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Marchand N, Moonaz S. On the Alignment of Yoga Therapy with Palliative Care. J Altern Complement Med 2020; 26:774-775. [PMID: 32924555 DOI: 10.1089/acm.2020.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nicole Marchand
- CSU Shiley Institute of Palliative Care, San Marcos, California, USA
| | - Steffany Moonaz
- Maryland University of Integrative Health, Laurel, Maryland, USA
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Patel RV, Patel VR, Patel DR, Kamal AH, Nelson JE. Top Ten Things Palliative Care Clinicians Should Know About Caring for Hindus. J Palliat Med 2020; 23:980-984. [PMID: 32302496 DOI: 10.1089/jpm.2020.0146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hinduism is one of the five major world religions with >1 billion followers worldwide and encompasses a diversity of belief systems. As of 2010, an estimated 1.8 million Hindus lived in the United States, and this number is expected to increase to 4.8 million by 2050, making the United States home to the largest Hindu population outside of South Asia. As this population continues to grow, it will become increasingly important that clinicians of all disciplines develop a basic understanding of their beliefs and practices to address their palliative care needs. This article highlights 10 considerations for Hindu patients and their families relevant to inpatient care, symptom management, and advance care planning.
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Affiliation(s)
- Rushil V Patel
- Supportive Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Viraj R Patel
- The University of Chicago Divinity School, Chicago, Illinois, USA
| | | | - Arif H Kamal
- Duke Cancer Institute, Duke Fuqua School of Business, Durham, North Carolina, USA
| | - Judith E Nelson
- Supportive Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Critical Care Service, Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Weill Cornell Medical College, New York, New York, USA
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Gielen J, Bhatnagar S, Chaturvedi SK. Prevalence and Nature of Spiritual Distress Among Palliative Care Patients in India. JOURNAL OF RELIGION AND HEALTH 2017; 56:530-544. [PMID: 27154352 DOI: 10.1007/s10943-016-0252-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In palliative care research, little attention has been paid to the empirical study of spirituality in patients in non-Western countries. This study describes the prevalence and nature of spiritual distress among Indian palliative care patients. Data from 300 adult cancer patients who had completed a questionnaire with 36 spirituality items were analyzed. Spirituality was shaped by the Indian religious and economic context. A latent class analysis resulted in three clusters: trustful patients (46.4 %), spiritually distressed patients (17.4 %), and patients clinging to divine support (36.2 %). After regression, the clusters were found to be associated with pain scores (p < .001), gender (p = .034), and educational level (p < .006). More than half of the patients would benefit from spiritual counselling. More research and education on spirituality in Indian palliative care is urgently required.
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Affiliation(s)
- Joris Gielen
- Center for Healthcare Ethics, 301A Fisher Hall, 600 Forbes Avenue, Pittsburgh, PA, 15282, USA.
| | - Sushma Bhatnagar
- Anesthesiology, Pain and Palliative Care, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Bangalore, 560029, India
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Carr T, Quinlan E, Robertson S, Duggleby W, Thomas R, Holtslander L. Yoga as palliation in women with advanced cancer: a pilot study. Int J Palliat Nurs 2016; 22:111-7. [PMID: 27018737 DOI: 10.12968/ijpn.2016.22.3.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The purpose of this pilot study was to investigate the palliative potential of home-based yoga sessions provided to women with advanced cancer. METHOD Personalised 45-minute yoga sessions were offered to three women with advanced cancer by an experienced yoga teacher. Each woman took part in a one-to-one interview after the completion of the yoga programme and was asked to describe her experiences of the programme's impact. RESULTS The personalised nature of the yoga sessions resulted in similar positive physical and psychosocial effects comparable to those demonstrated in other studies with cancer patients. Participants described physical, mental, and emotional benefits as well as the alleviation of illness impacts. The enhancement of mind-body and body-spirit connections were also noted. CONCLUSION Personalised home-based yoga programmes for people with advanced cancer may produce similar benefits, including palliation, as those institutionally-based programmes for people with non-advanced cancer.
