End-stage pulmonary disease

2007 ◽  
pp. 99-102
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Physical Symptoms ◽  
Curative Treatment ◽  
Total Care ◽  
End Stage ◽  
Spiritual Problems

End-stage pulmonary disease 100 The WHO defines palliative care as the active total care of patients whose disease is not responsive to curative treatment. The goal of palliative care is achievement of best quality of life for patients and their families. It includes control of pain and other physical symptoms as well as care of psychological, social and spiritual problems....

Palliative care in non-malignant respiratory disease

2010 ◽  
Author(s):  
Max Watson ◽  
Caroline Lucas ◽  
Andrew Hoy ◽  
Jo Wells
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Respiratory Disease ◽  
Pleural Disease ◽  
End Stage

This chapter covers the potential requirement for palliative care in end-stage pulmonary disease, terminal symptoms, quality of life, and survival of patients with end-stage pulmonary disease, chronic bronchitis and emphysema, and pneumothorax and pleural disease.

scholarly journals Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025692 ◽  
Author(s):  
Corita R Grudzen ◽  
Deborah J Shim ◽  
Abigail M Schmucker ◽  
Jeanne Cho ◽  
Keith S Goldfeld
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Palliative Care ◽  
Randomised Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Randomised Controlled ◽  
End Stage

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

scholarly journals Pain Relief as an Integral Part of the Palliative Care

2018 ◽  
Vol 6 (4) ◽  
pp. 739-741 ◽  
Author(s):  
Marija Sholjakova ◽  
Vesna Durnev ◽  
Andrijan Kartalov ◽  
Biljana Kuzmanovska
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Pain Relief ◽  
Pain Control ◽  
Palliative Therapy ◽  
The Other ◽  
Spiritual Problems ◽  
Active Care ◽  
Different Origin

BACKGROUND: Palliative therapy represents active care for patients whose illness has such nature that is not responding to the curative treatment.  The palliative care aims to provide comfort and prevention from the suffering of the patients at the end of their life. Treatment of the pain presents an important integral part of palliative care.AIM: This article aims to discuss and answer to some of the analgesic regimes and therapeutic dilemmas.RESULTS: Pain control, in addition to the other treatments such as alleviation of psychological, sociological and spiritual problems, has a priority. The proper pain management can achieve a better quality of life for the patients and their families.CONCLUSION: It can be concluded that because of the different origin of the pain, the use of analgesic therapy should be individualised and adapted to the real need of every person. Finally, only a good organisation and institutionalisation of the palliative care in one society could permit better prevention of suffering at the end of the life.

scholarly journals Severe symptoms and very low quality-of-life among outpatients newly diagnosed with advanced cancer: data from a multicenter cohort study

2020 ◽  
Vol 28 (11) ◽  
pp. 5547-5555
Author(s):  
Waldemar Siemens ◽  
Stefan S. Schönsteiner ◽  
Claudia Lorena Orellana-Rios ◽  
Ulrike Schaekel ◽  
Jens Kessler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cohort Study ◽  
Advanced Cancer ◽  
Physical Symptoms ◽  
Newly Diagnosed ◽  
Multicenter Cohort Study ◽  
European Organization ◽  
Multicenter Cohort

Abstract Purpose The aim of this study was to identify symptoms of severe intensity or very low scores for quality of life (QoL) domains in newly diagnosed outpatients with advanced cancer. Methods This multicenter cohort study from a state-wide palliative care network included adult outpatients with advanced cancer diagnosed within the preceding 8 weeks from four comprehensive cancer centers (DRKS00006162, registered on 19 May 2014). We used the Palliative Outcome Scale (POS), Hospital Anxiety and Depression Scale, and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30. For each questionnaire, cut-off scores defined symptoms and QoL domains that were considered “severe” or “very low.” Results Of 3155 patients screened, 481/592 (81.3%) were analyzed (mean age 62.4; women n = 245, 50.9%). We identified 324/481 (67.4%) patients experiencing at least one severe symptom or a very low QoL domain (median 2; range 0 to 16). Role functioning (n = 180, 37.4%), fatigue (n = 162, 33.7%), and social functioning (n = 126, 26.2%) were most commonly affected. QoL was very low in 89 patients (18.5%). Women experienced more anxiety symptoms, fatigue, and had lower POS scores. Patients often mentioned physical symptoms and fears of adverse events resulting from disease-modifying therapies (e.g., chemotherapy) as most relevant problems. Conclusions Already within the first 8 weeks after diagnosis, the majority of patients reported at least one severe symptom or a very low QoL domain. Gender differences were evident. The findings illustrate the value of early routine assessment of patient burden and the development of multi-professional and interdisciplinary palliative care.

