The Impact of Terminal Illness on the Spouse

This descriptive study explores the responses, concerns and problems of the hospitalized, terminally ill, cancer patient's spouse. The findings of the study suggest that spouses experience a deterioration in their health, disturbed thought processes, and a variety of emotional responses when confronted with the impending death of a husband / wife from cancer. Spouses are concerned about the physical symptoms, such as pain, experienced by the patient and their inability to communicate with him or her. The spouses’ problems centre on changes or anticipated changes in their lifestyle. An important finding of the study was the identification of a group of spouses who appear to be at risk. These spouses reported a high incidence of physical symptoms in relation to their own health, a high incidence of emotional responses, and numerous concerns.

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The National Policy Framework and Strategy on Palliative Care 2017‒2022: What’s in it for Terminally Ill Inmates in South Africa?

Obiter ◽

10.17159/obiter.v41i4.10474 ◽

2021 ◽

Vol 41 (4) ◽

pp. 671-684

Author(s):

Chesné Albertus

Keyword(s):

South Africa ◽

Palliative Care ◽

Terminal Illness ◽

National Policy ◽

Terminally Ill ◽

Policy Framework ◽

Correctional Settings ◽

The Moment ◽

The Right ◽

The Impact

In South Africa many people suffer from serious, incurable health conditions that may render them incapacitated and/or terminally ill. Such persons may inevitably require holistic care such as palliative care. The adoption in 2017 of the National Policy Framework and Strategy on Palliative Care 2017‒2022 (NPFSPC) in line with the Health Assembly Resolution 67.19 “Strengthening of Palliative Care as a Component of Comprehensive Care Throughout the Life Course” thus marked a significant milestone for advocates of palliative care, as well as for persons affected by terminal illness. Despite this positive step towards the fulfilment of the right to access healthcare, terminally ill persons who are inmates in South African correctional centres are not sufficiently protected by the NPFSPC. While the policy may be lauded for its detailed provisions aimed at affording appropriate care to free persons, it makes but a few fleeting references to inmates who are terminally ill – a very vulnerable group, given the often appalling conditions in correctional centres, the limited resources generally available to inmates and the stigma attached to them. It is therefore submitted that palliative care should be available to all inmates diagnosed with a terminal illness from the moment they are diagnosed. This article also analyses the stated purpose of the NPFSPC in relation to correctional settings, as well as the impact of disease on correctional centres, and the importance of fostering partnerships.

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The impact of multidimensional physical activity feedback on healthcare practitioners and patients

BJGP Open ◽

10.3399/bjgpopen18x101628 ◽

2019 ◽

Vol 3 (1) ◽

pp. bjgpopen18X101628 ◽

Cited By ~ 1

Author(s):

Max J Western ◽

Dylan Thompson ◽

Oliver J Peacock ◽

Afroditi Stathi

Keyword(s):

Physical Activity ◽

Primary Care ◽

At Risk ◽

Emotional Responses ◽

Activity Levels ◽

Structured Interviews ◽

Physical Activity Levels ◽

The Impact ◽

Personalised Feedback ◽

Low Activity

BackgroundPromotion of physical activity in primary care has had limited success. Wearable technology presents an opportunity to support healthcare practitioners (HCPs) in providing personalised feedback to their patients.AimTo explore the differing thoughts and feelings of both HCPs and at-risk patients provided with personalised multidimensional physical activity feedback.Design & settingQualitative study with HCPs (n = 15) and patients at risk of cardiovascular disease or type 2 diabetes (n = 29), recruited from primary care.MethodHCPs and patients wore a physical activity monitor for 7 days and were subsequently shown their personalised multidimensional feedback, including sedentary time, calorie burn, short (1-minute) or long (>10-minute) bouts of moderate-to-vigorous activity during semi-structured interviews. Transcripts were analysed thematically with comparisons made between individuals of high (n = 21) and low (n = 23) physical activity levels as to their cognitive–affective responses to their data.ResultsPersonalised feedback elicited positive emotional responses for highly active participants and negative emotional responses for those with low activity. However, individuals with low activity demonstrated largely positive coping mechanisms. Some low active participants were in denial over feedback, but the majority valued it as an opportunity to think of ways to improve physical activity (cognitive reappraisal) and started forming action plans (problem-focused coping). Around half of all participants also sought to validate their feedback against peers.ConclusionPersonalised, visual feedback elicits immediate emotional and coping responses in participants of high and low physical activity levels. Further studies should explore whether multidimensional feedback could help practitioners explore diverse ways for lifestyle change with patients.

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The Therapist’s Reaction to a Patient’s Suicide

Crisis ◽

10.1027/0227-5910/a000062 ◽

2011 ◽

Vol 32 (2) ◽

pp. 99-105 ◽

Cited By ~ 23

Author(s):

Friedrich Martin Wurst ◽

Isabella Kunz ◽

Gregory Skipper ◽

Manfred Wolfersdorf ◽

Karl H. Beine ◽

...

