To see the other types of publications on this topic, follow the link: Palliative care. Comfort. Patient.
Journal articles on the topic 'Palliative care. Comfort. Patient'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Palliative care. Comfort. Patient.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Karius, Diana. "Managing pain in palliative care." American Nurse Journal 17, no. 11 (2022): 25–54. http://dx.doi.org/10.51256/anj112225.
Full text
2
Blacquiere, Dylan P. V., Gord J. Gubitz, David Dupere, Deborah McLeod, and Stephen Phillips. "Evaluating an Organized Palliative Care Approach in Patients with Severe Stroke." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 36, no. 6 (2009): 731–34. http://dx.doi.org/10.1017/s0317167100008349.
Full textAbstract:
Background:A recent survey found few guidelines on the provision of palliative care following stroke; none examined the efficacy or results of any such process. The role of the patient's family in decision making and in conflicts with staff has not been evaluated. We sought to formally evaluate the use of locally-developed palliative care guidelines on our Acute Stroke Unit (ASU).Methods:We retrospectively examined records of 104 patients who died on our ASU over a two-year period to determine if our existing palliative guidelines were reflected in clinical practice, and to identify conflicts that arose. Data on medical and nursing care, palliative decisions, and medication use were compared to the ASU's existing palliative care guidelines. Family concerns about the palliative process were also reviewed.Results:Of patients admitted to the stroke unit, 104 (16% of total admissions) died. Ninety-four (90.4%) of these were palliated; all received routine nursing and comfort care prior to death. Median time from admission to palliation was 3.6 days; median time from admission to death was 8.5 days. Most had vital signs (98.9%), investigations (100%) and non-palliative medications (95.7%) stopped, and had nasogastric feeding (96.8%) and intravenous fluids (87.2%) withdrawn or never begun. Most were treated with morphine (93.6%) and scopolamine (81.9%). Concerns raised by family members centered around hydration and feeding (45.7%), doubts about palliative care (27.8%) and patient comfort (18.2%).Conclusions:A formal approach to palliation results in timely decisions regarding end of life care with relatively few conflicts. Further work to address the specific concerns of families is needed.
3
Melody, Megan Elizabeth, Chimere Bruning, Rachel Mack, et al. "Patient perceptions of palliative care in the process of allogeneic hematopoietic cell transplantation." Journal of Clinical Oncology 39, no. 15_suppl (2021): e24082-e24082. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e24082.
Full textAbstract:
e24082 Background: Allogeneic hematopoietic cell transplantation (allo-HCT) is associated with significant short- and long-term sequelae that affect patients’ overall quality of life (QoL) and their physical and psychological well-being. Studies have shown improvement in patient QoL and physician satisfaction with palliative care involvement in the allo-HCT process. However, patient and physician perceptions regarding palliative care often impact timely referral. We conducted a prospective study to examine patient perceptions of palliative care both before and after palliative care consultation during evaluation for allo-HCT. Methods: This is a prospective, single-center study, of patients > 18 years of age, who were referred for a palliative care consultation as part of standard evaluation for allo-HCT. Patients were administered a pre- and post-visit internally derived questionnaire to assess their understanding and comfort level with palliative care. The primary objective of this study was to examine patient perceptions of palliative care consultation during evaluation for allo-HCT. Primary end point was the change in patient pre- and post- questionnaire responses. Secondary endpoint was the completion of advance care planning documentation pre- and post- consultation. Results: We enrolled 32 patients (male = 14) undergoing evaluation for allo-HCT with a primary diagnosis of AML (n = 8), NHL (n = 8), MDS (n = 7), ALL (n = 2), and other (n = 7). Following consultation with palliative care there was a statistically significant increase in patient understanding of the reason for the appointment, p = 0.0006. There was also a significant increase in patient’s knowledge of palliative care, with only 28% describing their knowledge as “good” or “excellent” prior to consultation and 79.3% after consultation, p < 0.0001. There was an observed positive, non-statistically significant, trend in patient comfort level with palliative medicine with only 20.7% (n = 6) describing their comfort as “high” or “very high” prior to consultation and 51.7% (n = 15) after consultation, p = 0.60. There was a higher rate of completion of advance care planning documentation following consultation with palliative medicine 56.3% vs 71.4%, p = 0.042. Conclusions: Palliative care consultation prior to allo-HCT increases a patient’s understanding of the role of palliative medicine as part of their allo-HCT and improves advance care planning. These findings need to be validated in a larger, multicenter, patient cohort.
4
Smith, Pamela A. "Palliative Care in Dysphagia and Dementia." Perspectives of the ASHA Special Interest Groups 5, no. 2 (2020): 506–10. http://dx.doi.org/10.1044/2020_persp-19-00038.
Full textAbstract:
Purpose The purpose of this clinical focus article is to discuss palliative care for patients with dysphagia who also have a comorbid condition of dementia. It reviews the nature of palliative care as encompassing important aspects of patient/resident choice and comfort, which are important regardless of the cognitive status of the patient or the terminal nature of the diagnosis. It provides a comparison of palliative care, hospice care, and rehabilitative care. It then discusses issues that are specific to dementia and dysphagia for patients who are approaching the end of life. Conclusion The philosophy of palliative care need not be limited to end-of-life cases in dysphagia management as considerations for comfort, and patient's wishes should always be part of care planning. Clinicians working with cognitively impaired patients at the end of life must be particularly sensitive to their communication efforts and be willing to work cooperatively with family members and other stakeholders in developing plans of care using shared decision making.
5
Kogan, Alexis Coulourides, Valeria Cardenas, YuJun Zhu, Jenna Giulioni, Anna Rahman, and Susan Enguidanos. "It’s Yet Another Thing: Barriers to and Recommendations for Physician Referrals to Home-Based Palliative Care." Innovation in Aging 5, Supplement_1 (2021): 166. http://dx.doi.org/10.1093/geroni/igab046.635.
Full textAbstract:
Abstract To understand primary care providers’ (PCPs) experiences with referring patients to home-based palliative care (HBPC), we conducted individual, key-informant interviews with 31 PCPs. About half participants were male (54.8%), White (42.5%), US-born (58.1%), and were 57 years old (SD=9.17), on average. About one-third of participants (32.3%) indicated they refer 10+ patients annually to HBPC, while most (80.7%) reported “strong” comfort discussing palliative care with patients. Qualitative analysis revealed three prominent thematic categories, each related to barriers PCP experienced when referring patients to palliative care: (1) PCP-level (lack of knowledge and comfort); (2) perceived patient-level (culture, family disagreement, need, home-based aspect); and (3) HBPC program-level (need to close the loop with PCP, insurance coverage, program availability, and eligibility). PCP recommendations for overcoming identified barriers will be discussed. Findings hold important implications for timely patient-referrals to palliative care by PCPs and for sustaining palliative programs that rely on these referrals.
6
Kristjanson, Linda J. "Palliative Care for Individuals with Amyotrophic Lateral Sclerosis." Journal of Palliative Care 2, no. 2 (1987): 28–34. http://dx.doi.org/10.1177/082585978700200207.
Full textAbstract:
Palliative care has emerged in response to the comfort needs of the terminally ill cancer patient. From our experience with Amyotrophic Lateral Sclerosis patients and their families in different care settings, we believe that palliative care is also an appropriate approach for this population. The extent to which palliative care, as it is generally practised, fits the needs of the ALS patient and family and the ways that palliative care should be adjusted to meet their needs are discussed in this paper.
7
Timóteo, Francina Silva, Gabriel Costa, Gustavo Vieira Donega, Nicole Yoshie Gonçalves Sakamoto, and Mariana Cristina dos Santos Souza. "Palliative care in patients with diabetes mellitus: integrative review." Concilium 24, no. 14 (2024): 440–58. http://dx.doi.org/10.53660/clm-3786-23p37.
Full textAbstract:
Objective: To synthesize scientific publications related to palliative care for patients with Diabetes Mellitus. Method: Integrative Review guided by the question “‘what is the influence of palliative care on the comfort, quality of life and glycemic control of patients with DM1 and DM2?”. Articles published in the last ten years (2013-2023), in 8 libraries and databases, were reviewed. Results: After searching and applying the inclusion and exclusion criteria, 6,443 were found and, after the screening and eligibility steps, 3 were included for analysis. Four thematic classes emerged: Reluctance and taboo in Palliative Care; Glycemic control and quality of life; Family and professional involvement; Reception and Health Care Networks in the context of Diabetes Mellitus. Conclusion: It is emphasized how beneficial early adherence to palliative care can be for a diabetic patient, aiming for better comfort and quality of life. Some factors limited the referral of these patients to palliative care: patient and family acceptance, resource limitations in palliative care programs and difficulties in pathological prognosis. Encouraging research related to this topic would significantly strengthen the debate on effective reception and better monitoring in palliative care.
8
Geffre, Marcus, Frederick W. Endorf, and Rachel M. Nygaard. "571 Palliative Care Utilization in Burn Patients." Journal of Burn Care & Research 42, Supplement_1 (2021): S136. http://dx.doi.org/10.1093/jbcr/irab032.221.
