ABSTRACT
<b>Purpose:</b> To identify the nature of personal growth of family primary caregivers after bereavement and to explore the association between such growth and the experience of caring for a terminally ill cancer patient at home. <b>Methods:</b> A self-administered questionnaire survey was mailed to 112 bereaved family primary caregivers who, with assistance from a palliative care service, had cared for a terminally ill cancer patient at home. The main outcomes were measured using the After Bereavement Growth Inventory, previously developed. <b>Results:</b> Responses from 73 questionnaires were analyzed (effective response rate, 66%). The post-bereavement growth score was significantly higher among the study group than among the general population who had experienced bereavement due to illness-related death. Multiple regression analysis revealed that post-bereavement growth was more likely to occur among those family members who, "at the time they chose to provide home palliative care, intended to care for a patient at home until the time of death" and when "the patient desired home palliative care", those who "felt a deepening of their bond with the patient", and those who "felt the death was peaceful". <b>Conclusion:</b> Our findings suggest that for primary family caregiver's to experience personal growth after bereavement, medical professionals should support patients' preference of place at the end of life and caregivers' preparation for the expected home death, respect the family's bond with the patient, and through appropriate symptom management in home palliative care to maintain the patient's sense of peacefulness until the end of life.
ABSTRACT
<b>Purpose and Methods</b>: In the WHO guidelines on the management of cancer pain, global standard-dose acetaminophen (APAP) is described as a first-line drug, but there have been few studies comparing the efficacy and safety of APAP with other options in Japan. We retrospectively studied the efficacy and safety of global standard-dose APAP in the management of cancer pain, by comparing 182 patients treated with global standard-dose APAP (1,800-2,400 mg/day) (APAP group) and 86 patients treated with NSAIDs (NSAIDs group) at our clinic. <b>Results</b>: As the result, the management of cancer pain was comparable between the APAP group and the NSAIDs group. Despite the lack of sufficient investigation of concomitant drug such as opioids, etc., global standard-dose APAP was not inferior to NSAIDs in terms of efficacy as a non-opioid analgesic for the treatment of cancer pain. When we compared safety between the APAP group and the NSAIDs group, the incidence of nausea was significantly lower in the APAP group (<i>p</i><0.01), while the percentage of patients with AST/ALT levels 2.5 times higher than at baseline was comparable in the 2 groups. <b>Conclusion</b>: Based on the above efficacy and safety results, global standard-dose APAP was concluded to be a useful non-opioid analgesic option for the treatment of cancer pain in Japan. Palliat Care Res 2011; 6(2): 133-142