Keyword(s):

Emotional Responses ◽

Well Being ◽

Emotional Reaction ◽

Emotional Reactions ◽

Analog Scale ◽

General Hospitals ◽

Item Questionnaire ◽

Retrospective Nature ◽

The Impact ◽

Over Time

Background: A substantial proportion of therapists experience the loss of a patient to suicide at some point during their professional life. Aims: To assess (1) the impact of a patient’s suicide on therapists distress and well-being over time, (2) which factors contribute to the reaction, and (3) which subgroup might need special interventions in the aftermath of suicide. Methods: A 63-item questionnaire was sent to all 185 Psychiatric Clinics at General Hospitals in Germany. The emotional reaction of therapists to patient’s suicide was measured immediately, after 2 weeks, and after 6 months. Results: Three out of ten therapists suffer from severe distress after a patients’ suicide. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. The emotional responses immediately after the suicide explained 43.5% of the variance of total distress in a regression analysis. Limitations: The retrospective nature of the study is its primary limitation. Conclusions: Our data suggest that identifying the severely distressed subgroup could be done using a visual analog scale for overall distress. As a consequence, more specific and intensified help could be provided to these professionals.

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Small Firm Audit Partner Hiring Crisis: A Role Play for Critical Thinking and Negotiation Skills

Issues in Accounting Education ◽

10.2308/iace-51117 ◽

2015 ◽

Vol 30 (4) ◽

pp. 275-296 ◽

Cited By ~ 1

Author(s):

George R. Aldhizer

Keyword(s):

Critical Thinking ◽

Small Firm ◽

Role Play ◽

Terminally Ill ◽

Thinking Skills ◽

Critical Thinking Skills ◽

Planning Stage ◽

Skill Sets ◽

Final Agreement ◽

The Impact

ABSTRACT This role play requires students to consider the complexities of a small CPA firm urgently attempting to replace the unique industry knowledge and experience possessed by a terminally ill audit partner. In this role play, students assume the position of either an existing partner or a former partner who is considering rejoining the firm. This role play includes two sections. First, in the planning stage, students brainstorm mutually equivalent options that satisfy their critical financial and nonfinancial interests to address the problem of replacing the terminally ill partner in their respective existing partner and former partner teams. Second, students engage in a “table” negotiation with their assigned counterpart to reach an amicable agreement to this firm crisis and participate in a debriefing session and prepare a debriefing document. The small firm context provides a unique opportunity to make contributions to the existing accounting and auditing literature related to enhancing students' critical thinking and negotiation skills. Distinctive small firm role play elements that should enhance critical thinking and negotiation skills include considering contingent agreements that dovetail differences in future legal liability forecasts, and dovetailing differences to take advantage of complementary skill sets to mitigate industry-specific auditor detection risks and related business risks.1 Critical thinking skills also should be strengthened through negotiating a package of interests and related options including the impact of various tradeoffs that are not fully known until the table negotiation commences so that the final agreement does not exceed the firm's non-negotiable budgetary constraints.

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The Democratic Costs of Constitutionalization— The European Case

10.1093/oso/9780198805120.003.0005 ◽

2017 ◽

Author(s):

Dieter Grimm

Keyword(s):

At Risk ◽

Economic Integration ◽

Fundamental Rights ◽

European Law ◽

European Court ◽

Political Implications ◽

The Impact ◽

The Relationship ◽

The Eu

This chapter examines the democratic costs of constitutionalization by focusing on the European case. It first considers the interdependence of democracy and constitutionalism before discussing how constitutionalization can put democracy at risk. It then explores the tension between democracy and fundamental rights, the constitutionalization of the European treaties, and the European Court of Justice’s (ECJ) two separate judgments regarding the relationship between European law and national law. It also assesses the impact of the ECJ’s jurisprudence on democracy, especially in the area of economic integration. The chapter argues that the legitimacy problem the EU faces is caused in part by over-constitutionalization and that the remedy to this problem is re-politicization of decisions with significant political implications.

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Happiness at the end of life: A qualitative study

Palliative & Supportive Care ◽

10.1017/s1478951521000262 ◽

2021 ◽

pp. 1-7

Author(s):

Tan Seng Beng ◽

Wong Ka Ghee ◽

Ng Yun Hui ◽

Ooi Chieh Yin ◽

Khoo Wei Shen Kelvin ◽

...

