Palliative medicine
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Palliative medicine · Jan 1993
Ethics and the clinician: the daily experience with motor neurone disease.
Ethical issues in health care are typically perceived as arising from extreme situations which do not usually confront the average clinician. However, knowingly or otherwise, clinicians working with motor neurone disease deal daily with ethical issues in the form of value judgements, the application of choice limiting principles and the language of clinician-patient interaction.
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There are many ethical decisions to be made during palliative care of a patient with motor neurone disease. These may concern the physical and psychosocial care of the patient and will become highlighted when death approaches. By close involvement of the patient and his/her family with the interdisciplinary team the most appropriate decisions on the patient's care can be made.
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Palliative medicine · Jan 1993
Comparative StudyCharacteristics of clients referred to home, hospice and hospital palliative care services in Western Australia.
Perth, in Western Australia, has three major palliative care services: a home care service, a freestanding hospice and a purpose-built palliative care unit in a teaching hospital. A retrospective study of patients referred to these services over a six-month period was carried out to find how they were used. The records of 176 clients were compared, which showed that there were some differences between the client groups referred to each of the services. ⋯ Lung cancer accounted for more male admissions (29%) to all services, while breast and lung cancer were more common among women, with a mixed pattern of referral. Lack of private insurance did not seem to influence the choice of service. Overall the clients of the inpatient services were older, had more nursing needs and were less likely to have someone to care for them, characteristics which health services facing an ageing population need to consider.
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Palliative medicine · Jan 1993
Validity of the support team assessment schedule: do staffs' ratings reflect those made by patients or their families?
This study aimed to assess the validity of the Support Team Assessment Schedule (STAS), a measure of the outcome of palliative care, through comparisons with the views of patients and family members. STAS ratings completed by two support teams were compared with (1) patients' ratings and (2) family member/carer ratings of seven (of the total 17 STAS) items, collected by independent interviewers. Of 183 patients referred to the teams, 84 (46%) were interviewed and 99 (54%) could not be contacted. ⋯ Team ratings were usually closer to those of the patients than to those of the family member; a team rating often lay between the patient's and family member's rating. The STAS is a measure of professional assessment which is independent from, although based on, the patient and family. The results support the validity of STAS as a measure of the outcome of palliative care from the perspective of a palliative care team.