The Influence of the Family in Conceptions of Personhood in the Palliative Care Setting in Singapore and Its Influence Upon Decision Making

2013 ◽  
Vol 31 (6) ◽  
pp. 645-654 ◽  
Author(s):  
Lalit Kumar Radha Krishna ◽  
Rayan Alsuwaigh ◽  
Prabha Techna Miti ◽  
Sim Shin Wei ◽  
Khoo Hui Ling ◽  
...  
2021 ◽  
Vol 30 (3) ◽  
pp. 198-208
Author(s):  
Louisa Musa ◽  
Nicky Ore ◽  
Gillian Raine ◽  
Glenn Smith

Objective: The presence of sub-epidermal moisture (SEM) over a bony prominence is indicative of incipient pressure ulcer (pressure injury/decubitus/bedsore) (PU). Early identification of patients at increased risk of PU can prompt interventions that reduce the incidence and severity of hospital (or community)-acquired PUs (HAPUs). This study evaluated the clinical utility of a SEM Scanner device in HAPU management. Method: The study used a pragmatic ‘real-world’ approach. HAPU data before and during SEM Scanner use were obtained through routine audit. Patients had regular visual and daily SEM Scanner skin assessments over the sacrum and heels. Nursing care otherwise followed standard of care according to the established protocols of individual participating sites. HAPU incidence rates were determined and feedback gathered from health professionals on how the device influenced HAPU-related clinical decision-making. Results: There were 15 participating sites: 13 acute care, one palliative care and one community care setting. The sample size was 1478 patients. All sites reported a substantial reduction in mean HAPU incidence: 87.2% in acute care settings; 46.7% in the palliative care setting and 26.7% in the community care setting. A 100% incidence reduction was reported in 10 (66.7%) sites. In the palliative care setting, SEM Scanner results changed HAPU-related clinical decision-making for 40% of patients scanned. The community care site demonstrated a 82% change in clinical decision-making. Conclusion: In this study, SEM analysis fitted seamlessly into routine skin assessment and enabled early identification of increased risk of tissue damage, with clinically important reductions in the incidence of HAPU across all participating sites.


Author(s):  
E. Alessandra Strada

This chapter describes palliative psychology competencies in the third domain of palliative care, which focuses on identifying and addressing psychological and psychiatric needs in the patient and the family. Palliative psychology is a holistic discipline. It emphasizes not only the management of distress, but also the importance of facilitating psychospiritual well-being for the patient and for family caregivers. Because psychotherapy is one of the main psychological interventions provided by psychologists, this chapter defines palliative psychotherapy as a relevant framework for the palliative care setting. The essential components related to structure, delivery, and therapeutic stance are discussed. This chapter also discusses major depression, anxiety, and anticipatory grief reactions. Nonpharmacological and pharmacological approaches are discussed.


2009 ◽  
Vol 7 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Isabelle Dumont ◽  
David Kissane

ABSTRACTObjective:Family therapy has developed several approaches to framing questions within family meetings, but few of these techniques have been adapted for palliative care. We focus on the application of questioning techniques from systemic family therapy to palliative care. More specifically, we describe and give examples of the model of asking questions developed by Karl Tomm (1988) through its application in Family Focused Grief Therapy (FFGT), a preventive intervention delivered to high-risk families during palliative care and bereavement.Methods:First, the type of questions used across the course of therapy is explored based on the interventive questioning model. Then, a case example is provided to demonstrate the use and adaptation of this model in a palliative care setting.Results:At the beginning of therapy, the most frequent questions were linear and circular, moving around the family to build up a picture of events from everyone's perspective. As for the frequency of reflexive and strategic questions, these increased as the therapy progressed, bringing the family to new perspectives. The case example fleshes out the importance of each type of question, all of which have a proper place in the course of therapy.Significance of results:These illustrations highlight the value of having a model of questioning styles to guide the clinician when exploring palliative care issues, such as care provision, coping and grief, intimacy, and discussing death. This framework could be useful in guiding supervisors, trainees, and clinicians seeking to build skills and optimize their interventions in a palliative care setting.


2012 ◽  
Vol 30 (8) ◽  
pp. 752-758 ◽  
Author(s):  
Cindy Lee ◽  
Ryash Vather ◽  
Anne O’Callaghan ◽  
Jackie Robinson ◽  
Briar McLeod ◽  
...  

2008 ◽  
Vol 14 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Elizabeth Anita Thompson ◽  
Tina Quinn ◽  
Charlotte Paterson ◽  
Helen Cooke ◽  
Deidre McQuigan ◽  
...  

2007 ◽  
Vol 5 (4) ◽  
pp. 397-404 ◽  
Author(s):  
Maria E. Carlsson ◽  
Ingrid M. Nilsson

ABSTRACTObjectives:To improve the support to bereaved spouses during the year after the patient's death, a project was started consisting of three visits by a nurse (after 1, 3, and 13 months) with conversations about the patient's death and the spouse's life situation. The aim of this study was to describe the bereaved spouse's situation and adaptation during the first year after the loss.Methods:Spouses of patients cared for by The Advanced Home Care Team (APHCT) in Uppsala, Sweden, were invited to participate in the project. Each participant was encouraged to talk freely about his or her situation, but enough direction was given to ensure that all items listed on a standardized questionnaire were covered.Results:Fifty-one spouses met the inclusion criteria and were invited to participate and 45 accepted. The subjects felt quite healthy but were tired and suffered from sleep disturbance. The grief reactions had initially been high but showed a significant decline from 1 to 13 months (p < .01). Forty-nine percent had experienced postbereavement hallucinations.Significance of results:This study showed that the bereaved spouses felt quite healthy and adjusted quite well to their new life situation, after the patient's death in a palliative care setting. The grief reactions had initially been high but showed a significant decline during the year.


Nutrition ◽  
2021 ◽  
pp. 111264
Author(s):  
Enrico Ruggeri ◽  
Marilena Giannantonio ◽  
Rita Ostan ◽  
Federica Agostini ◽  
Anna Simona Sasdelli ◽  
...  

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