Paediatric palliative care
Richard Hain
pp 3-3
The first palliative medicine session at the annual meeting of the Royal College of Paediatrics and Child Health was in 2000. It attracted around 20 delegates. In 2005, the number was around 150, with attendance from a wide range of specialties, not just paediatricians, working in palliative medicine. Other than the numbers, what was remarkable about this session were repeated references to ‘the local paediatric palliative care (PPC) team’.
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Antibiotics and palliative care
Lukas Radbruch,Martina Pestinger, Annekatrin Mu¨ller and Frank Elsner
pp 5-9
Infections are common in patients with advanced cancer or other incurable diseases. The incidence ranges from 5% to 55% of patients.
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The management of breakthrough cancer pain: is current practice best practice?
Mary Nugent
pp 10-12
Great improvements have been made in addressing cancer-related pain over the last decade. However, the accepted practice of titrating regular pain relief medication according to an individual patient’s needs has failed to extend to the management of episodes of breakthrough cancer pain. Here, the traditional method of using an immediate-release formulation of strong opioid at a dose of one-sixth of the total 24-hour dose of regular or ‘around the clock’ (ATC) strong opioid leaves many patients still experiencing pain.
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Case study masterclass 24: Managing a young woman with cystic fibrosis
Jane Grant, Carol Davis and Clare Forsyth
pp 13-14
You are stopped one afternoon in the hospital corridor by one of your colleagues, the clinical nurse specialist in cystic fibrosis (CF). She wants to refer a 22-year-old patient to the hospital palliative care team (HPCT) for symptom control advice.
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Case study masterclass 23 answers: Difficult pain in a patient with mesothelioma
Sabrina Bajwah and Bernadette Lee
pp 14-14
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An audit of welfare benefits advocacy services in a hospice
Jean Levy and Malcolm Payne
pp 15-17
Welfare benefits advocacy has been seen as an important aspect of social work and some, famously Wootton in 1959, have argued that helping citizens to find a way through complex welfare systems should be its main role. Since the ‘rediscovery’ of poverty in the 1960s and 1970s, however, this has become an increasingly specialist role. There has been debate about whether social workers with generic roles can be expected to have the complex and legally based knowledge required for effective welfare benefits advocacy. This article reports on an audit of welfare benefits advocacy services in one hospice.
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The language of diversity: controversies relevant to palliative care research
Jonathan Koffman
pp 18-21
How we understand the influence of diversity in patterns of advanced disease, responses to treatment, and the use of palliative care services is important, given increasing evidence that we are not all equal in death. However, we need to be aware of a complex and contentious history in the evolution of ideas and terminology. Semantic confusion is very common when the concepts of race, ethnicity and culture are referred to in research, particularly as few authors attempt to define these concepts.
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Resilience in palliative care
Barbara Monroe and David Oliviere
pp 22-25
Resilience is a concept that is attracting growing interest. Vanistendae has defined it as ‘the capacity to do well when faced with difficult circumstances’ and the International Resilience Project, which collected data from 30 countries, described resilience as a, ‘universal capacity which allows a person, group or community to prevent, minimise or overcome damaging effects of adversity’. However, the definition of resilience is not as important as the philosophy that it can enhance. We believe that the concept has considerable relevance to palliative care.
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A social work perspective on palliative care for people with mental health problems
Emma Davie
pp 26-28
Adults with pre-existing severe mental health problems who develop a life-threatening illness that requires palliative care are among the most disadvantaged groups in our society. In relation to this, ‘Everyone deserves to face death with dignity, in their own surroundings with someone close by as a source of support and comfort. This is the cornerstone of hospice thinking, yet it can take on a complexity and poignancy when the dying individual has had a lifetime of coping with mental illness.’
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A model for reflection in children’s palliative care
Patricia McNeilly, Jayne Price and Sharon McCloskey
pp 31-34
The use of reflection as a means of enhancing performance is not a new concept. Almost 70 years ago, John Dewey, an educationist and philosopher, wrote about learning and thinking reflectively through analysis and critical thinking. Much has been written since about the notion of reflection within educational and other professional spheres.
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Palliative care in Poland – the Warsaw Hospice for Children
Stefan Friedrichsdorf, Sandra Brun, Boris Zernikow and Tomasz Dangel
pp 35-38
Only a few European countries provide professional paediatric palliative care, and even fewer have a paediatric hospice home care programme. Poland is fortunate to have such a service. This article reports epidemiological data on paediatric palliative care in Poland and describes the Warsaw Hospice for Children.
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Perception of the spiritual needs of patients
Sylvie Scaon, Gérard Chasseigne and Philippe Colombat
pp 39-40
An understanding of the perceptions of healthcare professionals of the spiritual needs of patients with a life-threatening illness is fundamental to understanding and, if required, modifying the care of dying patients. Such a study will be able to clarify the nature of the information which they retain to form an opinion, image or attitude towards patients.
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