Principles of palliative care

2018 ◽  
Vol 11 (12) ◽  
pp. 676-679
Author(s):  
Joshua Getty
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Symptom Control ◽  
Management Options ◽  
Initial Management ◽  
Factors Affecting ◽  
Dying Patients ◽  
Life Threatening ◽  
The Individual

Palliative care traditionally focused on symptom-control in dying patients, but has recently evolved to include care of life-threatening or limiting conditions by optimising the benefits of treatment and considering other ways to improve the quality of life for patients. This is achieved through holistic consideration of physical, psychosocial and spiritual factors affecting the individual patient. The aim of this article is to explore these factors and initial management options.

scholarly journals Pediatric Oncology Palliative Care Programs in Central America: Pathways to Success

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1031
Author(s):  
Wendy Cristhyna Gómez García ◽  
Silvia Rivas ◽  
Gabriela Paz ◽  
Marisol Bustamante ◽  
Gerardo Castro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Dominican Republic ◽  
Central America ◽  
Pediatric Oncology ◽  
Symptom Control ◽  
Financial Barriers ◽  
Future Directions ◽  
Life Threatening

Palliative care offers children who have life-limiting and life-threatening oncologic illnesses and their families improved quality of life. In some instances, impeccable symptom control can lead to improved survival. Cultural and financial barriers to palliative care in oncology patients occur in all countries, and those located in Central America are no exception. In this article, we summarize how the programs participating in the Asociación de Hemato-Oncólogos Pediatras de Centro America (AHOPCA) have developed dedicated oncology palliative care programs. The experience in Guatemala, El Salvador, Costa Rica, Panama, Dominican Republic and Haiti is detailed, with a focus on history, the barriers that have impeded progress, and achievements. Future directions, which, of course, may be impacted by the COVID-19 pandemic, are described as well.

scholarly journals Overview of Palliative Care

2014 ◽  
Vol 9 (2) ◽  
pp. 3-10
Author(s):  
B D Paudel ◽  
G Dangal ◽  
D Munday
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Symptom Control ◽  
Oral Morphine ◽  
Common Symptom ◽  
Depression And Anxiety ◽  
Threatening Condition ◽  
Life Threatening ◽  
The 1960S

Patients diagnosed with a life threatening condition like cancer suffer physically, socially and mentally. Their quality of life can be improved by effective communication and good symptom control even when the disease is incurable. Pain is the most common symptom and can be controlled by optimal use of analgesics especially oral morphine if severe. Psychosocial issues like depression and anxiety can be minimized by counseling and use of medicines. Death is more painful than birth but can be minimized by understanding the reality and by honest sharing which will help to minimize unnecessary sufferings. Palliative care is the care of these patients and their family members to make their life comfortable. Modern palliative care has developed around the world since the 1960s and in Nepal, since the beginning of 21st century. Much remains to be done before palliative care can be an integrated part of health care in Nepal. In this context gynaecologist having knowledge and skills in palliative care, have an important role in improving the quality of life of patients with life threatening condition and their family members.DOI: http://dx.doi.org/10.3126/njog.v9i2.11724

Genitourinary Issues in Palliative Care

2021 ◽  
pp. 198-213
Author(s):  
Min Ji Kim ◽  
Kimberson Tanco
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Symptom Management ◽  
Urinary Tract Obstruction ◽  
Performance Status ◽  
Treatment Options ◽  
Symptom Control ◽  
Kidney Injury ◽  
Management Options

Genitourinary problems in palliative care can be very distressing to patients and require prompt management and alleviation of symptoms. Examples include urinary tract obstruction, which can lead to pain and kidney injury, as well as infection, hematuria, renal colic, and bladder spasm-related pain. This chapter addresses relevant aspects of palliative care in patients with genitourinary issues, including consideration for context of symptoms and subsequent practical management. Options for symptom management may range from medications to procedural interventions. In deciding between treatment options, factors such as the patient’s preexisting comorbidities, performance status, goals of care, and anticipated benefit in symptom control and in quality of life versus potential burden of treatment must be considered.

