Claud Regnard’s research while affiliated with The Newcastle upon Tyne Hospitals NHS Foundation Trust and other places

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Publications (29)


Handling difficult questions in palliative care-a flow diagram
  • Article
  • Publisher preview available

July 1994

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79 Reads

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12 Citations

Ann Faulkner

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Claud Regnard

Patients with advanced disease ask many difficult questions, some of which have painful answers, some of which have answers which contain uncertainty, and some of which have no answers. They should be able to ask their questions in an environment that allows them to disclose their true worries, have the opportunity to talk them through, and look for options. Health professionals need to develop the relevant skills to help patients and their families to disclose and discuss difficult issues, while handling their own emotions.

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Breaking bad news - A flow diagram

February 1994

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55 Reads

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65 Citations

Breaking bad news is neither an easy nor a popular task. Properly handled, however, it can be given in a positive way that the individual can both accept and understand. There may be a range of emotions and concerns following the telling of bad news. These need to be explored and worked through with each individual. This flow diagram describes the steps in this important process.


Dealing with anger in a patient or relative: a flow diagram

January 1994

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48 Reads

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12 Citations

Anger from any cause can block effective interaction between the patient and the carer. It has many possible causes, which may be rational, irrational (i.e. inappropriate or misdirected) or pathological. This flow diagram suggests strategies for handling anger in patients with advanced disease.



Eliciting the current problems of the patient with cancer - a flow diagram

April 1993

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11 Reads

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15 Citations

The assessment of a patient is an integral part of clinical management. It should be conducted in a way which maximizes the likelihood of patients disclosing all their main problems, whether physical, social or psychological in nature. Unfortunately, professional carers can be uncertain of their ability to do this. This flow diagram leads the carer through key points in the assessment interview.


Managing the anxious patient with advancing disease- a flow diagram

February 1993

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13 Reads

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29 Citations

Anxiety can be one aspect of the psychological reaction to cancer and may be present at a clinical level. It can hinder or even prevent the diagnosis and management of other problems and when it develops into an anxiety state it can be disabling. This flow diagram describes the key clinical decisions involved in diagnosing and helping a patient troubled with anxiety.


Handling the withdrawn patient--a flow diagram

February 1993

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77 Reads

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2 Citations

Palliative Medicine

The withdrawn patient challenges effective communication. Some patients are naturally introverted or quiet, but for others the withdrawal represents a change with many possible causes. This flow diagram describes the approach to a withdrawn patient and outlines management.


Managing family problems in advanced disease-a flow diagram

January 1993

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6 Reads

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5 Citations

The interaction between patient, family and professional team can sometimes make difficult situations worse rather than better. This flow diagram attempts to clarify the process by which a professional assesses situations and suggests ways in which people can gain understanding about their difficulties. Once everyone has a greater understanding of what is or is not happening, the diagram points to ways in which professionals can use questions to help patient and family create a solution that is workable both for them and for the professionals.




Citations (13)


... Refusal of food and fluid by a dying person is a common occurrence, particularly as the body slowly shuts down, and this may be the evidence signifying an actively dying process rather than starvation (Ijaopo & Ijaopo, 2019). Previous studies have argued that dehydration is not distressing, rather, may provide comfort to the dying patient in reducing death rattle (Regnard & Mannix, 1991). One recently published multicenter prospective observational study showed that giving a dying person a higher amount of fluids, in excess of 250 mL/ day, during 48 to 25 hr before death may be associated with the occurrence of terminal restlessness in the last 24 hr of life (Lokker et al., 2021). ...

Reference:

A Review of Clinical Signs and Symptoms of Imminent End-of-Life in Individuals With Advanced Illness
Reduced Hydration or Feeding in Advanced Disease — a Flow Diagram

... Finally Occasionally, very severe anxiety can masquerade as depression or so called 'frozen terror'.3 3 Reduced concentration in the absence of anxiety, ambivalence, communication problems, or social problems may be due to distraction by physical symptoms such as pain, depression, or to another psychiatric illness. The latter may need referral for advice regarding management and treatment. ...

