Conceptual Barriers to Palliative Care and Enlightenment From Chuang-tze’s Thoughts

AbstractThis paper claims that palliative care (PC) is a suitable approach for offering comprehensive support to patients with life-threatening illness and unavoidable asthenia, to enhance their quality of life in aging and chronic illness. There are however some conceptual barriers to accessing that care on the Chinese Mainland: (1) Death-denying culture and society; (2) Misguidance and malpractice derived from the biomedical model; (3) Prejudice against PC and certain deviant understandings of filial piety culture. To counter these obstacles, the study introduces the philosophy of Chinese Taoist Chuang-tze to enlighten the public from ignorance and remove some illusions about death and dying; inspire people to face and accept illness and death calmly, and keep harmony and inner peace of mind to alleviate suffering, with the aim of providing wisdom and a shift of attitude toward life and death. Chuang-tze’s thoughts are consistent with the provision of palliative care, and to a certain degree, can promote its acceptability and delivery, and the conception of good death in practice.

Download Full-text

Experiential Palliative Care Immersion: Student Nurse’s Narratives Reflect Care Competencies

Western Journal of Nursing Research ◽

10.1177/0193945919833061 ◽

2019 ◽

Vol 41 (10) ◽

pp. 1465-1480 ◽

Cited By ~ 1

Author(s):

Toni L. Glover ◽

Hanna Åkerlund ◽

Ann L. Horgas ◽

Susan Bluck

Keyword(s):

Palliative Care ◽

Nursing Students ◽

Individual Values ◽

Undergraduate Nursing Students ◽

Undergraduate Nursing ◽

Immersion Experience ◽

Life Threatening Illness ◽

Life Threatening ◽

Compassionate Communication

Many nurses report a lack of confidence providing care for patients facing a life-threatening illness. Palliative care leaders have devised primary palliative nursing care competencies (CARES [Competencies And Recommendations for Educating undergraduate nursing Students]) that all students should achieve. In this study, nursing students participated in an innovative palliative care immersion experience, the Comfort Shawl Project. We performed a reliable content analysis of their narrative reflections. The goal was to evaluate whether reflections on their interactions with patients/families were consistent with CARES competencies. Nine female students wrote reflections after gifting each of the 234 comfort shawls to patients. Four CARES-related categories were analyzed: Individual Values and Diversity, Compassionate Communication, Fostering Quality of Life, and Self-Insight and Emotion. Reflections were highly representative (41%) of recognizing Individual Values and Diversity, representing sensitivity for patients’ unique differences in values, an integral component of palliative care. The Comfort Shawl Project shows promise as an experiential immersion for introducing nursing students to CARES competencies.

Download Full-text

The Online Representation of Palliative Care by Practice, Policy, and Advocacy Organizations: Definitional Variations and Discursive Tensions

Qualitative Health Research ◽

10.1177/10497323211043824 ◽

2021 ◽

pp. 104973232110438

Author(s):

Marjolein Matthys ◽

Naomi Dhollander ◽

Leen Van Brussel ◽

Kim Beernaert ◽

Benedicte Deforche ◽

...

Keyword(s):

Palliative Care ◽

Death And Dying ◽

Online Information ◽

Policy Advocacy ◽

Care Policy ◽

Advocacy Organizations ◽

The Public ◽

Negative Beliefs ◽

Total Care

Negative beliefs and a lack of clarity surrounding the meaning of palliative care have been widely reported as obstacles to its uptake. Information available to the public possibly contributes to this. A descriptive and discourse-theoretical analysis was conducted of information spread online by palliative care policy, advocacy, and practice organizations. Discrepancies were found in the way palliative care was defined in relation to curative, end-of-life, terminal, and supportive care. Beyond these definitional variations, meaning was generated through the representation of palliative care as a culture, connected to total care, compassion, and openness. Tensions arose around the concepts of autonomy, a natural death, and an emphasis on the quality of life away from death and dying. Overall, this study showed that the online information of palliative care is a potential source of confusion and might even contribute to its stigmatization. Insights are provided that may help improve clarity toward the public.

