Search

Background: Facing a terminal illness can be highly stressful and palliative care patients frequently suffer from mood symptoms. The focus of health care is often on treating symptoms whereas health-promoting factors receive less attention. The aim of this study was to explore the views of palliative care patients on resources and ways of coping that help them prevent or manage mood symptoms. Methods: A pilot qualitative study was performed through face-to-face semi-structured interviews with fifteen ambulant patients with advanced cancer. The interviews were transcribed verbatim and qualitative analysis was performed independently by two researchers, according to the principle of constant comparative analysis. Results: Patients reported on attitudes and specific coping strategies that they found helpful, as well as aspects of their life narrative and spirituality. Resources were found in meaningful contacts with family and friends and in personal attention of professional medical caregivers for their wellbeing. Conclusions: We conclude that palliative care patients could identify resources to cope with mood symptoms in the context of their unique life. In helping patients to identify the personal resources that are accessible and available in their specific context, patient autonomy in enhancing resilience could be increased. [ABSTRACT FROM AUTHOR]

Background: Many health-care providers experience barriers to addressing spiritual needs, such as not having the right vocabulary. The ars moriendi model might be a feasible tool for spiritual history taking in palliative care. Aim: To investigate the effect of a structured spiritual history taking on the spiritual well-being of palliative patients in home care. Design: Cluster randomized controlled trial, conducted between February and October 2013. Patients and methods: Registered nurses and general practitioners approached eligible patients with an incurable, life-threatening disease for study participation. Health-care providers allocated to the intervention arm of the study took a spiritual history on the basis of the ars moriendi model. Health-care providers in the control arm provided care as usual. Patient-reported outcomes on spiritual well-being, quality of life, pain, and patient–provider trust were assessed at two points in time. Results: A total of 245 health-care providers participated in the study (204 nurses and 41 physicians). In all, 49 patient–provider dyads completed the entire study protocol. The median age of the patients was 75 years (range: 41–95 years), and 55% of the patients were female. There were no significant differences at any point in time in the scores on spiritual well-being, quality of life, pain, or patient–provider trust between the intervention and the control group. Conclusion: This cluster randomized controlled trial showed no demonstrable effect of spiritual history taking on patient scores for spiritual well-being, quality of life, health-care relationship trust, or pain. Further research is needed to develop instruments that accurately assess the effectiveness of spiritual interventions in palliative care populations. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore nurses' and physicians' experiences with the ars moriendi model (AMM) for spiritual assessment. Design: Convergent, parallel, mixed-methods. Setting: Palliative home care in Belgium. Sample: 17 nurses and 4 family physicians (FPs) in the quantitative phase, and 19 nurses and 5 FPs in the later qualitative phase. Methods: A survey was used to investigate first impressions after a spiritual assessment Descriptive statistics were applied for the analysis of the survey. In a semistructured interview a few weeks later, nurses and physicians were asked to describe their experiences with using the AMM. Interviews were audio recorded, transcribed, and qualitatively analyzed. Quantitative and qualitative results were compared to see whether the findings were confirmative. Main Research Variables: The survey assessed the feasibility of the AMM for use in palliative home care, whereas the semistructured interviews collected in-depth descriptions of healthcare providers' (HCPs') experiences with the AMM. Findings: The AMM was perceived as valuable. Many patients shared their wishes and expectations about the end of life. Most HCPs said they felt that the patient-provider relationship had been strengthened as a result of the spiritual assessment. Almost all assessments raised new issues; however, many dyads had informally discussed spiritual issues before. Conclusions: The current study suggests that HCPs believe that the AMM is a useful spiritual assessment tool. Guided by the model, HCPs can gather information about the context, life story, and meaningful connections of patients, which enables them to facilitate person-centered care. Implications for Nursing: The AMM appears to be an important tool for spiritual assessment that can offer more insight into patients' spirituality and help nurses to establish person-centered end-of-life care. [ABSTRACT FROM AUTHOR]

Background Patients in a palliative care trajectory frequently suffer from depression. To distinguish depression from normal sadness, the use of screening instruments could facilitate the diagnostic process. However, in palliative care, screening instruments may not discern physical symptom burden from psychological distress, due to the high number of physical symptoms in palliative patients. Objectives The aim of this study was to explore physical symptom burden and psychological distress in patients with advanced cancer in relation to scores on screening instruments for depression. Methods Patients with advanced cancer were asked to fill out the Beck Depression Inventory ( BDI- II), Beck Depression Inventory Primary Care ( BDI- PC), Hospital Anxiety and Depression Scale ( HADS), and Memorial Symptom Assessment Scale Short Form ( MSAS- SF). The relationship between scores on screening tools for depression and different physical symptom clusters was explored. Results In the sample of 65 patients, screening instruments for depression correlated highly with different somatic symptom clusters. The BDI- II cognitive subscale was the only scale that was not significantly correlated with any of the somatic symptom clusters. Conclusion Screening tools for the detection of depression in patients with advanced cancer may not provide an accurate evaluation of depression. These tools seem to measure physical symptom burden as well, especially when patients suffer from symptoms of the clusters fatigue/anorexia/cachexia, neuropsychology, debility, or pain. In this study, the BDI- II cognitive subscale seems to differentiate best from somatic symptom burden. [ABSTRACT FROM AUTHOR]

The article defines the characteristics of palliative care patient. It is mentioned that for clear descriptions of palliative care patients, design involves a systematic review of medical literature for randomized controlled trials (RCTs). It suggests that elements of the patients' health status and the care delivered to them should be included in the definition of a palliative care patient. It is concluded that published RCTs have no clear definitions of palliative care patients.