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The American Surgeon Nov 2020The practice of surgical palliative care is not new. Dr Balfour M. M. Mount, a retired urologic surgeon is considered the father of North American Palliative Care and...
The practice of surgical palliative care is not new. Dr Balfour M. M. Mount, a retired urologic surgeon is considered the father of North American Palliative Care and coined the term Palliative Care in 1975. Dr Geoffrey P. Dunn, a retired general surgeon and hospice and palliative medicine specialist along with other like minded surgical colleagues were instrumental in developing the field of surgical palliative care. Dr Olga Jonasson, championed the American Board of Surgery becoming one of the sponsoring boards of the Hospice and Palliative Medicine certifying exam. Dr Anne Mosenthal advocated for palliative care to be integrated as parallel clinical aims so espoused in the Trauma Quality and Improvement Program Palliative Care Best Practice Guidelines. Dr Mosenthal currently chairs the American College of Surgeons Committee on Surgical Palliative Care. This introductory article is a brief history about the origins of surgical palliative care and sheds light on the current landscape of surgeons integrating primary and specialty palliative care into surgical practice. The aim of this surgical palliative care symposium is to take everyday surgical problems and highlight the application and benefit of palliative care when treating surgical patients with serious illness. Integrating palliative care principles into standard clinical management is evidenced based patient-centered practice.
Topics: General Surgery; History, 20th Century; Humans; Pain Management; Palliative Care; Surgical Procedures, Operative; United States
PubMed: 33231479
DOI: 10.1177/0003134820965951 -
The Medical Clinics of North America May 2020
Topics: Continuity of Patient Care; Humans; Palliative Care
PubMed: 32312416
DOI: 10.1016/j.mcna.2020.02.002 -
Journal of Social Work in End-of-life &... 2020
Topics: Advance Directives; Attitude to Death; Bereavement; Humans; Palliative Care; Social Media; Terminal Care
PubMed: 32941120
DOI: 10.1080/15524256.2020.1819082 -
The Nursing Clinics of North America Jun 2021Sleep-wake disturbances are common in patients with cancer. Despite the high prevalence of altered sleep patterns in oncology settings, there remains a gap in consistent... (Review)
Review
Sleep-wake disturbances are common in patients with cancer. Despite the high prevalence of altered sleep patterns in oncology settings, there remains a gap in consistent assessment of sleep, leading to an underrecognized and undertreated condition. Provider failure in addressing sleep-wake disturbances can result in chronic issues with insomnia and has a negative impact on quality of life and cancer survivorship. Often sleep-wake disturbances present in symptom "clusters" including, anxiety, depression, and fatigue, which adds to the complexity of managing sleep disorders in oncology. Aggressive management strategies for managing underlying symptom burden from disease or medications effects is a priority.
Topics: Fatigue; Humans; Neoplasms; Oncology Nursing; Palliative Care; Prevalence; Sleep Wake Disorders
PubMed: 34023114
DOI: 10.1016/j.cnur.2021.03.001 -
BMC Palliative Care May 2024The integral model of Palliative Care recognizes the community as essential element in improving quality of life of patients and families. It is necessary to find a... (Review)
Review
BACKGROUND
The integral model of Palliative Care recognizes the community as essential element in improving quality of life of patients and families. It is necessary to find a formula that allows the community to have a voice. The aim of this scoping review is to identify barriers and facilitators to engage community in PC.
METHODS
Systematic search was conducted in NICE, Cochrane Library, Health Evidence, CINAHL and PubMed database.
KEYWORDS
Palliative care, End of life care, community networks, community engagement, public engagement, community participation, social participation, barriers and facilitators.
RESULTS
Nine hundred seventy-one results were obtained. Search strategy and inclusion criteria yielded 13 studies that were read in detail to identify factors influencing community engagement in palliative care, categorized into: Public health and public engagement; Community attitudes towards palliative care, death and preferences at the end of life; Importance of volunteers in public engagement programs; Compassionate communities.
CONCLUSION
Societal awareness must be a facilitated process to catalyse public engagement efforts. National policy initiatives and regional system support provide legitimacy and focus is essential for funding. The first step is to get a sense of what is important to society, bearing in mind cultural differences and to channel those aspects through health care professionals; connecting the most assistential part with community resources. The process and long-term results need to be systematically evaluated.
Topics: Humans; Community Participation; Palliative Care; Terminal Care; Community Networks
PubMed: 38711035
DOI: 10.1186/s12904-024-01424-4 -
Journal of Hospice and Palliative... Feb 2019To effectively participate in provision of palliative care, nurses need to possess a combination of knowledge, skills, and positive attitudes in equal measure in a way... (Review)
Review
To effectively participate in provision of palliative care, nurses need to possess a combination of knowledge, skills, and positive attitudes in equal measure in a way that is sensitive and meaningful and in a dynamic manner. The aim of this review was to examine nurses' knowledge and attitudes about palliative care, to identify gaps to improve care of patients and families facing death. An integrative review method guided this review. After implementation of a search strategy, data from 26 studies were analyzed and synthesized. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. Data were extracted using a common table, and themes were generated from the available peer-reviewed studies using narrative synthesis. Findings revealed knowledge deficit but favorable attitudes toward palliative care among nurses. Education and the clinical experience of nurses in palliative care influenced their knowledge and attitudes toward palliative care. There is a need for mandatory inclusion of basic palliative care content in nursing school curricula and more in-depth postgraduate curricula. In clinical practice, there is a need to reinforce palliative care education by creating expert nurse support networks to model excellence in palliative care.