The effects of animal-assisted interactions on quality of life in children with life-threatening conditions and their parents

2021 ◽  
Vol 27 (10) ◽  
pp. 524-530
Author(s):  
Haley Walker ◽  
Mary Chapman Miller ◽  
Brittany Cowfer ◽  
Terrah Akard ◽  
Mary Jo Gilmer
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Palliative Care ◽  
Primary Caregivers ◽  
Randomised Clinical Trial ◽  
Severe Stress ◽  
Quality Of Life Research ◽  
Threatening Condition ◽  
Life Threatening

Background: Children with advanced cancer and their primary caregivers may experience severe stress and anxiety in coping with their life-threatening condition. As a way to help reduce these stressors and increase overall quality of life, research suggests that animal-assisted interactions may be beneficial when integrated into palliative care. Aims: This pilot study aims to provide evidence for the feasibility and efficacy of a randomised clinical trial using animal-assisted interactions to help improve the quality of life for children with an advanced life-threatening condition and their primary caregivers. This protocol paper outlines the basis of the research, goals, experimental design and methodology.

The Promise of Palliative Care

Pained ◽  
2020 ◽  
pp. 203-206
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Social Workers ◽  
Hospice Care ◽  
Care Plan ◽  
Life Care ◽  
High Quality ◽  
Life Threatening

This chapter assesses palliative care. Palliative care focuses on improving the quality of life for people with life-threatening illnesses by involving a team of nurses, doctors, social workers, and clergy in a care plan. Hospice care—administered in dedicated units and in services delivered at home—has been slowly expanding over the past two decades, but the increasing percentage of patients who use hospice for less than 7 days suggests that the full benefits of end-of-life palliative care are not being realized. Meanwhile, the use of unwanted, aggressive end-of-life care, often inconsistent with patient preferences, remains pervasive. For palliative care to be effective, it must be supported by government policies and insurer incentives; it must also be owned by communities, which must continue to ask for help in designing and paying for high-quality palliative care for patients and their caregiving families.

scholarly journals Integration of palliative care into the neuro-oncology practice: patterns in the United States

2014 ◽  
Vol 1 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Tobias Walbert
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Brain Tumor ◽  
End Of Life ◽  
Symptom Control ◽  
Tumor Patients ◽  
Life Phase ◽  
Improve Symptom ◽  
Oncology Practice

Abstract Background Between 80%–85 percent of all adult brain tumors are high-grade gliomas (HGGs). Despite aggressive treatment with surgical resection, radiotherapy and chemotherapy, the survival of patients with HGG is limited. Brain tumor patients develop unique symptoms and needs throughout their disease trajectory, and the majority lose the ability to communicate during the end-of-life phase. Palliative care (PC) is a proactive and systematic approach to manage issues that are important to patients and families affected by serious illness. The goal is to improve quality of life and symptom control and thereby reduce suffering. Most PC interventions take place during the end-of-life phase; however, newer data suggest that early PC interventions might improve symptom control and quality of life. Methods A literature review focusing on PC, hospice care, and end-of-life care was performed with the aim to describe the integration of PC into neuro-oncology practice. Results Recently there has been increased interest in the effects of PC and brain tumor patients. The origins, methodology, and conceptual models of delivering PC and how it might be applied to the field of neuro-oncology were reviewed. Patterns of referral and utilization in neuro-oncology are described based on the findings of a recent survey. Conclusions Despite a very high symptom burden, many HGG patients do not receive the same level of PC and have fewer interactions with PC services than other cancer populations. Early PC interventions and structured advance-care planning might improve symptom control and quality of life for brain tumor patients.

Urinary incontinence principles

2017 ◽  
Author(s):  
Christopher R. Chapple ◽  
Nadir I. Osman
Keyword(s):  
Urinary Incontinence ◽  
Neural Control ◽  
Well Being ◽  
Initial Management ◽  
Lost Productivity ◽  
Life Threatening ◽  
The Individual ◽  
Aetiological Spectrum ◽  
Broad Overview

Urinary incontinence (UI) is a highly prevalent and bothersome problem that affects men and women of all ages. The aetiological spectrum of UI is wide, encompassing dysfunctions of the lower urinary tract, its neural control, the pelvic floor as well as other factors such as the side effects of pharmacotherapy. Although not life-threatening, UI frequently impacts upon the quality of life, psychological and emotional well-being of affected individuals. Additionally, UI imposes a tremendous economic burden on both the individual and the wider society in costs of nursing care, treatments, and lost productivity. The purpose of this chapter is to provide a broad overview of the epidemiology, aetiopathophysiology of UI, and to discuss the approach to the assessment, investigation, and initial management of the patient presenting with UI.

scholarly journals Ethical sensitivity and perceptiveness in palliative home care through co-creation

2019 ◽  
Vol 27 (2) ◽  
pp. 446-460
Author(s):  
Jessica Hemberg ◽  
Elisabeth Bergdahl
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Home Care ◽  
Future Research ◽  
Main Theme ◽  
Ethical Sensitivity ◽  
Ethical Perspective ◽  
Palliative Home Care ◽  
Dying Patients

