The meaning of being in transition to end-of-life care for female partners of spouses with cancer

2009 ◽  
Vol 7 (4) ◽  
pp. 423-433 ◽  
Author(s):  
Nisha Sutherland
Keyword(s):  
Psychological Distress ◽  
End Of Life ◽  
End Of Life Care ◽  
Meaning Making ◽  
Care Service ◽  
Palliative Care Service ◽  
Major Theme ◽  
Life Care ◽  
Female Partners ◽  
Anticipatory Mourning

AbstractObjective:Female partners of cancer patients are at high risk for psychological distress. However, the majority of studies have focused on measurement of female partners' psychological distress during diagnosis and early treatment. There is a gap in the literature with regard to qualitative studies that examine the experiences of female partners of spouses with cancer during the transition to end-of-life care. The purpose of this qualitative study was to explore the meaning of being in transition to end-of-life care among female partners of spouses with cancer.Methods:An interpretive phenomenological approach based on Gadamer's (1960/1975) philosophy was used to gain a deeper understanding of the phenomenon of end-of-life transition. Eight female partners from two in-patient hospices and a community-based palliative care service were interviewed using a semistructured approach.Results:Three major themes and associated subthemes were identified that outlined female partners' experiences. One major theme, Meaning of Our Lives, included the subthemes Our Relationship, Significance of His Life, and Searching for Understanding. In another theme, Dying with Cancer, partners undertook the Burden of Caring, experienced an Uncertain Path and were Looking for Hope. In the last theme, Glimpses of the Future, participants Faced Tomorrow and confirmed their Capacity to Survive.Significance of results:The results centered on three major concepts: meaning making, anticipatory mourning, and hope. Although meaning making has been identified as a fundamental way in which bereaved individuals cope with loss, results of this study suggested that female partners made meaning of their situations before their spouses' deaths. Participants also spontaneously described aspects of anticipatory mourning, thus, validating a concept that has been widely accepted despite limited research. Another finding was that participants shouldered the responsibility of adjusting spouses' hopes in order to help them to cope. Implications for practice and research are drawn from these findings.

Aggressiveness of end-of-life care before and after the utilization of a palliative care service.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 9135-9135
Author(s):  
W. Gonsalves ◽  
T. Tashi ◽  
T. Davies ◽  
S. Ortman ◽  
R. Thota ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Life Care ◽  
Before And After

Association between family satisfaction and caregiver burden in cancer patients receiving outreach palliative care at home

2017 ◽  
Vol 16 (3) ◽  
pp. 260-268 ◽  
Author(s):  
Yoko Naoki ◽  
Yoshinobu Matsuda ◽  
Isseki Maeda ◽  
Hideka Kamino ◽  
Yoko Kozaki ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Family Satisfaction ◽  
Life Care ◽  
Care At Home

ABSTRACTObjective:Little is known about the associations between family satisfaction with end-of-life care and caregiver burden. We conducted a researcher-assisted questionnaire survey to clarify the impact of caregiver burden on family satisfaction and to determine the types of burden that decrease family satisfaction.Method:Bereaved family caregivers of patients with advanced cancer who received our outreach palliative care service were retrospectively identified. Family satisfaction with the end-of-life care provided by the palliative care service and caregiver burden were quantified using the Japanese versions of the FAMCARE Scale and the Zarit Burden Interview (ZBI), respectively.Results:Our study subjects included 23 family caregivers. The mean scores on the FAMCARE Scale and the ZBI for the total population were 72.8 ± 11.2 and 22.8 ± 17.3, respectively, indicating moderate-to-high satisfaction and low-to-moderate burden. Caregiver burden had a strong negative correlation to family satisfaction with end-of-life care (Spearman's rho [ρ] = −0.560, p = 0.005), which remained after adjustment for potential confounders (standardized beta [β] = −0.563, p = 0.01). Several burden items—including loss of control, personal time, social engagement with others, feeling angry with the patient, feeling that the patient wants more help than he/she needs, and a wish to leave the care to someone else—were associated with decreased satisfaction. The major cause of dissatisfaction for family members included the information provided regarding prognosis, family conferences with medical professionals, and the method of involvement of family members in care decisions.Significance of results:Caregiver burden can be a barrier to family satisfaction with end-of-life care at home. A home care model focused on caregiver burden could improve end-of-life experiences for patients and family caregivers.

scholarly journals Patterns of End-of-Life Care in Children With Advanced Solid Tumor Malignancies Enrolled on a Palliative Care Service

2015 ◽  
Vol 50 (3) ◽  
pp. 305-312 ◽  
Author(s):  
Tamara Z. Vern-Gross ◽  
Catherine G. Lam ◽  
Zachary Graff ◽  
Sara Singhal ◽  
Deena R. Levine ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Solid Tumor ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Life Care ◽  
Advanced Solid Tumor

A nurse practitioner-led community palliative care service in Australia

2019 ◽  
Vol 25 (5) ◽  
pp. 245-253 ◽  
Author(s):  
Julie Edwards ◽  
Dawn Hooper ◽  
Gillian Rothwell ◽  
Kerrie Kneen ◽  
John Watson ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Nurse Practitioner ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Community Setting ◽  
Essential Elements ◽  
Life Care ◽  
Community Based

Background: Patients want community-based palliative care, but there was no continuity of care for patients at the Sydney Adventist Hospital to receive palliative and end-of-life care within a community setting. A nurse practitioner (NP)-led community palliative care service was developed. Aims: To present the background, design, function, and essential elements of the Sydney Adventist Hospital Community Palliative Care Service (SanCPCS). Methods: Semi-structured and cyclical discussions with key informants alongside internal document reviews. Findings: This is the first description of an NP-led community palliative care service model. The NP role ensured specialist training and extended clinical practice within the community setting. The SanCPCS delivers accessible, continuous, community-based palliative care throughout the patient's palliative and end-of-life journey. Conclusion: NP-led models for palliative and end-of-life care in the outpatient or community setting are a logical direction to meet patient need.