Full textAbstract:
Abstract Introduction The morbidity and mortality of the severely burned patient can be affected by multiple variables. Many of these variables are also associated with an increased likelihood of withdrawal of care. Palliative care services can aid families in difficult decision making during this time and improve the process of transition to comfort cares. Despite this, palliative care services may be underutilized. The aim of our study is to assess factors associated with palliative care consultation in the setting of severe burns. Methods We analyzed 191 patients with a burn TBSA of ≥30% at our institution from 2007 to 2019. Univariate and multivariate analysis was performed to identify factors associated with consultation to palliative care. Results 17 of the 191 (8.9%) patients received a palliative care consultation. The average time to consultation was 10.3 days. On univariate analysis, age, inhalation injury, multiple comorbid conditions, and code status were associated with consultation to palliative care. Independent predictors of palliative care consult included inhalation injury, non-white race, code status, and ventilator days. Conclusions Palliative care consultation appears to be seldomly requested at our facility. The presence of an inhalation injury and comorbidities increase the likelihood of consultation. These factors correspond to the same factors that increase likelihood of transition to comfort care. Consult to palliative care on patients with these factors can help improve patient and family care.
9
Silveira, Aline Bueno da, Luciene Fernandes de Oliveira, Luciana Soares Rodrigues, Polliana Lucio Lacerda Pinheiro, and Ivani Pose Martins. "ENFERMAGEM E CUIDADOS PALIATIVOS: CONFORTO E QUALIDADE DE VIDA DO PACIENTE." Revista ft 29, no. 146 (2025): 15–16. https://doi.org/10.69849/revistaft/ch102025005080615.
Full textAbstract:
This study aimed to identify and analyze the main nursing interventions that contribute to the comfort and improvement of the quality of life of patients receiving palliative care. With the increase in life expectancy and the prevalence of chronic diseases, palliative care stands out as an approach that values the patient’s overall well-being, even in the face of terminal illness. This is an integrative literature review with a qualitative approach, conducted in the LILACS, MEDLINE, BDENF, and SciELO databases, covering the years 2020 to 2024. Descriptors such as “palliative care,” “patient comfort,” “nursing,” and “quality of life” were used. The analyzed studies highlight that nurses play a key role in alleviating suffering through strategies involving pain control, emotional support, active listening, non-pharmacological care, and effective communication with patients and families. It was also evidenced that humanization, spiritual support, and respect for patient autonomy are pillars for more dignified and comprehensive care. However, challenges remain, such as the lack of professional training, the absence of direct patient listening, and the limited number of studies focused on home care. It is concluded that strengthening nursing practices in palliative care significantly contributes to a more humanized and person-centered approach, promoting not only physical but also emotional and spiritual comfort during the end-oflife process.
10
McGahan, Rose K., Ellin F. Gafford, Bryan A. Whitson, Thomas J. Papadimos, and Ravi S. Tripathi. "Palliative Use of Nitroglycerin to Improve Microvascular Circulation." Journal of Palliative Care 35, no. 2 (2019): 75–77. http://dx.doi.org/10.1177/0825859719856563.
Full textAbstract:
Background: In the setting of critical illness, life preservation may come at the expense of limb as increasing concentration of vasopressors causes peripheral ischemia. When goals of care specify comfort measures, clinicians are faced with the difficult task of mitigating already present distal malperfusion while abiding to wishes of patient and patients’ families. Physical changes post vasopressor use, such as mottling of appendages or cooling of skin, can limit meaningful physical interactions with grieving family members. Case Presentation: We describe a case series of successful utilization of intravenous nitroglycerin to improve postvasopressor digital ischemia for comfort care measures to assist patient’s families in the grieving process. Conclusion: Following decision for comfort care measures, management for patient care goes beyond the realm of pain control. Dignified dying is an active process that requires clinicians to navigate care for both patient and patients’ families. By reversing the digital ischemia associated with vasopressors, patients’ families have the opportunity to give meaningful touch in setting of which it may be needed most.
11
Hertanti, Nuzul Sri, Mei-Chih Huang, Chia-Ming Chang, Susan Jane Fetzer, and Chi-Yin Kao. "Knowledge and comfort related to palliative care among Indonesian primary health care providers." Australian Journal of Primary Health 26, no. 6 (2020): 472. http://dx.doi.org/10.1071/py20111.
Full textAbstract:
This study investigated Indonesian primary health care providers’ knowledge and comfort towards palliative care. A descriptive cross-sectional design was used. From August 2017 to February 2018, the research team approached 70 primary care centres in the Yogyakarta province of Indonesia and invited health care providers to complete the Palliative Care Quiz for Nursing – Indonesia and describe their comfort in caring for terminally ill patients. Data were obtained from 516 health care providers. The mean (±s.d.) score of palliative care knowledge was low (7.8±3.3 of a possible score of 20). Current comfort level in providing palliative care was also low (1.6±2.7 of a possible score of 10). Only 11.3% of palliative care knowledge was explained by respondents understanding of palliative care definition, their education levels and experience in providing palliative care in hospital. However, 82.9% of provider comfort was explained by their experiences for caring for terminally ill patients in primary healthcare centres, palliative care training and years of work experience in primary healthcare centres. Indonesian evidence-based palliative care standards and guidelines must be established with education offered to all providers.
12
Yazdani, Shahram, Elana Evan, Danielle Roubinov, Paul J. Chung, and Lonnie Zeltzer. "A longitudinal method of teaching pediatric palliative care to interns: Preliminary findings regarding changes in interns' comfort level." Palliative and Supportive Care 8, no. 1 (2010): 35–40. http://dx.doi.org/10.1017/s147895150999068x.
Full textAbstract:
AbstractObjective:A longitudinal pediatric palliative care curriculum was introduced into the pediatric residency program at the University of California, Los Angeles. The present study explores the possible effects of this curriculum on the interns' self-assessed comfort levels regarding caring for children with life-threatening conditions.Methods:A newly created assessment tool was administered to interns in order to rate their comfort regarding pediatric palliative care at the beginning and conclusion of their intern year.Results:Twenty-two of the 29 interns completed this survey. Baseline data indicated 55% of the interns had some experience with taking care of a dying pediatric patient during their medical school training, and 79% indicated that they had taken care of a dying adult. Only 7% of the interns felt adequately prepared to deal with death and dying, but all interns indicated interest in further learning about pediatric palliative care. Comparison of the overall comfort levels of the 22 responding residents before and after the first year of training in 20 different related tasks demonstrated a significant self-assessed improvement of comfort in seven areas. There was no increase in self-reported comfort in communication related to palliative care.Significance of results:Residents indicated increased comfort in some areas of pediatric palliative care after the first year of their training. The underlying cause of this increased comfort is unclear at this time. The overall effect of longitudinal palliative care curriculums on residents' level of comfort in caring for this population deserves further assessment.
13
Haneef, Sara, and Marwah Abdullah. "Palliative Care Needs and Symptom Burden in Patients Undergoing Maintenance Hemodialysis: A Systematic Review." JOURNAL OF HEALTHCARE SCIENCES 04, no. 05 (2024): 201–15. http://dx.doi.org/10.52533/johs.2024.40502.
Full textAbstract:
While life-sustaining, hemodialysis imposes significant physical, emotional, and psychological burdens on patients. The integration of palliative care into the routine management of hemodialysis patients has shown promising benefits. Studies indicate that early palliative care intervention can significantly improve symptom control, enhance quality of life, and reduce hospital admissions and healthcare costs. By addressing the multifaceted needs of hemodialysis patients through palliative care, it is possible to enhance their quality of life significantly. This systematic review aims to synthesize the existing evidence on palliative care needs and symptom burden in hemodialysis patients, highlighting the critical role of palliative care in this vulnerable population. The inclusion criteria encompass studies focusing on adults undergoing maintenance hemodialysis. A quality assessment was performed using the Newcastle-Ottawa Scale to ensure the reliability and validity of findings. Findings highlight significant palliative care needs among hemodialysis patients and emphasize positive perceptions of palliative care interventions among patients underscoring their value while comfort-focused treatment, was prioritized defining the necessity for improved decision-making and access to palliative care services in dialysis settings. Additionally, research identified varied levels of palliative care needs among patients, with a notable proportion experiencing moderate to severe requirements. Furthermore, results of this study indicate the burden of symptoms among hemodialysis patients is extensive and diverse, encompassing issues like fatigue, pain, and itching, which are particularly pronounced among older individuals. These symptoms significantly impair patients' quality of life. Moreover, symptom severity varies widely among patients, with certain symptoms such as sleep disturbances and itching posing significant challenges to patient comfort and wellbeing. These findings underscore the complex symptom management needs within the hemodialysis population. Future research should focus on standardizing measures of palliative care needs, evaluating the effectiveness of tailored interventions, and addressing gaps in current evidence to improve palliative care delivery and patient outcomes in hemodialysis settings.
14
Czernecki, Karol Tomasz, and Barbara Ślusarska. "Comfort or discomfort for patients in palliative home care? – a pilot study." Pielegniarstwo XXI wieku / Nursing in the 21st Century 22, no. 1 (2023): 26–34. http://dx.doi.org/10.2478/pielxxiw-2023-0009.
