José Alencar Gomes da Silva (INCA) - Palliative Care Unit. Rio de Janeiro, Brazil
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Julião M. Still Mrs. B.-An Ode to Personhood During the Pandemic. J Pain Symptom Manage 2022; 65:e765-e766. [PMID: 35840044 PMCID: PMC9273570 DOI: 10.1016/j.jpainsymman.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal.
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21
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Julião M, Johnston B, Antunes B. Dignity Therapy - past, present and future journey: Beyond end of life cancer care. Responding to Grassi et al. Psychooncology 2022; 31:1431-1432. [PMID: 35719045 DOI: 10.1002/pon.5981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Inválidos do Comércio IPSS, Lisboa, Portugal
| | - Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Bárbara Antunes
- Primary Care Unit, Palliative and End of Life Care Research Group, University of Cambridge, Cambridge, United Kingdom
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22
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Valentino TCDO, Paiva CE, Julião M, Paiva BSR. Place of death among Brazilian patients with cancer: preferences and associated factors. BMJ Support Palliat Care 2022:bmjspcare-2022-003666. [PMID: 35428652 DOI: 10.1136/bmjspcare-2022-003666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 11/03/2022]
Affiliation(s)
| | | | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, University of Lisbon, Lisboa, Portugal
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23
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Julião M, Lemos-Caldas M, Ulrich J, Ferreira T, Calaveiras P, Costa E, Sobral MA, Bruera E. The Use of Olanzapine for Nonmedical Opioid Use in a Patient with Cancer Receiving Palliative Care. J Palliat Med 2022; 25:181-183. [PMID: 35119952 DOI: 10.1089/jpm.2021.0569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | | | - João Ulrich
- Serviço de Radioterapia-Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Tiago Ferreira
- Departamento de Saúde Mental-Hospital Prof. Doutor Fernando da Fonseca EPE, Amadora, Portugal
| | - Patrícia Calaveiras
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Elisabeth Costa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Maria Ana Sobral
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Julião M, Chochinov HM, Samorinha C, da Silva Soares D, Antunes B. Prevalence and Factors Associated With Will-to-Live in Patients With Advanced Disease: Results From a Portuguese Retrospective Study. J Pain Symptom Manage 2021; 62:820-827. [PMID: 33631327 DOI: 10.1016/j.jpainsymman.2021.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/01/2021] [Accepted: 02/11/2021] [Indexed: 01/30/2023]
Abstract
CONTEXT Will-to-live (WtL) is a complex and multifactorial dimension of end-of-life experience. Health care decisions on assisted suicide and euthanasia are rarely based on WtL evidence-based discussions. OBJECTIVES To inform the debate, we aimed to evaluate the prevalence of WtL and its associations within a tertiary home-based palliative care unit. METHODS Retrospective analysis of all WtL entries registered in our anonymized clinical registry, from October 2018 to September 2020. RESULTS One-hundred and twelve patients were included: 53% were male, average age was 66 years old; 88% had malignancies, with a mean performance status of 55%. Mean for WtL of was 3.26 (SD = 3.87) with a prevalence of 60.7% strong, 8.9% moderate and 30.4% weak WtL. Weaker WtL was observed among patients who were not well adapted to their disease (P = .001), felt a burden to others (P< .001), were depressed (P = .001), anxious (P< .001) and endorsed a desire for death (P< .001). Weaker WtL was associated with pain (P = .002) and lower well-being (P = .001). Results from the logistic regression model found that the adaptation to disease emerged as a significant predictor of WtL (P = .025), and burden to others remained marginally significant (P = .087). CONCLUSION The factors associated with lower WtL scores are consistent with previous studies, indicating that these patients experience a myriad of physical, psychological and existential symptoms requiring an interdisciplinary palliative care approach. These factors pertaining to WtL should be made known, as Portugal considers how to navigate death-hastening legislation.
