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Cubukcu M, Sahin B, Kiymaz D, Simsek Yurt N. Effect of Education on Symptom Management and Control in Cancer Patients Receiving Palliative Care. Pain Manag Nurs 2024; 25:e243-e249. [PMID: 38480085 DOI: 10.1016/j.pmn.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE This study aims to investigate the effect of an educational intervention on cancer patients receiving palliative care and their caregivers concerning symptom management and family needs. METHODS This study involved 120 participants-60 cancer patients and their respective caregivers-divided into intervention and control groups. Over a 2-week period, the intervention group received a comprehensive educational program focusing on symptom management, while the control group did not receive any educational intervention. The Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS) were used to assess patients' symptoms, their intensity, and performance, while the Family Need Scale (FNS) was utilized to evaluate caregivers' needs. These assessments were conducted at the beginning and end of the study. Primary outcomes focused on symptom assessment using ESAS and PPS, along with evaluating caregivers' needs through FNS. Secondary outcomes involved assessing participant satisfaction with the intervention. RESULTS At the end of the study, comparing initial and second evaluations, both ESAS and PPS scores significantly increased in the intervention and control groups (p = .003, p = .002, respectively). Additionally, a statistically significant decrease in the severity of symptoms, except for lethargy/hypokinesis, was observed in the intervention group compared to the control group. The FNS scale indicated that family needs satisfaction was higher in the intervention group compared to the control group. The data obtained demonstrated that there was a reduction the pain, fatigue, depression, anxiety, drowsiness, and shortness of breath levels in the intervention group compared to the control group, but there was no significant difference other than these symptoms. CONCLUSIONS The educational intervention positively impacted symptom management and family needs. Optimizing symptom control would greatly benefit palliative care patients and their caregivers.
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Affiliation(s)
- Mahcube Cubukcu
- Samsun University Faculty of Medicine, Department of Family Medicine, Samsun, Turkey
| | - Bekir Sahin
- Gazi State Hospital, Clinic of Internal Medicine, Samsun, Turkey
| | - Dilek Kiymaz
- Samsun Training and Research Hospital, Education Unit, Samsun, Turkey
| | - Nur Simsek Yurt
- Samsun University Faculty of Medicine, Department of Family Medicine, Samsun, Turkey; Samsun Training and Research Hospital, Clinic of Family Medicine, Samsun, Turkey.
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Maus K, Peusquens F, Kriegsmann-Rabe M, Matthias JK, Ateş G, Jaspers B, Geiser F, Radbruch L. 'Not a panacea' - Expert perspectives on the concept of resilience and its potential for palliative care. Palliat Care Soc Pract 2024; 18:26323524241254839. [PMID: 38807748 PMCID: PMC11131388 DOI: 10.1177/26323524241254839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/26/2024] [Indexed: 05/30/2024] Open
Abstract
Background Resilience is an increasingly used term in medicine and subject to various definitions, often not easy to grasp. There are established core concepts for patients receiving palliative care, for example, meaning in life, that have already been researched a lot. Resilience, relative to these concepts, is a new object of research in palliative care, where it has so far been used predominantly with regard to the well-being of teams. Aim To explore how experts in palliative care define the concept of resilience and its suitability for patients, significant others, and professionals. Design Qualitative study using summarizing content analysis according to Mayring. Setting/participants Twenty-one health and social care professionals with expertise caring for persons with life-threatening/limiting illnesses and their relatives were interviewed in three individual interviews and four focus groups. All conversations were recorded, transcribed, coded via MAXQDA, and validated by another researcher. Results Resilience has been described as something procedural, dynamic, individual, and flexible. In connection with well-known concepts such as posttraumatic growth or terms from the field of mindfulness, social environment or personal factors have also been linked to resilience. Resources such as spirituality can contribute to resilience, and resilience itself can function as a resource, for example, by contributing to quality of life. An active use of the term in practical work with patients or relatives is rare, but it is used in education or team measures. Limited lifespan can pose a challenge to an active use of the concept of resilience. Conclusion Resilience as a very individual approach provides added value to other core concepts of palliative care. Within the palliative context, the normative dimension of resilience must be well reflected. A broader definition of resilience is recommended, leaving room for everyone to find their own form of resilience. The concept of resilience in palliative care includes opportunities as well as risks and should, therefore, be implemented carefully, requiring specific training.
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Affiliation(s)
- Katja Maus
- Department of Palliative Medicine, University Hospital Bonn, Venusberg-Campus 1, Bonn 53127, Germany
| | - Frank Peusquens
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Milena Kriegsmann-Rabe
- Centre for Entrepreneurship, Innovation and SMEs, Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | | | - Gülay Ateş
- Institute for Digitalization and General Practice, University Hospital RWTH Aachen, Aachen, Germany
| | - Birgit Jaspers
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
- Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
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Honoré F, Lestienne L, Vieux M, Bislimi K, Chalancon B, Leaune E. "A sign that I am not alone": A grounded theory-informed qualitative study on spirituality after suicide bereavement. DEATH STUDIES 2024:1-12. [PMID: 38758642 DOI: 10.1080/07481187.2024.2355250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Suicide bereavement is known to be highly distressing and to negatively affect the mental health of the bereaved. The role of religion and spirituality after suicide bereavement remains understudied. We aimed to specifically explore the role of spirituality after suicide bereavement by conducting a qualitative study through semi-structured interviews with fifteen people bereaved by suicide. The grounded theory-informed thematic analysis identified five main themes, namely "continuing bonds with the deceased," "lightening the burden," "grounded spirituality," "perceptual and conceptual shift" and "the movement of giving." For many participants, spirituality was a resource that facilitated the process of accepting their loss by offering a larger entity to which to hand over their suffering. Moreover, the continuing bonds with the deceased helped them to get through this ordeal. Our results can enable mental health professionals to better understand how spirituality can facilitate post-traumatic growth in people bereaved by suicide.
