martes, 6 de marzo de 2018

Adicción a propofol / Propofol addiction

Marzo 6, 2018. No. 3014
Neurobiología de la adicción al propofol y la evidencia de apoyo: ¿cuál es el nuevo desarrollo
Neurobiology of Propofol Addiction and Supportive Evidence: What Is the New Development?
Brain Sci. 2018 Feb 22;8(2). pii: E36. doi: 10.3390/brainsci8020036.
Abstract
Propofol is a short-acting intravenous anesthetic agent suitable for induction and maintenance of general anesthesia as well as for procedural and intensive care unit sedation. As such it has become an unparalleled anesthetic agent of choice in many institutional and office practices. However, in addition to its idealistic properties as an anesthetic agent, there is accumulating evidence suggesting its potential for abuse. Clinical and experimental evidence has revealed that not only does propofol have the potential to be abused, but also that addiction to propofol shows a high mortality rate. Based on this evidence, different researchers have shown interest in determining the probability of propofol to be an addictive agent by comparing it with other drugs of abuse and depicting a functional similitude that involves the mesocorticolimbic pathway of addiction. In light of this, the Drug Enforcement Agency and the American Society of Anesthesiologists have put forth certain safety recommendations for the use of propofol. Despite this, the abuse potential of propofol has been challenged at different levels and therefore the preeminent focus will be to further validate the linkage from medicinal and occasional use of propofol to its addiction, as well as to explore the cellular and molecular targets involved in establishing this linkage, so as to curb the harm arising out of it. This review incorporates the clinical and biomolecular evidence supporting the abuse potential of propofol and brings forth the promising targets and the foreseeable mechanism causing the propofol addiction phenotypes, which can be called upon for future developments in this field.
KEYWORDS: GABAA receptor; abuse potential; fospropofol; glycine receptor; propofol
Reporte del primer caso de adicción al propofol en Turquía
A Case Report of the First Propofol Addiction in Turkey.
Turk J Anaesthesiol Reanim. 2015 Dec;43(6):434-6. doi: 10.5152/TJAR.2015.54872. Epub 2015 Dec 1.
Abstract
Propofol is a potent anaesthetic drug and also an effective sedative agent. Also, propofol may be used for non-anaesthetic purposes such as the treatment of seizures, migraine and tension headache in clinical practice. It has been abused, particularly among healthcare providers with high mortality rate. This report presents the case of a propofol-dependent patient who was an emergency medicine doctor with no difficulties in obtaining the drug. He himself visited our clinic for the treatment of propofol dependence. We started the patient's treatment with pharmacotherapeutic medicines and individual psychotherapy. Fourteen days after starting the therapy, the patient was discharged from hospital on his own will and he did not attend the follow-up visits in the outpatient clinic. Then, we were informed of his death, which was suspected to have occurred owing to drug intoxication in the hospital in which he worked. Nevertheless, the reason of death was important; the importance of this case report is to provide information regarding the drug's dependence profile. This is the first case report indicating propofol dependence in Turkey. Because of its easy access, rapid onset time and short duration of action, propofol dependence is increasing. We think that adding propofol to the controlled drug list and improving the knowledge of the clinicians regarding its abuse potential may limit the dependence cases.
KEYWORDS: Propofol; abuse; dependence; euphoria
Potencial de abuso del propofol utilizado para la sedación en la endoscopia gástrica y su correlación con las características del sujeto.
Abuse potential of propofol used for sedation in gastric endoscopy and its correlation with subject characteristics.
Korean J Anesthesiol. 2013 Nov;65(5):403-9. doi: 10.4097/kjae.2013.65.5.403. Epub 2013 Nov 29.
