Influence of social interactions, professional supports and fear of death on adults' preferences for life‐sustaining treatments and palliative care

2021 ◽  
Author(s):  
Ya‐Ling Huang ◽  
Patsy Yates ◽  
Fred Arne Thorberg ◽  
Chiung‐Jung (Jo) Wu
Keyword(s):  
Palliative Care ◽  
Social Interactions ◽  
Fear Of Death

Near-Death Experiences and the Psychology of Death

2014 ◽  
Vol 68 (3) ◽  
pp. 259-277 ◽  
Author(s):  
Natasha A. Tassell-Matamua
Keyword(s):  
Palliative Care ◽  
Fear Of Death ◽  
Mechanistic Models ◽  
Psychological Processes ◽  
Psychological Sequelae ◽  
Near Death Experiences

Little is known about the psychological phenomenology of death. Reported across known history and in all cultures by those who have died or been close to death, NDEs challenge objective-mechanistic models by suggesting the phenomenology of death may involve a variety of complex psychological processes. This article discusses three notable characteristics of the NDE—loss of the fear of death, psychological sequelae, and complex conscious abilities—supporting this claim. The implications these have for advancing societal understandings of death are discussed, and their pragmatic application for professions where death is frequently encountered, such as palliative care, is addressed.

The Quality of Life of Palliative Care Staff: A Personal Construct Approach

1994 ◽  
Vol 28 (3) ◽  
pp. 201-217 ◽  
Author(s):  
Linda L. Viney ◽  
Beverly M. Walker ◽  
Betsy Lilley ◽  
Barbara Tooth ◽  
Pam Bell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Content Analysis ◽  
Social Interactions ◽  
The Other ◽  
Care Staff ◽  
Anxiety And Depression ◽  
Personal Construct ◽  
Interview Schedule

Palliative care staff were compared with staff from burn and neonatal units, and with mature age general nursing trainees at the end of their training. Hypotheses, based on a personal construct model of their quality of life, sources of anxiety, and types of social interactions were tested. These tests were conducted by applying content analysis scales to their responses to an open-ended request in their interview schedule. The palliative care staff did express better quality of life, in terms of significantly less anxiety and depression, as well as more good feelings than the other staff groups. They showed, as predicted, significantly more anxiety about death, but less shame and diffuse anxiety. They also reported more helping and loving interactions but fewer influencing or vaguely defined, but shared interactions. The implications of these findings for the model and for the support of palliative care staff are considered.

Attitudes towards the dying and death anxiety in acute care nurses – can a workshop make any difference? A mixed-methods evaluation

2019 ◽  
Vol 18 (2) ◽  
pp. 164-169
Author(s):  
Chin Yee Cheong ◽  
Ngoc Huong Lien Ha ◽  
Laurence Lean Chin Tan ◽  
James A. Low
Keyword(s):  
Palliative Care ◽  
Death Anxiety ◽  
Core Curriculum ◽  
Knowledge Score ◽  
Positive Change ◽  
Fear Of Death ◽  
Nurse Training ◽  
Attitudes And Practices ◽  
Significant Difference ◽  
Eol Care

AbstractObjectivesIn Singapore, the core curriculum for end-of-life (EOL) care used in nurse training courses is limited. Only 45% of nurses indicated familiarity with inpatient palliative care. Nurses who lack skills in palliative care may develop anxiety and negative attitudes towards caring for dying patients. We explored whether a two-day, multimodal EOL care workshop could reduce nurses’ death anxiety and improve nurses’ skills, knowledge, and attitude towards palliative care.MethodsForty-five nurses participated in the workshop. At baseline before and at six weeks after, a 20-item knowledge-based questionnaire and the Death Attitude Profile-Revised (DAP-R) were administered. Six weeks post-workshop, in-depth interviews were conducted. We employed descriptive statistics, student paired samples t-test and inductive thematic analysis.ResultsThere was a significant improvement in nurses’ knowledge score (p < 0.01) and reduction in their death anxiety score (p < 0.01). Fear of Death (p = 0.025) and Death Avoidance (p = 0.047) sub-scores decreased significantly. However, the remaining domains such as Neutral Acceptance, Approach Acceptance, and Escape Acceptance did not show any significant difference, although Escape Acceptance showed a trend towards a reduced score (p = 0.063). After the workshop, more nurses adopted the Neutral Acceptance stance (76.2%), and none of them fell into the Fear of Death subdomain. Most nurses interviewed reported a positive change in their knowledge, attitudes, and practice even after the workshop.Significance of resultsThe multimodal palliative care workshop was useful in improving nurses’ EOL knowledge and reducing their anxiety towards death. The positive change in nurses’ attitudes and practices were noted to be sustained for at least six weeks after the intervention.

scholarly journals Ευθανασία: Ηθικά διλήμματα πολιτισμικής αυτοσυνειδησίας

Bioethica ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. 81
Author(s):  
Κωνσταντίνος Κορναράκης (Konstantinos Kornarakis)
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Personal Experience ◽  
Fear Of Death ◽  
Patient’S Autonomy ◽  
Theological Thinking

This paper focuses on the anthropological background of Euthanasia’s cultural profile, claiming that a cultural reception of Euthanasia should previously deal with anthropological questions such as patient’s autonomy and its relation to existential freedom, the fear of death, the meaning of personal experience of pain in shaping one’s own freedom and the cardinal importance of community’s role in patient’s palliative care. The theological thinking can contribute in this interscientific dialogue on the end of life, re-opening the question of the ontology of person and consequently the question of eschatology.

