Human relationship: The forgotten dynamic in palliative care

2003 ◽  
Vol 1 (3) ◽  
pp. 261-265 ◽  
Author(s):  
DENISE L. HAWTHORNE ◽  
NANCY J. YURKOVICH
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
World View ◽  
Human Relationship ◽  
Scientific Process ◽  
Incurable Disease ◽  
Shared Humanity ◽  
Dynamics Of Science ◽  
Current Emphasis

Objective: Palliative care is a philosophy of care for individuals experiencing progressive, incurable disease. It encompasses two dynamics, science-based practice and relationship between patient, family, and health professional. Each dynamic is essential for quality palliative care, yet the requisites for each are different.Methods: The scientific process of observation and measurement requires differentiation, distance, and detachment to fulfill its demands for objectivity, whereas relationship, unobservable and immeasurable, requires sameness, closeness, and connection of a shared humanity. It is science, however, the prevailing world-view, that shapes our thinking and consequently, influences the education and practice of health professionals.Results: We explore the dynamics of science and relationship and the incongruities between them. We examine the prominence of science in palliative care and its impact on relationship.Significance of results: We contend that questioning the current emphasis of science in palliative care and discovering the joy and rewards of shared human experience will enrich the quality of life for patients, families, and health professionals.

Evaluation of an Interdisciplinary Training Program in Palliative Care: Addressing the Needs of Rural and Northern Communities

1997 ◽  
Vol 13 (3) ◽  
pp. 5-12 ◽  
Author(s):  
Linda Kristjanson ◽  
Deborah Dudgeon ◽  
Fred Nelson ◽  
Paul Henteleff ◽  
Lynda Balneaves
Keyword(s):  
Palliative Care ◽  
Training Program ◽  
Health Professionals ◽  
Repeated Measures ◽  
Family Care ◽  
Interdisciplinary Training ◽  
Repeated Measures Design ◽  
Care Training ◽  
Care Of The Dying

Our study was a pilot test of an interdisciplinary training program in palliative care to improve the quality of care to terminally ill cancer and AIDS patients in rural and northern communities in Manitoba. The program involved two weeks of intense palliative care training for nurses, social workers, physicians, and volunteers. Four teams were trained during a six-month period. A repeated measures design was used to assess the effectiveness of the program. Results indicated that health professionals’ knowledge about care of the dying, care of individuals with HIV/AIDS, and attitudes toward care of the dying improved upon completion of the training program and remained improved three months following the program. Improvements in use of medications, increased attention to family care, increased discussion of DNR orders, and increased consultation related to symptom management were evident following the training program. The parallel training program for volunteers was also judged to be effective.

scholarly journals Perception of health professionals about neonatal palliative care

2019 ◽  
Vol 72 (6) ◽  
pp. 1707-1714
Author(s):  
Ernestina Maria Batoca Silva ◽  
Maria José Machado Silva ◽  
Daniel Marques Silva
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Neonatal Intensive Care ◽  
Ethical Decisions ◽  
Palliative Care Teams ◽  
Pain And Suffering ◽  
Probabilistic Sample ◽  
Perception Of Health ◽  
Relational Difficulties

ABSTRACT Objective: To identify the perception of health professionals about neonatal palliative care. Method: A phenomenological qualitative study, a non-probabilistic sample, of 15 health professionals from a neonatal intensive care unit in northern Portugal. Content analysis was performed. Results: Despite their lack of training in palliative care, the health professionals showed concern for the dignity, quality of life and comfort of the newborn and family. They expressed emotional and relational difficulties in following the trajectories of serious illness and death and in the ethical decisions regarding the end-of-life. Conclusion: It is emphasized that professionals are sensitive to pain and suffering and reveal dedicated and committed in the care of the newborn and family. They are available to train and embrace the current challenges posed by the constitution of pediatric palliative care teams and to help achieve an organizational culture that advances in such care.

Journeys to the centre of empathy

2017 ◽  
Author(s):  
Renee Lim ◽  
Stewart Dunn
Keyword(s):  
Palliative Care ◽  
Physical Health ◽  
Health Professionals ◽  
Professional Communication ◽  
Professional Burnout ◽  
Patient Complaints ◽  
Effective Training ◽  
Empathic Communication ◽  
Training Programmes

As a species, we appear to be programmed to respond to the situations and emotions of others. However, there is wide variation in the ways doctors and other health professionals experience and express this capacity, and there is a need for effective training to enhance these skills. Unfortunately, systematic reviews suggest that many of our current training programmes do not improve the quality of communication in cancer and palliative care so as to limit the burden of professional burnout, and to improve patients’ mental or physical health and satisfaction. Our attempts to produce a generation of empathic clinical communicators are inconsistent and reviews of patient complaints reveal an increasing discontent with professional communication. So what is missing? How do we develop, sustain, and teach empathic communication? The answer, according to Lim and Dunn, is to shift the focus from empathy to authenticity.

