International journal of palliative nursing
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This article draws on Illich's definition of health and explores the perspective of facing death as a process of adaptation. Research into psychoneuroimmunology is discussed. ⋯ The article mentions an educational strategy to encourage a health-promoting approach. This course uses the concept of holism as a framework for teaching and practice of palliative care.
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This article reports a continuous audit of pressure ulcer incidence within a specialist palliative care unit over 2 years. Details of every patient admission were considered (542 patients). Of these, 26.1% were admitted with pressure ulcers while 12.0% developed pressure damage during their stay. ⋯ In total, 95.3% were accurately assessed at 'high' or 'very high' risk using the Waterlow (1985) Pressure Sore Risk Assessment Tool and 89.2% of ulcers were Grade 1 or 2 measured using the Stirling Pressure Sore Severity Scale (Reid and Morrison, 1994). Of all developing ulcers, 78.4% were sacral and the position of the tumour, as well as comfort and positioning difficulties were considered most often responsible. Despite this knowledge and many 'improvements' introduced, the incidence did not improve with superficial ulcers often developing in the last days of life.
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Review Comparative Study
The use of oxycodone in cancer-related pain: a literature review.
Oxycodone is a semi-synthetic opioid agonist that can be used as an alternative to morphine in controlling cancer pain. It differs from morphine in its biphasic qualities in controlled release (CR) formulation. This review of post-1995 international literature explores the use of oxycodone compared with morphine, as well as titration studies comparing CR formulation against the conventional immediate release (IR) formulation. ⋯ Studies were graded based on research quality criteria of the US Agency for Health Care Policy and Research (United States Department for Health and Human Services, 1993). Conversion ratios and side-effects are discussed and recommendations made for the use of oxycodone in opioid rotation, particularly for patients suffering morphine-induced hallucinations. Several studies also recommend the use of oxycodone in preference to morphine in patients with renal impairment.
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Health professionals in rural Western Australia have embraced palliative care, however, to date no information has been available about the issues that face those providing the care. The descriptive study was undertaken to determine what palliative care education and support resources were available to rural health professionals, and to ascertain what further services would be of benefit to their practice. The findings of this study suggests that rural health professionals would welcome increased access to both education and support services when providing palliative care to patients in their communities. Recommendations are made that could enhance the delivery of palliative care education and support to rural Western Australia.
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In order to ensure that further developments and improvements are made in palliative care, research is essential. Palliative care is no different from other specialities in that it needs a scientific foundation on which to base its practice. ⋯ One of the major issues is how to obtain informed consent from patients. This article discusses the practical and ethical issues surrounding consent for quantitative research in palliative care, and offers some guidance to health professionals considering the issue with patients.