European journal of cancer care
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Eur J Cancer Care (Engl) · Jun 1996
Palliative care needs in a district general hospital: a survey of patients with cancer.
Although sophisticated treatment of cancer requires the resources of specialist cancer treatment centres, most patients with cancer still undergo initial diagnostic investigation and treatment in district general hospitals (DGHs). The DGH frequently remains the principle site of referral for management of symptoms and terminal care. This survey was carried out at a DGH which has no palliative care services. ⋯ Assessment of patients' symptoms suggested that 39 (62%) might have benefited from the services of a palliative care team. Interviews with nursing staff highlighted the need for improved communication between professionals, increased staff education and support, and highlighted the particular difficulties that exist in caring for patients with advanced cancer and their families on busy acute general hospital wards. Imaginative and flexible approaches to the design and delivery of palliative services are essential if patients with cancer in DGHs are to receive the highest standards of care at all stages of their illness.
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Eur J Cancer Care (Engl) · Jun 1996
Statutory and voluntary sector palliative care in the community setting: National Health Service professionals' perceptions of the interface.
Following the rapid service development brought about by the hospice movement, specialist palliative care services are involved with up to 50% of all patients dying with cancer in the United Kingdom, although the primary health care team remains the main provider of community based palliative care. This paper discusses findings from a survey of palliative care provision in the south west of England, and describes the perceptions of the primary care team (general practitioners and district nurses) about the interface between themselves and voluntary sector specialist palliative care providers (hospice in-patient units, hospice home care nurses and other charitably funded specialist palliative care nurses). ⋯ The interview and questionnaire data suggest that the voluntary sector services are perceived variably as substituting, supplementing, complementing and duplicating the services provided by the primary care team. Drawing attention to these dimensions and the ambivalence sometimes felt by general practitioners and district nurses could provide a means of negotiating consensus on appropriate professional tasks and facilitating interprofessional practice in what is increasingly a mixed economy of statutory and voluntary funded health care.