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Статті в журналах з теми "Medicina palliativa"

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Toraldo, Domenico Maurizio. "Il trattamento del cancro polmonare: evidenze scientifiche e valori bioetici in conflitto nelle scelte terapeutiche." Medicina e Morale 50, no. 4 (August 31, 2001): 741–78. http://dx.doi.org/10.4081/mem.2001.732.

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Il cancro del polmone costituisce una delle principali cause di morte dei paesi europei. La malattia se inoperabile ha una prognosi generalmente infausta e circa l’80% dei pazienti muore entro un anno dalla diagnosi. Stabilire un efficace piano di trattamento costituisce una priorità di salute pubblica e oggetto di continuo dibattito scientifico. La diagnosi precoce offre la possibilità al malato di usufruire del trattamento chirurgico che può guarire la malattia. La polichemioterapia e la radioterapia si rivelano spesso fallimentari e nel migliore dei casi possono allungare di qualche mese la vita del malato al costo di sofferenze importanti. Nella pratica clinica in molti ospedali italiani pur non esistendo un protocollo diagnostico-terapeutico di riferimento, e il trattamento medico viene proposto, nella maggior parte dei casi, senza un adeguato consenso informato che spieghi al paziente le difficoltà e la complessità terapeutiche ed il paziente nella maggior parte dei casi non partecipa alle decisioni che lo riguardano. L’Autore attraverso una revisione della letteratura scientifica recente mette a punto il problema dal punto di vista tecnico e affronta contestualmente i numerosi problemi bioetici e deontologici sollevati dall’assenza sia di un’etica della comunicazione nelle problematiche della diagnosi e della terapia sia della relazione di cura cioè nella conduzione della terapia nel tempo, mettendo in evidenza le inesauribili possibilità curative che il medico dovrebbe evidenziare con la su presenza e con il suo attaccamento al malato. Viene analizzato il ruolo decisivo del medico nelle ultime fasi della vita del paziente e l’utilità della medicina palliativa nella sedazione del dolore e nel controllo dei sintomi come forma di rispetto della dignità della persona. Infine l’Autore auspica la necessità di una formazione etica e deontologica attraverso corsi di aggiornamento obbligatorio del medico ospedaliero per poter acquisire una consapevolezza dei valori in gioco.
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Prönneke, Rainer. "Die palliative Sedierung." Der Klinikarzt 47, no. 08 (August 2018): 366–71. http://dx.doi.org/10.1055/a-0657-9120.

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ZusammenfassungEine gewerbemäßige, d. h. auf Wiederholung angelegte Suizidbeihilfe wurde per Gesetz unter Strafe gestellt, danach gehört die Suizidbeihilfe explizit nicht zur ärztlichen Aufgabe. Öffentlich kaum bekannt, ist die sogenannte palliative Sedierung gegen unerträgliches Leid als palliativmedizinische Behandlungsmethode eingeführt worden. Es beinhaltet ein Behandlungskonzept, welches bei fortgeschrittenen und fortschreitend Erkrankten zur Linderung unerträglichen Leids eine gezielte medikamentöse Bewusstseinsminderung bis zum Eintritt des Todes vorsieht. Die palliative Sedierung ist optionaler Bestandteil einer Palliativgesamtbehandlung und unterliegt damit dem palliativ-ethischen Grundgedanken, das Leben nicht gezielt verkürzen und die Sterbezeit nicht verlängern zu wollen. Basis der palliativen Sedierung bleibt neben der fachlichen Kompetenz und professionellen Reflektion der Behandler die menschliche Zuwendung und hospizliche Begleitung des Betroffenen und seiner häufig seelisch sehr bewegten Bezugspersonen.
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Inderbitzi, Rolf, and A. Rolle. "Surgical palliation in thoracic malignant diseases." Therapeutische Umschau 58, no. 7 (July 1, 2001): 435–41. http://dx.doi.org/10.1024/0040-5930.58.7.435.

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Palliative thoraxchirurgische Eingriffe zielen auf die Sicherung oder Wiederherstellung einer möglichst umfassenden Lebensqualität des betroffenen Patienten. Die chirurgischen Grundlagen dazu basieren einesteils auf gesicherten, statistischen Ergebnissen, andererseits setzen sie profunde, klinische Erfahrung in onkologischer Chirurgie voraus. Um so mehr, als Palliation nicht Heilung als Ziel fordern kann, setzen derartige Operationen eine präzise Information und den partnerschaftlichen Einbezug des betroffenen Patienten voraus. Die Operabilität hängt vom Allgemeinzustand des Kranken und von der Invasivität des geplanten Eingriffes ab. Wird Tumorgewebe reseziert, ist auch in der palliativen Situation die lokale Radikalität grundsätzliches Ziel; multimodale Therapiestrategien gestatten chirurgisch-anatomisch bedingte Modifikationen. Zu den zentralen Indikationen der pallativen Thoraxchirurgie gehören die Lungenmetastasenresektionen. Dank neuen, lasertechnischen Verfahren lässt sich der Parenchymverlust minimieren und die Lobektomierate von 25% auf 4% senken. Bei Mortalitäts- und Morbiditätsraten unter 1% beträgt die 5-Jahres-Überlebensrate nach kompletter Metastasenentfernung über 30%. Brustwandtumoren verursachen Schmerzen und neigen zur Exulzeration; zudem bewirken sie durch ihre stete Präsenz Angst. Ihre Entfernung, kombiniert mit der plastischen Defektdeckung, ist deshalb auch in fortgeschrittenem Stadium sinnvoll. Bei mediastinalen Tumoren stellt die Chirurgie kurativ und palliativ – nebst der Aufgabe zur Histologiesicherung – einen der plurimodalen Behandlungspfeiler dar. Die thorakoskopische Talkpleurodese weist bei malignen Pleuraergüssen eine Erfolgsrate von über 90% aus, wenn die Lunge nach Ergussdrainage noch entfaltbar ist.
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Signer, Michaela. "Depression in Palliative Care." Therapeutische Umschau 69, no. 2 (February 1, 2012): 99–106. http://dx.doi.org/10.1024/0040-5930/a000259.