Abstract
BACKGROUND: Propofol has been widely used for an induction and/or maintenance of general anesthesia, or for sedation for various procedures. Although it has many ideal aspects, there have been several cases of drug abuse and addiction. The authors investigated whether there are abuse liable groups among the general population. METHODS: We surveyed 169 patients after gastric endoscopic examination, which used propofol as a sedative, with the Addiction Research Center Inventory (ARCI) questionnaire. Other characteristics of the patients, such as past history, smoking habits, depression, anxiety, alcohol abuse liability and sleep disturbance, were recorded by history taking and several questionnaires before the exam. RESULTS: Propofol had a high Morphine-Benzedrine Group (MBG) score (representative value for euphoria) of 6.3, which is higher than marijuana, and a Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score (representative value of sedation) of 8.1, which is lower than most opioids. The MBG score showed no statistically significant correlation between any of the characteristics of the groups. In females, the PCAG score showed a correlation with age, and in males, it showed a correlation with a sleeping problem. CONCLUSIONS: Propofol had relatively high euphoria and low residual sedative effects. It had a more potent sedative effect in the female group who were young, and in the male group who had a low sleep quality index. There were differences in the abuse liability from a single exposure to propofol in the general population. Further study is needed to evaluate the abuse liability of repeated exposure. KEYWORDS: Addictive behavior; Dependency; Hypnotics and sedatives; Intravenous substance abuse; Propofol
Aumento de DeltaFosB por propofol en núcleo de rata accumbens.
Upregulation of DeltaFosB by propofol in rat nucleus accumbens.
Anesth Analg. 2011 Aug;113(2):259-64. doi: 10.1213/ANE.0b013e318222af17. Epub 2011 Jun 3.
Abstract
BACKGROUND: It is well established that all drugs of abuse converge onto common circuitry and induce chronic addiction by modulating the addictive signaling molecules such as DeltaFosB in the mesocorticolimbic system. Recent case reports suggest that propofol may have abuse potential. However, there is no direct evidence showing that propofol has an effect on the key addictive signaling molecules in the mesocorticolimbic system. In this study, we determined the effect of propofol on the expression of DeltaFosB in rat nucleus accumbens (NAc) and the potential mechanism involved. METHODS: To determine the effect of propofol on the expression of DeltaFosB in rat NAc, 2 well-known addictive agents, ethanol and nicotine, were used as positive controls. Experiments were conducted on 36 male Sprague-Dawley rats (150 to 200 g). These animals were divided into 4 treatment groups: vehicle (saline), propofol (10 mg/kg), ethanol (1 g/kg), and nicotine (0.5 mg/kg). All drugs were administered by intraperitoneal injection twice per day for 7 days. The animals were then killed and their NAc were isolated for DeltaFosB measurements. RESULTS: As expected, both ethanol and nicotine significantly increased DeltaFosB expression. Intriguingly, propofol elicited a robust increase in DeltaFosB expression similar to that of ethanol and nicotine. Moreover, the dopamine receptor D1, an upstream molecule of DeltaFosB, was also significantly upregulated by propofol. CONCLUSIONS: In the current study, we have identified, for the first time, that propofol is able to induce the addictive signaling molecule DeltaFosB in NAc via dopamine receptor D1. This new evidence at the molecular level suggests that propofol may have abuse potential.
El propofol nanomolar estimula la transmisión del glutamato a las neuronas dopaminérgicas: ¿un posible mecanismo de abuso potencial?
Nanomolar propofol stimulates glutamate transmission to dopamine neurons: a possible mechanism of abuse potential?
J Pharmacol Exp Ther. 2008 Apr;325(1):165-74. doi: 10.1124/jpet.107.132472. Epub 2008 Jan 23.
Abstract
Anesthesiologists among physicians are on the top of the drug abuse list, and the mechanism is unclear. Recent studies suggest occupation-related second-hand exposure to i.v. drugs, including propofol, may play a role. Growing evidence indicates that propofol is one of the choices of drugs being abused. In this study, we show that propofol at minute concentrations increases glutamatergic excitatory synaptic transmission and discharges of dopamine neurons in the ventral tegmental area (VTA). We found that acute application of propofol (0.1-10 nM) to the VTA in midbrain slices of rats increased the frequency but not the amplitude of spontaneous excitatory postsynaptic currents (EPSCs) mediated by alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. We observed that propofol increased the amplitude but decreased the paired-pulse ratio of EPSCs evoked by stimulation in the absence and the presence of gabazine (SR 95531), a GABA(A) receptor antagonist. Moreover, the propofol-induced facilitation of EPSCs was mimicked by 6-phenyl-4-azabicyclo[5.4.0]undeca-7,9,11-triene-9,10-diol (SKF38393), an agonist of dopamine D(1) receptor, and by 1-[2-(diphenylmethoxy)ethyl]-4-(3-phenylpropyl)piperazine dihydrochloride (GBR 12935), a dopamine reuptake inhibitor, but blocked by (+/-)-7-bromo-8-hydroxy-3-methyl-1-phenyl-2,3,4, 5-tetrahydro-1H-3-benzazepine hydrochloride (SKF83566), a D(1) antagonist, or by depleting dopamine stores with reserpine. Finally, 1 nM propofolincreased the spontaneous discharge rate of dopamine neurons. These findings suggest that propofol at minute concentrations enhances presynaptic D(1) receptor-mediated facilitation of glutamatergic synaptic transmission and the excitability of VTA dopamine neurons, probably by increasing extracellular dopamine levels. These changes in synaptic plasticity in the VTA, an addiction-related brain area might contribute to the development of propofol abuse and the increased susceptibility to addiction of other drugs.