Terror or depression? A case report
  • Citing Article
  • October 1990

... In the oropharynx, lesions are susceptible to mouthwashes (tranexamic acid or sucralfate) [26][27][28][29], while nebulisations can be used for less accessible lesions (adrenaline) [30]. Therapeutic options for inaccessible lesions are limited to systemic tranexamic acid [31]. ...

Management of bleeding in advanced cancer - a flow diagram

... There are no conclusive data showing which NSAID is more effective and neither the proper dose nor route of administration have been established (Brooks and O'Day, 1991; De Conno et al., 1993 ). The specific usefulness in bony pain has not been addressed appropriately, as results of controlled clinical trials of NSAIDs in cancer bone pain are not reported separately from pain which is not of bony origin and there is no clear evidence that the majority of patients with bone metastatic pain benefit from these drugs (Thompson and Regnard, 1992; Eisenberg et al., 1994). The chances of good pain control until death were high and the negative influence of incidental pain was less when patients achieved a good response using NSAIDs, according to an individual variability in response to analgesics (Mercadante et al., 1992 ). Whereas long-acting NSAIDs facilitating once or twice-daily dosing should be favored in patients already taking multiple drugs, rescue doses of particular formulations (fast release, sublingually or parenterally) of NSAIDs may be useful in controlling incidental pain when side-effects from opioids administered as needed can be expected once the breakthrough pain disappears (Mercadante, 1991; see below). ...

Managing pain in advanced cancer - a flow diagram

... Different etiologies have been recognized and some patients may have more than one cause. 1 Causes of nausea and vomiting include gastrointestinal motility disorders, metabolic derangement, raised intracranial pressure, chemotherapy and radiotherapy, psychosomatic factors, and drugs. The opioids, which are used extensively in advanced cancer patients with pain, 2 may be an important cause in some patients. ...

Nausea and vomiting in advanced cancer-a flow diagram

... Despite the Act and although numerous reviews have reported that there is no evidence that opioids accelerate deaths [6][7][8][9][10][11], many medical practitioners are affected by the misconceived correlation between using opioids for relieving patients' pain and the concern that opioid use may shorten the survival time of terminally ill patients. A review published in Lancet in 2003 focused on the use of opioids and sedatives at the end of life and highlighted the effect of opioids on survival [12]. ...

Opioids, sleep and the time of death
  • Citing Article
  • June 1987

... M alignant ascites and its associated symptoms are present in 3.6-6% of patients admitted to palliative care centers. 1,2 It is most frequently associated with abdominal malignancies such as ovarian, pancreatic, gastric, and endometrial cancers, whereas breast, lung, and lymphomas represent the most common extra-abdominal sites. 3 Malignant ascites causes a range of distressing symptoms, including abdominal discomfort, nausea, vomiting, and dyspnea and can severely impact quality of life. ...

Management of ascites in advanced cancer - a flow diagram

... Detta kan medföra att kunskapen begränsas mer än nödvändigt. Ett annat hinder är vårdpersonalens egna känslor (Schaerer, 1993;Espinosa et al., 1996) och rädsla för att tvingas ge svåra besked och/eller att tala om döden (Field & James, 1993;Andrae, 1994;Faulkner & Regnard, 1994;Kao & Lusk, 1997), liksom bristande förmåga att kommunicera på ett lämpligt sätt om dessa frågor (Weisman, 1967;Quirt et al., 1997;Kuuppelomäki & Lauri, 1998;Kutner et al., 1999). Personliga egenskaper hos patienten som exempelvis social klass, mental medvetenhet, diagnos och närståendes insikt kan ha betydelse för den kunskap en patient får tillgång till (Seale, et al., 1997). ...

Handling difficult questions in palliative care-a flow diagram

... The diagnosis should be shared if directly requested by a patient (by analogy with the literature on breaking bad news such as cancer diagnosis, e.g. Faulkner et al., 1994) as otherwise productive discussion of prognosis or management options can be threatened. Doing this within the framework of CBTp may lead to an improvement in insight without engendering depression (Rathod et al., 2005). ...

Breaking bad news - A flow diagram
  • Citing Article
  • February 1994