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal.
| | - Harvey Max Chochinov
- Department of Psychiatry, Research Institute of Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Manitoba, Canada
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Duarte da Silva Soares
- Departamento de Cuidados Paliativos da Unidade Local de Saúde do Nordeste, Bragança, Portugal
| | - Bárbara Antunes
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Department of Midwifery and Palliative Care, Florence Nightingale School of Nursing, King's College London, London, UK
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25
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Julião M, Calaveiras P, Costa E, Daniel S, Samorinha C, Faria de Sousa P. Antiodor Effect of Milled Brown Rice Sheets in a Malodorous Cancer Wound: A Case Report. J Palliat Med 2021; 24:175-176. [PMID: 33522855 DOI: 10.1089/jpm.2020.0631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Patrícia Calaveiras
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Elisabeth Costa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Sara Daniel
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
| | - Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Paulo Faria de Sousa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal
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Barros Lima C, Marques B, Duarte S, Afonso C, Neves D, Lai A, Julião M, Ruzickova L, Carda J, Gomes M, Cipriano A, Espadana A. PROGNOSTIC IMPACT OF NUTRITIONAL STATUS ON DLBCL PATIENTS. Hematol Oncol 2021. [DOI: 10.1002/hon.50_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C. Barros Lima
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - B. Marques
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - S. Duarte
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - C. Afonso
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - D. Neves
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - A. Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - M. Julião
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - L. Ruzickova
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - J. Carda
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - M. Gomes
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - A. Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. Espadana
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
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Julião M, Sobral MA, Runa D, Calçada P, Calaveiras P, Chaves P, Gonçalves C, Faria de Sousa P, Bruera E. Repeated filling of elastomeric infuser pumps for home-based subcutaneous medications: a case series. Int J Palliat Nurs 2021; 27:107-115. [PMID: 33886356 DOI: 10.12968/ijpn.2021.27.2.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Several medical devices have been developed for continuous subcutaneous drug infusion for home palliative care (HPC), such as elastomeric infuser pumps (EIP). There is no evidence on the repeated filling of EIP for continuous subcutaneous delivery for HPC. AIM A clinical case series report of terminally-ill patients cared for in HPC, with repeated filling of EIPs for home-based subcutaneous medications. METHODS A retrospective analysis of each patient's EIP-related entries in an anonymised database regarding: 1) EIP general functioning aspects; 2) clinical aspects: symptom control and local skin complications. Overall and per-patient cost-saving was also calculated. FINDINGS A total of 10 cases were analysed (four 50-hour EIP and six 30-hour EIP). All EIPs had a mean number of refillings (standard deviation (SD), mode) of 1.6 ((0.5), 2); with 3.2 drugs on average used in each EIP ((1.4), 4). Approximate total mean (SD) usage time for both types of EIP was 87 (29) hours; and all EIP were used, on average (SD), 49 (23) hours more than its labelled duration. All EIPs showed a complete reservoir deflation between refilling. Only one patient had a minor skin complication and no symptom aggravation was observed, except for two cases with mild anxiety and agitation. Cost-saving analysis for the complete case series showed that EIP refillings saved, on average, €24 per-patient and a total of nearly €240, for both types of infuser pumps. CONCLUSION This preliminary study suggests that refilling is safe and reduces cost. Future research on EIP refilling using controlled and systematic methodologies are warranted.
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Affiliation(s)
- Miguel Julião
- Professor Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Maria Ana Sobral
- Physician Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Daniela Runa
- Physician Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Paula Calçada
- Nurse Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Patrícia Calaveiras
- Nurse Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Petra Chaves
- Physician Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Célia Gonçalves
- Physician Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Paulo Faria de Sousa
- Physician Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Eduardo Bruera
- Department Chair Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
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Julião M, Fareleira F, Xavier MR, Brito AT. [Children's Emotional Understanding of Death: Response to Silva et al Paper]. ACTA MEDICA PORT 2021; 34:316. [PMID: 34214431 DOI: 10.20344/amp.15875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
| | - Filipa Fareleira
- Center for Health Technology and Services Research. University of Porto. Porto. Department of Community Medicine, Information and Health Decision Sciences. Faculty of Medicine. University of Porto. Porto. Portugal
| | - Maria Raúl Xavier
- Centro de Investigação para o Desenvolvimento Humano. Faculdade de Educação e Psicologia. Universidade Católica Portuguesa. Porto. Portugal
| | - Ana Teresa Brito
- Departamento de Educação. Centro de Investigação em Educação (CIE - ISPA). ISPA - Instituto Universitário. Lisboa. Fundação Brazelton Gomes-Pedro para as Ciências do Bebé e da Família. Lisboa. Portugal
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Affiliation(s)
- Harvey Max Chochinov
- Department of Psychiatry, Research Institute of Oncology and Hematology, Cancer Care Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Lisbon, Portugal
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30
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Brehaut E, Neupane D, Levis B, Wu Y, Sun Y, Krishnan A, He C, Bhandari PM, Negeri Z, Riehm KE, Rice DB, Azar M, Yan XW, Imran M, Chiovitti MJ, Saadat N, Cuijpers P, Ioannidis JPA, Markham S, Patten SB, Ziegelstein RC, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Tonelli M, Boruff JT, Kloda LA, Beraldi A, Braeken APBM, Carter G, Clover K, Conroy RM, Cukor D, da Rocha E Silva CE, De Souza J, Downing MG, Feinstein A, Ferentinos PP, Fischer FH, Flint AJ, Fujimori M, Gallagher P, Goebel S, Jetté N, Julião M, Keller M, Kjærgaard M, Love AW, Löwe B, Martin-Santos R, Michopoulos I, Navines R, O'Rourke SJ, Öztürk A, Pintor L, Ponsford JL, Rooney AG, Sánchez-González R, Schwarzbold ML, Sharpe M, Simard S, Singer S, Stone J, Tung KY, Turner A, Walker J, Walterfang M, White J, Benedetti A, Thombs BD. Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis. J Psychosom Res 2020; 139:110256. [PMID: 33069051 DOI: 10.1016/j.jpsychores.2020.110256] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/01/2020] [Accepted: 09/19/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale - depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence. METHODS We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated. RESULTS 6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was -21.1% to 19.5%. CONCLUSIONS HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview.
