Ann Acad Med Singap
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Spirituality plays an integral role in the care of the terminally ill. Hospice philosophy promotes patient/family centred care that is palliative, holistic and interdisciplinary. ⋯ Some issues related to the role of spirituality in medicine and hospice care include the difference between spirituality and religion, the patient-physician relationship, provision of spiritual care, and who provides this care. Guidelines for spiritual caregiving include self-knowledge of one's own spiritual needs, authenticity and honesty and respect for the beliefs and practices of the patient and family.
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Ann Acad Med Singap · Mar 1994
Development of cancer pain relief and palliative care in the Philippines.
The article describes the development and progress of cancer pain relief and palliative care in the Philippines from 1986 onwards. The strategy employed was a stepwise progression that began with the establishment of government policy, followed by measures to improve availability and accessibility to oral morphine, and finally, continuing nationwide professional education. Key elements to successful implementation were the presence of a national cancer control programme; the active participation of the World Health Organization, the Department of Health, the Philippine College of Surgeons, and the Philippine Cancer Society Inc; and research development and utilisation. Data from three clinical studies are also presented, which showed the efficacy of the WHO Method of Cancer Pain Relief among samples of Philippine patients, and that cancer pain relief alone did not significantly improve overall quality of life, demonstrating the need for comprehensive palliative care.
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A retrospective study was carried out in 100 adult patients with advanced malignant disease. They were given subcutaneous continuous infusions of medication for symptom relief. The drugs were administered through a butterfly needle inserted subcutaneously in the anterior chest wall using a battery-operated infusion pump. ⋯ The treatment was well tolerated by the patients and controlled their symptoms satisfactorily in the great majority. The use of continuous subcutaneous infusion via a syringe driver gives good symptom control. In the last days of life when the patients have difficulty tolerating oral medication, continuous subcutaneous infusion is a superior alternative to frequent intermittent parenteral injections.
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Ann Acad Med Singap · Mar 1994
Recent progress in cancer pain management and palliative care in Japan.
One out of every four deaths in Japan is due to cancer, so that health-care workers and the lay public have gradually become aware of the importance of cancer pain relief and palliative care in recent years. In 1984, the feasibility and effectiveness of the WHO method for relief of cancer pain was demonstrated in Japanese cancer patients. ⋯ These activities resulted in a 35-fold increase in the annual consumption of morphine preparations for medical purposes between 1979 and 1992. However, the annual consumption per capita is still much smaller than that in other developed countries, indicating the need for further information dissemination and professional education in the implementation of palliative care programmes.
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Ann Acad Med Singap · Mar 1994
Central Sydney Palliative Care Service: potential and limitations of an integrated palliative care service based in a metropolitan teaching hospital.
Palliative care needs to be available wherever needed, in hospital and home, and should be part of mainstream health care. Palliative care should be concurrent with anti-disease therapy, and includes but goes beyond "terminal care". The World Health Organization (WHO) encourages such development. ⋯ Approximately 1000 new patients are referred annually by doctors (specialists or general practitioners) for medical consultation. Registrar (fellow) training in palliative medicine is a feature of the service. Palliative care in a hospital or community-based service is an issue of justice and equity, and gives structure to compassion.