Background: Interdisciplinary team involvement is commonplace in many palliative care settings across the world. Teamwork is perceived by many experts as an indispensable functionality of palliative care teams. Significantly different structural and functional attributes of these teams between regional and organisational contexts could potentially act both as strengths and weaknesses towards their overall productivity. The sustainability and resilience of the team also has an indirect bearing on the team functioning. Aim: This article describes international evidence on dynamic palliative care teams with a view of how and when they function efficiently or adversely. Emphasis is also placed on studies that suggest means to mitigate the conflicts and limitations of teamwork in palliative care and related healthcare settings. Findings: Evidence strongly suggests that palliative care is best delivered through a multidisciplinary team approach. Conclusion: The overall performance of a healthcare team is largely determined by the supportive work environment built through effective communication, leadership skills and mutual respect.

Aims:Pain, a distressing symptom frequently suffered by cancer patients, is inherently associated with anxiety and depression yet often not alleviated with pharmacotherapy alone. This study was aimed at assessing the effect of an instrumental classical music listening session as an adjunct to the ongoing therapies, on pain, anxiety, and mood modulation in cancer patients.Materials and Methods:A randomized crossover open clinical trial was designed involving adult resident patients suffering pain at a tertiary cancer care institution. The same group of patients (n = 24) were monitored for selected outcomes without (day 1) and then with administration of music (day 2). The primary (subjective) outcomes such as pain, anxiety, and mood levels measured on visual analog scale and surrogate (objective) parameters such as pulse rate, systolic blood pressure, diastolic blood pressure, respiratory rate, and pupillary size monitored were compared utilizing paired-sample t-test.Results:Statistically significant improvements were noted in all three subjective parameters; pain and anxiety were significantly diminished until the 4th h (P = 0.007 and P = 0.0022, respectively), while low mood remained alleviated until the 12th h reading point (P = 0.007). Statistically significant reductions were present in surrogate end points such as pupillary size (P = 0.003 up to 12 h) and respiratory rate (P = 0.01 up to 8 h). Declines noted in the heart rate, and blood pressure readings were statistically insignificant. None suffered deterioration of their existing well-being.Conclusions:Hence, we conclude that culturally familiar instrumental classical music demonstrates a significant effect in alleviating pain, anxiety, and low mood as an adjunct to on-going therapies in cancer patients.

Background The limited knowledge on aetiology, epidemiology and risk factors for multimorbidity especially evident from low and middle-income countries curtail the development and implementation of sustainable healthcare models. Sri Lanka, boasting for one of South Asia’s most efficient public health systems that is accessible free-of-charge by the citizens is presently transitioning from lower-middle to upper-middle-income tier. Faced with the triple burden of disease, it is imperative for Sri Lanka to incorporate an integrated model to manage multimorbidity. Methods A descriptive cross-sectional study was carried out in medical clinics of a tertiary care hospital and a University primary care department. Data were extracted on to a form from the clinical records of patients over the age of 20 years with at least one non-communicable disease (NCD) and analysed. Results Multimorbidity was present among 64.1% of patients (n = 1600). Nearly 44.44% of the patients aged 20–35 years have a minimum of two disorders, and by the time they reach 50 years, nearly 64% of the patients have two or more non-communicable diseases. Nearly 7% of those aged over 65 years were diagnosed with four or more disorders. A fourth of the sample was affected by co-morbid diabetes mellitus and hypertension, whereas the combinations of coronary heart disease with hypertension and diabetes mellitus were also found to be significantly prevalent. A salient revelation of the binomial logistic regression analysis was that the number of disorders was positively correlated to the presence of mental disorders 7.25 (95% CI = 5.82–8.68). Conclusion Multimorbidity is highly prevalent among this population and seemingly has a detrimental effect on the psychological wellbeing of those affected. Therefore, the need for horizontal integration of all primary to tertiary care disciplines, including mental health, to manage multimorbidity by policymakers is emphasized as a priority task.

Objectives Discipline of palliative care is still evolving in developed parts of the world while it remains at an infantile stage in Sri Lanka which has not been formally assessed as of today. We aimed at evaluating the level of palliative care knowledge and opinions among young medical graduates. A descriptive cross-sectional study was carried out among pre-residency medical graduates of Sri Lanka through a social media based on-line survey. The pre-tested questionnaire assessed the level of knowledge on general principles, service organization, clinical management and ethical considerations while it also evaluated their opinions. Results Response rate was 35.8% (n=351). The average score among the respondents was 37.25% (standard deviation (SD) = 11.975). Specific knowledge on “general principles” was adequate (score>=50%) with an average of 62.61%, SD=24.5 while “ethics” was observed to be the area with poorest knowledge (average score=19.55%, SD=22). Average scores for “service organization” and “managerial aspects” were 34.54%, SD=17.6 and 32.26%, SD=22.3 respectively. The majority (>90%) believed that de-novo establishment of hospice, hospital and community-based palliative services would sustainably improve holistic patient care. Measures must be taken to optimize basic palliative care knowledge among the undergraduates in view of achieving Universal Health Coverage in the long term.

Objectives Discipline of palliative care is still evolving in developed parts of the world while it remains at an infantile stage in Sri Lanka which has not been formally assessed as of today. We aimed at evaluating the level of palliative care knowledge and opinions among young medical graduates. A descriptive cross-sectional study was carried out among pre-residency medical graduates of Sri Lanka through a social media based on-line survey. The pre-tested questionnaire assessed the level of knowledge on general principles, service organization, clinical management and ethical considerations while it also evaluated their opinions. Results Response rate was 35.8% (n=351). The average score among the respondents was 37.25% (standard deviation (SD) = 11.975). Specific knowledge on “general principles” was adequate (score>=50%) with an average of 62.61%, SD=24.5 while “ethics” was observed to be the area with poorest knowledge (average score=19.55%, SD=22). Average scores for “service organization” and “managerial aspects” were 34.54%, SD=17.6 and 32.26%, SD=22.3 respectively. The majority (>90%) believed that de-novo establishment of hospice, hospital and community-based palliative services would sustainably improve holistic patient care. Measures must be taken to optimize basic palliative care knowledge among the undergraduates in view of achieving Universal Health Coverage in the long term.