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EN
Introduction Taking care of a close relative who is coming to the end of their life may lead to negative consequences for their caregivers including the symptoms of multidimensional burden. Aim of the study The aim of the study was the assessment of the burden in a group of informal caregivers. Material and methods The study was conducted in a group of 30 informal caregivers whose close relatives were taken into hospice care. A Polish version of Caregiver Burden Scale was applied in the study. Results The highest level of burden was observed on the General strain (Mean=2.71) and Disappointment (Mean=2.48) subscales, whereas the lowest level on the Emotional involvement subscale (Mean=1.78). A statistically significant correlation was found between the total score (p=0.009), the level of burden on the Isolation(p=0.012) and Environment (p=0.026) subscales and the period of time during which care was provided. Conclusions Although in the examined group of caregivers a moderate level of burden was observed on all the subscales except the Emotional involvement one, an analysis of particular cases showed a high level of burden on various subscales in some respondents.
EN
Introduction. Pain in cancer diseases is a significant factor increasing suffering, anxiety and sufferer's dependence on other people. The stronger the pain, the more dependent the patients are. They require more help in everyday activities. Nurses play the key role in recognition and controlling the pain since they spend a considerable amount of time with patients in hospice. Aim. The aim of this study was to assess the knowledge of nurses on pain treatment delivered in training on methods of pain treatment. Material and method. The study used questionnaire carried out among 50 nurses working in Nursing Home facility in Kraszewo Czubaki. The study was conducted with the use of diagnostic survey. Results. More than 84% of respondents participating in training claim that they are familiar with the methods of pain treatment. However, 83% of respondents, who have not participated in any post-graduate training on methods of pain treatment, do not have sufficient knowledge about methods of pain treatment. Conclusions. The study showed that training has significant influence on the knowledge about methods of pain treatment used by nurses working in hospice.
PL
Wstęp. Ból w chorobie nowotworowej jest znaczącym czynnikiem zwiększającym cierpienie, niepokój i zależność chorego od innych osób. Im dolegliwości bólowe są silniejsze, tym pacjent jest mniej samodzielny i wymaga większego wsparcia w prostych czynnościach dnia codziennego. Zasadniczą rolę w procesie rozpoznawania i kontrolowania bólu odgrywa pielęgniarka, która spędza w hospicjum z pacjentem najwięcej czasu. Cel. Celem pracy była ocena wiedzy pielęgniarek uzyskanej w czasie szkoleń w zakresie metod leczenia bólu. Materiały i metody. Materiał do analizy stanowiły ankiety przeprowadzone wśród 50 pielęgniarek pracujących w Zakładzie Opiekuńczo Leczniczym Kraszewo Czubaki. Badanie zostało przeprowadzone z wykorzystaniem metody sondażu diagnostycznego. Wyniki. Ponad 84% osób uczestniczących w szkoleniach twierdzi, że zna metody leczenia bólu. Natomiast ponad 83% badanych, które nie brały udziału w formach kształcenia podyplomowego przyznaje, że nie posiada wiedzy w zakresie terapii bólu. Wnioski. W wyniku przeprowadzonych badań ustalono istotny wpływ szkoleń na znajomość metod leczenia bólu przez pielęgniarki pracujące w hospicjum.
EN
Introduction The problem of constipation in Poland concerns 13.4% of the healthy population. In the case of patients treated with opioids, this number increases to 70-90%, which constitutes a serious problem that lowers the patients' quality of life. The aim of the study was to assess the effects of abdominal massage, which successfully reduces constipation in various diseases, on palliative care patients. Material and methods The research included 18 patients of a palliative care facility (mean age 78.3 ± 10 years), 11 of whom completed the study. The study participants were randomly divided into two groups, i.e. a pilot group (abdominal massage and kinesiotherapy) and a control group (kinesiotherapy). The therapy lasted 8 weeks and blind evaluation was carried out once per week. The study involved evaluating constipation intensity (The Bowel Function Index), the frequency of defecation (medical documentation) and abdomen circumference (anthropometric tape). The collected data were analysed statistically with the use of Statistica software. Results The observed differences between the studied groups undergoing different therapies in subsequent weeks were not statistically significant. However, in the group in which abdominal massage was implemented, a decrease in the intensity of constipation, an increase in the frequency of defecation and a reduction in abdomen circumference were noted compared to the control group. The patients also indicated additional positive effects of this form of therapy, i.e. an improvement in breathing, easier urination, release of excessive gas and abdominal pain reduction. Conclusions The collected data led to the conclusion that abdominal massage may result in a decrease in disorders accompanying opioid-induced constipation. Therefore, it is worth considering the implementation of this form of therapy in the case of patients in an advanced stage of cancer. There is also a need for further research in this field which will include a larger number of patients.
