Discussing end-of-life issues with terminally ill cancer patients and their carers: a qualitative study

2005 ◽  
Vol 13 (8) ◽  
pp. 589-599 ◽  
Author(s):  
Josephine M. Clayton ◽  
Phyllis N. Butow ◽  
Robert M. Arnold ◽  
Martin H. N. Tattersall
2005 ◽  
Vol 3 (1) ◽  
pp. 15-22 ◽  
Author(s):  
TOMOYO SASAHARA ◽  
MITSUNORI MIYASHITA ◽  
MASAKO KAWA ◽  
KEIKO KAZUMA

Objective:To identify the factors associated with difficulties encountered by nurses working in general wards in hospitals in Japan.Methods:Questionnaires including items regarding difficulties in providing care to terminally ill cancer patients, the existence of a mentor regarding end-of-life issues, awareness of end-of-life issues, and demographic factors were administered to 375 staff nurses working in general in-patient wards. Multivariate regression analyses were employed to investigate correlations between factors.Results:Multivariate regression analysis revealed that the existence of a mentor for end-of-life issues was associated with fewer difficulties in all areas other than “Knowledge and skill of nurses.” Clinical experience was inversely related to difficulties in “Communication with patients and families” and “Personal issues.” Greater awareness of end-of-life issues was related to higher difficulties in most areas.Significance of results:The existence of a mentor was correlated with fewer difficulties in most areas. Support by a palliative care team might be effective in reducing difficulties experienced by nurses and in improving care for terminally ill cancer patients. Basic communication training undertaken sooner after registration might be also useful.


2005 ◽  
Vol 3 (4) ◽  
pp. 319-324 ◽  
Author(s):  
HAYLEY PESSIN ◽  
MEGAN OLDEN ◽  
COLLEEN JACOBSON ◽  
ANNE KOSINSKI

Depression is commonly experienced by cancer patients at the end of life. The identification of patients suffering from depression is essential to provide clinicians with an opportunity to relieve considerable suffering. However, the assessment of depressive symptoms is complex and often challenging in a terminally ill cancer population. This article offers practical guidelines to assist clinicians with the diagnosis of depression, reviews the defining symptoms of depression and their unique presentation in patients at the end of life, suggests modifications of the standard diagnostic interview, and provides examples of specific assessment questions to target depressive symptoms at the end of life.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19587-19587
Author(s):  
P. Heras ◽  
K. Kritikos ◽  
A. Georgopoulou ◽  
A. Hatzopoulos ◽  
N. Kritikos

19587 Background: The importance of spirituality and religion in coping with a terminal illness is becoming increasingly recognised. We aimed to assess the relation between spiritual well-being, religiosity, depression, and end-of-life despair in terminally-ill cancer patients. Methods: One hundred forty three terminally ill cancer patients with a life expectancy of less than 6 months were interviewed with a series of standardised instruments, including the FACIT Spiritual Well-Being Scale, a religiosity index similar to those used in previous research, the Hamilton depression rating scale, the Memorial Symptom Assessment Scale and the Duke-UNC Functional Social Support Questionnaire. Results: A strong negative association was observed between the FACIT Spiritual Well-Being scale and the HDRS, but no such relationship was found for religiosity. Similar patterns were observed for the FACIT subscales, finding a strong negative association between the meaning and peace subscale (which corresponds to the more existential aspects of spirituality) and HDRS scores, whereas a positive, albeit nonsignificant, association was observed for the faith subscale (which corresponds more closely to religiosity). Conclusions: These results suggest that the beneficial aspects of religion may be primarily those that relate to spiritual well-being rather than to religious practices per se. Spiritual well-being offers some protection against end-of-life despair in those for whom death is imminent. The area of spiritual work is fertile ground for further investigation, especially interventions aimed at improving spiritual health and general quality of life among terminally ill patients with cancer. No significant financial relationships to disclose.


2010 ◽  
Vol 26 (1) ◽  
pp. 219-227 ◽  
Author(s):  
Susan Gaeta ◽  
Kristen J. Price

The Lancet ◽  
2003 ◽  
Vol 361 (9369) ◽  
pp. 1603-1607 ◽  
Author(s):  
Colleen S McClain ◽  
Barry Rosenfeld ◽  
William Breitbart

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