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Depression ist eine häufige komorbide behandlungsbedürftige Störung, diedie Lebensqualität von Patienten und ihren Angehörigen erheblich beeinträchtigt. Phänomenologisch ist in palliativen Situationen ein breites Spektrum an Störungen anzutreffen, die es voneinander abzugrenzen gilt: "normal" zu wertende Reaktionen auf eine unheilbare Erkrankung wie Trauer, Wut und Verzweiflung bis hin zu schweren depressiven Störungen. Durch häufige Symptomüberschneidungen zwischen der somatischen Grunderkrankung und einer Depression sind die gängigen ICD-10-Kriterien zur Diagnosestellung Depression in der Palliative Care nicht anwendbar. Es empfiehlt sich, alle Symptome auszuschließen, die auch Folge der Grunderkrankung sein könnten. Durch eine adäquate palliative Betreuung als eines der wenigen Evidenz-basierten Elemente in der Betreuung palliativer Patienten mit Depression kann eine maximale Prävention erreicht werden. Bei der Therapieauswahl sollte neben dem Therapieziel die zu erwartende verbleibende Lebenszeit richtungweisend sein.
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Rosin, Ulrich. "Palliative psychosomatic medicine." Therapeutische Umschau 58, no. 7 (July 1, 2001): 449–52. http://dx.doi.org/10.1024/0040-5930.58.7.449.

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Die Psychotherapeutische Medizin, das fachärztliche Gebiet, das sich mit den Grundlagen der Psychosomatik beschäftigt, hat sich bisher überwiegend der Diagnostik und Therapie akuter Krankheitsbilder gewidmet. Die Verläufe bei Patienten mit bio-psycho-sozialen Störungen sind jedoch meist chronisch; und der Psychoanalytiker Sigmund Freud, der Begründer der wissenschaftlichen Psychotherapie, war selber 26 Jahre lang ein Palliativ-Patient, der wegen eines Gaumen- und Kieferkarzinoms über dreißigmal operiert werden musste. Es werden Ziele und einige psychotherapeutische Interventionsstrategien zum Einsatz in der palliativen Psychosomatik dargestellt. Dieses wichtige Aufgabengebiet hat als solches noch wenig Verbreitung gefunden sowie kaum konzeptuelle Darstellung und empirische Überprüfung erreicht.
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Gupta, Deepak, Seema Mishra, and Sushma Bhatnagar. "Interventional Palliation: Hour of Need for Evolution of Palliative Medicine." Journal of Palliative Medicine 11, no. 7 (September 2008): 958. http://dx.doi.org/10.1089/jpm.2008.0079.

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Beider, Shay. "An Ethical Argument for Integrated Palliative Care." Evidence-Based Complementary and Alternative Medicine 2, no. 2 (2005): 227–31. http://dx.doi.org/10.1093/ecam/neh089.

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‘In the midst of life, we are in death’from The Book of Common PrayerThe Palliative Care, or comfort care, movement in the USA is on the rise. Currently, palliative services are not integrated in an organized way throughout healthcare. If we accept the argument that palliative care is ethically desirable and that all patients are entitled to palliative services regardless of a terminal diagnosis, it follows that it needs to be integrated across a wide range of healthcare services. Ethical questions regarding palliative care and well-known ethical frameworks are discussed and an argument is made for integrating palliative healthcare services throughout the healthcare system and not simply at the end of life. Complementary and alternative medicine (CAM) therapies are discussed as useful and necessary components of palliative care. If we as a society look beyond separating cures and palliation, we will come closer to incorporating compassionate care throughout the disease process.
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Sasaki, Jiichiro. "Palliative medicine: how to standardize palliative medicine." Annals of Oncology 26 (November 2015): vii60. http://dx.doi.org/10.1093/annonc/mdv452.

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Horváth, Orsolya, Enikő Földesi, and Katalin Hegedűs. "Mikor és hogyan integráljuk az onkológiai és a palliatív ellátást?" Orvosi Hetilap 162, no. 44 (October 31, 2021): 1769–75. http://dx.doi.org/10.1556/650.2021.32254.

