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Revista Brasileira de Enfermagem Jun 2016to analyze scientifi c articles published in international online journals about palliative care and spirituality. (Review)
Review
OBJECTIVE
to analyze scientifi c articles published in international online journals about palliative care and spirituality.
METHODS
an integrative literature review with data collected in September 2014 from the LILACS, SCIELO, MEDLINE/PubMed, and IBECS databases.
RESULTS
thirty-nine publications were identifi ed and their textual analysis facilitated through four thematic approaches: the meaning of spirituality in the context of palliative care; palliative care and spiritual support; spirituality and relief of pain and other symptoms in patients under palliative care; and instruments to evaluate the spiritual dimension of the scope of palliative care.
CONCLUSION
this study examined the relevance of the spiritual dimension in the care of patients with palliative care and the need for developing new studies to disseminate knowledge about this topic.
DESCRIPTORS
Palliative Care; Palliative Care at End of Live; Spirituality; Religion; Health.
Topics: Humans; Palliative Care; Spiritual Therapies; Spirituality
PubMed: 27355311
DOI: 10.1590/0034-7167.2016690324i -
Journal of the American College of... Oct 2017Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an... (Review)
Review
Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliative care (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle to address unmet palliative needs earlier and throughout the illness course.
Topics: Disease Progression; Family Health; Heart Failure; Humans; Palliative Care; Patient Care Team; Patient Comfort; Quality of Life; Randomized Controlled Trials as Topic; Severity of Illness Index
PubMed: 28982506
DOI: 10.1016/j.jacc.2017.08.036 -
Nutrients Jan 2021The role of nutritional support for cancer patients in palliative care is still a controversial topic, in part because there is no consensus on the definition of a... (Review)
Review
The role of nutritional support for cancer patients in palliative care is still a controversial topic, in part because there is no consensus on the definition of a palliative care patient because of ambiguity in the common medical use of the adjective palliative. Nonetheless, guidelines recommend assessing nutritional deficiencies in all such patients because, regardless of whether they are still on anticancer treatments or not, malnutrition leads to low performance status, impaired quality of life (QoL), unplanned hospitalizations, and reduced survival. Because nutritional interventions tailored to individual needs may be beneficial, guidelines recommend that if oral food intake remains inadequate despite counseling and oral nutritional supplements, home enteral nutrition or, if this is not sufficient or feasible, home parenteral nutrition (supplemental or total) should be considered in suitable patients. The purpose of this narrative review is to identify in these cancer patients the area of overlapping between the two therapeutic approaches consisting of nutritional support and palliative care in light of the variables that determine its identification (guidelines, evidence, ethics, and law). However, nutritional support for cancer patients in palliative care may be more likely to contribute to improving their QoL when part of a comprehensive early palliative care approach.
Topics: Counseling; Humans; Malnutrition; Neoplasms; Nutrition Assessment; Nutritional Support; Palliative Care; Quality of Life
PubMed: 33498997
DOI: 10.3390/nu13020306 -
Clinics in Geriatric Medicine May 2015Primary care physicians are often the first medical providers patients seek out, and are in an excellent position to provide primary palliative care. Primary palliative... (Review)
Review
Primary care physicians are often the first medical providers patients seek out, and are in an excellent position to provide primary palliative care. Primary palliative care encompasses basic skills including basic evaluation and management of symptoms and discussions about goals of care and advance care planning. Specialty palliative care consultation complements primary care by assisting with complex psychosocial-spiritual patient and family situations. This article reviews primary palliative care skill sets and criteria for when to consider referring patients to specialty palliative care and hospice services.
Topics: Advance Care Planning; Aged; Decision Making; Geriatric Assessment; Humans; Palliative Care; Primary Health Care; Quality of Life; Referral and Consultation; Symptom Assessment
PubMed: 25920056
DOI: 10.1016/j.cger.2015.01.001 -
Seminars in Oncology Nursing Aug 2018To describe the evolution of oncology and palliative nursing in meeting the changing landscape of cancer care. (Review)
Review
OBJECTIVE
To describe the evolution of oncology and palliative nursing in meeting the changing landscape of cancer care.
DATA SOURCES
Peer-reviewed articles, clinical practice guidelines, professional organization, and position statements.
