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Holistic palliative care

Laura Nimmon, Gil Kimel, Lorelei Lingard, Joanna Bates
PURPOSE OF REVIEW: A holistic palliative approach for heart failure care emphasizes supporting nonprofessional informal caregivers. Informal caregivers play a vital role caring for heart failure patients. However, caregiving negatively affects informal caregivers' well being, and in turn heart failure patients' health outcomes. This opinion article proposes that complex adaptive systems (CAS) theory applied to heart failure models of care can support the resiliency of the heart failure patient - informal caregiver dyad...
November 30, 2018: Current Opinion in Supportive and Palliative Care
Lisa Jane Brighton, Sophie Miller, Morag Farquhar, Sara Booth, Deokhee Yi, Wei Gao, Sabrina Bajwah, William D-C Man, Irene J Higginson, Matthew Maddocks
BACKGROUND: Breathlessness is a common, distressing symptom in people with advanced disease and a marker of deterioration. Holistic services that draw on integrated palliative care have been developed for this group. This systematic review aimed to examine the outcomes, experiences and therapeutic components of these services. METHODS: Systematic review searching nine databases to June 2017 for experimental, qualitative and observational studies. Eligibility and quality were independently assessed by two authors...
November 29, 2018: Thorax
Deborah M Price, Linda K Strodtman, Marcos Montagnini, Heather M Smith, Bidisha Ghosh
BACKGROUND: The Institute of Medicine identifies that quality palliative/end-of-life (EOL) care should be provided to patients with serious, life-limiting illnesses and their families by competently prepared health professionals. PURPOSE: This study assessed perceived concerns of health professionals pertaining to the delivery of palliative/EOL care in the hospital setting. The specific aim was to determine thematic concerns in the delivery of palliative/EOL care which emerged from respondents' impressions of a memorable palliative/EOL patient experience...
November 21, 2018: American Journal of Hospice & Palliative Care
Noleen K McCorry, Sean O'Connor, Kathleen Leemans, Joanna Coast, Michael Donnelly, Anne Finucane, Louise Jones, W George Kernohan, Paul Perkins, Martin Dempster
BACKGROUND: The goal of Palliative Day Services is to provide holistic care that contributes to the quality of life of people with life-threatening illness and their families. Quality indicators provide a means by which to describe, monitor and evaluate the quality of Palliative Day Services provision and act as a starting point for quality improvement. However, currently, there are no published quality indicators for Palliative Day Services. AIM: To develop and provide the first set of quality indicators that describe and evaluate the quality of Palliative Day Services...
November 19, 2018: Palliative Medicine
Kathleen Mason, Frances Toohey, Merryn Gott, Tess Moeke-Maxwell
PURPOSE OF REVIEW: This article provides an informed perspective on cardiovascular disease (CVD) and palliative care need among Māori New Zealanders. High Māori CVD risk factors will contribute to a sharp increase in older Māori deaths which has implications for health and palliative care service provision. RECENT FINDINGS: CVD is New Zealand's leading cause of premature deaths and disability among Māori. A projected rise in older Māori deaths within the next 30 years will require increased palliative care...
November 13, 2018: Current Opinion in Supportive and Palliative Care
Susan Bluck, Emily L Mroz, Jacqueline Baron-Lee
OBJECTIVE: This study identifies health care providers' perspectives on palliative care at end of life (EOL) in a neuromedicine-intensive care unit (Neuro-ICU) and barriers to providing palliative care. BACKGROUND: Provider's EOL expertise is crucial in making timely referrals to palliative care as expectation of patient death can be high. Barriers to referral need to be clearly identified so as to engage quality initiatives that improve EOL care delivery. DESIGN AND PARTICIPANTS: The study is a survey design using a mixed-methods approach...
November 7, 2018: Journal of Palliative Medicine
Joseph M Sawyer, Rahul Asgr, Florence N Todd Fordham, John D H Porter
BACKGROUND: The treatment of Multidrug-Resistant Tuberculosis represents one of the most significant challenges to global health. Despite guidance on improving treatment outcomes, there is little focus on how to support individuals in their suffering. Palliative care is therefore proposed as a necessary component in the global strategy to fight Tuberculosis. We aim to describe the informal resources and networks available to persons affected by Multidrug-Resistant Tuberculosis, how they are accessed and how they are integrated into everyday lives...
October 31, 2018: BMC Palliative Care
Dolors Mateo-Ortega, Joaquín T Limonero, Jorge Maté-Méndez, Elba Beas, Jesús González-Barboteo, Elisabeth Barbero, Sara Ela, Xavier Gómez-Batiste
OBJECTIVE: The goal of this study is to describe the development of a new tool, the Psychosocial and Spiritual Needs Evaluation scale Instrumento de Evaluación de Necesidades Psicosociales y Espirituales del Enfermo al Final de Vida (ENP-E), designed to assess the psychosocial needs of end-of-life (EOL) patients. And, secondarily, to describe the face validity and psychometric properties of this instrument in the Spanish-speaking context. METHOD: The scale was developed through a seven-stage process: (1) literature review; (2) expert panel establishment; (3) discussion and agreement on the most relevant dimensions of psychosocial care; (4) description of key indicators and consensus-based questions to evaluate such dimensions; (5) assessment of the scale by external palliative care (PC) professionals; (6) evaluation by patients; and (7) analysis of scale's psychometrics properties...
October 16, 2018: Palliative & Supportive Care
Antonio Noguera, Ramón Robledano, Eduardo Garralda
PURPOSE OF REVIEW: The aim of this review is to understand how palliative care teaching (PCT) as a patient-centered learning model, influences medical undergraduate students' professional development. RECENT FINDINGS: To study PCT medical undergraduate students' learning experiences, we have employed the medical teaching concept, 'hidden curriculum,' as a way of describing attitudes and behavior conveyed implicitly by palliative care educators. Fifteen studies were selected: ten of those studies used a qualitative approach; two are theoretical explanations of the topic explored, one guideline, one review and just one quantitative study, made up the review...