The importance of identifying preferred place of death

2015 ◽  
Vol 9 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Maimoona Ali ◽  
Margred Capel ◽  
Gareth Jones ◽  
Terri Gazi
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Healthcare Providers ◽  
Palliative Care Service ◽  
Service Evaluation ◽  
Place Of Death ◽  
Life Care ◽  
At Home

ObjectivesThe majority of people would prefer to die at home and the stated intentions of both statutory and voluntary healthcare providers aim to support this. This service evaluation compared the preferred and actual place of death of patients known to a specialist community palliative care service.DesignAll deaths of patients (n=2176) known to the specialist palliative care service over a 5-year period were examined through service evaluation to compare the actual place of death with the preferred place of death previously identified by the patient. Triggers for admission were established when the patients did not achieve this preference.ResultsBetween 2009 and 2013, 73% of patients who expressed a choice about their preferred place of death and 69.3% who wanted to die at home were able to achieve their preferences. During the course of their illness, 9.5% of patients changed their preference for place of death. 30% of patients either refused to discuss or no preference was elicited for place of death.ConclusionsDirect enquiry and identification of preferences for end-of-life care is associated with patients achieving their preference for place of death. Patients whose preferred place of death was unknown were more likely to be admitted to hospital for end-of-life care.

Improving End-of-Life Care for Ventricular Assist Devices (VAD) Patients: Paradox or Protocol?

2013 ◽  
Vol 67 (1-2) ◽  
pp. 161-166 ◽  
Author(s):  
Peg McGonigal
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Hospital Admissions ◽  
Life Experience ◽  
Care Service ◽  
Palliative Care Service ◽  
Ventricular Assist Devices ◽  
Life Care ◽  
Ventricular Assist

When a person consents to have a ventricular assist device (VAD) implanted in one's heart, the intention is to extend life toward a new heart or toward more time. Complications may develop followed by frequent hospital admissions—most often in an intensive care unit (ICU) setting—rendering a transplant a distant reality and to discontinue the device means certain death. Emotional support for patient and family is critical. Regardless of the original goal for the device, palliative care provides assistance in communication, goal setting, and symptom management and yet its consultation is often more for brink-of-death care than end-of-life care provided at the time of diagnosis of a life-threatening disease such as heart failure. This study examined the recent deaths of hospitalized patients with VADs and the use of the palliative care service. Understanding the benefit and timing of palliative care for VAD patients—particularly in the ICU setting—may improve the end-of-life experience for patients, families, and healthcare providers.

scholarly journals Factors affecting attitudes towards end-of-life care among medical students in China: a cross-sectional study

2021 ◽  
Vol 21 ◽  
pp. 323-331
Author(s):  
Rui Jia ◽  
Min Chen ◽  
Kang Wang ◽  
Xinrui Zhou ◽  
Xin Wang ◽  
...  
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Hospice Care ◽  
Care Service ◽  
Human Life ◽  
Palliative Care Service ◽  
Special Kind ◽  
Life Care ◽  
Cross Sectional

End-of-life care is regarded as a special kind of palliative care service. At present, people in our country are still relatively unfamiliar with end-of-life care. As a future medical worker whose work is about human life, health, disease, and death, their attitudes towards end-of-life of medical students affects all aspects of their medical behavior. The purpose of our research is to identify and describe factors associated with medical students' attitudes towards end-of-life care. Ninety-one medical students chosen by stratified random sampling at School of Medicine, Xi'an Jiaotong University completed several questionnaires focused on attitudes towards end-of-life care. The scores of end-of-life care attitudes of nursing major (133.3±9.6) is higher than clinical; grade 1 (132.3±9.8) is higher than grade 2, 3 or 4; "Calm and open atmosphere" in discussing the death situation at home (132.4±9.8) was higher than "never discussed death" and other situations; who had never suffered from serious illness (131.8±9.5) was higher than that of those who had suffered. The differences were statistically significant (P<0.05). The correlations coefficient between meaning of life (r=0.47), between the death fear dimension (r=-0.35), death escape dimension (r=-0.27), natural acceptance dimension (r=0.34), approach acceptance dimension (r=-0.21), escape acceptance dimension (r=-0.24), adolescent life events (r=0.19) and end-of-life care attitudes were significant correlation (P<0.01). After controlling of demographic sociological variables, psychological factors have made new contributions to hospice care attitudes, and the explained variance has increased by 32.0%. Medical students with different characteristics have significant differences in end-of-life care attitudes, which suggesting the lack of education in end-of-life care in our country, and the failure of education to enable medical students of different backgrounds to establish a scientific, rational and humanistic care attitude.

scholarly journals End-of-Life Care for Hospitalized Patients with Lung Cancer: Utilization of a Palliative Care Service

2010 ◽  
Vol 13 (10) ◽  
pp. 1261-1266 ◽  
Author(s):  
Barbara Reville ◽  
Marshal N. Miller ◽  
Richard W. Toner ◽  
JoAnne Reifsnyder
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Hospitalized Patients ◽  
Life Care
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