BMJ supportive & palliative care
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BMJ Support Palliat Care · Sep 2012
An evaluation of a public health advocacy strategy to enhance palliative care provision in Zambia.
The provision of palliative and end-of-life care for patients with progressive disease is inadequate worldwide. The WHO strategy to develop a public health system of palliative care at the national level proposes a quadripartite approach: policy, education, drug availability and implementation. This is particularly necessary in low income countries facing a high disease burden with low resources. To date there have been no published evaluations of advocacy strategies aiming to use the WHO approach to enhance access to palliative care. ⋯ For palliative care to thrive in any resource-poor country it must be integrated into the public health system and secure long-term funding.
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BMJ Support Palliat Care · Sep 2012
Continuous palliative sedation until death: practice after introduction of the Dutch national guideline.
In 2005, a national palliative guideline was launched in The Netherlands. The authors describe the practice of continuous palliative sedation until death (CPS) after the introduction of this guideline. ⋯ Continuous palliative sedation practice in The Netherlands largely reflects the recommendations from the national guideline. Issues needing further attention are the pressure felt by physicians to start continuous sedation and the potential life-shortening effect as mentioned by the physicians.
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BMJ Support Palliat Care · Sep 2012
Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients.
To examine the impact of oncologist awareness of palliative care (PC), the intervention of the PC team (PCT) and multidisciplinary decision-making on three quality indicators of end-of-life (EOL) care. ⋯ Multidisciplinary decision-making with oncologists and the PCT is the most critical parameter for improving EOL care.
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BMJ Support Palliat Care · Sep 2012
On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.
This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. ⋯ Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.