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Összefoglaló. A palliatív ellátások korai bevonása az onkológiai betegek ellátásába előnnyel jár mind a beteg életminősége, mind a kezelés színvonala, mind a költséghatékonyság szempontjából. Szükség van egy olyan modellre, mely alapján a megfelelő időben, a megfelelő beteg a megfelelő minőségű palliatív ellátásban részesül. Ebben a közleményben a palliatív ellátás korai integrációjának előnyei, szintjei és a speciális palliatív ellátás fogalmának ismertetése után a leginkább elterjedt beutalási modellek előnyeit és hátrányait mutatjuk be a nemzetközi szakirodalom alapján. A speciális palliatív ellátást igénylő betegek kiszűrésére szolgáló, prognózisalapú modellek hátránya, hogy nincs elég kapacitás az ilyen módon beutalt nagyszámú beteg ellátására, ezért széles körben nem terjedtek el. A tüneteken alapuló modellek sokszor bonyolultak és a mindennapi klinikai gyakorlatban nem használatosak. Az új kutatások alapján egyszerű, gyakorlatias kérdéssorokat alkalmaznak, melyekkel könnyen kiemelhetők, akik profitálnak a speciális palliatív intervencióból. Ezek közül a Yale egyetemi és a PALLIA -10 modellt ismertetjük részletesen. Amennyiben az aktív onkológiai ellátást végzők a megfelelő palliatív beutalási kritériumokat ismerik és alkalmazzák, a betegek időben jutnak a megfelelő komplex kezeléshez anélkül, hogy a palliatív ellátórendszer túlterhelődne. Orv Hetil. 2021; 162(44): 1769–1775. Summary. Early integration of palliative care into the trajectory of cancer care brings advantages into the patients’ quality of life, the level of care and cost-efficiency, too. On the basis of a predefined model, the right patient may receive the right level of palliative care at the right time. Having defined the advantages, the levels of early integration of palliative care and the concept of special palliative care, we also aim to describe the advantages and disadvantages of the most common referral models on the basis of international literature in this article. The drawback of prognosis-based models to identify patients needing special palliative care is the lack of capacity to provide care for the large number of patients so recognised; therefore they have not become widespread. Needs-based models tend to be complicated and thus rarely applied in everyday clinical practice. On the basis of new researches, simple, pragmatic questionnaires are utilised through which the patients who could benefit from special palliative care interventions are easy to identify. Here we give a detailed report of the Yale University and PALLIA-10 models. On condition that appropriate palliative referral criteria are known and applied by active oncology care providers, patients may receive adequate complex care without the palliative care system being overloaded. Orv Hetil. 2021; 162(44): 1769–1775.
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Inoue, Akira. "Palliative Medicine." Haigan 59, Supplement (November 25, 2019): 1125–27. http://dx.doi.org/10.2482/haigan.59.1125.

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Дисертації з теми "Medicina palliativa"

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Moroni, Matteo <1974&gt. "Aspetti etici e morali della Sedazione Palliativa." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5550/1/Tesi_Sedazione_pdf.pdf.

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Анотація:
La sedazione palliativa come procedura terapeutica è ormai ampiamente affrontata e discussa in letteratura. A causa della delicatezza di tale procedura, molti studi affrontano le problematiche etiche ad essa relative con l’obiettivo di cercare una giustificazione morale e clinica. Questo lavoro intende affrontare la sedazione palliativa applicata ad un caso concreto. Seguendo la trama della storia di Matteo, uomo di 38 anni ricoverato in Hospice con diagnosi di cancro metastatico della mammella maschile (metastasi polmonari con incarceramento del polmone destro, metastasi diffuse a tutto il rachide, metastasi epatiche), verranno affrontate le problematiche etiche relative ad ogni fase della vicenda. In particolare i temi trattati sono i seguenti: il controllo di sé, la negoziazione della terapia e l’autodeterminazione; il principio di autonomia relazionale; l’etica del corpo; differenze tra sedazione palliativa ed eutanasia; le domande di fine vita e la spiritualità; documenti sul fine vita. Il paradigma teorico prescelto come punto di riferimento è quello dell’Etica della Cura.
Palliative Sedation is a medical procedure and it’s extensively discussed by literature. Because of the importance of this procedure, many studies analyze its ethical aspects to search a clinical and moral explanation. This thesis deal with palliative sedation in a real medical case. It follows Matteo’s history, 38 years old, admitted to hospice with a diagnosis of metastatic tumor of male breast (lung metastasis, liver metastasis, bone metastasis) and this analysis analyzes ethical dilemmas concerning every phase of the story. Particulary, these are the questions: self control, self-determination and the treatment’s negotiation; the relational autonomy; the Ethics of body; Differences between Palliative sedation and Euthanasia; The Spiritual Issues in End of life; the Importance of a law on Living will. The theoretical and ethics model for this analysis is The Ethics of Care.
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Moroni, Matteo <1974&gt. "Aspetti etici e morali della Sedazione Palliativa." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5550/.

Повний текст джерела
Анотація:
La sedazione palliativa come procedura terapeutica è ormai ampiamente affrontata e discussa in letteratura. A causa della delicatezza di tale procedura, molti studi affrontano le problematiche etiche ad essa relative con l’obiettivo di cercare una giustificazione morale e clinica. Questo lavoro intende affrontare la sedazione palliativa applicata ad un caso concreto. Seguendo la trama della storia di Matteo, uomo di 38 anni ricoverato in Hospice con diagnosi di cancro metastatico della mammella maschile (metastasi polmonari con incarceramento del polmone destro, metastasi diffuse a tutto il rachide, metastasi epatiche), verranno affrontate le problematiche etiche relative ad ogni fase della vicenda. In particolare i temi trattati sono i seguenti: il controllo di sé, la negoziazione della terapia e l’autodeterminazione; il principio di autonomia relazionale; l’etica del corpo; differenze tra sedazione palliativa ed eutanasia; le domande di fine vita e la spiritualità; documenti sul fine vita. Il paradigma teorico prescelto come punto di riferimento è quello dell’Etica della Cura.
Palliative Sedation is a medical procedure and it’s extensively discussed by literature. Because of the importance of this procedure, many studies analyze its ethical aspects to search a clinical and moral explanation. This thesis deal with palliative sedation in a real medical case. It follows Matteo’s history, 38 years old, admitted to hospice with a diagnosis of metastatic tumor of male breast (lung metastasis, liver metastasis, bone metastasis) and this analysis analyzes ethical dilemmas concerning every phase of the story. Particulary, these are the questions: self control, self-determination and the treatment’s negotiation; the relational autonomy; the Ethics of body; Differences between Palliative sedation and Euthanasia; The Spiritual Issues in End of life; the Importance of a law on Living will. The theoretical and ethics model for this analysis is The Ethics of Care.
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Åkerberg, Maria, and Ann-Sofie Thelander. "Anhörigas informationsbehov inom den palliativa vården. : En litteraturstudie." Thesis, Växjö University, School of Health Sciences and Social Work, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-1019.

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Den palliativa vården innefattar inte bara patienten utan i många fall också de anhöriga. Syftet med studien var att undersöka anhörigas informationsbehov inom den palliativa vården. För att besvara syftet gjordes en litteraturstudie där vetenskapliga artiklar användes. Genom databas- och manuellsökning valdes elva kvalitativa och kvantitativa artiklar ut. En innehållsanalys av artiklarna gjordes utifrån en kvalitativ ansats. Resultatet visar att anhörigas informationsbehov främst består av medicinsk-, omvårdnads- och organisationsinformation. De två viktigaste fynden när det gäller upplevelser av information var att de individuella behoven måste bejakas och att källan till informationen ansågs viktig. Resultatet visar dessutom att god information minskar ovisshet och stress hos anhöriga. Genom att få sitt informationsbehov tillfredsställt skapas förutsättningar till mental förberedelse. Författarna kan utifrån studien se att god information kan kopplas samman med välbefinnande hos anhöriga i den palliativa vården.

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Ardegård, Anna. "Sjuksköterskors upplevelser av att vårda personer i behov av palliativ vård på två medicinska vårdavdelningar : en kvalitativ intervjustudie." Thesis, Sophiahemmet Högskola, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1895.

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SAMMANFATTNING Många av de som avlider i Sverige idag, avlider på sjukhus, eller tillbringar dagar på sjukhus sitt sista år i livet. På en medicinavdelning vårdas personer med många olika diagnoser och multisjuka äldre. Sjuksköterskor som arbetar på medicinavdelning möter därför många personer som är i behov av palliativ vård. Vården på en medicinavdelning är oftast kurativt och akut inriktad, och den palliativa vården kan därför lätt hamna i skymundan. Värdegrunden i den palliativa vården innefattar närhet, helhet, kunskap och empati. Allmän palliativ vård ska kunna ges till alla patienter som är i behov av det. För att skapa en god palliativ vård krävs att vårdpersonal arbetar förebyggande och åtgärdar symtom i ett tidigt skede. När god omvårdnad, empati, trygghet och medicinska kunskaper finns att tillgå kan den palliativa vården bli en naturlig fortsättning på den vård personen fått innan. På medicinavdelning får sjuksköterskan ta ett stort ansvar gällande den palliativa vården, då de är närmast patienten och träffar dem ofta. Syftet med studien var att beskriva sjuksköterskors upplevelser av att vårda personer i behov av palliativ vård på medicinska vårdavdelningar. Metoden för studien var en kvalitativ intervjustudie och sju stycken sjuksköterskor på medicinavdelning intervjuades. För analysen av den insamlade datan användes en kvalitativ innehållsanalys. I resultatet framkom tre kategorier; Det komplexa i att vara professionell i vården av personer i behov av palliativ vård, Förutsättningar för att kunna ge en god palliativ vård och Hinder för att kunna ge en god palliativ vård. I studien framkommer att det finns en vilja att vara nära personen men även ett behov av att hålla distans för att själv behålla hälsan och balans. Sjuksköterskan upplever att hon har ett stort ansvar gällande den palliativa vården på avdelning. Bekräftelse från patient och närstående upplevs som viktigt för att veta att arbetet är utfört på ett bra sätt. Sjuksköterskorna beskrev tiden som viktig för att kunna ge en god palliativ vård. När personen i behov av palliativ vård fick kontinuitet, en plan och helhetssyn gav det sjuksköterskorna en känsla av att ha kunnat ge en god palliativ vård. Det är även viktigt att ha kunskap och erfarenhet inom palliativ vård för att ge sjuksköterskan, patient och närstående trygghet. Stöd från kollegor och specialiserat team var också en förutsättning. Organisationen gällande exempelvis resursbrist, och en miljö som inte var anpassad efter behoven, var något som många av sjuksköterskorna upplevde som ett hinder. Kunskapsbrist och erfarenhet saknades ibland och upplevdes som ett hinder i att ge en god vård. Detta kunde även leda till en upplevelse av att fel beslut togs gällande patientens fortsatta behandling. Studien visade att det finns förutsättningar för en god palliativ vård på medicinavdelningarna men att den behöver utvecklas. Detta för att personen i behov av palliativ vård ska få bästa möjliga vård. Det finns en önskan och vilja hos sjuksköterskor att göra annorlunda gällande till exempel omfördelning av resurser och vara mer närvarande i vården. Behov av utbildning och handledning både hos sjuksköterskor och hos läkare framkommer i studien. Organisatoriskt behövs mer resurser, tid och anpassad miljö för att kunna ge en helhetsvård till personen i behov av palliativ vård och dess närstående.
ABSTRACT Many of those who dies in Sweden today, dies in hospital or spend days in hospital their last year of life. In a medical ward people with many different diagnoses and multi-ill elderly is being cared for. Nurses' who works in a medical ward meets many people who are in need of palliative care. The care in a medical ward is usually curative and emergency-oriented and palliative care may be left aside. The values in palliative care includes; closeness, holism, knowledge and empathy. General palliative care should be given to all patients who are in need of it. To create a good palliative care requires that health professionals work to prevent and resolve symptoms in the early stages. With good care, empathy, security and medical knowledge available, the palliative care can be a natural continuation of the care the person had before. In medicine wards the nurses take a big responsibility regarding palliative care, since they are closest to the patient and meet them often. The aim of the study was to describe nurses' experiences of caring for people in need of palliative care in medical wards. The methodology for this study was a qualitative interview in which seven nurses in medical wards were interviewed. A qualitative content analysis was used for the analysis of the collected data. The results revealed three main categories; The complexity of being a professional in the care of people in need of palliative care, Conditions order to provide good palliative care and Obstacles in order to provide good palliative care. There is a desire to be close to the person, but also a need to keep the distance to maintain your health and balance. The nurse feels that she has a great responsibility regarding palliative care in the wards. Confirmation from the patient and family are perceived as important to know that the work is carried out in a good way. To provide a good palliative care, time was described as important. When the person in need of palliative care got continuity, a plan and a holistic approach the nurses got a sense of having been able to give a good palliative care. It also revealed how important it is to have knowledge and experience in palliative care to give the nurse, patient and family security. Support from colleagues and specialized team was also a prerequisite. Many of the nurses experienced the organization with lack of resources and environmental problems as an obstacle. Lack of knowledge and experience was perceived as an obstacle in providing good care. This could also lead to an experience of wrong decisions were taken regarding the patients continued treatment. The study showed that there are conditions for good palliative care medicine departments but it needs to be developed. This is to make the person in need of palliative care receive the best possible care. There is a desire and willingness of nurses to do differently and be more present in care. Need for training and supervision of both the nurses and the doctor emerges in the result. Organizationally are more resources, time and adapted environment needed, in order to provide a holistic care to the person in need of palliative care and their family members.
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Larsson, Annie, and Maria Viklund. "Närståendes behov av stöd vid palliativ vård." Thesis, Mid Sweden University, Department of Health Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-8841.

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Bakgrund: Vårdpersonalen har en viktig funktion i omvårdnaden av närstående till palliativt sjuka patienter. Den palliativa vårdsituationen var ofta en ny upplevelse för de närstående. Vårdpersonalens uppgift var därmed att ge aktuell information samt se till att närstående blev delaktiga i vården. Syftet: Med litteraturstudien var att belysa vårdpersonalens stöd till närstående samt beskriva vilka behov närstående hade i palliativ vård. Metod: Femton vetenskapliga artiklar med kvalitativ metod analyserades enligt innehållsanalys och låg till grund för litteraturstudien. Resultat: Det framkom att vårdpersonal och närstående ansåg att de viktigaste funktionerna var att ge och få stöd. Närstående önskade information och kunskap om den svårt sjukes tillstånd samt sjukdomsförlopp. Slutligen visade resultatet att det var viktigt när personalen tog sig tid att lyssna och tala med de närstående samt att alla parter var delaktiga i de beslut som togs. Diskussion: Genom stöd från vårdpersonalen blev den svåra situationen för de närstående hanterbar. Den viktiga informationen ledde till begriplighet över den nya situationen, där delaktigheten i vården av den svårt sjuke skapade en meningsfullhet för de närstående. Konklusion: Vårdpersonal borde få mer kunskap och träning i att ge information och omvårdnad till närstående för att kunna tillgodose deras behov.

 

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Täckström, Linda, Annette Johansson, and Lundholm Anne Björkegren. "Relations in palliative care." Thesis, Kristianstad University College, Department of Health Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-3601.

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Abstract

Background: Relation means the relationship between two parts. By creating a good relation between nurse and patient you can conduce a better caring. Aim: The aim of the study was to illustrate the relation within palliative care from nurse- patient perspective. Method: The study is a literature review where ten articles were analysed with qualitative content analysis. Results: The findings showed that knowledge, communication, continuity, silence and availability were the most important thing for the nurse in the relationship. Energy, regular contacts, having time and the nurse being able to listen was most important for the patient. In the encounter between the nurse and patient, communication is fundamental for understanding in the conversation where the patient tried to find information about treatment, medicament and the illness. The most valuable was being able to talk about feelings. You must get to know the patient as the person he is to be able to know his interests and what he considers important. Continuity is a prerequisite to make the patient feel safe and secure. Conclusion: Being able to pay attention to unspoken needs and understanding why the patient reacts the way he does is a proof that knowledge has appeared.

Keywords: Relationship, relation nurse – patient, communication, palliative care.

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Follin, Görel, and Marie Westberg. "Närståendes behov inom palliativ vård : En litteraturöversikt." Thesis, Mid Sweden University, Department of Health Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-11510.

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Bakgrund: När en familjemedlem blir svårt sjuk har det en stor påverkan på hela familjen. Närstående har och känner ofta ångest, depression och maktlöshet. Familjemedlemmens sjukdom kan också leda till att rollerna i familjen ändras, och en förändring i den ekonomiska situvationen och en ökad påfrestning för familjen. Syfte: Syftet med studien var att belysa behov som närstående till patienter inom palliativ vård kan ha. Metod: En litteraturstudie genomfördes med sökningar i Pubmed och Cinahl. Innehållsanalys gjordes av de 11 inkluderade artiklarnas huvudresultat. Tydliga framträdande fenomen i texten kondenserades, kodades och katogoriserades i underkategorier och kategorier. Resultat: I studiens resultat framkom att närstående till patienter inom palliativ vård har ett stort behov av kommunikation, information och stöd. Diskussion: Att ha en fungerande kommunikation fanns var något som var viktigt för de närstående, då det gav dem en känsla av trygghet. Det var även viktigt att rätt infomation gavs till de närstående, att den gavs vid rätt tillfällen och att de närstående kunde förstå informationen.För att stödja närstående spelar vårdpersonal en viktig roll, då de kan bidra med uppmuntran och hopp i en svår situation.

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Lauridsen, Linda. "Patienters upplevelser vid parenteral nutritionsbehandling hemma vid palliativ vård på grund av cancer – en litteraturstudiePatients experiences of parental nutrition at home due to palliative care of cancer - a literature study." Thesis, Kristianstad University College, Department of Health Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-4520.

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Malnutrition is a common problem for patients with cancer that leads to anxiety and frustration for the whole family. Patients with palliative cancer disease treated at home are entitled to an adequate nutrition treatment suited to individual needs.

Aim: The aim of the literature review was to describe how cancer patients experience their nutriment situation before and after the introduction of parental nutrition and the experience of getting home parental nutrition. Methods: A literature study was carried out where qualitative and quantitative articles were examined. Findings: Five qualitative and five quantitative articles were examined. Four categories were created; patients experiences of their nutriment situation before the introduction of parental nutrition, mental experiences receiving parental nutrition at home, physical experiences receiving parental nutrition at home, patients experiences in general receiving parental nutrition at home. Conclusion: Through the parental nutrition treatment at home patients felt that the physical condition improved and the physiological symptoms were decreased. Even though family life was affected patients strived for a normal life. More studies are needed on the role of the nurse in the palliative care regarding nutritional treatment and how her support affects the patient’s positive experience.

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Ekström, Lina, and Frida Hansson. "Beslut om övergången från kurativ till palliativ vård : Sjuksköterskors upplevelser och erfarenheter." Thesis, Halmstad University, School of Social and Health Sciences (HOS), 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-3785.

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Nu för tiden finns det livsuppehållande behandling som kan förlänga patienters liv. Detta kan göra det svårt för sjukvårdspersonalen att sätta gränsen för när övergången från kurativ till palliativ vård ska utföras. Syftet med litteraturstudien var att beskriva sjuksköterskors upplevelser och erfarenheter när beslut ska fattas om patienters övergång från kurativ till palliativ vård inom slutenvården.  Studien genomfördes som en litteraturstudie där 15 vetenskapliga artiklar granskades och analyserades. I resultatet framkom det fyra huvudkategorier: delaktighet, tidpunkt, utbildning/erfarenhet och emotionella reaktioner. Då sjuksköterskor spenderade mycket tid med patienter och hade en holistisk syn ansåg många att deras åsikt inte blev respekterad av läkarna när det kom till att vara delaktig i beslut gällande övergången från kurativ till palliativ vård. Tidpunkten hade betydelse för när beslutet fattades samt även när den kurativa behandlingen avslutades. Det fanns en skillnad mellan sjuksköterskor beroende på hur lång erfarenhet de hade och hur säkra de kände sig i sitt arbete. Sjuksköterskor upplevde att det var jobbigt när det inte fanns klara direktiv på hur den fortsatta behandlingen skulle fortlöpa. För att sjuksköterskor skulle känna sig säkrare borde mer och bättre utbildning införas för samtliga professioner inom hälso- och sjukvården samt mer forskning på patienters upplevelser av situationen.


Nowadays, there are life-sustaining treatment that can prolong patients’ lives. This may make it difficult for medical personnel to set the limit for when the transition from curative to palliative care should be performed in institutional care. The purpose of the study was to describe the nurses’ experiences when a decision would be taken on when the patient went from curative to palliative care. In this study fifteen scientific articles were reviewed and analyzed. Four headlines emerged from the result: involvement, point in time, education/experience and feelings. One thing nurses had in common was that they thought that their opinion did not matter for the doctors about the transition from curative to palliative care, even though they spent more time with the patient and had a holistic point of view on the situation. The point in time was important in regards to when the decision was made and when the curative treatment was brought to an end. One difference between nurses was their experience and how secure they felt within their occupation. The nurses felt that it was difficult when there were not straight directives on how the treatment should be carried out. To be more secure in their jobs as nurses, there should be a higher level of education introduced throughout all of the health and medical care fields and there should be more research done about the patient’s experiences in their situation.

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Westergren, Maja, and Oscar Södergren. "Spiritual and Existential needs in palliative care." Thesis, Kristianstad University College, Department of Health Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-3677.

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Background: Previous research has shown that the understanding and knowledge about the spiritual needs is not given high priority among nursing staff. During the latest years the body and its functions has controlled the healthcare and the spiritual needs has been placed in the background. All humans have spiritual needs that must be satisfied irrespective of religious background. Aim: The aim of this study was to in a caring perspective illustrate patients’ spiritual and existential needs in palliative care. Method: The study is a literature review where 12 articles has been analyzed and summarized to give an overview of rescent research. The approach for the work of the analysis of the articles was qualitative content analysis. Results: The spiritual needs increase in palliative care. To handle the increased needs coping strategies are needed. Nursing staff, relatives and religion are considered by the patient to be important resourses in order to handle the situation. The spiritual needs are not always payed attention to because of lack of knowledge among health care personal. Discussion: The older generation are most likely more spiritual and religious convinced. The sum of this becomes that most of the palliative care patients have a religious belief, that might explain the meaning of spirituality in palliative care. Conclusion: The spiritual needs increase in palliative care and the most important as a nurse is to pay attention to and answer these needs. Through education and increased awareness of spiritual needs, the palliative care could improve considerably.

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Книги з теми "Medicina palliativa"

1

Gaudio, Raffaele De. Vivere e morire in terapia intensiva: Quotidianità in bioetica e medicina palliativa. Firenze, Italy: Firenze University Press, 2013.

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Derek, Doyle, ed. Oxford textbook of palliative medicine. 3rd ed. Oxford: Oxford University Press, 2004.

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Derek, Doyle, ed. Oxford textbook of palliative medicine. 3rd ed. Oxford: Oxford University Press, 2004.

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4

Wendy, Makin, ed. Oncology for palliative medicine. 2nd ed. Oxford: Oxford University Press, 2003.

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Wendy, Makin, ed. Oncology for palliative medicine. Oxford: Oxford University Press, 1998.

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Textbook of palliative medicine. London: Hodder Arnold, 2009.

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7

K, Joishy S., ed. Palliative medicine secrets. Philadelphia: Hanley & Belfus, 1999.

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Pantilat, Steven, Wendy Anderson, Matthew Gonzales, and Eric Widera, eds. Hospital-Based Palliative Medicine. Hoboken, NJ: John Wiley & Sons, Inc, 2015. http://dx.doi.org/10.1002/9781118772607.

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Eduardo, Bruera, ed. Textbook of palliative medicine. London: Hodder Arnold, 2006.

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10

C, Hanks Geoffrey W., ed. Oxford textbook of palliative medicine. 4th ed. Oxford: Oxford University Press, 2009.

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Частини книг з теми "Medicina palliativa"

1

Cundiff, David, and Mary Ellen McCarthy. "Palliative Medicine." In The Right Medicine, 85–99. Totowa, NJ: Humana Press, 1994. http://dx.doi.org/10.1007/978-1-4612-0309-4_6.

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Malhotra, Sonia, and Robin Ulep. "Palliative Medicine." In Clinical Approaches to Hospital Medicine, 121–32. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-64774-6_9.