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Affiliation(s)
- Eliana Brehaut
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK.
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada.
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada.
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
| | - John P A Ioannidis
- Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA.
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK.
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Canada.
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
| | - Zahinoor Ismail
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, Clinical Neuroscience and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Carmen G Loiselle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Ingram School of Nursing, McGill University, Montréal, Québec, Canada; Centre for Nursing Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Oncology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Alberta Health Services, Edmonton, Alberta, Canada.
| | - Marcello Tonelli
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada.
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada.
| | - Anna Beraldi
- kbo Lech-Mangfall-Klinik für Psychatrie, Psychotherapie und Psychsomatik, Garmisch-Partenkirchen, Bayern, Germany.
| | - Anna P B M Braeken
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary, Maastricht University, Maastricht, The Netherlands.
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Calvary Mater Newcastle, Australia.
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia.
| | - Ronán M Conroy
- Royal College of Surgeons in Ireland Division of Population Health Sciences, Dublin, Ireland.
| | | | - Carlos E da Rocha E Silva
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Jennifer De Souza
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK.
| | - Marina G Downing
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia.
| | - Anthony Feinstein
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
| | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece; Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Felix H Fischer
- Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
| | - Alastair J Flint
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.
| | - Maiko Fujimori
- Section of Psychological Science, Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | | | - Simone Goebel
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Christian-Albrechts University, Kiel, Germany.
| | - Nathalie Jetté
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal.
| | - Monika Keller
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany.
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway, Norway; Department of Internal Medicine, Kolding Hospital, Hospital Lillebaelt, Denmark.
| | - Anthony W Love
- Department of Psychology, Victoria University, Victoria, Australia.
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain.
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Ricard Navines
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain.
| | - Suzanne J O'Rourke
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK. Suzanne.O'
| | | | - Luis Pintor
- Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, Spain; Consultation Liaison Psychiatry Unit, Hospital Clínico de Barcelona, Barcelona, Spain.
| | - Jennie L Ponsford
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia.
| | - Alasdair G Rooney
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK; Robert Fergusson Unit, Royal Edinburgh Hospital, NHS Lothian, Edinburgh, UK.
| | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Marcelo L Schwarzbold
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Michael Sharpe
- Department of Psychological Medicine, University of Oxford, Oxford, UK.
| | - Sébastien Simard
- Département des sciences de la santé, Université du Québec à Chicoutimi (UQAC), Québec, Canada; Centre intersectoriel en santé durable (CISD), Québec, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), Québec, Canada.
| | - Susanne Singer
- University Medical Centre Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany.
| | - Jon Stone
- Department of Neurology, University of Edinburgh, Edinburgh, UK.
| | | | - Alyna Turner
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, VIC, Australia.
| | - Jane Walker
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia; Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
| | - Jennifer White
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada.
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada; Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada.
