Palliative medicine
-
Fatigue is one of the most frequent symptoms in palliative care patients, reported in .80% of cancer patients and in up to 99% of patients following radio- or chemotherapy. Fatigue also plays a major role in palliative care for noncancer patients, with large percentages of patients with HIV, multiple sclerosis, chronic obstructive pulmonary disease or heart failure reporting fatigue. This paper presents the position of an expert working group of the European Association for Palliative Care (EAPC), evaluating the available evidence on diagnosis and treatment of fatigue in palliative care patients and providing the basis for future discussions. ⋯ Strong evidence has been accumulated that aerobic exercise will reduce fatigue levels in cancer survivors and patients receiving cancer treatment. In the final stage of life, fatigue may provide protection and shielding from suffering for the patient and thus treatment may be detrimental. Identification of the time point, where treatment of fatigue is no longer indicated is important to alleviate distress at the end of life.
-
Palliative medicine · Jan 2008
Challenges faced by palliative care physicians when caring for doctors with advanced cancer.
It is possible that patients with advanced cancer, who are from the medical profession, have different or additional care needs than other patients. Previous training, professional experiences and access to information and services may influence their needs and subsequent illness behaviour. Caring for ;one of our own' may also evoke particular feelings and emotions from health professionals involved in their care and pose unique challenges in the delivery of equitable patient-centred care. ⋯ The core needs of doctors with advanced cancer could be assumed to be the same as other patients. However, the juxtaposition of role from professional to patient appears to evoke unique care needs from the patient, and behaviour responses from the professional. Forewarning and awareness of these issues may help prevent potential problems in this patient group's cancer journey as well as the experience of the professionals involved in their management.
-
Palliative medicine · Dec 2007
Multicenter StudyFlecainide for the treatment of chronic neuropathic pain: a Phase II trial.
Management of neuropathic pain is challenging. Medications that interfere with sodium channel transport, such as lidocaine, mexilitene and flecainide, are promising as analgesics. ⋯ Flecainide produced a 30% response rate. Response in this study was defined to be highly relevant and clinically significant reduction in pain. The drug merits study in a randomized placebo-controlled trial.
-
Palliative medicine · Dec 2007
Multicenter StudyOfficial certification of doctors working in palliative medicine in Europe: data from an EAPC study in 52 European countries.
There is an increasing move to recognize palliative medicine as an area of certificated specialization. Drawing on a survey of palliative care provision in the World Health Organization European region, an overview of palliative care specialization and accreditation practices was presented. Within an international survey to key experts in palliative care carried out in 2005, conducted in 52 countries, a question about the certification for palliative care professionals was included. ⋯ Across countries there is disparity in the certification criteria followed and considerable variability in the demands that are made in order to achieve certification. Further studies are needed to focus in depth on palliative medicine certification and accreditation across Europe. Establishing uniform approaches to certification for palliative medicine in different European countries will contribute to wider take-up of specialty status and the improved recognition of palliative care as a discipline.