Journal of palliative medicine
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Although dignity is increasingly considered a goal of palliative care, little research has evaluated the understanding of dignity at the end of life from a caregiver's perspective. ⋯ It seems that SCEN physicians consider the physical aspects of suffering to be most influential and problematic in practice in preserving dignity, while volunteers think psychosocial aspects are most important in preserving dignity at the end of life. These findings suggest that the role and responsibilities of caregivers involved in care for terminally ill patients affect the factors that they think influence dignity.
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Advance care planning (ACP) is a process of communication among patients, health care providers, and relatives regarding end-of-life care. The aim of our study was to determine if a representative sample of the Dutch general public is currently involved or is inclined to be engaged in ACP, and to delineate the factors associated with greater engagement. ⋯ Although the majority of the Dutch population seems open to discussions about end-of-life care, our study revealed that discussions with physicians are exceedingly rare. To improve ACP as a joint process among patients, relatives, and physicians, the general public's awareness of the importance of end-of-life discussions with their physicians needs to be increased and physicians need to play a more active role by initiating conversations and dialogue regarding end-of-life care.
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Palliative care clinicians confront suffering as they care for people living with life-limiting conditions. When the degree of suffering becomes unjustified, moral distress can ensue. Promising work from neuroscience and social psychology has yet to be applied to clinical practice. ⋯ The adaptation and expansion of a conceptual framework offers a promising approach to designing interventions that help clinicians mitigate the detrimental consequences of unregulated moral distress and to build the resilience necessary to sustain themselves in clinical service.
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Awareness for pediatric palliative care in children with cancer increased in the last ten years in Germany. In this study we sought to determine whether this change in awareness led to improved palliative care outcomes in children dying due to cancer. ⋯ While the location of care during the end-of-life period shifted (from hospital to home), there remains substantial work to ease the suffering in children with cancer at end of life.