Articles: palliative-care.
-
Biography Historical Article
Learning from Sir William Osler about the teaching of palliative care.
The publication by Michael Bliss of his authoritative and illuminating text William Osler: a Life in Medicine (1) provides a wonderful opportunity to reflect on the life of a great man who had a major influence on medical undergraduate teaching and medical practice. His approach to the care of both patients and colleagues was warm and encouraging. ⋯ He had the ability to blend wide knowledge with high ideals and common sense to influence the ways in which the doctor-patient relationship developed. Drawing on passages from the biography of William Osler, and linking his practice with the work of Donald Schön and the development of reflective practice, this paper identifies elements of our roles as clinicians and teachers that could be enhanced by further examination of the life of a man who has been described as the "greatest doctor in the world" (1, p. 480); a physician "whose work lies on the confines of the shadowland" (1, p. 291).
-
Cochrane Db Syst Rev · Jan 2001
ReviewOpioids for the palliation of breathlessness in terminal illness.
Breathlessness is a common symptom in people with advanced disease. The most effective treatments are aimed at treating the underlying cause of the breathlessness but this may not be possible and symptomatic treatment is often necessary. Strategies for the symptomatic treatment of breathlessness have never been systematically evaluated. Opioids are commonly used to treat breathlessness: the mechanisms underlying their effectiveness are not completely clear and there have been few good-sized trials in this area. ⋯ There is evidence to support the use of oral or parenteral opioids to palliate breathlessness although numbers of patients involved in the studies were small. No evidence was found to support the use of nebulised opioids. Further research with larger numbers of patients, using standardised protocols and with quality of life measures is needed.
-
This paper explores how music therapy can assist patients and relatives in the processes of making friendship and love audible in a child cancer ward. Four short patient histories are presented to illustrate a health-oriented, ecological music therapy practice. Two histories describe how texts, made by patients, become songs, and how the songs are performed and used. ⋯ The paper indicates that these interventions may involve more than palliation (making a disease less severe and unpleasant without removing its cause). Not least, such activities can make it possible for the sick child to expand from being "just a patient" into playing, if only for a moment, a more active social role. The processes of artistic interplay, in- and outside the sickroom, influence various relationships in the child's social environment.
-
This study examined activities related to the provision of psychosocial care by counsellors in the hospice/palliative care setting. A qualitative design using written reports was used in an urban Canadian hospice/palliative care program. A convenient sample of 13 counsellors indicated the activities they typically performed in their work with patients and families. ⋯ These thematic findings confirmed those of previous studies and also highlighted two additional findings. Team support was seen as an activity that directly affected client care, and there was a strong emphasis on the activity of companioning the dying and their families. Also discussed are implications of these results, as well as suggestions for further research.