Der Schmerz
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Given the large number of palliative patients cared for by the emergency services, education and training in palliative care topics are playing an increasingly important role. To support decision-making in an emergency setting a palliative or emergency card has been introduced in many cities. ⋯ The Paramedic Palliative Care Test (PARPACT) is a validated measurement tool for testing educational interventions in paramedicine.
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Specialized outpatient palliative care (SAPV) was introduced by the legislature in 2007 in § 37b of the German Social Code Book V (SGBV) as a form of care for people with a life-limiting illness and an increased complexity of care. It is therefore only required by some of the palliative patients. It is intended to avoid unnecessary hospital admissions and to enable those affected to remain in their home environment in a dignified manner despite a complex illness and to be accompanied there until death. ⋯ Both SAPV and SAPPV involve the use of a specialized and multiprofessional palliative care team (PCT), which is characterized by 24‑h accessibility and special qualifications, thus providing comprehensive support. This is provided in addition to general outpatient palliative care (AAPV) and aims to maintain, promote and, if possible, improve the quality of life and self-determination at the end of life as much as possible. The SAPV is a health insurance benefit and requires a prescription via form 63 by a physician.
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A graded therapeutic concept for the treatment of chronic pain patients in Germany is only available to a limited extent. Following the onset of coronavirus disease (COVID-19), care for these patients has become even worse. ⋯ The evaluation takes place 3, 6 and 12 months after initial assessment and includes the German Pain Questionnaire with different psychometric tests.
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Quality improvement in conservative pain management (QUIKS), a module for nonoperative patients in the QUIPS project was tested on a cohort of tumor patients regarding its applicability. ⋯ The application of the questionnaire was well accepted by the patients but required a high level of assistance in completing it. A high level of pain was observed during the hospital stay and the adjustment of pain therapy or the involvement of pain medicine specialists was rare. The interpretation of statements regarding the quality of tumor pain may be limited as other (pre-existing) pain entities, such as nontumor-associated pain or chronic tumor pain could not be clearly delineated.