Gan to kagaku ryoho. Cancer & chemotherapy
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It is essentially important for home hospice care, which provides hospice care at home to palliate the patient's sufferings, such as pain for example, and to provide cares in the form of the interdisciplinary team approach. Though the actual way of providing hospice care at home is principally based upon an institutional hospice care, there are some which are peculiar to home hospice care. The principles of symptom control in case of home hospice care are: (1) to take account of patient's daily life, (2) to make much of the natural course of the disease, (3) to palliate the patient's sufferings by focusing on the subjective complaints and (4) to provide relief on medical aspect at home. As for the interdisciplinary team approach, a special consideration of the members to visit the patient's home as few as possible in order to keep the patient's life quiet.
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This paper reviews current cancer pain management guidelines, the challenge of managing pain across the care settings hospital to home. This also presents up-to-date information on the medications and strategies and the expansion of the World Health Organization's (WHO) analgesic ladder with several classes of drugs that are currently used to treat cancer pain: (1) non-steroidal anti-inflammatory drugs (NSAIDs), (2) opioid analgesics with opioid rotation and the control for side effect of opioid, (3) adjuvant analgesics including ketamine.
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Gan To Kagaku Ryoho · Dec 2007
[An attitude survey on the medical use of narcotics for cancer pain relief].
Narcotic medications are the major drug therapy for cancer pain relief. A clinical use of fentanyl patches and oxycodone extended-release tablets has recently become available, which led to more choices of narcotics to be used medically. On the other hand, palliative care systems have not yet been fully established by medical institutions. ⋯ The result showed that the recognition rate of morphine used for cancer pain relief was 88%, while the recognition rate of narcotics for medical use other than morphine available for cancer pain relief was 20%. The most acceptable dosage form of narcotics was a skin patch, followed by an oral preparation. A response percentage that the dosage form of medical narcotics should be selectable by users was 93%.
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Gan To Kagaku Ryoho · Dec 2007
[The role of oncology nurse in palliative care team--activities of oncology certified nurse specialist in palliative care team at National Hospital Organization Osaka National Hospital].
In Osaka National Hospital, we established a hospital based palliative care team in July 2004. The team provided consultations to 537 patients (298 male, 239 female: 18% lung cancer, 14% breast cancer: 177 pain, 221 psychiatric symptoms, 91 physical symptoms). ⋯ The major activities of OCNS are a nursing intervention for the out-patient chemotherapy unit and PCT. The major roles of OCNS in critical care unit at the general hospital are to make patients to have a high hope, an intervention to support patients and to have a supportive relationship with medical social workers.
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Gan To Kagaku Ryoho · Dec 2007
[The home palliative care transition manual for the regional cooperation from the general ward at Shizuoka Red Cross Hospital].
Recently, a home palliative care has been recommended for terminal stage cancer patients. However, a few clinics are available providing a home palliative care. As a result of that, there have been many cases of the terminal stage cancer patients who could not receive a peace of mind care and die peacefully at home. ⋯ We intervened 8 cases from April to July 2007. Six out of 8 cases were transferred to home, and 2 patients were died at home. The home care transition manual will be shared with other hospitals from now on.