RESUMO
Background: The World Health Assembly urges members to build palliative care (PC) capacity as an ethical imperative. Nurses provide PC services in a variety of settings, including the home and may be the only health care professional able to access some disparate populations. Identifying current nursing services, resources, and satisfaction and barriers to nursing practice are essential to build global PC capacity. Objective: To globally examine home health care nurses' practice, satisfaction, and barriers, regarding existing palliative home care provision. Design: Needs assessment survey. Setting/Subjects: Five hundred thirty-two home health care nurses in 29 countries. Measurements: A needs assessment, developed through literature review and cognitive interviewing. Results: Nurses from developing countries performed more duties compared with those from high-income countries, suggesting a lack of resources in developing countries. Significant barriers to providing home care exist: personnel shortages, lack of funding and policies, poor access to end-of-life or hospice services, and decreased community awareness of services provided. Respondents identified lack of time, funding, and coverages as primary educational barriers. In-person local meetings and online courses were suggested as strategies to promote learning. Conclusions: It is imperative that home health care nurses have adequate resources to build PC capacity globally, which is so desperately needed. Nurses must be up to date on current evidence and practice within an evidence-based PC framework. Health care policy to increase necessary resources and the development of a multifaceted intervention to facilitate education about PC is indicated to build global capacity.
Assuntos
Enfermagem Domiciliar/métodos , Enfermeiros de Saúde Comunitária/educação , Enfermeiros de Saúde Comunitária/psicologia , Enfermeiros de Saúde Comunitária/estatística & dados numéricos , Cuidados Paliativos/psicologia , Satisfação Pessoal , Papel Profissional/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Pancreas is a rare location for desmoplastic small round cell tumor. The present case highlights the dilemma in diagnosis and ascertaining the site of tumor origin. Morphologic and immunohistochemical features were complemented with the molecular markers and tumor origin which was initially nebulous was subsequently confirmed on exploratory laparotomy.
Assuntos
Neoplasias Intestinais/complicações , Neoplasias Intestinais/diagnóstico , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico , Sarcoma de Células Pequenas/complicações , Sarcoma de Células Pequenas/diagnóstico , Biópsia , Criança , Terapia Combinada , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Neoplasias Intestinais/patologia , Neoplasias Intestinais/terapia , Masculino , Divertículo Ileal/patologia , Divertículo Ileal/terapia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sarcoma de Células Pequenas/patologia , Sarcoma de Células Pequenas/terapia , Tomografia Computadorizada de Emissão , Tomografia Computadorizada por Raios XRESUMO
Primary lymphoma of the bone is a relatively rare entity. There are very few reported cases in literature of synchronous, multifocal Non-Hodgkin's Lymphoma (NHL) of the bone. Here, we report a patient with extranodal NHL of the clivus and scapula presenting with cranial nerve palsies and a scapular mass. He was treated with combination chemotherapy followed by involved field radiotherapy. At 15 months of follow-up, he is asymptomatic and in complete remission.