Comment: The challenge of palliative care
Marilène Filbet
pp 92-92
It is a great honour for the Société Française d’Accompagnement et de Soins Palliatifs to organise the second congress of the EAPC’s Research Network in Lyon. Following the success of the first congress, in Berlin, the members of the Research Network were encouraged to organise another gathering, and the second congress is to be held at the Lyon Teacher Training College.
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Methadone: an alternative conversion regime
Dean Blackburn, Eric Somerville and Janet Squire
pp 93-96
Methadone is an opioid that is gaining increasing credibility in the palliative care field and could now be considered the opioid of choice in neuropathic pain, because of its action on N-methyl-d-aspartate (NMDA) receptors. It can be used as an alternative opioid in patients with pain poorly responsive to other opioids or with opioid side-effects. Other advantages are that it is cheap and relatively safe in patients with renal failure.
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Cancer pain management in Colombia
Jairo Moyano, Franklin Ruiz and Anneli Vainio
pp 98-101
According to the reports of the WHO, more than four million people worldwide experience pain caused by cancer on any given day and most receive inadequate treatment. Marked differences in treatment practices of cancer pain exist between countries, and undertreatment has been reported – even in many industrialised countries with an advanced healthcare system. In developing countries the situation is much worse.
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Case study masterclass 3: Small cell lung cancer
Carol Davis and Rachel Newman
pp 102-103
A 69-year-old man with small cell lung cancer is referred by his GP to your service for assessment at home. He is married with two children, both of whom live locally. Their daughter, aged 35, is a single mother and is pregnant. Their main concern is her health. Small cell lung cancer was diagnosed seven months ago and he had multiple bone metastases at presentation.
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Case study masterclass 2 answers: Adenocarcinoma of the sigmoid colon
Carol Davis and Tim Harrison
pp 103-103
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The need for evidence-based proof in palliative care
Raymond Hermet, Benoît Burucoa and Angélique Sentilhes-Monkam
pp 104-107
At a time when medicine is based on proof, there is a pressing need to carry out and develop research into palliative care. There is a need to lend substance to the care protocols offered to patients and their friends and relatives, and improve both efficacy and quality while integrating the progress made in medicine. However, there is also a need to improve knowledge and skills in other essential areas such as human sciences, ethics and teaching. Research into palliative care is both quantitative and qualitative.
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Between personal aspirations and professional skills
Françoise Porchet
pp 108-111
The Swiss Medicine and Palliative Care Society commissioned two members of its committee to carry out a quantitative study on the current availability of palliative care training in the French-speaking cantons. This study highlighted the following points: Of the 44 existing palliative care training possibilities, 75% are available to nurses, 18% to non-qualified staff working in elderly people’s homes, and only 12% to doctors. In 64% of cases, the training is of short duration (1–3 days) without any consolidation between the different training possibilities.
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Information needs of patients and families
Sheila Payne
pp 112-114
It is now taken for granted that providing information for patients and families is an essential element in delivering high quality palliative care. However, the nature and style of information provision remains problematic. The aim of this article is to examine critically the assumptions that underpin approaches to research and practice in relation to communicating with patients and dealing with their information needs.
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Palliative care: only a phone call away
David Guigou
pp 116-118
Palliative care in France, long since shrouded in confidentiality, is now becoming widespread. In addition, patient care organisations are diversifying and complementing each other, a move that has led to the creation of interhospital mobile teams, extrahospital teams and an increase in the range of care offered. The outcome of all this has been the creation of hospital palliative care units.
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No sex please, I’m dying. A common myth explored
Peter Wells
pp 119-122
Just because a patient has a life-threatening diagnosis, it does not automatically mean that they no longer wish to express their sexual feelings, or to convey expressions of their sexuality. Trying to assess and address the sexual needs of palliative care patients seems like one of the great last taboos across health professions.
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Facing death with confidence
Kevin Dunn and Louise Forman
pp 123-125
Most people like to feel that they are more or less in control of their lives, and this feeling can be a source of security and strength. When a ‘person’ becomes a ‘patient’, they sometimes report a feeling of loss of control. A patient tends to be a person to whom things are done: there is a passivity about being a patient. The feeling of loss of control can become stronger when the patient becomes aware that they will soon die.
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