RESUMO
Mongolia has established the foundation measures for a national palliative care program. Generic cost-effective opioids have been made available. Prescription regulations have been changed to allow opioid use according to good medical practice. Education on palliative care has been incorporated into the undergraduate curricula of doctors, nurses, and social workers, and the training of specialists in palliative care has been initiated concurrent with established standards for palliative care.
Assuntos
Programas Nacionais de Saúde/organização & administração , Cuidados Paliativos/organização & administração , Analgésicos Opioides/uso terapêutico , Acessibilidade aos Serviços de Saúde , Humanos , Mongólia/epidemiologia , Neoplasias/epidemiologiaRESUMO
A model for pain relief and palliative care for the Middle East has been established in Jordan. King Hussein Cancer Centre (KHCC) in Amman is now a truly comprehensive cancer center as it includes palliative care for inpatients, outpatients, and patients at home. This is especially important in a country and a region where over 75% of the cancer patients are incurable when diagnosed. To support effective palliative care delivery, there have been many significant changes in Jordan between 2001 and 2006. Regulations governing opioid prescribing have been changed to facilitate effective pain management. The national opioid quota has been increased. Cost-effective, generic, immediate-release morphine tablets are being produced in Jordan. Intensive, interactive bedside training courses for doctors, nurses, and clinical pharmacologists have started to overcome opiophobia and motivate health care professionals to take up palliative care as a profession. "Champions" for palliative care have emerged who are leading the development of palliative care in Jordan's health care systems and starting to support neighboring countries to develop pain relief and palliative care. While before 2003, fewer than 250 patients per year received palliative care, by 2006 more than 800 patients per year were receiving pain relief and palliative care through the KHCC and Al Basheer Hospital. The achieved changes and the unusually rapid and effective institutionalization of palliative care serve as a model for other countries in the Middle East region as to what should be done and how.
Assuntos
Cuidados Paliativos/organização & administração , Analgésicos Opioides/uso terapêutico , Acessibilidade aos Serviços de Saúde , Humanos , Jordânia , Modelos Organizacionais , Projetos Piloto , Organização Mundial da SaúdeRESUMO
The gold standard for pain screening and assessment is the patient report. Research shows that many patients with mild to moderate cognitive impairment retain the ability to report pain. All patients should be given the opportunity to self-report their pain using valid and reliable tools.
Assuntos
Transtornos Cognitivos/complicações , Manejo da Dor , Medição da Dor/métodos , Dor/diagnóstico , Idoso , Analgésicos/uso terapêutico , Enfermagem em Saúde Comunitária , Delírio/diagnóstico , Demência/diagnóstico , Diagnóstico Diferencial , Esquema de Medicação , Expressão Facial , Feminino , Avaliação Geriátrica , Serviços de Assistência Domiciliar , Humanos , Entrevista Psiquiátrica Padronizada , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Dor/epidemiologia , Dor/etiologia , Medição da Dor/enfermagem , Cuidados Paliativos , Planejamento de Assistência ao Paciente , Educação de Pacientes como Assunto , Prevalência , Psicometria , Índice de Gravidade de DoençaRESUMO
The words of patients with cancer about pain management are powerful learning tools. Questions were posed about the meaning of pain for patients and families, effective pain management strategies, and professional caregivers' roles to three patients and families. This article details their responses about pain, pain management, and the barriers they encountered. Clinicians are urged to read these case reports to "hear" the importance of effective pain management to individuals and act appropriately.