Background: In research on co-creation in nursing, a caring manner can be used to create opportunities whereby the patient’s quality of life can be increased in palliative home care. This can be described as an ethical cornerstone and the goal of palliative care. To promote quality of life, nurses must be sensitive to patients’ and their relatives’ needs in care encounters. Co-creation can be defined as the joint creation of vital goals for patients through the process of shared knowledge between nurses, patients and their relatives. Aim: The aim of this study was to explore nurses’ experiences of caring encounters and co-creation in palliative home care from an ethical perspective. Research design, participants, and research context: A hermeneutical approach was used. The material consisted of texts from interviews with 12 nurses in a home care context. The method was inspired by thematic analysis. Ethical considerations: Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Findings: An overall theme, a main theme and four sub-themes emerged. Through ethical sensitivity and perceptivity, nurses can balance their actions in the moment and change their nursing care actions according to the patient’s wishes through co-creation in encounters. Here the time is crucial, as the time needed is unique to each patient. Discussion: The themes together can be considered prerequisites for good palliative home care. If nurses fail to be sensitive and perceptive in encounters with dying patients, good palliative home care cannot be achieved. Ethical sensitivity and perceptiveness can also be considered a part of nurses’ ethical competence. Conclusion: Patients’ dignity can be preserved through ethical sensitivity and perceptiveness, which is fundamental for good palliative care. Co-creation from patients’ perspectives should be the focus of future research.

Palliative and Hospice Care: Educational Needs of Inpatient Registered Nurses

2016 ◽  
Vol 22 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Jennifer L. Ashley ◽  
Tracy K. Fasolino
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Acute Care ◽  
Formal Education ◽  
Care Setting ◽  
Hospice Care ◽  
Acute Care Setting ◽  
Life Threatening ◽  
Hospice And Palliative Care

Hospice and palliative care aim to improve the quality of life for patients and families impacted by chronic, serious, and life-threatening illnesses. Patients and families benefit from earlier integration of palliative care and seamless transitions to hospice care. Nurses are an integral part of the care team, and their understanding of these services is critical. However, many nurses do not receive formal education in hospice and palliative care. This leads to lack of skills that nurses need to provide and discuss hospice and palliative care across care settings. Nurses in an acute care setting of a large health system were invited to participate in a survey, Attitudes Towards Care at the End-of-Life. The results of this survey revealed that nurses believe that patients and families need to be communicated with honestly regarding their disease, but nurses lack the knowledge of how to facilitate these discussions. Another key finding is that nurses feel less confident with non-pharmacologic interventions to relieve patients’ suffering. Education is urgently needed in these areas.

Initial Management of Low-Risk Pediatric Fever and Neutropenia: Efficacy and Safety, Costs, Quality-of-Life Considerations, and Preferences

2012 ◽  
pp. 570-574
Author(s):  
Lillian Sung
Keyword(s):  
Quality Of Life ◽  
Low Risk ◽  
Self Report ◽  
Future Research ◽  
Outpatient Management ◽  
Management Options ◽  
Initial Management ◽  
Parent Proxy Report ◽  
Meta Analyses

Overview: Initial management options for pediatric low-risk fever and neutropenia (FN) include outpatient compared with inpatient management and oral compared with intravenous therapy. Single-arm and randomized trials have been conducted in children. Meta-analyses provide support for the equivalence of outpatient and inpatient approaches. Outpatient oral management may be associated with a higher risk of readmission compared with outpatient intravenous management in children with FN, although other outcomes such as treatment failure and discontinuation of the regimen because of adverse effects were similar. Importantly, there have been no reported deaths among low-risk children treated as outpatients or with oral antibiotics. Costs, whether derived directly or through cost-effectiveness analysis, are consistently reduced when an outpatient approach is used. Quality of life (QoL) and preferences should be considered in order to evaluate different strategies, plan programs, and anticipate uptake of outpatient programs. Using parent-proxy report, child QoL is consistently higher with outpatient approaches, although research evaluating child self-report is limited. Preferences incorporate estimated QoL, but, in addition, factor in issues such as costs, fear, anxiety, and logistical issues. Only approximately 50% of parents prefer outpatient management. Future research should develop tools to facilitate outpatient care and to measure caregiver burden associated with this strategy. Additional work should also focus on eliciting child preferences for outpatient management. Finally, studies of effectiveness of an ambulatory approach in the real-world setting outside of clinical trials are important.

Sign in / Sign up

Export Citation Format

Share Document