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Tookman, Adrian, and Faye Gishen. "Palliative Medicine." In Medicine for Finals and Beyond, 597–606. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781003193616-16.

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Saint-Preux, Fabienne, Arpit Arora, Derek Moriyama, Esther Kim, and Arum Kim. "Cannabis in Palliative Medicine." In Cannabis in Medicine, 345–72. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-45968-0_13.

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Currow, David C., and Jane L. Phillips. "Models of Care in Palliative Medicine." In Palliative Surgery, 9–17. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-53709-7_2.

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Badgwell, Brian. "Palliative Surgery." In Oncologic Emergency Medicine, 483–91. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-26387-8_39.

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Lamba, Sangeeta, and Rebecca Goett. "Palliative Care." In Oncologic Emergency Medicine, 809–19. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-67123-5_60.

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Hodge, Caitlin, and Brian Badgwell. "Palliative Surgery." In Oncologic Emergency Medicine, 797–807. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-67123-5_59.

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Ogden, Danna. "Hospice Medicine." In Pain Management and Palliative Care, 205–10. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-2462-2_29.

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Do, Thomas B., Mark A. Scheurer, and Andrew M. Atz. "Palliative Procedures." In Pediatric Critical Care Medicine, 323–28. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6359-6_24.

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Тези доповідей конференцій з теми "Medicina palliativa"

1

Likar, R., S. Nuewersch, M. Kostenberger, and G. Pinter. "Palliative Competence in emergency medicine." In Depression in the Century of Mind, 4th Croatian Congress in Prevention and Rehabilitation in Psychiatry. Gyrus Journal, 2015. http://dx.doi.org/10.17486/gyr.3.2086.

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Leshchenko, Sofiia, and Viktoriia Horina. "THE ISSUE OF PALLIATIVE MEDICINE IN UKRAINE." In THEORETICAL AND EMPIRICAL SCIENTIFIC RESEARCH: CONCEPT AND TRENDS, chair Anastasiia Marchenko. European Scientific Platform, 2022. http://dx.doi.org/10.36074/logos-14.10.2022.44.

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Lawal, Nurah O., Tatiana M. Arevalo Soriano, Shimei S. Nelapati, and Daniel P. Mahoney. "Towards a Narrative Medicine Curriculum for Fellows in Hospice and Palliative Medicine." In AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.548.

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Boland, Jason W., Monisha Kabir, Shirley Bush, Juliet Spiller, Miriam J. Johnson, Meera Agar, and Peter Lawlor. "22 Delirium management by specialists in palliative medicine: an association for palliative medicine (apm) of great britain and ireland survey." In The APM’s Annual Supportive and Palliative Care Conference, In association with the Palliative Care Congress, “Towards evidence based compassionate care”, Bournemouth International Centre, 15–16 March 2018. British Medical Journal Publishing Group, 2018. http://dx.doi.org/10.1136/bmjspcare-2018-aspabstracts.22.

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Stewart, Katherine, Joanna Roberts, Grace Ting, Rebecca Singh-Curry, Clare Forshaw, Jennifer Wiseman, Esraa Sulaivany, Michelle Tombs, Andrew Fletcher, and Andrew Khodabukus. "26 Redesigning the regional teaching program for palliative medicine." In The APM’s Supportive & Palliative Care Conference, Accepted Oral and Poster Abstract Submissions, The Harrogate Convention Centre, Harrogate, England, 21–22 March 2019. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/bmjspcare-2019-asp.49.

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Yoon, Hae-chang, and Jung-hyo Cho. "P-164 The role of korean medicine in palliative medicine for patients with terminal cancer." In Leading, Learning and Innovating, Hospice UK 2017 National Conference, 22–24 November 2017, Liverpool. British Medical Journal Publishing Group, 2017. http://dx.doi.org/10.1136/bmjspcare-2017-hospice.189.

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Ponnampalam, Abi. "35 Palliative medicine trainees’ views on clinical supervision: a survey." In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 19–20 March 2020 | Telford International Centre. British Medical Journal Publishing Group, 2020. http://dx.doi.org/10.1136/spcare-2020-pcc.56.

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Crabtree, Alice, Annell Prosser, and Fiona Rawlinson. "15 How should the palliative medicine aspect of the new internal medicine curriculum be best implemented?" In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 19–20 March 2020 | Telford International Centre. British Medical Journal Publishing Group, 2020. http://dx.doi.org/10.1136/spcare-2020-pcc.36.

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Patel, Mobin, Nitin Kataria, and Andrew Mooningshe. "P-141 Medicines Administration Technicians (MATs) in palliative care." In Finding a Way Forward, Hospice UK National Conference, 22–24 November 2022, Glasgow. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/spcare-2022-hunc.158.

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Thompson, Rebecca, Karen Chumbley, and Jennie Stemp. "P-226 Review of a GP fellowship scheme in palliative medicine." In Transforming Palliative Care, Hospice UK 2018 National Conference, 27–28 November 2018, Telford. British Medical Journal Publishing Group, 2018. http://dx.doi.org/10.1136/bmjspcare-2018-hospiceabs.251.

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