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Article ; Online: Use and safety of peripherally inserted central catheters and midline catheters in palliative care cancer patients: a retrospective review.

Gravdahl, Eva / Steine, Siri / Augestad, Knut Magne / Fredheim, Olav Magnus

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2023 Volume 31, Issue 10, Page(s) 580

Abstract: Purpose: Some cancer patients in palliative care require intravenous administration of symptom relieving drugs. Peripherally inserted central catheters (PICCs) and midline catheters (MCs) provide easy and accessible intravenous access. However, limited ... ...

Abstract	Purpose: Some cancer patients in palliative care require intravenous administration of symptom relieving drugs. Peripherally inserted central catheters (PICCs) and midline catheters (MCs) provide easy and accessible intravenous access. However, limited evidence supports the use of these devices in palliative care. The aim was to assess the use, safety, and efficacy of PICC and MC in this patient population. Methods: A retrospective study of all palliative care cancer patients who received PICC or MC at the Department of Palliative Medicine at Akershus University Hospital between 2020 and 2022. Results: A total of 374 patients were included; 239 patients received a PICC and 135 an MC with a total catheterization duration of 11,698 days. The catheters remained in place until death in 91% of patients, with a median catheter dwell time of 21 days for PICCs and 2 days for MCs. The complication rate was 3.3 per 1000 catheter days, with minor bleeding and accidental dislocation as the most common. The catheters were utilized primarily for opioids and other symptom directed treatments, and 89% of patients received a patient or nurse-controlled analgesia pump. Patients with PICC or MC discharged to home or nursing homes spent 81% of their time out of hospital. Conclusion: PICC and MC provide safe parenteral access for palliative care cancer patients where intravenous symptom treatment is indicated. Their use can facilitate intravenous symptom treatment beyond the confines of a hospital and supplement the traditional practice relying on subcutaneous administration.
MeSH term(s)	Humans ; Retrospective Studies ; Palliative Care ; Catheters ; Pain Management ; Hospitals, University ; Neoplasms/drug therapy
Language	English
Publishing date	2023-09-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-023-08045-2
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Article ; Online: "Do not resuscitate" order and end-of-life treatment in a cohort of deceased in a Norwegian University Hospital.

van der Werff, Hans F L / Michelet, Torstein H / Fredheim, Olav M / Steine, Siri

Acta anaesthesiologica Scandinavica

2022 Volume 66, Issue 8, Page(s) 1009–1015

Abstract: Background: A "Do not resuscitate" (DNR) order implies that cardiopulmonary resuscitation will not be started. Absent or delayed DNR orders in advanced chronic disease may indicate suboptimal communication about disease stage, prognosis, and treatment ... ...

Abstract	Background: A "Do not resuscitate" (DNR) order implies that cardiopulmonary resuscitation will not be started. Absent or delayed DNR orders in advanced chronic disease may indicate suboptimal communication about disease stage, prognosis, and treatment goals. The study objective was to determine clinical practice and patient involvement regarding DNR and the prevalence of life-prolonging treatment in the last week of life. Methods: A cross-sectional observational study was made of a cohort of 315 deceased from a large general hospital in Norway. Data on DNR and other treatment limitations, life-prolonging treatment in the last week of life, and cause of death were obtained from medical records. Results: A DNR order was documented for 287 (91%) patients. Almost half the DNR orders, 142 (49%), were made during the last 7 days of life. The main causes of death were cancer (31%), infectious diseases (31%), and cardiovascular diseases (19%). The most frequent life-prolonging treatments during the last week of life were intravenous fluids in 221 patients (70%) and antibiotics in 198 (63%). During the last week of life, 103 (36%) patients received ICU treatment. Death by cancer (odds ratio 2.5, 95% confidence interval 1.24-5.65) and DNR decision made by a palliative care physician (odds ratio 3.4, 95% CI 1.21-3.88) were predictors of not receiving life-prolonging treatment. Conclusion: The findings of a high prevalence of life-prolonging treatment in the last week of life and DNR orders being made close to the time of death indicate that decisions about limiting life-prolonging treatment are often postponed until the patient's death is imminent.
MeSH term(s)	Cross-Sectional Studies ; Death ; Hospitals, University ; Humans ; Neoplasms/therapy ; Resuscitation Orders ; Retrospective Studies
Language	English
Publishing date	2022-07-14
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	80002-8
ISSN	1399-6576 ; 0001-5172
ISSN (online)	1399-6576
ISSN	0001-5172
DOI	10.1111/aas.14104
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Article ; Online: Clinical and ethical aspects of palliative sedation with propofol-A retrospective quantitative and qualitative study.

