Psychosocial and Spiritual Issues in Palliative Care

2018 ◽  
Author(s):  
Marvin Omar Delgado Guay ◽  
Sriram Yennurajalingam
Keyword(s):  
Palliative Care ◽  
Significant Role ◽  
Interdisciplinary Approach ◽  
Well Being ◽  
Complex Interplay ◽  
Spiritual Distress ◽  
Key Issues ◽  
Spiritual Issues ◽  
And Control

In patients with serious life-limiting illness, there is a complex interplay of psychosocial, cultural, and spiritual issues. Increasing evidence demonstrates that psychosocial as well as spiritual distress play a significant role in the overall distress in palliative care patients. These also negatively factor in the patient’s well-being and control of symptoms. However, the differentiation between psychosocial and spiritual is often difficult. An interdisciplinary approach is critical so as to alleviate this distress among patients receiving Palliative Care. This chapter reviews the assessment and management of key issues related to psychosocial, cultural, and spiritual issues in patients with serious life-limiting illness.

Directions for Palliative Care Nursing in Canada: Report of a National Survey

1995 ◽  
Vol 11 (3) ◽  
pp. 5-8 ◽  
Author(s):  
Linda J. Kristjanson ◽  
Lynda Balneaves
Keyword(s):  
Palliative Care ◽  
National Survey ◽  
Interdisciplinary Approach ◽  
Educational Needs ◽  
Professional Issues ◽  
Standards Of Practice ◽  
Care Association ◽  
Key Issues ◽  
Care Nursing

This paper reports the results of a national survey of palliative care nurses conducted following a meeting of nurses at the Fifth Canadian Palliative Care Association Conference in 1993. The intent of the survey was to obtain information about Canadian palliative care nurses's perceptions of practice and professional issues. Eighty percent of respondents believed that palliative care nurses should form a palliative care nurses’ organization, with the majority recommending that this occur under the auspices of the Canadian Palliative Care Association. Key issues of importance to palliative care nurses were identified. The two major issues of concern were (a) the need to develop standards of practice and (b) educational needs of palliative care nurses. Respondents also emphasized the importance of maintaining and fostering an interdisciplinary approach to palliative care. Results of this survey are to be further discussed at the Sixth Canadian Palliative Care Association Conference to be held in Halifax in October 1995.

Spiritual distress: symptoms, quality of life and hospital utilisation in home-based palliative care

2021 ◽  
pp. bmjspcare-2021-003090
Author(s):  
Andre Cipta ◽  
Bethany Turner ◽  
Eric C Haupt ◽  
Henry Werch ◽  
Lynn Reinke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Symptom Burden ◽  
Well Being ◽  
Spiritual Distress ◽  
Home Based ◽  
Edmonton Symptom Assessment Scale ◽  
Hospital Utilisation ◽  
Mental Well Being

ObjectivesThe purpose of this study was to use a spiritual screening question to quantify the prevalence of spiritual distress (SD) in a large cohort of seriously ill patients at admission to home-based palliative care (HBPC) and to examine the associations between SD with symptom burden, quality of life and hospital-based utilisation up to 6 months after admission to HBPC.MethodsData for this cohort study (n=658) were drawn from a pragmatic comparative-effectiveness trial testing two models of HBPC. At admission to HBPC, SD was measured using a global question (0–10-point scale: none=0; mild=1–4; moderate-to-severe=5+); symptoms and quality of life were measured with the Edmonton Symptom Assessment Scale (ESAS) and PROMIS-10. Hospital utilisation was captured using electronic records and claims. Median regression and proportional hazard competing risk models assessed the association between SD with symptoms and quality of life, and hospital utilisation, respectively.ResultsNearly half of the patients/proxies reported some level of SD. Increasing SD was significantly associated with higher symptom burden (increase of 7–14 points on ESAS) and worse mental well-being (decrease of 2.7 to 4.6 points on PROMIS-10-mental) in adjusted models. Compared with patients/proxies who reported no SD, those with at least some level of SD were not at increased risk for hospital-based utilisation over a median follow-up period of 2 months.ConclusionWhile SD is cross-sectionally associated with worse symptoms and mental well-being, it did not predict downstream hospital-based utilisation. Our results highlight the importance of assessing for and managing SD in patients with serious illness.

Lymphedema Management

2019 ◽  
pp. 238-250
Author(s):  
Mei R. Fu ◽  
Bonnie B. Lasinski ◽  
Janet H. Van Cleave ◽  
Charles P. Tilley
Keyword(s):  
Palliative Care ◽  
Quality Care ◽  
Well Being ◽  
Clinical Settings ◽  
Major Health Problem ◽  
Incurable Disease ◽  
Appropriate Therapy ◽  
And Control ◽  
Medical Advances

Nurses are the ideal resource for providing and improving quality care for patients suffering from lymphedema because they have access to large, diverse patient populations. Lymphedema or abnormal swelling is seen regularly in palliative and acute care settings. Lymphedema is a major health problem affecting thousands of individuals worldwide, yet it is often overlooked or neglected despite its capacity to cause pain and multiple distressing symptoms as well as to impair patients’ physical, functional, social, sexual, and affective well-being. Even with modern medical advances, lymphedema remains a lifelong, incurable disease requiring ongoing attention, appropriate therapy, and long-term management. Palliative care to alleviate symptoms and control swelling is the ultimate goal for lymphedema treatment and management. This chapter prepares nurses to understand, assess, and manage lymphedema in various clinical settings, including acute, outpatient, community, and palliative care.