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Affiliation(s)
- Tracey Carr
- Postdoctoral Fellow, at the Department of Sociology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Elizabeth Quinlan
- Associate Professor, at the Department of Sociology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Susan Robertson
- Research Associate, at the Department of Sociology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Wendy Duggleby
- Professor, Faculty of Nursing, University of Alberta, Edmonton
| | - Roanne Thomas
- Associate Professor, Faculty of Health Sciences, University of Ottawa, Ottawa
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Bhatnagar S, Noble S, Chaturvedi SK, Gielen J. Development and Psychometric Assessment of a Spirituality Questionnaire for Indian Palliative Care Patients. Indian J Palliat Care 2016; 22:9-18. [PMID: 26962275 PMCID: PMC4768456 DOI: 10.4103/0973-1075.173939] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: There are only a few studies on spirituality among palliative care patients in India. This gap in research may be caused by the absence of relevant questionnaires and scales specifically designed for Indian palliative care populations. In this study, we describe the development of such a questionnaire and explain its psychometric characteristics. Methods: We designed a questionnaire on the basis of a systematic review of the literature. After a review of the questionnaire by specialists and a subsequent pilot study, the questionnaire was amended. The final questionnaire consisted of a list of 36 spirituality items. It was administered to a sample of 300 cancer patients attending the pain clinic of a tertiary hospital in New Delhi. Results: A factor analysis led to four factors explaining 54.6% of variance: Shifting moral and religious values (Factor 1), support from religious relationship (Factor 2), existential blame (Factor 3), and spiritual trust (Factor 4). The skewness and kurtosis for Factors 1, 3, and 4 were within a tolerable range for assuming a normal distribution, but Factor 2 was skewed. The alphas showed that the four factors have an acceptable internal consistency. Statistically significant associations were observed for age and Factor 3 (P = 0.004), gender and Factor 4 (P = 0.014), marital status and Factors 3 (P = 0.002) and 4 (P = 0.001), educational level and Factors 3 (P < 0.001) and 4 (P < 0.001), and pain scores and Factors 1 (P < 0.001), 2 (P < 0.001), and 3 (P = 0.001). Conclusion: The questionnaire offers promising prospects for the study of spirituality among palliative care patients in India.
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Affiliation(s)
- Sushma Bhatnagar
- Unit of Anesthesiology, Pain, and Palliative Care, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Simon Noble
- Institute of Cancer and Genetics, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4YS, UK
| | - Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Joris Gielen
- Center for Healthcare Ethics, 301A Fisher Hall, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
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Spirituality as an ethical challenge in Indian palliative care: A systematic review. Palliat Support Care 2015; 14:561-82. [DOI: 10.1017/s147895151500125x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:Spiritual care is recognized as an essential component of palliative care (PC). However, patients' experience of spirituality is heavily context dependent. In addition, Western definitions and findings regarding spirituality may not be applicable to patients of non-Western origin, such as Indian PC patients. Given the particular sociocultural, religious, and economic conditions in which PC programs in India operate, we decided to undertake a systematic review of the literature on spirituality among Indian PC patients. We intended to assess how spirituality has been interpreted and operationalized in studies of this population, to determine which dimensions of spirituality are important for patients, and to analyze its ethical implications.Method:In January of 2015, we searched five databases (ATLA, CINAHL, EMBASE, PsycINFO, and PubMed) using a combination of controlled and noncontrolled vocabulary. A content analysis of all selected reports was undertaken to assess the interpretation and dimensions of spirituality. Data extraction from empirical studies was done using a data-extraction sheet.Results:A total of 39 empirical studies (12 qualitative, 21 quantitative, and 6 mixed-methods) and 18 others (10 reviews, 4 opinion articles, and 4 case studies) were retrieved. To date, no systematic review on spirituality in Indian PC has been published. Spirituality was the main focus of only six empirical studies. The content analysis revealed three dimensions of spirituality: (1) the relational dimension, (2) the existential dimension, and (3) the values dimension. Religion is prominent in all these dimensions. Patients' experiences of spirituality are determined by the specifically Indian context, which leads to particular ethical issues.Significance of results:Since spiritual well-being greatly impacts quality of life, and because of the substantial presence of people of Indian origin living outside the subcontinent, the findings of our review have international relevance. Moreover, our review illustrates that spirituality can be an ethical challenge and that more ethical reflection on provision of spiritual care is needed.