Informatics and Literature Search

2015 ◽  
Author(s):  
Jennifer J. Tieman ◽  
David C. Currow
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Domain Knowledge ◽  
Literature Search ◽  
Evidence Base ◽  
Practice Research ◽  
Clinical Knowledge ◽  
Research And Education ◽  
The Individual

Health information technology is changing how health professionals engage with and use knowledge and how health systems organize care. Tools and resources can facilitate access to evidence and enable its application in practice improving outcomes for the individual patient and for the health-care system. However, the quality of these applications relies on the quality and currency of the domain knowledge that is embedded within them and distributed through them. Therefore being able to identify and retrieve palliative care’s evidence base is more critical than ever. Given the complexity of timely, efficient, and effective retrieval of needed knowledge, new approaches are needed to manage the expanding and diffuse knowledge base for palliative care. Such strategies include developing online repositories of clinical knowledge to ensure immediate access and creating search solutions that shortcut access to literature and evidence to support practice, research, and education.

A psychosocial and pshycoeducational intervention for cancer patients integrated into routine care: A study from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19518-e19518 ◽  
Author(s):  
Anita Chandra
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Professionals ◽  
Psychosocial Intervention ◽  
Psychological Intervention ◽  
Symptom Control ◽  
Psychosocial Care ◽  
Patients With Cancer ◽  
Oncology Care

e19518 Background: Patients with cancer experience significant distress and access to effective psychosocial care is limited by lack of systematic approach. This paper presents results of a study to evaluate the effectiveness of a brief tailored psychosocial intervention delivered by health professionals in cancer care in developing countries. Methods: Health professionals deliver the multicomponent, psychoeducational and psychosocial intervention focusing on core concepts of quality of life, supportive-expressive, cognitive, social functioning, symptom scale and dignity-conserving care. A total of 100 patients recruited across all tumour sites, from July 2011 to December 2011, in a University Hospital in India. Eligible patients received 2 sessions, each for 30 minutes in length, delivered face-to-face at baseline and 12 week follow-up. Results: Quality of life was measured by using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire .In this study the functional scales were high, whereas in the symptom scales fatigue (48.9%) and financial difficulties (45.53%) were noted. Percentages of families who evaluated by the palliative care team voted as useful or very useful were: 80% (symptom control), 85% (emotional support), 86% (family support), and 87% (care coordination). Compared with participants receiving usual oncology care, those receiving a palliative care-focused intervention addressing psychosocial care provided concurrently with oncology care had higher scores for quality of life and mood. Conclusions: This study will provide important information about the effectiveness of a brief tailored psychological intervention for patients with cancer in a developing country. This model of care should be a systematic implementation in routine clinical practice cancer settings in resource restraints countries. [Table: see text]

scholarly journals Implantação de um Programa Multiprofissional de Assistência em Cuidado Paliativo: Relato de Experiência / Implementation of a Multiprofessional Assistance Program in Palliative Care: Experience Report

2021 ◽  
Vol 15 (57) ◽  
pp. 436-449
Author(s):  
Ana Paula Ribeiro Toldo ◽  
Hildegard Magdalena Klever Krause ◽  
Inez Maria de Fátima Robert
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Care Service ◽  
Palliative Care Service ◽  
Chronically Ill ◽  
Assistance Program ◽  
Care Experience ◽  
Expected Time ◽  
Relief Of Suffering

Resumo: Cuidado paliativo é uma abordagem que ampara a assistência do profissional de saúde nos cuidados aos doentes em situação de intenso sofrimento, decorrente de doença que ameaça a continuidade da vida, tendo como objetivo promover alívio do sofrimento e qualidade de vida do paciente e familiares, dentro das medidas possíveis e até o fim da vida. O estudo teve por objetivo realizar e descrever a implantação e implementação de um programa multiprofissional de assistência em Cuidado Paliativo. O estudo caracterizado como uma pesquisa ação, apresenta 5 fases para o desenvolvimento da proposta do serviço. Com a implementação do programa, pode-se proporcionar a humanização da equipe multiprofissional no trato aos pacientes e familiares. Dentre as expectativas que se atribuíram à proposta de criação de um serviço de cuidado paliativo, sua criação e aplicação foram realizadas dentro do tempo esperado, além de um aproveitamento e resultados maior do que os previamente previstos.Palavras-Chave: Cuidado paliativo; doentAbstract: Palliative care is an approach that supports the assistance of health professionals in the care of patients in situations of intense suffering, resulting from a disease that threatens the continuity of life, aiming to promote relief of suffering and quality of life for patients and their families, within of possible measures and until the end of life. The study aimed to carry out and describe the implementation and implementation of a multiprofessional assistance program in Palliative Care. The study characterized as action research, presents 5 phases for the development of the service proposal. With the implementation of the program, the humanization of the multidisciplinary team in dealing with patients and families can be provided. Among the expectations that were attributed to the proposal to create a palliative care service, its creation and application were carried out within the expected time, in addition to a better use and results than those previously expected. Keywords: Palliative care; chronically ill; assistance.e crônico; assistência.  

