-
Asian Pacific Journal of Cancer... Aug 2023Palliative care is the active holistic treatment of people of all ages who have serious health-related suffering as a result of severe illness, and especially of those... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Palliative care is the active holistic treatment of people of all ages who have serious health-related suffering as a result of severe illness, and especially of those who are close to the end of life. Palliative care is provided to cancer patients who experience serious suffering that cannot be relieved without professional intervention and that compromises physical, social, spiritual, and emotional functioning. A straightforward, low-risk, and affordable palliative care approach may be provided through aromatherapy, a type of complementary and alternative medicine. The study objective is to assess the comparative effectiveness of massage, aromatherapy massage, and massage combined with aromatherapy inhalation on cancer patients receiving palliative care.
METHODS
A total of 100 participants who were divided into four groups at random. The first group, designated as the control group, received standard hospital nursing care, the second group received massage only (using the odorless almond carrier oil), the third group received massage with lavender oil, and the fourth group received combined (inhalation and massage) aromatherapy. The Rotterdam Symptom Checklist (RSCL), given two weeks after aromatherapy, was used to examine participants' perspectives of care.
RESULTS
On the RSCL, combined aromatherapy performed best. In terms of reported physical symptoms, psychological symptoms, and activities, there were statistically significant differences between the scores of the control group and each of the experimental groups. Nonetheless, the total quality of life score showed no significant difference between the control group and the massage only group (t = 0.529, p = 0.60).
CONCLUSIONS
When paired with aromatherapy inhalation, massage has a positive effect on physical, psychological symptoms, activities, and overall quality of life for cancer patients receiving early palliative care. Nurses and other healthcare providers are recommended to support programs that provide message therapy to reduce reported bodily symptoms, psychological problems, and limited activities among cancer patients.
Topics: Humans; Aromatherapy; Mind-Body Therapies; Neoplasms; Palliative Care; Quality of Life
PubMed: 37642059
DOI: 10.31557/APJCP.2023.24.8.2729 -
Palliative Medicine Feb 2024The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting...
BACKGROUND
The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability.
AIM
To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers.
DESIGN
Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure.
SETTING
European.
PARTICIPANTS
International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation.
RESULTS
A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms used to encompass distressing physical and psychological symptoms as well as existential suffering and to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided.
CONCLUSIONS
This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.
Topics: Humans; Palliative Care; Delphi Technique; Terminal Care; Consensus; Anesthesia; Deep Sedation
PubMed: 38297460
DOI: 10.1177/02692163231220225 -
The Yale Journal of Biology and Medicine Jun 2023The climate crisis is a planetary existential threat, disproportionately affecting the poorest populations worldwide. People in low- and middle-income countries (LMICs)... (Review)
Review
The climate crisis is a planetary existential threat, disproportionately affecting the poorest populations worldwide. People in low- and middle-income countries (LMICs) experience the most detrimental consequences of climate injustice, endangering their livelihoods, safety, overall wellbeing, and survival. Although the 2022 United Nations Climate Change Conference (COP27) put forth several internationally salient recommendations, the outcomes fall short to efficiently tackle the suffering that exists at the intersection of social and climate injustice. Individuals with serious illness living in LMICs have the highest burden of health-related suffering globally. In fact, more than 61 million people experience serious health-related suffering (SHS) each year that is amenable to palliative care. Despite this well-documented burden of SHS, an estimated 88-90% of palliative care need is unmet, the majority in LMICs. To equitably address suffering at individual, population, and planetary levels in LMICs, a palliative justice approach is crucial. The interplay of human and planetary suffering requires that current planetary health recommendations be expanded to incorporate a whole-person and whole-people perspective that recognizes the need for environmentally conscious and community-based research and policy initiatives. Conversely, palliative care efforts should incorporate planetary health considerations to ensure sustainability in capacity building and service provision. In sum, the optimal health of the planet will remain elusive until we can holistically recognize the value of relieving all suffering due to life-limiting conditions, as well as the value in preserving the natural resources of countries in which all people are born, live, age, suffer, die, and grieve.
