J Palliat Care
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Hopelessness, loss of meaning, and existential distress are proposed as the core features of the diagnostic category of demoralization syndrome. This syndrome can be differentiated from depression and is recognizable in palliative care settings. ⋯ A treatment approach is described which has the potential to alleviate the distress caused by this syndrome. Overall, demoralization syndrome has satisfactory face, descriptive, predictive, construct, and divergent validity, suggesting its utility as a diagnostic category in palliative care.
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This paper explores how music therapy can assist patients and relatives in the processes of making friendship and love audible in a child cancer ward. Four short patient histories are presented to illustrate a health-oriented, ecological music therapy practice. Two histories describe how texts, made by patients, become songs, and how the songs are performed and used. ⋯ The paper indicates that these interventions may involve more than palliation (making a disease less severe and unpleasant without removing its cause). Not least, such activities can make it possible for the sick child to expand from being "just a patient" into playing, if only for a moment, a more active social role. The processes of artistic interplay, in- and outside the sickroom, influence various relationships in the child's social environment.
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Biography Historical Article
Learning from Sir William Osler about the teaching of palliative care.
The publication by Michael Bliss of his authoritative and illuminating text William Osler: a Life in Medicine (1) provides a wonderful opportunity to reflect on the life of a great man who had a major influence on medical undergraduate teaching and medical practice. His approach to the care of both patients and colleagues was warm and encouraging. ⋯ He had the ability to blend wide knowledge with high ideals and common sense to influence the ways in which the doctor-patient relationship developed. Drawing on passages from the biography of William Osler, and linking his practice with the work of Donald Schön and the development of reflective practice, this paper identifies elements of our roles as clinicians and teachers that could be enhanced by further examination of the life of a man who has been described as the "greatest doctor in the world" (1, p. 480); a physician "whose work lies on the confines of the shadowland" (1, p. 291).
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The meaning of dignity is commonly assumed but rarely examined in palliative care. Dying with dignity often forms the basis of clinical decision making at the end of life, but is constructed differently depending upon setting and context. A discourse analysis of patient and family case studies found that relationships and embodiment were important aspects of dignity that have been neglected in the literature, although these constructions of dignity matter to dying people and their families. An understanding of these constructions can assist clinicians in providing sensitive palliative care across a range of community and medical settings.
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A survey was conducted to explore Internet use by palliative care health professionals (HCP). The survey was placed on the World Wide Web with an underlying database, and palliative care HCP were invited to participate via a palliative-care-related website, listserv, and newsletter. A total of 417 evaluable responses were received over a four-month period. ⋯ This survey illustrates the global outreach of the Internet and draws attention to the growing interest in the use of the Internet for education, research, and clinical use. Further development of online resources should address the needs of users. Evaluation of these resources is called for.