An evaluation of the domiciliary occupational therapy service in palliative cancer care in a community trust: a patient and carers perspective.

In the past 20 years there has been considerable growth in the provision of palliative care services. The shift in emphasis from hospice and hospital care to the development of community services has been significant. This enables people to be cared for at home and is in keeping with Government agenda. While this may be beneficial for the patient and fit in with the wishes of the family, it is likely to put heavy demands on the coping resources of individual carers. The views of service users are of paramount importance when discussing service evaluation and patient, family and carer empowerment. This research presents the findings of an evaluation of the domiciliary occupational therapy service provided for patients in the palliative stage of cancer care in North and West Belfast from the perspective of the patients and carers. For the purpose of this study, the palliative stage of cancer care is defined as the point from which the patient is no longer responsive to curative treatment, until death. A sample of 30 patients and their primary informal carers were selected using purposive sampling. A structured interview was carried out with both the patients and their carers to obtain views. Results suggest that although both patients and their carers value the service provided and report high levels of satisfaction, there are gaps identified in service provision and a lack of clear information among patients and their carers about the role of the occupational therapist and the range of services they can provide. There is a need to build upon the good work being done by domiciliary occupational therapists in the area of palliative cancer care and increase education and resources to ensure that a patient-centred, holistic, approach to care is used, addressing both the needs of the patient and their carers.

Susceptibility of tooth surfaces to carious attack in young adults.

This paper reports on the pattern of carious attack, prior to and after enlistment, experienced by a cohort of 291 Royal Air Force recruits first inspected in 1988 and observed again in 1992. On enlistment the recruits had suffered more occlusal than approximal caries. Over the next five years approximal caries occurred more often than occlusal caries in premolars, its incidence was the same as that of occlusal caries in first molars but less than for occlusal caries in second molars. On enlistment, 88 per cent of the occlusal surfaces of first molars and 56 per cent of second molars were already missing, filled or carious. One in 10 sound molars succumbed to occlusal caries during the study although only 1 in 120 premolars did likewise. It was concluded that the incidence of occlusal caries in this age group justifies placing or repairing fissure sealants in molar teeth.

Dental treatment needs of a cohort of Royal Air Force recruits over 5 years.

The paper reports the dental status of a cohort of Royal Air Force (RAF) recruits in 1988 and details the work required to render and maintain them dentally fit for their first 5 years in the service. The mean DMFT (7.3) at inspection in 1988 increased by 0.8 whilst the mean number of restorations placed was 4.0. Endodontic therapy was required by 13.4 percent of the recruits and crowns were provided for 9.6 percent. The recruits required twice as many restorations in their first year in the service to render them dentally fit as were required in any subsequent year to maintain fitness, this work needed 58 minutes of dental officers' time in their first year and 43 minutes per year thereafter. The number of dentists seen or courses of treatment undertaken did not have a significant effect on the number of restorations provided. The prevalence and incidence of caries in this group appeared to justify the RAF's policy of annual inspections but the number of carious lesions which did not progress far enough to require restoration after 5 years indicated that a preventive approach to treatment planning is important to avoid overtreatment.