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Existential suffering

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https://www.readbyqxmd.com/read/29676712/-living-longer-than-expected-admitted-to-a-hospice-with-an-underestimated-life-expectancy
#1
E C T Geijteman, M Oolbekkink, H J van Esch
In the Netherlands, patients who have a life expectancy of less than three months may be admitted to a hospice. In a small number of patients, however, their life expectancy is underestimated. It is assumed that patients are delighted to have this extra time. We present the cases of three patients admitted to a large Dutch hospice: two females aged 82 and 83 years, and a 49-year-old man -who ended up living (significantly) longer than expected. Their cases make clear that patients in this situation may suffer from psychological, psychosocial, and existential distress...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29651244/ethical-challenges-for-an-understanding-of-suffering-voluntary-stopping-of-eating-and-drinking-and-the-wish-to-hasten-death-in-advanced-patients
#2
Andrea Rodríguez-Prat, Cristina Monforte-Royo, Albert Balaguer
Some persons with advanced disease but no significant cognitive impairments consciously decide to stop taking food and fluids orally, even though they remain physically able to do so. The question is to what extent voluntarily stopping eating and drinking (VSED) may be considered an expression of a wish to hasten death, in the sense that the latter has been defined recently. We analyze the data reported in some studies in relation to primary care patients who died as a result of VSED and examine their results in light of the qualitative findings of patients that expressed a wish to die...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29597333/from-the-child-s-word-to-clinical-intervention-novel-new-and-innovative-approaches-to-symptoms-in-pediatric-palliative-care
#3
Katharine E Brock, Joanne Wolfe, Christina Ullrich
Despite vast improvements in disease-based treatments, many children live with life-threatening disorders that cause distressing symptoms. These symptoms can be difficult to comprehensively assess and manage. Yet, frequent and accurate symptom reporting and expert treatment is critical to preserving a patient's physical, psychological, emotional, social, and existential heath. We describe emerging methods of symptom and health-related quality-of-life (HRQOL) assessment through patient-reported outcomes (PROs) tools now used in clinical practice and novel research studies...
March 28, 2018: Children
https://www.readbyqxmd.com/read/29564900/-early-integration-of-palliative-care-in-oncology
#4
Marek Sochor
Palliative care has evolved in the last half a century from a philosophy of care aiming at care of dying patients to specific/standalone medical specialization caring of patients with incurable diseases. Patients with advanced cancer suffer from physical and psychical symptoms, existential and social distress and have limited prognosis. Today we have strong clinical data about feasibility and usefulness of early integration of palliative care in oncology in terms of better quality of life, symptom control and survival...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29532465/voluntary-stopping-eating-and-drinking
#5
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29531109/a-narrative-approach-to-healing-chronic-illness
#6
Thomas R Egnew
Many clinicians may feel poorly prepared to manage patient suffering resulting from the travails of chronic illness. This essay explores the thesis that chronically and terminally ill patients can be holistically healed by transcending the suffering occasioned by the degradations of their illnesses. Suffering is conveyed as a story and clinicians can encourage healing by co-constructing patients' illness stories. By addressing the inevitable existential conflicts uncovered in patients' narratives and helping them edit their stories to promote acceptance and meaning, suffering can be transcended...
March 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29525977/personal-transformation-process-of-mental-health-relief-workers-in-sichuan-earthquake
#7
Zhengjia Ren, Meng Gao, Mark Yang, Wei Qu
After Sichuan earthquake, a few dedicated teams of psychological volunteers have been committed to helping the survivors of the disaster for a long period. Their personal transformation experiences were absent in the literatures. The purpose of this qualitative research was to adopt a qualitative research to examine individuals' lived experiences of personal transformation after long-term disaster mental health services. The study interviewed 10 psychological counselors, 3 psychiatric nurses, 4 psychiatrist, and 6 social workers...
