Aesthetic Expression

2006 ◽  
Vol 10 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Alexis B. Ressler
Keyword(s):  
Terminally Ill ◽  
Human Experience ◽  
Biomedical Ethics ◽  
New Paradigm ◽  
Terminally Ill Patients ◽  
Dying Patients ◽  
Existential Concerns ◽  
Aesthetic Expression

The author discusses a new paradigm for working with terminally ill patients that focuses on each individual’s unique human experience rather than on the more abstract principles of biomedical ethics. This paradigm is based on a four-part framework developed by existential psychoanalyst, Irving Yalom. The author examined each portion of Yalom’s framework and focused the discussion on the relational ways in which clinicians might address their dying patients’ inevitable existential concerns.

Definition of a Good Death, Attitudes Toward Death, and Feelings of Interconnectedness Among People Taking Care of Terminally ill Patients With Cancer: An Exploratory Study

2019 ◽  
Vol 37 (5) ◽  
pp. 343-349 ◽  
Author(s):  
Andrea Bovero ◽  
Francesco Gottardo ◽  
Rossana Botto ◽  
Chiara Tosi ◽  
Marta Selvatico ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Terminally Ill ◽  
Good Death ◽  
Care Providers ◽  
Death Attitudes ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Attitudes Toward Death ◽  
Open Questions ◽  
Dying Patients

The concept of a good death is crucial in palliative care, but its relationship with attitudes toward death and feelings of interconnectedness needs to be further deepened. The first aim of this study was to explore the concept of good death, attitudes toward death, and feelings of interconnectedness among family caregivers (FCs) and health-care providers (HCPs) of terminally ill patients with cancer. The second aim was to analyze associations of good death concept with attitudes toward death and feelings of interconnectedness. Participants were asked to assess the importance of features that characterize a good death. To explore each person’s attitude toward death and feelings of interconnectedness, 3 open questions were used. The sample consisted of 49 participants: 24 (48.98%) FCs and 25 (51.02%) HCPs. Nine good death features were considered essential by more than 70% of participants. These referred to the physical (eg, symptoms control), social (eg, loved ones’ presence), emotional (eg, sharing emotions), and spiritual (eg, inner peace) dimensions. Importance attributed to components of a good death such as patient’s awareness and acceptance of death, meaning, respect for the patient’s wishes, and inner peace were found to be associated with lack of avoidance and acceptance toward death and feelings of interconnectedness. Given the importance of FCs and HCPs in providing care and their impact on the patients’ dying process, it is necessary to reflect upon how their personal attitudes and previous experiences influence the care of dying patients.

Psychiatric Day Hospital Treatment of Terminally Ill Patients

1977 ◽  
Vol 7 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Stanley E. Slivkin
Keyword(s):  
Psychiatric Treatment ◽  
Death And Dying ◽  
Terminally Ill ◽  
Treatment Programs ◽  
Hospital Treatment ◽  
Day Hospital ◽  
Interface Area ◽  
Terminally Ill Patients ◽  
Dying Patients ◽  
Working Out

The psychiatric Day Hospital offers a forum for working out bereavement issues of terminally ill patients. Through individual and group psychotherapy, patients and their families are assisted in coping with the issues of death and dying. Coordination of medical, surgical, and psychiatric treatment of dying patients is enhanced by Day Hospital educational and treatment programs which afford continuity of care at the interface area between treatment specialties.

Terminally Ill Patients and Desire for Death

1986 ◽  
Author(s):  
J. H. Brown ◽  
P. Henteleff ◽  
S. Barakat ◽  
C. J. Rowe
Keyword(s):  
Terminally Ill ◽  
Terminally Ill Patients ◽  
Desire For Death

scholarly journals The role of EORTC QLQ-C15-PAL scores and inflammatory biomarkers in predicting survival in terminally ill patients with cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yoshihiro Shitashimizu ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Cox Regression ◽  
Terminally Ill ◽  
Inflammatory Biomarkers ◽  
Survival Curves ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Patient Reported ◽  
Eortc Qlq

Abstract Background The clinical use of patient-reported outcomes as compared to inflammatory biomarkers for predicting cancer survival remains a challenge in palliative care settings. We evaluated the role of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative scores (EORTC QLQ-C15-PAL) and the inflammatory biomarkers C-reactive protein (CRP), albumin (Alb), and neutrophil-lymphocyte ratio (NLR) for survival prediction in patients with advanced cancer. Methods This was an observational study in terminally ill patients with cancer hospitalized in a palliative care unit between June 2018 and December 2019. Patients’ data collected at the time of hospitalization were analyzed. Cox regression was performed to examine significant factors influencing survival. A receiver operating characteristic (ROC) analysis was performed to estimate cut-off values for predicting survival within 3 weeks, and a log-rank test was performed to compare survival curves between groups divided by the cut-off values. Results Totally, 130 patients participated in the study. Cox regression suggested that the QLQ-C15-PAL dyspnea and fatigue scores and levels of CRP, Alb, and NLR were significantly associated with survival time, and cut-off values were 66.67, 66.67, 3.0 mg/dL, 2.5 g/dL, and 8.2, respectively. The areas under ROC curves of these variables were 0.6–0.7. There were statistically significant differences in the survival curves between groups categorized using each of these cut-off values (p < .05 for all cases). Conclusion Our findings suggest that the assessment of not only objective indicators for the systemic inflammatory response but also patient-reported outcomes using EORTC QLQ-C15-PAL is beneficial for the prediction of short-term survival in terminally ill patients with cancer.

scholarly journals Symptom clusters and their influence on prognosis using EORTC QLQ-C15-PAL scores in terminally ill patients with cancer

2021 ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yuuna Tahara ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Symptom Clusters ◽  
Rank Test ◽  
Appetite Loss ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Log Rank Test ◽  
Eortc Qlq ◽  
Cluster 2

Abstract Purpose The aims of the present study were to investigate the symptom clusters in terminally ill patients with cancer using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL), and to examine whether these symptom clusters influenced prognosis. Methods We analyzed data from 130 cancer patients hospitalized in the palliative care unit from June 2018 to December 2019 in an observational study. Principal component analysis was used to detect symptom clusters using the scored date of 14 items in the QLQ-C15-PAL, except for overall QOL, at the time of hospitalization. The influence of the existence of these symptom clusters and Palliative Performance Scale (PPS) on survival was analyzed by Cox proportional hazards regression analysis, and survival curves were compared between the groups with or without existing corresponding symptom clusters using the log-rank test. Results The following symptom clusters were identified: cluster 1 (pain, insomnia, emotional functioning), cluster 2 (dyspnea, appetite loss, fatigue, and nausea), and cluster 3 (physical functioning). Cronbach’s alpha values for the symptom clusters ranged from 0.72 to 0.82. An increased risk of death was significantly associated with the existence of cluster 2 and poor PPS (log-rank test, p = 0.016 and p < 0.001, respectively). Conclusion In terminally ill patients with cancer, three symptom clusters were detected based on QLQ-C15-PAL scores. Poor PPS and the presence of symptom cluster that includes dyspnea, appetite loss, fatigue, and nausea indicated poor prognosis.

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