Parenteral nutrition complications in palliative medicine

2021 ◽  
pp. bmjspcare-2021-002991
Author(s):  
Zoe Smith ◽  
Emily Sills
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Parenteral Nutrition ◽  
Care Patient ◽  
Fluid Retention ◽  
First Case ◽  
Harmful Effects ◽  
Palliative Patients

Parenteral nutrition in palliative care is contentious, and decisions on starting or continuing its treatment in palliative patients centre on an individual’s preference, balanced with quality of life. This case report describes the unusual onset of pain and agitation secondary to fluid retention, in a patient with metastatic pseudomyxoma peritonei, established on 2.5 L/day of parenteral nutrition. Immediate volume reduction of the parenteral nutrition to 1 L/day successfully reversed the patient’s symptoms. To our knowledge, this is the first case of parenteral nutrition inducing pain and agitation in a palliative care patient. There is no specific internationally acclaimed guidance concerning parenteral nutrition content and volume in palliative patients, due to a lack of high quality studies. This case study highlights the need for further research into parenteral nutrition content and volume in palliative care, to prevent harmful effects from fluid retention, impacting on quality of life.

scholarly journals MODERN METHODS OF TREATMENT IN PALLIATIVE CARE

2019 ◽  
Vol 72 (7) ◽  
pp. 1229-1235
Author(s):  
Ewa Kucharska ◽  
Aleksandra Kucharska ◽  
Aleksander Sieroń ◽  
Mariusz Nowakowski ◽  
Karolina Sieroń
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Hospice Care ◽  
Clinical Symptoms ◽  
Care Patient ◽  
Unique Type ◽  
Modern Methods ◽  
High Dynamics ◽  
Methods Of Treatment

The palliative care patient is definitely a unique type of patient. Due to the complexity of the symptoms requires a holistic therapeutic approach. Modern methods of treatment in palliative and hospice care underline an important role of physio, kinesiotherapy and pharmacological treatment coexistence. The rehabilitation reduces clinical symptoms, accompanying the basic disease and increases the quality of life of palliative patients and their families. It becomes an inseparable element of treatment, both in outpatient care as well as in stationary care and home care. Due to the high dynamics onset of cancer in the group of geriatric patients there is a need for a broader analysis of the topic. The goal of palliative care is to achieve the best possible quality of life for patients and their families.

Caring for the caregiver: factors associated with the quality of life of family caregivers to palliative care patients

2015 ◽  
Vol 3 (3) ◽  
pp. 352
Author(s):  
Macarena Quesada ◽  
Manuel Madrigal ◽  
Aurelio Luna ◽  
Maria D Perez-Carceles
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Family Caregivers ◽  
Care Patient ◽  
Terminal Phase ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Impact

Purpose: The aim was to investigate the factors associated with the quality of life (QoL) of family caregivers to palliative care patients. Methods: A cross-sectional survey was conducted of 125 family caregivers of patients in the terminal phase of their illness and included in palliative care programs. Data were collected using WHOQOL-BREF, the socio-demographic characteristics of both caregiver and patient, clinical questions and information about caregiving. Results: The QoL of caregivers was lower than that of the national average for healthy people. Significantly lower QoL scores were obtained in the case of caregivers if they were women, over 55 years, uneducated, unemployed or the patient’s spouse. Cancer diagnosis and patients who were dependent for their Activities of Daily Living also lower caregiver QoL. The factors associated with higher caregiver QoL in each domain differed: being employed in the physical domain (OR:3.3; 95% CI:1.47-7.4), the patient receiving palliative care in hospital in the psychological domain (OR:3.05; 95% CI:1.19-7.7), a higher level of caregiver´s education in the social domain (OR:3.3; 95% CI:1.4-9.8) and caregivers between 45-55 years in the environmental domain (OR:5.4; 95% CI:1.6-9.2).Conclusion: Family caregivers of palliative care patients are highly burdened during caregiving. Characteristics of the patient and caregiver and the conditions under which care is performed, significantly affect QoL. We consider it essential to increase health professionals’ awareness of the importance of the role of the caregiver in providing services to the terminally ill, given the impact of the caregiver’s QoL on the QoL of the palliative care patient and its importance for the delivery of person-centered care at the end of life.    

scholarly journals Exploring Challenges of Hospital Chaplains in Transdisciplinary Teams

2020 ◽  
Vol 5 ◽  
Author(s):  
Stephen A. Spates ◽  
Catherine Y. Kingsley Westerman ◽  
Leslie A. Laam ◽  
Ryan Goke
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Outcomes ◽  
Quality Care ◽  
Ability To Work ◽  
Hospital Chaplains ◽  
Communication Challenges ◽  
Medical Health

Hospital chaplains experience obstacles in contributing to team objectives when a part of transdisciplinary teams. This case study explores the communication challenges of membership on transdisciplinary teams for hospital chaplains, using a fictional account based on data from a previous study. Chaplain David Howard is one of three chaplains at Grace Hospital and is assigned to the newly formed palliative care transdisciplinary team. The purpose of this team is to work towards providing quality care to patients in the upcoming integrative medicine wing. Although the team is tasked with improving the quality of life for patients, David notices that his concerns of quality care often clash with his medical colleagues' concerns about improved medical health outcomes. As the team's differing perspectives are revealed, it is evident that their communication is crucial to their ability to work together successfully.