Full textAbstract:
Abstract Introduction. Ensuring comfort in patients in palliative home care is a difficult task. Care, in which patient’s comfort is fundamental, was fi rst introduced by Katharine Kolcaba. Aim. Assessing comfort levels of patients in palliative home care, including selected determinants of this condition. Material and methods. The study included 55 palliative care patients in home settings, receiving services provided by the home palliative care team and a group of 63 informal caregivers providing home care. A pilot study, by diagnostic survey, using a survey questionnaire with the PAPI technique was conducted among patients in palliative care treated in home-based settings in the fi rst half of 2022. Results. There was a statistically signifi cant relationship between satisfaction with care, and the level of comfort provided (p<0.05). Those who strongly indicated satisfaction were characterized by signifi cantly higher levels of comfort provided (M=35.43; SD=5.32 vs. M=33.38; SD=4.63), compared to other patients. Conclusions. There is a correlation between the level of comfort perceived by patients, and methods of providing comfort to patients in home settings used by informal caregivers. Individuals, who are characterized by a higher feeling of comfort provision, at the same time achieve higher degree of comfort provided by the caregiver.
15
Gidwani, Risha, Diane E. Meier, Steven M. Asch, and Rebecca A. Kirch. "Physicians' perceptions of palliative care." Journal of Clinical Oncology 32, no. 31_suppl (2014): 80. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.80.
Full textAbstract:
80 Background: Physicians are often gatekeepers to palliative care for their patients. Physicians’ attitudes and beliefs regarding palliative care will therefore influence patient receipt of these services. Here, we explored physicians’ perceptions of palliative care. Methods: We conducted a focus group with 2 hospitalists and 3 medical oncologists. We asked physicians to define palliative care and elicited their suggestions regarding best way to communicate the role of palliative care to patients as well as to other physicians. Results: Physicians generally defined palliative care as comfort care, with two physicians denoting palliative care as occurring during the end of life. Focus group participants felt the best way to communicate the role of palliative care to other physicians was to denote its ability to support physicians in their work by helping coordinate patient care, managing complex physical and emotional symptoms, devoting time to intensive family meetings, and resolving conflicts between patients/families and physicians concerning goals of care, do-not-resuscitate orders, and treatment requests. They disagreed that palliative care should be integrated at all points in a patient’s disease trajectory. Conclusions: Physicians had generally positive reactions to palliative care. Palliative care is often associated with end-of-life care. Further research and exchange about the appropriate timing of palliative care is needed.
16
Mohammed, B. Alshahrani, A. Almarhoun Saja, A. Khoutan Hoda, et al. "Enhancing Comfort in Palliative Care: The Critical Role of Respiratory Therapists in Managing Dyspnea at End of Life." International Journal of Innovative Research in Engineering & Multidisciplinary Physical Sciences 6, no. 4 (2018): 1–6. https://doi.org/10.5281/zenodo.13681333.
Full textAbstract:
Background: Dyspnea is a prevalent and distressing symptom in palliative care patients, significantly impacting their quality of life. Respiratory therapists (RTs) play a vital role in managing this symptom, yet detailed studies evaluating the effectiveness of their interventions are sparse.Methods: This retrospective study analyzed the medical records of 120 end-of-life patients in a palliative care unit at a large tertiary hospital from January 2016 to December 2017. The effectiveness of respiratory therapy interventions, including non-invasive ventilation, supplemental oxygen, and nebulized medications, was assessed based on changes in dyspnea severity and patient comfort levels.Results: Post-intervention, patients exhibited significant improvements in dyspnea severity, with scores decreasing from an average of 7.4 to 4.2 on a 10-point scale (p < 0.001). Comfort scores improved from 4.6 to 7.8 (p < 0.001). The study also noted a reduction in the need for crisis interventions and an increase in patient satisfaction with care.Conclusion: The findings underscore the critical role of respiratory therapists in enhancing the quality of life for palliative care patients by effectively managing dyspnea. These results advocate for the integration of specialized respiratory interventions in palliative care practices to improve patient outcomes.
17
Zimmerman, Kristin, James Rudolph, Marci Salow, and L. Michal Skarf. "Delirium in Palliative Care Patients: Focus on Pharmacotherapy." American Journal of Hospice and Palliative Medicine® 28, no. 7 (2011): 501–10. http://dx.doi.org/10.1177/1049909111403732.
Full textAbstract:
Patients receiving palliative care often possess multiple risk factors and predisposing conditions for delirium. The impact of delirium on patient care in this population may also be far-reaching: affecting not only quality of remaining life but the dying process experienced by patients, caregivers, and the medical team as well. As palliative care focuses on comfort and symptom management, the approach to assessment and subsequent treatment of delirium in palliative care patients may prove difficult for providers to navigate. This article summarizes the multifactorial nature, numerous predisposing medical risk factors, neuropsychiatric adverse effects of palliative medications, pharmacokinetic changes, and challenges complicating delirium assessment and provides a systematic framework for assessment. The benefits, risks, and patient-specific considerations for treatment selection are also discussed.
18
Glover, Toni L., Hanna Åkerlund, Ann L. Horgas, and Susan Bluck. "Experiential Palliative Care Immersion: Student Nurse’s Narratives Reflect Care Competencies." Western Journal of Nursing Research 41, no. 10 (2019): 1465–80. http://dx.doi.org/10.1177/0193945919833061.
Full textAbstract:
Many nurses report a lack of confidence providing care for patients facing a life-threatening illness. Palliative care leaders have devised primary palliative nursing care competencies (CARES [Competencies And Recommendations for Educating undergraduate nursing Students]) that all students should achieve. In this study, nursing students participated in an innovative palliative care immersion experience, the Comfort Shawl Project. We performed a reliable content analysis of their narrative reflections. The goal was to evaluate whether reflections on their interactions with patients/families were consistent with CARES competencies. Nine female students wrote reflections after gifting each of the 234 comfort shawls to patients. Four CARES-related categories were analyzed: Individual Values and Diversity, Compassionate Communication, Fostering Quality of Life, and Self-Insight and Emotion. Reflections were highly representative (41%) of recognizing Individual Values and Diversity, representing sensitivity for patients’ unique differences in values, an integral component of palliative care. The Comfort Shawl Project shows promise as an experiential immersion for introducing nursing students to CARES competencies.
19
Sullivan, Suzanne S., Catherine M. Mann, and Elaine Wittenberg. "Communication Openings: A Novel Approach for Serious Illness Communication in Homecare." Journal of Gerontological Nursing 49, no. 11 (2023): 33–41. http://dx.doi.org/10.3928/00989134-20231011-02.
Full textAbstract:
Serious illness communication in homecare about hospice and/or palliative care transitions is lacking due to clinical culture. The purpose of the current study was to understand communication openings using COMFORT™, a palliative care communication model used to train nurses. Qualitative, focus group interviews with 31 homecare nurses were conducted. Data were transcribed verbatim and thematically analyzed using NVivo software, followed by hand-sorting. Four themes for communication openings for initiating discussions about potential hospice and/or palliative care transitions were identified: Organizational Openings (homecare appropriateness, eligibility requirements, and staffing); Patient Openings (patient physical decline, psychosocial changes, safety concerns, and denying/stopping care); Caregiver Openings (caregiver physical changes and patient readiness); and Nurse Openings (need for hospice, checking for prognosis understanding, increasing interprofessional care needs, and providing end-of-life care). This study extends the concept of communication openings in the COMFORT model. Further development of communication openings as part of COMFORT communication is needed in educational and intervention research. [ Journal of Gerontological Nursing, 49 (11), 33–41.]
20
Zuniga-Villanueva, Gregorio, Jose Luis Ramirez-GarciaLuna, and Kevin Weingarten. "Factors Associated With Knowledge and Comfort Providing Palliative Care: A Survey of Pediatricians in Mexico." Journal of Palliative Care 34, no. 2 (2019): 132–38. http://dx.doi.org/10.1177/0825859719827021.
Full textAbstract:
Background: Lack of education and training in palliative care has been described to be one of the most important barriers to pediatric palliative care implementation. Objective: To examine what factors determine the degree of knowledge and level of comfort Mexican pediatricians have providing pediatric palliative care. Methods: A questionnaire that assessed palliative care concepts was developed and applied online to Mexican pediatricians, both generalists and specialists. Results: A total of 242 pediatricians responded. The majority had not received palliative care education (92.6%) and felt uncomfortable discussing palliative needs with patients and families (92.1%). The mean score of the questionnaire was 6.8 (±1.4) of 10 correct answers. Knowledge in palliative care was associated with exposure to oncologic patients ( P = .01) and previous palliative care education ( P = .02) but inversely related to the pediatrician’s age ( P = .01). Comfort addressing patient’s palliative care needs was associated with knowledge in palliative care ( P < .01), exposure to oncologic patients ( P = .03), and previous education in palliative care ( P = .02). Conclusions: Although Mexican pediatricians have basic knowledge of palliative care concepts, they do not feel comfortable addressing palliative care needs, suggesting that the main barrier for implementing palliative care is not the lack of knowledge but rather feeling uncomfortable when addressing these issues with patients and families. Educational programs should incorporate strategies that could help physicians develop comfort in approaching palliative care patients.
