Palliative medicine: Historical record and challenges that remain

2016 ◽  
Author(s):  
David Clark
Keyword(s):  
Palliative Care ◽  
Palliative Medicine ◽  
Evidence Base ◽  
Central Place ◽  
Historical Record ◽  
Life Threatening Illness ◽  
The Face ◽  
Life Threatening ◽  
Global Coverage

With its growing recognition by the early decades of the twentieth century, palliative medicine was moving from the margins to a more central place within medicine. Much had been achieved and there was growing evidence of palliative care’s successes around the world. At the same time, there were ongoing concerns about the quality of the evidence base to support its practices. There were questions about the relationship between palliative care and end-of-life care. There was also the challenge of delivering good care to all who might need it in the face of serious and life-threatening illness in an era of population growth and ageing. There seemed to be many ways to conceptualize and deliver palliative care. Would this lead to global coverage and spread, and what would be the particular role of palliative medicine within the process? This chapter concludes with reflections on progress to date and challenges for the future.

scholarly journals Psychological tool for role of spirituality in palliative care- a study

2017 ◽  
Vol 5 (01) ◽  
Author(s):  
Daksha Kala
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Face Validity ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Readiness To Adopt ◽  
Spiritual Struggles ◽  
Test Retest Reliability ◽  
Development And Validation

The process undertaken for development and validation of a tool to measure spirituality in palliative care included sample comprised of 70 participants (30 terminally ill patients and 40 caregivers and family members of the terminally ill). The spirituality scale has 44 items. It is a multidimensional 5 point Likert type scale. Content validity, face validity, construct validity and test-retest reliability of the tool were ascertained and a reliable and valid scale of spirituality was developed. The diagnosis of chronic or life- threatening illness can lead to spiritual struggles among patients and their families. The aim of the tool is to measure one's inclination towards spirituality, readiness to adopt spirituality in life and highlight the benefits of the same in palliative care.

Assessment Of The Knowledge Of Palliative Medicine Among General Practitioners

2021 ◽  
Author(s):  
Magdalena Osowicka ◽  
Anna Wyszadko ◽  
Piotr Mróz ◽  
Agnieszka Gorzewska
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Palliative Medicine ◽  
Working Hours ◽  
Bad News ◽  
Individual Treatment ◽  
Multiple Choice Questions ◽  
Life Threatening Illness ◽  
Correct Definition ◽  
Important Activity

Abstract Background: Palliative patients who stay at home require exceptional medical care provided by General Practitioners (GPs) in conjunction with specialists in palliative medicine. To ensure effective treatment, proper cooperation between them is essential. Aim: An assessment of the knowledge and attitudes of GPs towards palliative medicine Design: The research was based on a survey questionnaire, consisting of 8 multiple choice questions. A total of participated anonymously in the survey. The data analysis included descriptive statistics and logistic regression. Participants: 83 GPs from the Pomeranian Region, 58 female and 25 male practitioners. Results: 59% of respondents defined palliative care as an activity that improves the quality of life of patients and their families facing problems related to a life-threatening illness. The coordination of the work of the palliative team was the most important task for the specialist in palliative medicine (58% of respondents). The majority stated that the most important activity was the prescription of painkillers (86%) and 84% found that being available during business hours was the most important. The next most important activity was delivering bad news (42% of respondents). Conclusions: Most of the GPs knew the correct definition of palliative care and the basics of pain management. Experienced physicians declared a lower willingness to be available during working hours and less often delivered bad news to terminal patients, compared to their younger colleagues. Individual treatment planning (98% of respondents) and reducing antibiotic therapy seem to be the most important aspects in pharmacotherapy.

Effects of a support group programme for patients with life-threatening illness during ongoing palliative care

2012 ◽  
Vol 27 (3) ◽  
pp. 257-264 ◽  
Author(s):  
Anette Henriksson ◽  
Kristofer Årestedt ◽  
Eva Benzein ◽  
Britt-Marie Ternestedt ◽  
Birgitta Andershed
Keyword(s):  
Palliative Care ◽  
Support Group ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Group Programme

scholarly journals A Novel Narrative E-Writing Intervention (NeW-I) for Parents of Children with Chronic Life-Threatening Illnesses: Protocol for an Open-Label Randomized Controlled Trial

2019 ◽  
Author(s):  
Andy Hau Yan Ho ◽  
Oindrila Dutta ◽  
Geraldine Tan-Ho ◽  
Toh Hsiang Benny Tan ◽  
Casuarine Low Xinyi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Family Caregivers ◽  
Controlled Trial ◽  
Well Being ◽  
Writing Intervention ◽  
Open Label ◽  
Randomized Controlled ◽  
Life Threatening Illness ◽  
Spiritual Well Being ◽  
Life Threatening

Abstract Background: Conventionally, psycho-socio-spiritual interventions for parents of children with chronic life-threatening illness begin post child loss. Pre-loss interventions addressing anticipatory grief can improve holistic well-being and grief outcomes among family caregivers of dying patients. Globally, palliative care strives to holistically support patients and their caregivers at the end-of-life. However, inadequacies exist both globally and in Singapore in providing culturally sensitive psycho-socio-spiritual support to parents whose children need pediatric palliative services. Aim: A novel evidence-based Narrative e-Writing Intervention (NeW-I) is developed to address this gap. NeW-I is a strength-focused, meaning-oriented and therapist-facilitated mobile app and web-based counseling platform that aims to enhance quality of life, spiritual well-being, hope and perceived social support, and reduce depressive symptoms, caregiver burden and risk of complicated grief among parents facing their child’s chronic life-threatening illness. Methods: The design of NeW-I is informed by an international systematic review and a Singapore-based qualitative inquiry on the lived experience of bereaved parents of children with chronic life-threatening illness. The online NeW-I platform and the relative anonymity it offers to participants is sensitive to the unique cultural needs of Asian family caregivers who are uncomfortable with emotional expression even during times of loss and separation. Together with four local pediatric palliative care providers, NeW-I is implemented in Singapore as an open-label pilot randomized controlled trial with 72 parents. Potential effectiveness of NeW-I and accessibility and feasibility of implementing and delivering the intervention are assessed. Discussion: NeW-I aspires to improve psycho-socio-spiritual well-being of parents facing their child’s chronic life-threatening illness through a structured cyber-counseling platform, thereby enhancing holistic pediatric palliative care and parental bereavement support services. Findings from this pilot study will inform the development of a standardized NeW-I protocol and further research to evaluate the efficacy of NeW-I in Singapore and in other Asian communities around the world.

Holding Secrets While Living With Life-Threatening Illness: Normalizing Patients’ Decisions to Reveal or Conceal

2019 ◽  
Vol 30 (5) ◽  
pp. 655-665 ◽  
Author(s):  
Anne Bruce ◽  
Rosanne Beuthin ◽  
Laurene Sheilds ◽  
Anita Molzahn ◽  
Kara Schick-Makaroff
Keyword(s):  
Health Care Providers ◽  
Narrative Analysis ◽  
Social Practice ◽  
Narrative Approach ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Health And Illness ◽  
Life Threatening ◽  
Normative Practice

Communicating openly and directly about illness comes easily for some patients, whereas for others fear of disclosure keeps them silent. In this article, we discuss findings about the role of keeping secrets regarding health and illness. These findings were part of a larger project on how people with life-threatening illnesses re-story their lives. A narrative approach drawing on Frank’s dialogical narrative analysis and Riesman’s inductive approach was used. Interviews were conducted with 32 participants from three populations: chronic kidney disease, HIV/AIDS, and cancer. Findings include case exemplars which suggest keeping secrets is a social practice that acts along continuums of connecting–isolating, protecting–harming, and empowering–imprisoning. Keeping secrets about illness is a normative practice that is negotiated with each encounter. Findings call health-care providers to rethink the role of secrets for patients by considering patient privilege, a person’s right to take the lead in revealing or concealing their health and illness experience.

