The Second Domain of Palliative Care

2018 ◽  
Author(s):  
E. Alessandra Strada
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Treatment Adherence ◽  
Psychological Factors ◽  
Physical Symptoms ◽  
Team Work ◽  
Advanced Illness ◽  
Interdisciplinary Work ◽  
Physical Suffering

This chapter proposes palliative psychology competencies in the second domain of palliative care: physical aspects of care. It discusses the importance of interdisciplinary work in assessment and management of pain and other physical symptoms. Palliative psychologists with the necessary knowledge, skills, and attitudes can contribute greatly to team work by identifying and managing psychological factors that can contribute to the patient’s physical suffering. This chapter also briefly describes relevant approaches to dyspnea and constipation. Clinical examples of pain assessment and intervention are provided based on real case scenarios. The basics of pharmacological approaches to pain management in advanced illness are discussed, in order to facilitate the role of palliative psychologists in promoting communication and treatment adherence. The use of integrative medicine modalities to improve physical symptoms is highlighted.

Spirituality in patients with advanced illness: The role of symptom control, resilience and social network

2016 ◽  
Vol 21 (12) ◽  
pp. 2765-2774 ◽  
Author(s):  
Miguel Fombuena ◽  
Laura Galiana ◽  
Pilar Barreto ◽  
Amparo Oliver ◽  
Antonio Pascual ◽  
...  
Keyword(s):  
Social Support ◽  
Structural Model ◽  
Symptom Control ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Advanced Illness ◽  
Cross Sectional ◽  
Palliative Care Teams ◽  
Symptomatic Control

In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.

scholarly journals Understanding and Addressing the Role of Coping in Palliative Care for Patients With Advanced Cancer

2020 ◽  
Vol 38 (9) ◽  
pp. 915-925 ◽  
Author(s):  
Joseph A. Greer ◽  
Allison J. Applebaum ◽  
Juliet C. Jacobsen ◽  
Jennifer S. Temel ◽  
Vicki A. Jackson
Keyword(s):  
Palliative Care ◽  
Coping Strategies ◽  
Advanced Cancer ◽  
Physical Symptoms ◽  
Early Palliative Care ◽  
Beneficial Effects ◽  
Symptoms Of Depression ◽  
Home Based ◽  
Oncology Care

Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of such coping strategies is associated with multiple outcomes, including quality of life, symptoms of depression and anxiety, illness understanding, and end-of-life care. Accumulating data demonstrate that early palliative care, integrated with oncology care, not only improves these key outcomes but also enhances coping in patients with advanced cancer. In addition, trials of home-based palliative care interventions have shown promise for improving the ways that patients and family caregivers cope together and manage problems as a dyad. In this article, we describe the nature and correlates of coping in this population, highlight the role of palliative care to promote effective coping strategies in patients and caregivers, and review evidence supporting the beneficial effects of palliative care on patient coping as well as the mechanisms by which improved coping is associated with better outcomes. We conclude with a discussion of the limitations of the state of science, future directions, and best practices on the basis of available evidence.

Communication in oncology pharmacy

2017 ◽  
Author(s):  
Bethan Tranter ◽  
Simon Noble
Keyword(s):  
Palliative Care ◽  
Treatment Adherence ◽  
Drug Safety ◽  
Medication Compliance ◽  
Healthcare Providers ◽  
Optimal Drug ◽  
Treatment Medication ◽  
Hospice And Palliative Care ◽  
Timely Treatment

Pharmacists are considered to have a pivotal role in the provision of information in oncology, and in hospice and palliative care. Effective communication is essential for optimal drug safety, timely treatment, medication compliance, and education. The role of the pharmacist has expanded to offer enhanced pharmaceutical care, which serves to improve the communication between healthcare providers and the function of the multidisciplinary team. Furthermore, through optimal communication with patients there will be increased treatment adherence and improved overall care. This chapter focuses on the breadth of communication issues faced by pharmacists involved in cancer care through the full length of the cancer journey, be it curative or palliative.

scholarly journals The Experience of Palliative Care Specialists in Implementing Palliative Care into their Work Settings in Lusaka, Zambia

2019 ◽  
Vol 4 (4) ◽  
Keyword(s):  
Palliative Care ◽  
Personal Development ◽  
Unmet Need ◽  
Structured Interview ◽  
Team Work ◽  
Situational Analysis ◽  
Advanced Illness ◽  
Research Education ◽  
Work Settings ◽  
Home Based

There is a significant unmet need for palliative care globally: of the 58 million people dying annually, it was estimated that at least 60% will have a prolonged advanced illness and dying and would benefit from palliative care. Zambia has a total population of 15,066,266 people. About 1,150,400 people are living with HIV and 18,900 people were reported to have died of HIV in 2014 alone. The most recent palliative care situational analysis in Zambia highlighted that palliative care remained ‘an essential absent factor’ and revealed that there were gaps in the type of care given in various home based care (HBC) programs. Therefore, this study aimed at exploring the experiences of trained palliative care specialists in implementing palliative care in Lusaka, Zambia. This study was an exploratory qualitative research. The population comprised of the trained palliative care specialists in either degree or diploma in palliative care, working in Lusaka. Purposive sampling was used and the sample totaled 6 (n-6). The data collection was done using a semi-structured interview guide, through face-to-face in-depth interviews. The interviews lasted for an average of 20 minutes. Prompts and probes were used to increase detailed analysis explorations Eleven themes broadly classified as facilitators or challenges emerged from the study. Among the facilitators: training influence; higher level support; effective team work and delivery models; and personal development and motivation to serve. challenges included: lack of PC knowledge; lack of essential medication for PC; work burden; lack of financial resources; lack of acceptance of PC; lack of PC guidelines; and legal restrictions on the use of opioids. The study provided evidence of the challenges and facilitators that influence palliative care specialists experience while implementing PC. It is therefore, recommended that more research, education, effective teamwork is promoted as the study revealed that participants needed support for effective implementation of palliative care.