Asegurar la declaración de posición de Propofol
Securing Propofol Position Statement
The American Association of Nurse Anesthetists (AANA) supports the well-being, safety, and professional self-care of Certified Registered Nurse Anesthetists and Student Registered Nurse Anesthetists. The AANA recognizes that anesthesia professionals have an increased occupational risk of substance use disorder, as well as the professional and personal consequences of substance use disorder
Adicción al propofol: estudio de 22 casos tratados
Addiction to propofol: a study of 22 treatment cases.
J Addict Med. 2013 May-Jun;7(3):169-76. doi: 10.1097/ADM.0b013e3182872901.
Abstract
OBJECTIVE: To review and report the history and clinical presentation of a cohort of health care professionals (HCPs) who have abused the drug propofol. METHODS: The authors queried a clinical database (the HCP Database) that contained information about HCPs treated at a large addictioncenter between 1990 and 2010. Patients who reported propofol use were removed from the HCP Database and placed in a second database referred to herein as the Propofol Database. The medical records of each of the cases in the Propofol Database were pulled and carefully reviewed; a clinical case history of each case was prepared. The Propofol Database was expanded by this chart review, adding demographics, drugs used, course of substance use, other clinical history, presenting signs, diagnoses, and comorbid conditions. At this point, the case histories and databases and were anonymized. When variables were present in both data sets, significance was tested between the HCP Database and the Propofol Database. When comparable data were not present in the HCP Database, the authors reported simple percentages within the Propofol Database. This study focused on gender, medical education and specialty, drugs used, course of illness, and comorbid conditions. RESULTS: Compared with the composite treatment population of HCPs during the same time, records showed that the propofol group was more likely to work in the operating theater, be female, and have training as an anesthesiologist or certified registered nurse anesthetist. Presentation into treatment from the propofol cohort more commonly occurred soon after beginning propofol use, often presenting in a dramatic fashion such as motor vehicle accidents or other physical injuries. When such injuries occurred, it was a direct result of acute propofol intoxication. The number of cases arriving in treatment increased over the duration of the study. The propofol group frequently suffered with a depressive illness and had a history of earlier life trauma. They had a high frequency of biological relatives with substance dependence. The most common subjective response as to why they began using propofol was to induce sleep. Most of these patients identified propofol as one of their preferred drugs of abuse. CONCLUSIONS: This study suggests the incidence and/or detection rate of propofol abuse in HCPs is increasing. Women and anesthesia personnel were overrepresented in the propofol cohort. Propofol-dependent patients commonly have a history of depression and earlier life trauma. A rapid downhill course and physical injury are common adverse effects of propofol abuse. The time from initial use to treatment entry is often contracted when compared with other drugs of abuse making the diagnosis of a true dependence disorder and disposition after treatment more difficult.
CONCLUSIONES: Este estudio sugiere que la tasa de incidencia y / o detección de abuso de propofol en HCP está aumentando. Las mujeres y el personal de anestesia estaban sobrerrepresentados en la cohorte de propofol. Los pacientes dependientes de propofol comúnmente tienen antecedentes de depresión y de traumas anteriores en la vida. Un curso de descenso rápido y lesiones físicas son efectos adversos comunes del abuso de propofol. El tiempo desde el uso inicial hasta la entrada al tratamiento a menudo se contrae cuando se compara con otras drogas de abuso, haciendo que el diagnóstico de un verdadero trastorno de dependencia y la disposición después del tratamiento sea más difícil.