EN
Since the dawn of time, care for terminally ill people was considered a challenge, a duty or an obligation. The Latin word hospes meant initially a hospitable person providing shelter and food for those in need. Places where most severely ill people were cared for were called hospitale, hospitium or infirmarium. In ancient Greece and Rome, chronically ill people were placed in special rooms, usually adjacent to temples. Throughout the entire Western Empire, the poor and the ill were cared for by religious congregations. Monasteries ran “hospitable rooms” providing shelter not only for pilgrims, but also for ill people, who could also benefit from simple medical procedures. Numerous pilgrimages, epidemics, wars and crusades, resulted in rapid increase of number of hospitals and shelters in Medieval Europe. Homes of care designed exclusively for the terminally ill appeared in the XIX century. The essence of their mission was compassion for suffering and pain experienced by other people, expressed by will to help, resulting also from religious motives. In the XX century, Cecily Saunders M.D. organized the first St. Christopher Stationary Hospice in London, thereby giving rise to modern hospice organizations. Later, the Hospice expanded its activity on home-based patient care and support of families after loss of the loved ones. In the ‘70s of the XX century, the term “palliative care” has been introduced in the USA and Canada. The Latin word pallium, meaning a large woollen coat, has been adopted to denote protection of patients and their relatives from physical and mental suffering. Nevertheless, definition of palliative care has been developed as late as 1990 and has been published in a WHO document. It specifies the basic mission of this medical specialty: comprehensive and active care for terminally ill people, whose disease does not respond to cause-oriented treatment. Palliative treatment encompasses relief of pain and other ailments, as well as overall support in mental, spiritual and social areas. The essence of palliative care is team work of persons representing various specialties - doctors, nurses, priests, psychologists, physiotherapists, non-medical volunteers, aiming at improving the patients’ quality of life.
PL
Od zarania dziejów opieka nad chorymi i umierającymi stanowiła wyzwanie, powinność lub obowiązek. Łacińskie słowo hospes początkowo oznaczało osobę udzielającą gościny. Miejsca opieki nad najciężej chorymi określano mianem hospitale, hospitium lub infirmarium. W starożytnej Grecji i Rzymie budowano pokoje dla przewlekle chorych, umiejscowione zazwyczaj w pobliżu świątyń. Na terenach dawnego Cesarstwa Zachodniego opiekę nad ubogimi i chorymi sprawowały zgromadzenia zakonne. W przyklasztornych „izbach gościnnych” przyjmowano nie tylko pielgrzymów, ale i chorych, u których wykonywano proste zabiegi lecznicze. Liczne pielgrzymki, a także epidemie, wojny i krucjaty spowodowały szybki wzrost liczby szpitali i przytułków w średniowiecznej Europie. Domy opieki przeznaczone wyłącznie dla umierających zaczęły powstawać w XIX wieku. Celem ich działalności było zrozumienie cierpienia i bólu drugiego człowieka wyrażone poprzez chęć niesienia pomocy, wynikającą także z pobudek religijnych. W XX wieku z inicjatywy doktor Cecily Saunders powstało w Londynie Stacjonarne Hospicjum św. Krzysztofa, co dało początek nowożytnemu ruchowi hospicyjnemu. Wkrótce działalność Hospicjum została poszerzona o pomoc domową oraz wsparcie dla rodzin, które utraciły najbliższych. W latach 70. XX wieku w Stanach Zjednoczonych i Kanadzie upowszechnił się termin „opieka paliatywna”. Określenie palium (łac. pallium - rodzaj szerokiego, greckiego płaszcza) oznaczało ochronę chorego i jego bliskich przed cierpieniem zarówno cielesnym, jak i duchowym. Definicja opieki paliatywnej powstała dopiero w 1990 roku, opublikowano ją w dokumencie wydanym przez Światową Organizację Zdrowia (WHO), według którego zasadniczym zadaniem tej dziedziny jest całościowa, czynna opieka nad cierpiącymi, których choroba nie poddaje się skutecznemu leczeniu przyczynowemu. Obejmuje zwalczanie bólu i innych dolegliwości oraz pomoc w problemach psychicznych, duchowych i socjalnych. Istotą opieki paliatywnej jest wspólna praca ludzi różnych specjalności: lekarzy, pielęgniarek, kapłanów, psychologów, fizykoterapeutów, wolontariuszy nieme-dycznych oraz ich dążenie do poprawy jakości życia chorych.
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