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CommonHealth. 2005 Spring; 36-43.As defined by the World Health Organization (WHO):2 Palliative medicine is the study and management of patients with active, progressive, far advanced disease for whom the prognosis is limited and the focus of care is the quality of life. [It is] the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social, and spiritual problems, is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are applicable earlier in the course of the illness, in conjunction with treatment. Palliative care: Affirms life and regards dying as a normal process; Neither hastens, nor postpones, death; Provides relief from pain and other distressing symptoms; Integrates the psychological and spiritual aspects of patient care; Offers a support system to help patients live as actively as possible until death; and Offers a support system to help families cope during a patient's illness and with their own bereavement. In short, palliative care comprehensively addresses the physical, emotional, and spiritual impact a life-threatening illness has on a person, no matter the stage of the illness. It places the sick person and his/her family, however defined, at the center of care and aggressively addresses all of the symptoms and problems experienced by them. Many healthcare providers apply certain elements of the palliative care treatment approach-- such as comprehensive care and aggressive symptom management-- to the care of all of their patients, not only those who are terminally ill, offering the type of care we would all like to receive when we are sick. (excerpt)
Statement by the chairman of the Technical Working Group on the Psychosocial Aspects of HIV Infection / AIDS in Mothers and Children.
In: International Conference on the Implications of AIDS for Mothers and Children: technical statements and selected presentations jointly organized by the Government of France and the World Health Organization, Paris, 27-30 November 1989. Geneva, Switzerland, WHO, Global Programme on AIDS, 1989. 33-5. (WHO/GPA/DIR/89.12)Sensitive attention to the psychosocial impact of human immunodeficiency virus (HIV) infection on mothers and children and the maternal-child bond must be an integral part of all health and social service programs. Comprehensive, community-based counseling services must be available to help family members deal with issues such as guilt, fear, rejection, and discrimination. Given the centrality of motherhood to the self- definition and self-esteem of many women, HIV-infected women often choose to bear children, yet may experience extreme guilt when HIV is transmitted to their infant. HIV-infected children face neurodevelopmental disabilities that my be exacerbated by family poverty, homelessness, malnutrition, a lack of access to adequate medical care, and serious physical and psychological problems in the parents. These children should receive early intervention from physiotherapists, speech and language therapists, psychologists, and social workers. Although HIV-infected children should have the opportunity to interact with other children with confidentiality maintained, parents must decide how and when to inform a child of his or her HIV status. A neglected group is the uninfected siblings, who may encounter stigmatization outside the home and inappropriate nursing care burdens in the home. Respite care for these siblings and HIV-infected children should be considered when a parent is acutely ill. Children orphaned by HIV disease should be guaranteed the potential of normal development through placement in foster care or adoption.
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE. 1989 Jan-Feb; 83(1):33-5.We prefer to use the term infant mortality rate (IMR) than infant mortality. IMR is less emotional, causes less anxiety, and implies poverty and hardship while infant mortality signifies dead children. Not all societies consider prevention of infant deaths as their 1st priority albeit still a social and emotional priority. IMR has been used for a century as a health subindex. Further many people consider the IMR as an indicator of adverse economic, nutritional, environmental, and social conditions. The IMR should be used in a more restrictive manner since children can be saved from death yet they continue to experience morbidity and live in poverty. Further those factors which cause infant deaths also affect survivors and their consequences are hard to gauge. To improve on overall health and not just reduction of infant mortality, a local and appropriate health service which the population accepts must have clear objectives and provide continuous prevention and treatment programs for all cohorts of children. Yet many developing countries which would clearly benefit from continuous child health programs do not operate such a health system. Similarly international, bilateral, and other external organizations who support child survival programs must also plan on continuous self sustaining services that are directed to the living as well as the dead. Moreover their priorities should be compatible with national priorities. In conclusion, a global or even national recession that raises absolute or relative poverty or reduces the transfer of resources which are now going to temporary vertical infant death prevention programs will most likely increase IMR and decrease infant health.
WORLD HEALTH FORUM. 1990; 11(4):412-5.In this article, the author explains that the use of humor and analogies can be instrumental in teaching about health at the grassroots level. When the author, who is president of the International Institute of Rural Reconstruction (IIRR), began trying to educate rural communities in the Philippines, he found that a format relying on lectures and technical information often proved ineffective. So to make it easier to transmit the information, he began using analogies between health processes and the villagers' everyday experiences. For example, the author used a string bean to illustrate the ovulation process, and explained the idea of immunization by comparing it to a preliminary skirmish that alerts an army to the coming of an invasion. These teaching methods proved highly effective and amusing. They even got the villagers involved in the teaching process, as they started coming up with their own comparisons or tried to improve previous ones. Encouraged by the results, IIRR developed more than 600 analogies to illustrate family planning and health concepts throughout the 3rd World. Most of the analogies involve agricultural comparisons. In Thailand, for example, farmers are taught about the importance of birth spacing by alluding to the fact that when papaya trees are planted too closely, the quality of the fruit is poor. And in Bangladesh, people are told that the children of couples who marry too young are like the fruit of immature coconut trees. IIRR has also used humorous anecdotes and parables as educational devices. And the information and skills gained from these methods will help 3rd World villagers improve their condition.
CANADIAN NURSE. 1986 Jan; 82(1):28-31.The House, a health service of Planned Parenthood in Toronto, seeks to promote responsible sexual decision making and family planning by supporting adolescents in all areas of health. The program has designed a questionnaire, known as healthworks, to encourage adolescents to discuss underlying fears and concerns with clinic personnel and to provide practitioners with a rapid assessment tool. Healthworks consists of simple "yes" or "no" questions covering areas such as emotional health, friends, recreation, sexuality/birth control, school and work, family, and tobacco and toxins. The questions invite self-evaluation and illustrate the many factors that affect health. They also introduce the areas of concern that program staff are willing to discuss with teenagers. Surveys have indicated that sexuality, substance abuse, and emotional disturbances are topics teenagers are unlikely to discuss with a family physician. This hesitancy stems from concerns about confidentiality, embarrassment, or discomfort with the physician's attitude. The House seeks to provide a nonjudgmental, relaxed, and supportive atmosphere for the discussion of sensitive issues. The patient return rate for the questionnaire has been about 45%.
Icmc Migration News. 1981 Jan-Mar; 30(1):3-12.Add to my documents.