International journal of palliative nursing
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Palliative care is rarely delivered by one provider; for most patients their care will be managed by community and one or more hospital teams at the least. This can be problematic for patients, their family and friends, and health professionals. Evidence suggests that, in general, providers work in isolation from each other. ⋯ The aim was to improve communication and dialogue to promote more effective integrated working between the two sites and develop effective interprofessional working. This article will evaluate the impact of this new post, after 18 months, on collaboration between the teams, their practices and their patients. Finally, it will offer recommendations for future development.
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to clarify the concept of hope as perceived by patients with a terminal illness, to develop hope as an evidence-based nursing concept, to contribute new knowledge and insights about hope to the relatively new field of palliative care; endeavouring to maximize the quality of life of terminally ill patients in the future. ⋯ By completing all the steps to Rodgers' (2000a) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved. This provides a solid conceptual foundation for further study.
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This article outlines the conceptual thinking and development of core competencies for a palliative care educator. It is suggested that the process of defining a common core of key skills, personal qualities and attributes that reflect the unique role of a palliative care educator can provide an indicator of the diversity and complexity of this role, which can be used by the educator and employer in job planning, review and professional development. It can also potentially inform pay remuneration that is commensurate with both experience and responsibilities. For employers there is the opportunity to use the core competencies in the appointment of suitably able educators above and beyond the requirements of a standard job description.
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The Mental Capacity Act 2005 is due to be fully implemented in the UK in October 2007 with some of its provisions having already come into force in April 2007. The Act is concerned with the way in which decisions are made on behalf of those individuals who lack the capacity to make their own decisions. It is therefore expected that the Act will have a significant impact on decision-making within palliative care.
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Between 40 and 80% of patients with advanced cancer experience breakthrough pain (BTP), a sudden, rapidly escalating flare of pain occurring against a background of otherwise well-controlled persistent pain. Patients often have up to four episodes of BTP each day, with a typical episode reaching its peak intensity in three to five minutes and lasting about 30 minutes in total. ⋯ The usual approach is to treat BTP with a short-acting, 'normal release' oral opioid, but this is absorbed too slowly to treat the typical episode of BTP. As this article explains, oral transmucosal fentanyl citrate (Actiq) is an effective strong opioid that has a rapid onset and short duration of action that closely matches the characteristics of an episode of BTP.