摘要 :
Palliative care in Japan has developed through a number of transition stages. The first of these was the recognition of costs for care received at a palliative care unit as eligible for reimbursement under the medical insurance sy...
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Palliative care in Japan has developed through a number of transition stages. The first of these was the recognition of costs for care received at a palliative care unit as eligible for reimbursement under the medical insurance system. The second stage was the recognition of costs for care received from a hospital-based palliative care team as eligible for reimbursement under the medical insurance system. The third stage was government policy relating to palliative care, including establishment of the Cancer Control Act formulation of the Basic Plan to Promote Cancer Control Programs and implementation of the Promotion Plan for the Platform of Human Resource Development for Cancer. A total of 350 000 cancer patients died during fiscal 2011, of which 9% made use of a palliative care unit. The use of palliative care is steadily growing with a trend away from palliative care units toward palliative care teams and care in the home. Whereas it was once seen as the limited treatment of terminal care, palliative care is increasingly becoming integrated into mainstream treatment. Basic palliative care education programs for physicians not specializing in palliative care and other medical practitioners are bringing about the spread of basic palliative care in Japan, thus putting in place broad foundations for the practice of palliative care. Improving the quality of palliative care and providing specialized palliative care are essential in Japan. Future challenges are (i) the construction of a community palliative care network, (ii) fostering specialists in palliative care and (iii) the provision of high-quality palliative care and end-of-life care to patients with life-threatening illnesses that are not limited to cancer.
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摘要 :
Palliative care in Japan has developed through a number of transition stages. The first of these was the recognition of costs for care received at a palliative care unit as eligible for reimbursement under the medical insurance sy...
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Palliative care in Japan has developed through a number of transition stages. The first of these was the recognition of costs for care received at a palliative care unit as eligible for reimbursement under the medical insurance system. The second stage was the recognition of costs for care received from a hospital-based palliative care team as eligible for reimbursement under the medical insurance system. The third stage was government policy relating to palliative care, including establishment of the Cancer Control Act formulation of the Basic Plan to Promote Cancer Control Programs and implementation of the Promotion Plan for the Platform of Human Resource Development for Cancer. A total of 350 000 cancer patients died during fiscal 2011, of which 9% made use of a palliative care unit. The use of palliative care is steadily growing with a trend away from palliative care units toward palliative care teams and care in the home. Whereas it was once seen as the limited treatment of terminal care, palliative care is increasingly becoming integrated into mainstream treatment. Basic palliative care education programs for physicians not specializing in palliative care and other medical practitioners are bringing about the spread of basic palliative care in Japan, thus putting in place broad foundations for the practice of palliative care. Improving the quality of palliative care and providing specialized palliative care are essential in Japan. Future challenges are (i) the construction of a community palliative care network, (ii) fostering specialists in palliative care and (iii) the provision of high-quality palliative care and end-of-life care to patients with life-threatening illnesses that are not limited to cancer.
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The right to adequate outpatient palliative care has existed for several years in Germany. In recent years outpatient palliative care has developed very positively. Nevertheless, in emergency situations paramedics and emergency ph...
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The right to adequate outpatient palliative care has existed for several years in Germany. In recent years outpatient palliative care has developed very positively. Nevertheless, in emergency situations paramedics and emergency physicians were often included in the care of palliative care of patients. The aim of our study was to investigate the cooperation between outpatient palliative care teams and the emergency medical services. Another aim was to identify structural realities and based on these to discuss the possibilities in the optimization of outpatient palliative medical emergency situations.
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ObjectiveTo describe the evolution of oncology and palliative nursing in meeting the changing landscape of cancer care. Data SourcesPeer-reviewed articles, clinical practice guidelines, professional organization, and position stat...
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ObjectiveTo describe the evolution of oncology and palliative nursing in meeting the changing landscape of cancer care. Data SourcesPeer-reviewed articles, clinical practice guidelines, professional organization, and position statements. ConclusionNurses have been at the forefront of efforts to develop and implement oncology and palliative care programs. Fifty years ago a cancer diagnosis meant a poor prognosis, high symptom burden, and disease uncertainty. Current cancer care has advanced to include palliative care in conjunction with innovative therapies and symptom management. Implications for Nursing PracticeSpecialty trained oncology and palliative care nurses are essential in disease and symptom management, psychosocial and spiritual support, and advance care planning.
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In the past 40 years, the field of palliative care for people faced many of the same obstacles in development and expansion that veterinary palliative care now confronts. A series of interviews with pioneers in human palliative ca...
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In the past 40 years, the field of palliative care for people faced many of the same obstacles in development and expansion that veterinary palliative care now confronts. A series of interviews with pioneers in human palliative care revealed what those early obstacles were professionally, personally, and institutionally. Many of the hurdles are strikingly similar to what veterinary professionals are currently facing in their attempts to grow palliative care as both an independent subspecialty and an integrated part of general practice. We can translate their experiences and successes to help veterinary palliative care flourish.