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Affiliation(s)
- Foucauld Honoré
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
| | - Laurène Lestienne
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupement d'Etude et de Prévention du Suicide, Brest, France
| | - Maxime Vieux
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupement d'Etude et de Prévention du Suicide, Brest, France
| | - Kushtrim Bislimi
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
| | - Benoit Chalancon
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupement d'Etude et de Prévention du Suicide, Brest, France
| | - Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupement d'Etude et de Prévention du Suicide, Brest, France
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon, France
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Batzler YN, Stricker N, Bakus S, Schallenburger M, Schwartz J, Neukirchen M. Implementing spiritual care education into the teaching of palliative medicine: an outcome evaluation. BMC MEDICAL EDUCATION 2024; 24:411. [PMID: 38622620 PMCID: PMC11017578 DOI: 10.1186/s12909-024-05415-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 04/11/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The concept of "total pain" plays an important role in palliative care; it means that pain is not solely experienced on a physical level, but also within a psychological, social and spiritual dimension. Understanding what spirituality entails, however, is a challenge for health care professionals, as is screening for the spiritual needs of patients. OBJECTIVE This is a novel, interprofessional approach in teaching undergraduate medical students about spiritual care in the format of a seminar. The aim of this study is to assess if an increase in knowledge about spiritual care in the clinical context is achievable with this format. METHODS In a mandatory seminar within the palliative care curriculum at our university, both a physician and a hospital chaplain teach strategies in symptom control from different perspectives (somatic domain - spiritual domain). For evaluation purposes of the content taught on the spiritual domain, we conducted a questionnaire consisting of two parts: specific outcome evaluation making use of the comparative self-assessment (CSA) gain and overall perception of the seminar using Likert scale. RESULTS In total, 52 students participated. Regarding specific outcome evaluation, the greatest gain was achieved in the ability to define total pain (84.8%) and in realizing its relevance in clinical settings (77.4%). The lowest, but still fairly high improvement was achieved in the ability to identify patients who might benefit from spiritual counselling (60.9%). The learning benefits were all significant as confirmed by confidence intervals. Overall, students were satisfied with the structure of the seminar. The content was delivered clearly and comprehensibly reaching a mean score of 4.3 on Likert scale (4 = agree). The content was perceived as overall relevant to the later work in medicine (mean 4.3). Most students do not opt for a seminar solely revolving around spiritual care (mean 2.6). CONCLUSIONS We conclude that implementing spiritual care education following an interprofessional approach into existing medical curricula, e.g. palliative medicine, is feasible and well perceived among medical students. Students do not wish for a seminar which solely revolves around spiritual care but prefer a close link to clinical practice and strategies.
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Affiliation(s)
- Yann-Nicolas Batzler
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - Nicola Stricker
- Evangelical Church in the Rhineland, Duesseldorf, Germany
- Institut Protestant de Théologie, Paris, France
| | - Simone Bakus
- Evangelical Hospital Chaplaincy (Pastoral Care), University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - Manuela Schallenburger
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany.
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty, Heinrich Heine University Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Jacqueline Schwartz
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - Martin Neukirchen
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
- Department of Anesthesiology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
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Vitorino LM, Machado Teixeira PH, Dominato PC, de Azevedo MPC, Resende MM, Lucchetti G. The effectiveness of spiritual care training on medical students' self-reported competencies: A quasi-experimental study. Palliat Support Care 2024; 22:251-257. [PMID: 37042249 DOI: 10.1017/s1478951523000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of spiritual care training on medical students' self-reported competencies. METHODS This is a quasi-experimental (controlled and non-randomized) study including 115 Brazilian medical students. Participants were enrolled into 2 groups: fourth-year students (n = 64) who received spiritual care training and sixth-year students (n = 51) who did not receive this training - control group (i.e., usual teaching). Participants answered a self-reported Spiritual Care Competence Scale. Comparisons between groups were performed and effect sizes were reported. RESULTS Providing a spiritual care training resulted in significantly higher self-reported scores for the dimensions of "Assessment" (d = 0.99), "Improvement of care" (d = 0.69), "Counseling (d = 0.88)," "Referral" (d = 0.75), and "Total Spiritual Care" (d = 1.044) as compared to the control group. Likewise, 21 out of 27 items of the Spiritual Care Competence Scale were significantly higher for the intervention group, presenting effect sizes (d) ranging between 0.428 and 1.032. SIGNIFICANCE OF RESULTS Medical students receiving spiritual care training showed greater self-reported competencies as compared to those in the usual teaching. These results reinforce the importance of promoting spirituality teaching in medical schools.
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Affiliation(s)
| | | | | | | | | | - Giancarlo Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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Hu X, Gao J, Liang S, Yue Z, Zheng R. Status and influential factors of spiritual well-being in cancer patients with drug clinical trials: a cross-sectional study. Support Care Cancer 2023; 31:646. [PMID: 37855931 DOI: 10.1007/s00520-023-08112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE The purpose of this study was to investigate the spiritual well-being status of cancer patients in drug clinical trials and its influencing factors, and to provide theoretical support for the spiritual health intervention of clinical trial cancer patients. METHODS This cross-section study was conducted among 244 cancer patients in clinical trials. The Memorial Symptom Assessment Scale Short Form (MSAS-SF), Connor-Davidson Resilience Scale 10 (CD-RISC 10), and Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-SP-12) were used to measure symptom burden, psychological resilience, and spiritual well-being. The Multiple Linear Regression Model was used to determine the influencing factors of patients' spiritual health. RESULTS The overall spiritual health level of cancer patients with clinical trials was high (36.87 ± 11.0), and the spiritual health level was positively correlated with psychological resilience (r = 0.872, P < 0.001). Religious belief, nationality, treatment regimen, and resilience were independent risk factors for the spiritual health of cancer patients in clinical trials. Patients with religious beliefs (β = 0.097, P = 0.012), ethnic minorities (β = 0.087, P = 0.023), and high resilience scores (β = 0.874, P < 0.001) had higher levels of spiritual health. Patients who received single antineoplastic therapy (β = - 0.079, P = 0.028) had lower levels of spiritual health. CONCLUSION Our study found that the spiritual health of cancer patients in clinical trials was at a high level, superior to cancer patients receiving conventional anti-tumor therapy. Religious belief, nationality, treatment regimen, and psychological resilience were the influential factors of spiritual health.
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Affiliation(s)
- Xue Hu
- Department of Biotherapy Research, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Sichuan Province, 37 Guo Xue Rd, Chengdu, 610041, China
| | - Jiaying Gao
- Department of Biotherapy Research, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Sichuan Province, 37 Guo Xue Rd, Chengdu, 610041, China
| | - Shiqi Liang
- Divison of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhiying Yue
- Department of Biotherapy Research, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Sichuan Province, 37 Guo Xue Rd, Chengdu, 610041, China
| | - Rujun Zheng
- Department of Biotherapy Research, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Sichuan Province, 37 Guo Xue Rd, Chengdu, 610041, China.