scholarly journals Scialorrea e tappi di muco: consigli pratici di gestione nei pazienti eleggibili alle cure palliative pediatriche

QUADERNI ACP ◽  
2021 ◽  
Vol 28 (2) ◽  
pp. 76-79
Author(s):  
Irene Avagnina ◽  
Chiara Paolin ◽  
Micaela Santini ◽  
Franca Benini
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Professionals ◽  
Management Strategies ◽  
Family Members ◽  
Pediatric Palliative Care ◽  
Oncological Disease ◽  
Clinical Level ◽  
High Care

Pediatric palliative care is a multidisciplinary area of pediatrics that aims to ensure a quality of life for children suffering from incurable diseases with high care complexity and also respond to their needs and those of their families. At the clinical level, there are many disturbing symptoms with a wide impact on the quality of life, which must be managed and treated. In particular some of them represent a major challenge for caregivers and health professionals looking after children eligible for PPC. This work aims to present, with a practical and immediately useful cut for the pediatrician, the management strategies of frequent symptoms, starting with drooling and mucus plugs; the latter are very frequent in children with non-oncological disease, followed by PPC. If not treated, they limit the child’s quality of life and have a significant impact on the concerns and management of family members / caregivers.

scholarly journals Palliative care medical student education: a cross-sectional medical school survey in mainland China

2019 ◽  
pp. bmjspcare-2019-002044
Author(s):  
Guanchen Ye ◽  
Jiahui Mao ◽  
Jingjing Hu ◽  
Jie Chen ◽  
Therese Hesketh
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Health Professionals ◽  
Mainland China ◽  
Medical Schools ◽  
Ministry Of Education ◽  
Care Education ◽  
Associate Deans ◽  
Palliative Care Education

ObjectiveAccording to the 2015 Quality of Death Index, China ranks 71st in terms of quality of palliative care out of 80 countries. Lack of palliative care education for health professionals is regarded as largely responsible. The study aims to evaluate the status of palliative care education for medical students in mainland China.MethodsA list of all medical schools was obtained from the Ministry of Education. A telephone survey of associate deans responsible for medical education at all 282 medical schools in mainland China was conducted in May 2019, following a standardised protocol. Telephone interviews focused on attitudes to palliative care teaching and the extent and manner in which palliative care is incorporated into the curriculum.ResultsAssociate deans from 173 (61.2%) of the 282 medical schools responded. A total of 120 schools (42.5%) completed the interview, while 53 (18.7%) evaded direct questions related to palliative care. Of the responding deans, 92 (76.7%) regarded palliative care education as very important. However, only 11 (9.2%) provided specific teaching on palliative care. A few schools (n=18) integrated palliative care education within required curricula, such as medical ethics and nursing science. The main reason reported for not providing palliative care education was that the medical curriculum dictated by the Ministry of Education does not require it.ConclusionA very small minority of medical schools in mainland China have any formal teaching about palliative care. Clearly, national standards for didactic and clinical teaching in palliative care for medical students and other health professionals are needed.

Addressing sexuality and intimacy in people living with Parkinson's during palliative care and at the end of life

2019 ◽  
Vol 28 (12) ◽  
pp. 772-779
Author(s):  
Jenny Wright
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Sexual Dysfunction ◽  
Older People ◽  
End Of Life ◽  
Health Professionals ◽  
Unmet Need ◽  
Improve Quality ◽  
Emotional Connectedness

Sexuality and intimacy are poorly researched in both people living with Parkinson's and in older people. Triggers for discussion usually centre on sexual dysfunction and hypersexuality in relation to Parkinson's. However, there are many more factors that impact on physical and emotional connectedness. Despite highlighting this unmet need there are limited tools or comprehensive assessments available to help improve quality of life. Further research is required within this field, with emphasis on health professionals' education and on highlighting to patients that they have permission for this topic to be discussed and actioned.

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