scholarly journals Hypnosis in a specialist palliative care setting – enhancing personalized care for difficult symptoms and situations

2020 ◽  
Vol 14 ◽  
pp. 263235242095343
Author(s):  
Sara Booth
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Symptom Control ◽  
Evidence Base ◽  
Self Management ◽  
Specialist Palliative Care ◽  
Personalized Care ◽  
Improve Symptom ◽  
Palliative Care Setting

This is a personal account of using hypnosis as an adjunct to specialist palliative care (SPC) treatment approaches. After a brief systematic review of the literature, one clinician’s experience is outlined illustrated by short, anonymized case histories. It argues that the approach is underused in SPC. The barriers currently restricting its routine adoption in SPC are discussed including (1) a lack of SPC clinical trials, (2) a misunderstanding of hypnosis leading to stigma, and (3) its absence from clinicians’ training pathways. While the evidence base for the effectiveness of hypnosis in ‘supportive care’, for example, managing chemotherapy-induced vomiting, is appreciable, there is a gap in SPC. There is little data to guide the use of hypnosis in the intractable symptoms of the dying, for example, breathlessness or the distress associated with missed or late diagnosis. There are many people now ‘living with and beyond cancer’ with chronic symptomatic illness, ‘treatable but not curable’. Patients often live with symptoms over a long period, which are only partially responsive to pharmacological and other therapies. Hypnosis may help improve symptom control and quality of life. SPC trials are needed so that this useful tool for self-management of difficult symptoms can be more widely adopted.

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.

scholarly journals Current dilemmas in the assessment of suffering in palliative care

2014 ◽  
Vol 13 (4) ◽  
pp. 1093-1101 ◽  
Author(s):  
Alicia Krikorian ◽  
Juan Pablo Román
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Theoretical Background ◽  
Chronic Illnesses ◽  
General Description ◽  
Palliative Care Setting ◽  
Different Populations ◽  
Assessment Measures ◽  
Quality Tools

AbstractObjective:Although relief from suffering is essential in healthcare and palliative care, few efforts have aimed at defining, operationalizing, and developing standards for its detection, assessment, and relief. In order to accurately explore and identify factors that contribute to suffering, more attention needs to be focused on quality assessment and measurement, not only for assessment purposes but also to test the effectiveness of interventions in relieving suffering. The scope of the present paper is to discuss the strategies that aid in the detection and assessment of the suffering experience in patients with chronic illnesses and/or in palliative care settings, and the dilemmas commonly encountered regarding the quality of available assessment measures.Method:A general description of instruments available for suffering assessment is provided. Matters regarding the accuracy of the measures are discussed. Finally, some dilemmas regarding the quality of the measures to screen for and assess suffering are presented.Results:There have been some achievements toward adequate suffering assessment. However, a more robust theoretical background is needed, and empirical evidence aimed at supporting it is required. In addition, further examination of the psychometric characteristics of instruments in different populations and cultural contexts is needed.Significance of results:An interesting number of assessment measures are now available for use in the palliative care setting, employing innovative approaches. However, further examination and validation in different contexts is required to find high-quality tools for detection of suffering and assessment of the results of intervention.

scholarly journals Diet and Nutrition in Cancer Survivorship and Palliative Care

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Anthony J. Bazzan ◽  
Andrew B. Newberg ◽  
William C. Cho ◽  
Daniel A. Monti
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Survivorship ◽  
End Of Life Care ◽  
Care Setting ◽  
Cancer Recurrence ◽  
Current Data ◽  
Wide Range ◽  
Palliative Care Setting

The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a recent emphasis in the literature on nutrition and cancer as an important factor in both quality of life and in the pathophysiology of cancer. Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of cancer patients in the palliative care setting.

scholarly journals Psychiatric liaison in palliative care

2003 ◽  
Vol 9 (4) ◽  
pp. 241-248 ◽  
Author(s):  
Simon Dein
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Depressive Illness ◽  
Care Staff ◽  
Cognitive Behavioural ◽  
Palliative Care Setting ◽  
Total Care ◽  
Body Image Disturbances ◽  
Illness Anxiety

Palliative care is the active, total care of patients whose disease is not responsive to curative treatment. Psychological problems such as depressive illness, anxiety, delirium, problems coping and body image disturbances are common in the palliative care setting, although they are often missed. A full assessment of these patients should take into account physical, emotional and spiritual factors; therapeutic work should include the patient's family. Pharmacological (antidepressants, anxiolytics and antipsychotics) and cognitive–behavioural treatments are often effective in allaying distress in this group of patients, and can improve coping skills and quality of life. Liaison psychiatrists have a role in teaching palliative care staff to recognise psychiatric disorders. A number of case studies are presented to illustrate these points.

The caregiver perspective: Advancing the understanding of cancer caregiving in the palliative care setting.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 17-17 ◽  
Author(s):  
Martha Raymond ◽  
Margaret-Ann Simonetta
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Focus Groups ◽  
Care Setting ◽  
Unmet Needs ◽  
Supportive Services ◽  
Caregiver Support ◽  
Palliative Care Setting ◽  
Cancer Caregivers

17 Background: 2018 data from the National Cancer Institute’s Surveillance, Epidemiology & End Results (SEER) Program estimates there are 15.5 million cancer survivors in the U.S. Throughout the care continuum, cancer caregivers provide invaluable support which greatly impacts and improves patient quality of life. In the palliative care setting caregiver support is vitally important, but many caregivers struggle to take care of their own needs and are not aware of supportive services. Our study explores the unmet needs of cancer caregivers in the palliative care setting. Methods: Over a two-year time period (2015-2017), our professional facilitator met with cancer caregivers in 32 states hosting nationwide focus groups. Primary goals were reaching caregivers in rural, urban, medically underserved, and community oncology settings to gain perspective from diverse populations. Focus groups were held in person and online via facetime conferencing. Results: 778 caregivers (42% male, 58% female) participated. 92% of caregivers did not feel comfortable defining palliative care nor did they realize the various supportive elements palliative care provides. 76% were extremely anxious during care transitions; 71% feel overwhelmed with daily caregiving tasks; 69% want to help make end of life decisions including advance directives in partnership with their loved one, but did not feel equipped to make tough decisions; 64% report lack of patient/caregiver centered communication with their healthcare team, including guidance on adverse effects and training for medical hands-on tasks. Conclusions: Caregivers in the palliative care setting need additional supportive services, effective interventions, and educational programs to meet their unmet needs. With additional support and awareness, enhanced quality of life for both caregiver and patient is possible. Our conversations with caregivers will continue as we increase palliative care awareness, collaborate with partners, develop meaningful programs, and expand our outreach to help meet the needs of caregivers in the palliative care setting.

scholarly journals Delivering preference for place of death in a specialist palliative care setting

2013 ◽  
Vol 2 (1) ◽  
pp. u201375.w897 ◽  
Author(s):  
David Oxenham ◽  
Anne Finucane ◽  
Elizabeth Arnold ◽  
Papiya Russell
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Place Of Death ◽  
Specialist Palliative Care ◽  
Palliative Care Setting
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