Palliative & supportive care
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Palliat Support Care · Mar 2003
ReviewA systematic review of spiritual and religious variables in Palliative Medicine, American Journal of Hospice and Palliative Care, Hospice Journal, Journal of Palliative Care, and Journal of Pain and Symptom Management.
There has been increasing recognition and acceptance of the importance of addressing existential and spiritual suffering as an important and necessary component of palliative medicine and end-of-life care in the United States. This paper seeks to. empirically and systematically examine the extent to which there is an adequate scientific research base on spirituality and its role in palliative care, in the palliative care and hospice literature. ⋯ While researchers in the field of palliative care have studied spiritual/religious variables more than other areas of medicine, the total percentage for studies is still a low 6.3%. To move the field of palliative medicine forward so appropriate guidelines for spiritual care can be developed, it is critical that good research be conducted upon which to base spiritual care in an evidence-based model. Recommendations are made for future studies on spiritual care in palliative medicine.
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Palliat Support Care · Mar 2003
Initial validation of a scale to measure purposelessness, understimulation, and boredom in cancer patients: toward a redefinition of depression in advanced disease.
The problem of boredom in people with cancer has received little research attention, and yet clinical experience suggests that it has the potential to profoundly affect quality of life in those patients. We were interested in developing a Purposelessness, Understimulation, and Boredom (PUB) Scale to identify this problem and to begin to differentiate it from depression. ⋯ The PUB Scale was found to be a statistically viable tool with the ability to detect boredom and differentiate it from depression. In many respects this work is in concert with much of the current research and clinical effort going on in psycho-oncology that defines components of distress that in sum, redefines depression in advanced cancer.
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Palliat Support Care · Mar 2003
Comparative StudyA comparison of patients dying at home and patients dying at a hospice: sociodemographic factors and caregivers' experiences.
The aim of this study was to investigate whether there were any differences between patients who died at home and patients who died at a hospice, that is, sociodemographic variables, the family caregivers' experiences of burden, and their opinion of reasons for hospice care. ⋯ This study showed that women died to a lesser degree at home than men. The explanation for this is unknown and requires further investigation. It is important to establish whether female patients or male caregivers need another type of support than male patients or female caregivers, since the aim of palliative care is that every patient who wishes to die at home should have this wish fulfilled.
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The codes of ethics of the National Hospice and Palliative Care Organization and the National Association of Social Workers support ethical standards of client self-determination and confidentiality. Lack of societal consensus on the parameters of a terminally ill person's right to die continues to confound at times the health care field, including hospice programs. This article explores an actual case where a hospice social worker faced an ethical dilemma related to the sanctity of life versus patient autonomy. While a more seasoned social worker might have chosen a different alternative to the dilemma, this case illustrates the importance of creating an interdisciplinary rather than multidisciplinary hospice team and the need for ongoing dialogue on how to support patient choice.