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Julião M. Letter to the Editor Regarding Barranha´s Paper: "Is There a Role for Psychiatry in Physician-Assisted Death in Portugal?". ACTA MEDICA PORT 2020; 33:779. [PMID: 33054932 DOI: 10.20344/amp.14853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
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Julião M, Costa E, Calaveiras P, Daniel S, de Sousa PF, Dias R. Treatment of Lower Extremity Edema by Controlled Subcutaneous Drainage at Home: A Case Report. Am J Hosp Palliat Care 2020; 38:1053-1056. [PMID: 32940545 DOI: 10.1177/1049909120960715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Lower severe edema is a common condition faced by advanced cancer patients with an impact on comfort, quality of life, and care planning. Diuresis and mechanical interventions are the mainstream options for the treatment of edema, but, although effective, may not be indicated for frail, bed-bound, and dependent patients cared for in the community setting.We present a case report of a young female with severe edema to her right lower limb, which accepted controlled subcutaneous fluid drainage at her home. Subcutaneous fluid drainage at home was effective, safe, and feasible and improved the patient's comfort and well-being.
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Elisabeth Costa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | | | - Sara Daniel
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | | | - Rute Dias
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
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Julião M. Administration of end-of-life drugs by family caregivers during covid-19: opportunity for future home prescribing plans. BMJ 2020; 369:m2408. [PMID: 32554622 DOI: 10.1136/bmj.m2408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, 2635-364 Rio de Mouro, Sintra, Portugal
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Julião M, Antunes B, Nunes B, Sobral MA, Chaves P, Runa D, Bruera E. Measuring Total Suffering and Will to Live in an Advanced Cancer Patient Using a Patient-Centered Outcome Measure: A Follow-Up Case Study. J Palliat Med 2020; 23:733-737. [DOI: 10.1089/jpm.2019.0137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
| | - Bárbara Antunes
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), University of Coimbra, Coimbra, Portugal
- Center for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- King's College London, Cicely Saunders Institute, London, United Kingdom
| | - Baltazar Nunes
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Maria Ana Sobral
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
| | - Petra Chaves
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
| | - Daniela Runa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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35
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Wu Y, Levis B, Sun Y, Krishnan A, He C, Riehm KE, Rice DB, Azar M, Yan XW, Neupane D, Bhandari PM, Imran M, Chiovitti MJ, Saadat N, Boruff JT, Cuijpers P, Gilbody S, McMillan D, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Henry M, Ismail Z, Loiselle CG, Mitchell ND, Tonelli M, Al-Adawi S, Beraldi A, Braeken APBM, Büel-Drabe N, Bunevicius A, Carter G, Chen CK, Cheung G, Clover K, Conroy RM, Cukor D, da Rocha E Silva CE, Dabscheck E, Daray FM, Douven E, Downing MG, Feinstein A, Ferentinos PP, Fischer FH, Flint AJ, Fujimori M, Gallagher P, Gandy M, Goebel S, Grassi L, Härter M, Jenewein J, Jetté N, Julião M, Kim JM, Kim SW, Kjærgaard M, Köhler S, Loosman WL, Löwe B, Martin-Santos R, Massardo L, Matsuoka Y, Mehnert A, Michopoulos I, Misery L, Navines R, O'Donnell ML, Öztürk A, Peceliuniene J, Pintor L, Ponsford JL, Quinn TJ, Reme SE, Reuter K, Rooney AG, Sánchez-González R, Schwarzbold ML, Senturk Cankorur V, Shaaban J, Sharpe L, Sharpe M, Simard S, Singer S, Stafford L, Stone J, Sultan S, Teixeira AL, Tiringer I, Turner A, Walker J, Walterfang M, Wang LJ, White J, Wong DK, Benedetti A, Thombs BD. Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale - Depression subscale scores: An individual participant data meta-analysis of 73 primary studies. J Psychosom Res 2020; 129:109892. [PMID: 31911325 DOI: 10.1016/j.jpsychores.2019.109892] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). METHODS Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed. We fit binomial generalized linear mixed models to compare odds of major depression classification for the Structured Clinical Interview for DSM (SCID), Composite International Diagnostic Interview (CIDI), and Mini International Neuropsychiatric Interview (MINI), controlling for HADS-D scores and participant characteristics with and without an interaction term between interview and HADS-D scores. RESULTS There were 15,856 participants (1942 [12%] with major depression) from 73 studies, including 15,335 (97%) non-psychiatric medical patients, 164 (1%) partners of medical patients, and 357 (2%) healthy adults. The MINI (27 studies, 7345 participants, 1066 major depression cases) classified participants as having major depression more often than the CIDI (10 studies, 3023 participants, 269 cases) (adjusted odds ratio [aOR] = 1.70 (0.84, 3.43)) and the semi-structured SCID (36 studies, 5488 participants, 607 cases) (aOR = 1.52 (1.01, 2.30)). The odds ratio for major depression classification with the CIDI was less likely to increase as HADS-D scores increased than for the SCID (interaction aOR = 0.92 (0.88, 0.96)). CONCLUSION Compared to the SCID, the MINI may diagnose more participants as having major depression, and the CIDI may be less responsive to symptom severity.
