Comment: Palliative nurse education – towards a common language
Martine De Vlieger, Nuria Gorchs, Philip Larkin and Françoise Porchet
pp 135-138
Undoubtedly, the need to provide clinically relevant, focused and substantive education programmes to meet the challenges of palliative care practice remains high on the agenda for educators in the field. The proliferation of research activity in this field is supplemented by the increasing number of courses, both vocational and academic.
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Caring for patients with pseudomyxoma peritonei
Gary Witham
pp 139-141
Pseudomyxoma peritonei (PMP) is a rare, slowly progressive disease. It produces extensive mucus accumulation within the abdomen and pelvis. There are three pathologically and prognostically distinct groups of peritoneal mucinous lesions: ? The most classical is defined histologically as a benign mucinous epithelium associated with an appendiceal adenoma. This is true pseudomyxoma and should be diagnosed as ‘disseminated peritoneal adenomucinosis’ (DPAM)
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Neurolytic coeliac plexus block in the treatment of abdominal cancer pain
Sebastiano Mercadante
pp 142-145
The neurolytic coeliac plexus block (NCPB) is an established, well developed procedure and the most widely applicable of all the neurolytic pain blocks available. It is the least hazardous means of palliative treatment for cancer of the upper abdominal viscera. Unlike other nerve blocks, motor and sensory complications are rare as the coeliac ganglia carries only sympathetic and parasympathetic supply to the upper abdominal viscera.
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Case study masterclass 16: A patient with rapidly progressive dementia
Carol Davis
pp 146-147
Mr Crentz*, a 61-year-old farmer, is an inpatient at the regional neurological centre. He was well until about six weeks ago when his wife noticed some memory loss and loss of concentration. About two weeks later, he was unable to remember his children’s names or which television programmes he normally watched.
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Case study masterclass 15 answers: A man with metastatic malignant melanoma and nausea
Carol Davis
pp 147-147
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Ensuring that patients are able to die a good death
Marie Kritah, Gill Hale, Allison Graham and Alexis Beedie
pp 148-151
The remit of comprehensive spinal cord injury (SCI) care is stated as extending from the time of injury to the grave. Research has focused on intervention at the initial stages of diagnosis and management rather than the terminal events of that patient’s life. Information that exists concentrates on the medical causes of death and life expectancy rather than the symptoms, environmental and emotional aspects.
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Information provision for palliative care families
Peter Hudson, Sanchia Aranda and Linda Kristjanson
pp 153-157
Caring for a family member who is dying of cancer can have negative physical and psychological implications for the carer. One means of alleviating this distress for family carers is to ensure that they are supported by healthcare professionals knowledgeable about palliative care. Access to palliative care supports varies greatly. However, the empirical literature confirms that many carers have needs that remain unmet despite input from healthcare professionals, suggesting that usual approaches to family care may not be sufficient.
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The attending doctor and the palliative care unit
Vincent Vandenhaute
pp 158-159
The subject of supporting and taking care of people at the end of life has already taken up a great deal of literature. The emergence of palliative care, in both the visionary and the practical sense, and especially the global pain management programme followed in St Christopher’s Hospice in London, has sparked a revolution in this area.
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Balancing in palliative care
Hans Thulesius, Anders Håkansson and Kerstin Petersson
pp 160-162
Balancing is a problem-solving model developed with the purpose of serving as a tool for palliative care education and decision-making, and inspiring future research. We did a grounded theory analysis of individual and focus group interviews with healthcare professionals, patients and relatives, and other qualitative data from participant observation and literature in the field of end-oflife cancer care. A conceptual theory of palliative care, described as a basic social process, thus emerged.
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Palliative care delivery in Southern Africa
Katri Elina Clemens and Eberhard Klaschik
pp 164-166
Not withstanding infectious and parasitic diseases, cancer continues to grow as a healthcare problem in Southern Africa. Of the 10 million new cancer cases each year, 4.7 million occur in developed countries and nearly 5.5 million in the developing countries. In developed countries, the number of cancer deaths is about one-fifth of all deaths with mortality figures second only to those for cardiovascular diseases.
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Terminal care in an institution
Isabelle Millioud, Christophe Pont and Brigitte Berthouzoz
pp 167-168
An institution specialising in the care of people with learning disabilities asked the home palliative care team from the Centre François-Xavier Bagnoud de soins palliatifs à domicile (CFXB) to support Elodie – one of its residents. Elodie had Down’s Syndrome and was suffering from a large abdominal tumour.
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