Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
-
Support Care Cancer · May 2002
ReviewSpirituality and meaning in supportive care: spirituality- and meaning-centered group psychotherapy interventions in advanced cancer.
Existential and spiritual issues are at the frontier of new clinical and research focus in palliative and supportive care of cancer patients. As concepts of adequate supportive care expand beyond a focus on pain and physical symptom control, existential and spiritual issues such as meaning, hope and spirituality in general have received increased attention from supportive care clinicians and clinical researchers. ⋯ These two constructs of spirituality are reviewed in terms of their role in supportive care. Finally, a review of existing psychotherapeutic interventions for spiritual suffering are reviewed and a novel meaning-centered group psychotherapy for advanced cancer patients is described.
-
Support Care Cancer · May 2002
The impact of a palliative medicine consultation service in medical oncology.
This prospective study of consecutive patients describes the palliative medicine consult service in a tertiary level cancer center and its impact on patient care. All inpatients/outpatients referred to the Palliative Medicine Program in a 4-month period were enrolled. Data were collected at the initial consultation using standardized forms with spaces for: reason for the consultation, referring service, demographics and history, ECOG performance status, symptoms, prognosis and diagnostic tests, treatment, and care plan. ⋯ Plan of care foresaw outpatient follow-up for 40%, inpatient follow-up for 32%, and transfer to palliative medicine for 27%. In 39% of cases the consults were considered late referrals. New medications suggested were opioids for 46% of patients, antiemetics for 28%, a bowel regimen for 24%, steroids for 15%, and others for 51%. (1) Palliative medicine consultation involves common complex medical, psychological, and social problems. (2) Complex symptomatology in this population is confirmed. (3) Multiple interventions were suggested even at the initial consultation. (4) Important issues such as DNR (do not resuscitate) status, support system, treatment goals, and eligibility for hospice care had often not been addressed.
-
Support Care Cancer · May 2002
Education / training in supportive and palliative care in central and eastern Europe. Results of a questionnaire survey.
During the totalitarian era terminal care was excluded from the health care system, and oncology, including education in the field, was rather neglected. The political and economic reforms that started in the 1990s in the countries of eastern and central Europe enhanced the development of palliative care and improvements in cancer treatment standards. This survey was performed to assess the current status of education and training in supportive and palliative care. ⋯ Access to professional literature should be improved, and the creation of national literatures should be encouraged. The role of local leaders, NGOs and professional associations must be emphasized. The main goals are: improvement of education, and better quality and availability of palliative and supportive care, not only for patients with cancer but also in other progressive life-threatening diseases.