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Psychology, McGill University, Montréal, QC, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Xin Wei Yan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Pim Cuijpers
- EMGO Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - Dean McMillan
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - John P A Ioannidis
- Department of Clinical, Neuro and Developmental Psychology, Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA
| | | | - Scott B Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, AB, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute & O'Brien Institute for Public Health, Calgary, AB, Canada; Department of Psychiatry, Clinical Neuroscience and Community Health Sciences, University of Calgary, Calgary, AB, Canada; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Carmen G Loiselle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Ingram School of Nursing, McGill University, Montréal, QC, Canada; Centre for Nursing Research, Jewish General Hospital, Montréal, QC, Canada; Department of Oncology, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada; Alberta Health Services, Edmonton, AB, Canada
| | - Marcello Tonelli
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Oman, Oman
| | - Anna Beraldi
- Psychotherapie und Psychsomatik, kbo Lech-Mangfall-Klinik für Psychatrie, Garmisch-Partenkirchen, Bayern, Germany
| | - Anna P B M Braeken
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary, Maastricht University, Maastricht, the Netherlands
| | - Natalie Büel-Drabe
- Department of Psychiatry and Psychotherapy, University Hospital Zürich, Zürich, Switzerland
| | - Adomas Bunevicius
- Harvard University, Boston, MA, USA; Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gregory Carter
- University of Newcastle, Australia; Calvary Mater Newcastle, Australia
| | - Chih-Ken Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan; Department of Psychiatry, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Gary Cheung
- University of Auckland, Auckland, New Zealand
| | - Kerrie Clover
- Centre for Brain and Mental Health Research, University of Newcastle, NSW, Australia
| | - Ronán M Conroy
- Royal College of Surgeons in Ireland Division of Population Health Sciences, Dublin, Ireland
| | | | - Carlos E da Rocha E Silva
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eli Dabscheck
- The Alfred Hospital, Prahran, VIC, Australia; Monash University, Melbourne, Australia
| | - Federico M Daray
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Elles Douven
- Alzheimer Center Limburg and School for Mental Health and Neuroscience (MHeNs), Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Marina G Downing
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia
| | - Anthony Feinstein
- University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Panagiotis P Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece; Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Felix H Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alastair J Flint
- University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Maiko Fujimori
- Section of Psychological Science, Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Milena Gandy
- The Department of Psychology, Macquarie University, Sydney, Australia
| | - Simone Goebel
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Christian-Albrechts University, Kiel, Germany
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy; Psychiatric Unit, Integrated Department of Mental Health and Addictive Behavior, Health Trust, University Hospital, Ferrara, Italy
| | - Martin Härter
- Department of Medical Psychology, University of Hamburg, Hamburg, Germany
| | - Josef Jenewein
- Clinic Zugersee, Center for Psychiatry and Psychotherapie, Oberwil-Zug, Switzerland; University of Zurich, Zurich, Switzerland
| | - Nathalie Jetté
- Departments of Neurology and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal
| | - Jae-Min Kim
- Chonnam National University Medical School, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Republic of Korea
| | - Marie Kjærgaard
- Endocrinology Research Group, Medical Clinic, University Hospital of North Norway, Norway; Department of Internal Medicine, Kolding Hospital, Hospital Lillebaelt, Denmark
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Wim L Loosman
- Onze Lieve vrouw Gasthuis, Amsterdam, the Netherlands
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Loreto Massardo
- Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia, Universidad San Sebastián. Santiago, Chile
| | - Yutaka Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; Lifestyle Medicine, Cooperative Graduate Program, The Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - Ricard Navines
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | | | | | - Jurate Peceliuniene
- Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Luis Pintor
- Consultation Liaison Psychiatry Unit, Hospital Clínico de Barcelona, Barcelona, Spain; Instituto de Investigaciones Biomédicas Augusto Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jennie L Ponsford
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Monash Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, VIC, Australia
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Silje E Reme
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Katrin Reuter
- Private Practice for Psychotherapy and Psycho-oncology, Freiburg, Germany
| | - Alasdair G Rooney
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK; Robert Fergusson Unit, Royal Edinburgh Hospital, NHS Lothian, Edinburgh, UK
| | - Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Marcelo L Schwarzbold
- Department of Internal Medicine, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Juwita Shaaban
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | | | - Sébastien Simard
- Département des sciences de la santé, Université du Québec à Chicoutimi (UQAC), QC, Canada; Centre intersectoriel en santé durable (CISD), QC, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), QC, Canada
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Jon Stone
- University of Edinburgh, Edinburgh, UK
| | - Serge Sultan
- Université de Montréal, QC, Canada; CHU Sainte-Justine, Montréal, QC, Canada
| | - Antonio L Teixeira
- University of Texas Health Science Center at Houston, Houston, TX, USA; Santa Casa BH Ensino & Pesquisa, Belo Horizonte, Brazil
| | - Istvan Tiringer
- Institute of Behavioral Sciences, Pécs University, Medical School, Pécs, Hungary
| | - Alyna Turner
- IMPACT Strategic Research Centre and School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; Faculty of Health and Medicine, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | | | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia; Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | | | - Dana K Wong
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada; Department of Medicine, McGill University, Montréal, QC, Canada.
