scholarly journals A palliative care approach in psychiatry: clinical implications

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mattias Strand ◽  
Manne Sjöstrand ◽  
Anna Lindblad
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Psychiatric Disorders ◽  
Patient Centeredness ◽  
Palliative Approach ◽  
Clinical Scenarios ◽  
Care Approach ◽  
Life Threatening ◽  
Treatment Refractory

Abstract Background Traditionally, palliative care has focused on patients suffering from life-threatening somatic diseases such as cancer or progressive neurological disorders. In contrast, despite the often chronic, severely disabling, and potentially life-threatening nature of psychiatric disorders, there are neither palliative care units nor clinical guidelines on palliative measures for patients in psychiatry. Main text This paper contributes to the growing literature on a palliative approach in psychiatry and is based on the assumption that a change of perspective from a curative to a palliative approach could help promote patient-centeredness and increase quality of life for severely ill patients in psychiatry as well as in somatic medicine. To exemplify this, we offer three different clinical scenarios: severe and enduring anorexia nervosa, treatment-refractory schizophrenia, and chronic suicidality and persistent self-injury in borderline personality disorder. Conclusion We emphasize that many typical interventions for treatment-refractory psychiatric disorders may indeed be of a palliative nature. Furthermore, introducing traditional features of palliative care, e.g. so-called goals of care conversations, could aid even further in ensuring that caregivers, patients, and families agree on which treatment goals are to be prioritized in order to optimize quality of life in spite of severe, persistent mental disorder.

scholarly journals Psychosomatic Medicine and Palliative Care

2020 ◽  
Author(s):  
Manuel Mejías-Estévez ◽  
Rocio Dominguez Álvarez ◽  
Ignacio Jauregi Lobera
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Psychiatric Disorders ◽  
Psychosomatic Medicine ◽  
Terminally Ill ◽  
Scientific World ◽  
Life Threatening ◽  
Medical Disciplines ◽  
Anxiety Depression

Psychosomatic medicine (MP) and palliative care are disciplines with history and both are based in the scientific world. Although the psychosomatic diagnosis is exclusionary, it can help palliative care to be more effective. The influence of the psychosomatic in the palliative exists. According to all the bibliography available in the electronic databases, psychosomatic medicine is a biopsychosocial model related to both physical and psychosocial factors, which helps improve the care of patients with advanced cancer in palliative care (improved survival, quality of life, reduces the burden on caregivers). It helps analyze and address psychiatric disorders, as well as in the control of complex symptoms such as life-threatening anxiety, depression or delirium. Therefore, both medical disciplines are related from the beginning and help to the quality of life of terminally ill patients.

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 Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis

2017 ◽  
Vol 24 (5) ◽  
pp. 663-674 ◽  
Author(s):  
Alessandra Solari ◽  
Andrea Giordano ◽  
Francesco Patti ◽  
Maria Grazia Grasso ◽  
Paolo Confalonieri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Palliative Care ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Symptom Burden ◽  
Palliative Approach ◽  
Home Based ◽  
Palliative Care Outcome Scale

Background: Evidence on the efficacy of palliative care in persons with severe multiple sclerosis (MS) is scarce. Objective: To assess the efficacy of a home-based palliative approach (HPA) for adults with severe MS and their carers. Methods: Adults with severe MS-carer dyads were assigned (2:1 ratio) to either HPA or usual care (UC). At each center, a multi-professional team delivered the 6-month intervention. A blind examiner assessed dyads at baseline, 3 months, and 6 months. Primary outcome measures were Palliative care Outcome Scale-Symptoms-MS (POS-S-MS) and Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW, not assessed in severely cognitively compromised patients). Results: Of 78 dyads randomized, 76 (50 HPA, 26 UC) were analyzed. Symptom burden (POS-S-MS) significantly reduced in HPA group compared to UC ( p = 0.047). Effect size was 0.20 at 3 months and 0.32 at 6 months, and statistical significance was borderline in per-protocol analysis ( p = 0.062). Changes in SEIQoL-DW index did not differ in the two groups, as changes in secondary patient and carer outcomes. Conclusion: HPA slightly reduced symptoms burden. We found no evidence of HPA efficacy on patient quality of life and on secondary outcomes.

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.

scholarly journals The Role of Physiotherapy in Pediatric Palliative Care: A Systematic Review

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1043
Author(s):  
Silvia Ortiz-Campoy ◽  
Cristina Lirio-Romero ◽  
Helena Romay-Barrero ◽  
David Martín-Caro Álvarez ◽  
Purificación López-Muñoz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Scientific Evidence ◽  
Pediatric Palliative Care ◽  
Cochrane Library ◽  
Her Family ◽  
Life Threatening ◽  
Respiratory Physiotherapy

Pediatric palliative care (PPC) is a set of actions aimed at children who suffer from a severe or life-threatening disease to alleviate the symptoms of the disease and improve the quality of life of both the child and his/her family. One of the tools used to control symptoms is physiotherapy; however, its application in the child population has not been thoroughly studied. The main objective of this study was to gather, analyze, and critically evaluate the available scientific evidence on physiotherapy in children who require palliative care through a systematic review of the studies published in the last 10 years in the following databases: PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Of a total of 622 studies, the inclusion criteria were only met by seven articles, which were focused on the relationship between physiotherapy and PPC. This study analyzed: (1) the main pathologies treated, with a predominance of cerebral palsy and cancer; (2) the interventions applied, such as respiratory physiotherapy, neurological physiotherapy, therapeutic massage, and virtual reality; (3) the effects achieved in the child and his/her family, highlighting the control of symptoms and the improvement of the quality of life; and (4) the knowledge of the physiotherapists on PPC, observing that most of the professionals had not received training in this scope. The findings of this review indicate a lack of an adequate evidence foundation for physiotherapy in PPC.

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.

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 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

Palliative care

2007 ◽  
pp. 159-168
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Care Services ◽  
Palliative Care Services ◽  
Life Threatening

Background 160 Interface between cancer and palliative care services 162 Caring for dying people 164 Bereavement 166 Models of bereavement 167 Support for the bereaved 168 The practice of palliative care aims to enhance the quality of life of people experiencing life-threatening illnesses and their families. The principles on which palliative care is based suggest that it...

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