Articles: palliative-care.
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Anecdotal reports from hospices show a low incidence of suicide, yet depression is increased in cancer patients, and the likelihood of suicide is increased in depressed patients. Suicide would be expected to be more common in terminally ill patients. A postal survey was undertaken of 43 palliative care units. ⋯ Nine units (38%) had one or more suicides, with a total of 21 suicides reported. Sixteen units (67%) had one or more attempted suicides (total 37). There are implications in the study both for direct patient care, but also data collection, staff support and training.
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To describe the services available for the treatment of acute pain in surgical hospitals in New Zealand. ⋯ Most New Zealand surgical hospitals use a wide range of modern analgesic modalities and an increasing number are providing formal acute pain services with designated medical and/or nursing time.
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La Revue du praticien · Jun 1997
[Radiotherapy and symptomatic treatments of advanced colorectal cancers].
Treatments of colorectal cancers can still be curative up to fairly advanced stage. Clinical situations vary greatly depending on the primary: local recurrence is a major event in rectal cancer whereas metastases are the main problem in colon cancer. Therefore, rectal cancer benefit from locoregional combined treatments, chemotherapy, radiotherapy and surgery, to control the pelvic disease. ⋯ Radiotherapy for bone or brain metastasis is well known and frequently used; irradiation of painful liver metastasis is less regularly discussed despite its efficacy. Symptomatic treatments like analgesics narcotic or not, non steroidal anti-inflammatory, anxiolytics, etc. are useful. All these treatments must be evaluated, not only in term of anti-tumoural but also from the quality of life point of view.
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A variety of treatments can be effective palliative therapy of symptoms of airway obstruction caused by endobronchial tumour: Nd-YAG laser resection may be indicated for tumours that are relatively short in length, situated in trachea, mainstem or proximal lobe bronchi. Cryotherapy may be an alternative to laser resection. ⋯ Endobronchial stents. Randomised trials are required to determine the relative merits of these treatments and the optimal management of endobronchial complications of lung cancer.
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J Public Health Med · Jun 1997
ReviewOutcome measures in palliative care for advanced cancer patients: a review.
Information generated using outcome measures to measure the effectiveness of palliative care interventions is potentially invaluable. Depending on the measurement tool employed the results can be used to monitor clinical care, carry out comparative research, provide audit data or inform purchasing decisions. However, the data collected can only ever be as good as the method used to obtain them. ⋯ The criteria for the inclusion and assessment of measures were a measure assessing more than one domain and a target population of advanced disease or palliative care Forty-one measures were identified, 12 of which satisfied the inclusion criteria. These contained between five and 56 items and covered aspects of physical, psychological and spiritual domains. Each measure meets some but not all of the objectives of measurement in palliative care, and fulfils some but not all of our criteria for validity, reliability, responsiveness and appropriateness.