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada; Department of Psychology, McGill University, Montréal, QC, Canada; Department of Medicine, McGill University, Montréal, QC, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.
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Sobral MA, Runa D, Julião M. Letter to the Editor: Clinical Signs of Impending Death, A Retrospective Descriptive Analysis. ACTA MEDICA PORT 2019; 32:789. [PMID: 31851890 DOI: 10.20344/amp.12737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/22/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Maria Ana Sobral
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
| | - Daniela Runa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
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Julião M. The Use of Dignity Therapy Beyond Terminal Illness: A Case Report. Psychosomatics 2019; 60:101. [DOI: 10.1016/j.psym.2018.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/30/2022]
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Clemons M, Mazzarello S, Pond G, Amir E, Asmis T, Berry S, Brackstone M, Brule S, Goodwin R, Hilton JF, Julião M, Nicholas G, Stewart DJ, Wheatley-Price P, Cholmsky L, Krentel A, Hutton B, Joy AA. A prospective intervention to improve happiness and reduce burnout in oncologists. Support Care Cancer 2018; 27:1563-1572. [PMID: 30506102 DOI: 10.1007/s00520-018-4567-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 11/20/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is a paucity of data about effective interventions to improve happiness and reduce burnout in oncologists. Benjamin Franklin developed a 13-week program of "necessary activities" or "virtues" (temperance, silence, order, resolution, frugality, industry, sincerity, justice, moderation, cleanliness, tranquility, chastity, and humility) to follow, in his attempt at self-improvement. In this pilot study, we explored whether using a modified version of this was associated with any discernable impact on physician happiness, burnout, or compliance with each of the virtues. METHODS Self-reported happiness (Oxford happiness scores) and burnout (Abbreviated Maslach Burnout Inventory) were completed at baseline (pre-study), week 13, and 1 month after completion of the program. Each day during the 13-week program, oncologists were emailed a list of virtues to focus on and scored how they felt they were complying with them. The oncologist's spouses also assessed how they felt the oncologist was complying with the virtues. RESULTS Thirteen physicians completed the baseline scores, 11 completed Maslach/Oxford scores at the end of the study, and 8 the 1-month post-study assessment. No significant improvements in happiness and burnout (emotional exhaustion, depersonalization, personal accomplishment) scores were observed. Statistically significant changes in self-rated virtue scores were observed for temperance (p = 0.046), order (p = 0.049), and resolution (p = 0.014). Additionally, although not reaching statistical significance, 11 of 13 virtues (excepting sincerity and chastity) assessed by spouses indicated a positive change over time. CONCLUSION In this hypothesis generating study, daily reflection on personal virtues was not associated with any statistically significant change in happiness or burnout scores. Alternative strategies should be considered.
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Affiliation(s)
- Mark Clemons
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada.
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada.
