ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00011.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00012.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Significant Event Analysis can be used to improve the effectiveness of a Primary Health Care Team caring for terminally ill patients. A method of doing this is described in detail. Positive team qualities were confirmed and enhanced. Significant areas for improvement were identified: insufficient information had been given to some key workers, changes in medication had been poorly planned, continuity of care, and emotional and professional support of team members were inadequate. A strategy for change was developed and implemented. Performance was reviewed a year later. It was found that the Significant Event Analysis had caused changes in team practices, and was valid and reliable enough to be used as a tool for improving teamwork in primary care in future.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00013.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The emergence of the speciality of palliative medicine in the UK has been generally welcomed and can be seen as a continuation of the attempts to improve the care of dying people begun by the modern hospice movement. However, not everyone has welcomed the new speciality unreservedly. In part, this reflects a more general ambivalence and concern about the role of medicine in terminal care. After a brief discussion of the‘medicalization’of death and an overview of the hospital care of dying people, the paper identifies five concerns about the development of the speciality of palliative medicine in Britain. These are:•the lack of clarity about its remit;•a potential shift of focus away from terminal care;•the inappropriate use of medical technology;•the role of other health workers;•the consequences for

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00014.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The issues surrounding nurses and their use of research are many and complex. Experience in a newly developing area of nursing–the management of lymphodema–has revealed three key reasons why nurses do not, on the whole, use the research process to answer clinical problems or use the results of research to change clinical practice. First, nurses tend not to see research as their own responsibility; secondly, they tend not to read on a regular basis; and finally, nurses are neither taught nor encouraged to think critically about what they do. The situation can be improved if senior nurses make a positive effort to foster an atmosphere of enquiry, report research findings in a language all can understand, and encourage fellow nurses in the pursuit of knowle

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00015.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A questionnaire survey was carried out of all general practitioners, community hospital nurses and community nurses working in Worcester Health District in the west of England, to assess the present state and future needs of their education in palliative care.The overall response rate of the survey was 72%. The respondents were an experienced group of doctors and nurses. They felt that their undergraduate or basic training did not prepare them to care for dying patients in the community.Educational needs were identified: control of symptoms other than pain and bereavement care were priorities for doctors. Community hospital nurses rated pain control education as a major need. Alternative medicine and caring for dying children were additional areas for further education for the general practitioner and community nurses.Ninety per cent of general practitioners, 84% of community hospital nurses and 95% of community nurses felt that multi‐disciplinary teaching sessions would be helpful. Analysis of their responses revealed that these would be most likely to succeed it they were arranged in the middle of the day during lunch or in the evenings.The doctors felt that they lacked protected learning time. Nurses also felt this, but in addition, identified lack of finance as a limiting factor in their post‐basic education. There was evidence that existing educational resources in the district are under‐uti

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00016.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This paper provides an overview of issues relating to pain assessment and management. Areas to be covered include the problems involved in assessing pain as a subjective phenomenon, the constraints of assessment within the clinical field, factors that affect pain, and pain assessment tools and questionnaires. The aim of the reference list is to provide back‐up reading to assist in exploring the options available when considering the possibility of compiling a pain assessment protocol for individual clinical area

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00017.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A practical framework for the management of pain control in palliative care of patients with advanced malignancies, using analgesics and co‐analgesics is described. The analgesic ladder is used as a model for the logical progression of options for the day‐to‐day application of analgesics. Strong opioids and their side‐effects are discussed. Indications for the most frequently applied co‐analgesics are given, including the more commonly required psychotrop

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00018.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

All treatments carry risks as well as potential benefits. For patients with cancer, management decisions have to consider the quality of survival, as well as the prolonging of life and choices about treatment which are often particularly stark. Participation in these decisions helps some patients adapt to their illness, increases their satisfaction with medical care and promotes acceptance of the treatment (Brody, 1980). For other patients it can impose undue responsibility and confusion, heighten anxiety or undermine trust in the doctor (Ingelfinger, 1986). Where does the balance lie?

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00019.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Book Reviews in this ArticlePrinciples of Health Care Ethics, edited by Raanan Gillon.Conflicts in Care: Medicine and Nursing, by Lesley Mackay.The Management of Terminal Malignant Disease, by C. Saunders&N. Sykes.Sociology of Health and Health Care, edited by Steve Taylor&David Field.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1994.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY