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The Use of Baclofen to Control Vertical Nystagmus in a Patient with Advanced Glioma: A Case Report. 使用巴氯芬控制胶质瘤晚期患者的垂直性眼球震颤:病例报告。
Pub Date : 2024-12-01 DOI: 10.14475/jhpc.2024.27.4.177
Luma Alfraihat, Sami Ayed Alshammary, Hassan Yousef Alghar

Nystagmus, characterized by involuntary eye movements, can arise from several causes, with benign paroxysmal positional vertigo being the most prevalent. Additionally, central lesions such as tumors may also induce nystagmus. This case report describes the amelioration of vertical nystagmus in a patient with advanced glioma after treatment with the GABAergic drug baclofen.

眼球震颤以眼球不自主运动为特征,可由多种原因引起,其中以良性阵发性位置性眩晕最为常见。此外,中枢病变如肿瘤也可诱发眼球震颤。本病例报告描述了一名晚期胶质瘤患者在使用gaba能药物巴氯芬治疗后垂直眼球震颤的改善情况。
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引用次数: 0
End-of-life Care, Comfort Care, and Hospice: Terms and Concepts. 临终关怀、舒适护理和安宁疗护:术语和概念。
Pub Date : 2024-12-01 DOI: 10.14475/jhpc.2024.27.4.162
Hyeon Ju Kim, Jung-Sik Huh

Purpose: This study aims to clarify and standardize the terms and concepts associated with end-of-life care, specifically within the contexts of hospice and palliative care.

Methods: We reviewed references pertaining to hospice and palliative care, including definitions of end-of-life care and comfort care. Two meetings were held with members of the medical terminology committee of the Korean Society for Hospice and Palliative Care, along with experts in the field, to establish a consensus on the terms used. In the first round, six experts participated, and in the second round, eight experts engaged in online meetings to brainstorm, exchange opinions, and review and discuss reference materials concerning terms related to hospice and palliative care.

Results: Legal definitions do not always align with those used in clinical medical settings. Although it is challenging to define the period precisely, end-of-life care encompasses all diseases, including age-related infirmities, typically spanning 6 months to 1 year. Hospice care, in contrast, includes certain non-cancerous terminal diseases as well as terminal cancer, covering a period of 3 to 6 months. Comfort care generally refers to the care provided approximately 7 days before death.

Conclusion: A conceptual understanding of terms related to end-of-life care must be reached through cultural and social consensus. Furthermore, end-of-life care should not be limited to cancer but extended to all diseases. In the future, the scope of end-of-life care should expand to encompass care for bereaved families, evolving into a more comprehensive concept of comfort care.

目的:本研究旨在厘清与规范与临终关怀相关的术语与概念,特别是在安宁疗护与缓和疗护的背景下。方法:我们回顾了有关安宁疗护和缓和疗护的文献,包括临终关怀和舒适疗护的定义。与韩国临终关怀和缓和护理协会医学术语委员会成员以及该领域的专家举行了两次会议,以就所使用的术语达成共识。第一轮有6位专家参与,第二轮有8位专家参与在线会议,就临终关怀和姑息治疗相关术语进行头脑风暴、交换意见、审查和讨论参考资料。结果:法律定义并不总是与临床医疗环境中使用的定义一致。虽然很难准确界定这一时期,但临终关怀涵盖了所有疾病,包括与年龄有关的疾病,通常持续6个月至1年。相比之下,临终关怀包括某些非癌症晚期疾病和晚期癌症,为期3至6个月。舒适护理一般是指在死亡前大约7天提供的护理。结论:对临终关怀相关术语的概念性理解必须通过文化和社会共识达成。此外,临终关怀不应局限于癌症,而应扩展到所有疾病。在未来,临终关怀的范围应该扩大到包括对失去亲人的家庭的照顾,演变成一个更全面的舒适护理的概念。
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引用次数: 0
Content Analysis of Online Resources Regarding Needs for Advance Care Planning. 有关预先护理规划需求的在线资源内容分析。
Pub Date : 2024-09-01 DOI: 10.14475/jhpc.2024.27.3.87
Minju Kim, Jieun Lee

Purpose: This study aimed to investigate advance care planning needs expressed online.

Methods: This study collected data from online community posts and healthcare news sites. The search keywords included "death," "euthanasia," "life-sustaining medical care," "life-sustaining treatment," "advance directives," "advance medical directives," and "advance care planning." Data collection spanned from February 2018 to February 14, 2020. Out of 2,288 posts, 1,190 were included in the final analysis. Data analysis was conducted using NVivo 12, a qualitative data analysis software program.

Results: Content analysis categorized patients' advance care planning needs into eight themes, 11 theme clusters, and 33 meaningful statements. Similarly, care providers' advance care planning needs were categorized into eight themes, 14 theme clusters, and 42 meaningful statements. The identified themes of care needs included life-sustaining medical care, decision-making related to life-sustaining medical care, physical care, environmental care, supportive and spiritual care, respect, preparing for death, and family.

Conclusion: This study identified care needs from the perspectives of patients and their families. The findings may serve as preliminary data for future research and clinical applications.

目的:本研究旨在调查网上表达的预先护理规划需求:本研究从在线社区帖子和医疗保健新闻网站收集数据。搜索关键词包括 "死亡"、"安乐死"、"维持生命的医疗"、"维持生命的治疗"、"预先指示"、"预先医疗指示 "和 "预先护理计划"。数据收集时间为 2018 年 2 月至 2020 年 2 月 14 日。在 2,288 个帖子中,1,190 个被纳入最终分析。数据分析使用定性数据分析软件程序 NVivo 12 进行:内容分析将患者的预先护理规划需求分为 8 个主题、11 个主题集群和 33 个有意义的陈述。同样,护理提供者的预先护理计划需求也被分为 8 个主题、14 个主题集群和 42 个有意义的陈述。确定的护理需求主题包括维持生命的医疗护理、与维持生命的医疗护理相关的决策、身体护理、环境护理、支持性和精神护理、尊重、为死亡做准备以及家庭:本研究从病人及其家属的角度确定了护理需求。结论:本研究从病人及其家属的角度确定了护理需求,其结果可作为未来研究和临床应用的初步数据。
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引用次数: 0
A Phased Plan for the Expansion of Hospice and Palliative Care. 扩大临终关怀和姑息治疗的分阶段计划。
Pub Date : 2024-09-01 DOI: 10.14475/jhpc.2024.27.3.103
So Young Park

Palliative care is a comprehensive approach aimed at improving the quality of life for patients and their families. The symptom burden and care needs of patients with end-stage, non-malignant diseases are similar to those experienced by patients with advanced cancer. Therefore, the World Health Organization (WHO) has recommended the expansion of palliative care to encompass a broad spectrum of diseases. However, in Korea, the adoption of palliative care for non-malignant conditions remains markedly low, presenting numerous challenges that differ from those associated with cancer. Key barriers to implementing hospice care for non-malignant diseases include the difficulty in predicting end-of-life and a general lack of awareness about hospice palliative care among healthcare providers, patients, and their families. Additionally, there is a risk that suggesting palliative care to patients with non-malignant diseases might be misinterpreted as an endorsement by healthcare providers to cease treatment or abandon the patient. This article explores strategies to broaden the scope of hospice and palliative care for patients with non-malignant diseases.

姑息关怀是一种旨在改善病人及其家属生活质量的综合方法。晚期非恶性疾病患者的症状负担和护理需求与晚期癌症患者相似。因此,世界卫生组织(WHO)建议扩大姑息治疗的范围,使其涵盖广泛的疾病。然而,在韩国,对非恶性疾病采用姑息关怀的比例仍然很低,这带来了许多与癌症不同的挑战。对非恶性疾病实施安宁疗护的主要障碍包括难以预测生命末期,以及医疗服务提供者、患者及其家属普遍缺乏对安宁疗护姑息关怀的认识。此外,向非恶性疾病患者建议姑息关怀可能会被误解为医疗服务提供者赞同停止治疗或放弃患者。本文探讨了为非恶性疾病患者扩大临终关怀和姑息关怀范围的策略。
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引用次数: 0
Ethical and Practical Issues with the Use of Antimicrobial Agents during the End of Life. 生命末期使用抗菌药物的伦理和实践问题。
Pub Date : 2024-09-01 DOI: 10.14475/jhpc.2024.27.3.99
Amlak Bantikassegn

The use of antimicrobials in patients receiving end-of-life (EOL) care, which is generally defined as supportive care provided to patients anticipated to live less than 1 year, has been actively debated in the realm of palliative care medicine due to the nebulous nature of the topic. In this article, we explore the use of antimicrobial use near EOL as it relates to both the ethical and practical issues that face physicians. We also discuss the reasons underlying the scarcity of prospective studies on this topic.

生命末期(EOL)护理一般是指为预计寿命不超过 1 年的患者提供的支持性护理,由于该主题的模糊性,姑息治疗医学界一直在积极讨论在接受生命末期护理的患者中使用抗菌药物的问题。在本文中,我们将探讨在临终前使用抗菌药物与医生面临的伦理和实际问题之间的关系。我们还讨论了有关该主题的前瞻性研究很少的原因。
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引用次数: 0
Early Hospice Consultation Team Engagement for Cancer Pain Relief: A Case Report. 安宁疗护咨询团队早期参与癌症疼痛缓解:病例报告
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.77
Jisoo Jeong

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

本病例报告探讨了与阿片类药物治疗癌痛相关的挑战和复杂性,强调了安宁疗护咨询团队早期参与和采用多学科护理方法的重要性。一名 56 岁的胰腺癌晚期患者经历了疼痛升级和不适当的阿片类药物处方,凸显了传统疼痛管理方法的缺陷。尽管主治医生进行了程序性干预并增加了阿片类药物的剂量,但患者的病情还是恶化了。随后,安宁疗护咨询团队的介入以及精神科的协作治疗使患者的病情得到了全面改善。该病例强调了在优化以患者为中心的姑息治疗过程中,早期安宁疗护参与、社会心理评估和协作方法的必要性。
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引用次数: 0
Knowledge and Perceptions of the End of Life among Tunisian Medical and Paramedical Staff. 突尼斯医务人员和辅助医务人员对生命终结的认识和看法。
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.64
Nayssem Khessairi, Dhouha Bacha, Rania Aouadi, Rym Ennaifer, Ahlem Lahmar, Sana Ben Slama

Purpose: End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care.

Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index.

Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers.

Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.

目的:生命末期(EOL)护理是个人生命中的一个脆弱时期。医疗保健专业人员(HPs)努力在保护人的生命与尊重病人意愿之间取得平衡。我们研究的目的是评估医护人员对临终关怀的认识和看法,并提出需要改进的地方,以提高护理质量:我们进行了一项单中心横断面研究,涉及一家大学医院中遇到临终关怀情况的医护人员。我们使用的问卷分为知识、实践、感知和培训四个部分。我们计算了回答正确率和集体能力指数:分析了 86 份问卷,其中 82.5%(71/86)由医务人员填写,17.5%(15/86)由医务辅助人员填写。71.8%(51/71)的受访者为实习生和住院医师。研究的重点是姑息治疗、临终医疗救助、积极治疗和安乐死,结果发现前三个方面的知识充足。被分配到重症监护室的受访者和拥有 8 年以上工作经验的受访者的正确答案率明显高于同类受访者。75%的受访者(65/86)表示,他们对临终关怀的掌握程度很低或根本没有掌握,主要原因是培训不足和没有培训人员:根据我们的研究结果(我们认为这在突尼斯尚属首次),我们可以得出结论,保健医生在临终关怀方面拥有可接受的知识水平。然而,他们需要更多的接触和培训,以发展这方面的专业知识。
{"title":"Knowledge and Perceptions of the End of Life among Tunisian Medical and Paramedical Staff.","authors":"Nayssem Khessairi, Dhouha Bacha, Rania Aouadi, Rym Ennaifer, Ahlem Lahmar, Sana Ben Slama","doi":"10.14475/jhpc.2024.27.2.64","DOIUrl":"10.14475/jhpc.2024.27.2.64","url":null,"abstract":"<p><strong>Purpose: </strong>End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care.</p><p><strong>Methods: </strong>We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index.</p><p><strong>Results: </strong>Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers.</p><p><strong>Conclusion: </strong>Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 2","pages":"64-76"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inpatient Hospice Care in Korea during the COVID-19 Pandemic: A Preliminary Study. COVID-19 大流行期间韩国的住院病人临终关怀:初步研究。
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.82
Youn Seon Choi, Sun Wook Hwang, In Cheol Hwang

Purpose: This study examined the quality of life (QoL) and quality of care (QoC) in inpatient hospice settings in Korea before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Data were obtained from three institutions that participated in two prospective cohort studies. The primary outcomes measured were the QoL of patients with terminal cancer and their family caregivers (FCs), as well as the QoC as perceived by the FCs.

Results: Multivariable regression analysis revealed that during the COVID-19 pandemic, both patients and FCs experienced better QoL than before the pandemic, and FCs reported a higher QoC.

Conclusion: Health policymakers should consider our findings when planning for future pandemics.

目的:本研究调查了韩国 2019 年冠状病毒病(COVID-19)大流行之前和期间住院临终关怀机构的生活质量(QoL)和护理质量(QoC):数据来自参与两项前瞻性队列研究的三家机构。测量的主要结果是晚期癌症患者及其家庭照顾者(FCs)的 QoL 以及家庭照顾者认为的 QoC:多变量回归分析表明,在 COVID-19 大流行期间,患者和家庭照顾者的 QoL 均优于大流行之前,而家庭照顾者报告的 QoC 更高:卫生决策者在规划未来的大流行时应考虑我们的研究结果。
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引用次数: 0
An Evolutionary Concept Analysis of Pediatric Hospice and Palliative Care. 儿科临终关怀与姑息治疗的演变概念分析。
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.51
Jung Hwa Lee, Soon Young Lee, Kyung Mi Cha

Purpose: This study aimed to clarify the concept of pediatric hospice and palliative care through conceptual analysis. It also sought to identify the differences between related concepts such as pediatric death care and pediatric spiritual care, in order to provide foundational data for the development of nursing theory and knowledge.

Methods: A conceptual analysis of pediatric hospice and palliative care was conducted using Rodgers' evolutionary method. Out of 5,013 papers identified, 28 were selected for detailed reading and analysis.

Results: Pediatric hospice and palliative care encompasses physical, psychological, social, mental, spiritual, and family care for children with acute and chronic diseases with uncertain prognoses ahead of death, as well as their families. Effective pediatric hospice and palliative care will require multidisciplinary team nursing, effective communication, and supportive policies.

Conclusion: The findings of this study suggest that providing pediatric hospice and palliative care will lead to improvements in pain relief for children and families, the efficiency of responses to death in children, and the quality of life for children and families. The significance of this study is that it clearly clarifies the concept by analyzing pediatric hospice and palliative care using an evolutionary method.

目的:本研究旨在通过概念分析澄清儿科临终关怀和姑息关怀的概念。研究还试图找出相关概念(如儿科死亡护理和儿科精神护理)之间的差异,从而为护理理论和知识的发展提供基础数据:方法:采用罗杰斯进化法对儿科临终关怀和姑息关怀进行了概念分析。在确定的 5013 篇论文中,选择了 28 篇进行详细阅读和分析:结果:儿科临终关怀和姑息治疗包括对患有急性和慢性疾病、死亡前预后不确定的儿童及其家人的身体、心理、社会、精神和家庭护理。有效的儿科临终关怀和姑息关怀需要多学科团队护理、有效沟通和支持性政策:本研究的结果表明,提供儿科临终关怀和姑息治疗将有助于减轻儿童和家属的疼痛,提高应对儿童死亡的效率,改善儿童和家属的生活质量。本研究的意义在于通过使用进化方法分析儿科临终关怀和姑息关怀,明确了这一概念。
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引用次数: 0
Attitudes toward Social Issues Related to Opioid Use among Palliative Care Physicians. 姑息治疗医生对阿片类药物使用相关社会问题的态度。
Pub Date : 2024-03-01 DOI: 10.14475/jhpc.2024.27.1.45
In Cheol Hwang, Seong Hoon Shin, Youn Seon Choi, Myung Ah Lee, DaeKyun Kim, Kyung Hee Lee

Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use.

Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC).

Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education.

Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

目的:本研究调查了姑息关怀医生对阿片类药物使用相关社会问题的态度:方法:向韩国安宁缓和医疗协会(KSHPC)的 674 名会员医生发送电子邮件调查:对 66 名医生的数据进行了分析(回复率为 9.8%)。约 70% 的参与者表示,他们的处方模式不受与阿片类药物使用相关的社会问题的影响,90% 的参与者认为额外的规定应仅限于非癌症疼痛。在当前情况下,迫切需要对医生进行疼痛教育,并提高公众的认识。半数受访者认为 KSHPC 是负责提供疼痛教育的主要机构:姑息治疗医生的处方模式不受与阿片类药物使用相关的社会问题的影响,这些问题也不应影响癌症疼痛控制。
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引用次数: 0
期刊
Journal of hospice and palliative care
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