scholarly journals Understanding patient requirements for technology systems that support pain management in palliative care services: A qualitative study

2017 ◽  
Vol 25 (3) ◽  
pp. 1105-1115 ◽  
Author(s):  
Matthew J Allsop ◽  
Sally Taylor ◽  
Michael I Bennett ◽  
Bridgette M Bewick
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Electronic Systems ◽  
Framework Analysis ◽  
Convenience Sample ◽  
Face To Face ◽  
Care Services ◽  
Palliative Care Services ◽  
Pain Patients

Approaches to pain management using electronic systems are being developed for use in palliative care. This article explores palliative care patients’ perspectives on managing and talking about pain, the role of technology in their lives and how technology could support pain management. Face-to-face interviews were used to understand patient needs and concerns to inform how electronic systems are developed. A total of 13 interviews took place with a convenience sample of community-based patients with advanced cancer receiving palliative care through a hospice. Data were analysed using framework analysis. Four meta-themes emerged: Technology could be part of my care; I’m trying to understand what is going on; My pain is ever-changing and difficult to control; and I’m selective about who to tell about pain. Patients described technology as peripheral to existing processes of care. To be relevant, systems may need to take account of the complexity of a patient’s pain experience alongside existing relationships with health professionals.

Palliative care in the emergency department

2015 ◽  
Author(s):  
Paul L. DeSandre ◽  
Karen May
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Rapid Assessment ◽  
Physical Symptoms ◽  
Care Needs ◽  
Advanced Illness ◽  
Complex Needs ◽  
Life Threatening ◽  
Access To Medical Care ◽  
Palliative Care Needs

The emergency department provides immediate access to medical care for patients and families in crisis. As the proportion of elderly in our populations increases, complications related to advanced illness will likely drive increasing numbers of patients with palliative care needs into emergency departments. In addition to immediately life-threatening situations, severe physical symptoms, psychological distress, social upheaval, or even an unrecognized spiritual crisis near death can overwhelm patients or their caregivers, who come to the emergency department hoping for relief from their suffering. Emergency clinicians must rapidly assess these complex needs while negotiating interventions with effective and efficient communications. This chapter addresses several of these essential clinician skills for effective primary palliative care in the emergency department. These include rapid assessment of patients with palliative care needs, titration of opioids for pain emergencies, efficiently establishing goals of care, skilful and empathic death disclosure, and a structured approach to involving family presence during cardiopulmonary resuscitation.

scholarly journals COVID-19, Suffering and Palliative Care: A Review

2021 ◽  
pp. 104990912110462
Author(s):  
Tan Seng Beng ◽  
Carol Lai Cheng Kim ◽  
Chai Chee Shee ◽  
Diana Ng Leh Ching ◽  
Tan Jiunn Liang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Healthcare Workers ◽  
Psychosocial Support ◽  
Symptom Control ◽  
Physical Symptoms ◽  
Integral Component ◽  
Who Guideline

According to the WHO guideline, palliative care is an integral component of COVID-19 management. The relief of physical symptoms and the provision of psychosocial support should be practiced by all healthcare workers caring for COVID-19 patients. In this review, we aim to provide a simple outline on COVID-19, suffering in COVID-19, and the role of palliative care in COVID-19. We also introduce 3 principles of palliative care that can serve as a guide for all healthcare workers caring for COVID-19 patients, which are (1) good symptom control, (2) open and sensitive communication, and (3) caring for the whole team. The pandemic has brought immense suffering, fear and death to people everywhere. The knowledge, skills and experiences from palliative care could be used to relieve the suffering of COVID-19 patients.

A Facilitator in Self-Reported Perception of Physical Symptoms: The Role of Contingency between Physical Symptom and Aversive Event

1997 ◽  
Vol 85 (3) ◽  
pp. 787-799
Author(s):  
Maki Tsukamoto ◽  
Makoto Iwanaga ◽  
Hidetoshi Seiwa
Keyword(s):  
Physical Condition ◽  
Psychological Factors ◽  
Physical Symptom ◽  
Physical Symptoms ◽  
Aversive Event ◽  
Motor Tasks ◽  
Shoulder Muscles ◽  
Motor Condition ◽  
Physical Responses

Perceptions of physical symptoms are influenced not only by the passive process of physiological stimuli but also by psychological factors such as the contingency between a physical symptom and an aversive event which we examined here in two experiments. 18 subjects in Exp. 1 and 14 subjects in Exp. 2 performed motor tasks. In the Physical condition, an aversive event was contingent on the physical symptom of ‘racing heart’ in Exp. 1, and on the symptom of ‘overstraining shoulder muscles’ in Exp. 2. In the Motor condition, an aversive event was contingent on the response of the ‘disordered pace of motor tasks’ in both experiments. Self-reported scores on attention to and perception of the physical symptoms under the Physical condition were higher than those under the Motor condition. However, there were no differences in the actual physical responses between the two conditions. These results suggest that a contingency between a physical symptom and an aversive event facilitates attention to and perception of the physical symptom.

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