Articles: palliative-care.
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Palliative medicine · May 2001
ReviewMainstreaming palliative care for cancer patients in the acute hospital setting.
Palliative care is now emerging as an integrated part of mainstream health care delivery. The importance of patient choice regarding place of dying means that a substantial proportion of palliative care provision occurs in community settings. In part, this is due to the inappropriateness of the acute hospital setting for the care of dying patients. ⋯ Therefore, there remains a need for skilled and compassionate provision for the care of dying patients in the acute hospital setting. This paper presents a case for the provision of palliative care services in teaching hospitals. It further argues that a high level of integration between cancer treatment services and palliative care services is needed to optimize the care of cancer patients.
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Palliative medicine · May 2001
Educational opportunities in palliative care: what do general practitioners want?
It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educational preferences vary. The aim of this study was to explore the current educational preferences of GPs in different geographical locations as part of an evaluation of an educational intervention. ⋯ More inner-city GPs wanted education in opiate prescribing (43%), controlling nausea and vomiting (45%), and using a syringe driver (38%) than their urban and rural colleagues (26%, 29% and 21%, respectively). Increased educational preference and increased difficulty in accessing information was associated with reduced confidence in symptom control. To maximize educational uptake it will be important for educational strategies to be developed and targeted according to variations in demand, and in particular to respond to the need for palliative care education in symptom control for patients suffering from advanced non-malignant disease.
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The number of patients handicapped by chronic pain is increasing in Sweden. Many of these patients do not receive adequate care despite guidelines issued in 1994 by the National Board of Health and Welfare recommending councils to establish multidisciplinary pain teams according to the guidelines issued by the International Association for the Study of Pain. A survey of Swedish general hospitals reveals that these recommendations have not yet been implemented. With the exception of university hospitals only one out of five hospitals has set up specialised pain care teams; in remaining hospitals the organisation of pain management leaves much to be desired.