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Gonçalves F, Teixeira MI, Magalhães B. The role of spirituality in people with amyotrophic lateral sclerosis and their caregivers: Scoping review. Palliat Support Care 2023; 21:914-924. [PMID: 36464916 DOI: 10.1017/s1478951522001511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND There are few studies evaluating the role of spirituality and the role of spiritually integrated interventions in people with amyotrophic lateral sclerosis (PALS) and their caregivers. OBJECTIVES A scoping review was conducted to examine the nature and breadth of peer-reviewed literature on the role of spirituality, interventions integrating spirituality, and outcomes for PALS and their caregivers. METHODS A literature review was performed, following the methods from the Joanna Briggs Institute Reviewers, based on all articles published between January 2006 and April 2022, identified in the CINAHL Complete, MEDLINE Complete, MedicLatina, Psychology and Behavioral Sciences Collection, and SPORTDiscus with full-text databases using key terms. Extracted data included research aims, study design, population and characteristics, theme description, and measures or type of intervention. RESULTS A total of 18 articles were included in this study: 14 qualitative, 3 quantitative, and 1 protocol of a quantitative study. Eight studies were based in Europe. The search identified different main themes related to spirituality for caregivers and patients, 2 spiritual measure scales, and one intervention. However, many studies were limited in sample size, generalizability, and transferability and used less sophisticated research designs. SIGNIFICANCE OF THE RESULTS This scoping review illustrates the importance given to spirituality by caregivers and PALS and reveals a very heterogeneous response. Thus, experimental studies in the area of spirituality are needed to systematically explore the impact of spiritual interventions, and the results of these studies could advance practice and policy by enhancing the quality of life for PALS and their caregivers.
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Affiliation(s)
- Filipe Gonçalves
- APELA - Portuguese Amyotrophic Lateral Sclerosis Association, Porto, Portugal
- Faculty of Health Sciences, University of A Coruña (UdC), A Coruña, Spain
| | - Margarida I Teixeira
- APELA - Portuguese Amyotrophic Lateral Sclerosis Association, Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Bruno Magalhães
- Oncology Nursing Research Unit, IPo-Porto Research (CI-POP), Portuguese Oncology Institute of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto. CCC) & Rise@Ci-IPOP (Health Research Network), Porto, Portugal
- School of Health, University of Trás-os-Montes and Alto Douro (ESS-UTAD), Vila Real, Portugal
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Araujo MCR, da Silva DA, Wilson AMMM. Nursing interventions in palliative care in the intensive care unit: A systematic review. ENFERMERIA INTENSIVA 2023; 34:156-172. [PMID: 37684063 DOI: 10.1016/j.enfie.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 04/02/2022] [Indexed: 09/10/2023]
Abstract
CONTEXT Patients in palliative care are found in different places where care is provided, including the intensive care environment with important role of the nursing staff. OBJECTIVE The aim of this systematic review was to answer the following question: which nursing interventions are aimed to the palliative care patients who are in the intensive care unit (ICU). DATA SOURCES US National Library of Medicine (PUBMED), Virtual Health Library (BVS), SciELO, The Cochrane Library (Cochrane) and Lilacs databases were used. DATA EXTRACTION After applying inclusion and exclusion criteria in accordance with the PRISMA method, a total of 36 entries published between 2010 and 2020 were used. DATA ANALYSIS The records extracted were analyzed from a qualitative approach, so no statistical analysis was carried out. RESULTS The findings demonstrated that the interventions that focus on promoting the patient's autonomy and respect their needs on ICU involves effective communication, promoting shared decision with patient and family, individualize care for each patient including the family on the daily care and decisions, maintaining basic nursing care as hygiene and comfort and encouraging self-care, as well as the involvement of nursing palliative care specialists the care is important. Other interventions included promoting a continuing education program for the nursing staff and other professionals involved in caring for patients in palliative care at ICU. CONCLUSION This review highlighted the need for specific nursing interventions aimed at palliative care patients at ICU to promote patient autonomy and the focus on patient needs, always sharing decisions with the patient and family. However, it showed that there is a need for the continuous training of the nursing staff because factors such as the nurses' lack of technical-scientific knowledge and, concomitantly, the absence of a standardized and specific intervention model linked to a bureaucratic system, make it difficult to carry out a specialized care for this type of patient.
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Affiliation(s)
- M C R Araujo
- Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
| | - D A da Silva
- Dr. José de Carvalho Florence Municipal Hospital, São José dos Campos, SP, Brazil
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Laranjeira C, Dixe MA, Querido A. Perceived Barriers to Providing Spiritual Care in Palliative Care among Professionals: A Portuguese Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6121. [PMID: 37372708 DOI: 10.3390/ijerph20126121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants' perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Maria Anjos Dixe
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
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Liang M, Xie X, Pan Y, Cheng ASK, Ye Z. A qualitative meta-synthesis of patient dignity from the perspective of caregivers. BMC Geriatr 2023; 23:351. [PMID: 37277725 DOI: 10.1186/s12877-023-04071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND The concept of dignity remains disputed, with most studies defining dignity based on its external dimension. Although its inherent dimension is a rooted attribute of dignity, it has received scarce attention. Caregivers have close relationships with their care recipients and thus may perceive their patient's inherent as well as external dimensions of dignity. Therefore, in this study, we aimed to identify, analyze, and synthesize evidence on human dignity presented in qualitative studies from the perspective of caregivers to gain a deeper comprehension of the preservation of patients' dignity by their caregivers. METHODS A qualitative meta-synthesis was performed by searching for relevant qualitative literature via systematic electronic databases, including MEDLINE, PsycINFO, ProQuest, CINAHL, Embase, Health Source, and Web of Science, from inception to March 15, 2022. RESULTS Nine studies were eligible for inclusion and included in the meta-synthesis. Three overarching categories were identified: integrated person, "rootedness" and "growth" atmosphere, and balanced state. CONCLUSIONS Dignity is rooted in its inherent dimension, whereas its external dimension may promote individual dignity. Furthermore, caregiver-patient relationships may be a key factor linking the inherent dimension of dignity with its external dimension. Thus, further studies should focus on the mechanism of relationships in preserving dignity.
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Affiliation(s)
- Minyu Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiyan Xie
- Nursing Department, Home for the Aged Guangzhou, Guangzhou, Guangdong Province, China
| | - Yichao Pan
- Department of Cardiovascular Medicine, Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
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Micco A, Carpentieri E, Di Sorbo A, Chetta A, Del Donno M. Palliative care and end of life management in patients with idiopathic pulmonary fibrosis. Multidiscip Respir Med 2023; 18:896. [PMID: 36909932 PMCID: PMC9994447 DOI: 10.4081/mrm.2023.896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/25/2023] [Indexed: 02/23/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic disease with an unknown etiology that causes deterioration of the structure of the lung parenchyma, resulting in a severe and progressive decline in respiratory function and early mortality. IPF is essentially an incurable disease, with a mean overall survival of 5 years in approximately 20% of patients without treatment. The combination of a poor prognosis, uncertainty about the disease's progression, and the severity of symptoms has a significant impact on the quality of life of patients and their families. New antifibrotic drugs have been shown to slow disease progression, but their impact on health-related quality of life (HRQoL) has to be proven yet. To date, studies have shown that palliative care can improve symptom management, HRQoL, and end-of-life care (EoL) in patients with IPF, reducing critical events, hospitalization, and health costs. As a result, it is essential for proper health planning and patient management to establish palliative care early and in conjunction with other therapies, beginning with the initial diagnosis of the disease.
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Affiliation(s)
| | | | | | - Alfredo Chetta
- Pneumology Clinic, Department of Medicine and Surgery, University of Parma, Italy
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De Clercq E, Gamondi C. Challenges for palliative care professionals in providing spiritual care to patients from religious or cultural minority groups: a scoping review of the literature. Int J Palliat Nurs 2023; 29:6-16. [PMID: 36692483 DOI: 10.12968/ijpn.2023.29.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In light of the increasing number of people living into advanced age and the intensification of migration flows, care provision to multi-cultural and religious patient populations has become an important concern for many palliative care professionals. The current scoping review aims to explore the main barriers to spiritual care provision for minority groups and identify some strategies to overcome such obstacles. The review draws some general recommendations for researchers, policymakers and clinicians. First, more empirical research on different patient groups is needed; studies should target not only nurses, but also other healthcare providers, to ensure that practice adequately reflects the multidisciplinary nature of palliative care. Secondly, training and education should be offered in various forms and at different levels, as well as go beyond factual knowledge about the beliefs and practices of various religions.
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Affiliation(s)
- Eva De Clercq
- Doctor, University of Basel, Institute for Biomedical Ethics, Switzerland
| | - Claudia Gamondi
- Doctor, University of Basel, Institute for Biomedical Ethics, Switzerland
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Mendes BV, Donato SCT, Silva TLD, Penha RM, Jaman-Mewes P, Salvetti MDG. Spiritual well-being, symptoms and performance of patients under palliative care. Rev Bras Enferm 2023; 76:e20220007. [PMID: 37042924 PMCID: PMC10084779 DOI: 10.1590/0034-7167-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/15/2022] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES to assess the relationship between spiritual well-being, symptoms and performance of patients under palliative care. METHODS this is a descriptive correlational study, conducted with 135 patients seen in palliative care outpatient clinics. Karnofsky Performance Status Scale, Edmonton Symptom Assessment Scale, Spirituality Scale and Hospital Anxiety and Depression Scale were used. Data were submitted to descriptive statistical analysis and Spearman's correlation. RESULTS among participants, 68.2% were cancer patients. The most prevalent symptoms were changes in well-being (65.2%), anxiety (63.7%), sadness (63%) and fatigue (63%). Sadness, dyspnea, sleepiness, anxiety and depression presented weak to moderate correlation with spiritual well-being. Symptom overload showed weak negative correlation with performance. CONCLUSIONS symptom intensification was correlated with worsening in spiritual well-being perception. The reduction in performance was related to increased number of symptoms, especially depression and anxiety.
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Affiliation(s)
| | | | | | - Ramon Moraes Penha
- Universidade Federal do Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul,, Brazil
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Mosalli RM, Mousa AH, Alshanberi AM, Almatrafi MA. Evaluation of Medical Students' Knowledge on Palliative Care: A Single Institution Cross-sectional Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:893-901. [PMID: 36017250 PMCID: PMC9397427 DOI: 10.2147/amep.s369006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Palliative care is the branch of medicine which has a target of setting focus on the improvement of the quality of life of patients, particularly toward their end of life, such as cases of terminal diseases with low prognosis. Despite growing recognition of the importance of palliative care, a gap remains in medical education. Our study aims to evaluate the current level of knowledge of medical students in regard to palliative care. METHODS A cross-sectional descriptive study was conducted in Batterjee Medical College, Jeddah, Saudi Arabia, through a period of three months from December 2021 to March 2022. RESULTS A total of 254 students participated in our study. Psychosocial and spiritual needs of the patient alongside definition of palliative care were perceived the most important by the students with a mean score of 3.9 each. CONCLUSION Our study concludes that there is an overall lack of confidence among medical students in providing palliative care. We recommend further enhancement and implementation of palliative care as part of undergraduate mandatory courses.
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Affiliation(s)
- Rafat Mohammed Mosalli
- Department of Pediatrics, Batterjee Medical College, Jeddah, Saudi Arabia
- Department of Pediatrics, Um Al-Qura University, Makkah, Saudi Arabia
| | - Ahmed Hafez Mousa
- College of Medicine, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Asim Muhammed Alshanberi
- College of Medicine, Batterjee Medical College, Jeddah, Saudi Arabia
- Department of Community Medicine and Pilgrims Health Care, Umm Al-Qura University, Makkah, Saudi Arabia
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Araujo M, da Silva D, Wilson A. Nursing interventions in palliative care in the intensive care unit: A systematic review. ENFERMERÍA INTENSIVA 2022. [DOI: 10.1016/j.enfi.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guerrero M, Castroman P, Quiroga O, Berenguel Cook M, Narvaez Tamayo MA, Venturoni L, Pergolizzi Jr J, Rekatsina M, Varrassi G. Pain Management and COVID-19: A Latin American Perspective. Cureus 2022; 14:e23100. [PMID: 35464506 PMCID: PMC9001811 DOI: 10.7759/cureus.23100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/12/2022] [Indexed: 11/25/2022] Open
Abstract
Vaccinations and therapeutics have been developed for COVID-19, but vaccine uptake varies markedly among countries. Public health responses have also varied, in particular, with lockdown efforts and school closing. All over the world, the pandemic exposed healthcare and economic weaknesses. COVID-19 exacerbated mental health issues by exposing the population to prolonged periods of fear, anxiety, financial stress, psychological uncertainties, and sometimes isolation from even family and friends. Chronic pain patients have been disproportionately affected. The pandemic-associated stresses may have exacerbated their already painful symptoms while at the same time interrupting their access to care. The ramifications of the COVID-19 post-viral syndrome (“long COVID-19”) are not yet known. COVID-19 viral infection has been associated with neuropathic pain symptoms. Tele-triage and telehealth applications can help manage chronic pain patients in the COVID-19 era, but many interventional procedures, injections, or other treatments have been delayed. The role of palliative care for patients with terminal cases of infection must be re-examined. Palliative care is a relatively new medical specialty and allows terminally ill patients to die in as much comfort and peace as can be afforded to them. More training in palliative care for all clinicians is urgently needed. COVID-19 exposed much that is wrong or weak or inadequate in our healthcare systems, but it also allowed us to embrace new technologies and develop better systems to manage the challenge of a pandemic.