Topics: Health Knowledge, Attitudes, Practice; Humans; Nurses; Palliative Care
PubMed: 30608355
DOI: 10.1097/NJH.0000000000000481 -
Emergency Medicine Journal : EMJ Dec 2018Heart failure is a common ED presentation that is underserved by palliative care services and is associated with significant morbidity and mortality. We sought to...
OBJECTIVES
Heart failure is a common ED presentation that is underserved by palliative care services and is associated with significant morbidity and mortality. We sought to evaluate use of palliative care services in patients with heart failure presenting to the ED. The primary outcome studied was palliative care involvement. Secondary outcomes of the study were: (1) 1-year mortality, (2) ED visits, (3) hospital admissions and (4) heart failure clinic involvement.
METHODS
We conducted a health records review of 500 patients with heart failure who presented to two Canadian academic hospital EDs from January to August 2013.
RESULTS
Patients were of mean age 80.7 years, women (53.2%) and had significant comorbidities. Only 41% of all deceased patients at 1 year had any palliative care involvement. Of those with palliative care, 44 (76%) patients had less than 2 weeks of palliative care involvement prior to death. Compared with those with no palliative care, the 79 (15.8%) patients with palliative care involvement had a higher 1-year mortality rate (70.9% vs 18.8%) and more hospital admissions/year (1.4 vs 0.85) for heart failure.
CONCLUSIONS
We found that few patients with heart failure had palliative care services. Additionally, the majority of those who have palliative care involvement do not meet current recommendations for early palliative care involvement in heart failure. This study suggests that the ED may be an appropriate setting to identify and refer high-risk patients with heart failure who could benefit from earlier palliative care involvement.
Topics: Aged; Aged, 80 and over; Emergency Service, Hospital; Female; Heart Failure; Hospitalization; Humans; Male; Ontario; Palliative Care
PubMed: 30042165
DOI: 10.1136/emermed-2017-207186 -
The American Journal of Hospice &... Aug 2018With the expansion of palliative care, the concept of clinical excellence is worthy of study and has not been described well in the literature. (Review)
Review
BACKGROUND
With the expansion of palliative care, the concept of clinical excellence is worthy of study and has not been described well in the literature.
OBJECTIVE
To apply the domains of clinical excellence, as proposed and published by the Miller Coulson Academy of Clinical Excellence, to the field of palliative care.
DESIGN
Review of the literature to identify episodes of superb palliative care delivered by individuals and teams.
MEASUREMENT AND MAIN RESULTS
In reviewing 821 publications, we found multiple palliative care case reports to serve as exemplars for each of the distinct domains of clinical excellence.
CONCLUSIONS
The domains of excellence are relevant and applicable to the field of palliative care. This article aims to inspire clinicians-and advance the field-by promoting thoughtful reflection on what clinical excellence in palliative care entails.
Topics: Clinical Competence; Communication; Health Knowledge, Attitudes, Practice; Humans; Interpersonal Relations; Palliative Care; Professionalism; Quality of Health Care
PubMed: 29277108
DOI: 10.1177/1049909117748882 -
Chinese Clinical Oncology Jun 2018Palliative care acknowledges the historical origin of the hospice developed in the UK during the 20th century. Palliative care initially focused primarily on end-of-life... (Review)
Review
Palliative care acknowledges the historical origin of the hospice developed in the UK during the 20th century. Palliative care initially focused primarily on end-of-life care provided at hospices, but then changed to at-home care, leading to the formation of a support system provided by the palliative care team. The palliative care team further coordinated with acute care hospitals and became involved in earlier stages of care as well, such as providing symptomatic relief in conjunction with cancer treatment. On this backdrop, the concept of palliative care itself also evolved over time. In recent years, attempts at early-stage palliative care from the initial stages of treatment are being studied with respect to cases with complications such as advanced cancer. Early-stage palliative care has been reported to improve patient quality of life (QOL), improve depression, reduce the burden on the family, and possibly improve survival prognosis for some advanced cancers. Currently, efforts to integrate palliative care into standard oncology care regimens by providing specialist palliative care and cancer treatment as a single unit are anticipated to enter more widespread practice. Such a care approach differs from conventional palliative care, which is started around the time when the end of conventional cancer treatment, and consists of applying specialist palliative care from the stage where cancer treatments are administered to address with multiple problems. Many breast cancer patients have severe problems such as esthetic outcome, sexuality and psycho-social effects associated with breast cancer itself and treatment. And it effects their QOL for a long time not only during therapy but also having done therapy or recurrence. Therefore, it may be effectiveness for patients to integrate of palliative care into standard oncology care in breast cancer, but the effect of it for only breast cancer patients has not been reported on yet. In this paper, after reviewing the concepts and historical evolution of palliative care, we describe the integration of palliative care into standard oncology care that has been making progress recently.
Topics: History, 20th Century; History, 21st Century; Humans; Integrative Oncology; Medical Oncology; Palliative Care; Standard of Care
PubMed: 30056734
DOI: 10.21037/cco.2018.06.02 -
The New England Journal of Medicine Oct 2021
Topics: Attitude to Death; Death; Humans; Palliative Care; Terminal Care
PubMed: 34623785
DOI: 10.1056/NEJMp2107941