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.

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....

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.

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.

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 Improving the quality of life of people with advanced respiratory disease and severe breathlessness

Breathe ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 198-215 ◽  
Author(s):  
Sara Booth ◽  
Miriam J. Johnson
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Respiratory Disease ◽  
Symptom Management ◽  
Best Practice ◽  
Symptom Burden ◽  
Poor Quality ◽  
List Type ◽  
The Impact

Advanced respiratory disease imposes a greater symptom burden than many cancers but not does have comparable recognition of the need for supportive and palliative care or the infrastructure for its systematic delivery. Consequently, many people with advanced respiratory disease (and those closest to them) have a poor quality of life, disabled by chronic breathlessness, fatigue and other symptoms. They are socially isolated by the consequences of long-term illness and are often financially impoverished. The past decade has seen an increasing realisation that care for this group must improve and that symptom management must be prioritised. Clinical guidelines recommend person-centred care, including access to supportive and palliative care as needed, as part of standard medical practice. Advanced lung disease clinics and specialist breathlessness services (pioneered within palliative care) are developing within respiratory medicine services but are provided inconsistently.This review covers the comprehensive assessment of the patient with advanced respiratory disease, the importance of supporting carers and the current best practice in the management of breathlessness, fatigue and cough. It also suggests ways to incorporate person-centred care into the general respiratory clinic, assisted by better liaison with specialist palliative and primary care. Emerging evidence shows that excellent symptom management leads to better clinical outcomes and reduces inappropriate use of emergency medical services.Key pointsPeople living with advanced respiratory disease and severe chronic breathlessness (and those closest to them) have a poor quality of life.Chronic breathlessness is a disabling symptom, and acute-on-chronic/episodic breathlessness is frightening to experience and observe.Chronic breathlessness imposes profound physical limitations and psychosocial burdens on those suffering from it or living with someone experiencing it.Fatigue and cough are two other cardinal symptoms of advanced respiratory disease, with very detrimental effects on quality of life.The impact of all these symptoms can be alleviated to a variable extent by a predominantly non-drug complex intervention.Many of the interventions are delivered primarily by allied health or nursing professionals.Doctors, nurses and other health professionals also need to play an active part in promoting quality of life as part of excellent medical care.A person-centred, psychologically informed approach is needed by all clinicians treating patients with advanced respiratory disease.Educational aimsTo give specialist respiratory clinicians practical clinical tools to help improve the quality of life of their patients with advanced respiratory disease and chronic breathlessness.To outline the evidence base for these interventions with reference to definitive sources.To highlight the importance of person-centred care in people with respiratory disease at all stages of illness.

scholarly journals Palliative Care in Patients with End-Stage Renal Disease: A Meta Synthesis

2021 ◽  
Vol 18 (20) ◽  
pp. 10651
Author(s):  
Nur Fithriyanti Imamah ◽  
Hung-Ru Lin
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Present Condition ◽  
Stage Renal Disease ◽  
End Stage ◽  
Positive Outlook

End-stage renal disease is the last stage of chronic kidney disease and is associated with a decreased quality of life and life expectancy. This study aimed to explore palliative care with end-stage renal disease. Qualitative meta-synthesis was used as the study design. The search was performed for qualitative studies published until June 2021 and uses reciprocal translation and synthesis of in vivo and imported concepts. Five themes were included: Struggling to face the disease, experiencing deterioration, overcoming the challenges of dialysis, leading to a positive outlook, and preparing for the end of life. In facing chronic disease with life-limiting potential, patients experienced some negative feelings and deterioration in their quality of life. Adaptation to the disease then leads patients to a better outlook through increased spirituality and social status. Furthermore, by accepting the present condition, they started to prepare for the future. Increasing awareness of mortality leads them to discuss advance care (ACP) planning with healthcare professionals and families.

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