ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00234.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00235.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This paper reports on the social and personal relevance of religious faith entering into the situation of family stress due to the illness of a child with cancer. The expectations of religious faith may include, objectively, the actual physical healing of the child or the determination of the child's fate; it may include, subjectively, the hope for emotional support, the provision of moral guidance in time of difficulty, or an overarching life‐view. There were major religious changes in 20% of the families. While all the major religious faiths in South Korea were represented in the study, 61% of the sample identified Christianity as their primary religious respons

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00236.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The aims of this paper were to describe the patients' perceived well‐being, general health, symptoms and coping ability 1 year after surgery and to compare the results with the same as recorded before and 6 weeks after surgery and with those of healthy individuals. The investigation was carried out in a surgical unit at the Karolinska Hospital in Stockholm, Sweden during 1992 and 1993. Sixty‐nine patients (34 men, 35 women) with diagnoses of colorectal or gastric cancer participated in the study. Two randomly selected samples of healthy individuals were available for comparisons and were used as reference subjects. Main measurements were the Health Index (HI) and the General Health Rating Index (GHRI). The HI measured the change in well‐being before and after surgery. There were few and small differences in the patients' sense of well‐being 1 year after surgery compared with before. There was no significant difference between the total HI scores before and 1 year after surgery but the HI subscale scores for energy, bowel function and mobility had improved. The patients living alone rated their well‐being as inferior in comparison with those who lived with relatives. Furthermore, the cancer patients perceived their well‐being as inferior to that of healthy individuals. One year after surgery the patients had not returned to a state of normal health. Social and marital status apparently affected the patients' sense of

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Cancer patients are increasingly being cared for in the community. However, the role of the community oncology nurse specialist (CONS) remains a rare appointment in the United Kingdom. There is little research evidence to substantiate the view that this is a worthwhile and effective role. This study aimed to explore the role of one CONS using a qualitative case study approach. The sample consisted of the CONS, seven patients, no relatives and five community nurses. Semi‐structured interviews were used to elicit the view of these participants. In addition, documents containing details of the CONS's work to date were reviewed. A number of the CONS's role components were identified by the different respondent groups. Five themes were identified within the data collected: functions of the CONS, communication between the CONS and other health care professionals, structural and organizational factors, characteristics of the service and benefits to patients and their families. Furthermore, all respondent groups were positive about the service offered by the CONS, and felt that the role was valuable. Some negative features were identified and these were concerned with organizational aspects of the service. The findings suggest the need for further research and evaluation in this are

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In response to the particular demands upon patients and nursing staff in the outpatient setting, and the identification of a need for nursing orientated documentation, a new nursing documentation system has been developed and implemented within an oncology day unit. The documentation is used by the nursing team engaged in the care of patients receiving outpatient chemotherapy treatment. The system consists of documents for the initial and ongoing assessment, planning, implementation and evaluation of nursing care. These include pretreatment patient self‐assessment forms, flowsheets for the documentation of chemotherapy treatment and administration and a record for information and teaching given to patients and significant others. Referrals to other services and health care professionals are also documented. This tool is designed to ensure a high standard of nursing intervention and maximize quality of life in this group of patients. An audit is planned to evaluate the effectiveness of this tool and highlight any areas requiring improvement or modification. There are also plans to further develop this system for use in the inpatient and community settin

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This study aimed to document current palliative care initiatives, identify any reported changes in working practice as a result of audit, and determine the opinions of palliative care staff towards audit. All 31 established palliative care services within the former North West Thames Regional Health Authority were sent a brief postal questionnaire on previous and current audit activities. Of the 28 units who responded, most (78%,n=21) were currently involved in audit with a further 7% (n=2) planning to implement audit in the near future. Changes as a result of audit included implementation of standards, for example response to referrals; improvements in documentation, for example revision of case notes; and changes to unit practice, such as converting to multidisciplinary care plans. The respondents viewed the main advantage of carrying out any audit project as the improvement or maintenance of the quality of patient care. The principal disadvantage expressed was the time‐consuming nature of audit. An audit with a clear aim and thorough design can provide valuable evidence upon which new policies or strategies in palliative care can be based. By educating and training staff in audit and illustrating the benefits, any concerns about carrying out audit could be addresse

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00240.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The development of palliative care originated from shortcomings in mainstream health services. Palliative care aims to cater for both the psycho‐social needs of dying patients and the allieviation of their physical symptoms. This is reflected by the good and bad death perceptions of palliative care workers, though increasing signs of institutionalization in palliative care have challenged the idealization of a good death. This study aimed to investigate the health professionals’perception of both a good and a bad death and their perception of patients’awareness context. Seventy questionnaires were distributed to nurses and social workers. The 50 returned questionnaires revealed that health professionals perceived a good death as controlling the patients’physical symptoms and psychologically preparing them, whilst a bad death was perceived as the inability to control pain and deal with any psychological distress. Factor analysis identified three main factors (lack of patient distress, patient control and staff's supporting role perceptions) in the perception of a good death whereas four main factors (the negative effect of death on the family, a patient's non‐acceptance of death, not dealing with patients’fears and the age of a dying person) were identified with the perception of a bad death. Overall, health professionals perceived themselves to be open and sensitive in communicating with patients although over half felt poorly supported by

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00241.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Although only 25% of patients die at home, more than 90% of the terminally ill patient's last year of life is at home under the care of their own general practitioner (GP). In the United Kingdom, doctors training for general practice undergo a 3‐year training with 2 years in hospital posts and a year in general practice. This questionnsire study of 33 GPs who had recently completed their vocational training was carried out to ascertain the teaching given on palliative care during the general practice component of training. Very few GPs (15%) had received tutorials on palliative care from within their practice. Less than a third felt they had received adequate teaching on pain and symptom control and fewer than 10% perceived the teaching on psychological support to be adequate. Compared to previous studies, the knowledge of specific therapeutics in palliative care had improved, but several were uncertain of basic principles such as the maximum dose of oral opiates which could be prescribed. The majority (85%) wished to have a placement in a hospice as part of their vocational training. This survey suggests that today's GPs would be very receptive to more focused teaching on palliative care encompassing both symptom control and psychological care during their GP training and would also welcome the opportunity of a hospice placemen

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00242.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A project was funded by the UK's Department of Health to develop national guidelines for breast cancer related lymphoedema using a Consensus Strategy. This involved the organization of a consensus conference with a multidisciplinary panel of experts, an extensive literature review, the production of clinical guidelines and the implementation of the guidelines at three pilot sites (breast unit, hospice and community). The EORTC QLQ‐30, MOS SF‐36 and a standard assessment form were used to evaluate patient outcome. Diaries and semi‐structured interviews were used to elicit data on practitioner compliance and practical issues of implementing change using clinical practice guidelines. Results showed stable or improved scores in all categories of physical, social and emotional functioning and a stable or measured decrease in limb volume for 75% of the sample. Qualitative data obtained from practitioners demonstrated high levels of compliance from practitioners and patients and offers useful recommendations. This project highlights the importance of raising awareness of lymphoedema through the development and utilization of research‐based, patient‐centred g

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1996.tb00243.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY