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Holistic palliative care

Suzie Gillon, Ian J Clifton
Breathlessness is a common symptom for patients with terminal illness and can be challenging to manage. Breathlessness is acknowledged to be an interaction between body and mind. There are a variety of pharmacological and non-pharmacological therapies that can be beneficial. The holistic assessment of the breathlessness patient should enable delivery of a tailored package of care focused on relief of symptoms.
February 2, 2019: British Journal of Hospital Medicine
Shazi Shakil
Alzheimer's disease, a neurodegenerative disorder continues to be an area of investigation by the international researchers' fraternity. Despite all the ongoing efforts, the effective set of promising cholinesterase inhibitors available in the market for patients' use is limited. Furthermore, the currently available drugs could provide only a palliative type of treatment instead of providing a complete cure or foolproof prevention. Hence, design/discovery of fresh drug molecules as acetylcholinesterase (AChE) inhibitors still remains an urgent requirement...
February 11, 2019: Journal of Cellular Biochemistry
Soyoung Choi, JooYoung Seo
The inclusion of caregivers in a holistic care approach represents a basic principle in palliative care. However, many palliative care professionals have a lack of understanding of difficulties or unmet needs among caregivers. To enhance the quality of life of caregivers and the quality of care for patients, healthcare professionals should be better informed about the constructs of caregiver burden. The aim of this study is to synthesize the concept of caregiver burden in palliative care, providing implications for the caregivers and their support systems...
February 8, 2019: Nursing Forum
Rekha Rachel Philip, Emilie Venables, Abdulla Manima, Jaya Prasad Tripathy, Sairu Philip
BACKGROUND: Home-based palliative care is an essential resource for many communities. We conducted a qualitative study to explore perceptions of a home-based palliative care programme in Kerala, India, from the perspective of patients, their care-givers and the doctors, nurses and volunteers running the intervention. METHODS: A descriptive qualitative study was carried out. One focus group discussion (FGD) was conducted with patients (n = 8) and two with male and female volunteers (n = 12); and interviews were conducted with doctors (n = 3), nurses (n = 3) and care-givers (n = 14)...
February 4, 2019: BMC Palliative Care
Tanja Fusi-Schmidhauser, Alessia Riglietti, Katherine Froggatt, Nancy Preston
Although chronic obstructive pulmonary disease (COPD) is recognized as being a life-limiting condition with palliative care needs, palliative care provision is seldom implemented. The disease unpredictability, the misconceptions about palliative care being only for people with cancer, and only relevant in the last days of life, prevent a timely integrated care plan. This systematic review aimed to explore how palliative care is provided in advanced COPD and to identify elements defining integrated palliative care...
February 4, 2019: COPD
Kathryn A Pfaff, Lisa Dolovich, Michelle Howard, Deborah Sattler, Merrick Zwarenstein, Denise Marshall
Designing and implementing population-based systems of care that address the social determinants of health, take action on multiple levels, and are guided by evidence-based principles is a pressing priority, and an international challenge. Aging persons are a priority demographic whose health needs span physical, psychosocial and existential care domains, increase in the last year of life, are often poorly coordinated and therefore remain unmet. Compassionate communities (CCs) are an example of a public health approach that fully addresses the holistic healthcare needs of those who are aging and nearing end of life...
January 27, 2019: Health Promotion International
Jason W Boland, Stephen Barclay, Jane Gibbins
Palliative care is the holistic care of patients with advanced, progressive incurable illness. Palliative care is well recognized as an essential component of medical student curricula. However, teaching is variable within medical schools. Using current literature, these tips aim to highlight key points necessary to facilitate the development and delivery of palliative care teaching to medical students. The key practice points include: clinical exposure to patients with palliative care needs and those that are dying, being compulsory (and integrated) across the course, summative and formative assessments to encourage learning, support from within the university for curricular time and development, visits to a hospice/inpatient palliative care facility, emphasis on clinically based learning later in the course, teaching by specialists in palliative care as well as specialists in other areas including Family Doctors/General Practitioners, innovative teaching methods and inter-professional learning to develop teaching...
January 28, 2019: Medical Teacher
Christina Gerlach, Swantje Goebel, Sascha Weber, Martin Weber, Katherine E Sleeman
BACKGROUND: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The 'Surprise'-Question can be used to facilitate referral to palliative care. AIM: To explore experiences, views and perceptions of haemato-oncologists on the use of the 'Surprise'-Question in the haemato-oncology outpatients clinics of a university hospital in Germany...
