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Biomedical subjects

Peter Strang

Publications and source records attributed to Peter Strang.

25 records · Page 2Linked to original sources
PubMed2002

Questions posed to hospital chaplains by palliative care patients.

CONTEXT: Questions of vital importance are actualized when facing one's own death. Studies on patient need for a hospital chaplaincy as an integral part of hospital care are lacking. OBJECTIVE: To categorize the three most important questions patients pose to hospital chaplains at the end of life and to assess the degree to which hospital staff should be able to handle them. DESIGN AND SETTING: A Swedish national survey using an open-ended questionnaire and content analysis. PARTICIPANTS: One hundred seventy-two Swedish hospital chaplains (national coverage, 74% response rate). Categories developed from open-ended questions. Categories of questions posed to hospital chaplains. RESULTS: Five main categories were identified: meaning (34%); death and dying (21%); pain and illness (13%); relationships (15%); and religious issues (8%). Questions of a general existential nature concerned with meaning-related issues and with death and dying were frequently the primary issue. Many questions dealt with pain, fear of suffocation, and illness in general (i.e., questions that the palliative team should be able to handle). Only 8% of the issues were explicitly religious and these were often third-hand choices. CONCLUSION: The role of the hospital chaplaincy has changed. Today it entails specialized competence and is needed in existential discussions with different patients in crisis, regardless of their personal faith or lack of faith. Nonetheless, physicians and other staff members should be able to handle many of the questions that are of a more general/medical character.

Adaptation, Psychological↗
PubMed2002

Parkinson-plus patients--an unknown group with severe symptoms.

The Parkinson-plus syndromes, which include multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD), are still not well-known. Research concerning diagnosis and treatment is ongoing; nursing studies are lacking. Therefore, the aims of this study were to survey the patients about their symptoms, their previous contacts with physicians and other caregivers, the questions about their disease that were of most importance to them, and their perceived quality of life. The mapping caregivers and symptoms (MCAS) questionnaire, which was constructed for the study, and the Nottingham Health Profile (NHP), were used. Twenty-three patients participated. Early in the course of the disease Parkinson-plus patients needed to consult physicians from different specialties and many other professional caregivers because of a multitude of problems such as slow movements, weak voice, stiffness, dysphagia, muscle pain, and incontinence. The NHP revealed that many participants ran out of energy, and this affected their everyday lives and leisure time. As the disease progressed, palliative needs successively increased. Patients in all stages wanted to know about the disease course and their prognosis and about issues that could give them hope. In accordance with palliative care philosophy, caregivers can help direct the patients' hope from cure to a palliative goal, with a focus on quality of life.

Activities of Daily Living↗
PubMed2002

Physical and psychosocial impact of xerostomia in palliative cancer care: a qualitative interview study.

Xerostomia is often considered to be merely a physical problem. The aim of this study was to explore the global effects of xerostomia, with a specific focus on psychological and social consequences. Semi-structured, tape-recorded interviews were conducted with 16 patients with advanced malignancies and symptomatic xerostomia. A phenomenographic (qualitative) analysis was performed. Four main categories were identified in the study: 1) subjective discomfort, e.g. dryness or burning sensation, 2) loss of function, e.g. articulation or swallowing, (3) increased infection, (oral thrush and ulcerations), 4) psychosocial effects, including shame, increased feelings of being a patient rather than a person and a tendency to avoid social contact, resulting in loneliness. Xerostomia and its associated symptoms have a considerable, negative global impact, resulting in shame, anxiety, disappointments and verbal communication difficulties. There should therefore be more focus on the management of xerostomia, which is often neglected in palliative care.

Aged↗
PubMed2002

A palliative approach to existential issues and death in end-stage dementia care.

UNLABELLED: The aim of this study was to investigate how, in relation to the palliative philosophy of care, municipal staff caring for patients with dementia deal with existential issues, the dying process, and bereavement follow up with next of kin. METHODS: Thirty-one semi-structured interviews were performed and analyzed using a modified phenomenographic method. RESULTS: Those interviewed experienced existential issues as difficult to handle, and they felt lost. Three patterns of answers emerged: 1) attempting to minimize or ignore the issue, 2) pleading, in relation to the patient, that no one has control over issues concerning life and death, and 3) showing affection for the patient. When faced with dying patients, they made things easier for the family, and their goal was that the patient should not be left alone. No systematic bereavement follow up of next of kin occurred. DISCUSSION: Suggestions are made for improving municipal care, and applying palliative care principles for patients dying of dementia.

Adult↗
PubMed1995

Rapid, reproducible pain relief with [131I]iodine-meta-iodobenzylguanidine in a boy with disseminated neuroblastoma.

[131I]Iodine-meta-iodobenzylguanidine ([131I]MIBG) is a radioactively labelled substance which is incorporated intracellularly by cells with neuroendocrine differentiation and used in the treatment of neuroendocrine malignancies. The agent was systemically administered on three occasions during a period of 16 weeks to a 4-year-old boy afflicted with disseminated neuroblastoma and suffering from severe pain caused by the disease. Initially, during the weeks immediately prior to radionuclide therapy, the boy required continuous intravenous infusions of morphine. On the 3rd day after each treatment, morphine administration could be discontinued and the boy appeared to be pain free. His appetite returned to normal and he became more mobile. The therapy had a good effect on his pain on each of the three occasions. Recurrent side effects were thrombocytopenia and cystitis. It is concluded that treatment with systemic radiotherapy in the form of [131I]MIBG was easy to perform and effective in this case of disseminated neuroblastoma and illustrates that this primary therapy can be used for palliative purposes.

3-Iodobenzylguanidine↗
PubMedDate not supplied

[Palliative medicine network promotes research and development].

Research in palliative medicine is often rendered difficult because of limited patient materials. It's important to find new solutions to this problem. In 2002, the palliative research network in Sweden - PANIS - was established, and now comprises 43 palliative units with over 1,700 patients enrolled. So far, we have conducted five surveys and collected data from over 3,700 patients. The subjects have been: The occurrence of hiccups in terminal cancer patients, the occurrence of antitumoral treatments among cancer patients in palliative care, the use of opioids in palliative care, treatment with blood transfusion and erythropoietin in palliative care and the use of corticosteroids in palliative care. A web-based survey generator simplifies the handling of the results and enables the participating units to get instant feedback. We hope to be able to identify adequate and interesting research questions and facilitate the recruitment of patients into palliative studies.

Adolescent↗