The Physical Hospital Environment and Its Effects on Palliative Patients and Their Families: A Qualitative Meta-Synthesis

2021 ◽  
pp. 193758672110329
Author(s):  
Elizabeth M. Miller ◽  
Joanne E. Porter ◽  
Michael S. Barbagallo
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Hospital Environment ◽  
Room Size ◽  
Centered Care ◽  
Palliative Care Units ◽  
Qualitative Literature ◽  
Palliative Patients

Aim: To review the latest qualitative literature on how the physical hospital environment affects palliative patients and their families. Background: People with a life-limiting illness may receive palliative care to improve their quality of life in hospital and may have multiple admissions as their illness progresses. Yet, despite a preference for a death at home, more than half of the dying population will receive end-of-life care in hospital. The physical hospital environment consists of ambiance, aesthetics, and architectural factors, and it is well known that the hospital’s acute wards are not a homely environment. Demand is increasing for the physical environment to be improved to better meet the needs and demands of palliative and end-of-life patients and their families. Method: Combining thematic analysis and meta-ethnography methodologies, 12 international qualitative papers were analyzed and synthesized by the three authors. Results: Findings resulted in the development of the SSAFeR Place approach that incorporates the concepts that are important to palliative and end-of-life patients and their families by describing an environment within the acute or palliative care units that feels safe, is private, customizable, and accommodates family; is a space to share with others, is homelike in ambiance and aesthetics, and is conducive for reflection. The concepts of identity, belonging, and safety are connected to the notions of home. Conclusions: To provide person-centered care and to move the focus toward the palliative approach of comfort and quality of life, attention to room size, layout, aesthetics, and ambiance is needed.

scholarly journals SPIRITUAL PASIEN PALIATIF DI RUMAH SAKIT, YOGYAKARTA SPIRITUALITY OF PALLIATIVE PATIENT IN HOSPITAL, YOGYAKARTA Milatul

2019 ◽  
Vol 7 (3) ◽  
pp. 265-271
Author(s):  
Milatul Afifah ◽  
Arianti
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Mean Values ◽  
Palliative Patient ◽  
The Mean ◽  
Descriptive Survey ◽  
Palliative Patients

Background: Palliative care goal is to improve the quality of life of the patient. Spiritual is believed can improve the quality of life in palliative patients. Objective: The purpose of this research is to identify the spiritual status of palliative patients in PKU Muhammadiyah Gamping Yogyakarta Hospital. Methods: This study is a non-experiment research. It used descriptive survey research method with 100 subjects which used total sampling technique. FACIT-Sp is choosen based on this validity(r=0,5) dan realibity (r=0,768) to get the spiritual status of the sample. Results: The result of univariate analysis showed that the spiritual level of palliative patients in PKU Muhammadiyah Gamping Hospital with the mean values of 36,79 (0-48) and the spiritual component consisted of mean is 12,26 (0-16), faith is 12,85 (0-16) and peace 68 (0-16). Conclusion: The spiritual status of palliative patients at Muhammadiyah Gamping Yogyakarta Hospital in the categories of meaning, faith, peace and spiritual level most have passed the cut of point, it showed that the palliative patient is headed to the good spiritual. Keyword : Palliative care, spiritual, mean, faith, peace

Utilizing participation in meaningful occupation as an intervention approach to support the acute model of inpatient palliative care

2013 ◽  
Vol 12 (5) ◽  
pp. 409-412 ◽  
Author(s):  
Erin Ashworth
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Treatment Plan ◽  
Occupational Therapists ◽  
Care Practice ◽  
Occupational Performance ◽  
Occupational Participation ◽  
Specific Symptoms

AbstractPalliative care is a model of care that aims to improve quality of life (QOL) for patients and their families/carers who are facing the challenges associated with a life limiting illness (WHO, 2012). Until recently, palliative care has been seen to be largely focused on the medical management of specific symptoms, with little or no consideration given to the patient's occupational identity and goals.Occupational therapy is a profession whose core philosophy is grounded in occupational participation. Occupational therapists have the skills and expertise to incorporate an individual's occupational performance goals into their treatment plan, thereby helping people to participate in personally meaningful occupations, within the limitations of their illness and physical capacity.The present article aims to illustrate (using case-study examples) how personally meaningful occupational participation can better support an acute model of palliative care practice, resulting in better patient outcomes and improved quality of life for both patients and their carers.