21
McCracken, James A., Mohamed Nakeshbandi, Carline Sainvil, Eduard Porosnicu, and Roopali Sharma. "160. A Pre- and Post-intervention Study to Implement a Successful Antimicrobial Stewardship Program in Palliative Care." Open Forum Infectious Diseases 7, Supplement_1 (2020): S89—S90. http://dx.doi.org/10.1093/ofid/ofaa439.205.
Full textAbstract:
Abstract Background In patients receiving palliative care, medical interventions are transitioned away from aggressive and curative attempts to less invasive and more comfort measures. Antimicrobial usage remains a challenging subject in palliative care decisions, where many physicians focus interventions on reduction of patient pain and discomfort, without consideration for adverse effects such as the development of antimicrobial resistance or patient-specific adverse drug events. With limited data on the comfort benefit, we aimed to assess antimicrobial use in patients at the end of life in our institution as well as the success of targeted stewardship interventions in palliative care patients. Methods Patients who expired between November 2018 and August 2019 were assessed retrospectively for antimicrobial use during their last 14 days of life. In January 2020, a prospective stewardship initiative began in collaboration with our institution’s palliative care team to focus antimicrobial interventions on patients involved in goals of care discussions. Results In our retrospective review of 200 patients, 139 (69.5%) of patients received antimicrobials in their last two weeks of life, with 50% having formal palliative care consultations. The most commonly used antimicrobials were piperacillin-tazobactam (64.7%) and vancomycin (60.4%), with primary indications being pneumonia (34.5%) and empiric coverage/sepsis (24.5%). Of note, 46% of antimicrobial regimens were eligible for optimization through stewardship initiatives. From January through February 2020, sixteen stewardship interventions were made on thirteen palliative care patients, with an 81.3% acceptance rate. Duration of therapy based on indication and discontinuation of antibiotics following transition to comfort measures only were the most frequent interventions made. Table 1. Baseline Characteristics Table 2. Antimicrobial Usage - Pre-intervention Table 3. Prospective Intervention Data Conclusion Close of half of patients receiving antimicrobials at the end of life are eligible for interventions to improve antibiotic regimens. These patients are often overlooked in antimicrobial stewardship, and, despite small sample size, our study shows the benefit of targeted stewardship in palliative care populations with an intervention acceptance rate of over 80%. Disclosures All Authors: No reported disclosures
22
Kent, Erin E., Rebecca A. Ferrer, Michelle Mollica, Grace Huang, Angela Falisi, and Wen-ying Sylvia Chou. "What does 'palliative care' mean? Diverse definitions from cancer care providers." Journal of Clinical Oncology 34, no. 26_suppl (2016): 40. http://dx.doi.org/10.1200/jco.2016.34.26_suppl.40.
Full textAbstract:
40 Background: Existing literature on the epistemology of palliative care has mostly centered on patient/family perspectives. Understanding how multi-disciplinary healthcare providers themselves define palliative care is a critical step towards addressing barriers and harnessing facilitators that affect optimal delivery. Methods: Semi-structured key informant interviews (N = 19) were conducted with members of healthcare provider teams as part of a qualitative study on goals of care for cancer patients enrolled in clinical trials. Purposive sampling included diverse roles: attending physicians/principal investigators, oncology fellows, physician assistants, research and clinical nurses, patient care coordinators, palliative care physicians, social workers, chaplains, and pharmacists. One probe asked participants, “What does palliative care mean to you in your work?” Responses were transcribed and independently coded by two raters using interview-derived deductive and emergent inductive codes. Themes were then identified and analyzed using NVivo. Results: Informants included different elements in their definitions: attributes of palliative care (“Palliative care is helpful”); structure (“We have a pain and palliative team”); patient outcomes “(comfort”), and relation to other services (“adjunct to necessary medical care”). Additional themes also included (1) the charge of palliative care to alleviate suffering; (2) the recognition that palliative care should be holistic; (3) the centrality of symptom management, in particular pain; (4) the conflation of end-of-life, hospice, and palliative care; (5) tensions between palliative and curative care. Provider role and specific team membership appear to influence perspectives on definitions of palliative care. Conclusions: Providers share a wide range of perspectives on the operationalization of palliative care in their work. In addition to soliciting input from patients and family members, the viewpoints of a diverse set of providers should be ascertained often to inform models of care, alleviate tensions between palliative and curative care provider teams, and increase optimal usage of palliative care.
23
Wright, Frances Catriona. "Early integration of palliative care in Ontario cancer settings." Journal of Clinical Oncology 35, no. 15_suppl (2017): e18234-e18234. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18234.
Full textAbstract:
e18234 Background: Introducing palliative care early in the cancer journey results in a better life quality, less aggressive care and possibly longer survival compared to patients receiving standard care. The INTEGRATE project aimed to identify and manage patients who may benefit from palliative care earlier in their cancer treatment. This pilot project assessed whether multidisciplinary forums (Multidisciplinary Cancer Conferences, Clinics and Diagnostic Assessment Programs ) could be used to identify patients using the UK Gold Standards Framework Surprise Question (SQ) “Would you be surprised if this person died within the next year?” Methods: Cancer centres volunteered to pilot test the efficacy of the SQ at multidisciplinary forums and implement a palliative model of care. A survey was completed at 3 different points during the project to measure provider comfort in providing palliative care. All sites received primary level palliative care education. Patient and caregiver experience were assessed using interviews and a validated survey. Identified patients received Advance Care Planning (ACP), symptom management, referrals and standardized reporting to primary care. Patient level data was collected. Results: 3 academic and 1 non-academic cancer centres used the SQ in multidisciplinary forums to identify patients in the Lung, Gastrointestinal and Central Nervous System disease sites between February '15-August '16. A baseline survey showed over 50% of providers had no palliative care training. 157 providers received education and at the end of the project providers had increased comfort & confidence in delivering palliative care. Analyses show that 933 patients were identified using the SQ, from which 78% had ACP initiated and 83% are receiving community palliative care services Conclusions: Multidisciplinary forums appear to be excellent for identifying patients who may benefit from a palliative approach to care. Inter-professional provider education and organized approaches to linking patients to community resources, had a positive impact on provider willingness to address end-of-life and palliative issues. Patients & caregivers report positive experiences of care, but different levels of ‘readiness’ to have the ACP discussions.
24
Davis, Michael, and Joanne M. Bargman. "Peritoneal palliative dialysis." Journal of Kidney Care 7, no. 2 (2022): 58–62. http://dx.doi.org/10.12968/jokc.2022.7.2.58.
Full textAbstract:
Patients with end-stage kidney disease vary significantly in comorbidities and frailty, prompting consideration of a palliative approach to care in the sickest cohort. Peritoneal dialysis offers a unique opportunity to provide renal replacement therapy by offering modified dialysis prescriptions, particularly in patients with cardiorenal syndrome, hepatorenal syndrome and cognitive decline. By developing comfort and expertise in this area, in addition to replacing traditional dialysis parameters with clinical assessment, peritoneal dialysis serves as a good opportunity to use patient-centred goals of care to manage kidney disease patients at the end of life, minimise their symptom burden and maximise their quality of life.
25
Cobbe, Sinéad. "Lymphoedema and oedema in palliative care patients." British Journal of Community Nursing 26, Sup4 (2021): S6—S15. http://dx.doi.org/10.12968/bjcn.2021.26.sup4.s6.
Full textAbstract:
Oedema and lymphoedema commonly occur in patients receiving palliative care. Community nurses frequently manage both in the home or must decide to refer for medical or specialist lymphoedema assessment. This article describes the types of oedema seen in palliative care and assists in clinical reasoning around the type of oedema presented and when to refer onwards. The treatments for palliative care oedema and lymphoedema are described, including how to adapt for complex cases and for patient comfort. Genital swelling, abdominal swelling, head and neck oedema and lymphorrhoea are also discussed.
26
Salem, A. Alshahrani, H. Alaqeily Ahmed, F. Alsamannoudi Hashem, and A. Al Mesned Mohammed. "The Role of Respiratory Therapists in Palliative Care: Investigating Their Experiences, Challenges, and Contributions to Patient Care." International Journal of Innovative Research in Engineering & Multidisciplinary Physical Sciences 7, no. 4 (2019): 1–8. https://doi.org/10.5281/zenodo.13254144.
Full textAbstract:
Abstract:This qualitative study explores the role of respiratory therapists (RTs) in palliative care settings, focusing on their experiences, challenges, and contributions to patient care. Through semi-structured interviews and focus group discussions with 20 RTs from palliative care environments, the research identifies key themes related to patient care, interdisciplinary collaboration, emotional and psychological challenges, and professional satisfaction. Findings reveal that RTs play a crucial role in improving patient comfort and quality of life, while facing significant emotional strain and role ambiguity. The study highlights the need for better support and recognition of RTs’ contributions in palliative care. These insights aim to inform improvements in training, support, and practice within palliative care teams.
27
Carter, Alix J. E., Marianne Arab, Michelle Harrison, et al. "Paramedics providing palliative care at home: A mixed-methods exploration of patient and family satisfaction and paramedic comfort and confidence." CJEM 21, no. 4 (2019): 513–22. http://dx.doi.org/10.1017/cem.2018.497.
