Articles: palliative-care.
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Ann Acad Med Singap · Mar 1994
Central Sydney Palliative Care Service: potential and limitations of an integrated palliative care service based in a metropolitan teaching hospital.
Palliative care needs to be available wherever needed, in hospital and home, and should be part of mainstream health care. Palliative care should be concurrent with anti-disease therapy, and includes but goes beyond "terminal care". The World Health Organization (WHO) encourages such development. ⋯ Approximately 1000 new patients are referred annually by doctors (specialists or general practitioners) for medical consultation. Registrar (fellow) training in palliative medicine is a feature of the service. Palliative care in a hospital or community-based service is an issue of justice and equity, and gives structure to compassion.
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Social science & medicine · Feb 1994
Are bereaved family members a valid proxy for a patient's assessment of dying?
To compare assessments made retrospectively by bereaved family members (or the nearest carer to the patient) with assessments made before death by palliative staff and, where available, by patients themselves or the family member. ⋯ Retrospective assessments by bereaved family members may be valid for some items related to service provision, but not as the sole assessment of a patient's pain, symptoms or anxiety. We suggest that studies which rely on these retrospective ratings should assess the validity of their responses and record more information about the mood and grief of the family member.
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Family physicians were asked about their recent experience with caring for dying patients at home and for their evaluation of a recently established Palliative Care Home Support Team. Ninety-four percent of the respondents had cared for at least one dying patient at home during the previous 2 years. ⋯ One quarter felt personally drained by the experience, but almost as many found it personally renewing. Of those who had referred patients to the team, two thirds gave the team high ratings for being supportive, helpful, quick to respond, and effective in communication.
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Palliative medicine · Jan 1994
Safety and efficacy of nebulized lignocaine in patients with cancer and breathlessness.
Although anecdotal reports suggest nebulized lignocaine may help breathlessness in patients with cancer this has not been examined formally. We report a pilot study comparing nebulized lignocaine 100 mg and 200 mg with saline in six patients with cancer who were breathless at rest. ⋯ The effort of breathing (measured on a visual analogue scale) did not differ between treatments, whereas the distress of breathing was less after saline than after either dose of lignocaine. These findings do not support the reported benefits of nebulized lignocaine.