Fredheim, Olav M / Skulberg, Ingeborg M / Magelssen, Morten / Steine, Siri

Acta anaesthesiologica Scandinavica

2020 Volume 64, Issue 9, Page(s) 1319–1326

Abstract: Background: The anesthetic propofol is often mentioned as a drug that can be used in palliative sedation. The existing literature of how to use propofol in palliative sedation is scarce, with lack of information about how propofol could be initiated for ...

Abstract	Background: The anesthetic propofol is often mentioned as a drug that can be used in palliative sedation. The existing literature of how to use propofol in palliative sedation is scarce, with lack of information about how propofol could be initiated for palliative sedation, doses and treatment outcomes. Aim: To describe the patient population, previous and concomitant medication, and clinical outcome when propofol was used for palliative sedation. Methods: A retrospective study with quantitative and qualitative data. All patients who during a 4.5-year period received propofol for palliative sedation at the Department of palliative medicine, Akershus University Hospital, Norway were included. Results: Fourteen patients were included. In six patients the main indication for palliative sedation was pain, in seven dyspnoea and in one delirium. In eight of these cases propofol was chosen because of the pharmacokinetic properties (rapid effect), and in the remaining cases propofol was chosen because midazolam in spite of dose titration failed to provide sufficient symptom relief. In all patients sedation and adequate symptom control was achieved during manual dose titration. During the maintenance phase three of 14 patients had spontaneous awakenings. At death, propofol doses ranged from 60 to 340 mg/hour. Conclusions: Severe suffering at the end of life can be successfully treated with propofol for palliative sedation. This can be performed in palliative medicine wards, but skilled observation and dose titration throughout the period of palliative sedation is necessary. Successful initial sedation does not guarantee uninterrupted sedation until death. Editorial comment: In palliative care, some patients at the end of life can reach a stage where there have been maximal analgesic and or anxiolytic treatments though without achieving comfort in the awake state. This report describes and discusses use of propofol in these infrequent cases to relieve suffering as part of palliative care.
MeSH term(s)	Conscious Sedation ; Humans ; Hypnotics and Sedatives ; Midazolam ; Palliative Care ; Propofol ; Retrospective Studies
Chemical Substances	Hypnotics and Sedatives ; Midazolam (R60L0SM5BC) ; Propofol (YI7VU623SF)
Language	English
Publishing date	2020-07-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80002-8
ISSN	1399-6576 ; 0001-5172
ISSN (online)	1399-6576
ISSN	0001-5172
DOI	10.1111/aas.13665
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Article ; Online: Palliative treatment of patients with COVID-19.

Brenne, Anne-Tove / Nordbø, Arve / Steine, Siri / Fasting, Anne / Berglund, Maren Anne / Røynstrand, Endre / Hjorth, Nina E

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2020 Volume 140, Issue 7

Title translation	Palliativ behandling av pasienter med covid-19.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Palliative Care ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	Norwegian
Publishing date	2020-04-03
Publishing country	Norway
Document type	Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.20.0276
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Article: Palliativ behandling av pasienter med covid-19

Brenne, Anne-Tove / Nordbø, Arve / Steine, Siri / Fasting, Anne / Berglund, Maren Anne / Røynstrand, Endre / Hjorth, Nina E

Tidsskr. nor. laegeforen.

