Articles: palliative-care.
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Palliative medicine · Sep 2021
Multicenter StudyFactors related to spiritual well-being in the last days of life in three East Asian countries: An international multicenter prospective cohort study.
Some factors associated with spiritual well-being in dying patients have previously been reported. However, there has been no cross-cultural study comparing factors related to spiritual well-being. The current investigation may shed light on this under-investigated area through a comparison of diverse factors. ⋯ This study found novel factors related to spiritual well-being in the last days of life, several of which differed according to country. Recognition of factors associated with spiritual well-being can improve the quality of palliative care.
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J Pain Symptom Manage · Sep 2021
ReviewQuality of life and symptom burden improve in patients attending a multidisciplinary clinical service for cancer cachexia: a retrospective observational review.
Cancer cachexia negatively affects quality of life (QoL) and increases symptom burden. A multimodal treatment approach may optimize cachexia outcomes, including QoL. We evaluated QoL and symptoms over time among patients attending a multidisciplinary clinical service for cancer cachexia. ⋯ Significant improvements in QoL and symptoms were associated with attending a cancer cachexia clinical service. Our findings support using multidisciplinary, multimodal cancer cachexia treatment approaches to improve patient wellbeing.
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Background: Medical Assistance in Dying (MAiD) was legalized in Canada in June 2016. MAiD is available to those who are at least 18 years of age with an irremediable medical condition and an irreversible state of decline causing unbearable suffering. Between June 2016 and December 2019, 13,946 MAiD cases were reported in Canada.3 Although 35.2% have taken place in the home, very little is known about the experience of caregivers in this setting. ⋯ Conclusion: We hypothesize that caregivers in our study were better prepared for the upcoming death due to more certainty as to how and when their loved one would die. Having closure and being able to say goodbye may also have positively influenced the bereavement experience. Finally, MAiD may have spared the caregivers the trauma of witnessing their loved one deteriorate in their final days of life.
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Background: Parents previously identified eight core functions of communication with clinicians in pediatric oncology. Objective: To determine clinicians' views on communication functions in pediatric oncology. Design: In 10 focus groups with 59 clinicians at two academic centers, we asked open-ended questions about communication goals and purposes. ⋯ After reviewing the eight functions described by parents, all clinicians agreed with the framework: building relationships, exchanging information, making decisions, enabling family self-management, managing uncertainty, responding to emotions, supporting hope, and providing validation. Conclusions: Pediatric oncology clinicians corroborated this functional communication framework. Clinicians and researchers can utilize this framework to guide care and research in the future.
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Randomized Controlled Trial
Parent Perspectives after the PRISM-P Randomized Trial: A Mixed-Methods Analysis.
Background: Parents experience high distress following their child's diagnosis of cancer. We previously tested two delivery models (group and one-on-one) of the "Promoting Resilience in Stress Management for Parents" (PRISM-P) intervention in a randomized trial: one-on-one delivery improved resilience and benefit finding at three months when compared to usual care (UC). Objective: The objective of this analysis was to evaluate quantitative and qualitative outcomes at six months. ⋯ Conclusions: Although the PRISM-P benefits observed at three months were not sustained for six months, all interviewed parents found it valuable. Additional opportunities to strengthen and sustain resilience resources include longer follow-up, flexible format, and skill reinforcement. Trial Registration: NCT02998086.