No PDF
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

II Curso Avanzado de Artroscopia, Tenoscopia y Cirugía Deportiva de Pie y Tobillo

Vamos al Guadalajara Jalisco, este congreso es imperdible!!!!



jueves, 1 de marzo de 2018

Complicaciones en anestesia regional / Regional anesthesia complications

Febrero 28, 2018. No. 3008
La anestesia general epidural combinada se asoció con un menor riesgo de complicaciones postoperatorias en pacientes sometidos a cirugía abdominal abierta por feocromocitoma: un estudio de cohortes retrospectivo.
Combined epidural-general anesthesia was associated with lower risk of postoperative complications in patients undergoing open abdominal surgery for pheochromocytoma: A retrospective cohort study.
Li N1, Kong H1, Li SL1, Zhu SN2, Wang DX1.
PLoS One. 2018 Feb 21;13(2):e0192924. doi: 10.1371/journal.pone.0192924. eCollection 2018.
Abstract
BACKGROUND: Current evidences show that regional anesthesia is associated with decreased risk of complications after major surgery. However, the effects of combined regional-general anesthesia remain controversial. The purpose of our study was to analyze the impact of anesthesia (combined epidural-general anesthesia vs. general anesthesia) on the risk of postoperative complications in patients undergoing open surgery for pheochromocytoma. METHODS: This was a retrospective cohort study. 146 patients who underwent open surgery for pheochromocytoma (100 received combined epidural-general anesthesia and 46 received general anesthesia) in Peking University First Hospital from January 1, 2002 to December 31, 2015 were enrolled. The primary outcome was the occurrence of postoperative complications during hospital stay after surgery. Multivariate Logistic regression models were used to analyze the association between the choice of anesthetic method and the risk of postoperative complications. RESULTS: 17 (11.6%) patients developed complications during postoperative hospital stay. The incidence of postoperative complications was lower in patients with combined epidural-general anesthesia than in those with general anesthesia (6% [6/100] vs. 23.9% [11/46], P = 0.006). Multivariate Logistic regression analysis showed that use of combined epidural-general anesthesia (OR 0.219, 95% CI 0.065-0.741; P = 0.015) was associated with lower risk, whereas male gender (OR 5.213, 95% CI 1.283-21.177; P = 0.021) and perioperative blood transfusion (OR 25.879; 95% CI 3.130-213.961; P = 0.003) were associated with higher risk of postoperative complications. CONCLUSIONS: For patients undergoing open surgery for pheochromocytoma, use of combined epidural-general anesthesia may decrease the occurrence of postoperative complications.
Tratamiento con emulsiones lipídicas para el mioclono posterior a la anestesia espinal
Lipid Emulsion Treatment for Post Spinal Anesthesia Myoclonus
Nguyen TA, Phan DV, Dang TT, Joseph Eldor.
J Health Sci Development 2018; 1:1 (19-24).
Abstract
Two case reports of myoclonus of legs post spinal anesthesia treated successfully by IV lipid emulsion are first described in the medical literature. A review of cases of myoclonus post regional anesthesia (spinal or epidural) are discussed with the hypothesis that the Lipid Emulsion effects are on the mitochondria and the intracellular calcium. Keywords: Myoclonus; Post spinal anesthesia myoclonus; Post epidural anesthesia myoclonus; Intralipid; Lipidem; Fat emulsion; Mitochondria; Intracellular calcium
Fallas y complicaciones en la Anestesia Regional Obstétrica
Dr. Francisco J Cisneros-Rivas,* Dr. Israel Chávez-Ruiz*
Rev Mex Anestiol Vol. 40. Supl. 1 Abril-Junio 2017 pp S150-S154
Introducción
La anestesia neuroaxial es la técnica preferida en la paciente embarazada debido a que reduce o inhibe el dolor en las diferentes fases del trabajo de parto, el alumbramiento, así como en caso de requerirse en la cesárea, además de disminuir el uso de medicamentos que atraviesen la barrera placentaria que pudieran afectar al producto. Como cualquier otro procedimiento, la anestesia regional no se encuentra libre de fallas y complicaciones, debiendo tener en cuenta alternativas como la anestesia general y en caso de complicaciones saber cuáles son, con qué frecuencia se presentan, cuál es su sintomatología, saber cómo prevenirlas y en su caso cómo tratarlas, para evitar lesiones permanentes que puedan ser causa de una acción legal en contra de nosotros, independientemente de la seguridad y calidad que brindemos a nuestros pacientes.