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Vesel T, O'Connor M, Vesel L, Beveridge C, McGann C, Jullien S, Nishizawa Y. Pediatric Palliative Care Education Model in Low Resource Settings: A Mixed-Methods Evaluation. J Pain Symptom Manage 2022; 63:1-10. [PMID: 34411661 DOI: 10.1016/j.jpainsymman.2021.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/17/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
CONTEXT Globally, approximately 21.6 million children need pediatric palliative care (PPC). The greatest burden lies in low- and middle-income countries, where the demand for PPC exceeds available resources. OBJECTIVES The objective of this study was to assess the impact of a PPC workshop on healthcare providers' self-efficacy, comfort and confidence related to the provision of PPC in a Bhutanese referral-level hospital. METHODS This mixed-methods study included a one-and-a-half day PPC workshop with surveys administered to participants at three time points (before, immediately after, and six months after the workshop) to evaluate changes in self-efficacy, comfort and confidence. The study was conducted in January 2017 with healthcare providers at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan. RESULTS Forty-one providers participated in the workshop; 38 completed the post-workshop survey and 27 completed the six months post-workshop survey. Results showed statistically significant increases in comfort levels from pre- to post-workshop surveys across nearly all areas. Qualitative results supported these findings. CONCLUSION The results of this study suggest that a short, interactive and interdisciplinary workshop, originally designed for the United States setting but adapted to a low resource context, is an effective way to improve providers' self-efficacy, comfort and confidence in the provision of PPC in resource-limited settings.
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Affiliation(s)
- Tamara Vesel
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan.
| | - Meaghan O'Connor
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan
| | - Linda Vesel
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan
| | - Christiana Beveridge
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan
| | - Carolyn McGann
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan
| | - Sophie Jullien
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan
| | - Yoriko Nishizawa
- Division of Palliative Care (T.V.), Tufts Medical Center, Boston, Massachusetts, USA; QualityMetric (M.O.C.), Inc., Johnston, Rhode Island, USA; Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health (L.V.), Boston, Massachusetts, USA; University of Texas Southwestern Medical Center (C.B.), Dallas, Texas, USA; Jigme Dorji Wangchuck National Referral Hospital (C.M., S.J., Y.N.), Thimphu, Bhutan; Children's Hospital of Philadelphia (C.M.), Philadelphia, Pennsylvania, USA; Khesar Gyalpo University of Medical Sciences of Bhutan (Y.N.), Thimphu, Bhutan
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Evangelista CB, Lopes MEL, Costa SFGD, Batista PSDS, Duarte MCS, Morais GSDN, França JRFDS, Gomes BDMR. Nurses' performance in palliative care: spiritual care in the light of Theory of Human Caring. Rev Bras Enferm 2021; 75:e20210029. [PMID: 34586201 DOI: 10.1590/0034-7167-2021-0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/16/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to analyze nurses' role in assisting patients in palliative care, with emphasis on the spiritual dimension, in the light of Theory of Human Caring. METHODS this is an exploratory, qualitative study, carried out in a hospital in João Pessoa, Paraíba, between August and December 2019, with 10 nurses. For data collection, semi-structured interviews were used. For analysis, we opted for content analysis. RESULTS the spiritual dimension of care is contemplated by several religious and spiritual practices. These are respected and encouraged by nurses, although there is difficulty in providing care for the spiritual dimension. FINAL CONSIDERATIONS nurses have attitudes consistent with Jean Watson's Theory and apply the Caritas Process elements during assistance to patients' spiritual dimension in palliative care.
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Guidozzi F, Guidozzi D. God, spirituality and religion in women dying from gynecological cancer. Climacteric 2021; 25:215-219. [PMID: 34278909 DOI: 10.1080/13697137.2021.1948995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Thoughts of death and dying will prevail constantly in the minds of women with gynecologic cancer. Invariably, there is the hope that, when the end comes, there will be 'a good death'. End-of-life decisions, with particular emphasis on what the patient and her family constitute 'a good death' to be, will be influenced by emotional, psychological, mental, physical, spiritual and religious backgrounds. It is important to allow patients to resolve their despair by communicating their innermost thoughts. Spirituality and religious belief are important components that may play major roles in enabling patients to obtain peace and require the participation of all members of the health-care team managing the cases. Clinicians should appreciate the patient's concerns, beliefs, fears, spiritual and religious needs and be sensitive to comments that may indicate spiritual distress. Active listening and supportive dialogue may help patients work through existential issues and find peace. Patients who are in spiritual distress should be referred to certified and trained spiritual care professionals, chaplains, counselors and clergy.
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Affiliation(s)
- F Guidozzi
- Department of Obstetrics and Gynaecology, Parklane Clinic, Johannesburg, South Africa
| | - D Guidozzi
- Department of Obstetrics and Gynaecology, University of Witwatersrand, Johannesburg, South Africa
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Mota-Romero E, Esteban-Burgos AA, Puente-Fernández D, García-Caro MP, Hueso-Montoro C, Herrero-Hahn RM, Montoya-Juárez R. NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention. BMC Palliat Care 2021; 20:98. [PMID: 34174856 PMCID: PMC8234765 DOI: 10.1186/s12904-021-00788-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/04/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country. METHODS A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals. RESULTS As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program. CONCLUSIONS The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program.
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Affiliation(s)
- Emilio Mota-Romero
- Salvador Caballero Primary Care Centre, Andalusian Health Service, Granada, Spain
| | - Ana Alejandra Esteban-Burgos
- Department of Nursing, Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Daniel Puente-Fernández
- Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain.
| | - María Paz García-Caro
- Department of Nursing, Brain and Behaviour Research Institute, University of Granada, Mind, Spain
| | | | | | - Rafael Montoya-Juárez
- Department of Nursing, Brain and Behaviour Research Institute, University of Granada, Mind, Spain
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Ajisegiri WS, Abubakar AA, Egwuenu A, Balogun MS, Adedire E, Sabitu K. Beyond drug treatment: a cross-sectional assessment of palliative care services for people living with HIV/AIDS at public health facilities, Abuja, Nigeria. Pan Afr Med J 2021; 39:24. [PMID: 34394815 PMCID: PMC8348280 DOI: 10.11604/pamj.2021.39.24.23180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/07/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction palliative care offers a care and support system to people living with Human Immunodeficiency Virus (HIV) infection/Acquired Immunodeficiency Syndrome (AIDS). In Nigeria, the palliative care (PC) practice generally is new and still developing. While most studies on HIV/AIDS assess drug treatment and adherence for people living with HIV/AIDS (PLWHA), there is paucity of data on PC services available for them. We therefore assessed the PC services offered and referral services available to PLWHA in health facilities. Methods we conducted a cross-sectional study across all public secondary and tertiary health facilities offering HIV care services in Abuja, Nigeria between February and May 2017. We used an interviewer-administered semi-structure questionnaire to collect information from the heads of health facilities. The questionnaire assessed palliative care and referral services for PLWHA. Frequencies and proportions were calculated using Microsoft-Excel. Results of the 17 health facilities assessed, only 6 (35.3%) have constituted a palliative care team but only 3 (17.6%) had some sources of fund for PC. Twelve (70.6%) provided nutritional support for PLWHA, 6 (35.3%) provided spiritual and 8 (47.1%) offered bereavement support for families of PLWHA. Sixteen (94.1%) had well-established referral services for PLWHA. Conclusion palliative care services for PLWHA were generally poor in all the health facilities. There exists a well-established referral services for PLWHA in most of the health facilities. We recommend that the PC structure for PLWHA should be improved by increasing and ensuring compliance to guidelines and the established referral network should continue to be strengthened.
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Affiliation(s)
- Whenayon Simeon Ajisegiri
- Nigerian Field Epidemiology and Laboratory Training Programme (NFELTP), Abuja, Nigeria.,Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | | | | | - Elizabeth Adedire
- Nigerian Field Epidemiology and Laboratory Training Programme (NFELTP), Abuja, Nigeria
| | - Kabiru Sabitu
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
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Benites AC, Rodin G, Leite ACAB, Nascimento LC, Dos Santos MA. 'The experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care: A meta-synthesis'. Eur J Cancer Care (Engl) 2021; 30:e13424. [PMID: 33547680 DOI: 10.1111/ecc.13424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/27/2020] [Accepted: 01/11/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Spirituality is a multidimensional aspect of human experience. In the context of palliative care, it is an individual resource that can be used to cope with illness and to assign new meanings to suffering. Qualitative studies that aim to investigate the experience of spirituality and the needs of family caregivers in this context are rare. OBJECTIVE This meta-synthesis aimed to synthesise qualitative studies on the experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care. METHODS A systematic review was performed in six databases, and 14 studies were included in this meta-synthesis. RESULTS The results are presented as a thematic synthesis divided into two analytical themes: (1) The interweaving of spirituality with end-of-life care and (2) The dimensions of suffering and spirituality in the dying process of the loved one. Each analytical theme is explained by two descriptive themes. The results showed that family caregivers express their spirituality in a multidimensional way, giving meaning to the care provided and reassessing the meanings of their lives and their suffering. CONCLUSION Investigating the suffering and spiritual needs of family members in this context may be of value to inform comprehensive and multi-professional psychosocial care.
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Affiliation(s)
- Andrea Carolina Benites
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Psicologia, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ana Carolina Andrade Biaggi Leite
- Escola de Enfermagem de Ribeirão Preto, WHO Collaborating Centre for Nursing Research Development, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lucila Castanheira Nascimento
- Escola de Enfermagem de Ribeirão Preto, WHO Collaborating Centre for Nursing Research Development, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Manoel Antônio Dos Santos
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Psicologia, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
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Marques TCS, Pucci SHM. Espiritualidade nos cuidados paliativos de pacientes oncológicos. PSICOLOGIA USP 2021. [DOI: 10.1590/0103-6564e200196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo A espiritualidade como ferramenta aos cuidados paliativos de pacientes oncológicos vem sendo cada vez mais abordada no contexto acadêmico, como integrante da qualidade de vida. Este estudo analisa de que forma a espiritualidade pode influenciar positivamente no tratamento oncológico e em cuidados paliativos, e contribuir com a melhora da qualidade de vida destes pacientes. Foram selecionados 29 artigos nacionais que evidenciaram a espiritualidade como variável positiva no enfrentamento aos cuidados paliativos, tanto para paciente quanto familiares e equipe multidisciplinar. A espiritualidade é utilizada como ferramenta pela equipe de cuidados paliativos como auxiliadora na compreensão do impacto causado pelo diagnóstico e cuidado integral do paciente, possibilitando ao profissional psicólogo intervir sobre o paciente e sua rede. Ao paciente e sua família, a espiritualidade atua como estratégia de enfrentamento e conforto. Este estudo encontrou limitações acerca de pesquisas com pacientes infantis/adolescestes e sua família.
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Associated factors of distress in patients with advanced cancer: A retrospective study. Palliat Support Care 2020; 19:447-456. [PMID: 33222720 DOI: 10.1017/s1478951520001066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The objective of this study was to assess the psychosocial distress and associated factors in advanced cancer patients consulting at the outpatient Palliative Care Unit at the National Cancer Institute in Mexico City. DESIGN A retrospective study was conducted using electronic records (June 2015 to December 2016). SAMPLE A total of 646 patients with advanced cancer during their first visit to the outpatient palliative care unit at the National Cancer Institute in Mexico were evaluated using the Distress Thermometer (DT) and ECOG performance status scores. FINDINGS Overall, 62% were women, with a median age of 57 years, and married (54.8%). The most frequent diagnosis was gastrointestinal cancer (28.6%), and 38.9% had a functional performance status of ECOG 2. The median DT score was 4.0 (IQR = 2-6), with 56% reporting DT scores ≥4. The three most frequent problems ≥4 were sadness (82.6%), feeling weak (81.2%), worry (79.6%), and <4 were feeling weak (57.7%), fatigue (55.6%), and financial security (52.1%). The variables associated with distress according to the multiple logistic regression analysis were problems with housing (OR = 2.661, 95% CI = 1.538-4.602), sadness (OR = 2.533, 95% CI = 1.615-3.973), transportation (OR = 1.732, 95% CI = 1.157-2.591), eating (OR = 1.626, 95% CI = 1.093-2.417), nervousness (OR = 1.547, 95% CI = 1.014-2.360), and sleep (OR = 1.469, 95% CI = 1.980-2.203). CONCLUSION The principal factors were related to distress levels, housing problems, transportation issues, and emotional problems such as sadness, nervousness, lower functionality, and younger age. Therefore, psychosocial support is of considerable relevance in palliative care. These findings will help clinicians understand the distress of patients with advanced cancer in palliative care in Latin American countries.
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Arentz S, Hunter J, Deed G. Integrating Traditional and Complementary Medicine Recommendations into Clinical Practice Guidelines for People with Diabetes in Need of Palliative and End-of-Life Care: A Scoping Review. J Altern Complement Med 2020; 26:571-591. [PMID: 32673080 DOI: 10.1089/acm.2020.0028] [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: 12/22/2022] Open
Abstract
Objectives: This study was conducted before an evidence review on Traditional and Complementary Medicine (TCM) to update the clinical practice guidelines (CPGs): "Deciding palliative and end-of-life (P/EoL) care for people with diabetes." The aim was to frame the PICO (population/problems, interventions/comparisons, and outcomes), ascertain their importance, and identify other modifying factors for grading recommendations. Design: A systematic scoping review mapped information about diabetes P/EoL problems and outcomes, TCM use, provision, benefits and risks, and stakeholder preferences and values. Thirteen electronic databases were searched in 2017/18 until no new information was identified. Relevant data were extracted, rated for quality, directness, and relevance, and synthesized using triangulation methods. Excluded was diabetes prevention or treatment, as this is not an important P/EoL problem. Results: Of the 228 included articles, except for diabetes P/EoL problems, insufficient direct evidence led to data being extrapolated from either adults with diabetes or any P/EoL diagnosis. The findings affirmed that caring for people with diabetes in need of P/EoL care is complex due to multiple fluctuating needs that are influenced by the P/EoL trajectories (stable, unstable, deteriorating, terminal, or bereaved), multimorbidity, and difficult-to-manage chronic and acute problems. The only problem specific to diabetes P/EoL care, was unstable glycemia. Over 50 TCM interventions commonly used by patients and/or provided by services were identified, of which, many might simultaneously address multiple problems and 18 had been appraised in systematic reviews. Physical and psychologic symptom reliefs were most often evaluated; however, these were only one aspect of a "good death." Other important outcomes were the quality and location of care, personal agency, relationships, preparations for the dying process, spirituality, and affirmation of the whole person. Other important modifying factors included opportunity costs, affordability, availability, preferences, cultural appropriateness, and alignment with beliefs about the meaning of illness and death. Conclusions: There is a role for TCM in the multidisciplinary holistic P/EoL care of people with diabetes. Due to the paucity of evidence specific to this population, the generalizability of some of these results is broader and the updated CPG will also need to consider indirect evidence from other patient groups. Along with recommendations about indications for TCM use, the CGP should provide guidance on ceasing unnecessary interventions, reducing polypharmacy and managing unstable glycemia is required. Before ceasing a TCM, a broader risk-benefit analysis is recommended, as unlike many conventional therapies, there may be multiple benefits warranting its continuation.
