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Biomedical subjects

B Livesley

Publications and source records attributed to B Livesley.

At least 19 recordsLinked to original sources
PubMed2001

The need for palliative care for patients with non-cancer diseases: a review of the evidence.

The palliative care needs of patients with cancer are understood and managed well by specialist palliative care services. Patients dying of non-cancer diseases are rarely offered these services. A literature review was conducted to determine the physical and psychosocial problems of patients dying from non-cancer diseases. Studies were identified using a systematic keyword search of six electronic databases. Fourteen studies were identified and assessed according to rigour of design. Findings suggest that some patients dying of non-cancer have needs comparable with those dying of cancer. Low response rates, subject bias, and measurement bias mean that findings should be viewed with caution. More prospective, rigorously designed research is necessary to identify which patients with non-cancer diagnoses may benefit from specialist palliative care.

Health Services Needs and Demand↗
PubMed1988

Newly registered elderly patients: who are they and why such delay in the transfer of their medical records?

The time taken to transfer the records of elderly patients registering with a new general practice was investigated. Thirty five (5%) of a total of 671 patients aged 75 and over were entered as new patients on to the age-sex register of an urban group practice during one year. Twenty nine had moved into the area and six had changed their general practitioner for personal and other reasons. An average of 141 (range 71-296) days elapsed before dispatch of their medical records to the new practice. During this period an average of 3.5 (range 0-15) consultations with a general practitioner were recorded, indicating the need of such patients for medical care. The long delays were caused by the processing of medical records at the central register and the transfer of records between family practitioner committees and general practitioners. Delays were most apparent in the time taken for general practitioners to dispatch the necessary documents to the family practitioner committees, and these should be minimised. The use of a summary card written and updated by the general practitioner and retained by the patient would facilitate continuing care should patients change to a new practice. Meanwhile, assessment of elderly patients after registration with a new practice by a member of the primary health care team may identify problems before the records have been transferred and may help the resettlement of these high risk elderly patients.

Aged↗
PubMed1986

Changes in the population aged over 75 of an urban general practice: implications for screening.

In an urban group practice of six principals 545 (4.2%) of 13 100 patients were over 75 years of age. Although 54 of these patients died during one year, there were 72 "urban migrants" (42 removed from the district and were replaced by 30 new registrations) and 58 age transfers within the age-sex register. Although urban migrants who were aged over 75 and over 85 represented only a small percentage (0.6% and 0.1% respectively) of the total practice population, they accounted for 12.8% and 14.9% of their respective age groups. There may be delays of up to three months before such patients are routinely registered with new practices. Thus a potentially hidden and appreciably vulnerable section of the aged population who are likely to require crisis intervention has been identified. This may explain previous conflicting views about the value of health screening programmes in the elderly.

Aged↗
PubMed1984

Doctor to doctor.

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Communication↗
PubMed1984

Beware of burnout.

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Burnout, Professional↗
PubMed1983

Dying as a diagnosis: difficulties of communication and management in elderly patients.

91 responses to a standard interview from medical and nursing staff who had cared for 24 elderly patients who died were assessed to determine whether staff and patients knew that dying was part of the diagnosis. 45% of respondents had concluded that their patients knew the clinical diagnosis and 42% that their patients knew death was imminent. Only 18% of respondents had discussed the diagnosis with patients and only 14% had discussed impending death. Other means of communication contributed to the staff's awareness of the patient's knowledge of diagnosis in a further 27% and of impending death in 29%. The needs of 13 of 14 alert dying patients were not adequately appreciated by the staff. Failure of medical and nursing staff to pool perceptions of patients' difficulties may contribute to the inappropriate care of patients dying in hospital and the stress experienced by staff after patients die.

Aged↗