No abstract

Our results showed that the great majority of the population that seeks for medical support in a Brazilian university hospital wishes to be informed on this health condition, even in case of serious illness. In addition, there are intense familiar bonds that make patients want to have their families also informed.

Among cancer patients in Brazil, late referral to palliative care is common. Patients who enter palliative care earlier appear to receive less aggressive end-of-life treatment.

SummaryObjectivesSpirituality is related to the care and the quality of life of cancer patients. Thus, it is very important to assess their needs. The objective of this study was the translation and cultural adjustment of the Spiritual Needs Assessment for Patients (SNAP) questionnaire to the Brazilian Portuguese language.MethodologyThe translation and cultural adjustment of the SNAP questionnaire involved six stages: backtranslation, revision of backtranslation, translation to the original language and adjustments, pre-test on ten patients, and test and retest with 30 patients after three weeks. Adult patients, with a solid tumour and literate with a minimum of four years schooling were included. For analysis and consistency we used the calculation of the Cronbach alpha coefficient and the Pearson linear correlation.ResultsThe final questionnaire had some language and content adjustments compared to the original version in English. The correlation analysis of each item with the total score of the questionnaire showed coefficients above 0.99. The calculation of the Cronbach alpha coefficient was 0.9. The calculation of the Pearson linear correlation with the test and retest of the questionnaire was equal to 0.95.ConclusionThe SNAP questionnaire translated into Brazilian Portuguese is adequately reliable and consistent. This instrument allows adequate access to spiritual needs and can help patient care.

In May 2008, the Japanese government launched the 'Emergency Project for Improvement of Medical Care and Quality of Life for People with Dementia' under the idea that it is necessary to build a society, without delay, where people can live life safely without anxiety even after being affected by dementia, where they can be supported by appropriate and integrated services of medical care, long-term care and community care. We would like to introduce our future dementia policy standing on the outcome of this project, which was published as a report on 10 July 2008. The measures for people with dementia in Japan have gradually achieved good results. For example, public understanding and awareness of dementia has increased through renaming the term for dementia in Japanese from 'Chiho' to 'Ninchisho' in 2004, and the comprehensive care system was founded focusing on the importance of providing community based long-term care while maintaining the person's familiar human relationships and residential circumstances. However, case reports show that there are yet some cases that fail to deliver appropriate treatment or long-term care service as a result of a lack of timely definite diagnosis in an early stage or a lack of coordination between medical care and long-term care. Therefore, the future dementia policy should be designed by envisaging the flow of the measures that would support the life of the person and his/her family, and improve their quality of life; starting with measures that link early notice of the patient, his/her family or neighbor to early diagnosis, and then measures to develop well-designed comprehensive care planning that provides appropriate medical and longterm care services through good coordination, while promoting research and development of diagnosis/treatment technology. In addition, in regard to early-onset dementia, comprehensive self-support measures including employment assistance should be promoted.