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Biomedical subjects

J Hockley

Publications and source records attributed to J Hockley.

18 recordsLinked to original sources
PubMed2000

Psychosocial aspects in palliative care--communicating with the patient and family.

The dynamics surrounding the patient and family facing a death as the 'unit of care' is discussed. Aspects of communication, openness within the family, especially concerning children and teenagers, and factors that enable a family to function under the stress of a loved one's terminal illness are explored. The use of a genogram in palliative care to help to piece together the family dynamics and available support is fundamental to the care for the whole family.

Adult↗
PubMed1999

Specialist palliative care within the acute hospital setting.

The hospital-based specialist palliative care service is the latest extension of the hospice movement in the UK, bringing the message of specialist palliative care back into the hospital setting. There are now over 200 palliative care services within the acute setting, including 76 specialist palliative care teams. The composition, advantages and disadvantages of such teams are described, and the challenge and importance of evaluating these services are discussed.

Clinical Competence↗
PubMed1996

The development of a palliative care team at the Western General Hospital, Edinburgh.

The evolution of palliative medicine as a specialty in the UK has meant that specialist services for palliative care are now being integrated into the acute hospital setting. The developing multidisciplinary team at the Western General Hospital is the first in Scotland and is based in the Regional Cancer Unit but has a hospital-wide remit. Advice is given on complex aspects of advancing disease to patients (and their families) suffering from cancer as well as on non-malignant disease. Evaluation of these teams and their effectiveness is discussed.

Evaluation Studies as Topic↗
PubMed1993

The concept of hope and the will to live.

Hope is defined as a concept that suggests a greater emotional component than mere expectation, and is seen as an active process of conscious and unconscious reasoning. Hope is intrinsically linked with caring, and the professional role of the nurse can often influence the generation of hope or hopelessness in the care of patients. The appropriateness of removing all hope even within palliative care is questioned. A case study is presented in which a patient, requesting euthanasia, hovered on the brink of death yet would not die. For this patient all 'hope' of wanting to live had waned, yet she could not die. A new concept of 'rational no-hope' is postulated.

Attitude to Death↗
PubMed1979

Haemostatic factors in Black and White diabetics.

Haemostatic factors in 33 Black and 32 White maturity-onset diabetics were analysed and compared with those in 19 normal Black and 19 White subjects. The Black-White diabetic group comparisons revealed depressed antithrombin (AT) III functional activity, a raised factor VII level and a raised factor V level in females in the White diabetic group. On comparing the White diabetics with their respective controls a rise in factor VIII and fibrinogen activity was demonstrated. These changes are suggestive of a hypercoagulable state in the White maturity-onset diabetic. In contrast, Black diabetics have higher functional AT III levels than their respective controls. This may indicate a protective reaction which would explain in part the reported lower incidence of occlusive vascular disease in this group. Platelet hyperactivity was not demonstrated in the majority of White and Black diabetics. Black diabetics and controls demonstrated higher factor VIII levels than the corresponding White groups, confirming previous observations of raised factor VIII levels among Blacks and suggesting that this feature is a racial characteristic.

Adult↗
PubMed1978

Activity of intraperitoneal heparin during peritoneal dialysis.

A pharmacokinetic study of intraperitoneal heparin was undertaken in eleven chronic renal failure patients as a guide for its therapeutic use in peritoneal dialysis. The intraperitoneal heparin was assayed as the activated-partial-thromboplastin time (A-PTT) of peritoneal aspirate or outflow dialyzate added to control plasma. This was noted to decay relatively slowly, the mean t 1/2 of heparin in the peritoneal cavity being 10.8 +/- 0.93 hr. The heparin cofactor antithrombin III determined by both immunological and functional methods was found to be present in low concentration in residual peritoneal fluid aspirated prior to commencing dialysis. Generally this was less than one-third of normal plasma values, and with the repeated dilution and outflow sequences of dialysis the cofactor concentrations rapidly fell to negligible levels that were incapable of activating any heparin present. Systemic blood coagulation was unaffected by single 10000 U doses of heparin administered intraperitoneally in that plasma A-PTT values were not lengthened when measured over the ensuing six hours.

