Articles: palliative-care.
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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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Uncontrolled metastatic carcinoma of the shoulder girdle is a difficult oncologic problem. This study reviews our experience with palliative forequarter amputation with emphasis on patient selection criteria, preoperative radiologic assessment, surgical technique, epineural postoperative analgesia, and clinical outcome. ⋯ Palliative forequarter amputation is relatively safe and reliable and provides effective pain relief for selected patients with unresectable metastatic carcinoma to the axilla and bony shoulder girdle in whom radiotherapy and/or chemotherapy has not been effective. The triad of pain, motor loss, and an obliterated axillary vein is indicative of brachial plexus infiltration and unresectability.
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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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Caring for the patient with end-stage renal disease poses many challenges for the bedside nurse. Yet, how do we care for patients who continue to seek hemodialysis with a guarded prognosis? A discussion about palliative care and specific interventions used to help improve quality of life for the end-stage renal patient is provided. A case example accompanies this article, and highlights the interventions used successfully for one such patient.