Articles: palliative-care.
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J. Peripher. Nerv. Syst. · Jan 1996
Clinical TrialPain relief by various kinds of interference stimulation applied to the peripheral skin in humans: pain-related brain potentials following CO2 laser stimulation.
Pain perception is changed by various kinds of interference stimulation applied to the peripheral skin in humans. We investigated pain-related somatosensory evoked brain potentials (pain SEPs) following CO2 laser stimulation applied to the hand or foot in normal subjects, to elucidate the underlying mechanisms. A pain visual analogue scale (VAS) was also scored to determine the degree of subjective feeling of painful sensation. ⋯ These findings could not be accounted for by simple changes in the subjects' attention. Pain relief was more prominent at the second pain ascending through C fibers than that of the first pain ascending through Adelta fibers. The responsible sites for this phenomenon are considered to be the dorsal horn of the spinal cord, the brainstem and some parts of the brain such as the second sensory cortex and the cingulate cortex.
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We studied family members' care experiences during the palliative care phase as predictors of family members' health and family functioning during the palliative care phase and three months following the death of the patient. Eighty family members of advanced cancer patients participated in the study at time one (T1) (palliative care phase) and 64 family members completed the data collection protocol at time two (T2) (three months bereavement). Data were also obtained from 36 of the patients within one month of their deaths. ⋯ Family members' scores on the health index (symptom of stress scale) were significantly lower (p < 0.05) than normative scores reported in a study using a healthy population. The strongest predictor of family members' health scores in the bereavement period was their health score at T1 (r = 0.71, p < 0.01). As well, family functioning at T1 was strongly correlated with family functioning at T2.
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Rhenium-186(Sn)-1,1-hydroxyethylidene diphosphonate (186Re-HEDP) has been used for palliation of metastatic bone pain. The purpose of this study was to find a relationship between the bone marrow absorbed dose and the toxicity, expressed as the percentage decrease in the peripheral blood platelet count. ⋯ Although the function of normal bone marrow is affected by metastases in patients with metastatic bone disease, the MIRD model can be used to relate toxicity to the bone marrow absorbed dose after a therapeutic dosage of 186Re-HEDP.
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The Palliative Performance Scale (PPS), a modification of the Karnofsky Performance Scale, is presented as a new tool for measurement of physical status in palliative care. Its initial uses in Victoria include communication, analysis of home nursing care workload, profiling admissions and discharges to the hospice unit, and, possibly, prognostication. We assessed 119 patients at home, of whom 87 (73%) had a PPS rating between 40% and 70%. ⋯ Only two patients at 60% or higher died in the unit. The PPS may become a basis for comparing drug costs at home and for studying the effects of treatments (e.g. hypodermoclysis) at various levels of physical performance. Validity and reliability testing are currently being undertaken.
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The Greater Victoria Hospital Society (GVHS) Palliative Care Committee surveyed medical and nursing staff from four hospitals and The Victoria Hospice Society in February, 1993. The purpose of the survey was to identify physicians' and nurses' perceived educational needs related to death and dying. ⋯ Physicians and nurses identified communication skills as being paramount. Communications concerning ethical issues were highlighted as the most difficult to cope with.