Palliative & supportive care
-
Palliat Support Care · Jun 2008
Developing a renal supportive care team from the voices of patients, families, and palliative care staff.
Although half a million Americans suffer from end stage renal disease (ESRD), their quality of end-of-life care has been woefully inadequate. The Renal Supportive Care Team is a demonstration project that is designed to elicit and provide for the needs of dialysis patients and their families throughout the trajectory of their illnesses. ⋯ Palliative and supportive care issues in ESRD need greater attention.
-
Palliat Support Care · Jun 2008
General practitioners' experiences of the psychological aspects in the care of a dying patient.
General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients. ⋯ The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.
-
Palliat Support Care · Jun 2008
Screening for psychological distress in two French cancer centers: feasibility and performance of the adapted distress thermometer.
Little is known about the prevalence of psychiatric disorders in French cancer patients. This study aimed to assess the feasibility of a screening procedure using the Psychological Distress Scale (PDS). The PDS is a French adaptation of the National Comprehensive Cancer Network Distress Thermometer. The screening performance of the PDS was assessed by comparison with the established clinical case threshold on the Hospital Anxiety and Depression Scale (HADS). ⋯ Using the PDS appeared feasible, acceptable and effective for psychological distress screening in French ambulatory cancer care settings.
-
Palliat Support Care · Jun 2008
Psychiatric issues in palliative care: recognition of delirium in patients enrolled in hospice care.
Delirium is prevalent, difficult to assess, under-recognized, and undertreated in hospice and palliative care settings. Furthermore, it is associated with significant morbidity and mortality. Under-recognition of delirium results in under-treatment and increased suffering. The intent of this study was to retrospectively evaluate the recognition of delirium in a large cohort of hospice patients by interdisciplinary hospice care teams. ⋯ If documentation is representative of the care that the interdisciplinary teams provide, delirium of any kind appears to be under-recognized in this population. In fact, it is on the low end of prevalence estimates in the literature. Improved delirium assessment is needed in order to minimize the impact of delirium on patients living with advanced, life-threatening illnesses and their caregivers.
-
Palliat Support Care · Jun 2008
Predictors of well-being in bereaved former hospice caregivers: the role of caregiving stressors, appraisals, and social resources.
The current literature on caregiving and bereavement indicates that the relationship between these two common life events is complex and needs to be further studied in order to gain a more comprehensive understanding of their interaction. ⋯ Results support both the resource depletion and anticipatory grief hypotheses and suggest that short-term bereavement outcomes are different than factors that predict well-being while caregiving. Future studies should address whether long-term bereavement outcomes differ by baseline caregiving characteristics to guide intervention research.