Psychosocial nursing – a new discipline in cancer care
Lena Wettergren
pp 6-8
Psychosocial oncology is a new specialist field in Swedish nursing, open to registered nurses experienced in cancer care. The work can be organised according to patients’ needs in a variety of settings. It is concerned mainly with counselling, rehabilitation, education and clinical supervision.
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Hospice-based groups for bereaved siblings
J Barry Wright, Jan Aldridge, Helen Gillance and Alan Tucker
pp 10-15
Many studies on the effects of bereavement in children have looked at the consequences of losing a parent. Less work has been done on the loss of a sibling. There is a prevailing cultural belief that children will cope with the loss of a sibling without the need for any significant input and without their coming to any long-term harm.
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Sedation and ethical contradiction
Jean-Claude Fondras
pp 17-20
The term ‘sedation’, derived from the Latin sedare (to calm), is widely used in anaesthesia and intensive care to describe pharmacological methods used to reduce the awareness of a patient in a state of pain or anxiety. In terminal palliative care, sedation may be defined as the prescription of psychotropic agents, in the main benzodiazepines and neuroleptics, with a view to controlling physical symptoms (pain, dyspnoea), psychological symptoms (insomnia, anxiety crises, agitation) or to make a patient unconscious in certain dramatic situations (eg, sudden haemorrhage). They may also be used to ‘put the patient to sleep’ on request, but also without his knowledge. In addition, some side effects are likely to hasten death in patients whose general condition is already very frail.
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Symbolic death as grief therapy
Jean Monbourquette
pp 21-25
I have been working with the bereaved for 20 years, both in individual and group therapy, and have set up a programme tailored to the various stages of the grieving process. From my own experience in numerous grief therapy sessions, and also from the experience of other therapists, my interest has come to focus on a specific moment in the resolution of grief, which I call symbolic death.
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The International School for Cancer Care
Robert Twycross
pp 26-27
The UK-based International School for Cancer Care (ISCC) provides advice and assistance to health workers from countries where education and training in palliative cancer care are not readily available. ISCC tries to target those who are in a position to pass on their skills and experience to others in their own communities.
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The hospice movement in Russia
Sue Beven
pp 28-30
Up until 1990, home and inpatient care for terminally-ill patients had disappeared in Russia and the status of these patients in the community was low, as they were of no further use to the State. Patients were often not told that they were dying and even their families were badly informed about the seriousness of the illness. Mistrust between all parties was therefore high.
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Catering for the needs of foreign patients
Michèle Salamagne and Nathalie Keunebroek
pp 32-34
‘Foreign’ often means ‘strange’. There is a world of difference between coping with what is familiar and being at a loss when faced with the unfamiliar. How can we ensure that a foreign patient will be welcomed appropriately in a palliative care unit? How can we respond to their specific needs, while respecting their cultural, social, religious and spiritual backgrounds – often very different from our own?
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