Articles: palliative-care.
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This retrospective study was designed to investigate whether chronic lumbar intrathecal administration of morphine leads to the development of opioid tolerance in patients suffering from intractable cancer pain. ⋯ The requirement for a moderate increase in intrathecal opioid doses reflects the development of tolerance but did not limit the patients' ability to obtain adequate analgesia during the course of their painful disease.
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The family is usually the primary provider of care for the terminally ill patient with cancer or other serious progressive illness. The way in which such a family functions is a major determinant of psychological well-being for its members. Through screening with the Family Relationships Index (FRI) (Moos and Moos, 1981), dysfunctional families and those at risk can be identified, and then helped to achieve better family functioning, thus improving psychosocial outcome of their grief. In this paper, we describe the techniques and themes involved in the application of our empirically developed model of family grief therapy, designed as a preventive intervention for use in the setting of palliative care and bereavement.
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Wien Med Wochenschr · Jan 1998
Assessment of satisfaction with the communication process during consultation of cancer patients with potentially curable disease, cancer patients on palliative care, and HIV-positive patients.
The aim of this study was to evaluate the attitudes of cancer patients towards the medical interview and to determine their psychosocial satisfaction subsequent to the dialogue. The answers given by patients with curable cancer were compared to those given by cancer patients whose treatment intent was palliative and to the replies of patients infected with the human immunodeficiency virus (HIV), a nonmalignant but also incurable state. The subject population comprised a total of 139 patients. ⋯ Cancer patients considered themselves better informed compared to patients with HIV-infection. This is in significant contrast with the actual, measurable knowledge about their disease in the latter group. It is indeed surprising that only a small minority of incurable cancer patients realized that the goal of the medical care they received was relief of symptoms, the principle objective of palliation.
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J Health Hum Serv Adm · Jan 1998
Analysis of comfort care for the terminally ill: the hospice approach.
Much of the published literature on hospice care focuses on a single dimension of this increasingly popular approach to meeting the needs of the terminally ill. By contrast, this article takes a broader view by examining the hospice concept and its implementation through the lens of the nine dimensions of the SEPTEMBER model--focusing in turn on each of the social, economic, political, treatment, ethical, managerial, bereavement, education, and research elements. This broader perspective brings together in kaleidoscopic fashion these diverse but interconnected elements of hospice care. This integrated conceptual model helps administrators and health care professionals to develop a clearer overall picture of the multifaceted challenges involved in delivering palliative care to dying patients.