scholarly journals Chosen Moments: a Reflective Journey Illustrating Terminally Ill Patients Choosing the Moment to Die

2021 ◽  
Author(s):  
◽  
Viona Jane Maries
Keyword(s):  
Terminally Ill ◽  
Reflective Process ◽  
Terminally Ill Patients ◽  
The Moment ◽  
Precise Moment ◽  
Over Time

<p>In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and most profoundly reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result.  The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars; Taylor (2000), Benner (1984) and Johnstone (1999). This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time. This offers a professional and personal record of the author's insights.</p>

scholarly journals Chosen Moments: a Reflective Journey Illustrating Terminally Ill Patients Choosing the Moment to Die

2021 ◽  
Author(s):  
◽  
Viona Jane Maries
Keyword(s):  
Terminally Ill ◽  
Reflective Process ◽  
Terminally Ill Patients ◽  
The Moment ◽  
Precise Moment ◽  
Over Time

<p>In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and most profoundly reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result.  The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars; Taylor (2000), Benner (1984) and Johnstone (1999). This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time. This offers a professional and personal record of the author's insights.</p>

Attitudes and Desires of Terminally Ill Patients Regarding Euthanasia and Physician-Assisted Suicide (DRAFT)

2018 ◽  
Author(s):  
Yu Jung Kim
Keyword(s):  
Cohort Study ◽  
Depressive Symptoms ◽  
Severe Pain ◽  
Assisted Suicide ◽  
Terminally Ill ◽  
Physician Assisted Suicide ◽  
Care Needs ◽  
Terminally Ill Patients ◽  
Over Time

No studies have explicitly addressed the attitudes and desires of terminally ill patients on euthanasia and physician-assisted suicide (PAS). In this prospective cohort study, 988 terminally ill patients and 893 caregivers were surveyed. A total of 60.2% patients supported euthanasia or PAS in a standard poll question, but only 10.6% seriously considered these interventions for themselves. Patients with depressive symptoms, moderate to severe pain, and significant care needs were more likely to consider euthanasia and PAS. Half of the patients who initially considered euthanasia or PAS changed their minds at the follow-up interview, and an almost equal number newly considered these interventions. Patients with depressive symptoms and dyspnea were more likely to change their minds over time. According to the caregivers of 256 deceased patients, 5.6% of patients discussed euthanasia or PAS in the last month of life, 2.5% hoarded drugs for suicide, and 0.4% died by PAS.

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 Agritourism—A Business Reality of the Moment for Romanian Rural Area’s Sustainability

2021 ◽  
Vol 13 (11) ◽  
pp. 6313
Author(s):  
Ramona Ciolac ◽  
Tiberiu Iancu ◽  
Ioan Brad ◽  
Tabita Adamov ◽  
Nicoleta Mateoc-Sîrb
Keyword(s):  
Rural Communities ◽  
Distribution Channels ◽  
Scientific Paper ◽  
Business Owners ◽  
The Future ◽  
Tourism Potential ◽  
The Moment ◽  
Managerial Experience ◽  
Over Time

The agritourism activity can be a characteristic reality of the present, considering rural area’s sustainability, being at the same time a business reality for rural entrepreneurs and a “must have” for rural communities that have tourism potential. It is a form of tourism, through which the tourist can receive a qualitative product at a reasonable price, but also a field that can ensure sustainable development over time, being at the same time environmentally friendly. The purpose of this scientific paper is to identify the aspects that make agritourism “a possible business reality of the moment”, for Romanian rural area’s sustainability. We take into account the following areas: Bran-Moieciu area—considered “the oldest” in terms of agritourism experience, and Apuseni Mountains area, with a great inclination and potential for this activity. The study conducted for these two areas is focused on several aspects: the degree of involvement in agritourism activities, considering the number of years and managerial experience, the analysis of the types of activities/experiences offered by agritourism structures, the identification of the main reasons/motivations for the orientation towards agritourism and the manner in which this field is perceived. Aspects related to the marketing-finance part of the agritourism business are also taken into account: customers, distribution channels, financial sources, shortcomings observed by agritourism business owners and possible action directions so as to improve the activity/agritourism product. Agritourism may be “a possible business reality of the moment” for the studied areas and not only, but in the future, the entrepreneur/farmer must be constantly updated because of the changing situations that appear on the market, be able to make sustainable decisions for his/her own business, which in the future will ensure its viability and obviously its long-term profitability and development, and in the same time rural area’s sustainability.

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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