ABSTRACT
BACKGROUND: It is currently believed that the home is not the most adequate place to die. Ninety percent of the deaths happen in hospitals. The home care of terminally ill cases by a palliative care team is analyzed. METHODS: In 93 (53 males and 40 females, mean age 63 years, range 31-89 years) oncologic patients followed at home until death the number of visits and their length, the most important symptoms, the length of the terminal phase and the place of death were analyzed. RESULTS: Two hundred fifteen visits were carried out. The length per visit per patient was of 40 minutes. The terminal phase oscillated between 1 and 425 days with a median of 50 days. Pain and dyspnea were the most important symptoms. Death occurred at home in fifty-three (59%) patients and in the hospital in 37 (41%). The median survival from diagnosis was 10 months. CONCLUSIONS: Home care increase the percentage of deaths in the home if adequate alleviation of symptoms, permanent communication and constant family support are provided.
Subject(s)
Home Care Services , Palliative Care , Adult , Aged , Aged, 80 and over , Female , Home Care Services/statistics & numerical data , Humans , Male , Middle Aged , Neoplasms/mortality , Neoplasms/therapy , Palliative Care/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Spain/epidemiology , Survival Analysis , Terminal Care/statistics & numerical data , Time FactorsABSTRACT
Fibromyalgia syndrome is characterized by generalized musculoskeletal pain and abnormal sensitivity to palpation of characteristic myofascial areas. We evaluated its prevalence in the 673 patients seen as first consultations in a hospital rheumatological outpatient clinic during one year, and we made an automatized review of the Spanish literature about this condition in the last 17 years. We found 70 cases (10.4%) of fibromyalgia syndrome, none of which had been referred to the hospital with this diagnosis. We report their clinical features. In our bibliographical search we found only one article describing this condition. We conclude that it is a common clinical syndrome, unknown in nonspecialized milieus. Generally, the patients are inadequately diagnosed and treated, and/or referred to hospital.