Full textAbstract:
ABSTRACTObjectiveParamedics Providing Palliative Care at Home was launched in two provinces, including a new clinical practice guideline, database, and paramedic training. The aim of this study was to evaluate patient/family satisfaction and paramedic comfort and confidence.MethodsIn Part A, we gathered perspectives of patients/families via surveys mailed at enrolment and telephone interviews after an encounter. Responses were reported descriptively and by thematic analysis. In Part B, we surveyed paramedics online pre- and 18 months post-launch. Comfort and confidence were scored on a 4-point Likert scale, and attitudes on a 7-point Likert scale, reported as the median (interquartile range [IQR]); analysis with Wilcoxon ranked sum/thematic analysis of free text.ResultsIn Part A, 67/255 (30%) enrolment surveys were returned. Three themes emerged: fulfilling wishes, peace of mind, and feeling prepared for emergencies. In 18 post-encounter interviews, four themes emerged: 24/7 availability, paramedic professionalism and compassion, symptom relief, and a plea for program continuation. Thematic saturation was reached with little divergence. In Part B, 235/1255 (18.9%) pre- and 267 (21.3%) post-surveys were completed. Comfort with providing palliative care without transport improved post launch (p = < 0.001) as did confidence in palliative care without transport (p = < 0.001). Respondents strongly agreed that all paramedics should be able to provide basic palliative care.ConclusionsAfter implementation of the multifaceted Paramedics Providing Palliative Care at Home Program, paramedics describe palliative care as important and rewarding. The program resulted in high patient/family satisfaction; simply registering provides peace of mind. After an encounter, families particularly noted the compassion and professionalism of the paramedics.
28
Baldi, Beatriz Zilda, Manoel Luiz Correia Junior, Bruno Baldassaro Baldi, et al. "Impact of Spirituality in Palliative Care for Cancer Patients: An Integrative Review." CONTRIBUCIONES A LAS CIENCIAS SOCIALES 18, no. 3 (2025): e16202. https://doi.org/10.55905/revconv.18n.3-106.
Full textAbstract:
Spirituality is an essential aspect of holistic patient care, especially in palliative care, where the search for meaning and purpose in life becomes even more relevant. For terminal oncology patients, spirituality can provide emotional comfort and relief from suffering. This study explores the significance of spirituality in palliative care for cancer patients, examining its impact on quality of life and emotional and physical well-being. An integrative literature review was conducted, analysing 17 articles selected from a total of 489 identified in PubMed, SciELO, and BVS databases. The focus was on the relationship between spirituality, oncology, and palliative care. Spirituality is defined as the search for meaning and purpose, with or without religious association. The study found that spirituality significantly contributes to reducing suffering, offering relief, comfort, and a reframing of life for terminal patients. Additionally, it provides biopsychosocial benefits for patients, their families, and healthcare teams. However, spiritual care is often overlooked by many professionals, partly due to the lack of training and clear guidelines for its integration into palliative care. The study concludes that spirituality should be considered a fundamental component of oncology care, requiring greater attention and inclusion in care protocols.
29
Szekendi, Marilyn K., Jocelyn Vaughn, Beth McLaughlin, et al. "Integrating Palliative Care to Promote Earlier Conversations and to Increase the Skill and Comfort of Nonpalliative Care Clinicians: Lessons Learned From an Interventional Field Trial." American Journal of Hospice and Palliative Medicine® 35, no. 1 (2017): 132–37. http://dx.doi.org/10.1177/1049909117696027.
Full textAbstract:
While the uptake of palliative care in the United States is steadily improving, there continues to be a gap in which many patients are not offered care that explicitly elicits and respects their personal wishes. This is due in part to a mismatch of supply and demand; the number of seriously ill individuals far exceeds the workload capacities of palliative care specialty providers. We conducted a field trial of an intervention designed to promote the identification of seriously ill patients appropriate for a discussion of their goals of care and to advance the role of nonpalliative care clinicians by enhancing their knowledge of and comfort with primary palliative care skills. At 3 large Midwestern academic medical centers, a palliative care physician or nurse clinician embedded with a selected nonpalliative care service line or unit on a regularly scheduled basis for up to 6 months. Using agreed-upon criteria, patients were identified as being appropriate for a goals of care conversation; conversations with those patients and/or their families were then conducted with the palliative care specialist providing education, coaching, and mentoring to the nonpalliative care clinician, when possible. All of the sites increased the presence of palliative care within the selected service line or unit, and the nonpalliative care clinicians reported increased comfort and skill at conducting goals of care conversations. This intervention is a first step toward increasing patients’ access to palliative care to alleviate distress and to more consistently deliver care that honors patient and family preferences.
30
Chang, Alice, James Espinosa, Alan Lucerna, and Neelesh Parikh. "Palliative and end-of-life care in the emergency department." Clinical and Experimental Emergency Medicine 9, no. 3 (2022): 253–56. http://dx.doi.org/10.15441/ceem.22.341.
Full textAbstract:
With current medical advances, the human population continues to age. This presents healthcare practitioners with the increasing complexity of providing care to elderly patients with multifactorial medical and personal needs. This is a particular challenge in the emergency department, where patients often present for care in the last months of their lives. Early identification of palliative care needs and initiation of comfort care can drastically improve patient care and quality of life. Although emergency physicians agree that palliative care is an important area of knowledge, there is a gap in palliative care training in emergency medicine residencies. It is increasingly important for emergency medicine providers to have the resources and training to provide palliative care and to understand end-of-life issues.
31
Lazaridis, Lazaros, Niklas Pepper, Sarina Agkatsev, et al. "EOLP-02. END-OF-LIFE CHALLENGES IN NEURO-ONCOLOGICAL PATIENT CARE: A YOUNGNOA SURVEY." Neuro-Oncology 26, Supplement_8 (2024): viii137. http://dx.doi.org/10.1093/neuonc/noae165.0536.
Full textAbstract:
Abstract BACKGROUND Malignant brain tumors inevitably relapse, almost always causing significant functional and neurological impairments. Thus, palliative care is crucial in managing individuals with malignant brain tumors. It is essential for neuro-oncologists to be well-prepared to openly communicate about and meet the palliative needs of these patients. With this survey, we sought to evaluate palliative care practices in Germany and their impact on the treatment of neuro-oncological patients. METHODS We conducted an anonymous, interdisciplinary survey targeting palliative care practices among neuro-oncologists in Germany, all members of the Neuro-oncology Working Group of the German Cancer Society. The questionnaire, designed in close coordination with board-certified palliative care specialists, was distributed to 450 physicians. It collected personal information and assessed respondents’ knowledge of and access to palliative care structures. The survey was conducted online from March 31 to April 30, 2023. RESULTS Ninety-two physicians completed the survey. Of these, 81 (88%) reported feeling comfortable with end-of-life conversations, while 11 (12%) did not. No significant differences were observed between the two subgroups regarding their level of medical education (p=0.7140), workplace (p=0.4966), sex (p=0.9999), medical specialty (p=0.5478), or region of practice (p=0.9999). However, those comfortable with end-of-life discussions had significantly more palliative care training either during specialty training (p=0.0475) or through active participation in palliative care courses (p=0.0254). Further detailed analysis is in progress. CONCLUSIONS The survey indicates that while the majority of participants are comfortable with end-of-life discussions, a clear correlation exists between their comfort level and the extent of palliative care training received. This highlights the critical need for enhanced and targeted palliative care education within neuro-oncology training programs to prepare physicians for the complex communication and care challenges in neuro-oncological palliation. Further analysis will continue to explore additional educational and systemic factors that could increase the quality of palliative care in neuro-oncology.
32
Black, SarahRose, Gary Rodin, and Camilla Zimmermann. "Comfort, Connection and Music: Experiences of Music Therapy and Inter-Active Listening on a Palliative Care Unit." Music and Medicine 9, no. 4 (2017): 227. http://dx.doi.org/10.47513/mmd.v9i4.508.
Full textAbstract:
Music therapy in palliative care aims to provide psychosocial support, assistance with pain and symptom management and opportunities for life review and legacy work. Although there have been a variety of studies conducted on the effects of music therapy in palliative care facilities, there is a gap in research examining the experience and feasibility of music therapy on acute palliative care units within cancer care settings. This qualitative study explored the lived experience of inter-active listening (IAL), an individualized music therapy in which the therapist plays music or sings while the patient engages through listening, for nine inpatients on a palliative care unit. The study found that a receptive music therapy referred to as IAL was associated, in cancer patients in an acute palliative care unit, with increased emotional and spiritual well-being and a greater sense of connection to self and others. Further research into specific effects of various music therapy intervention styles is warranted.
33
Rodrigo, Marques Barreto Da Costa, Thaysa de Lima Tavares Bruna, Mayara do Amaral Lorena, et al. "OBSTACLES PREDOMINANTLY FOUND BY THE MULTIDISCIPLINARY TEAM IN THE MANAGEMENT OF PALLIATIVE SEDATION IN THE INTENSIVE CARE UNIT." Revistaft 27, no. 127 (2023): 68. https://doi.org/10.5281/zenodo.8432668.
