ABSTRACT
Objective: To create an authorized translation of the “definition of palliative care” according to WHO using the Delphi method. Methods: Through a palliative care association council (hereafter referred to as the “council”) composed of 18 academic organizations, this research aimed to create an authorized translation draft and develop a consensus for it using the Delphi method according to 54 experts, three from each organization. The main clause and nine subordinate clauses of the document were evaluated from “not at all appropriate” (1 point) to “completely appropriate” (9 points). The standard for consensus was if the median was 7 points or above, or if there was a difference of 5 points or less between the maximum and minimum. The council created an authorized translation in light of the consensus status. Results: Three rounds of the Delphi method were performed; the response rates were 100%, 93%, and 91% respectively. As 30% of the clauses reached the predetermined standard for consensus, the council discussed and considered, established an authorized translation draft, and made a decision upon public comment from each academic organization. Conclusion: Academic organizations associated with palliative care jointly created an authorized translation for the “definition of palliative care” according to WHO.
ABSTRACT
Purpose: The field survey was conducted to evince the current status of palliative care for non-cancer patients. Methods: The on-line questionnaire survey was conducted covering 196 representatives of the Japanese Society for Palliative Medicine. Multiple-choice questions were asked about their medical experiences with non-cancerous diseases, their attitudes towards palliative care, their feelings of bewilderment upon providing palliative care, and what they thought would be required for future education in this field. Results: One-hundred and eleven (111) representatives (57%) responded the survey. Ninety-nine (99)% of the respondents experienced providing non-cancer patients with palliative care, but 63% of them experienced less than 50 patients in the terminal phases even in cumulative total. Eighty (80)% of them said they were feeling insecure about providing non-cancer patients with palliative care, and 83% of them were feeling difficulty when they had to do so. The reasons listed included that prognostic prediction for such cases wouldn’t be easy and that it wouldn’t be covered by public health insurances. What they felt necessary about future education included communication and multi-disciplinary team medicine, in this order. Conclusions: The representatives of the Japanese Society for Palliative Medicine are well-aware of the demands for palliative care for non-cancer patients, but not many of them have experienced such cases and more than 80% of them are feeling insecure and difficulty about providing it.
ABSTRACT
Alleviating fatigue of a patient with advanced cancer often meets troubles, for which medication is restricted. We experienced two cases with cancer-related fatigue, in which 4,000mg of taurine a day was administered orally and the improvement of the Cancer Fatigue Scale (CFS) score was identified as a result. There hasn't been any literature reporting the effect of taurine to cancer-related fatigue yet. However, taurine has been known as a medicine with various effects for quite a long time, and it is possible that it will be recognized as one of the medicines effective for cancer-related fatigue.
ABSTRACT
<b>Purpose</b>: In terminally ill patients with advanced cancer,it is recognized that delirium is reversible in 20-50% of the patients with it. Identification of its cause is vital to ensure the quality of life of the patients with delirium at the end of life. We would like to report a case of the advanced cervical cancer patient with delirium, successfully treated by intravenous administration of vitamin B1. <b>Case</b>: An 83-year-old woman, who was diagnosed the advanced cervical cancer with carcinomatous peritonitis, was admitted to Shizuoka Cancer Center Palliative Care Unit. Four days after the admission, she presented sleep-wake cycle disturbance, poor attention, poor concentration,and short-term memory loss, and these conditions were diagnosed with delirium. Vitamin B1 deficiency was suspected by normal examinations including laboratory results and head computed tomography except for the low level (19ng/ml) of vitamin B1. One week after starting intravenous administration of vitamin B1, the symptoms of delirium were improved. <b>Conclusion</b>: In this case, delirium by vitamin B1 deficiency developed even though having adequate oral intake (about 1,000kcal/day), indicating malabsorption of vitamin B1 due to hypoperistalsis and edema of the bowel. Advanced cancer patients can easily develop vitamin B1 deficiency due to inadequate oral intake, increased consumption of vitamin B1 and malabsorption of vitamin B1. Therefore,the examination of vitamin B1 deficiency is necessary for patients with delirium that cannot be specified. Palliat Care Res 2009; 4(2): 330-333