Palliative & supportive care
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Palliat Support Care · Dec 2006
Review Meta Analysis Comparative StudyPerspectives on spirituality at the end of life: a meta-summary.
A meta-summary of the qualitative literature on spiritual perspectives of adults who are at the end of life was undertaken to summarily analyze the research to date and identify areas for future research on the relationship of spirituality with physical, functional, and psychosocial outcomes in the health care setting. ⋯ The findings from this meta-summary confirm the fundamental importance of spirituality at the end of life and highlight the shifts in spiritual health that are possible when a terminally ill person is able to do the necessary spiritual work. Existing end-of-life frameworks neglect spiritual work and consequently may be deficient in guiding research. The area of spiritual work is fertile ground for further investigation, especially interventions aimed at improving spiritual health and general quality of life among the dying.
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Palliat Support Care · Dec 2006
Comparative StudyThe relation between the experience of time and psychological distress in patients with hematological malignancies.
The experience of time is strongly related to our momentary mood states. Patients with a life-threatening illness experience an extreme change in mood and suffer from psychological distress that can develop into clinically relevant psychiatric disorders, like anxiety and depression. The aim of this study was to investigate the associations among the subjective perception of time, psychological distress, and quality of life in patients with hematological malignancies. ⋯ Our interpretation of the results is that patients with a life-threatening illness who show symptoms of psychological distress draw attention away from meaningful thoughts and actions and, thus, experience time as passing more slowly. An altered sense of time can be a sign of mental suffering, which should be addressed within psycho-oncological interventions. As this is the first study to demonstrate this relation in cancer patients, further research is needed to investigate the experience of time and its relation to meaning as an issue in clinical diagnostics.
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Palliat Support Care · Sep 2006
The impact of a breathlessness intervention service (BIS) on the lives of patients with intractable dyspnea: a qualitative phase 1 study.
Disabling breathlessness is the most common symptom of advanced cardiopulmonary disease. It is usually intractable, even when patients receive maximal medical therapy for their underlying condition. A pilot study was undertaken to evaluate a newly formed palliative Breathlessness Intervention Service (BIS). ⋯ This Phase I study has helped to remodel the service rapidly by uncovering the aspects of BIS that users find most valuable and areas that need change or improvement. The BIS needs to provide written information, to reinforce and extend contacts with other agencies to build on support it already provides for patients and carers, and extend its flexibility and accessibility. Providing a "drop-in" service and continuing education after the initial program of contacts is completed could be a useful service development, warranting further evaluation. A qualitative methodology involving service users and referrers can help to shape service development rapidly.
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Palliat Support Care · Sep 2006
Attitudes toward euthanasia and physician assisted suicide: a survey among medical students, oncology clinicians, and palliative care specialists.
The aim of this study was to compare the results of surveys about attitudes toward euthanasia and related issues that was conducted among palliative care specialists, health care professionals of a cancer center, and first- and second-year medical students. ⋯ Significant variations among different professionals exist in attitudes toward euthanasia. The hypothesis that familiarity with the care of severely ill and dying patients is an important underlying factor explaining variance has been confirmed by these surveys.
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Palliat Support Care · Sep 2006
Conceptualization of psycho-existential suffering by the Japanese Task Force: the first step of a nationwide project.
Although the relief of psycho-existential or spiritual suffering is one of the most important roles of palliative care clinicians, lack of an accepted conceptual framework leads to considerable confusion in research in this field. The primary aim of this article is to illustrate the process of developing a conceptual framework by the Japanese Task Force as the initial step of a nationwide project. ⋯ A Japanese nationwide multidisciplinary group agreed on a conceptual framework to facilitate research in psycho-existential suffering in terminally ill cancer patients. This model will be revised according to continuing qualitative studies, surveys, and intervention trials.