Full textAbstract:
<strong>Introduction: </strong>Palliative Care (PC) plays a crucial role in improving the quality of life for individuals facing advanced chronic illnesses, especially when they are in the Intensive Care Unit (ICU). Multiprofessional involvement is of utmost importance in this context, as it addresses the complex physical, mental, and emotional needs of patients and their families during this fragile process. In many cases, individuals under PC may require the use of palliative sedation to manage end-of-life pain and other symptoms, which demands specialized and integrated care from the ICU healthcare team. <strong>Objectives:</strong> To identify and discuss the main practices and approaches of the multiprofessional team in the management of palliative sedation in patients under palliative care in the Intensive Care Unit, as well as effective methods to improve them. <strong>Methodology:</strong> An Integrative Literature Review was conducted using the PubMed, Embase, Web of Science, and BVS databases. The research question was, "Do (Population) professionals in services providing care in ICUs (Intervention) that promote palliative care services in ICUs (Outcomes) use what approaches for palliative sedation management in these patients?" The descriptors used were "((Palliative Care OR Palliative sedation) AND (sedation) AND (Intensive Care Unit) AND (Patient Care Team OR Multiprofessional Team OR Multiprofessional Health Team))." Articles in all languages were included, with a focus on those published between 2013 and 2023. Exclusion criteria included articles that did not have the search terms in their titles or abstracts and articles not addressing the central issue of our study. <strong>Results:</strong> Pain management in patients undergoing palliative care in the intensive care unit involves multiprofessional approaches aimed at providing effective pain relief, proper utilization of palliative sedation, and end-of-life comfort. In this context, the integration of medical teams, nursing, psychologists, and physiotherapists plays a fundamental role in the pharmacological analgesia of these patients. <strong>Conclusion:</strong> Interdisciplinary assessment of pain, combined with appropriate medication administration and the proper incorporation of palliative sedation, has proven to be effective in optimizing patient comfort and promoting a good death.
34
Setyoharsih, Titis Wening, and Sidik Awaludin. "Non-Maleficence concept in palliative care patient in ICU: A concept analysis." Malahayati International Journal of Nursing and Health Science 7, no. 5 (2024): 554–58. http://dx.doi.org/10.33024/minh.v7i5.310.
Full textAbstract:
Background: Non-maleficence is one of the main ethical principles that is important in the implementation of patient care. The principle of non-maleficence is still ambiguous and is often confused with the principle of beneficence. Research on the principle of non-maleficence has been widely conducted, but study on the principle of non-maleficence in palliative care in the ICU is still rare and unclear even though on-maleficence as one of the ethical principles is needed by health workers in making palliative care decisions on patients in the ICU. Purpose: To find a clear definition of the concept of non-maleficence in palliative care patients in the ICU. Method: The analysis approach is based on the Avant concept, which was obtained from online databases namely PubMed and Google Scholar using the keywords "non-maleficence", "palliative care" and "Intensive care unit" or "ICU". The collected literature was published in the last two decades, namely in 2003-2023. Results: This concept analysis show the concept and operational definition of the non-maleficence in palliative care patients in the ICU. We determines the attributes, antecedents, consequences and empirical referents of non-maleficence in palliative care patient in ICU. Conclusion: From this concept analysis, an operational definition of non-maleficence is produced, namely the prohibition of taking actions that can harm or worsen or cause harm to patients. With the principle of non-maleficence in palliative care patients, nurses can make the best decisions, not hurt patients, and provide patient comfort to patients which results in improved patient quality of life.
35
Haslam, Miranda, and Jeffrey Anderson. "724 Palliative Care Consultation in an Urban Burn Center." Journal of Burn Care & Research 45, Supplement_1 (2024): 209. http://dx.doi.org/10.1093/jbcr/irae036.267.
Full textAbstract:
Abstract Introduction There is growing evidence supporting early palliative care consultation in many surgical patient populations; however, current literature regarding palliative care consultation in the burn population is limited. Given the significant morbidity and potential mortality associated with burn injuries, especially large total body surface area (TBSA) burn injuries, there is likely benefit to increased utilization of specialty palliative care in the burn patient population. In this study, we investigated current practice patterns of palliative care consultation at our burn center. Methods A retrospective chart review was performed at our American Burn Association verified burn center of patients admitted from 2020 to 2023. Inclusion criteria included patients who presented with greater than or equal to 30% TBSA burns or experienced in-hospital mortality. Comparison was made between patients who did and did not receive palliative care consultation during their hospitalization. Student’s T-Test and Chi-Square Test were used for categorical and continuous variables, respectively. Results A total of 38 patients met our inclusion criteria. 13 of the 38 patients (34%) received a palliative care consult during their admission, with an average of 10.2 days between admission and consultation. There was a trend towards older age and higher TBSA in patients who received a palliative care consultation (52.9 years vs. 49.2 years, 53.4% TBSA vs. 50.4% TBSA), though these differences were not statistically significant (p = 0.56, 0.33). There was no significant difference in likelihood of palliative care consultation based on presentation characteristics of intubation or inhalation injury. There was also no significant difference identified between patients who did and did not receive palliative care consultation in transition to comfort directed care, in-hospital death, or length of stay. In a subgroup analysis of patients who survived hospitalization, rates of home discharge were higher in those patients who did not receive palliative care consultation (p= 0.005). Conclusions Opportunities exist for increased integration of specialty palliative care in the burn patient population. This study represents one of the first reviews of palliative care consultation utilization in an urban burn center patient population. Understanding of current practice patterns relating to palliative care consultation is an essential first step in developing practices to increase utilization of palliative care in the burn patient population. Applicability of Research to Practice Significant opportunities exist for improved integration of specialty palliative care in the burn patient population. This research will be used to inform development of triggers for palliative care consultation at our burn center.
36
Geary, Sean P., Maria R. Brown, Christopher Decker, Lisa M. Angotti, Ashar Ata, and Carl Rosati. "Patient Characteristics Associated with Comfort Care among Trauma Patients at a Level I Trauma Center." American Surgeon 84, no. 11 (2018): 1832–35. http://dx.doi.org/10.1177/000313481808401144.
Full textAbstract:
Trauma patients admitted to the intensive care unit are a unique population with high mortality. This study aims to identify characteristics predicting the likelihood of progressing to palliative management often referred to as comfort care measures, thus enabling the trauma team to broach end-of-life decisions earlier in these patients’ care. This is a retrospective analysis of the prospectively collected New York State Trauma Registry database for a single Level I trauma center for patients admitted from 2008 to 2015. During this time, a total of 13,662 patients were admitted to the trauma service and there were 827 deaths, resulting in a crude annual mortality rate of approximately 6 per cent. Approximately one-half of the total mortalities, 404 of 827 (48.9%), were ultimately designated as comfort care. Univariate analysis identified the following risk factors for comfort care designation: advanced age, multiple comorbidities, blunt trauma mechanism, traumatic brain injury, and admission location. Multivariate analysis confirmed advanced age and traumatic brain injury. Subgroup analysis also identified advanced directives, pre-existing dementia, and bleeding disorders as significant associations with comfort care designation. The identification of factors predicting comfort care will result in improved care planning and resource utilization.
37
Piven, Anastasiia, and Yulia Haraborska. "HISTORICAL DEVELOPMENT OF PALLIATIVE ESTABLISHMENTS IN THE WORLD AND IN UKRAINE." Architectural Bulletin of KNUCA, no. 22-23 (December 12, 2021): 33–39. http://dx.doi.org/10.32347/2519-8661.2021.22-23.33-39.
Full textAbstract:
The object of the research is centers of palliative help.
 The article of research is historical development of establishments of palliative medicine.
 Global environmental problems of today lead to increase in the incidence of population and increase in incurable cases. The problems of terminally ill patients are been dealt with by palliative medicine, which takes care of the situation of such patients and their families. The article deals with the history of development of palliative care facilities in the world - hospices. The situation of creation of such establishments in Ukraine is analyzed, which indicates the need to revise the state regulatory framework for design. The analysis conducted in the article indicates the inconsistency of the current norms and the absence of special normative bases for the design of hospices. Current situation does not allow for proper development of the construction of palliative care facilities. In addition, the main criteria and needs are discussed in the article:
 
 Physical comfort (achieved by creating a home atmosphere in the hospital)
 Psychological comfort (achieved using the principle of an individual approach to each patient, taking into account all their needs)
 Social comfort (achieved by designing places for communication with other patients, as well as with relatives and friends. It is important that such places possess and create a positive attitude and distract from negative thoughts)
 
 Visual comfort (achieved with the help of thoughtful landscaping and designing places for walks, squares, intimate areas for rest and relaxation, as well as for the hobbies of patients)
38
Beider, Shay. "An Ethical Argument for Integrated Palliative Care." Evidence-Based Complementary and Alternative Medicine 2, no. 2 (2005): 227–31. http://dx.doi.org/10.1093/ecam/neh089.