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Affiliation(s)
- Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Gary Deed
- Metabolism Ageing Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Ebenau A, Groot M, Visser A, van Laarhoven HWM, van Leeuwen R, Garssen B. Spiritual care by nurses in curative oncology: a mixed-method study on patients' perspectives and experiences. Scand J Caring Sci 2020; 34:96-107. [PMID: 31095760 PMCID: PMC7074061 DOI: 10.1111/scs.12710] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/12/2019] [Indexed: 11/26/2022]
Abstract
AIMS Spirituality can be important in adjusting to the experience of cancer and its medical treatment. Since nurses have frequent contact with patients, they seem to have a unique role in providing spiritual care. Nurses consider spiritual care important; however, little is known about how patients in a curative setting experience and value spiritual care. Therefore, this study aimed to give insight into patients' experiences with and opinions about spiritual care as provided by nurses in curative cancer care. METHODS This is a national, multicentre mixed-methods study, combining a quantitative approach using questionnaires (n = 62) and a qualitative analysis of semi-structured interviews (n = 61). Nonparametric tests were used for quantitative data, and qualitative data were analysed inductively. FINDINGS Most patients rarely received spiritual care by nurses. If spiritual care was provided, it mainly consisted of noticing problems and referring to other professionals. This appeared to be dependent on certain 'triggers', such as age. Structural discussions on spirituality with a nurse were experienced rarely. This was explained by, among other factors, the hospital setting. Yet, the majority (79%) of patients found the attention to spirituality sufficient or very good. Furthermore, a majority (58%) viewed spiritual care as a nursing task: nurses should notice spiritual problems and refer to other professionals, though extensively discussing patients' spirituality was neither considered nurses' task nor capability. CONCLUSIONS Attention to spiritual care in a curative setting, though not so much desired by most patients, should be pursued, because of its importance in performing person-centred nursing care and its positive impact on patients' health. By training nurses in offering spiritual care in proactive and 'nonactive' (accepting) ways, spiritual care could be structurally offered in clinical practice in personalised forms. Since younger and less spiritual patients are not much satisfied with spiritual care by nurses, they need special attention.
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Affiliation(s)
- Anne Ebenau
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department of Anesthesiology, Pain and Palliative CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Marieke Groot
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department of Anesthesiology, Pain and Palliative CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Anja Visser
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Faculty of Theology and Religious Studies, Comparative Study of ReligionUniversity of GroningenGroningenThe Netherlands
| | | | - René van Leeuwen
- Faculty of Health CareChristian University of Applied Sciences ViaaZwolleThe Netherlands
| | - Bert Garssen
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department Health PsychologyRijksuniversiteit GroningenGroningenThe Netherlands
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Özveren H, Kırca K. Influence of Palliative Care Training on Last-Year Nursing Department Students' Perception on Regarding Spirituality and Spiritual Care: A Single-Group Pretest-Posttest Intervention Study. JOURNAL OF RELIGION AND HEALTH 2019; 58:860-869. [PMID: 30229412 DOI: 10.1007/s10943-018-0701-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Spiritual care is a part of integrated care and should not be considered as a separate aspect of palliative care. Spirituality is seen as a requirement that must be met for all patients. The aim of this study is to determine the influence of palliative care on the perception levels of student nurses regarding spirituality and spiritual care. The research was carried out as a single-group pretest-posttest intervention study. The study was conducted with 70 student nurses. Data were collected via personal information form and spirituality and spiritual care grading scale (SSCGS). Frequency, percentage, average, standard deviation, paired sample t-test and Wilcoxon test were used to analyze the data. 55.7% of the students who participated in research stated that they had never heard of spiritual care, and 81.4% of the students stated that they had not obtained any information regarding spiritual care. The point average of the student nurses related to SSCGS was found to be 3.27 ± 0.21 before training and 3.35 ± 0.22 after training. The difference between the total point averages of the student nurses pre- and posttraining was found to be statistically significant (p < 0.05).As a result of the research, the perception of the student nurses regarding spirituality and spiritual support was found to be above the middle and increased significantly after the training. In accordance with these results, it is suggested that spiritual care training should be included more into nursing education.
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Affiliation(s)
- Hüsna Özveren
- Nursing Department, Faculty of Health Sciences, Kırıkkale University, 71450, Kirikkale, Turkey.
| | - Kamile Kırca
- Nursing Department, Faculty of Health Sciences, Kırıkkale University, 71450, Kirikkale, Turkey
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Meneguin S, Matos TDDS, Ferreira MDLDSM. Perception of cancer patients in palliative care about quality of life. Rev Bras Enferm 2019; 71:1998-2004. [PMID: 30156689 DOI: 10.1590/0034-7167-2017-0360] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/14/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To understand the perception of cancer patients in palliative care about quality of life and identify propositions for its improvement. METHOD This is a quantitative research carried out with 96 patients in palliative care, admitted in a public hospital from March 2015 to February 2015. The interviews were transcribed and analyzed by the methodology Discourse of the Collective Subject. RESULTS Quality of life was tied to meanings of health, well-being, happiness and spirituality; however, family and financial problems also had an impact on the perception of the construct. Interventions aimed at the relief of suffering, possibility of return to work and resolution of problems had suggestions for improvement. CONCLUSION The results indicate that the concept of quality of life is subjective, tied to personal values and influenced by the repercussions of the health-disease process. In addition, they can guide actions based on interdisciplinary assistance aimed at the real needs of these patients.
