[Evaluation of family function in home care].

Quantitative and qualitative analyses of a caring family are needed to improve home care. We propose a three-dimensional quantitative evaluation of family functioning. The first dimension is food, clothing, and shelter; the second dimension is patient, medical, and caring conditions; and the third dimension is the caring family condition. We used the home care score and Family Adaptability and Cohesion Evaluation Scale at Kwansei Gakuin(FACESKG)IV for the quantitative evaluation of family functioning. Narrative medicine and ethnography are valuable for the qualitative evaluation of a caring family.

[2 cases of successful symptom management at home by using opioid rotation from a fentanyl preparation to a continuous subcutaneous injection of morphine hydrochloride, at a dose less than the equivalent dose based on the conversion table].

We report our experiences of 2 cases of successful pain management at home by using opioid rotation from a fentanyl preparation to a continuous subcutaneous injection of morphine hydrochloride, at a dose less than the equivalent dose based on the conversion table. Our experiences also suggested that opioid rotation according to the conversion ratios might be associated with the risk of delay in the detection of adverse reactions to opioid overdose in patients under home care, whose conditions cannot be checked frequently by health care providers.