A positive psychology study and intervention on the well-being of French PhD students in biology

2017 ◽  
Author(s):  
Gabriel Marais ◽  
Rebecca Shankland ◽  
Pascale Haag ◽  
Robin Fiault ◽  
Bridget Juniper
Keyword(s):  
Mental Health ◽  
Positive Psychology ◽  
Large Fraction ◽  
Reference Sample ◽  
Well Being ◽  
Attrition Rates ◽  
Human Costs ◽  
The Uk ◽  
And Control ◽  
Health And Well Being

In France, little data are available on mental health and well-being in academia, and nothing has been published about PhD students. From studies abroad, we know that doing a PhD is a difficult experience resulting in high attrition rates with significant financial and human costs. Here we focused on PhD students in biology at university Lyon 1. A first study aimed at measuring the mental health and well-being of PhD students using several generalist and PhD-specific tools. Our results on 136 participants showed that a large fraction of the PhD students experience abnormal levels of stress, depression and anxiety, and their mean well-being score is significantly lower than that of a British reference sample. French PhD student well-being is specifically affected by career uncertainty, perceived lack of progress in the PhD and perceived lack of competence, which points towards possible cultural differences of experiencing a PhD in France and the UK. In a second study, we carried out a positive psychology intervention. Comparing the scores of the test and control groups showed a clear effect of the intervention on reducing anxiety. We discuss our results and the possible future steps to improve French PhD students’ well-being.

Social Capital and Sustainable Health Care: An Analysis of Community Based Palliative Care Model of Kerala

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdul Azeez. E.P
Keyword(s):  
Social Capital ◽  
Palliative Care ◽  
Social Services ◽  
Social Inclusion ◽  
Well Being ◽  
Vital Role ◽  
Voluntary Organizations ◽  
Community Based ◽  
The Social ◽  
Palliative Care Units

Social Capital is the most crucial asset which significantly influence the efficacy and resilience of any community. Social capital is a dependent variable that depends upon the competence and coherence of the individuals in the community and mode of social relationships, trust and networks they maintain. It is one of the most sustainable social resources that originate from human relations and results on the mutual support of people. Utilization of Social capital has a wide applicability in the process of social inclusion, especially in dealing with the vulnerable and disadvantaged sections in the community itself. Voluntary organizations are very keen to utilize the social capital for community/social services and community development in a sustainable manner. Community based de-institutionalized Palliative Care is one of the foremost among such organizations that made social capital in a strategic way for social inclusion and community well being. This paper analyses the extent to which different elements of social capital helps in initiating the sustainable community based palliative care movement by assessing the unique intervention strategies carried out by the palliative care. This paper explores conceptual questions of how social capital and voluntary community based services are correlated. A case study method was adopted for the study in which ten palliative care units were analyzed. The results show that a number of social capital elements are playing a vital role in the sustainability of community palliative care movement in Kerala.

Diagnosis, assessment, and treatment of depression in advanced disease

2018 ◽  
Author(s):  
Matthew Hotopf
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Antidepressant Treatment ◽  
Population Level ◽  
Care Staff ◽  
Care Services ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Palliative Care Services ◽  
Key Issues

Depression in palliative care is common, under-recognised and has significant impacts for sufferers. There are effective treatments but often a shortage of staff to provide them. This chapter sets out a number of key issues to consider when assessing and treating individual patients and considers the way in which palliative care services can innovate to provide a population level response to depression. Palliative care staff can be trained to deliver basic depression care and follow simple protocols to initiate, monitor and adjust antidepressant treatment. These approaches have been tested in trials in cancer care but the challenge is to take these approaches from research trials conducted in centres of excellence with good resources, to other settings.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

scholarly journals DESIGN FOR CONTINUOUS USE OF PRODUCT-SERVICE SYSTEMS: A CONCEPTUAL FRAMEWORK

2021 ◽  
Vol 1 ◽  
pp. 983-992
Author(s):  
Yutaro Nemoto ◽  
Hitesh Dhiman ◽  
Carsten Röcker
Keyword(s):  
Conceptual Framework ◽  
Well Being ◽  
Service Systems ◽  
Customer Acceptance ◽  
Product Service ◽  
Value Propositions ◽  
Conceptual Study ◽  
And Control ◽  
Continuous Use ◽  
Product Service Systems

AbstractProduct-service systems (PSSs) have attracted researchers in engineering design for the past decades. Recent advances in digital technologies have expanded the potential functionalities that PSSs could deliver and designers' repertoire of tools and techniques to make new value propositions. The key to the success of new value propositions is to achieve customer acceptance and continuous use. However, little is known about the precise routes by which customers accept and use PSSs over time and its dynamics. This conceptual study aims to provide an enhanced view of customer acceptance and continuous use of PSSs by integrating multiple theories and literature streams. In this paper, we suggest three propositions based on the key concepts found in our literature review—well-being, trust and control—, and illustrate a conceptual framework that represents the dynamics of customer acceptance and continuous use of PSSs. Based on the proposed framework, we outline further research questions that could advance our knowledge about design for continuous use of PSSs.

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