International journal of palliative nursing
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Self-awareness of one's own reactions towards patients and their relatives is of paramount importance for all professionals in palliative care. 'Core attitude' describes the way in which a person perceives himself and the world, and forms the basis for his actions and thoughts. ⋯ In the field of palliative care, core attitude consists predominately of authenticity, manifests itself in relationships, and requires a high degree of perceptiveness.
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The integrated care pathway is used in end-of-life care to improve quality of care; the Liverpool Care Pathway (LCP) has been used in Europe and North America. Tuen Mun Hospital is a regional hospital in Hong Kong, China. The End-of-life Care Pathway (ECP) based on the concepts used in the Liverpool Care Pathway, was developed, with modification to suit the local condition. ⋯ The audit result suggested integrated care pathway in end-of-life care could be implemented successfully in an Oriental culture. The acceptance of using the ECP as a standard clinical practice takes time and education. Appropriate template design and supervision are the keys to success.
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Transdermal fentanyl patches first became available in the early 1990s and provided an innovative treatment for the management of cancer pain. Since then, they have become a familiar and convenient method for providing analgesia for patients with stable levels of cancer pain. Transdermal delivery is more complex than oral administration and some specific factors need to be taken into consideration for the patches to be used appropriately and to their best advantage. This article will review the use of transdermal fentanyl, looking at their place in the overall therapy plan, the use of appropriate adjunctive prescribing and some specific practical and safety issues.
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Comparative Study
Quality-of-life assessment in a palliative care setting in Germany: an outcome evaluation.
Quality-of-life (QoL) assessment is crucial for the evaluation of a palliative care outcome. This article investigates the applicability of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) on a German sample of terminally ill cancer patients receiving palliative care in different settings. Patients were randomly selected in 10 palliative homecare services and one palliative care unit in a general hospital and 'evaluated' among the consecutively 'registered' patients. ⋯ The questionnaire was well accepted in the present patient population. In addition, the questionnaire was found to be useful in detecting the effectiveness of palliative treatment over a period of time. This study shows that QoL measures can be used to assess the outcome in palliative care.
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Experiences of family members of terminally ill patients with hospital end-of-life care were explored. The study is part of a larger study that investigated patients' and families' experiences; this study describes family members' unique experiences. ⋯ Nurses can best improve families' experiences of hospital end-of-life care when they are aware of families' priorities and take excellent care of the patient first, but, in addition, recognize family members, approach them actively and integrate them as co-caregivers as much as wished by patient and family member.