Palliative care

Background 160 Interface between cancer and palliative care services 162 Caring for dying people 164 Bereavement 166 Models of bereavement 167 Support for the bereaved 168 The practice of palliative care aims to enhance the quality of life of people experiencing life-threatening illnesses and their families. The principles on which palliative care is based suggest that it...

2013 ◽  
Vol 2 (2) ◽  
pp. 5-15
Author(s):  
Riawati Jahja

Trials have demonstrated improvement in patients’ quality of life through palliative care services (PCS). However, many of these trials are limited by their research methodologies. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched to conduct a systematic review of review articles related to PCS from January 2001 to December 2011. The paper examined evidence from studies on PCS that aimed to improve elderly patients’ end-of-life outcomes by i) systematically reviewing literature on models of palliative care (PC) delivery patients received; ii) exploring methodological issues surrounding recruitment of the patients, implementation of the studies and comparison of health care services; and iii) addressing the costs of care with/without a palliative program. Seventeen trials and three observational studies were selected from nine systematic review articles. Overall, early introduction of PC to patients following identification of their life-limiting conditions and needs re-quires an organized and coordinated care approach to ensure accessibility of these services. The ideal system that offers the potential of improving patients’ quality of life is one that is integrated, interdisciplinary and holistic. Dying is commonly institutionalized; however, providing outreach programs that allow patients to die at their place of wish, such as domiciliary care, offers the potential of addressing the issue of ever-increasing health-care expenditure for the aged. However, further investigation is needed to evaluate the cost effectiveness of these programs. Methodological problems and ethical issues surrounding the study of terminally-ill patients necessitate that researchers use a combination of observational studies and surveillance system over time. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15937 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 5-15


2019 ◽  
Author(s):  
Leslye Rojas-Concha ◽  
Maiken Bang Hansen ◽  
Morten Aagaard Petersen ◽  
Mogens Groenvold

Abstract Background: The assessment of patients’ quality of life (QOL) is essential when evaluating the outcome of palliative care; however, no instruments have been validated for measuring symptoms and QOL in patients receiving palliative care in Chile. We aimed to investigate the content validity of the EORTC Quality of Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL), replicating the methods used previously to shorten the EORTC Quality of Life Questionnaire Core 30 (QLQ-C30) for use among patients in palliative care.Methods: This cross-sectional study was conducted from October to November 2017 in four palliative care services. Patients with advanced cancer and health care professionals (HCPs) were invited to individual interviews to determine the relevance, appropriateness and relative importance of the 30 items of the QLQ-C30 for evaluating the outcome of palliative care, and whether relevant additional issues should be included. Results: A total of 48 patients and 35 HCPs participated. The most important dimensions selected were pain, physical functioning, sleeping difficulties, emotional functioning, nausea/vomiting, fatigue, and social functioning. Qualitative data identified important additional issues not covered by the questionnaire such as satisfaction with care, emotions and psychological support, as well as linguistic issues in the dyspnea and constipation items. Conclusions: The EORTC QLQ-C15-PAL showed good content validity in the assessment of symptoms and QOL of advanced cancer patients; therefore, we recommend the use of this questionnaire in palliative care in Chile. Dyspnea and constipation items were revised by the EORTC group. More research is needed to add a social dimension for a comprehensive assessment of patients’ QOL.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Leslye Rojas-Concha ◽  
Maiken Bang Hansen ◽  
Morten Aagaard Petersen ◽  
Mogens Groenvold

Abstract Background The assessment of patients’ quality of life (QOL) is essential when evaluating the outcome of palliative care; however, no instruments have been validated for measuring symptoms and QOL in patients receiving palliative care in Chile. We aimed to investigate the content validity of the EORTC Quality of Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL), replicating the methods used previously to shorten the EORTC Quality of Life Questionnaire Core 30 (QLQ-C30) for use among patients in palliative care. Methods This cross-sectional study was conducted from October to November 2017 in four palliative care services. Patients with advanced cancer and health care professionals (HCPs) were invited to individual interviews to determine the relevance, appropriateness and relative importance of the 30 items of the QLQ-C30 for evaluating the outcome of palliative care, and whether relevant additional issues should be included. Results A total of 48 patients and 35 HCPs participated. The most important dimensions selected were pain, physical functioning, sleeping difficulties, emotional functioning, nausea/vomiting, fatigue, social functioning, lack of appetite, role functioning and constipation. Qualitative data identified important additional issues not covered by the questionnaire such as satisfaction with care, emotions and psychological support, as well as linguistic issues in the dyspnea and constipation items. Conclusions The EORTC QLQ-C15-PAL showed good content validity in the assessment of symptoms and QOL of advanced cancer patients; therefore, we recommend the use of this questionnaire in palliative care in Chile. Dyspnea and constipation items were revised by the EORTC group. More research is needed to add a social dimension for a comprehensive assessment of patients’ QOL.


