Palliative Medicine & Hospice Care – Open Journal

Palliative Medicine & Hospice Care – Open Journal

Basic info

  • Publisher: Openventio Publishers
  • Country of publisher: india
  • Date added to EuroPub: 2019/Nov/15

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  • Language of fulltext: english

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  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

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  • Open Access Statement: No
  • Year open access content began: 2015
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

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This journal has '51' articles

Importance of Psychological Research in Palliative Care: Barriers in its Development

Importance of Psychological Research in Palliative Care: Barriers in its Development

Authors: Joaquín T. Limonero
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Abstract

Diseases in general, and particularly those that threat the continuation of life, may affect the person in diverse manners causing suffering or emotional distress. At the end of life, suffering may be caused by different dimensions (physical, psychological, social & spiritual), and these dimensions can contribute separately or in an accumulative way to the experience of suffering. Consequently, the problems related to one dimension can cause or increase others leading to total suffering (in patients and their families).

Keywords: Palliative Care. Emotional distress.
The Fight against the “Human Disaster” of Cancer in the Middle Eastern Countries

The Fight against the “Human Disaster” of Cancer in the Middle Eastern Countries

Authors: Michael Silbermann
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Abstract

Cancer is considered to be one of the leading causes of death globally. With the increasing prevalence of cancer, the World Health Organization (WHO) expects cancer cases to surge in the next two decades from 14 million in 2012 to 22 million in 2022.1 Tremendous efforts are exerted world-wide to fight this “human disaster”.

Keywords: Cancer. Palliative Care . Middle Eastern Countries.
Spirituality and Religiosity During the
Peri-Operative Period for Cancer Patients
and their Family: An Integrative Systematic
Review

Spirituality and Religiosity During the Peri-Operative Period for Cancer Patients and their Family: An Integrative Systematic Review

Authors: Joann B. Hunsberger
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Abstract

Background: Religion and Spirituality (R/S) may influence cancer patient’s emotional distress, mental health and healing throughout their diagnosis and treatment. Objective: This systematic review examines studies exploring R/S of cancer patients and their family in the perioperative period. Design: We completed a systematic review of the databases MEDLINE, EMBASE, CINAHL, SCOPUS, the Web of Science, and Cochrane library concerning the terms “religion and spirituality” and “cancer surgery”. Inclusion criteria included qualitative or quantitative studies evaluating R/S of cancer patients or their family members within the perioperative period (one month pre- and post-surgery). Exclusion criteria included review articles, grey literature, editorials, case studies and studies evaluating R/S of healthcare providers. Results: Seven publications met criteria for analysis. Five studies described cross-sectional surveys, one used a focus-group approach, and one utilized in-person interviews. Studied populations predominantly were female breast cancer patients. There were considerable heterogeneity in survey instruments, variables, and outcomes. Based on these studies: 1) Faith and religious beliefs were used as coping mechanisms during the perioperative period; 2) Evangelical Christians tended to differ in religious coping compared to Catholics; 3) R/S correlated with coping styles and distress; 4) There was increased religious coping and religious involvement during the perioperative period; Conclusions: Studies evaluating R/S of cancer patients and their families in the perioperative period are few and heterogeneous in design. Direct comparison is difficult, but data suggests that R/S during the perioperative period may increase as compared to R/S during other stages of cancer diagnosis and treatment.

Keywords: Religion.Spirituality.Religiosity.Cancer.Tumor.Surgery.Perioperative.
Palliative Care for Nephropathic Patients

Palliative Care for Nephropathic Patients

Authors: Gianluca Villa
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Abstract

