Articles: palliative-care.
-
The family is usually the primary provider of care for the terminally ill patient with cancer or other serious progressive illness. The way in which such a family functions is a major determinant of psychological well-being for its members. Through screening with the Family Relationships Index (FRI) (Moos and Moos, 1981), dysfunctional families and those at risk can be identified, and then helped to achieve better family functioning, thus improving psychosocial outcome of their grief. In this paper, we describe the techniques and themes involved in the application of our empirically developed model of family grief therapy, designed as a preventive intervention for use in the setting of palliative care and bereavement.
-
Wien Med Wochenschr · Jan 1998
Assessment of satisfaction with the communication process during consultation of cancer patients with potentially curable disease, cancer patients on palliative care, and HIV-positive patients.
The aim of this study was to evaluate the attitudes of cancer patients towards the medical interview and to determine their psychosocial satisfaction subsequent to the dialogue. The answers given by patients with curable cancer were compared to those given by cancer patients whose treatment intent was palliative and to the replies of patients infected with the human immunodeficiency virus (HIV), a nonmalignant but also incurable state. The subject population comprised a total of 139 patients. ⋯ Cancer patients considered themselves better informed compared to patients with HIV-infection. This is in significant contrast with the actual, measurable knowledge about their disease in the latter group. It is indeed surprising that only a small minority of incurable cancer patients realized that the goal of the medical care they received was relief of symptoms, the principle objective of palliation.
-
Palliative care is the active total care of patients whose disease is not or no more responsive to curative treatment. Its action strategies should be applied at the time when the goals change from cure to care. Palliative care is total care of body, mind and spirit. ⋯ The general principles of treating dyspnoea and pain are the same as for any other aspect of treatment in palliative care: 1. to define and treat the underlying cause of dyspnoea wherever possible and reasonable for the patient. This includes oncological interventions such as chemotherapy and radiotherapy as far as the patient's status allows it. 2. to relieve dyspnoea without adding new problems by way of sideeffects, interactive effects, social or financial burdens. The rule of proportionality to treatment affirms that symptom control and life-prolonging treatment are contraindicated when they cause more suffering than benefit. 3. to consider whether a treatment will be worthwhile for the patient and his family bearing in mind his prognosis and adverse effects of invasive procedures. 4. to discuss all reasonable treatment options (including the decision of "no intervention") with the patient and his family, allowing them to make the final decision as far as possible by themselves.
-
Acta neurochirurgica · Jan 1998
The effect of peripheral glycerol on trigeminal neuropathic pain examined by quantitative assessment of abnormal pain and sensory perception.
In nine patients with trigeminal neuropathic pain after nerve injury, we examined prospectively the effect of peripheral glycerol neurolysis on abnormal pain and sensory perception. In the painful facial skin area of these patients, we found increased temperature and tactile thresholds and the presence of abnormal temporal summation of pain. In seven patients, neuropathic pain was peripheral and disappeared after application of local anaesthesia at or proximal to the site of nerve injury. ⋯ We suggest that glycerol-induced reduction of primary afferent hyperactivity may secondarily result in down-regulation of central neuronal hyperexcitability. The efficacy of application of glycerol at the site of nerve injury in patients with peripheral trigeminal neuropathic pain may warrant further investigation. However, this prospective study does not provide evidence that application of glycerol proximal to the site of nerve injury has a place in the treatment of trigeminal neuropathic pain.