266 research outputs found
Global palliative care: from need to action
Katherine Sleeman and colleagues
report the first
worldwide projection of the future global burden
of serious health-related suffering. The calculation
followed the methods used by the Lancet Commission on
Palliative Care and Pain Relief assessing global palliative
care need.
Combining these methods with WHO’s
revised global and regional projections of mortality up to
2060,3
the authors estimate the global burden of serious
health-related suffering requiring palliative care by world
regions and age groups for 20 health conditions. The
vision of the future delivered by this Article is alarming:
“By 2060, an estimated 48 million people (47% of all
deaths globally) will die each year with serious healthrelated suffering, and 83% of these deaths will occur
in low-income and middle-income countries”.1
These
numbers indicate that 130000 people worldwide will die
every day with serious health-related suffering by 2060,
the equivalent to twice the size of a Super Bowl stadium.
The real burden of serious health-related suffering is
even greater because the authors’ calculations are based
on mortality data and do not include the burden of
people living with serious health-related suffering who
do not die in a given period
Palliative care in its own discourse: a focused ethnography of professional messaging in palliative care
Background
Despite 50 years of modern palliative care (PC), a misunderstanding of its purpose persists. The original message that PC is focused on total care, helping to live until the person dies, is being replaced and linked to feelings of fear, anxiety and death, instead of compassion, support or appropriate care. Society is still afraid to speak its name, and specialized units are identified as “places of death” as opposed to “places of life” meant to treat suffering. This issue is prohibitive to the implementation and development of PC policies worldwide. It is imperative to identify what message PC professionals are relaying to patients and other health care specialists and how that message may condition understandings of the right to access PC.
Methods
A qualitative study, employing focused ethnography and participant observation (PO) of the daily interaction of PC professionals with patients and family members in three different PC services. Two researchers independently conducted a thematic analysis, followed by member checking with participants.
Results
A total of 242 h of participant observation revealed the following messages sent by PC professionals in their daily interaction with patients and families: i) We are focused on your wellbeing; ii) You matter: we want to get to know you; iii) Your family is important to us.
Conclusion
The complexity of PC discourses contributes to the difficulty of identifying a clear universal message between PC professionals, patients and families. The PC professionals observed transmit a simple message focused on their actions rather than their identity, which may perpetuate some social/cultural misunderstandings of PC. It seems there is a common culture, based on the same values and attitudes, within the messages that PC professionals transmit to patients and their families. PC teams are characterised by their availability
Alucinaciones visuales y dolor inusual en relación a hipomagnesemia en un paciente con cáncer avanzado
Hypomagnesemia has been related to high accumulated
doses of cisplatin, and its clinical presence is
characterized by neuromuscular and cardiovascular
alterations.
We present the case of an advanced cancer patient
who had received successive lines of chemotherapy
and who was receiving opioid treatment for cancer
pain. During his hospital stay, he experienced visual
hallucinations and very intense, unexplained pain in
one shoulder. Symptoms reverted with the normalization
of his plasma magnesium levels, which were low.
We consider that plasma magnesium levels should be
monitored in oncology patients with neurological or
psychiatric symptoms or with unusual pain
Palliative care professionals’ message to others: an ethnographic approach
Introduction: Palliative care continues to be misunderstood within the world of healthcare. Palliative care professionals are key agents for promoting a greater understanding of their field. This study aims to examine the messages, both implicit and explicit, that palliative care professionals transmit about themselves and their work within their teams and to other health professionals. Methods: Focused ethnographic secondary analysis, exploring the interactions of palliative care professionals as it happens at everyday work. An inductive thematic analysis was developed from 242 h of observation of the daily work practices of palliative care professionals, focusing on their interactions with others. The data was coded without predefined categories, and the analysis was performed independently by two researchers. Results: Palliative professionals communicate that they are part of an active team working in an organized manner. They value and feel proud of their work. Despite the intensity of their work, these professionals are always available to others, to whom they demonstrate a clear professional identity. They convey their expertise in alleviating suffering, respectful behavior and collaborative ability. Conclusion: Professionals, in their daily work, communicate through their messages the essence of palliative care. It is essential that palliative care professionals perceive themselves as potential influencers and explicitly transmit the reasons for their intervention. Otherwise, others will perpetuate the myths, misunderstandings, and lack of a positive reputation for palliative car
Experiences in clinical ethics: a project for meetings on clinical ethics in palliative medicine
"Meetings on Clinical Ethics in Palliative Medicine," as outlined in this article, is a project on ethical and clinical training in the area of palliative care. The project is part of a clinical program and broader research pertaining to recovery of the anthropological and ethical roots in the clinical practice of palliative care. It is aimed at professionals and researchers in palliative care and consists of informal meetings where the human and professional values involved in actual clinical cases are analyzed. Anthropology, general ethics, medical epistemology and philosophy of medicine are considered essential in this program of ethical and clinical training, as are the valuable insights provided by the humanities. The specific objective is not only to provide a list of ethical principles, but also to promote an ethical disposition on the part of the person who acts."Encuentros sobre ética clínica en la medicina paliativa" es un proyecto de formación ética y clínica en el ámbito de los cuidados paliativos. Hace parte de un programa clínico y de investigación más amplio que pertenece a la línea de recuperación de las raíces antropológicas y éticas en la práctica clínica de los cuidados paliativos. Está dirigido a profesionales e investigadores en cuidados paliativos, y contempla el desarrollo de reuniones informales, donde se analizan los valores humanos y profesionales involucrados en casos clínicos reales. En este programa de formación ética y clínica, se consideran esenciales la antropología, la ética general, la epistemología médica y la filosofía de la medicina, además es valiosa la información proporcionada por las humanidades. El objetivo específico no es solo proporcionar una lista de principios éticos, sino también promover una disposición ética de parte de la persona que actúa
Public health opportunities to improve palliative care integration across Europe
The ageing of the European population results in a higher risk of suffering from cancer, neurodegenerative and chronic diseases. The integration of palliative
care in to the national healthcare systems, and in to those disciplines dealing with chronic and advanced
diseases, is of the utmost importance to guarantee equal access to appropriate palliative care for citizens in Europe
Astenia en cáncer avanzado y uso de psicoestimulantes
Asthenia is the most frequent symptom in patients
with advanced cancer and is probably what most
affects the quality of life of oncology patients since it interferes
in their physical and social activity. Treatment
in the majority of cases is symptomatic. There is
growing interest in the use of psychostimulants for treating
asthenia. Methylphenidate and modafinil are two
psychostimulants that have already been tested in controlled
studies on asthenia of the patient with advanced
cancer; they have proved to be efficient, particularly in
patients in very advanced stages who are very tired
Suffering and personal growth in coping with illness
En este número de Anales del Sistema Sanitario de Navarra se publican tres estudios diferentes que reflejan las distintas caras del sufrimiento ante la enfermedad. Uno de ellos trata sobre el sufrimiento del paciente que tiene dificultades para adaptarse al trasplante cardiaco, otro versa sobre el sufrimiento de la familia (en este caso, de los padres de niños oncológicos), y un tercer artículo aborda el sufrimiento del profesional, médico de Atención Primaria3. Sufre el enfermo, sufre su familia y puede sufrir el profesional que les atiende. Sin embargo, una lectura detenida de los trabajos nos permite ser optimistas porque se ve cómo la enfermedad puede ser también ocasión de crecimiento personal para los diferentes agentes implicados
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