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PURPOSE OF REVIEW: As the benefit of early palliative care for the quality of life of patients with advanced cancer is currently receiving widespread recognition, cancer specialists increasingly inquire about the practical implica...
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PURPOSE OF REVIEW: As the benefit of early palliative care for the quality of life of patients with advanced cancer is currently receiving widespread recognition, cancer specialists increasingly inquire about the practical implications of this concept. This publication presents the available information about how to provide early palliative care for patients with advanced cancer. RECENT FINDINGS: Oncologists and other cancer specialists provide general palliative care from the time of diagnosis of incurable cancer together with the patients' family doctors. This includes basic assessment of symptoms and distress, their initial management as well as sensitive communication with the patient, including advance care planning and end-of-life issues and hope. The additional integration of a specialized palliative care team early in the care trajectory has been found to be beneficial for quality of life and survival. This concept is known as 'early palliative care' or 'early integration' and has become recommended by institutions such as the American Society of Clinical Oncology. SUMMARY: Palliative care is warranted from the time of diagnosis of incurable cancer. From this early stage, palliative care consists of general palliative care provided by cancer specialists and family doctors and additional support of a specialized palliative care program. Guidance from different guidelines is presented alongside practical recommendations derived from our experience with an early palliative care program for comprehensive cancer care over the last 7 years.
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This article synthesizes literature for better understanding of the concept of transitional palliative care (TPC) within the context of older people moving from hospital to the community with life-limiting conditions and palliativ...
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This article synthesizes literature for better understanding of the concept of transitional palliative care (TPC) within the context of older people moving from hospital to the community with life-limiting conditions and palliative care needs. The constructs gleaned from the synthesis connote that transitional care is more than only an act of transfer as older adults experience multiple transitions in our health care environment. It is a process of adjustment and adaptation for older adults to accommodate the changes as a result of the illness experience. The transition from cure to palliative care is one of the ongoing tensions because our health care system favors goals directed toward cure instead of comfort. The concept of a shift to palliation is also not enabled in a structure that a "one-size-fits-all'' notion applies. The authors argue that current forms of TPC ignore influences of multifaceted health and social factors, which impact choices of older persons and their families.
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? 2021 American Academy of Hospice and Palliative MedicineContext: Palliative care (PC) research has grown over the last 20 years. Yet, the causal components and pathways of PC interventions remain unclear. Objectives: To document...
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? 2021 American Academy of Hospice and Palliative MedicineContext: Palliative care (PC) research has grown over the last 20 years. Yet, the causal components and pathways of PC interventions remain unclear. Objectives: To document the prevalence and application of theoretical frameworks in developing and testing PC interventions. Methods: We conducted a secondary analysis of previously published systematic reviews of PC randomized clinical trials. Trials were evaluated for explicit mention of a theoretical framework, process or delivery model, or clinical practice guideline that supported the development of the intervention. We used a structured data extraction form to document study population, outcomes, and whether and how authors used a theoretical framework, process/delivery model, or clinical practice guideline. We applied an adapted coding scheme to evaluate use of theoretical frameworks. Results: We reviewed 85 PC trials conducted between 1984 and 2021. Thirty-eight percent (n = 32) of trials explicitly mentioned a theoretical framework, process or delivery model, or clinical practice guideline as a foundation for the intervention design. Only nine trials included a theoretical framework, while the remaining 23 cited a process/delivery model or clinical practice guideline. Conclusion: Most PC trials do not cite a theoretical foundation for their intervention design. Future work should focus on developing and validating new theoretical frameworks and modifying existing theories and models to better explain the mechanisms of the variety of PC interventions.
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Background and aim of the work: Many authors tried to clarify the palliative care nurses’ role, overall in the home care setting, but little is known in different settings of care. We aim to present a Specialist profile of pallia...
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Background and aim of the work: Many authors tried to clarify the palliative care nurses’ role, overall in the home care setting, but little is known in different settings of care. We aim to present a Specialist profile of palliative care (PC) nurses in an Italian hospital-based Palliative Care Unit. Methods : With an organizational case study approach, we conducted a literature review on PC nurse’s role, and we presented the Specialist PC nurses’ profile, describing competences and key related activities. Results: Our specialist profile highlights that clinical activities are similar to the experiences described in the literature (symptom assessment and management, communication, interprofessional work), while training and research activities are new fields of interest that it’s important to explore and promote, most of all in our country. Conclusions : Sustaining the flexibility of the role, being recognized by colleagues and keeping the three dimensions connected are the major challenges: drawing up a specialist palliative care nurses’ profile can help the team to better define the role framework in an interdisciplinary context.
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