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #209827
Database	COVID19

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Article ; Online: Seponering av B-preparater--hvordan opplever brukerne det?

Torper, Johan / Steine, Siri

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2004 Volume 124, Issue 18, Page(s) 2342–2344

Abstract: Background: The prescription of addictive drugs has been a cause for concern. Various small-scale interventions towards patients and doctors have proven effective in terms of cutting down the number of prescriptions. However, little is known about users' ...

Title translation	Withdrawal of addictive drugs--patients' experiences?.
Abstract	Background: The prescription of addictive drugs has been a cause for concern. Various small-scale interventions towards patients and doctors have proven effective in terms of cutting down the number of prescriptions. However, little is known about users' experience with withdrawal of addictive drugs; exploring this is the main aim of the present study. Material and method: Six focus group sessions with 27 former high and low dosage drug users, mainly of benzodiazepines, were conducted. All groups were audiotaped and analysed by qualitative methods. Results and interpretation: Five distinct themes emerged: reasons for drug use initiation, experience of being a user, experience related to drug withdrawal, of leading a life without medication, and experience with and expectations from doctors. Our group members pointed out that drug use was often initiated by the doctor and offered instead of counselling in acute crises. Information on side effects such as addictiveness was reported as largely absent. Both high and low dosage users reported a significant increase in self esteem and ability to cope that was directly related to drug withdrawal and they reported a substantially improved quality of life. Doctors seldom initiated drug reduction strategies and were largely regarded as absent during the withdrawal process. Our informants wanted better care, information and ability to communicate from their doctors, but also stricter prescription strategies and systematic control mechanisms.
MeSH term(s)	Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Anti-Anxiety Agents/administration & dosage ; Anti-Anxiety Agents/adverse effects ; Benzodiazepines/administration & dosage ; Benzodiazepines/adverse effects ; Codeine/administration & dosage ; Codeine/adverse effects ; Crisis Intervention ; Drug Prescriptions ; Female ; Focus Groups ; Humans ; Male ; Practice Patterns, Physicians' ; Quality of Life ; Substance Withdrawal Syndrome/etiology ; Surveys and Questionnaires
Chemical Substances	Analgesics, Opioid ; Anti-Anxiety Agents ; Benzodiazepines (12794-10-4) ; Codeine (Q830PW7520)
Language	Norwegian
Publishing date	2004-09-23
Publishing country	Norway
Document type	English Abstract ; Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
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Zs.B 422: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 546: Show issues

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Book ; Thesis: The use of double-contrast barium enema in an outpatient clinic

Steine, Siri

referrals, diagnostic outcome, and patients' experiences of pain

1993

Author's details	by Siri Steine
Language	Undetermined
Size	58 S
Publishing place	Oslo
Document type	Book ; Thesis
Thesis / German Habilitation thesis	@Oslo, Univ., Diss. : 1994
Accompanying material	6 Sonderdr.
ISBN	8277030053 ; 9788277030050
Database	Former special subject collection: coastal and deep sea fishing

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Article: The final version of the Patient Perspective Survey (PPS): a new tool to improve consultation outcome and patient participation in general practice patients with complex health problems. Doctors' and patients' evaluation and guidelines for clinical use.

Laerum, Even / Steine, Siri / Finckenhagen, Morten / Finset, Arnstein

Family practice

2002 Volume 19, Issue 3, Page(s) 264–271

Abstract: Background: The Patient Perspective Survey (PPS) is a new clinical communication tool designed to stimulate patient involvement in the management of complex health problems in general practice and to improve patient and doctor satisfaction with the ... ...

