J Palliat Care
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Collaboration between nurses and physicians is essential for successful pain management, especially in home care settings. This study describes how physicians collaborate with nurses for the pain management of terminally ill cancer patients treated at home in Japan, and evaluates the use of standing orders in pain management. ⋯ In general, institutions caring for fewer patients per year were less likely to make specific efforts to collaborate with nurses and less likely to use standing orders in pain management. Given that many institutions provide home palliative care services on a small scale, a standard protocol for care should be developed and applied across all institutions to ensure the availability of quality home palliative care throughout the country.
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To provide further evidence about the prevalence and correlates of the sense of "self-perceived burden" (SPB) to others, and to examine its association with caregiver reports of burden. ⋯ SPB is a common and distressing concern for many patients receiving palliative care and is associated with a number of other distressing concerns.
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Most care received by cancer patients is provided in the community by informal or unpaid caregivers. The unrelenting care demands can lead to physical, emotional, social, and financial reactions; furthermore, studies indicate that the effects of caregiving may endure after the patient's death. A need therefore exists for instruments measuring both caregiving and post-caregiving reactions. ⋯ As hypothesized, results provide support for a 5-factor structure of responses to this modified version of the CRA. The concurrent validity of responses to the scale was also supported. Replication of the findings with randomly derived and larger sample sizes is needed.
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The provision of some form of bereavement services is an integral part of any pediatric hospice program. The Canuck Place hospice program has offered bereavement services since it began in 1995. A mixed-method evaluation of the impact of the Canuck Place program on the families it served during its first two-and-a-half years of operation was conducted. ⋯ Findings indicated that the follow-up component of the program was well-received by family members. When assessing their group experiences, children and parents most appreciated the support and understanding they received, the freedom to express themselves, a diminished sense of isolation, and the normalization of their emotions. Practical considerations when offering bereavement support groups are discussed in this paper.
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Pediatric palliative care requires the orchestrated efforts of a multidisciplinary care team of medical staff, nursing, psychosocial staff, and other healthcare professionals. Augmenting this team are support staff including financial counsellors, volunteers, secretaries, and others not involved in the direct administration of medical services. Prior research in palliative care has studied the perceptions, training, and professional resources of medical staff and social workers, but neglected to investigate such factors in support staff. ⋯ They indicated that such experiences had caused some adverse outcomes in their lives, and that few felt they had sufficient knowledge or training in palliative care. Our respondents voiced noteworthy opinions on symptom control, cultural issues, and spirituality pertinent to pediatric palliative care. Support staff play a key role in the palliative care team; research and resources need to be directed to educating, training, and supporting them.