Full textAbstract:
‘In the midst of life, we are in death’from The Book of Common PrayerThe Palliative Care, or comfort care, movement in the USA is on the rise. Currently, palliative services are not integrated in an organized way throughout healthcare. If we accept the argument that palliative care is ethically desirable and that all patients are entitled to palliative services regardless of a terminal diagnosis, it follows that it needs to be integrated across a wide range of healthcare services. Ethical questions regarding palliative care and well-known ethical frameworks are discussed and an argument is made for integrating palliative healthcare services throughout the healthcare system and not simply at the end of life. Complementary and alternative medicine (CAM) therapies are discussed as useful and necessary components of palliative care. If we as a society look beyond separating cures and palliation, we will come closer to incorporating compassionate care throughout the disease process.
39
Felipelli Bernardes, Juliana. "Dysthanasia and palliative care: nursing in palliative care." International Physical Medicine & Rehabilitation Journal 8, no. 1 (2023): 88–93. http://dx.doi.org/10.15406/ipmrj.2023.08.00339.
Full textAbstract:
According to the World Federation of Right to Die Societies the term Comfort Care is often used as a synonym for Palliative Care. Palliative Care encompasses in its concept the management of pain and symptoms, support for the patient and family, and the opportunity to achieve a meaningful closure to life. Thus, the article delves into various texts to understand the role of the nursing professional in the maintenance and promotion of health in view of palliative care. Thus, the guiding question of this article is: in the national scientific scenario, how is palliative care presented in the nursing field? The bibliographic review, as a data collection technique, was selected, aligning itself with the expectations of this work, which is to present a broad discussion on the theme in question. This work was carried out from a search on the Google Academic platform, which presented the bases PubMed, Virtual Health Library (VHL) and Portal Capes. The descriptors used were “Palliative care”, “dysthanasia” and “nursing care”, applying a time cut from 2015 to 2023, being selected 30 articles with titles associated with the terms “nursing and complications associated with palliative care”. From the analysis of the articles, it was noted that the professional nurse, in palliative care, must be qualified to make accurate assessments, lead, plan, and have the human eye when practicing care. These assessments result in the nurse’s ability to develop plans for dealing with symptoms and side effects: constipation from narcotic analgesics, nausea and vomiting, lethargy, insomnia, anxiety, and dyspnea. The nurse and the multidisciplinary team responsible for implementing techniques to minimize these problems that are painful for patients and family members who are present in the face of their loved one’s suffering.
40
Palmer, Sarah Jane. "Managing lymphoedema and lymphoedema-related complications in end-of-life care." British Journal of Community Nursing 30, no. 6 (2025): 280–84. https://doi.org/10.12968/bjcn.2025.0069.
Full textAbstract:
Lymphoedema is a condition often seen in palliative patients, characterised by impaired lymphatic drainage, which leads to swelling in affected areas. In the context of end-of-life care, managing lymphoedema and its associated complications, such as lymphorrhoea and infections, is crucial for enhancing patient comfort and quality of life. This article discusses the various management strategies for lymphoedema in palliative care, including compression therapy, manual lymphatic drainage, skin care and gentle exercise. Attention is given to complications such as cellulitis and lymphorrhoea, emphasising early intervention and holistic care to prevent deterioration. Additionally, the importance of mobility support, tailored care plans, and collaboration with healthcare specialists are explored. The article also highlights recent studies, including those on subcutaneous needle drainage and the limitations of current treatment options. Ultimately, effective management of lymphoedema in end-of-life care requires a comprehensive approach that prioritises comfort, symptom relief and the dignity of the patient.
41
Iffat Kazi, Prof. "WellNest: An Intelligent & Holistic Palliative Care Platform." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT 09, no. 05 (2025): 1–9. https://doi.org/10.55041/ijsrem47159.
Full textAbstract:
ABSTRACT - WellNest is an innovative platform designed to enhance palliative care through the integration of advanced technologies like AI and immersive tools. It provides personalized care plans, real-time emotional support via a chatbot, and volunteer-patient matching to improve the quality of life for individuals with serious illnesses. WellNest aims to optimize health outcomes, manage pain and anxiety, and foster a supportive community for patients, caregivers, and healthcare providers. The platform also offers educational resources, interactive wellness activities, and seamless communication channels to ensure holistic care. By bridging the gap between technology and compassionate healthcare, WellNest sets a new standard in palliative care, empowering individuals to navigate their journey with dignity and comfort. Keywords — Palliative Care, Artificial Intelligence, Natural Language Processing, Patient-Volunteer Matching, Chatbots, Holistic Healthcare
42
Costa, Vitória Gonçalves de Lima, Aryana Fernandes Rocha Rizzo, Érica de Oliveira Souza, et al. "The role of the multidisciplinary team in decision-making at the end of life: an analysis of integrated palliative care management." CONTRIBUCIONES A LAS CIENCIAS SOCIALES 17, no. 2 (2024): e5195. http://dx.doi.org/10.55905/revconv.17n.2-157.
Full textAbstract:
The text highlights the importance of palliative care management in improving the quality of life and comfort of patients in the advanced stages of incurable or potentially terminal diseases. The multidisciplinary team, made up of professionals from various fields, plays an essential role in providing integrated care and making well-founded decisions considering various aspects. This team assesses the physical, psychological, social and spiritual needs of the patient and their family, developing a personalized care plan that aims to relieve pain, promote comfort, dignity and improve quality of life in this delicate phase. Healthcare professionals work together, sharing information, discussing cases and offering mutual support, which enables more informed and collaborative decision-making, taking into account medical, ethical and emotional aspects. In addition, the multidisciplinary team provides emotional support for both patients and their families, helping them to face challenges and make difficult decisions. Integrated palliative care management is patient-centered, seeking to meet patients' individual needs and promote well-being in all areas of life. In the context of palliative care at the end of life, the multidisciplinary team plays a key role, offering support, knowledge and diverse perspectives to help make informed decisions and promote the physical, emotional and spiritual well-being of patients and their families.
43
Muhammad, Maroof, Faisal Muhammad, Jabeen Nighat, Maroof Tabeen, and Maroof Nirmeen. "Palliative Care and End-of-Life Decision-Making: Navigating a Complex and Compassionate Landscape." Palliative Care and End-of-Life Decision-Making: Navigating a Complex and Compassionate Landscape 8, no. 12 (2023): 2. https://doi.org/10.5281/zenodo.10376446.
Full textAbstract:
In the intricate realm of healthcare, palliative care stands as a beacon of compassion and comfort for individuals facing life-limiting illnesses. This extensive research paper embarks on a comprehensive exploration of palliative care and end-of-life decision-making, delving into the complex intricacies of this essential field. It unfolds a rich tapestry of principles, challenges, ethical dilemmas, and the multifaceted landscape of patient- centered care at the end of life. As we navigate the labyrinth of palliative care principles, the complexities of communication, ethical dilemmas, and the multifaceted interplay between healthcare providers, patients, and families, we find ourselves entangled in a web of compassion and complexity. Keywords:- Palliative Care, End-of-Life Decision-Making, Compassion, Life-Limiting Illnesses, Ethical Dilemmas, Complex Intricacies.
44
Alvarez, Maria Catherine I., Whindie Clemente, Ronald Joseph A. Rillo, and Roison Andro Narvaez. "Creative pathways to comfort: the transformative role of art therapy in palliative and hospice care." International Journal of Palliative Nursing 31, no. 1 (2025): 18–28. https://doi.org/10.12968/ijpn.2025.31.1.18.
Full textAbstract:
Background: Art therapy offers a creative outlet for patients in palliative and hospice care to express emotions, manage distress and enhance wellbeing by addressing physical, emotional and spiritual challenges. Aims: This review evaluates the effectiveness, challenges and outcomes of art therapy in improving the quality of life for patients in palliative and hospice care. Methods: An integrative review. Findings: The review of 27 studies identified four key themes: (1) the effects of art therapy on the quality of life of patients, (2) intervention and patient outcomes, (3) improved wellbeing through self-expression, and (4) challenges in care delivery. Art therapy significantly reduced emotional distress, including anxiety, depression and psychological fatigue, while alleviating physical symptoms, like pain and exhaustion. It fostered emotional expression, personal growth and coping skills, helping patients manage their conditions more effectively. Participants also reported enhanced self-awareness, stronger interpersonal connection and a greater sense of control over their lives, leading to improved emotional and physical wellbeing. Conclusion: Art therapy provides significant benefits by alleviating emotional and physical distress and enhancing wellbeing. Integrating art therapy into palliative and hospice care supports holistic, patient-centered care, though further research is needed to address access barriers and ensure consistent delivery.
45
Sood, Kanuja, Yogesh Chamola, and Sunil Kumar Chamola. "ROLE OF PSYCHIATRY IN PALLIATIVE CARE - A CASE REPORT." International Journal of Advanced Research 11, no. 09 (2023): 204–7. http://dx.doi.org/10.21474/ijar01/17521.