Evaluación de la seguridad y eficacia de la anestesia regional en comparación con la anestesia general en el procedimiento de biopsia pulmonar toracoscópica en pacientes con fibrosis pulmonar idiopática.
Evaluation of safety and efficacy of regional anesthesia compared with general anesthesia in thoracoscopic lung biopsy procedure on patient with idiopathic pulmonary fibrosis.
Saudi J Anaesth. 2018 Jan-Mar;12(1):46-51. doi: 10.4103/sja.SJA_265_17.
Abstract
BACKGROUND: Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF). SUBJECTS AND METHODS: This is a retrospective qualitative study based on adult cases of video-assisted thoracoscopy (VAT) lung biopsy on patients with IPF admitted in the division of Thoracic Surgery, Department of General Surgery, King Khalid University Hospital, Riyadh, KSA. We included 67 patients with IPF, 26 with RA, and 41 with GA, who underwent this procedure from January 2008 to December 2015. Procedures performed under RA were done using three different approaches, intercostal nerve blocks, extrapleural infusion, and paravertebral block while GA was performed using double-lumen endotracheal tube placement. For statistical analysis, SPSS program, version 21.0. Software used to analyze the obtained data. The statistical significance was defined as P < 0.05. RESULTS: Sixty-seven patients underwent the procedure of thoracoscopic lung biopsy. Twenty-six of them (38.8%) underwent the procedure under RA and 41 (61.2%) under GA. The cross tabulation of the intercostal chest tube duration showed that it was significantly longer in GA group (6.23 ± 5.1 days) compared to RA group (3.12 ± 1.5 days), P = 0.004. Furthermore, for the Intensive Care Unit (ICU) stay, it was significantly longer in GA group (3.38 ± 2.1 days) compared to RA group (1.09 ± 0.7 days), P = 0.019. Regarding the relation between the number of biopsies taken and type of anesthesia performed, the probability values for GA group as well as RA group come out to be >0.05 (statistically independent) and the results of risk estimate also show that there was no significant association found between them. The cross tabulation of the representation of biopsies taken by the two methods showed that all biopsies taken under both settings were representative of the disease. Of 41 procedures done under GA, 16 of the total showed a number of complications. Likewise, of 26 procedures under RA, five cases showed complications. The significant (two-sided) value was (P = 0.110), there was no statistical significance between the risks of complications and the two types of anesthesia. CONCLUSION: There was a significant decrease in chest tube duration and ICU stay in RA group compared to the GA group. There was no statistical difference between both types of anesthesia in the number of biopsy, representation, and postoperative complications although the rate of these complications was much less in the RA group. Based on this outcome, we can conclude that VAT lung biopsy procedure on patients with IPF under RA is safe, representative, and effective operation. In addition, high-risk patients for GA can go through this procedure under RA as an alternative and safe option with no added complications.
KEYWORDS: General anesthesia; idiopathic pulmonary fibrosis; regional anesthesia; thoracoscopic lung biopsy
Simposio Internacional de Emergencias Médicas y Paciente Crítico
Santiago de Chile
31 de Mayo al 1 de Junio, 2018
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Cuidados paliativos / Palliative care

Marzo 1, 2018. No. 3009
Cuidado y cuidado domiciliario
Caregiving and Home Care
Edited by Mukadder Mollaoglu, ISBN 978-953-51-3779-5, Print ISBN 978-953-51-3778-8, 238 pages, Publisher: InTech, Chapters published February 14, 2018 under CC BY 3.0 license
DOI: 10.5772/66261
Edited Volume
The management of chronic diseases is one of the tasks of all members of the health team, and different models need to be applied in the practice of chronic care management. One of these models is home care services. There are two main sections in this book. In the first part of the section, the concept of caregiving and care at home is explained. In the second part, the responsibilities of caregivers at home and the responsibilities of caregivers of people who have health problems that occur during different periods of life are discussed. In the second section, the problems of caregivers are also included. I would like to think that what is quoted in this book, which contains examples from different cultures of the world for home care approaches, will contribute to the development of home care services. This book is presented to all health professionals working in the field of health services as well as health politics professionals and students trained in these areas.
