Indian journal of palliative care
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Indian J Palliat Care · Jan 2012
Should Patients and Family be Involved in "Do Not Resuscitate" Decisions? Views of Oncology and Palliative Care Doctors and Nurses.
"Do not resuscitate" (DNR) orders are put in place where cardiopulmonary resuscitation is inappropriate. However, it is unclear who should be involved in discussions and decisions around DNR orders. ⋯ From the viewpoint of oncology and palliative care healthcare professionals, patients should be involved at least in discussing if not in the determination of DNR orders, challenging the norm of familial determination in the Asian context. The varied responses highlight the complexity of decision making on issues relating to the end of life. Thus, it is important to take into account the innumerable bio-psychosocial, practical, and ethical factors that are involved within such deliberations.
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Patients with advanced cancer often suffer from multiple intractable physical symptoms. Though majority of the symptoms can be controlled, in some of the patients these symptoms remain refractory and uncontrolled till the end. ⋯ The main concern while using PS is its life-shortening effect. This case report describes the feasibility of administering PS in Indian home settings.
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Indian J Palliat Care · Jan 2012
Palliative care for patients with chronic obstructive pulmonary disease: current perspectives.
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory illness with a myriad of disabling symptoms and a decline in the functional parameters that affect the quality of life. The mortality and morbidity associated with severe COPD is high and the patients are mostly housebound and in need of continuous care and support. ⋯ The areas that may improve the quality of care include the management of dyspnea, oxygen therapy, nutritional support, antianxiety, and antidepressant treatment, and advance care planning. Hence, it is necessary to pursue a holistic care approach for palliative care services along with disease-specific medical management in all such patients to improve the quality of life in end-stage COPD.
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Indian J Palliat Care · Sep 2011
Reporting of pediatric palliative care: a systematic review and quantitative analysis of research publications in palliative care journals.
Pediatric palliative care clinical practice depends upon an evidence-based decision-making process which in turn is based upon current research evidence. ⋯ The overall reporting rate for pediatric palliative care articles in palliative care journals was very low and there were no randomized clinical trials and systematic reviews found. The study findings indicate a lack of adequate evidence base for pediatric palliative care.
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Indian J Palliat Care · Sep 2011
Opioid-prescribing Practices in Chronic Cancer Pain in a Tertiary Care Pain Clinic.
Under treatment of pain is a recognized global issue. Opioid analgesic medication is the mainstay of treatment in cancer patients as per the World Health Organization (WHO) pain relief ladder, yet 50% of cancer patients worldwide do not receive adequate pain relief or are undertreated. ⋯ This study shows that the under treatment of pain and under dosing of opioids coupled with improper side effect management are major issues.