The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Nov 2004
ReviewChanges in endocrine therapy: anastrozole and advanced breast cancer in postmenopausal women.
Emerging data on endocrine therapies necessitates a re-evaluation of treatment strategies for advanced breast cancer. In this review, we present data from recent studies of the third-generation, nonsteroidal aromatase inhibitor (AI) anastrozole that illustrate its changing role in the treatment of postmenopausal women with advanced breast cancer. These studies demonstrate that anastrozole is now a treatment of choice as first-line therapy for patients presenting with advanced breast cancer and for patients who have progressed to advanced disease after adjuvant therapy with tamoxifen. A further trial has also shown that anastrozole is an effective and well-tolerated alternative to tamoxifen as adjuvant treatment for postmenopausal women with early breast cancer.
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Am J Hosp Palliat Care · Nov 2004
Identifying barriers to psychosocial spiritual care at the end of life: a physician group study.
The recent literature addresses the need to improve care for dying patients. The purpose of this study was to identify barriers to the psychosocial spiritual care of these patients by their physicians. Psychosocial spiritual care is defined as aspects of care concerning patient emotional state, social support and relationships, and spiritual well-being. The study was an exploratory means for generating hypotheses and identifying directions for interventions, research, and training in care for the dying. ⋯ This study suggests that research and educational approaches to improving the psychosocial spiritual care of the dying by physicians should address barriers at the cultural, organizational, and clinical levels. Suggestions for interventions at various levels are offered.
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Am J Hosp Palliat Care · Nov 2004
Information needs of family caregivers of terminal cancer patients in Taiwan.
Previous studies have indicated that when family caregivers are provided with enough of the right information their coping strategies in caring for terminal cancer patients are enhanced. In Taiwan, family caregivers are highly involved in their ill family member's symptom management and must stay at the bedside to share the nursing and caregiving tasks in the palliative care unit. The cross-sectional survey described here used a structured questionnaire to identify six domains of information needed among family caregivers who stay in the palliative care units to prepare them to provide hospice homecare after discharge. ⋯ Age, gender, educational level, and socioeconomic status (SES) of family caregivers were factors in how they viewed the importance of each domain. Situation-related variables, such as the extent of each caregiver's role in decision making, duration of the patient's disease, and the treatment the patient was undergoing were also related to how caregivers valued each type of information. Study results indicated that the education of caregivers in the palliative care unit should be individualized based on each patient's condition and each family's characteristics.