CONCLUSION
Nurses have been at the forefront of efforts to develop and implement oncology and palliative care programs. Fifty years ago a cancer diagnosis meant a poor prognosis, high symptom burden, and disease uncertainty. Current cancer care has advanced to include palliative care in conjunction with innovative therapies and symptom management.
IMPLICATIONS FOR NURSING PRACTICE
Specialty trained oncology and palliative care nurses are essential in disease and symptom management, psychosocial and spiritual support, and advance care planning.
Topics: Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse-Patient Relations; Oncology Nursing; Palliative Care; Quality of Health Care
PubMed: 30119999
DOI: 10.1016/j.soncn.2018.06.001 -
Australian Journal of General Practice Nov 2018While most people say they would prefer to be cared for and to die at home, this outcome is often not achieved. This represents a service gap that general practitioners...
BACKGROUND
While most people say they would prefer to be cared for and to die at home, this outcome is often not achieved. This represents a service gap that general practitioners (GPs) are optimally positioned to fill.
OBJECTIVES
The aim of this paper is to synthesise existing evidence-based frameworks of palliative care together with other resources, to present a cohesive model of care that GPs can easily systematise to guide high-quality home-based palliative care.
DISCUSSION
Key clinical processes include advance care planning and development of medical goals of patient care plans and terminal care plans. Three essential elements for high-quality palliative care incorporated into the model include a compassionate GP, the care team and various practical resources. Palliative care sits well within the GP specialist scope of practice. GPs have at their disposal many resources that effectively and efficiently support them in their palliative care practice.
Topics: Advance Care Planning; Attitude of Health Personnel; General Practice; Home Care Services; Humans; Palliative Care
PubMed: 31207670
DOI: 10.31128/AJGP-06-18-4607 -
Current Treatment Options in Oncology Feb 2020As palliative care (PC) continues its rapid growth, an emerging body of evidence is demonstrating that its approach of interdisciplinary supportive care benefits many... (Review)
Review
As palliative care (PC) continues its rapid growth, an emerging body of evidence is demonstrating that its approach of interdisciplinary supportive care benefits many patient populations, including in the oncology setting. As studies and data proliferate, however, questions persist about who, what, why, when, and how PC as well as the ideal time for a PC consult and length of involvement. When comparing outcomes from chemotherapy trials, it is important to consider the dosing regimens used in the various studies. In the same way, it is important to account for the "dose" of the PC interventions utilized across studies, and apples to apples comparisons are needed in order to draw accurate conclusions about PC's benefits. Studies which include a true interdisciplinary PC intervention consistently show improvements in patient quality of life, as well as cost savings, with further study needed for other outcomes. These benefits cannot be extrapolated to care which may be labeled "palliative care," but which does not meet the standard of true interdisciplinary PC. The ultimate question is: Does PC indeed improve outcomes?
Topics: Caregivers; Costs and Cost Analysis; Humans; Neoplasms; Outcome Assessment, Health Care; Palliative Care; Patient Reported Outcome Measures; Patient Satisfaction; Prognosis; Quality of Life
PubMed: 32025964
DOI: 10.1007/s11864-020-0702-x -
Canadian Family Physician Medecin de... Apr 2019To help increase the confidence of both caregivers and clinicians in providing palliative care to adults with intellectual and developmental disabilities (IDD) using an... (Review)
Review
OBJECTIVE
To help increase the confidence of both caregivers and clinicians in providing palliative care to adults with intellectual and developmental disabilities (IDD) using an easy-to-follow framework to improve and overcome barriers to effective palliative care in this population.
QUALITY OF EVIDENCE
A literature review was conducted to explore recent best evidence to address these palliative care needs and to allow for a focused opportunity to consider the details of implementing clinical practice guidelines in the palliative care context. Evidence ranges from level I to level III.
