Palliative care: not only for treating symptoms: a case report

2020 ◽  
Vol 106 (6) ◽  
pp. NP1-NP4
Author(s):  
Maria Caterina Pallotti ◽  
Marianna Ricci ◽  
Romina Rossi ◽  
Lorenzo Cecconetto ◽  
Domenico Barone ◽  
...  

Introduction: Palliative care (PC) aims to treat symptoms independently of the disease. In many medical disciplines, including oncology, there is an emphasis on personalizing treatment, identifying the most effective therapeutic option by studying the genetic heritage of the patient and the molecular characteristics of the disease. PC, on the other hand, encompasses the overall (physical and spiritual) well-being of the patient and his or her caregivers. The increasing use of early PC and its integration with oncology could represent a fruitful collaboration among specialists. Case description: We present the case of a 79-year-old woman with advanced breast cancer attending our institute who was referred to our PC Unit because of continuous ear pain, paresthesia around the mouth, strabismus, and facial dysesthesia. The patient was in good clinical condition (Eastern Cooperative Oncology Group 1) and was undergoing chemotherapy at the time. For these reasons, the PC physician carefully assessed the pain characteristics and differential diagnosis and discussed them with the oncologist, radiologist, and neurologist. Joint consultation led to a specific study of Meckel cave by MRI, revealing an extrameningeal gasserian ganglion metastasis, a very rare localization of breast cancer. Conclusion: We present a case that underlines the importance of specialized PC assessment not limited to the control of symptoms. The search for the etiopathogenesis of a patient’s symptoms and the evaluation of overall clinical conditions may be necessary to plan appropriate diagnostic evaluations, target palliative therapies, and achieve effective symptom control.

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.


2017 ◽  
Vol 28 ◽  
pp. x147
Author(s):  
J. Srivastava ◽  
H.S. Shukla ◽  
S.S. Kaushik ◽  
M. Tewari

2019 ◽  
Author(s):  
Andy Hau Yan Ho ◽  
Oindrila Dutta ◽  
Geraldine Tan-Ho ◽  
Toh Hsiang Benny Tan ◽  
Casuarine Low Xinyi ◽  
...  

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.


2019 ◽  
Vol 6 (1) ◽  
pp. 35-40
Author(s):  
Mónica Gallegos Alvarado ◽  
Ma Cristina Ochoa Estrada ◽  
Mayra Guadalupe Hernández Romero ◽  
Martha Lilia Parra Dominguez ◽  
Eloísa Esquivel Rodriguez ◽  
...  

2019 ◽  
Vol 9 (7) ◽  
pp. 496-513 ◽  
Author(s):  
Fadime Çinar*, Turgay Sirin

Background: One of the indispensable aspects of the philosophy of holistic care,and negative situations such as life-threatening illness, spiritual well-being, which isdefined as the search for a relationship with a divine soul, is a requirement that mustbe met in order to maintain the existence of the individual. The patient's need forsocial and spiritual well-being increases even more in cases of long-term treatment,such as cancer, that reduce the quality of life. Determining and meeting the spiritualneeds of the individual in the difficult times of the crisis can be realized bydetermining the spiritual well-being levels of the individuals and by providing theindividual spiritual care. This study was conducted to determine the level of thespiritual well-being of palliative care patients diagnosed with cancer. Methods: Thisis a descriptive study. The population of the study consisted of 124 patientsdiagnosed with cancer who were hospitalized in the palliative unit between Januaryand August 2018 and were treated in two state hospitals operating on the Europeanside of Istanbul. The sample consisted of 111 people with voluntary participationand communication. Personal Information Form and Spiritual Well-being Scalewere used to collect data. Data were evaluated by one-way analysis of variance (one-way anova) and significance (t-test) of the difference between the two means.Results: The total score averages from the spiritual good scale of individualsparticipating in the Study were determined to be good with x = 4,15. In terms ofthe level of education of Scale scores, only "Anomi" is significantly differentiatedbetween groups of age, with a total score of the scale, In the sub-dimension oftranscendity and the subdimension of "Harmony with Nature" according to thevariable metastasis (p > 0.05). Conclusion: Spiritual Well-being has a positive effecton the healing process of individuals with impaired health. It helps individuals whohave a crisis in life threatening diseases such as Cancer to cope with this crisis and toprovide spiritual well-being in the sense of life. In This process, spiritual careinitiatives by healthcare professionals can be transformed into a part of the healingprocess and the spiritual goodness of the individual can be increased. Furtherresearch in This area is projected to contribute to the richening of the relevantliterature in Turkey.Key words: Spiritual, spiritual well-being, palliative care, palliative care unit


Religions ◽  
2020 ◽  
Vol 11 (7) ◽  
pp. 361
Author(s):  
Maria Komariah ◽  
Urai Hatthakit ◽  
Nongnut Boonyoung

This research emphasizes the nurse’s role in incorporating Islamic teaching through the care practices provided in order to promote spiritual well-being in Muslim women with breast cancer undergoing chemotherapy. In addition, religion and spirituality have been recognized as the primary resources for coping. The aim of the study, therefore, was to explore the impact of an Islam-based caring intervention on the spiritual well-being of Muslim women with cancer. Furthermore, data were collected using a questionnaire and, also, the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) on baseline (Time 1), days 3 (Time 2), 23 (Time 3), and 44 (Time 4). The results showed the significant impact of an Islam-based caring intervention on the participants’ level of spiritual well-being. In addition, the mean scores varied between the intervention and control group over time. Based on the reflection, participants stipulated feeling peace of mind, closer to God, spirit for further life, and healthier.


2016 ◽  
Vol 15 (4) ◽  
pp. 490-498 ◽  
Author(s):  
Philip Austin ◽  
Roderick MacLeod

ABSTRACTThe purpose of this review was to investigate and review the concept of “peace” and the role it plays in the spiritual well-being and care of people with a chronic or terminal illness. Our objectives were, first, to examine the importance of peace in palliative care as a measure of acceptance and in chronic illness settings as a predictor of improved survival. Second, we explored the dimensions of peace and their relationships with spiritual well-being. We further examined how the constructs of peace are assessed both within valid spiritual well-being measures and as individual items related solely to peace. Finally, we examined therapies aimed at promoting peace and emotional well-being in palliative and chronic illness settings. Despite much being written about different constructs of peace and the positive effects of being at peace during times of illness, the effects of therapies on the feeling of peace are not well-studied.


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