Journal of palliative medicine
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Multicenter Study
Preparedness for the death of a loved one and mental health in bereaved caregivers of patients with dementia: findings from the REACH study.
Although it has been suggested that family and friends who are prepared for the death of a loved one have less distress, the relationship between preparedness and bereavement mental health is inconclusive. ⋯ Despite providing high-intensity care, often for years, many bereaved caregivers perceived themselves as unprepared for the death. These caregivers had more depression, anxiety, and complicated grief symptoms. Future work should be directed to confirming these findings and determining how best to intervene with high-risk caregivers.
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For patients confronting a life-threatening illness such as advanced cancer, religious coping can be an important factor influencing their quality of life (QOL). ⋯ Findings show that religious coping plays an important role for the QOL of patients and the types of religious coping strategies used are related to better or poorer QOL.
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Alleviation of suffering is a fundamental goal of medicine, especially at the end of life. Although physical distress is a component of suffering, other determinants likely play a role. This study attempted to elucidate these other components in an effort to understand the nature of suffering better. ⋯ Patients reporting lack of distress resulting from physical symptoms did not necessarily indicate lack of suffering because of physical symptoms or lack of overall suffering. Factors other than physical symptom distress, such as diagnosis, age, and QOL appear to affect the perception of suffering. In order to better address suffering at the end of life, care must be taken to understand differences between physical symptom distress, suffering caused by physical symptoms and overall suffering.
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What were the needs of outpatients for symptom management? ⋯ While there exists some disconnect between perceived need for symptom management between outpatient and oncologist, it is evident that pain is the symptom of primary concern. An interdisciplinary team of oncologist, nurse, social worker, dietician, pharmacist, and psychologist could collaboratively address the presenting symptoms. Users, both outpatients and oncologists perceive benefit from a collaborative and interdisciplinary symptom management clinic.