Journal of palliative medicine
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Little is known about the relevance of advance care planning (ACP), including the use of advance directives (AD) and health care power of attorney in transitional countries where access to health care is often limited. ⋯ ACP is deemed relevant and helpful in this South African context. Factors for consideration include sensitivity to diverse cultural and individual preferences, available resources to meet preferences, wider participation in discussion among collectivist-oriented societies, and the role of gender in family decision making.
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Palliative care (PC) services are a very limited service in Albania and are provided mainly from the nonprofit sector (nongovernmental organizations [NGOs]) that cover about 30% of the demand. There are very few doctors and nurses qualified in PC and pain management. Training and education programs on opioid treatment do not exist and patients cannot access opioids easily. ⋯ At the end of the seminar barriers were significantly lower, with the total mean scores (with standard deviation) reduced from 2.4±0.6 to 1.6±0.7. High barriers to the use of opioids in family physicians in Albania were reduced significantly following a one-day training, demonstrating the effectiveness of the intervention. However, more research on the sustainability of the training effect is needed.