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Selman L, McDermott K, Donesky D, Citron T, Howie-Esquivel J. Appropriateness and acceptability of a Tele-Yoga intervention for people with heart failure and chronic obstructive pulmonary disease: qualitative findings from a controlled pilot study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:21. [PMID: 25887324 PMCID: PMC4324792 DOI: 10.1186/s12906-015-0540-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 01/23/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are highly prevalent and associated with a large symptom burden, that is compounded in a dual HF-COPD diagnosis. Yoga has potential benefit for symptom relief; however functional impairment hinders access to usual yoga classes. We developed a Tele-Yoga intervention and evaluated it in a controlled pilot trial. This paper reports on the appropriateness and acceptability of the intervention and the evaluation design. METHODS A controlled, non-randomised trial was conducted of an 8-week Tele-Yoga intervention versus an educational control (information leaflets mailed to participants with one phone call a week). Biweekly one-hour Tele-Yoga classes were implemented via multipoint videoconferencing that connected participants to live classes via an Internet connection to their televisions. Semi-structured qualitative interviews were conducted with participants post study exit to explore reasons for and experiences of participating, including views of study outcome measures and physiological tests. Transcribed interviews were analysed using thematic content analysis. RESULTS Fifteen people participated in the pilot study (7 in the intervention group, 8 in the control). Of these, 12 participants were interviewed, 6 in each group, mean age 71.2 years (SD 10.09); 3 were male. Themes are reported in the following categories: acceptability and appropriateness of the intervention, potential active ingredients of the intervention, acceptability and appropriateness of the control, participation in the research, and acceptability of the testing procedures. The intervention was acceptable and appropriate: the intervention group reported enjoying yoga and valuing the home-based aspect and participants described a high symptom burden and social isolation. However, technological problems resulted in poor video-streaming quality for some participants. Potential active ingredients included physical postures, breathing exercises and guidance in relaxation and meditation. The educational control intervention was acceptable and appropriate, with participants reporting little effect on their well-being and no impact on mechanisms hypothesised to explain yoga's effectiveness. The questionnaires and home physiological testing were acceptable to participants. CONCLUSIONS Tele-Yoga is an acceptable and appropriate intervention in people with HF and COPD and further research is warranted to refine the technology used in its delivery. Findings provide guidance for researchers working in tele-interventions, yoga, and similar populations. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02078739 (4 March 2014).
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Affiliation(s)
- Lucy Selman
- Department of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, Bessemer Road, London, SE5 9PJ, U.K.
| | - Kelly McDermott
- University of California, San Francisco, Osher Center for Integrative Medicine, 1545 Divisadero Street, 4th Floor, San Francisco, CA, 94115-3010, U.S.A.
| | - DorAnne Donesky
- Department of Physiological Nursing, UCSF School of Nursing Building, University of California, San Francisco, 2 Koret Way, Box 0610, San Francisco, CA, 94143-0610, U.S.A.
| | - Tracie Citron
- Department of Physiological Nursing, UCSF School of Nursing Building, University of California, San Francisco, 2 Koret Way, Box 0610, San Francisco, CA, 94143-0610, U.S.A.
| | - Jill Howie-Esquivel
- Department of Physiological Nursing, UCSF School of Nursing Building, University of California, San Francisco, 2 Koret Way, Box 0610, San Francisco, CA, 94143-0610, U.S.A.
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Selman LE, Williams J, Simms V. A mixed-methods evaluation of complementary therapy services in palliative care: yoga and dance therapy. Eur J Cancer Care (Engl) 2011; 21:87-97. [PMID: 21880079 DOI: 10.1111/j.1365-2354.2011.01285.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
To inform service provision and future research, we evaluated two complementary therapy services: yoga classes and dance therapy [The Lebed Method (TLM)]. Both were run as 6-week group courses. Patients completed the Measure Yourself Concerns and Wellbeing questionnaire pre- and post-course. Mean change over time was calculated for patient-nominated concern and well-being scores. Qualitative data regarding factors affecting health other than the therapy and benefits of the service were analysed using content analysis. Eighteen patients participated (mean age 63.8 years; 16 female; 14 cancer diagnoses); 10 were doing yoga, five TLM, and three both yoga and TLM; 14 completed more than one assessed course. Patients' most prevalent concerns were: mobility/fitness (n= 20), breathing problems (n= 20), arm, shoulder and neck problems (n= 18), difficulty relaxing (n= 8), back/postural problems (n= 8), fear/anxiety (n= 5). Factors affecting patients' health other than the therapy were prevalent and predominantly negative (e.g. treatment side effects). Patients reported psycho-spiritual, physical and social benefits. Concern scores improved significantly (P < 0.001) for both therapies; improved well-being was clinically significant for yoga. Evaluations of group complementary therapy services are feasible, can be conducted effectively and have implications for future research. Yoga and TLM may be of benefit in this population.
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Affiliation(s)
- L E Selman
- Department of Palliative Care, Policy & Rehabilitation, King's College London, Bessemer Road, Denmark Hill, London, UK.
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