December 2018: Current Opinion in Supportive and Palliative Care
Alexandra Gray-Renfrew, Barbara Kimbell, Anne Finucane
Introduction Patients with advanced liver disease live mainly in the community with treatment of complications provided for in-hospital. The illness trajectory of advanced liver disease is uncertain and most do not have access to end of life care. Gaps in knowledge and understanding of the patient experience of this condition have been identified. Methods Secondary analysis of 15 transcripts from in-depth interviews with people with advanced liver disease collected as part of a previous longitudinal study on the experience of liver disease...
October 4, 2018: Chronic Illness
Mark Clayton, Jan Aldridge
In a society of diverse views, faiths and beliefs, what can paediatric palliative care contribute to our understanding of children's spirituality? By failing to recognise and respond to their spirituality in this work, we risk missing something of profound importance to children and their families. We overlook their search for wholeness in the absence of cure and fall short of offering truly holistic care. This paper explores how developments in advance care planning and related documentation are addressing these issues...
September 28, 2018: Archives of Disease in Childhood. Education and Practice Edition
Alison Rodriguez
No abstract text is available yet for this article.
October 2018: Evidence-based Nursing
Anna W LaVigne, Babe Gaolebale, Goitseone Maifale-Mburu, Surbhi Grover
BACKGROUND: A rising tide of cancers and other chronic diseases, alongside the ongoing HIV/AIDS epidemic, has created an increasing demand for palliative care in Africa. Yet, few African nations have established effective palliative care programs. In Botswana, the escalating HIV/AIDS crisis revealed an unmet need for holistic care, prompting efforts to expand palliative care education and policy, and target curricular and health system integration in the years that followed. Despite numerous successes, Botswana continues to face barriers to palliative care development...
October 2018: Annals of Palliative Medicine
Mohamad-Hani Temsah
Advances in critical care and technology capabilities may lead to new ethical encounters in paediatrics, especially in the paediatric intensive care unit (PICU). As each patient has unique psychosocial and clinical condition interactions, paediatricians and healthcare providers must develop and adopt a suitable approach for ethical decision-making in the PICU. The healthcare provider needs to balance the four ethical domains of autonomy, beneficence, non-maleficence and justice, and apply these principles to clinical decision-making...
2018: Sudanese Journal of Paediatrics
N Siouta, P Clement, B Aertgeerts, K Van Beek, J Menten
BACKGROUND: Patients with Chronic Heart Failure (CHF) and patients with Chronic Obstructive Pulmonary Disease (COPD) share similar symptom burden with cancer patients, however, they are unlikely to receive palliative care (PC) services. This article examines the perceptions of health care professionals and the current practices of integrated palliative care (IPC) in Belgium. METHODS: Cardiologists and pulmonologists, working in primary care hospitals in Belgium, participated in this study with semi-structured interviews based on IPC indicators...
August 24, 2018: BMC Palliative Care
Kareem Ahmad, Steven D Nathan
Idiopathic pulmonary fibrosis (IPF) treatment was revolutionized by the advent of two novel antifibrotics, nintedanib and pirfenidone. However, neither is a panacea and other agents are still sorely needed. This review presents on-going efforts to improve outcomes for patients with IPF by targeting novel pharmacologic pathways, improving comorbidity management, and aiming for improved quality of life. Areas covered: We provide an overview of on-going basic and clinical science efforts focused on development of additional drug therapies for patients with IPF...
October 2018: Expert Review of Respiratory Medicine
Maisa Vitória Gayoso, Marla Andréia Garcia de Avila, Thays Antunes da Silva, Rúbia Aguiar Alencar
OBJECTIVE: To verify the association between the level of comfort of the caregiver and socio-demographic variables related to caregiving, and the patient's functional status and symptoms. METHOD: Cross-sectional study with non-probabilistic intentional sample. The instruments Palliative Performance Scale (score 0 to 100%), Edmonton Symptom Assessment Scale (symptom scores from zero to ten) and Holistic Comfort Questionnaire (total score ranging from 49 to 294 and mean score from 1 to 6) were used...
August 9, 2018: Revista Latino-americana de Enfermagem
Kathryn Eckert, Lila Motemaden, Michelle Alves
Patients with end-stage renal disease (ESRD) should choose a treatment modality, such as hemodialysis (HD) or conservative medical management (CMM), to improve their symptoms with the goal of attaining a good quality of life (QOL), a concept highly aligned with palliative care principles. This article aims to answer if elderly patients with ESRD have improved QOL with CMM compared with HD. Conservative medical management focuses on managing symptoms, rather than invasive procedures such as HD, with more focus on holistic care...
June 2018: Journal of Hospice and Palliative Nursing: JHPN
Adriana Coelho, Vitor Parola, Anna Sandgren, Olga Fernandes, Katharine Kolcaba, João Apóstolo
Guided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program...
August 2018: Journal of Hospice and Palliative Nursing: JHPN
Anu Viitala, Marita Saukkonen, Juho T Lehto, Mira Palonen, Päivi Åstedt-Kurki
The purposes of this study were to describe the coping processes and support needs of patients with incurable cancer. The study was conducted as a qualitative study. The research data were gathered by conducting thematic interviews with outpatients with incurable cancer (n = 16) and analyzed by means of inductive content analysis. The results of the study indicate that the lives of patients were temporarily interrupted by the incurable illness. A sympathetic family was perceived as strength, and after the initial shock, the patients began to rebuild their lives...
April 2018: Journal of Hospice and Palliative Nursing: JHPN
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