Understanding Quality of Life for Palliative Patients With Dysphagia Using the Swallowing Quality of Life (SWAL-QOL) Questionnaire

2021 ◽  
pp. 104990912199253
Author(s):  
Laurence Lean Chin Tan ◽  
Yujun Lim ◽  
Peiyan Ho ◽  
Lee Yen Lim ◽  
Ying Yin Lim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Palliative Care ◽  
Symptom Score ◽  
Food Selection ◽  
Palliative Patients

Objective: There are few studies concerning the differences in quality-of-life (QOL) between palliative care patients with and without dysphagia to date. We aimed to compare the QOL and symptoms in palliative patients with and without dysphagia using Swallowing Quality of Life (SWAL-QOL). Methods: Eighty-one palliative patients with and without dysphagia underwent the SWAL-QOL questionnaire. A series of Mann Whitney U tests were performed between non-dysphagic and dysphagic groups for the total SWAL-QOL score and the 11 SWAL-QOL domains. Results: Dysphagia significantly impacted patients’ QOL in the dysphagic group (mean, 69.5; SD 21.9) than non-dysphagic group (mean, 83.2; SD 14.8) ( P = 0.006). Significant differences were observed between both groups for the domains of burden, eating desire, eating duration, symptoms, food selection, communication and mental health. The results also showed that the dysphagic group had lower symptom score across all symptoms, suggesting higher symptom burdens. Conclusions: This study is the first to examine QOL and swallow symptoms in palliative care patients with and without dysphagia. Dysphagia causes significantly worse QOL in palliative care patients. Screening for dysphagia and managing its impact on symptoms and QOL domains is important in palliative care.

scholarly journals SPIRITUAL PASIEN PALIATIF DI RUMAH SAKIT, YOGYAKARTA

2019 ◽  
Vol 7 (3) ◽  
pp. 265-271
Author(s):  
Milatul Afifah ◽  
Arianti Arianti
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Mean Values ◽  
Palliative Patient ◽  
The Mean ◽  
Descriptive Survey ◽  
Palliative Patients

Background: Palliative care goal is to improve the quality of life of the patient. Spiritual is believed can improve the quality of life in palliative patients. Objective: The purpose of this research is to identify the spiritual status of palliative patients in PKU Muhammadiyah Gamping Yogyakarta Hospital. Methods: This study is a non-experiment research. It used descriptive survey research method with 100 subjects which used total sampling technique. FACIT-Sp is choosen based on this validity(r=0,5) dan realibity (r=0,768) to get the spiritual status of the sample. Results: The result of univariate analysis showed that the spiritual level of palliative patients in PKU Muhammadiyah Gamping Hospital with the mean values of 36,79 (0-48) and the spiritual component consisted of mean is 12,26 (0-16), faith is 12,85 (0-16) and peace 68 (0-16). Conclusion: The spiritual status of palliative patients at Muhammadiyah Gamping Yogyakarta Hospital in the categories of meaning, faith, peace and spiritual level most  have passed the cut of point, it showed that the palliative patient is headed to the good spiritual.   Keyword : Palliative care, spiritual, mean, faith, peace

QUALITY OF LIFE OF PATIENTS RECEIVING HOME-BASED PALLIATIVE CARE FROM FAMILY PHYSICIANS AND MOBILE PALLIATIVE CARE TEAM

2020 ◽  
Vol 73 (8) ◽  
pp. 1681-1689
Author(s):  
Oryna Z. Detsyk ◽  
Oleksandra P. Bratsyun ◽  
Раvlo M. Babich
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Family Physicians ◽  
Palliative Care Team ◽  
Care Team ◽  
Life Questionnaire ◽  
Financial Difficulties ◽  
The Impact ◽  
Palliative Patients

The aim: To evaluate the quality of life (QoL) of palliative patients receiving general palliative care and the impact of palliative care provided by mobile palliative care team (MPCT) on their QoL. Materials and methods: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (QLQ-C30) was used to evaluate QoL of 219 palliative patients receiving general palliative care from family physicians in the Center for primary health care of Uzhhorod city, Ukraine. In the second part of the study, the subgroup of 25 patients who had at least one of fifteen QLQ-C30 scales evaluated lower than 50 points were selected. They were provided with PC from the MPCT for 2 weeks and their QoL was measured again. Results: For the patients who received general palliative care from a family physicians mean m (SD) QoL value was 38.63 (16.9), and the main symptoms that affected QoL were fatigue 48.60 (23.30) and pain 46.11 (20.97). The most impact on QoL scores had role (rs=0,430;), emotional (0.321) and physical (0.301) functioning and such symptoms as pain (-0.392), insomnia (-0.311), dyspnoea (-0.294), financial difficulties (-0.255). For the patients who received palliative care from MPCT mean the mean QoL score increased by 30.0 points, mean pain score decreased by 42.22 points, fatigue score decreased by 38.0 points and level of financial difficulties also decreased by 76.0 points. Conclusions: The involvement of the MPCT could have a significant positive impact on the QoL of palliative patients.

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