MAIN MESSAGE
Pain and psychological and emotional distress are important issues for individuals with IDD, as they can be difficult to assess and measure, and often present atypically, especially in those with limited communication skills. Further, little is known about end-of-life needs in the adult population with IDD, especially for those living in community residences. The conducted literature review of patient, caregiver, and clinician experiences exposed considerable barriers, including incorrect assumptions about patients' capacity to understand and discomfort of both caregivers and clinicians with open communication. This has resulted in exclusion of adults with IDD from their own care, which has proven harmful. Maximizing time in familiar surroundings and establishing trust and continuity are crucial. Sometimes trial and error with empiric use of comfort medications is necessary, but this can be mitigated with careful examination of distress patterns and judicious use of diagnostic testing. It is always best to integrate the palliative approach into the existing pattern of care.
CONCLUSION
The validated tools and recommendations provided will assist with communication, symptom interpretation, treatment decisions, advanced care planning, addressing grief, and important considerations in end-of-life care.
Topics: Adult; Aged; Caregivers; Communication; Decision Making; Female; Health Services for Persons with Disabilities; Humans; Male; Middle Aged; Palliative Care; Persons with Mental Disabilities; Physician-Patient Relations
PubMed: 31023774
DOI: No ID Found -
Journal of Clinical Nursing Jan 2018To explore how nurses, across various health systems, describe their role in providing palliative care for patients with life-threatening illnesses. (Meta-Analysis)
Meta-Analysis Review
AIMS AND OBJECTIVES
To explore how nurses, across various health systems, describe their role in providing palliative care for patients with life-threatening illnesses.
BACKGROUND
Despite the fact that nurses make up the largest group of healthcare professionals, little is known about their role in palliative care, across health services.
DESIGN
A qualitative systematic review of studies.
METHODS
A search was made for relevant articles, published between January 2000-June 2016. Twenty-eight articles were selected and analysed using thematic synthesis.
RESULTS
The themes that emerged from the analysis were as follows: Being available, which gave nurses a pivotal role in palliative care and paved the way for Being a coordinator of care for patients and relatives, as well as for other health personnel. Doing what's needed was to handle an enormous breadth of activities, always in a holistic framework of understanding. Being attentively present and dedicated as well as using flexible and nontraditional methods was essential in the role. Standing in demanding situations dealt with lack of time and resources, limited legitimacy, handling ethical dilemmas and being in need of support and knowledge.
CONCLUSION
Being available as well as a coordinator characterises the nurse's role across healthcare systems. The nurse acts as a link between different levels of health care, between different professions and between patient and family, which contribute to ensuring the quality of care to the individual patient. The review illuminates that the basic tenets of care in nursing are also fundamental to the nurse's role in palliative care. To be able to give individually tailored palliative care to patients with life-threatening illnesses and their relatives, the nurses need all their knowledge of basic nursing. Situations challenge nurses in practical, relational and moral dimensions of care and make demands on their role in a comprehensive way.
RELEVANCE TO CLINICAL PRACTICE
Nurses need knowledge and training, guidance and support to fulfil their role.
Topics: Adult; Attitude of Health Personnel; Female; Humans; Male; Middle Aged; Nurse's Role; Nursing Staff; Palliative Care; Qualitative Research
PubMed: 28695651
DOI: 10.1111/jocn.13912 -
Journal of Clinical Oncology : Official... Jan 2017Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012... (Review)
Review
Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer. Methods ASCO convened an Expert Panel of members of the ASCO Ad Hoc Palliative Care Expert Panel to develop an update. The 2012 PCO was based on a review of a randomized controlled trial (RCT) by the National Cancer Institute Physicians Data Query and additional trials. The panel conducted an updated systematic review seeking randomized clinical trials, systematic reviews, and meta-analyses, as well as secondary analyses of RCTs in the 2012 PCO, published from March 2010 to January 2016. Results The guideline update reflects changes in evidence since the previous guideline. Nine RCTs, one quasiexperimental trial, and five secondary analyses from RCTs in the 2012 PCO on providing palliative care services to patients with cancer and/or their caregivers, including family caregivers, were found to inform the update. Recommendations Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment. Referral of patients to interdisciplinary palliative care teams is optimal, and services may complement existing programs. Providers may refer family and friend caregivers of patients with early or advanced cancer to palliative care services.
Topics: Communication; Evidence-Based Medicine; Humans; Neoplasms; Palliative Care; Patient Care Team; Referral and Consultation
PubMed: 28034065
DOI: 10.1200/JCO.2016.70.1474