Palliative Care in End-Stage Chronic Obstructive Pulmonary Disease

2018 ◽  
Author(s):  
Linh My Thi Nguyen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Poor Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
End Stage

Patients with end-stage chronic obstructive pulmonary disease (COPD) experience high symptom burden due to severe dyspnea, fatigue, anxiety, depression, disability, and social isolation, resulting in poor quality of life. The caregiving burden for the family is also severe. Despite high symptom burden, because of limited access and difficulty with prognostication, the quality of care for patients with end-stage COPD who receive palliative care compares poorly to the care received by patients with cancer, and the proportion of COPD patients who receive palliative care is much lower than that of cancer patients. Therefore, patients with COPD receive less palliative care and die following more aggressive treatments at the end of life compared to patients with lung cancer, despite having the same preferences for palliative care. This chapter discusses the key issues related to end-stage COPD, including symptom assessment, management, and hospice eligibility.

Palliative Care in the Last Hours of Life

2018 ◽  
Author(s):  
Ahsan Azhar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Communication Skills ◽  
Physical Symptoms ◽  
Accurate Assessment ◽  
Effective Management ◽  
Relief Of Suffering ◽  
Key Aspects

Patients with life-limiting illnesses often experience severe distressing psychosocial and physical symptoms during the last hours of life. Prompt relief of suffering is paramount; hence, accurate assessment and effective management of symptoms, along with excellent communication skills, help clinicians not only relieve patients’ distressing symptoms but also provide education about end of life along with psychosocial and emotional support to the caregivers. The aim is for improving the quality of life of patients and caregivers and reduce the incidence of complicated grief especially among the over-whelmed caregivers. This chapter reviews the key aspects of care of patients in the last hours of life.

Palliative care in old age

2001 ◽  
Vol 11 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Raymond SK Lo ◽  
Jean Woo
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Palliative Medicine ◽  
Holistic Approach ◽  
Physical Symptoms ◽  
World Health ◽  
Team Approach ◽  
Curative Therapy ◽  
Care And Support

What is palliative medicine?In 1987, the Royal College of Physicians recognized palliative medicine as a specialty, defining it as ‘the study and management of patients with far-advanced disease for whom the prognosis is limited and the focus of care is quality of life’. In 1990, the World Health Organization added its definition, ‘the active and total care of a person whose condition is not responsive to curative therapy’. The aim of palliative medicine is to control pain and other physical symptoms, together with integration of psychological, social, spiritual care and support. The ultimate goal is to help patients to achieve their best quality of life. Palliative medicine places emphasis on a holistic approach, offering care and support not just for patients but also for their families. Palliative medicine hence requires an interdisciplinary team approach. With the co-ordinated efforts of all disciplines (such as doctors, nurses, therapists, social workers, clinical psychologists, dieticians, pastoral care workers and volunteers), patients can be supported in living their remaining lives as actively as possible, and families can be assisted in coping with illness, death and bereavement. Palliative care neither intends to postpone death nor does so, but affirms life and regards dying as a normal process. When a patient faces an incurable illness, it is incumbent on the palliative care team to provide the best treatment and care, adding life to days when days cannot be added to life.

scholarly journals Pengaruh Perawatan Paliatif Terhadap Peningkatan Kualitas Hidup Penderita Karsinoma Nasofaring Stadium Lanjut di RSUP Dr. Kariadi Semarang

2019 ◽  
Vol 6 (2) ◽  
pp. 125-130
Author(s):  
Muyassaroh Muyassaroh ◽  
Tri Lestari
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Nasopharyngeal Carcinoma ◽  
T Test ◽  
Screening Criteria ◽  
Key Word ◽  
Before And After ◽  
Observational Cohort ◽  
End Stage

Background: Palliative care can improve the quality of life for patients with end stage nasopharyngeal carcinoma (NPC). Palliative care includes handling nutrition, relieving pain and reducing the severity of symptoms from the disease, side effects of therapy or other complaints. It also improve psychological, social and spiritual aspects. The purpose of this study was to analyze the effect of palliative care on improving the quality of life for end stage NPC patients. Methods: Observational cohort study in 15-70 years old NPC patients included in the screening criteria for palliative care (total score 4). The sample was divided into 2 groups, 20 sampels per group. Quality of life was assessed with modified Gill scale questionnaire. Data was analyzed with t test. Results: The quality of life of NPC patients increased after palliative care (score 31,8 to 35,6). Decreased in groups without palliative care (score 33,0 to 30,9). Statistical analysis found significant differences between before and after palliative care (p = 0.055). Conclusion: Palliative care improves the quality of life for end stage NPC patients. Key word: Quality of life, Palliative care, Nasopharyngeal carcinoma   Latar belakang : Perawatan paliatif dapat meningkatkan kualitas hidup penderita karsinoma nasofaring (KNF) stadium lanjut. Perawatan paliatif meliputi penanganan nutrisi, menghilangkan nyeri dan mengurangi keparahan gejala yang timbul akibat penyakit tersebut ataupun akibat efek samping terapi atau keluhan lain yang tidak lagi responsif terhadap terapi kuratif, serta mengupayakan  perbaikan  dalam  aspek psikologis, sosial dan spiritual. Tujuan penelitian ini adalah menganalisis pengaruh perawatan paliatif terhadap peningkatan kualitas hidup penderita KNF stadium lanjut. Metode : Penelitian kohort observasional pada penderita KNF stadium lanjut usia 15 – 70 tahun yang masuk dalam kriteria penapisan perawatan paliatif (total skor 4). Sampel dibagi menjadi 2 kelompok yaitu kelompok perlakuan dan kelompok kontrol. Besar sampel ditentukan sebanyak 20 tiap kelompok. Kualitas hidup dinilai dengan kuesioner modifikasi skala mc Gill. Analisis data dengan Uji t test. Hasil : Kualitas hidup penderita KNF meningkat setelah dilakukan perawatan paliatif (skor 31,8 menjadi 35,6). Menurun pada kelompok tanpa perawatan paliatif (skor 33,0 menjadi 30,9). Analisis statistik didapatkan perbedaan bermakna antara sebelum dan sesudah dilakukan perawatan paliatif p=0,055.  Simpulan : Perawatan paliatif meningkatkan kualitas hidup penderita KNF stadium lanjut. Key word : Kualitas hidup, Perawatan paliatif, Karsinoma Nasofaring

scholarly journals Clown Care In A Palliative Care Unit: A Useful Paradox? A Preliminary Pilot Study Involving Questionnaires And Text Analysis.

2021 ◽  
Author(s):  
Laoridi Aouridi-Héritier ◽  
Sophie Alonzo ◽  
Pascale Fabbro-Peray ◽  
Marion Guinamard ◽  
Sylvie Blanchard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Pilot Study ◽  
Physical Symptoms ◽  
Palliative Care Unit ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Life Questionnaire ◽  
The Impact

Abstract Title: The impact of Clown Therapy in a Palliative Care Unit (PCU); a pilot studyBackground: Although several studies on clown therapy have demonstrated benefits for children and the elderly, few studies exist on its impact on quality of life in adult terminal patients.We devised this monocentric, prospective, descriptive pilot study, covering both quantitative and qualitative aspects, to test the hypothesis that “clowning” in the PCU would help to improve the quality of life of patients, and benefit those accompanying them and their carers.Methods: 30 terminal patients [age range 63-79, 19 women, 11 men] from the palliative care unit at Nîmes University Hospital were included in the study from 31/03/2016 to 08/11/2016. All had given written informed consent. 2 clowns visited the patients and their companions, inviting them to take part in 15 to 30-minute improvised role-plays to prepare them for the inevitable separation. Primary outcome measures for the impact of the clowns’ interventions were: The Edmonton Symptom Assessment System evaluating patients’ physical symptoms and the McGill Quality of Life Questionnaire assessing patients’ quality of life. The secondary outcome measure was Alceste textual data analysis software to analyse semi-structured interviews held with patients, their companions and carers. Results: However long the clown’s intervention, the ESAS scores indicated a significant improvement in nausea (p=0.0248) and dyspnea (p=0.0476). Scores for depression (p=0.0160) also showed an improvement. A slight difference in the scores for anxiety (p=0.0900) and drowsiness (p=0.0812) was also observed. 2 days after the clowns’ intervention, the Mc Gill scores revealed a significantly greater physical quality of life (p=0.0044) and a very slight increase in the patients’ overall quality of life (p=0.0807). Results of the lexical analysis with Alceste revealed benefits for all those involved and gave an indication for better patient management at the PCU. Conclusions: This pilot study demonstrating the impact of “clowning” on various physical and mental symptoms in adult patients indicates the benefits of such interventions for patients, their companions and carers. Although the usefulness of clowns for children with life-threatening diseases is clear, the results obtained with our study clearly indicate the benefits of these interventions in adult, end-of-life patients. Further studies would be required to confirm these findings.Date of first registration : 20/11/2015Trial registration: ClinicalTrials.gov ID: NCT02610452This research was registered under the following reference : IDRCB 2015-A00719-40 and approved by the local committee for the protection of persons, CPP Sud-Méditerranée III-Nîmes on November 6th, 2015 under the reference 2015.06.03.

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