January 28, 2019: Palliative Medicine
Anne Warby, Haryana M Dhillon, Steven Kao, Janette L Vardy
BACKGROUND: Malignant pleural mesothelioma (MPM) has a poor prognosis and heavy symptom burden. Here, we investigate health professionals' attitudes to management and decision-making in people with MPM. METHODS: Survey questions were based on previous interviews with health professionals, MPM patients, and caregivers. Surveys were sent to specialist doctors and nurses who treat MPM. RESULTS: Surveys were completed by 107 doctors and 19 nurses from January-September 2014...
January 25, 2019: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Alicia M Bonanno, Laszlo N Kiraly, Timothy R Siegel, Karen J Brasel, Mackenzie R Cook
INTRODUCTION: There is increasing recognition that Surgical Palliative Care is an essential component of the holistic care of surgical patients and involves more than end-of-life care in the intensive care unit. General surgery residents are clinically exposed to patients with palliative care needs during each year of training, but few have a dedicated surgical palliative care curriculum. We undertook this educational needs assessment as the first step towards a longitudinal curriculum...
January 17, 2019: American Journal of Surgery
Ulrika Östlund, Karin Blomberg, Annika Söderman, Carina Werkander Harstäde
BACKGROUND: An essential aspect of palliative care nursing is to conserve the dignity of the patient. A Dignity Care Intervention (DCI) has been developed in Scotland to facilitate this role for nurses. The DCI is now being adapted to a Swedish context (DCI-SWE) and a central step is to identify culturally relevant, dignity-conserving care actions. These care actions will be incorporated into the DCI-SWE. Therefore, the aim of this study was to suggest care actions for conserving dignity in palliative care from the perspectives of the patients, significant others (SOs), and health care professionals (HPs) in municipality care in Sweden...
January 24, 2019: BMC Palliative Care
Marina Maffoni, Piergiorgio Argentero, Ines Giorgi, Julia Hynes, Anna Giardini
OBJECTIVES: Palliative care providers may be exposed to numerous detrimental psychological and existential challenges. Ethical issues in the healthcare arena are subject to continual debate, being fuelled with ongoing medical, technological and legal advancements. This work aims to systematically review studies addressing the moral distress experienced by healthcare professionals who provide adult palliative care. METHODS: A literature search was performed on PubMed, Scopus, Web of Science and PsycINFO databases, searching for the terms 'moral distress' AND 'palliative care'...
January 12, 2019: BMJ Supportive & Palliative Care
Danique Lm Radder, Nienke M de Vries, Niels P Riksen, Sarah J Diamond, Ditza Gross, Daniel R Gold, John Heesakkers, Emily Henderson, Adrianus Laj Hommel, Herma H Lennaerts, Jane Busch, Ray E Dorsey, John Andrejack, Bastiaan R Bloem
Parkinson's disease (PD) is a chronic multisystem disorder that causes a wide variety of motor and non-motor symptoms. Over time, the progressive nature of the disease increases the risk of complications such as falls and loss of independence, having a profound impact on quality of life. The complexity and heterogeneity of symptoms therefore warrant a holistic, multidisciplinary approach. Specific healthcare professionals, e.g. the movement disorders neurologist and the PD nurse specialist, are considered essential members of this multidisciplinary team...
December 20, 2018: Expert Review of Neurotherapeutics
Michael D McGoon, Pisana Ferrari, Iain Armstrong, Migdalia Denis, Luke S Howard, Gabi Lowe, Sanjay Mehta, Noriko Murakami, Brad A Wong
The assessment of objective measurement of cardiopulmonary status has helped us achieve better clinical outcomes for patients and develop new therapies through to the point of market access; however, patient surveys indicate that more can be done to improve holistic care and patient engagement. In this multidisciplinary review, we examine how clinical teams can acknowledge and embrace the individual patient's perspective, and thus improve the care for individual patients suffering from pulmonary hypertension by cultivating the importance and relevance of health-related quality of life in direct clinical care...
December 13, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Marianne K Schallmo, Sharon Dudley-Brown, Patricia M Davidson
CONTEXT: Heart failure is a chronic complex syndrome that is common and burdensome. International clinical practice guidelines recommend that healthcare providers communicate palliative care options with patients with heart failure. OBJECTIVES: The aim of this study was to conduct an integrative review to evaluate how healthcare providers perceived communication barriers to offering information to individuals in the palliative phase of heart failure. METHODS: Four databases and the gray literature were searched from January 1987 to February 2017...
December 11, 2018: Journal of Cardiovascular Nursing
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
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