Oral care experiences of palliative care patients, their relatives/carers and healthcare professionals

2021 ◽  
Vol 27 (10) ◽  
pp. 504-514
Author(s):  
Maria Bernardes Delgado ◽  
Anastasios Plessas ◽  
Lorna Burns ◽  
Helen Neilens ◽  
Sarah Griffiths ◽  
...  
Keyword(s):  
Palliative Care ◽  
Social Interactions ◽  
Thematic Analysis ◽  
Healthcare Professionals ◽  
Data Extraction ◽  
Oral Care ◽  
Data Synthesis ◽  
Electronic Search ◽  
Oral Symptoms ◽  
Final Synthesis

Aim: To explore the oral care experiences of palliative care patients and of those who support or deliver oral care to these patients: nurses, doctors, dentists, their relatives and carers. Data Sources: An electronic search of the databases included: Embase, MEDLINE, DOSS, AMED and PsycINFO was performed. Data selection: Six articles were included in the final synthesis. Data extraction: Thematic analysis was applied by two researchers. Data synthesis: Three themes were identified: ‘performing oral care’, ‘effects on oral health’ and ‘challenges in palliative care’. Conclusions: Despite similarities of oral care experiences, this review identified some differences, crucially in terms of the wider impact of oral symptoms, namely social interactions with others and challenges to oral care. This confirms the need to investigate these topics further in relation to different stakeholders, such as nurses; and to have consistent guidance to facilitate the provision of effective oral care to palliative care patients.

scholarly journals End-of-life dreams and visions as perceived by palliative care professionals: A qualitative study

2021 ◽  
pp. 1-6
Author(s):  
Stina Nyblom ◽  
Ulla Molander ◽  
Inger Benkel
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Qualitative Content Analysis ◽  
Nordic Country ◽  
Fear Of Death ◽  
Focus Group Interviews ◽  
Inner Experiences ◽  
Dreams And Visions ◽  
Sound Mind ◽  
Group Interviews

Abstract Objective End-of-life dreams and visions (ELDVs) have been suggested to be prevalent psychic phenomena near death that can provide meaning and comfort for the dying. There is a lack of studies from the secular Nordic countries. The aim of this study was to determine whether palliative care professionals in a Nordic country have experience of patients expressing dreams, visions, and/or inner experiences and, if so, how they are perceived. Method Focus-group interviews with 18 professionals in end-of-life palliative care were subjected to qualitative content analysis. Results Most (15/18) professionals had experience of patients with ELDVs. A dominant content was deceased loved ones. According to most professionals, many patients perceived their ELDVs as real and could report them with clarity. The experience could result in peacefulness for patients, as well as loved ones, and reduce fear of death. Some professionals themselves perceived ELDVs to be real and a normal part of dying while a few found them scary. Most professionals, however, found ELDVs hard to grasp. Many tried to explain the phenomena as the result of medical circumstances and confusion, although reporting that they considered most patients to be normal and of sound mind in connection with their reports on ELDVs. Most patients wanted to talk about their ELDVs, but some could be reluctant due to fear of being considered crazy. The professionals were open-minded and reported having no problem talking about it with the patients and tried to normalize the experience thereby calming the patient and loved ones. Significance of results The results strengthen the suggestion that ELDVs are common phenomena near death, worldwide. Although most professionals in palliative care recognized ELDVs as beneficial to patients, many found the phenomena hard to grasp and sometimes difficult to distinguish from confusion, indicating a continuous need for exploration and education.

Cross-Cultural Issues

2014 ◽  
pp. 127-142
Author(s):  
William S. Breitbart
Keyword(s):  
Palliative Care ◽  
Death And Dying ◽  
Culturally Sensitive ◽  
Cross Cultural ◽  
Fear Of Death ◽  
Cultural Issues ◽  
Culturally Specific ◽  
Methods Of Evaluation ◽  
Terminal Illnesses ◽  
Fear Of Cancer

Across cultures, the universal fear of cancer and other terminal illnesses are caused by the fear of death as well as images associated with debility and pain. Yet individual societies place different emphases on issues surrounding death and dying. This chapter provides an overview of the culturally specific issues surrounding death and dying, methods of evaluation of cultural issues, and guidance on delivering culturally sensitive palliative care around the globe.

The Fear of Dying: A Case Study Using the SPIKES Protocol

2018 ◽  
Vol 99 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Courtney Carver
Keyword(s):  
Palliative Care ◽  
Medical Care ◽  
Social Workers ◽  
Spiritual Care ◽  
Hospital Setting ◽  
Bad News ◽  
Fear Of Death ◽  
The Future ◽  
Delivering Bad News

The SPIKES protocol will be discussed in the context of working with a patient who was referred to palliative care in the hospital setting. Palliative care is complex because it is not only medical care but also emotional and spiritual care. Those working in palliative care often explain a diagnosis to the patient, both what the diagnosis is and what it likely means for the future. The SPIKES protocol, a conversational tool for delivering bad news, has applications for social workers. This case study will tell the story of a patient whose fear of death almost cost him the ability to live fully at the end of his life and how the SPIKES tool was implemented in helping this patient understand and come to terms with his diagnosis.

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