March 10, 2018: Journal of Religion and Health
https://www.readbyqxmd.com/read/29518277/the-meaning-of-living-with-uncertainty-for-people-with-motor-neurone-disease
#8
Denise Andrea Harris, Kirsten Jack, Christopher Wibberley
AIM: The aim of this study was to explore the meaning of living with uncertainty for people diagnosed with motor neurone disease (MND). BACKGROUND: MND is a progressive neurodegenerative condition resulting in multiple needs, arising from the complex nature of the disease trajectory. People with MND are often required to make decisions for symptom management and end-of-life care. Research into the lived experience of MND has previously highlighted: the shock of receiving such a diagnosis and prognosis; subsequent concerns relating to the future and loss; and the existential suffering for a person with MND...
March 8, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29517346/endurance-with-partnership-a-preliminary-conceptual-framework-for-couples-undergoing-in-vitro-fertilisation-treatment
#9
Liying Ying, Lai Har Wu, Xiangli Wu, Jing Shu, Alice Yuen Loke
BACKGROUND/OBJECTIVES: Infertility affects both women and men in the physical, emotional, existential, and interpersonal realms. When couples seek in vitro fertilisation (IVF) treatment, they further suffer from the difficulties of the treatment and the uncertainty of its outcome. The aim of this study was to develop a preliminary conceptual framework for couples undergoing IVF treatment to give health professionals a better understanding of the experiences of such couples, and to guide the development of an intervention...
January 5, 2018: Journal of Reproductive and Infant Psychology
https://www.readbyqxmd.com/read/29499028/is-all-suffering-equal-or-is-it-time-to-address-existential-suffering
#10
Tessie W October
No abstract text is available yet for this article.
March 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29489630/a-philosophical-model-of-the-nature-of-nursing
#11
Catherine Green
BACKGROUND: Today, when nurses are expected to manage large stores of data while providing precision care to individuals or groups of patients, it seems more important than ever that we understand the nature of nursing. Recently, there has been a renewed interest in examining what nursing is and how a clear understanding would impact nursing practice. OBJECTIVE: The goal of this article is to review an ontological account of nursing that seeks to understand the nature of nursing by showing the relation between the goal and structure of nursing care in association with the persons who are its recipients and practitioners...
March 2018: Nursing Research
https://www.readbyqxmd.com/read/29436007/survivors-experiences-of-consequences-and-recovery-five-years-after-a-major-bus-crash
#12
Isabelle Doohan, Lina Gyllencreutz, Ulf Björnstig, Britt-Inger Saveman
RATIONALE: There is a lack of long-term follow-up studies focused on injured and uninjured survivors' experiences of the recovery process after major traffic crashes. AIM: To explore all survivors' experiences of long-term physical and psychological consequences and recovery 5 years after a major bus crash. METHODOLOGICAL DESIGN AND JUSTIFICATION: A qualitative design was used to explore experiences in a 5-year follow-up study. RESEARCH METHODS: Participants were 54 survivors of a bus crash with 56 survivors and six fatalities...
February 12, 2018: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29409563/dignity-in-cancer-patients-with-a-life-expectancy-of-a-few-weeks-implementation-of-the-factor-structure-of-the-patient-dignity-inventory-and-dignity-assessment-for-a-patient-centered-clinical-intervention-a-cross-sectional-study
#13
Andrea Bovero, Nader Alessandro Sedghi, Rossana Botto, Chiara Tosi, Valentina Ieraci, Riccardo Torta
OBJECTIVE: Hospice is a favored setting for dignity care. Studies on dignity dimension in end-of-life patients are growing. The Patient Dignity Inventory (PDI) is a tool that can lead to interesting information on dignity-related aspects of suffering. The study aimed to investigate dignity among end-of-life cancer patients, by examining the Italian version of the PDI factor structure and assessing the relationship between dignity and other patients' psychosocial and spiritual variables to improve a patient-centered clinical practice...
