RESUMEN
The prevalence and prognosis of cancer are changing. The number of diagnosed cancers is rising in Western countries. These diseases often become chronic illnesses and necessitate major efforts of adjustment and coping for patients and families, but also for health professionals. This paper focuses on the question of the follow-up of cancer patients and highlights some of the difficulties faced by professionals and institutions when attempting to improve the quality of care in this field. We describe how the divisions of general medical rehabilitation and of oncology of the Geneva university hospitals promote the implementation of supportive oncological care practice in a rehabilitation centre.
Asunto(s)
Oncología Médica/tendencias , Neoplasias/rehabilitación , Hospitales Universitarios , Humanos , Pronóstico , Calidad de la Atención de SaludRESUMEN
The authors analyse the results of 4 years home supervision of high-risk pregnancies by hospital midwives. The inquiry concerns 813 women out of a total of 12,643 deliveries in the same period of time (1978-1981). This supervision deals with the people who were selected by patient consultation or after hospitalisation. It is particularly concerned with patients with threatened premature labour. The role of the midwife is at once medical in that she undertakes a constant review of the state of the pregnancy, and social and psychological. Domiciliary visiting can often take the place of admission to hospital. Even though has not been a great decrease in the number of premature labours it does seen certain that patients who have been followed in this way have had pregnancies that have lasted longer. Over the 4 years when the experience has been gained the number of deliveries occurring before the 34th week has dropped from 2.8 to 1%. Finally, it is an extremely efficient way of lowering hospital expenses.
