Articles: palliative-care.
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Palliative medicine · Sep 1997
Organization and patients' perception of palliative care: a crosscultural comparison.
The hospice model of care for patients with advanced diseases exists in almost all industrialized countries. To date, there have been no international or crosscultural comparisons of the organization and patient outcomes associated with hospice services in different parts of the world. ⋯ Across all countries, there were similar levels of comfort and satisfaction with care. We conclude that the hospice philosophy addresses the basic needs of dying patients which are independent of cultural background, but may be adapted to very different cultures.
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Palliative medicine · Sep 1997
Palliative care in a multicultural society: perceptions of health care professionals.
This study assesses the perceived competence of 191 Australian palliative care professionals in delivering crosscultural care. The relationship between the perceived competence levels of professionals and their experience and training is examined. ⋯ The results of this study suggest that specific education, rather than individual experience of crosscultural interactions, which may not always be positive, is needed to improve the competence of palliative care professionals. Education, therefore, is the key to the provision of culturally appropriate care to patients and their families from all cultural backgrounds.
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Support Care Cancer · Sep 1997
Multicenter Study Clinical TrialEvaluation of the cost of home care for terminally ill cancer patients.
The aim of this work was to carry out a cost evaluation of the home care programme for terminally ill cancer patients run by the Istituto Oncologico Romagnolo (I. O. R.) in the areas of Forlì, Cesena, Ravenna and Rimini (Romagna, Italy). ⋯ Examination of the relation between the cost of 1 week of care and KPS values clearly shows that healthcare costs increased as KPS decreased (from 152.2 Ecu with KPS > or = 60 to 292.6 Ecu with KPS < or = 20; P < 0.001). Home care costs were also seen to vary with some clinical characteristics and symptoms present when patients entered the study: asthenia, anorexia, nausea/vomiting, bedsores. Given the good results of home care for cancer patients in terms of quality of life, this method of cost accounting for home-care providers can help to monitor the rising cost of assistance and confirm the cost effectiveness of this type of care.
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Taiwan is an island country, with a small area and a dense population. Cancer has been the leading cause of death for over 15 years, and the number of cancer deaths is increasing year by year. The hospice movement started in 1983, and the first hospice was set up in 1990. ⋯ The curriculum for palliative medicine has recently been confirmed for education in the future. The Government has been a great help in the development of palliative care, and more service needs are identified. The situation with the hospice movement in Taiwan is positive and promising.
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J Pain Symptom Manage · Aug 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of a once-a-day sustained-release morphine formulation with standard oral morphine treatment for cancer pain.
Kadian/Kapanol (K) is a capsule formulation of morphine designed for 12- or 24-hourly dosing. This double-blind study compared the efficacy and safety of K every 24 hr to K every 12 hr and MS Contin tablets (MSC) every 12 hr. One hundred fifty-two patients with cancer pain were titrated to adequate analgesia with immediate-release morphine (IRM) solution. ⋯ Patient global assessment significantly favored K every 24 hr over MSC every 12 hr (P = 0.018). There were no statistically significant differences among the treatments for any morphine-related side effects when adjusted for baseline. K had efficacy and safety profiles similar to MSC every 12 hr but had the advantage of 12- or 24-hourly administration.