| | - Sasha Mazzarello
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Gregory Pond
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - Eitan Amir
- Princess Margaret Cancer Centre, Toronto, Canada
| | - Timothy Asmis
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - Scott Berry
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Canada
| | | | - Stephanie Brule
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
| | - Rachel Goodwin
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
| | - John F Hilton
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos ACES Sintra, Sintra, Portugal
| | - Garth Nicholas
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
| | - David J Stewart
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - Paul Wheatley-Price
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Box 912, Ottawa, ON, K1H 8L6, Canada
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - Laurel Cholmsky
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | | | - Brian Hutton
- Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Anil A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Canada
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Rocha É, Sousa P, António N, Medeiros S, Julião M. [Letter to the Editor: The Concept of Dignity in Non-institutionalized Elderly People Cared for in Primary Health Care: A Preliminary Empirical Model]. ACTA MEDICA PORT 2018; 31:441-442. [PMID: 30189175 DOI: 10.20344/amp.10943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/02/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Érica Rocha
- Unidade de Saúde Familiar AlphaMouro. Rio de Mouro. Portugal
| | - Paulo Sousa
- Unidade de Saúde Familiar AlphaMouro. Rio de Mouro. Faculty of Medicine. University of Lisbon. Lisboa. Portugal
| | - Nuno António
- ISCTE - Instituto Universitário de Lisboa. Lisboa. Portugal
| | - Susana Medeiros
- Unidade de Saúde Familiar AlphaMouro. Rio de Mouro. Portugal
| | - Miguel Julião
- Life and Health Sciences Research Institute (ICVS). School of Medicine. University of Minho. Braga. ICVS/3B's. Portuguese Government Associate Laboratory. Braga/Guimarães. School of Medicine. University of Minho. Braga. Portugal
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Lemos Caldas M, Julião M. The Use of the Patient Dignity Question in Palliative Patients Cared for in the Primary Care Setting: Preliminary Results. J Palliat Med 2018; 21:1062-1063. [PMID: 30133364 DOI: 10.1089/jpm.2018.0115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mafalda Lemos Caldas
- 1 USF Travessa da Saúde , ACES Loures Odivelas, Sacavém, Portugal .,2 Faculdade de Medicina da Universidade de Lisboa , Lisboa, Portugal
| | - Miguel Julião
- 3 Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho , Braga, Portugal .,4 ICVS/3B's, PT Government Associate Laboratory , Guimarães, Portugal
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Julião M, Courelas C, Costa MJ, Correia Santos N, Fareleira F, Antunes B, Magalhães S, Faria de Sousa P, Chochinov HM. The Portuguese versions of the This Is ME Questionnaire and the Patient Dignity Question: tools for understanding and supporting personhood in clinical care. Ann Palliat Med 2018; 7:S187-S195. [PMID: 29860855 DOI: 10.21037/apm.2018.04.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/13/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Modern medicine can be impersonal and routinized, paying insufficient attention to issues of personhood. The Patient Dignity Question (PDQ) and This Is ME (TIME) Questionnaire are clinical tools developed with the aim of probing for personhood, reinforcing dignity and promoting health care attitudes based on looking at people for who they are and not defining them solely based on their medical condition. This study aimed to translate and validate the TIME Questionnaire and the PDQ into European Portuguese, coined as Questionário Este Sou EU (ESEU) and Pergunta da Dignidade (PD), respectively. METHODS A three-stage research design, namely: a forward and back translation process (which included an expert committee panel), collected data on a sample of 43 non-institutionalized active elderly for the validation stage and a final expert panel consultation. Inclusion criteria: being 50 years old or older; ability to provide written informed consent; ability to read, speak and understand Portuguese. RESULTS The original TIME authors fully endorsed the back translated version. A Portuguese version was created. Forty-three participants (response rate of 62%) were included, 53% of whom were male. The average age was 69 years old (range, 60-80 years old). The interviewed elderly strongly felt that the ESEU's summary captured their essence as a person beyond whatever health problems they might be experiencing (6.8, SD =0.48), heightened their sense of dignity (6.1, SD =1.48), considered important that health care professionals (HCPs) have access to ESEU´s summary (6.6, SD =0.73) and that this information could affect the way HCPs see and care for them (6.4, SD =0.86), rated on a Likert scale: 1 "strongly disagree"-7 "strongly agree". According to the experts' evaluations, the translated ESEU Questionnaire was clear, precise, comprehensible and captured important dimensions of personhood. CONCLUSIONS The Questionário ESEU and the PD are clear, precise, comprehensible and well-aligned in terms of measuring aspects of personhood. This measure could add additional value to the patient-healthcare provider relationship, allowing a new perspective on how healthcare professionals perceive patients in suffering, ensuring they acknowledge not just patienthood, but critical dimensions of personhood.
