International journal of palliative nursing
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In order to ensure that further developments and improvements are made in palliative care, research is essential. Palliative care is no different from other specialities in that it needs a scientific foundation on which to base its practice. ⋯ One of the major issues is how to obtain informed consent from patients. This article discusses the practical and ethical issues surrounding consent for quantitative research in palliative care, and offers some guidance to health professionals considering the issue with patients.
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This article reviews the provision of palliative care services in the Republic of Cyprus, highlighting healthcare resources in general and palliative care in particular. An interesting feature of palliative care in Cyprus is the extent to which community palliative care provision appears to be expanding and developing, with hospice care supplementing the work of home care nurses. The role of the home care nurse is discussed and the key role played in patient and family education highlighted. The article raises some interesting features of the relationship between bereavement and culture highlighting the influence that medicalization of health has on traditional ways of caring for patients with cancer and non-cancer conditions.
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Delirium is a frequent and serious clinical problem in the terminally ill cancer patient. Multiple dimensions of delirium make definition, measurement, and assessment of it challenging in clinical nursing practice. ⋯ Four delirium assessment scales determined to be useful in assessing patients with terminal illness are reviewed. The use of a delirium assessment instrument in routine nursing assessments would be important for the nurse's early detection of delirium so that interventions to reverse the causes of delirium could immediately be implemented.
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Subcutaneous drug infusion using a portable syringe driver has had a significant impact on patient comfort in palliative care. It permits the continuous delivery of a range of drug therapies, so bypassing problems of dysphagia, weakness and the inability of many patients in the terminal phase to take oral medication. ⋯ Mechanical problems, reactions at the infusion site and difficulties with the mixing of drugs in the syringe are all widely recognized. This article reviews some general issues with the operation of portable syringe drivers, and discusses a range of potential problems and their solutions.
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Efficient, comprehensive documentation is a vital element of all healthcare provision. It not only provides a record of care, but should reflect the quality of that care, enable continuity of care between practitioners and reinforce care standards. ⋯ This article describes the formulation of an integrated system of documentation which aims to address the failings of documentation procedures in one hospice/palliative care unit. The resulting system seeks to embody the rationale of palliative care within a dynamic, patient-centred approach to nursing documentation.