M T Claessens's research while affiliated with Johns Hopkins University and other places

... et al. 23 used diary cards to record changes in symptoms, including pain, over the past 48 h. Claessens et al. 28 included two questions about pain but did not specify the corresponding focal period. None of the included studies utilised a subdomain of a quality of life scale in their assessment of pain. ...

... 9 Population-based studies were conducted to explore palliative care utilization by patients with COPD in North America and Belgium; their findings indicated that prevalence of COPD gradually increased and was influenced by comorbidities at a life-limiting stage. [10][11][12] Globally, 38.5% of cardiovascular diseases, 34% of cancers, 10.3% of chronic respiratory diseases, and other chronic diseases may benefit from palliative care; however, its utilization in such cases remains limited. 13 To respect patients' dignity and their end-of-life preferences, the Taiwanese National Health Insurance has taken progressive steps by reimbursing both inpatient and outpatient palliative care services, including patients with advanced lung disease. ...

... 16,17 A survey conducted in seriously ill patients and their families revealed that 55% of the patients were conscious in the last 3 days of life, and 40% of the patients had severe pain most of the time. 18 In patients with advanced lung malignancies, a study supported that up to 47% of the patients suffered significant pain even in the last 48 h of life. 19 Insufficient pain management of cancer patients in the last days of life is a common medical problem, but one that is rarely discussed openly. ...

... 6 Across ICUs in the USA, UK, and Europe, limitation of lifesustaining treatments (LST) toward death, albeit widely variable, is overall high and increasing. [7][8][9] Paradoxically, in the low-and middle-income countries (LMICs) including India, both haves and have-nots die poorly, due to overtreatment in the former and lack of access to palliative care (PC) overall. 2 In India, barriers identified to end-of-life care (EOLC) include a lack of attention to the needs of the dying, reluctance to discuss anticipated death or make ethically challenging decisions, physician and organizational concerns over the legality of foregoing of lifesustaing treatments (FLST), family's inability to pay and lack of integration of PC in ICUs. [10][11][12] A questionnaire-based survey in Asian countries indicated that ICU physicians' practice of FLST in the LMICs (including India) compared to the HICs is hampered by perceived legal risks while curative treatments could be prematurely closed due to financial considerations. ...

... However, the severity of dyspnea increases with the progression of the disease. In one study, while severe dyspnea was manifest in 32% of stage III-IV patients, this rate increased up to 90% in the near-death period [40]. The presence of dyspnea is a poor prognostic factor and related to mortality in lung cancer [41,42]. ...

... Bu durum bireyin yaĢam kalitesini azaltmaktadır. Bireylerin performansını etkileyen ve performans kısıtlamasına sebep olan en önemli semptom dispne (nefes darlığı) dir (Canadian Thoracic Society, 2007;Lynn et al., 2000). Öksürük ve balgam KOAH'da sık görülmektedir. ...

... 6 In Canada, this number is closer to 59%. 7 Generalist physicians, such as family doctors and internal medicine specialists, 8,9 provide the majority of inpatient end-of-life care. Within this group, there are varying levels of expertise 10,11 and managing endof-life in an acute care setting brings additional challenges when compared with dying at home or in a hospice setting. The well-known SUPPORT trial 12 published 30 years ago highlighted shortcomings in communication, high frequency of aggressive treatments, and suboptimal symptom management in hospitalized patients at the end of their life. ...