Cuidados paliativos en el hospital: ¿Deberíamos reconsiderar qué función deberían tener los hospitales en pacientes con enfermedad en etapa terminal o cáncer avanzado?
In-Hospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?
J Clin Med. 2018 Jan 30;7(2). pii: E18. doi: 10.3390/jcm7020018.
Abstract
Traditionally, palliative care (PC) systems focused on the needs of advanced cancer patients, but most patients needing PC have end-stage organ diseases. Similarly, PC models focus on the needs of patients in hospices or at home; however, in most cases PC is provided in acute hospitals. Indeed, the symptom burden that these patients experience in the last year of life frequently forces them to seek care in emergency departments. The majority of them are admitted to the hospital and many die. This issue poses important concerns. Despite the efforts of attending healthcare professionals, in-hospital patients do not receive optimal care near the end-of-life. Also, evidence is emerging that delay in identifying patients needing PC have a detrimental impact on their quality of life (QoL). Therefore, there is an urgent need to identify, early and properly, these patients among those hospitalized. Several trials reported the efficacy of PC in improving the QoL in these patients. Each hospital should ensure that a multidisciplinary PC team is available to support attending physicians to achieve the best QoL for both PC patients and their families. This review discusses the role and the impact of in-hospital PC in patients with end-stage disease or advanced cancer.
KEYWORDS: acute palliative care unit; cost savings; end-of-life; palliative care team; quality of life; seriously ill patients; symptom relief
Traducción de un modelo de cuidados paliativos precoces de EE. UU. Para Turquía y Singapur.
Translating a US Early Palliative Care Model for Turkey and Singapore.
Asia Pac J Oncol Nurs. 2018 Jan-Mar;5(1):33-39. doi: 10.4103/apjon.apjon_73_17.
Abstract
The field of palliative care is growing in acceptance and sophistication globally. No longer considered just for patients at end-of-life, palliative care is now being incorporated early in the disease trajectory. Despite professional guidelines supporting early palliative care, there are few models that have been created that can be translated into practice cross-culturally. In the United States, the Educate, Nurture, Advise, Before, Life Ends (ENABLE) early palliative care telehealth model has demonstrated effectiveness in improving quality of life, mood, symptom relief, and survival for patients with cancer and is now being tested in patients with heart failure. Family caregivers of patients who have received ENABLE concurrent with their care recipients have also demonstrated positive outcomes in quality of life and caregiver burden. Internationally, a number of investigators are culturally adapting ENABLE for patients and family caregivers. While some elements of ENABLE, such as symptom management and self-care, and the caregiving role are relevant cross-culturally, others have been built on Western principles of self-determination or represent concepts such as advance care planning which will require more cultural adaptation. In addition, ENABLE was initially an in-person approach that was converted to telehealth to accommodate a rural population-it will be important to understand cultural norms related to receiving care by phone or if an in-person approach will be more culturally acceptable. This paper describes efforts in Turkey and Singapore to culturally adapt the ENABLE early palliative care principles for their countries.
KEYWORDS: Advise; Before Life Ends; Educate; Nurture; oncology patients; palliative care
Hospicio y cuidados paliativos en China: desarrollo y desafíos.
Hospice and Palliative Care in China: Development and Challenges.
Lu Y1, Gu Y1, Yu W2.
Asia Pac J Oncol Nurs. 2018 Jan-Mar;5(1):26-32. doi: 10.4103/apjon.apjon_72_17.
Abstract
Hospice and palliative care have been demonstrated to improve quality of life, shorten hospital stays, and save costs. As a developing country, faced with a rapidly aging population and an increasing number of patients with life-threatening illnesses such as cancer, China has made great progress in promoting hospice and palliative care during the past few decades. A trained nurse can play a significant role in promoting quality hospice and palliative care by providing care, coordinating a multidisciplinary team, calling for policy support, and raising public awareness. It is critical for nurses to clearly understand the development and challenges that currently exist in the country. With this awareness, nurses will improve their ability to recognize and address patients' and families' needs, resulting in quality, dignified, and individualized end-of-life care.
KEYWORDS: Challenge; China; development; hospice and palliative care; nurses
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905