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Affiliation(s)
- Silmara Meneguin
- Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu Medical School. Botucatu, São Paulo, Brazil
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Ameli R, Sinaii N, Luna MJ, Cheringal J, Gril B, Berger A. The National Institutes of Health measure of Healing Experience of All Life Stressors (NIH-HEALS): Factor analysis and validation. PLoS One 2018; 13:e0207820. [PMID: 30540764 PMCID: PMC6291293 DOI: 10.1371/journal.pone.0207820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/06/2018] [Indexed: 11/18/2022] Open
Abstract
Two hundred patients with severe and/or life-threatening disease were recruited form the NIH Clinical Center and participated in the validation of the NIH-HEALS, which included exploratory factor analysis, principal component analysis, reliability, convergent validity, and divergent validity analyses. Item-reducing principal components analysis and internal consistency and split-half reliability demonstrated excellent internal consistency and split-half reliability (Cronbach's alpha = 0.89, split-half reliability = 0.95). Exploratory factor analysis revealed a three-factor structure, namely Connection (including religious, spiritual, and interpersonal), Reflection & Introspection, and Trust & Acceptance. Seven items were not retained. Convergent and divergent validity of 35-item NIH-HEALS against other validated measures of healing and spirituality provided strong evidence for its validity. As predicted, the Healed factor of the Self-Integration Scale (SIS), and Meaning, Peace, and Faith factors of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12 Scale (FACIT-SP12) were all positively and significantly correlated with the NIH-HEALS and its three factors. Divergent validity was also confirmed by the significant negative correlation between the NIH-HEALS and the Codependent factor on the SIS. Confirmatory Factor Analyses revealed good model fit by GFI (0.96), adjusted GFI (0.95), SRMR (0.077), and RMSEA (0.065), supporting the use of the NIH-HEALS with 35 items.
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Affiliation(s)
- Rezvan Ameli
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ninet Sinaii
- Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - María José Luna
- Northwestern University, Chicago, Illinois, United States of America
| | - Julia Cheringal
- Walter Reed National Military Medical Center, Bethesda, MD, United States of America
| | - Brunilde Gril
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Ann Berger
- Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
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García-Alandete J, Hernández Jiménez MJ. El sufrimiento existencial en el paciente oncológico en estadio avanzado: dimensiones y ejes vertebradores para la intervención psicológica. PERSONA Y BIOÉTICA 2018. [DOI: 10.5294/pebi.2018.22.2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
El alivio del sufrimiento existencial en los pacientes oncológicos en estadio avanzado es un objetivo terapéutico de primer orden. En el presente trabajo se sugieren una serie de ejes sobre los cuales podría pivotar la intervención psicoterapéutica, con el fin de propiciar: 1) la experiencia de que a pesar del “ya” de la situación límite, la vida “todavía” tiene sentido; 2) experiencias emocionales positivas que promuevan el bienestar y la calidad de vida; 3) el afrontamiento de la experiencia de enfermedad grave y de muerte esperada más o menos inminente, mediante el desarrollo de una actitud serena, reconciliada con la vida e integradora con uno mismo y con los demás, a la par que abierta a la trascendencia.
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Prado RT, Leite JL, Silva ÍR, Silva LJD, Castro EABD. The process of dying/death: intervening conditions to the nursing care management. Rev Bras Enferm 2018; 71:2005-2013. [PMID: 30156690 DOI: 10.1590/0034-7167-2017-0173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/23/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To exhibit the factors that influence the Nursing care management in the face of death and the process of dying/death of hospitalized adults in the medical-surgical units for hospitalization. METHOD The Grounded Theory was applied with the theorical support of the Complex Thinking Theory. Data have been collected through semi-structured interviews from May, 2015 to January, 2016 with three sample groups totaling 41 participants: nurses, assistant nurses and members of multidisciplinary group. Data analysis followed the steps of open coding, axial coding and selective coding. RESULTS The category "Pointing out the interfaces of care management to patients in process of death/dying and their families" and its respective subcategories show the complex interactions established by the nurse due to the Nursing care management. FINAL CONSIDERATIONS Subjective, educational, sociocultural and institutional conditions influence the nurse interactions, causing order/disorder on care management.
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Affiliation(s)
- Roberta Teixeira Prado
- Universidade Federal do Rio de Janeiro, Anna Nery Nursing School. Rio de Janeiro, Brazil
| | - Josete Luzia Leite
- Universidade Federal do Rio de Janeiro, Anna Nery Nursing School. Rio de Janeiro, Brazil
| | - Ítalo Rodolfo Silva
- Universidade Federal do Rio de Janeiro, Anna Nery Nursing School. Rio de Janeiro, Brazil
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Arrieira ICDO, Thofern MB, Porto AR, Amestoy SC, Cardoso DH. Av Enferm 2016; 34. [DOI: 10.15446/av.enferm.v34n2.38144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
Abstract
Objetivo: Compreender como a espiritualidade é incorporadapelos integrantes da equipe do Programa de Internação Domiciliar Interdisciplinar (pidi) Oncológico no cuidado paliativo.Metodologia: Estudo de abordagem qualitativa, descritivae exploratória, fundamentada na Teoria Histórico-Cultural deVygotsky. Compuseram a pesquisa todos os integrantes da equipe interdisciplinar, totalizando oito sujeitos. Os dados foram coletados por meio da técnica de grupo focal, com cinco encontros realizados durante o período de fevereiro a maio de 2009, nos quais contou-se com a participação de dois observadores. Resultados: Emergiram dois temas: Cuidados paliativos e aespiritualidade e A espiritualidade e o processo de morrer. Os profissionais relacionaram a espiritualidade como forma de promover reflexão e aceitação da morte e sua relevância nas ações paliativistas.Conclusão: Podemos perceber que esta equipe mostrou-se disposta a compreender e adotar a espiritualidade durante a execução dos cuidados paliativos das pessoas em processo de morrer.
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Oliver A, Benito E, Sansó N, Galiana L. Cuestionarios de atención espiritual en cuidados paliativos: revisión de la evidencia para su aplicación clínica. PSICOONCOLOGIA 1970. [DOI: 10.5209/psic.54443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objetivo: Revisar los cuestionarios de evaluación de necesidades y recursos espirituales en cuidados paliativos más recientes y evaluar su aplicabilidad clínica en nuestro entorno.Método: Revisión sistemática, siguiendo las guías PRISMA de las publicaciones realizadas durante 2015-2016 de trabajos sobre espiritualidad. Los artículos debían estar centrados en el cuidado espiritual o la evaluación de la espiritualidad, basados en población de cuidados paliativos; y sometidos a revisión por pares.Resultado: de los 42 artículos identificados, tras evaluación independiente de dos observadores, 15 cumplieron criterios de selección. Estos se analizan respecto sus características, propiedades psicométricas y aplicabilidad.Conclusiones: La necesidad de mejorar la atención espiritual en el proceso de morir ha llevado a la aparición de múltiples herramientas de evaluación y acompañamiento espiritual. Su uso debe ponderarse con la experiencia del clínico y su aplicabilidad según el entorno cultural en el que se ha construido y sus propiedades psicométrica
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