Abstract	Background: The Patient Perspective Survey (PPS) is a new clinical communication tool designed to stimulate patient involvement in the management of complex health problems in general practice and to improve patient and doctor satisfaction with the consultation. The development of this final 38-item version of the PPS has been described elsewhere. Objective: The aims of this article are to present recommendations for clinical use and how GPs and patients have evaluated this new tool. Methods: The study material included 159 patients (78% females) with a mean age of 45 years, mainly presenting with longstanding musculoskeletal and psychosocial disorders, selected by 32 GPs. After the PPS-based consultation, both doctor and patient were asked to fill in evaluation forms. Results: In as many as 55-85% of the consultations' various aspects, it was perceived by the GPs that the use of the survey helped (to some extent, much or very much) in achieving improved clinical communication and a constructive consultation. The most important elements appeared to be stimulation of positive interaction/processes and obtaining new and relevant information. Similar results were found regarding patient evaluation. There was significantly more positive doctor evaluation if the doctor-patient relationship had lasted less than 1 year, and if the patient agreed to prepare a 'plan of action' for a follow-up consultation. Guidelines for clinical use are presented. Conclusion: We now regard the PPS to be completed for daily clinical use and believe that it has been shown to be a potent tool to improve consultation outcome in the large and challenging group of patients with complex health problems in general practice.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Family Practice/methods ; Female ; Humans ; Male ; Medical History Taking/methods ; Middle Aged ; Patient Participation/methods ; Patient-Centered Care/methods ; Physician-Patient Relations ; Surveys and Questionnaires
Language	English
Publishing date	2002-06
Publishing country	England
Document type	Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605939-9
ISSN	1460-2229 ; 0263-2136
ISSN (online)	1460-2229
ISSN	0263-2136
DOI	10.1093/fampra/19.3.264
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Zs.A 2021: Show issues

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Article ; Online: En polarekspedisjon i motbør--opplevelser og psykiske reaksjoner.

Steine, Siri / Steine, Kjetil / Sandbaek, Gunnar / Røseth, Arne G

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2003 Volume 123, Issue 24, Page(s) 3524–3528

Abstract: Four men, in the company of 16 dogs, skied for five weeks from Gåsefjord to Ellef Ringnes Land, North Canada. The expedition met with considerable unforeseen challenges such as extreme and prolonged cold, unmotivated Greenland dogs, and much pack ice. ... ...

Title translation	A polar expedition in challenging circumstances--experiences and psychological reactions.
Abstract	Four men, in the company of 16 dogs, skied for five weeks from Gåsefjord to Ellef Ringnes Land, North Canada. The expedition met with considerable unforeseen challenges such as extreme and prolonged cold, unmotivated Greenland dogs, and much pack ice. Psychological reactions were described and measured by a qualitative free text analysis and a test battery including GHQ-30 (General Health Questionnaire) and STAI State (State-Trait Anxiety Inventory) before, during, and after the expedition. Five main themes were found: external influences, relations between men and animals, progress and expectations, interpersonal relations, and thoughts at the end of the expedition. Negative emotional reactions were mostly present at the beginning of the expedition and were related to the environment and the pressure of perceived expectations from the outside world. Frustrations were enhanced by forced inactivity. Perceived essential positive elements were a strong group identity and friendship. The acceptance of dissension was low; the group strived to achieve consensus before decisions were made. The psychometric results showed more stress and anxiety immediately before the expedition than after. These parameters also increased significantly at the beginning of the expedition, then there was a reverse. The level of anxiety was higher in the two leaders. The expedition was concluded in an overall atmosphere of mutual affection, satisfaction, and pride.
MeSH term(s)	Adult ; Animals ; Anxiety/diagnosis ; Arctic Regions ; Bonding, Human-Pet ; Cold Climate ; Dogs ; Expeditions ; Health Status ; Humans ; Interpersonal Relations ; Male ; Mental Health ; Middle Aged ; Northwest Territories ; Psychiatric Status Rating Scales ; Psychometrics ; Stress, Psychological ; Surveys and Questionnaires
Language	Norwegian
Publishing date	2003-12-23
Publishing country	Norway
Document type	English Abstract ; Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.B 422: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 546: Show issues

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