Palliative medicine
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Palliative medicine · Oct 2010
Multicenter StudyThe use of morphine to control pain in advanced cancer: an investigation of clinical usage in Bangladesh.
In 2007, 13% of all deaths worldwide were due to cancer, and of these 72% occurred in low- and middle-income countries. Opioids are essential for the successful delivery of palliative care and pain control. This paper reports data from a cross-sectional survey that aimed to investigate the use of morphine in advanced cancer in palliative care setting in Bangladesh, in order to inform clinical practice and fledgling service development. ⋯ Lack of morphine availability resulted in physical suffering of patients and emotional distress of their families. Lack of availability of morphine was identified as the main barrier to pain control. International attention and collaboration with local policy makers is needed to simplify narcotic regulations and increase the availability of morphine.
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Palliative medicine · Oct 2010
The development and validation of a novel questionnaire to measure patient and family satisfaction with end-of-life care: the Canadian Health Care Evaluation Project (CANHELP) Questionnaire.
The purpose of this study was to further validate a novel instrument to measure satisfaction with end-of-life care, called the Canadian Health Care Evaluation Project (CANHELP) questionnaire. Data were collected by a cross-sectional survey of patients who had advanced, life-limiting illnesses and their family caregivers, and who completed CANHELP, a global rating of satisfaction, and a quality of life questionnaire. We conducted factor analysis, assessed internal consistency using Cronbach's alpha, and evaluated construct validity by describing the correlation amongst CANHELP, global rating of satisfaction and the quality of life questionnaire scores. ⋯ Each subscale for each questionnaire had acceptable to excellent internal consistency (Cronbach's alpha ranged from 0.69-0.94). We observed good correlations between the CANHELP overall satisfaction score and global rating of satisfaction (correlation coefficient 0.49 and 0.63 for patient and family, respectively) which was greater than the correlations between CANHELP and the quality of life instruments. We conclude that the CANHELP Questionnaire is a valid and internally consistent instrument to measure satisfaction with end-of-life care.
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Palliative medicine · Oct 2010
An exploration into the palliative and end-of-life experiences of carers of people with Parkinson's disease.
Although most people with Parkinson's disease are cared for in the community, little is known about family members' lived experiences of palliative or end-of-life care. The aim of this study was to explore former carers' lived experiences of palliative and end-of-life care. In total, 15 former family caregivers of patients who had died with Parkinson's disease were interviewed using a semi-structured topic list. ⋯ A multi-disciplinary team-based approach was advocated by participants. These findings provide important insights into the experience of caregiving to patients with Parkinson's disease in the home at the end-of-life stage. According to palliative care standards, patients and their carers are the unit of care; in reality, however, this standard is not being met.