Full textAbstract:
Palliative care aims to improve the quality of life for individuals facing life-threatening illnesses by addressing physical, psychological, social, and spiritual needs. While palliative care traditionally emphasizes symptom management and pain relief, the role of psychiatry in this field has gained recognition as an essential component of comprehensive patient-centred care. This case report provides an overview of the evolving role of psychiatry in palliative care, highlighting its significance in addressing the complex emotional and psychological aspects of end-of-life care.Psychiatrists play a crucial role in assessing and diagnosing mental health conditions that often co-occur with serious illnesses, such as depression, anxiety, and adjustment disorders. Identifying and addressing these conditions is vital to improving patients overall well-being. Psychiatric interventions are valuable in managing distressing psychological symptoms, including anxiety, depression, delirium, and existential distress. Appropriate pharmacological and psychotherapeutic interventions can alleviate suffering and enhance the patients overall comfort. Collaborating with Palliative care specialists, psychiatrists provide psychosocial support to patients and their families, helping them cope with the emotional challenges that arise during the end-of-life journey. This includes facilitating open and honest communication, addressing complex family dynamics, and assisting in advanced care planning.In conclusion, the role of psychiatry in palliative care is expanding to meet the complex needs of individuals facing life-limiting illnesses. Recognizing and addressing the emotional and psychological aspects of end-of-life care not only improves the patients quality of life but also contributes to a more compassionate and comprehensive approach to palliative care. Integrating psychiatry into palliative care services ensures that individuals receive the support they need to navigate the challenging journey of serious illness with dignity and comfort.
46
Lujain, Shaker Bin Ladin Fahad Sultan Alrajhi Maad Saad Altalhi Nawal Misfer Alwadai Rashad Mohammed Alzahrani Fawziah Ali Halawani Ghaida Mansour Alharbi Lamyaa Omar Al-Gelban Hamad Dakhilullah Alotaibi Ghofran Bader Al –Saif. "MANAGEMENT OF TERMINAL PATIENTS." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 12 (2019): 17496–502. https://doi.org/10.5281/zenodo.2532603.
Full textAbstract:
<strong><em>Introduction:</em></strong><em> A great majority of patients are keen on discussing end-of-life care with their physician,</em> <em>and most trust that doctors ought to present the topic. End-of-life discussion should address a wide cluster of issues fundamental to the dying patient and family. Discussions that emphasis focus solely on resuscitation neglect to perceive critical physical and psychosocial importance.</em> <em>Most individuals, as they get closer to death, contend with same feelings of fear, needs, and desires. Dying patients encounter fear of pain, fear of indignity, fear of abandonment, and fear of the unknown. Open and direct discussions can ease a great number of these fears. By including family members in these discussions, relationships inside the family such as relatives can be strengthened and can diminish the isolation encountered by the dying patient.</em> <strong><em>Aim of work: </em></strong><em>In this review, we will discuss multiple aspects of end-of-life care, emphasizing on symptomatic care, and the best way to of a physician to approach the patient and family. </em> <strong><em>Methodology:</em></strong><em> We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: end of life care, palliative care, supportive care, terminal patients, symptomatic treatment</em> <strong><em>Conclusions: </em></strong><em>The job of palliative care toward the end of life is to soothe the suffering of patients and their families by the extensive evaluation and treatment of physical, psychosocial, and spiritual symptoms patients encounter. As death approaches, the side effect burden of a patient may decline and require more aggressive palliation. As comfort measures intensify, so does the support given to a dying patient's family. When death has happened, the job of palliative care centers primarily around the support of the patient's family and bereavement</em> <strong>Key words:</strong><em> end of life care, palliative care, supportive care, terminal patients</em>
47
Lazaridis, L., N. Pepper, S. Agkatsev, et al. "P22.07.A END-OF-LIFE CHALLENGES IN NEURO-ONCOLOGICAL PATIENT CARE: A YOUNGNOA SURVEY." Neuro-Oncology 26, Supplement_5 (2024): v124. http://dx.doi.org/10.1093/neuonc/noae144.421.
Full textAbstract:
Abstract BACKGROUND Despite advanced treatments, malignant brain tumors inevitably relapse, almost always causing significant functional and neurological impairments in patients. Thus, palliative care is crucial in managing individuals with malignant brain tumors. It is essential for neuro-oncologists to be well-prepared and supported to openly communicate about and meet the palliative needs of these patients. With this survey, we sought to evaluate palliative care practices in Germany and their impact on the treatment of neuro-oncological patients. MATERIAL AND METHODS We conducted an anonymous, interdisciplinary survey targeting palliative care practices among neuro-oncologists in Germany, all members of the Neuro-oncology Working Group “Neuroonkologische Arbeitsgemeinschaft” (NOA) of the German Cancer Society (Deutsche Krebsgesellschaft, DKG). The questionnaire, designed in close coordination with board-certified palliative care specialists, was distributed to 450 physicians. It collected personal information and assessed respondents’ knowledge of and access to palliative care structures. The survey was conducted online from March 31 to April 30, 2023. RESULTS Ninety-two physicians (39 female, 52 male, 1 unspecified) participated and completed the survey (response rate: 20%). Of these, 81 (88%) reported feeling comfortable with end-of-life conversations, while 11 (12%) did not. No significant differences were observed between the two subgroups regarding their level of medical education (p=0.7140), workplace (p=0.4966), sex (p=0.9999), medical specialty (p=0.5478), or region of practice (p=0.9999). However, those comfortable with end-of-life discussions had significantly more palliative care training either during specialty training (p=0.0475) or through active participation in palliative care courses (p=0.0254). Further detailed analysis is in progress. CONCLUSION The survey indicates that while the majority of participants are comfortable with end-of-life discussions, a clear correlation exists between their comfort level and the extent of palliative care training received. This highlights the critical need for enhanced and targeted palliative care education within neuro-oncology training programs to better prepare physicians for the complex communication and care challenges in neuro-oncological palliation. Further analysis will continue to explore additional educational and systemic factors that could increase the quality of palliative care in neuro-oncology.
48
Baby, Skaria, Manjit George, and Girijanandan D. Menon. "Palliative Care in COVID Times – Quality of Death Matters!!" Indian Journal of Palliative Care 28 (January 29, 2022): 113–14. http://dx.doi.org/10.25259/ijpc_72_21.
Full textAbstract:
Palliative care for patients with chronic non-malignant diseases is a less addressed area. In-hospital care, particularly, critical care of elderly population with advanced organ failure, can lead to poor resource management. ICU beds come under the strained resource category, more so in the backdrop of the recent COVID-19 pandemic. Home-based palliative care ensures better comfort to the patient and their kin, at the same time facilitating better resource utilisation. This approach may also reduce the mental trauma caused by the loss of a dear one. Major hurdles in providing palliative care for the chronically ill are lack of awareness and financial constraints. The need of the hour is enhanced awareness and promotion of the practice of palliative care. A favourable change in government policy and budget allocation will go a long way in achieving this goal. Home-based palliative care paves the way to care for the subset of patients with end-stage organ failure in a more humane manner.
49
Feijão, Daniela de Mesquita. "The use of technology in monitoring elderly patients in palliative care: benefits, challenges, and implications." Brazilian Journal of Health Review 8, no. 2 (2025): e78898. https://doi.org/10.34119/bjhrv8n2-265.
Full textAbstract:
The integration of technology in palliative care has become a crucial innovation in providing more efficient and personalized care, particularly for elderly patients. With aging populations and increased life expectancy, healthcare systems worldwide face significant challenges in delivering quality palliative care to older individuals, especially those with chronic and terminal conditions. The use of technology—such as telehealth systems, wearable devices, and remote monitoring tools—has shown promise in improving the management of symptoms, enhancing communication between patients and healthcare providers, and ensuring timely interventions. By enabling continuous monitoring of vital signs, symptom progression, and medication adherence, these technologies offer elderly patients and their caregivers greater comfort and reduce the need for frequent hospital visits. Moreover, they empower patients to take an active role in managing their health from the comfort of their homes. This article explores the role of technology in monitoring elderly patients in palliative care settings, highlighting its potential benefits and challenges. It discusses the various technological tools being utilized and examines their impact on patient outcomes. Additionally, the article presents insights from recent studies on how technology can be effectively implemented to enhance palliative care for the elderly, ensuring that they receive the dignity and quality of life they deserve at the end of life.
50
Pinto, Sara, Sílvia Caldeira, and José Carlos Martins. "A qualitative study about palliative care patients’ experiences of comfort: Implications for nursing diagnosis and interventions." Journal of Nursing Education and Practice 7, no. 8 (2017): 37. http://dx.doi.org/10.5430/jnep.v7n8p37.
Full textAbstract:
Background and objective: Comfort is a complex experience, particularly important to palliative care patients. Although it is listed in nursing classifications and taxonomies there is a gap between theory and practice. Thus, little research has been done about patient's perceptions and experiences in this context of care. This paper aims to analyze palliative care patients’ experiences about comfort.Methods: Qualitative study with fifteen participants, using in-depth, semi-structured, face-to-face interviews, tape-recorded, transcribed verbatim and analyzed using interpretative content analysis.Results: Five main themes have been identified. Holistic comfort may be a difficult outcome for many end-of-life patients but the context of provision of care, the presence of family, the way information is managed, the search for meaning in life, and the need to keep life under control were perceived as important determinants for comfort.Conclusions: This study provides a general overview about comfort experiences and the main discomforts of hospitalized patients who are suffering from chronic and incurable diseases. Findings highlight comfort as a complex intervention within multidisciplinary palliative care team and this is supporting the nursing diagnosis “Impaired Comfort” as a syndrome. The study adds a contribution to the accuracy and completeness of nursing classifications and nursing practice in palliative care.