February 7, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29383612/palliative-management-of-peritoneal-metastases
#14
REVIEW
Laura A Lambert, Jason Wiseman
Despite significant recent advances in the management of peritoneal carcinomatosis, this diagnosis still is accompanied frequently by a grim survival prognosis, often measured in weeks to months. The poor prognosis also is accompanied often by complications and symptoms that have a dramatic impact on quality of life and are challenging to the managing health care provider and devastating to loved ones caring for the person who is suffering. Consequently, management of carcinomatosis often revolves around palliation of symptoms such as bowel obstruction, nausea, pain, fatigue, and cachexia as well as emotional and existential concerns...
January 30, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29382541/palliative-sedation-for-existential-suffering-a-systematic-review-of-argument-based-ethics-literature
#15
REVIEW
Paulo Rodrigues, Jasper Crokaert, Chris Gastmans
CONTEXT: Although unanimity exists on using palliative sedation (PS) for controlling refractory physical suffering in end-of-life situations, using it for controlling refractory existential suffering (PS-ES) is controversial. Complicating the debate is that definitions and terminology for existential suffering are unclear, ambiguous, and imprecise, leading to a lack of consensus for clinical practice. OBJECTIVES: To systematically identify, describe, analyze, and discuss ethical arguments and concepts underpinning the argument-based bioethics literature on PS-ES...
January 31, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29356590/taking-psychedelics-seriously
#16
Ira Byock
BACKGROUND: Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically supervised and monitored approach. A single or brief series of sessions often results in substantial and sustained improvement among people with treatment-resistant depression and anxiety, including those with serious medical conditions...
April 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29344910/mimesis-and-clinical-pictures-thinking-with-plato-and-broekman-through-the-production-and-meaning-of-images-of-disease
#17
Marjolein Oele
This paper contends, following Plato and Broekman, that (1) seeing images as images is crucial to theorizing medicine and that (2) considering clinical pictures as images of images is a much-needed epistemic complement to the domineering view that sees clinical pictures as mirrors of disease. This does not only offer epistemic, but also ethical benefits to individual patients, especially in those cases where patients suffer from chronic, debilitating, and terminal illnesses and where medicine provides no, or limited, answers in terms of treatment, intervention, and meaning...
January 17, 2018: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/29334753/physicians-perceptions-of-hope-and-how-hope-informs-interactions-with-patients-a-qualitative-exploratory-study
#18
Airin Wolf, Catherine F Garlid, Kristiina Hyrkas
OBJECTIVES: Today some studies of physicians' perceptions of hope are available, but not studies of how hope informs patient care. The objectives of this qualitative study were to describe the ways physicians conceptualize hope and how these may inform interactions with their patients. METHODS: Ten physicians working in a large tertiary care teaching hospital were interviewed. They represented palliative care, oncology, and 7 other specialties. Minimal amount of background information was collected...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29281944/unveiling-the-maelstrom-of-the-early-breast-cancer-trajectory
#19
Mary Godfrey, Sarah Price, Andrew Long
Length and complexity of illness and treatment in early breast cancer mean that the acute phase may extend over months. Employing concepts of "trajectory" and "work" from chronic illness, we explored the temporality of the illness experience for women as it unfolded from diagnosis through acute treatment. We performed multiple, qualitative interviews with 14 women at critical points in their first year postdiagnosis. We differentiated between subphases of the acute breast cancer trajectory: becoming a person with breast cancer: a turning point; first steps in treatment: struggling to protect self-concept; being and feeling ill: "cure" as suffering; and conditional "recovering": an uncertain future...
March 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29279037/how-to-increase-the-quality-of-a-suffering-experience-lessons-derived-from-the-diary-narratives-of-a-dying-adolescent-girl
#20
Mustafa Volkan Kavas
Personal narratives are assumed to be primary sources of the essential meaning of lived experiences of dying. In this study, I analyzed the personal diary of Miraç Fidan, a terminally ill adolescent with advanced cancer who kept a diary until her death at the age of 15. Miraç's Diary, also published as a book, was subjected to hermeneutic phenomenological narrative analysis. Inferences were drawn regarding the following basic elements: (a) The dynamics in which Miraç lived and (2) her perceptions of herself, her immediate environment, and her experiences...
February 2018: Omega
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