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Holistic palliative 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...
October 8, 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...
August 7, 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
Charlotte Sortedahl, Jean Krsnak, Michelle M Crook, Lisa Scotton
PURPOSE: The purpose of this article is to examine how case managers, taking a holistic, patient-centered approach that is grounded in advocacy, have a crucial role to play in the opioid crisis response. This includes providing education, support, and resources to prevent misuse of and addiction to opioids prescribed for pain management and intervening with more resources to help combat the nonmedical use of prescription opioids and heroin. PRIMARY PRACTICE SETTINGS: In addition to case managers in acute care, workers' compensation, and palliative care, who have frequent contact with patients who are prescribed opioid medications for pain management, all case managers may interact with patients and support systems/families who are directly or indirectly impacted by opioid use, misuse, and addiction...
September 2018: Professional Case Management
Geronimo Jimenez, Woan Shin Tan, Amrit K Virk, Chan Kee Low, Josip Car, Andy Hau Yan Ho
OBJECTIVE: To provide an overview of the current state of research of advance care planning (ACP), highlighting most studied topics, publication time, quality of studies and reported outcomes, and to identify gaps to improve ACP receptivity, utilization, implementation, and outcomes. METHOD: Cochrane methodology for conducting overviews of systematic reviews. Study quality was assessed using a modified version of the Assessing the Methodological Quality of Systematic Reviews tool...
July 30, 2018: Palliative & Supportive Care
Claire E Johnson, Peta McVey, Joel Jin-On Rhee, Hugh Senior, Leanne Monterosso, Briony Williams, Julia Fallon-Ferguson, Matthew Grant, Harriet Nwachukwu, Michèle Aubin, Patsy Yates, Geoffrey Mitchell
BACKGROUND: With an increasing ageing population in most countries, the role of general practitioners (GPs) and general practice nurses (GPNs) in providing optimal end of life (EoL) care is increasingly important. OBJECTIVE: To explore: (1) patient and carer expectations of the role of GPs and GPNs at EoL; (2) GPs' and GPNs' contribution to advance care planning (ACP) and (3) if primary care involvement allows people to die in the place of preference. METHOD: Systematic literature review...
July 25, 2018: BMJ Supportive & Palliative Care
Paloma Millan-Billi, Candela Serra, Ana Alonso Leon, Diego Castillo
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and fatal disease. The treatment is challenging and nowadays a comprehensive approach based not only in pharmacological strategies is necessary. Identification and control of comorbidities, non-pharmacological treatment, prevention and management of exacerbations as well as other areas of care (social, psychological) are fundamental for a holistic management of IPF. Gastroesophageal reflux, pulmonary hypertension, obstructive sleep apnea, combined with emphysema, lung cancer and cardiovascular involvement are the main comorbidities associated with IPF...
July 24, 2018: Medical Sciences: Open Access Journal
Jiwon Lee, Younghye Park, Kyounjoo Lim, Ari Lee, Hanul Lee, Jong-Eun Lee
BACKGROUND: As the population ages, the prevalence of various chronic diseases increases. Palliative care for patients at the end of life with a noncancer diagnosis is currently limited because of the difficulties of demarcating the boundaries of the end-of-life care period and of determining the various care needs of patients at the end of life. PURPOSE: This study aimed to investigate the levels of importance and difficulty of the multidimensional care needs for patients with a noncancer diagnosis during various end-of-life stages...
July 19, 2018: Journal of Nursing Research: JNR
Wei Ling Chin, Tiina Jaaniste, Susan Trethewie
Siblings of children with life limiting conditions (LLC) are an important part of the broader family system and require consideration in the holistic care of the family. There can be considerable variation in the functioning and adjustment of these siblings. The current paper explores the resilience paradigm, particularly in the context of siblings of children with LLC and serious medical conditions. The potential impact of children living with a seriously ill brother or sister will be overviewed, and a range of functional outcomes considered...
July 16, 2018: Children
Anne Black, Tamsin McGlinchey, Maureen Gambles, John Ellershaw, Catriona Rachel Mayland
BACKGROUND: There is limited understanding of the 'lived experience' of palliative care patient within the acute care setting. Failing to engage with and understand the views of patients and those close to them, has fundamental consequences for future health delivery. Understanding 'patient experience' can enable care providers to ensure services are responsive and adaptive to individual patient need. METHODS: The aim of this study was to explore the 'lived experience' of a group of patients with palliative care needs who had recently been in-patients in one acute hospital trust in the north-west of England...
July 6, 2018: BMC Palliative Care
Qiu-Mei Wang, Xiao-Hong Ning, Xiao-Hong Liu, Hui-Hui Li
According to the World Health Organization,palliative care is an approach that prevents and alleviates the pain of patients with life-threatening illness and improves the quality of life of patients and their families through early identification,assessment and treatment of pain and other physical,psychosocial and spiritual problems. It is the active holistic care accomplished by multidisciplinary team. This article describes the practice of the palliative care in a patient with advanced retroperitoneal sarcoma...
June 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
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