The use of personal narratives in hospital-based palliative care interventions: An integrative literature review

2019 ◽  
Vol 33 (10) ◽  
pp. 1255-1271 ◽  
Author(s):  
Stine Gundtoft Roikjær ◽  
Malene Missel ◽  
Heidi Maria Bergenholtz ◽  
Mai Nanna Schønau ◽  
Helle Ussing Timm
Keyword(s):  
Palliative Care ◽  
Personal Narratives ◽  
Hospital Setting ◽  
Life Review ◽  
Eligibility Criteria ◽  
Theoretical Understanding ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Care Practices ◽  
Critical Appraisal Skills

Background: People living with life-threatening illness experience unmet existential needs despite the growing research and clinical field of palliative care. Narrative interventions show promise in managing these problems, but more knowledge is needed on the characteristics of narrative interventions and the feasibility of using personal narratives in a hospital. Aim: To review the literature on personal narratives in hospital-based palliative care interventions and to strengthen palliative care practices. Design: We conducted a systematic integrative review with qualitative analysis and narrative synthesis in accordance with PRISMA where applicable (PROSPERO#:CRD42018089202). Data sources: We conducted a systematic search in PubMed, Embase, Scopus, Cinahl, SocINDEX and PsychInfo for primary research articles published until June 2018. We assessed full-text articles against the eligibility criteria followed by a discussion of quality using the Critical Appraisal Skills Programme. Results: Of 480 articles, we found 24 eligible for this review: 8 qualitative, 14 quantitative and 2 mixed methods. The articles reported on dignity therapy, legacy building, outlook, short-term life review and life review. Data analysis resulted in five themes: core principles, theoretical framework, content of narrative, outcome and, finally, acceptability and feasibility. Conclusion: Various types of systematic palliative care interventions use personal narratives. Common to these is a shared psychotherapeutic theoretical understanding and aim. Clinical application in a hospital setting is both feasible and acceptable but requires flexibility regarding the practices of the setting and the needs of the patient.

Palliative and Supportive Care: Introducing a new international journal; The “Care” Journal of Palliative Medicine

2003 ◽  
Vol 1 (1) ◽  
pp. 1-2 ◽  
Author(s):  
William Breitbart
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
End Of Life ◽  
Palliative Medicine ◽  
Continuum Of Care ◽  
Educational Resource ◽  
Delivery Of Care ◽  
Life Threatening

We are extremely proud and gratified to present the inaugural issue of our new international palliative care journal, Palliative & Supportive Care (P&SC). P&SC is the first international journal of palliative medicine that focuses on the psychiatric, psychosocial, spiritual, existential, ethical, philosophical, and humanities aspects of palliative care. The journal's aim is to serve as an educational resource for practitioners from a wide array of disciplines engaged in the delivery of care to those with life-threatening illnesses along the entire continuum of care, from diagnosis to the end of life. The journal also seeks to both stimulate and provide a forum for research in the psychiatric, psychosocial, and spiritual components of palliative care.

Psychosocial Palliative Care

2014 ◽  
Author(s):  
International Psycho-Oncology Society
Keyword(s):  
Palliative Care ◽  
Cultural Sensitivity ◽  
Symptom Control ◽  
Physical Symptom ◽  
Global Perspective ◽  
Life Threatening Illness ◽  
Online Resource ◽  
Life Threatening ◽  
Psychiatric Complications ◽  
And Training

This online resource guides the psycho-oncologist through the most salient aspects of effective psychiatric care of patients with advanced illnesses. It reviews basic concepts and definitions of palliative care and the experience of dying, the assessment and management of major psychiatric complications of life-threatening illness, including psychopharmacologic and psychotherapeutic approaches, and covers issues such as bereavement, spirituality, cultural sensitivity, communication and psychiatric contributions to common physical symptom control. A global perspective on death and palliative care is taken throughout, and an appendix provides a comprehensive list of international palliative care resources and training programs.

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