Journal of pediatric hematology/oncology
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J. Pediatr. Hematol. Oncol. · Apr 2011
Optimizing pain care delivery in outpatient facilities: experience in NCI, Cairo, Egypt.
As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. ⋯ Importantly, the facility provides comprehensive care with professionals available 24 hours/7 days. On-call teams assigned to manage pain and other treatment modalities comprises of staff supervised by the primary cancer clinicians; this arrangement facilitates reaching this goal. This study will illustrate our experience through 25 years, trying to provide the highest care of patients with cancer pain on an outpatient basis.
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Palliative care is a very new concept in Palestine. In fact, it is still not applicable or provided within the Palestinian health care system. However, Al-Sadeel Society had organized a one day workshop in Bethlehem on November 2008 for the health professionals from the governmental and non-governmental sectors to initiate and introduce the idea of palliative care for the first time in Palestine. ⋯ We conducted a needs assessment survey within the only four facilities that provide care for the oncology patients in the West Bank and were filled by the direct health care providers. The results were expressing the fact that there is no palliative care service available for cancer patients or their families, absence of organizations strategic planning for palliative care, No presence of educational resources for palliative care, No presence of communication or consultation to the clergy man, Absence of bereavement support group, no active follow up for the patient and the family, no standards for palliative care service or training programs in palliative care, no home care service for palliative care, absence of community awareness for palliative care And Absence of national standard for palliative care. The recommendations that we can conclude, depending on the needs assessment that we did, and according to the recommendations that come up through the workshop that was organized by Al-Sadeel Society and was attended by key personnel from the Palestinian MOH who summarized the conclusion, are as follows: 1. The need for better quality care for the cancer patient.2. The need for training of health professionals in palliative care.3. The importance of networking and cooperation between the national NGO's and the MOH.4. The need for public awareness regarding the early detection for cancer especially breast cancer.5. The need for national policy and standards for palliative care and opioids legislations.6. The importance of base line data and research. 7. The need for interdisciplinary team work in the issue of cancer. 8. To involve palliative care education within the curriculum of schools of health professions.
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J. Pediatr. Hematol. Oncol. · Apr 2011
Opioids for cancer pain in the Middle Eastern countries: a physician point of view.
Cancer is an increasing problem in the Middle Eastern (ME) countries. It is the fourth leading cause of death in this region. At present, resources for cancer control in the ME countries as a whole are not only inadequate but directed almost exclusively to treatment. ⋯ An estimated 60% (27 million) of these people in developing countries would benefit from palliative care, and this number is growing as chronic diseases such as cancer rise rapidly. From the situation analysis of palliative care in the ME countries, suggesting that pain relief is insufficient, improvements in palliative care delivery are a high priority. We reviewed the situation of pain management and pain control in Lebanon and the ME countries, the barriers that are present, and we propose the priorities and a reform for an integrated approach to address the problem of under-treated pain at all levels:
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J. Pediatr. Hematol. Oncol. · Apr 2011
Opioids for cancer pain: availability, accessibility, and regulatory barriers in Turkey and Pallia-Turk Project.
Palliative care is an emerging topic in Turkey within recent years. Currently, there are only few number of palliative care services across the country and majority of the centers are pain control units. ⋯ One of the main headings of Turkish Cancer Control Programme 2009-2015 is palliative care and a serial palliative care unit implementation with continuous training programmes is planned to be finalized until 2015. This article reviews the current palliative care situation in Turkey, opioid availability in Turkey and also briefly summarizes Pallia-Turk Project which is unique with respect to many different aspects for implementation, and can be a good model for many other countries that still did not have such an implemented palliative care program.
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Children with cancer experience repeated invasive and painful medical procedures. Pain and distress does not decrease with repeated procedures and may worsen if pain is not adequately managed. ⋯ Guiding principles described in the recommendations continue to hold true today: maximize comfort and minimize pain, use nonpharmacologic and pharmacologic interventions, prepare the child and family, consider the developmental age of the child, support family and child involvement, assure provider competency in performing procedures and sedation, and use appropriate monitoring to assure safety. This article reviews these key components for managing painful procedures in children and reviews the latest pharmacological and nonpharmacological interventions most effective in minimizing pain and discomfort.