Download Full-text

Palliative care

Oxford Handbook of Nutrition and Dietetics ◽

10.1093/med/9780199585823.003.0035 ◽

2011 ◽

pp. 715-718

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Nutritional Status ◽

Early Stage ◽

Disease Process ◽

Life Care ◽

Life Threatening Illness ◽

Incurable Condition ◽

Life Threatening

Palliative care 716 Palliative care is the approach taken to provide comfort and quality of life to people with a life-threatening illness and their families. When curative treatment is not possible, palliative care should be implemented at an early stage in the disease process. The aim is to alleviate symptoms and to support physical, emotional, spiritual and cultural needs. Although palliative care encompasses end of life care, it should be noted that many people live with an incurable condition for many months or years. Throughout this time, optimizing an individual's nutritional status is essential if physical function and quality of life are to be maintained....

Download Full-text

Stoma therapy in palliative care

10.1093/med/9780199656097.003.0412 ◽

2015 ◽

Author(s):

Jane Ellen Barr

Keyword(s):

Palliative Care ◽

Nurse Specialist ◽

Spiritual Support ◽

Term Care ◽

Life Threatening Illness ◽

Psychological Disturbances ◽

Life Threatening ◽

Improve Health

Patients with ostomies, wounds, or incontinence in the setting of a serious or life-threatening illness experience numerous challenges, including distress related to pain and other symptoms, psychological disturbances, and family concerns. Expert management of these conditions and their many complications is an essential part of a comprehensive palliative plan of care. In many countries, nurse specialists with advanced training in the management of ostomies, wounds, or incontinence are available as consultants or as members of a specialist palliative care team. These professionals can improve health care and quality of life for selected patients across venues of care that include hospital, home, long-term care, hospice, and specialized settings. If a stoma nurse specialist is available, he or she may have a key role in directing decision-making and care management related to these problems, evaluating and controlling symptoms that cause patients and families suffering, and providing psychosocial and spiritual support.

Download Full-text

Perception of Palliative Care among Medical Students in a Teaching Hospital

Journal of Nepal Medical Association ◽

10.31729/jnma.2772 ◽

2015 ◽

Vol 53 (198) ◽

pp. 113-117 ◽

Cited By ~ 3

Author(s):

Samiksha Pandey ◽

Deepshikha Gaire ◽

Sheela Dhakal ◽

Neelam Jaishwal ◽

Pushpa Mani Kharal ◽

...

Keyword(s):

Palliative Care ◽

Medical Students ◽

Teaching Hospital ◽

Institute Of Medicine ◽

Undergraduate Medical Students ◽

Medical Study ◽

Life Threatening Illness ◽

Life Threatening ◽

Care Perception

Introduction: Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness. Palliative care must be a part of every medical personnel’s practice. But still medical education curriculums have not included palliative care in its syllabus, sufficiently due to which most of the health professional are not aware about this specialty. The purpose of this study is to find out the perception of the medical students in palliative care in a teaching hospital. Methods: A descriptive study was done among 270 undergraduate medical students studying in Institute of Medicine using a self structured pretested questionnaire. Data was entered in Microsoft Excel and analyzed by using SPSS 21. Results: Of the total 270 undergraduate medical students only 152 has heard the word “palliative care”. Only 84 students know, palliative care can be provided early in the life threatening illness. Total 80 students know it doesn’t intend to postpone and hasten death. Though only 49 students didn’t know PC is not included in our curriculum, 227 are interested to learn about it if given any opportunity. Conclusions: The perception of palliative care medicine is low in first couple of year of medical study. It is increased in clinically exposed students but is surprisingly more in fourth year than final year undergraduate medical students. However, it should be included in undergraduate medical study. Keywords: medical students; palliative care; perception.

Download Full-text

Affected Physical and Psychosocial Domain in Patient of Palliative Care (A Case Report)

10.47363/jmcn/2021(2)116 ◽

2021 ◽

pp. 1-2

Author(s):

Sharafat Ali ◽

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Case Report ◽

Early Identification ◽

Patient Needs ◽

Life Changes ◽

Life Threatening Illness ◽

Life Threatening ◽

Psychosocial Domain

Palliative care is an approach that improves the quality of life of patients and their families who facing the problems associated with life-threatening illness. The approach of palliative care also provide them and their families a support system to cope with their problems associated with life changes. Along with this it make efforts to prevent their suffering, early identification of their problems through proper assessment, treatment of their problems and fulfill patient needs mainly psychosocial and spiritual need

Download Full-text

Principles of Palliative Care

Psychosocial Palliative Care ◽

10.1093/med/9780199917402.003.0001 ◽

2014 ◽

pp. 3-10 ◽

Cited By ~ 1

Author(s):

William S. Breitbart

Keyword(s):

Palliative Care ◽

Care Delivery ◽

Clinical Care ◽

Early Palliative Care ◽

Life Threatening Illness ◽

Hospice Movement ◽

Medical Discipline ◽

Life Threatening ◽

Research Findings

Palliative medicine refers to the medical discipline of palliative care. Modern palliative care has evolved from the hospice movement into a more expansive network of clinical care delivery systems with components of home care and hospital-based services. Palliative care begins with the onset of a life-threatening illness and proceeds past death to include bereavement interventions for family and others, with a mission to meet the physical, psychological, social, spiritual, and existential needs of the “whole patient.“ This chapter includes an overview of definitions of palliative care, the global need for palliative care, and ideal components of palliative care programs. A comprehensive review of the most recent research findings on impact of early palliative care on quality of life and survival is provided.

Download Full-text

More comprehensively measuring quality of life in life-threatening illness: the McGill Quality of Life Questionnaire – Expanded

BMC Palliative Care ◽

10.1186/s12904-019-0473-y ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

S. Robin Cohen ◽

Lara B. Russell ◽

Anne Leis ◽

Javad Shahidi ◽

Pat Porterfield ◽

...

Keyword(s):

Quality Of Life ◽

Second Order ◽

Model Fit ◽

Life Questionnaire ◽

Quality Of Life Questionnaire ◽

Healthcare Environment ◽

Life Threatening Illness ◽

Life Threatening ◽

Order Factor

Abstract Background Domains other than those commonly measured (physical, psychological, social, and sometimes existential/spiritual) are important to the quality of life of people with life-threatening illness. The McGill Quality of Life Questionnaire (MQOL) – Revised measures the four common domains. The aim of this study was to create a psychometrically sound instrument, MQOL – Expanded, to comprehensively measure quality of life by adding to MQOL-Revised the domains of cognition, healthcare, environment, (feeling like a) burden, and possibly, finance. Methods Confirmatory factor analyses were conducted on three datasets to ascertain whether seven new items belonged with existing MQOL-Revised domains, whether good model fit was obtained with their addition as five separate domains to MQOL-Revised, and whether a second-order factor representing overall quality of life was present. People with life-threatening illnesses (mainly cancer) or aged > 80 were recruited from 15 healthcare sites in seven Canadian provinces. Settings included: palliative home care and inpatient units; acute care units; oncology outpatient clinics. Results Good model fit was obtained when adding each of the five domains separately to MQOL-Revised and for the nine correlated domains. Fit was acceptable for a second-order factor model. The financial domain was removed because of low importance. The resulting MQOL-Expanded is a 21-item instrument with eight domains (fit of eight correlated domains: Comparative Fit Index = .96; Root Mean Square Error of Approximation = .033). Conclusions MQOL-Expanded builds on MQOL-Revised to more comprehensively measure the quality of life of people with life-threatening illness. Our analyses provide validity evidence for the MQOL-Expanded domain and summary scores; the need for further validation research is discussed. Use of MQOL-Expanded will enable a more holistic understanding of the quality of life of people with a life-threatening illness and the impact of treatments and interventions upon it. It will allow for a better understanding of less commonly assessed but important life domains (cognition, healthcare, environment, feeling like a burden) and their relationship to the more commonly assessed domains (physical, psychological, social, existential/spiritual).

Download Full-text