Biomedical subjects
P Kedziera
Publications and source records attributed to P Kedziera.
Advanced certification examination challenging but not insurmountable.
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Collaborative practice in oncology.
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Transdermal fentanyl: seeding trial in patients with chronic cancer pain.
In this study, 6 patients with pain from advanced cancer were enrolled in a multicenter, open-label seeding trial of transdermal fentanyl. Following equianalgesic dose conversion, transdermal fentanyl patches were applied every 3 days. Mean fentanyl dosage doubled by week 2 and tripled by week 4. Pain control improved in all patients. There were no significant changes in mood, constipation, nausea, sedation, daily activities, or interpersonal relationships from pretrial to posttrial analyses. Following the study period, 5 patients were monitored for a mean total of 55 days with a mean final fentanyl dose of 240 micrograms/hr. As part of a comprehensive cancer pain management program, transdermal fentanyl appears to be safe and effective, and should prove to be a useful addition to currently available opioid analgesics.
The role of patient education in cancer pain control.
Patient education should be a central component of pain control regimens for cancer patients. Few systematically developed and carefully evaluated pain control patient education programs have been reported. Patient education for cancer pain control should include five phases: assessment, goal setting, selection of educational strategies, implementation and reassessment. Each of these phases should be included to maximize the goals of pain prevention and pain relief.
Models of healthcare delivery in cancer pain management.
The delivery of pain management services to patients with cancer varies across healthcare settings. Identification of areas common to successful programs would be helpful to healthcare professionals developing or restructuring their own programs. The delivery of pain management services in six different systems is described with respect to organizational structure, service process, and essential components. Three elements common to successful programs are identified: (1) team effort and coordination, (2) provision of education, and (3) accountability and administrative support. The authors conclude that these three elements are critical to the delivery of pain management services across healthcare settings.
End-of-life care: hospice or home?
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Issues in managing severe cancer pain.
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