Topics: Humans; Palliative Care
PubMed: 37396979
DOI: 10.59249/RTYB9681 -
Ugeskrift For Laeger Oct 2023The Danish Health Authority recommends that all patients with life threatening disease, regardless of the diagnosis, are offered palliative care with respect for... (Review)
Review
The Danish Health Authority recommends that all patients with life threatening disease, regardless of the diagnosis, are offered palliative care with respect for individual goals of care. Only few studies have investigated the evidence of ACP in patients with decompensated liver cirrhosis. This review defines ways to identify patients with decompensated liver cirrhosis in need of palliative care and how to analyse the goals of care. We present a strategy for ACP-conversations and how to implement these in the daily clinical work.
Topics: Humans; Advance Care Planning; Palliative Care; Liver Diseases; Communication; Liver Cirrhosis
PubMed: 37921108
DOI: No ID Found -
British Journal of Hospital Medicine... Mar 2024Enhanced supportive care is a care model providing earlier access to multiprofessional, coordinated care for patients from the point of cancer diagnosis. As a proactive... (Review)
Review
Enhanced supportive care is a care model providing earlier access to multiprofessional, coordinated care for patients from the point of cancer diagnosis. As a proactive model of care, it stands as a contrast to providing access to a multidisciplinary team once a patient has hit a crisis point, or when their prognosis has become sufficiently poor that they are able to access traditional end-of-life services. Its arrival in the UK through palliative care teams working in cancer care has led to enhanced supportive care being synonymous with early palliative care. While enhanced supportive care has enabled early palliative care, as it has become more embedded in the UK, it has taken on a wider remit for patients living longer with cancer and the management of side effects. Enhanced supportive care services have also begun to provide care for cancer survivors. Enhanced supportive care services have a key role in modern cancer care in maintaining and improving patients' quality of life alongside cancer treatment and ensuring that patients' priorities and preferences for treatment are considered. Furthermore, enhanced supportive care has been shown to support the wider healthcare system by creating capacity within the NHS, reducing demand on hospital services and saving money. As enhanced supportive care services continue to grow and venture into the care and support of cancer survivors and those receiving potentially curative treatments, ongoing work is needed to determine how these services can be made available throughout the NHS and how a shared vision of the way enhanced supportive care operates can be realised.
Topics: Humans; Quality of Life; Palliative Care; Terminal Care; Neoplasms; Delivery of Health Care
PubMed: 38557099
DOI: 10.12968/hmed.2023.0416 -
BMJ Supportive & Palliative Care May 2024
Topics: Humans; Palliative Care; Hematologic Neoplasms
PubMed: 38388211
DOI: 10.1136/spcare-2024-004812 -
Annals of Palliative Medicine Jan 2024
Topics: Humans; Spinal Neoplasms; Palliative Care; Medical Oncology
PubMed: 38199801
DOI: 10.21037/apm-23-572 -
Intensive Care Medicine Dec 2023
Topics: Humans; Palliative Care; Critical Care; Intensive Care Units; Terminal Care
PubMed: 38010381
DOI: 10.1007/s00134-023-07260-z -
The Lancet. Healthy Longevity May 2024
Topics: Humans; Longevity; Palliative Care; Universal Health Care
PubMed: 38705147
DOI: 10.1016/S2666-7568(24)00070-9 -
Critical Care (London, England) Sep 2023The timely integration of palliative care is important for patients suffering from various advanced diseases with limited prognosis. While a German S-3-guideline on... (Review)
Review
BACKGROUND
The timely integration of palliative care is important for patients suffering from various advanced diseases with limited prognosis. While a German S-3-guideline on palliative care exists for patients with incurable cancer, a recommendation for non-oncological patients and especially for integration of palliative care into intensive care medicine is missing to date.
METHOD
Ten German medical societies worked on recommendations on palliative care aspects in intensive care in a consensus process from 2018 to 2023.
RESULTS
Based on the german consensus paper, the palliative care aspects of the respective medical disciplines concerning intensive care are addressed. The recommendations partly refer to general situations, but also to specific aspects or diseases, such as geriatric issues, heart or lung diseases, encephalopathies and delirium, terminal renal diseases, oncological diseases and palliative emergencies in intensive care medicine. Measures such as non-invasive ventilation for symptom control and compassionate weaning are also included.
CONCLUSION
The timely integration of palliative care into intensive care medicine aims to improve quality of life and symptom control and also takes into acccount the often urgently needed support for patients' highly stressed relatives.
Topics: Humans; Aged; Palliative Care; Quality of Life; Brain Diseases; Consensus; Critical Care
PubMed: 37723595
DOI: 10.1186/s13054-023-04622-3