Search

Introduction: current data regarding the decision on rehydration of patients with terminal-stage cancer remain controversial. Objective: the present study was to evaluate the effect of intravenous hydration and supplementary vitamins and trace elements on clinical symptoms and biochemical parameters in palliative cancer patients. Methods: a randomized clinical trial including 72 palliative cancer patients aged 18 years and older was performed at the National Cancer Institute in Mexico. Patients were divided into two groups: intervention and control, both receiving intravenous saline solution weekly for 4 weeks, but the former was also supplemented with vitamins and trace elements. Symptoms were assessed at baseline and 4 weeks after with the Edmonton Symptom Assessment Scale. Same measurements applied to biochemical parameters. Results: the mean age of the patients was 58.75 years. The most frequent cancer diagnoses were gastrointestinal (32 %). In the betweengroups analysis significant improvements were found for the intervention group in anorexia (p = 0.024), pain (p = 0.030), chloride (p = 0.043), phosphorus (p = 0.001), potassium (p = 0.006), and total proteins (< 0.0001). Conclusion: we highlight the improvement in the control of most symptoms and some biochemical parameters in the intervention group receiving vitamins and oligoelements along with intravenous hydration. Further studies are needed. [ABSTRACT FROM AUTHOR]

aim: To share with the medical community the development of palliative care in an Spanish speaking country. method: Documental research and direct interview to physicians actively involved in the development of palliative care in Mexico. results: Pain clinics in were born in early seventies and the palliative care movement during the eighties. It is recently that the legislation in this nation favors palliative care. Conclusions: Mexico is now among those countries with a legislation that includes palliative care. The laws and legislation of that country define and guide those health care providers that interact with palliative patients, and also stablish palliative care as a health right for its habitants. [ABSTRACT FROM AUTHOR]

Care is the essence of the nursing profession and takes full meaning in the field of palliative care. Palliative nursing acquires an important role in the relationship with the patient and/or family and accompaniment in suffering. Analysing whether there is quality or not in the nursing care provided to the patient with terminal illness and his family, helps to build continuous improvement and professional excellence. The aim of our study is to carry out a theoretical review on the quality of nursing care in the field of palliative care. For this purpose, we worked with the databases Academic Search Complet, PsycInfo, CINAHL, CUIDEN and MEDLINE. The results indicate that the quality of nursing care seems to be a poorly researched field, and that the instruments of measurement evaluate the perceived quality from patient satisfaction, only in the hospital setting. There is a broad consensus on the essential dimensions for assessing the quality of palliative care, but no scales have been found that specifically measure the quality of nursing palliative care. Quality is therefore evaluated through advanced nursing competencies and nursing professional values in palliative care. [ABSTRACT FROM AUTHOR]

This paper aims to analyse if there is a positive relationship between resilience and spirituality in its three dimensions (intrapersonal, interpersonal and transpersonal) as shown in previous studies. At the same time, it explores if there is a relationship with sociodemographic variables. A descriptive, correlational, cross-sectional study in hospitalised palliative patients was carried out. Resilience (BRCS) and Spirituality (GES) were used as variables. A sample of 105 hospitalised palliative patients was chosen, of which the average age was 65.88 and 53.3% were women. Oncologic diagnosis = 86.7%, low cultural level = 59%; single = 56.2%, and average PPS = 54.2. Concerninn the relationship between resilience and spirituality, GES total and GES intra was 57.7%, GES inter 36.3%, and GES trans 37.3% (Pearson's correlation). As a conclusion, there is a positive correlation between resilience and spirituality, as it was proved in previous studies. However, the intrapersonal dimension has the strongest relationship with resilience. [ABSTRACT FROM AUTHOR]

