Communication in palliative care

Communication consists in an intentional exchange of verbal and non-verbal signs (symbols) undertaken in order to improve cooperation or share meanings among partners. The communication occurs on many levels, from the intrapersonal through interpersonal (involving a group), to the public level. In the context of palliative care, special importance is gained by the basic social behaviours, such as the ability to conduct a conversation. Communicativeness is a skill that is not only acquired through experience, but also through professional training. The interest of the interdisciplinary team requires improvement of the qualifications of its members in this respect. Only through full cooperation with the patient and the family, which will take into account the emotions and needs, can one negotiate common goals concerning care. Interdisciplinary team members should ensure proper communication in order to ensure the provision of optimal support to the patient and the family.Communication consists in an intentional exchange of verbal and non-verbal signs (symbols) undertaken in order to improve cooperation or share meanings among partners. The communication occurs on many levels, from the intrapersonal through interpersonal (involving a group), to the public level. In the context of palliative care, special importance is gained by the basic social behaviours, such as the ability to conduct a conversation. Communicativeness is a skill that is not only acquired through experience, but also through professional training. The interest of the interdisciplinary team requires improvement of the qualifications of its members in this respect. Only through full cooperation with the patient and the family, which will take into account the emotions and needs, can one negotiate common goals concerning care. Interdisciplinary team members should ensure proper communication in order to ensure the provision of optimal support to the patient and the family

Komunikacja w opiece paliatywnej

Komunikacja opiera się na intencjonalnej wymianie znaków (symboli) podejmowanej w celu poprawienia współpracy lub dzielenia się znaczeniami pomiędzy partnerami. Odbywa się ona na wielu poziomach - od intrapersonalnego, poprzez interpersonalny (angażujący grupę osób), aż do publicznego. W kontekście opieki paliatywnej specjalnego znaczenia nabierają podstawowe zachowania społeczne, takie jak zdolność do prowadzenia rozmowy. Komunikatywność to umiejętność, którą nabywa się nie tylko poprzez doświadczenie, ale także poprzez profesjonalny trening. W interesie zespołu interdyscyplinarnego leży podnoszenie kwalifikacji poszczególnych osób właśnie w zakresie komunikacji. Tylko poprzez pełną współpracę z pacjentem i jego rodziną, przy uwzględnieniu emocji i potrzeb, można uzgodnić wspólne cele związane z opieką nad chorym. Członkowie zespołów interdyscyplinarnych powinni zagwarantować właściwą komunikację w celu zapewnienia optymalnego wsparcia dla pacjenta i jego rodziny. Medycyna Paliatywna w Praktyce 2010; 4, 2: 81-8

Zgoda chorego na leczenie u kresu życia

W pracy przedstawiono problem informowania chorych kierowanych do opieki paliatywnej oraz prawnoetyczne argumenty przemawiające za uzyskiwaniem uświadomionej zgody chorego na tę opiekę. Omówiono także aspekty zgody zastępczej oraz przyjmowania chorych niekompetentnych do hospicjów. Medycyna Paliatywna w Praktyce 2010; 4, 3: 119-12

Age influence on opioid consumption in terminally ill digestive cancer patients

The aim of this work was to estimate the influence of the age and gender on the opioids usage in terminally ill digestive cancer patients. A retrospective files analysis of the 344 patients who had died in two palliative units, divided into three groups (< 60, 60–70, > 70 years old) was performed. Morphine Equivalent Daily Dose (MEDD) on admission, within the last 3 days, last 5 days and in the last day of life were compared. The number of patients receiving coanalgesics and the number of coanalgesics used per patient were also analyzed. The amount of opioids remained stable through the last 5 days. The mean daily MEDD values in every time intervals were significantly higher in the youngest group than in older ones. The number of coanalgesics used was the highest in the youngest group. Smaller number of patients received coanalgesics in the oldest group. Women < 60 years old required a significantly higher MEDD than men in each time interval, except of the admission. Study confirms the lower amount of opioids used in the elderly digestive terminal cancer patients and also within younger males