European journal of cancer care
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Eur J Cancer Care (Engl) · Sep 1998
ReviewRegional implementation of a national cancer policy: taking forward multiprofessional, collaborative cancer care.
The vision of the Calman-Hine paper is of patient-centred care, delivered by co-ordinated services which have genuine partnerships with each other. There is integration of other providers of support, to meet psychological and non-clinical needs. There is access to palliative care when required, from diagnosis onwards, and not just in the terminal stage. ⋯ Our recommendations are based upon in-depth discussions with purchasers, doctors and nurses, and others involved with cancer services within hospitals or the community across the region. They reflect the priorities placed on the development of good practice. Purchasers and providers should work together to implement these guidelines.
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Cancer support nurses (CSNs) have a key co-ordinating role in the cancer services in North Lancashire and South Lakeland. The working practices of the three CSNs in North Lancashire are described in detail. ⋯ CSNs are an essential element of cancer service provision. A ratio of one CSN to 40,000 population gives a manageable workload, provided there is an infrastructure of supportive care to which patients, carers and bereaved can be referred.
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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.
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Eur J Cancer Care (Engl) · Dec 1995
ReviewNursing as therapy in the management of breathlessness in lung cancer.
Breathlessness has been described as an unpleasant sensation, but if it encompasses suffering, as some argue, it is much more than this. Breathlessness is also a major issue for people with cancer. Much of the effort to manage breathlessness has thus far focused on the treatment of underlying causes or on pharmacological strategies. ⋯ Evidence is presented from a small study of the experiences of nurses working in the experimental clinic for breathlessness which suggests that the emotional consequences of breathlessness have a profound influence on how it is managed in practice. Finally, it is argued that symptoms are sometimes generalized too much. Experience is particular, not universal, and an open, accepting and therapeutic approach to managing illness has to be involved with messy and sometimes frightening emotions.