Introduction: In palliative patients, psychological intervention is of great importance. In the terminal phase of a disease, treatment no longer has any curative effect and life expectancy is less than six months. During this phase, several processes and intense emotions are present, both for the patient and for the caregivers and their families. Objectives: To specify and enumerate the areas of psychological importance that must be addressed in order to carry out an adequate intervention. Methodology: After reviewing authoritative studies on the subject and dealing with these patients clinically, we have synthesized those scientific principles that have been proved (or shown to be effective, depending on the circumstances) in each of the different areas to be explored. Results: We have summarized fourteen areas and brought them together under the following labels: Current status, Knowledge about the patient's situation and progress, Decisions on the degree of information to be disclosed, Possible obstacles to information, Conspiracy of silence and reaction(s) to it, Confidence and tranquility to express emotions, Feelings of integrity and respect for patient autonomy, Possibilities and ability to enjoy themselves, Perceived degree of support, Perceived passage of time, Time for oneself and time for others, Feelings that arise, Exploring fears and Strategies previously used. Conclusions: The literature confirms that exploring these factors is of great importance at this stage as they affect quality of life and must, therefore, be addressed in therapeutic work. [ABSTRACT FROM AUTHOR]

Aprovechando la publicación del Plan estratégico de Cuidados Paliativos (CP) de nuestra comunidad, nos planteamos, desde la Comisión de CP, reflexionar sobre la atención paliativa en nuestra OSI (organización sanitaria integrada). Decidimos darle un nuevo enfoque unificando lenguaje y abordaje entre todos los niveles asistenciales, actualizando conceptos básicos como la transición gradual de enfoque preventivo, curativo y paliativo. Intentamos dimensionar nuestra población con necesidad de CP haciendo un diagnostico de situación retrospectivo del 2016 y 2017. Apostamos por un modelo basado en 3 eslabones, equipo de Atención Primaria (médico y enfermera) sobre el que pivota el plan y HaD (Hospitalización a domicilio) y/o hospitalización convencional de apoyo según nivel de complejidad de cada caso (IDC-Pal). Hemos reforzado el uso de las herramientas de identificación (NECPAL) y de escalas de predicción de mortalidad (PALIAR y Pap Score), disponibles en nuestro programa de Historia electrónica (Osabide Global), que nos ayudan a codificar precozmente y a elaborar el PIA (plan individualizado de atención accesible y modificable por todos los eslabones participantes) conjuntamente con paciente, familia y oncólogo y/o especialista de órgano del paciente si se precisa. Detectamos las necesidades de formación de los profesionales de nuestra OSI en una encuesta que remitimos a médicos, enfermeras y auxiliares en el 2017 y realizamos talleres y sesiones sobre comunicación, vía subcutánea, aspectos éticos y legales, CP pediátricos...con la idea de proporcionar formación continuada y mantener "viva" la atención paliativa en la práctica asistencial diaria. También analizamos los principios de prescripción al final de la vida valorando retirar fármacos según expectativa de vida, objetivo del tratamiento, tiempo necesario para producir beneficio, administración difícil...con mejoría de calidad de vida y gestión más racional de los recursos. Con todo ello hemos elaborado "la Ruta asistencial de CP de nuestra OSI" para garantizar la atención paliativa precoz a todos los que la necesiten las 24 horas y todos los días del año con apoyo de Osarean (consejo sanitario) y Emergencias y atención Psicológica al paciente, familia, duelo y los profesionales que lo necesiten. Hemos desplegado nuestra estrategia a toda la OSI y estamos en fase de evaluación del plan con indicadores que nos miden anualmente desde la organización central y de otros que tenemos pendientes de definir y/o empezar a medir. Conclusiones: 1) la atención paliativa en nuestra OSI no era adecuada 2) el equipo de AP es el eslabón central de esta atención 3) HaD y la Hospitalización convencional colaboran según complejidad 4) el apoyo psicológico es fundamental 5) se precisa Atención Paliativa precoz y a pacientes oncológicos, no oncológicos y pediátricos a los que se elaborará un Plan individualizado tras la codificación 6) necesitamos un plan de formación continuada 7) se precisa evaluación con indicadores de resultados 8) los Cuidados paliativos privilegian la vida y contemplan la muerte como un proceso natural. [ABSTRACT FROM AUTHOR]