Articles: palliative-care.
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Clin Oncol (R Coll Radiol) · Jan 1992
Factors affecting treatment patterns of radiation oncologists in the United States in the palliative treatment of cancer.
A questionnaire was sent to 488 radiation oncologists in the United States and 268 replied. Each was given a brief account of three hypothetical patients (one with brain metastases, one with locally advanced lung cancer and one with bone metastases) and asked how they would approach the problems posed. ⋯ The aim of the radiation oncologist was related to the treatment pattern chosen, with the aim to extend life frequently related to higher total dose and number of fractions. When the amount of private funding was compared with dose, number of treatments, and whether the case was called palliative or not, no relationship was found.
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A study conducted for the Dr. Charles A. ⋯ The article describes those needs, and then outlines the multidisciplinary palliative home care program that was established by the health centre to address them. The program's procedures of operation and follow-up, and the evaluation process are discussed.
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Palliative care, supportive care of the dying, is rapidly changing to better meet the needs of the patients and families. If palliative care is provided in the home rather than in hospital, there is a potential for improvement in the quality of life for patients and their families and a potential for cost reduction in the health care system. Our study was undertaken to determine whether or not palliative care patients admitted to University Hospital could have been cared for at home rather than in the hospital. ⋯ The results indicated that 61% of these palliative care patients did not receive any palliative care at home and that 94% died in an acute care hospital setting. Only 18% lived in a setting other than their own home, and 68% had a spouse or other family member living with them at the time of their final admission. Based on the level of support in the place of residence prior to final admission and the reasons for admission, we determined that many of the patients could have been managed at home for at least some of the palliative care period if appropriate support from a home care team had been available.
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Comparative Study
Palliative care in a general teaching hospital. 1. Assessment of needs.
To assess the palliative care needs and the results of treatment of patients with terminal cancer admitted to a general teaching hospital. ⋯ One-third of patients with terminal cancer in a general teaching hospital received inadequate pain relief; the reasons for this included lack of medical expertise in the use of analgesics for chronic cancer pain and the frequent use of analgesia given only "as required". The underuse of allied health services, the infrequent documentation of psychological issues and the observation that only a small proportion of patients were able to die outside hospital all underline the need for a coordinated multidisciplinary approach to the management of patients with terminal cancer.