Keyword(s):

Palliative Care ◽

Qualitative Study ◽

End Of Life ◽

Terminal Illness ◽

Terminally Ill ◽

Social Connections ◽

Targeted Interventions ◽

Pain And Suffering ◽

The University ◽

Eudaimonic Happiness

Abstract Objective Dying is mostly seen as a dreadful event, never a happy experience. Yet, as palliative care physicians, we have seen so many patients who remained happy despite facing death. Hence, we conducted this qualitative study to explore happiness in palliative care patients at the University of Malaya Medical Centre. Method Twenty terminally ill patients were interviewed with semi-structured questions. The results were thematically analyzed. Results Eight themes were generated: the meaning of happiness, connections, mindset, pleasure, health, faith, wealth, and work. Our results showed that happiness is possible at the end of life. Happiness can coexist with pain and suffering. Social connections were the most important element of happiness at the end of life. Wealth and work were given the least emphasis. From the descriptions of our patients, we recognized a tendency for the degree of importance to shift from the hedonic happiness to eudaimonic happiness as patients experienced a terminal illness. Significance of results To increase the happiness of palliative care patients, it is crucial to assess the meaning of happiness for each patient and the degree of importance for each happiness domain to allow targeted interventions.

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The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽

10.3390/cancers13071700 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1700

Author(s):

Melissa Chalada ◽

Charmaine A. Ramlogan-Steel ◽

Bijay P. Dhungel ◽

Christopher J. Layton ◽

Jason C. Steel

Keyword(s):

Risk Factors ◽

Ultraviolet Radiation ◽

Uveal Melanoma ◽

World Health Organisation ◽

World Health ◽

Genetic Mutations ◽

High Incidence ◽

The World ◽

The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

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The malaria burden of Amerindian groups of three Venezuelan states: a descriptive study based on programmatic data

Malaria Journal ◽

10.1186/s12936-021-03819-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Juan C. Gabaldón-Figueira ◽

Carlos Chaccour ◽

Jorge Moreno ◽

Maria Villegas ◽

Leopoldo Villegas

Keyword(s):

Risk Factors ◽

Plasmodium Falciparum ◽

Malaria Incidence ◽

Hot Spot ◽

Public Health Problem ◽

Epidemiological Data ◽

Descriptive Study ◽

Malaria Burden ◽

Indigenous Groups ◽

The Impact

Abstract Background Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Although the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups. Methods This is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states (Amazonas, Bolivar, and Sucre) were calculated and compared using the Kruskal Wallis test, risk factors for Plasmodium falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis. Results 116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly in the south of Bolivar. Most cases (73.3%) were caused by Plasmodium vivax, but the Hoti, Yanomami, and Eñepa indigenous groups presented higher odds for infection with Plasmodium falciparum. Conclusion Malaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution than those among the general population. These findings suggest that tailored interventions will be necessary to curb the impact of malaria transmission in these groups.

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Development of a patient-reported outcome measure for neck pain in military aircrew: qualitative interviews to inform design and content

BMJ Open ◽

10.1136/bmjopen-2020-039488 ◽

2021 ◽

Vol 11 (2) ◽

pp. e039488

Author(s):

Anna Dowling ◽

Ellen Slungaard ◽

Nicola R Heneghan

Keyword(s):

Neck Pain ◽

Outcome Measure ◽

Physical Symptoms ◽

Patient Reported Outcome ◽

Direct Access ◽

Specific Patient ◽

Concept Elicitation ◽

Patient Reported Outcome Measure ◽

Patient Reported ◽

The Impact

IntroductionThe prevalence of flight-related neck pain is 70% in UK fast jet pilots; much higher than the general population. The Aircrew Conditioning Programme and direct access physiotherapy exist to minimise the impact on military capability, but a population specific patient-reported outcome measure (PROM) is required to investigate the effectiveness of these. We aimed to explore the experiences of flight-related neck pain to inform the content validity and development of a population specific PROM.MethodsQualitative semistructured interviews combining phenomenological and grounded theory methods, reported using Consolidated criteria for Reporting Qualitative research guidelines. A purposive sample of 10 fast jet pilots with neck pain was recruited. Concept elicitation interviews were audio recorded, transcribed verbatim along with field notes. Data analysis involved subject and methodological expertise used a concept elicitation approach.ResultsParticipants included 10 male fast jet pilots, age 34.7 years. Identified themes included: (1) physical symptoms associated with flying activities; (2) occupational effects revealed modifications of flying, or ‘suboptimal’ performance owing to neck pain; (3) psychological effects revealed feelings or worry and (4) social and activity effects showed impact on out of work time.ConclusionPopulation-specific occupational, psychological and social factors should be considered alongside physical symptoms when managing neck pain in military aircrew. Findings support the development of a PROM specifically designed for military aircrew with neck pain.

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IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

British Journal of Surgery ◽

10.1093/bjs/znab160.023 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

A Fernández Candela ◽

L Sánchez-Guillén ◽

L García Catalá ◽

C Curtis Martínez ◽

M Bosch Ramírez ◽

...

Keyword(s):

Body Image ◽

Colorectal Surgery ◽

Laparoscopic Colorectal Surgery ◽

Wound Complication ◽

Descriptive Study ◽

Surgical Quality ◽

Body Image Scale ◽

Study Results ◽

The Impact ◽

Observational Descriptive Study

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

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