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Affiliation(s)
- Miguel Julião
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal.
| | - Carla Courelas
- School of Medicine, University of Minho, Braga, Portugal
| | - Manuel João Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal; Clinical Academic Center-Braga (CCAB), Braga, Portugal
| | - Filipa Fareleira
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Faculty of Medicine, University of Porto, Portugal; Faculty of Medicine, University of Porto, Portugal
| | - Bárbara Antunes
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Faculty of Medicine, University of Porto, Portugal; Faculty of Medicine, University of Porto, Portugal; Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Portugal; Department of Midwifery and Palliative Care, Florence Nightingale School of Nursing, King's College London, London, UK
| | - Susana Magalhães
- Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal; Universidade Fernando Pessoa, Porto, Portugal
| | - Paulo Faria de Sousa
- Unidade de Saúde Familiar AlphaMouro, Rio de Mouro, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal
| | - Harvey Max Chochinov
- Department of Psychiatry, Manitoba Palliative Care Research Unit, Cancer Care Manitoba, Manitoba, Canada
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Faria de Sousa P, Julião M, Rodrigues AP, Nunes B. Accuracy of the Surprise Question on Patients with Advanced Chronic Disease in the Primary Care Setting: Preliminary Results. J Palliat Med 2018. [DOI: 10.1089/jpm.2017.0624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paulo Faria de Sousa
- Unidade de Saúde Familiar AlphaMouro, Rio de Mouro, Portugal
- Faculty of Medicine, University of Lisbon, Lisboa, Portugal
| | - Miguel Julião
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
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43
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Affiliation(s)
- Miguel Julião
- Escola de Medicina da Universidade do Minho , Braga, Portugal
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Affiliation(s)
- Paulo Faria de Sousa
- Unidade de Saúde Familiar AlphaMouro, Rio de Mouro, Portugal
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Miguel Julião
- School of Medicine, University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal
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Affiliation(s)
- Miguel Julião
- 1 Faculty of Medicine of the University of Lisbon , Lisbon, Portugal .,2 Hospital da Universidade Fernando Pessoa , Gondomar, Portugal
| | - Isabel Cunha
- 2 Hospital da Universidade Fernando Pessoa , Gondomar, Portugal
| | - Ana Costa
- 2 Hospital da Universidade Fernando Pessoa , Gondomar, Portugal
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Giestas S, Casela A, Agostinho C, Souto P, Camacho E, Julião M, Cipriano MA, Sofia C. Skin Metastases: The Visible Face of a Disastrous Unusual Finding. GE Port J Gastroenterol 2016; 23:282-284. [PMID: 28868479 PMCID: PMC5580018 DOI: 10.1016/j.jpge.2015.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 12/02/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Sílvia Giestas
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Adriano Casela
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Cláudia Agostinho
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Paulo Souto
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ernestina Camacho
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Julião
- Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Carlos Sofia
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Julião M, Nunes B, Barbosa A. Dignity therapy and its effect on the survival of terminally ill Portuguese patients. Psychother Psychosom 2015; 84:57-8. [PMID: 25547879 DOI: 10.1159/000366207] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 07/24/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Miguel Julião
- Center of Bioethics, University of Lisbon, Lisbon, Portugal
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Julião M, Oliveira F, Nunes B, Vaz Carneiro A, Barbosa A. Efficacy of Dignity Therapy on Depression and Anxiety in Portuguese Terminally Ill Patients: A Phase II Randomized Controlled Trial. J Palliat Med 2014; 17:688-95. [DOI: 10.1089/jpm.2013.0567] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Miguel Julião
- Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal
- Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal
- Departmentof Palliative Medicine, Casa de Saúde da Idanha, Belas, Portugal
- Palliative Medicine and Home-Based Hospitalization Unit, Centro Clínico Champalimaud, Champalimaud Centre for the Unknown, Lisboa, Portugal
| | - Fátima Oliveira
- Department of Palliative Medicine, Casa de Saúde da Idanha, Belas, Portugal
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Dr. Ricardo Jorge, Lisboa, Portugal
| | - António Vaz Carneiro
- Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal
| | - António Barbosa
- Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal
- Department of Psychiatry, Hospital de Santa Maria, Lisboa, Portugal
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Julião M, Oliveira F, Nunes B, Barbosa A. Time and Life Perception in the Terminally Ill: Its Utility in Screening for Depression. J Palliat Med 2013; 16:1433-7. [DOI: 10.1089/jpm.2013.0149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Miguel Julião
- Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal
- Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal
- Department of Palliative Medicine – IIHSCJ – Casa de Saúde da Idanha, Belas, Portugal
- Centro Clínico Champalimaud - Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Fátima Oliveira
- Department of Palliative Medicine – IIHSCJ – Casa de Saúde da Idanha, Belas, Portugal
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - António Barbosa
- Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal
- Department of Psychiatry, Hospital de Santa Maria, Lisbon, Portugal
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