Asian Pac J Cancer P
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Asian Pac J Cancer P · Jan 2010
Beyond quality of life: the meaning of death and suffering in palliative care.
The majority of patients treated for cancer will have pain at some point in their journey. Suffering and death are common events in cancer patients. Palliative care has been very successful in reducing the discomfort caused by physical pain, but does not have the means to address the questions related to the meaning of suffering and death. ⋯ The clinical definition of spiritual and existential pain is evolving and so is its treatment. Classical clinical trials have little to offer for these conditions. Qualitative research in its various forms, including open ended questions, content analysis and mainly personal narrative are the most promising forms of research to comprehend spiritual and existential pain.
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In the early 1900's, Americans had a life expectancy of about 50 years. Childhood mortality was very high and an adult who lived into their sixties was considered to be doing pretty well. Prior to the advent of different types of antibiotics, people would die quickly of infectious disease or accidents and medicine only really focused on caring and comfort. ⋯ We use the Project Grace Advance Care Plan which was developed by a physician and is very simple to understand. With this tool, we are able to bring up the discussion while trying to focus in on the patients spirituality and the coping mechanism as the cancer patient. This allows the conversation of end of life treatment preferences and what the patients typical desire is for life sustaining measures.
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The purpose of the paper is to discuss means of assisting terminally ill patients in seeking for sources of meaning and hope, alongside the acknowledgment that their lifespan is short. Psycho-spiritual aspects make a substantial component patients suffering from incurable illness have to deal with. Evaluating and mapping the causes and expressions of psychological--spiritual suffering may assist in tailoring appropriate strategies of distress relief. ⋯ Whereas existential--spiritual interventions are recommended to be given by qualified professional therapists, the operation of fulfilling wishes is feasible by everyone, from family members to multi-disciplinary staff. Case illustrations for meaning--centered interventions will be discussed in the course of the paper. Cultural and traditional differences within the Israeli society, expressed in themes of work with patients, will lead to the conclusion, that there are many creative ways for researching meaning of life and sources for hope.
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Asian Pac J Cancer P · Jan 2010
Historical perspectives and trends in the management of pain for cancer patients in oman.
Sultanate of Oman is the second largest country in the Gulf, with a population of 2,867,428 (2008) of which 35.2% is under 15 years and only 3.7% above 65 years. Incidence of newly diagnosed cancers is also the second highest in the Gulf with 11%. Research conducted between 1997-2007 revealed that the most frequent cancers in males: stomach 10%, non-Hodgkins lymphoma 8.6% and prostate 7% while in females: breast 18.9%, thyroid 8.3% and cervix uteri 6.5%. A population-based registry was established in 1996 to compile an accurate database and monitor cancer trends. There is a rigorous follow up of reported cases. Unfortunately most patients report at the hospitals in advanced stages which complicate pain management. All treatment modalities of cancer are available in Oman at the two centers, Royal Hospital and SQUH. There is a continuous effort to develop national educational guidelines, protocols for cancer treatment, palliative care and pain management (PM). ⋯ There is no doubt that the Sultanate of Oman has progressed tremendously since 1970. The Government is working very hard and is taking major steps to improve cancer care in order to meet the International Bench Mark. Each 5 year plan focuses on actual needs. One of the important needs that have been addressed is the management of pain which has significantly improved. Factors that have improved PM in Oman include the introduction of the PM Teams, training of Nurses and Doctors, follow up of the PM services in the clinical areas, authorizing MOH hospitals to use oral opioids, opening of the National Oncology Centre with Radiation Therapy, inter institutional discussions and development of guidelines, implementation of WHO Guidelines on PM and audits, peer reviews and research.
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Asian Pac J Cancer P · Jan 2010
HPV vaccine acceptance among women in the Asian Pacific: a systematic review of the literature.
To inform human papillomavirus (HPV) vaccination programs in the Asian Pacific region by elucidating factors associated with women's intent to receive the vaccine. ⋯ HPV vaccine campaigns should address gaps in knowledge regarding HPV, genital warts, and cervical cancer, and should attend to concerns about vaccine safety and efficacy. Strategies should also be undertaken to decrease social stigma surrounding receipt of the HPV vaccine and to foster familial and partner support of women's decision to be vaccinated.