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.

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.

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.

Depression means different things: A qualitative study of psychiatrists' conceptualization of depression in the palliative care setting

2014 ◽  
Vol 13 (5) ◽  
pp. 1223-1230 ◽  
Author(s):  
Felicity Ng ◽  
Gregory B. Crawford ◽  
Anna Chur-Hansen
Keyword(s):  
Palliative Care ◽  
Depressive Symptoms ◽  
Gold Standard ◽  
Care Setting ◽  
Depressive Illness ◽  
Medical Practitioners ◽  
Palliative Care Setting ◽  
Heterogeneous Nature ◽  
Data Saturation ◽  
Unitary Model

AbstractObjective:Medical practitioners conceptualize depression in different ways, which adds to the challenges of its diagnosis and treatment, as well as research in the palliative care setting. Psychiatric assessment is often considered the “gold standard” for diagnosis, therefore how psychiatrists conceptualize depression in this setting is pertinent. Our study aimed to investigate this issue.Method:Psychiatrists working in palliative care in Australia were individually interviewed using a semistructured approach. Nine participants were interviewed to reach data saturation. Interview transcripts were analyzed for themes.Results:Three overarching themes were identified: (1) depression means different things; (2) depression is conceptualized using different models; and (3) depression is the same concept within and outside of the palliative care setting. Participants explicitly articulated the heterogeneous nature of depression and described a different breadths of concepts, ranging from a narrow construct of a depressive illness to a broader one that encompassed depressive symptoms and emotions. However, depressive illness was a consistent concept, and participants considered this in terms of phenotypic subtypes. Participants used three models (spectral, dichotomous, and mixed) to relate various depressive presentations.Significance of Results:Psychiatrists did not subscribe to a unitary model of depression but understood it as a heterogeneous concept comprised of depressive illness and other less clearly defined depressive presentations. Given the influence of psychiatric opinion in the area of depression, these findings may serve as a platform for further discussions to refine the concepts of depression in the palliative care setting, which in turn may improve diagnostic and treatment outcomes.

scholarly journals How did Music Therapy Contribute to Patients’ Quality of Life in a Hospice and Palliative Care Setting?

2021 ◽  
Author(s):  
◽  
Ah Young Jeong
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Music Therapy ◽  
Care Setting ◽  
Research Question ◽  
Palliative Care Setting ◽  
Hospice Patients ◽  
Hospice And Palliative Care ◽  
Affective Awareness

<p>This qualitative research explores how I, as a student music therapist, contributed to patients’ quality of life (QoL) in a hospice and palliative care setting. The study principally focuses on the different music therapy and personal approaches that I used and which seemed to contribute to patients’ QoL. The research was carried out at a hospice in New Zealand and I had sessions with in-patients, day hospice patients and out-patients who were all at varying stages of illness.  In this research, secondary analysis of data is used to answer my research question. The data used in this study are the clinical notes and reflexive journals that I gathered while working with 67 patients in a total of 194 sessions. Because QoL is a broad complex concept, I have chosen to use a conceptual framework suggested by music therapy theorist Even Ruud (1997) to put a structure to answering my research question. In thematic analysis, the data were both deductively and inductively analysed.  The findings describe music therapy methods, activities, strategies and techniques as well as personal approaches I employed which seemed to promote a sense of affective awareness, agency, belonging and meaning, and coherence of life in patients receiving hospice and palliative care. This study indicated that Ruud’s (1997) framework has particular meaning in the context of hospice palliative care and that the framework could be extended for use in hospice and palliative care. The clinical vignette further provide an exploratory view of the use of music therapy techniques and the quality of relationships, and how both of these contributed to increasing a patient’s QoL.  In the discussion, the findings are further explained in the light of other studies. In particular, ‘being with’ patients underpinned all of the musical and personal approaches that I made in working with hospice patients and this is evaluated as an overarching point. Although Ruud’s (1997) idea of QoL was a good fit in my study, the study may suggests how his model could address ways in which affective awareness, agency, belonging and meaning and coherence of life can be supported with various music and personal approaches in the context of music therapy in hospice and palliative care settings.</p>

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.

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