Articles: palliative-care.
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Case Reports
[Appropriate early open heart palliation of univentricular atrioventricular connection with subaortic stenosis].
Long-term conventional pulmonary artery banding deteriorates ventricular function in patients who have univentricular atrioventricular connection with subaortic obstruction. Protection of the pulmonary vascular bed and early relief of subaortic stenosis is essential to improve the outcome after Fontan operation. From January 1995 through January 1996, three infants underwent open heart palliation because of univentricular atrioventricular connection with subaortic stenosis. ⋯ It is difficult to adjust appropriate blood flow through a Blalock-Taussing shunt and a surgically isolated pulmonary artery is capable of inducing pulmonary distortion after Damus-Norwoood type operation. Whereas natural regulation of the pulmonary arterial blood flow by a restrictive ventricular outflow tract is come up after a palliative arterial switch operation. Palliative arterial switch operation is an useful alternative open heart palliation for neonates and early infants who had univentricular atrioventricular connection with subaortic stenosis.
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Using an action research approach, the author worked with district nurses to enable them to identify their own palliative care education needs and to plan the appropriate education programme, with reflective practice enabling the identification of further education needs. This approach overcame some of the problems of pre-planned, unresponsive palliative care education programmes. ⋯ The knowledge gained from reflective practice is as relevant to nursing as the knowledge derived from academic theories. Reflective practice within palliative care education facilitates learning in a relatively new field of practice and generates a greater understanding of the complexities of palliative care and associated education needs.