Antithrombins↗
PubMed1977

The monitoring of heparin activity during extracorporeal circulation.

Heparin activity was assessed in 11 patients who underwent extracorporeal circulation for open-heart surgery. The activated partial thromboplastin time (A-PTT), thrombin time, protamine sulphate titration and factor Xa inhibition assay were used. The patients received heparin 3 mg/kg body weight, and 20 mg/450 ml blood was added to the pump. When the operative procedure was extended beyond 100 minutes patients received an additional 1,5 mg heparin/kg body weight. Protamine sulphate in a dose of 1,5 mg/1 mg heparin, was given to neutralize the heparin activity. The A-PTT was the easiest test which gave reliable results. The factor Xa inhibition assay measured heparin levels most precisely and mirrored the A-PTT results in all but one instance. These results indicate that the protocol employed produced adequate anticoagulation for the bypass procedure in all the patients. Protamine sulphate failed to neutralize heparin adequately after bypass in the 3 patients who received additional heparin during the surgical procedure. The monitoring of heparin activity during and after extracorporeal circulation is a desirable addition to open-heart surgical treatment.

Blood Coagulation Tests↗
PubMed1976

A human brain thromboplastin standard for distribution in South Africa.

As part of an international co-operative study of the International Committee for Standardisation in Haematology, human brain thromboplastins prepared by the acetone-extracted and phenol-saline extraction techniques have been compared as to the yield, the proportion of reagent discarded and wasted, and the sensitivity related to an international standard, the British Comparative Thromboplastin standard (BCT). The phenol-saline extract showed greatly improved sensitivity with greatly reduced batch-to-batch variation as compared with the acetone-dried preparation. In addition, the sensitivity of this reagent conformed to that of the BCT. The implications of the use of such a standardised reagent to the therapeutic management of oral anticoagulant therapy are: (i) standardised, reproducible results; (ii) results comparable with those carried out by other laboratories using a similarly standardised reagent; and (iii) stable therapeutic range.

Acetone↗
PubMed1976

Coagulation studies in long-term survivors after renal allograft transplantation.

Screening coagulation studies were carried out on 69 long-term survivors who had received renal allografts. Fibrinogen levels were significantly raised in this group. Factor VIII activity was increased in 7 of the 11 patients studied. Six long-term survivors of renal allografts demonstrated arterial thrombotic phenomena. The onset of the thrombotic episode occurred at a relatively young age. It is considered that the hypercoagulable state may contribute to the observed increased tendency towards arterial thrombotic phenomena.

Adolescent↗
PubMedDate not supplied

Role of the hospital support team.

The hospital support team is a multidisciplinary team through which the expertise of hospice care can be extended to the acute hospital situation. This article highlights the aims of such a team and the expertise of different members, emphasizing the advisory role and the importance of 'role-modelling'.

Hospices↗
PubMedDate not supplied

Caring for the dying in acute hospitals.

In 1983, a small descriptive study looking at the distressing symptoms of 26 terminally ill patients (dying from malignant as well as non-malignant disease) was carried out at two different hospitals before the setting up of a hospital support team. Fifty-two nurses involved in the care of these patients were also interviewed, using a taped, semi-structured interview. Nurses generally found caring for the terminally ill rewarding, but first-year nurse learners found coping with their emotions difficult. The senior nurses would have liked more teaching on pain control and care of relatives. Support of nursing staff was seen to be better in wards where the nursing process was being practised.

Adaptation, Psychological↗
PubMedDate not supplied

Audit pinpoints i.v. drug administration pitfalls.

This paper describes an approach to auditing the time spent by nurses giving intravenous drugs. The results of the audit, carried out at Wycombe General Hospital, are reported and discussed together with the measures taken to address practical and medico-legal issues. The authors conclude that much nursing time could be saved with closer adherence to guidelines for practice.

Drug Therapy↗