Author(s):  
Wallace Chi Ho Chan ◽  
Raymond Kam Wing Woo ◽  
Denis Ka-Shaw Kwok ◽  
Clare Tsz Kiu Yu ◽  
Lawrence Man-Hon Chiu

Introduction This study aimed to examine the mental health of palliative care professionals in Hong Kong during the COVID-19 pandemic, the relationship of mental health with socio-demographic factors, and the impact of the pandemic on palliative care services. Methods A total of 142 palliative care professionals in Hong Kong participated in an online survey. The questionnaire includes measurements on depression, anxiety, perceived stress, post-traumatic stress, professional quality of life, items that measure the effect of COVID-19 on palliative care services, and one open-ended question for describing how the services were affected. Descriptive and multivariate regression analyses were conducted. Quantitative and qualitative data about the impact of COVID-19 on palliative care services were analyzed and triangulated using a mixed-methods approach. Results Up to 82%, 43%, and 42% of the participants felt moderately to highly stressed, anxious, and depressed, respectively, during the pandemic. Younger participants tended to have poorer mental health and professional quality of life. Around 82% felt stressed when communicating with patients and family members under the no-visiting policy during the pandemic. More than three-quarters of participants showed lack of confidence in the anti-epidemic policy of the government. Qualitative findings identified 3 themes affecting the provision of palliative care: 1. the tightening of restrictions on visitors; 2. the limited provision of services; and 3. staff deployment. Conclusions Appropriate responses are required to give extra support to palliative care professionals during the pandemic and facilitate their coping with the impact of COVID-19 on the provision of palliative care.


2021 ◽  
Vol 162 ◽  
pp. S145-S146
Author(s):  
Niyazi Kilic ◽  
Julia Ritchie ◽  
Ashley Haggerty ◽  
Emily Ko ◽  
Ashley Graul

2020 ◽  
Vol 30 (2) ◽  
pp. 144-146
Author(s):  
Melissa I. Owen ◽  
Lynne T. Braun ◽  
Rebekah J. Hamilton ◽  
Kathleen L. Grady ◽  
Rebecca A. Gary ◽  
...  

The purpose of this article is to describe palliative care incorporation within the care of heart transplant patients. Palliative care is a holistic approach to care that includes symptom management and goal setting to improve patients’ quality of life. Palliative care is designed to be used with patients who have chronic illness that impacts quality of life and should be incorporated early in the disease. All providers have a responsibility to be knowledgeable in palliative care approaches and to know when to refer a patient for specialty palliative care services. This article will describe palliative care, research study findings, and current professional guideline recommendations for patients. The article also describes challenges and barriers to the use of palliative care in heart transplant patients and strategies to address these challenges and barriers.


2018 ◽  
Vol 25 (6) ◽  
Author(s):  
C. Courteau ◽  
G. Chaput ◽  
L. Musgrave ◽  
A. Khadoury

Palliative care (pc) is a fundamental component of the cancer care trajectory. Its primary focus is on “the quality of life of people who have a life-threatening illness, and includes pain and symptom management, skilled psychosocial, emotional and spiritual support” to patients and loved ones. Palliative care includes, but is not limited to, end-of-life care. The benefits of early introduction of pc services in the care trajectory of patients with advanced cancer are well known, as indicated by improved quality of life, satisfaction with care, and a potential for increased survival. In turn, early referral of patients with advanced cancer to pc services is strongly recommended. So when, how, and why should patients with advanced cancer be referred to pc services? In this article, we summarize evidence to address these questions about early pc referral:■ What are the known benefits?■ What is the “ideal” pc referral timing?■ What are the barriers?■ Which strategies can optimize integration of pc into oncology care?■ Which communication tools can facilitate skillful introduction of pc to patients?


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