A new light has recently been shed on palliative care, especially, on its multidisciplinary approach developed to improve the Quality of life of seriously ill patients and their families. However, palliative care is still often mistakenly referred to as an end-of-life care and wrongly interchanged with hospice care. Nephropathic patients usually present a decrease in expectancy and Quality of life and may benefit from palliative care as opposed to hospice care. Palliative care requires a tight collaboration among different health care professionals, patients and their families, to share diagnosis, prognosis, realistic goals of treatment and therapeutic decisions. Several approaches may be attempted to improve the Quality of life of chronic nephropathic patients, such as palliative dialysis, conservative management and peritoneal dialysis. For example, personalized goals and a wider concept of adequacy of extracorporeal treatment are the bases of palliative dialysis. In specific subgroups of frail patients, the pharmacological conservative management could be more appropriate than extracorporeal treatment, as the former reduces the burdens derived from invasive procedures. Finally, peritoneal dialysis could be an important option for frail patients to avoid an aggressive extracorporeal treatment while maintaining a gentle solute and fluid control. However, only limited evidences are available on palliative and hospice care performed on patients with Acute Kidney Injury (AKI). Herein, the main variables affecting the medical decision-making on palliative care in nephropathic patients are described, and the different approaches available to improve quality of palliative care during Chronic and Acute Kidney Injury are analyzed.

Keywords: Palliative care.Hospice care.Chronic Kidney Disease.End-Stage Renal Disease.Acute Kidney Injury.Renal Replacement Therapy.
The Challenge of Allocating Scarce
Medical Resources During a Disaster in a
Low Income Country: A Case Study from
the 2010 Haitian Earthquake

The Challenge of Allocating Scarce Medical Resources During a Disaster in a Low Income Country: A Case Study from the 2010 Haitian Earthquake

Authors: Annekathryn Goodman
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Abstract

Scarce medical resources during a natural disaster challenge the existing protocols for medical intervention. Triage decisions about which patient to care for can be extremely stressful for a medical team. This case analysis describes the experience of one mobile field hospital in Haiti in the aftermath of the January 12, 2010 earthquake. The medical team was confronted with the need to choose which of three critically ill patients should receive the remaining, dwindling oxygen supply. The ethical framework around these decisions is discussed. The development of an onsite ethics committee from team members is suggested to help lighten the burden of decision making off of the individual care provider.

Keywords: Haiti earthquake. Disaster. Resources Crisis. Palliative care.
Clinical Management of Cancer-Related Cachexia: Review of the Literature

Clinical Management of Cancer-Related Cachexia: Review of the Literature

Authors: Gustavo dos Santos Fernandes
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Abstract

palliative care setting. It represents a metabolic syndrome affecting essential functional circuits involved in the regulation of homeostasis, with symptoms including anorexia, and fat and muscle tissue wasting. Most patients experiencing cachexia do not receive proper management and suffer a profoundly distressing experience, affecting not only the patients, but also the entire family. Thus, oncologists and palliative care clinicians must understand its complex pathophysiology and treatment. This article will review special considerations about the anorexia-cachexia syndrome and which interventions are most effective in relieving this condition.

Keywords: Cachexia. Interleukin.Metabolic syndrome.Hypercatabolic state.Anorexia-cachexia.
Hospice and Palliative Care for Older Lesbian, Gay, Bisexual and Transgender Adults: The Effect of History, Discrimination, Health Disparities and Legal Issues on Addressing Service Needs

Hospice and Palliative Care for Older Lesbian, Gay, Bisexual and Transgender Adults: The Effect of History, Discrimination, Health Disparities and Legal Issues on Addressing Service Needs

Authors: Deborah F. Farmer
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Abstract

The acronym LGBT refers to groups of people who are lesbian, gay, bisexual and transgender, groups historically marginalized, mistreated, ignored by society and the health care delivery systems, including hospice and palliative care services. The purpose of this literature review was to explore the characteristics, history, health and health care disparities, social support systems and legal issues of LGBT persons with a particular focus on older adults, endof-life care, and ways in which hospice and palliative care organizations can better meet their needs. Despite the fact that sound enquiry is needed to improve health-related outcomes, what little research has been done with LGBT adults in general and, specifically, with older LGBT adults, has focused mainly on HIV/AIDS and other sexually transmitted diseases. As a social minority, LGBT persons are more likely to experience economic insecurity, lack health insurance, experience invisibility, and be victimized and mistreated. This is especially true of older LGBT adults who grew up in a less tolerant era when sexual minorities were criminalized and stigmatized as pathological, sinful, and immoral. Their minority status has led to health issues and health care disparities, and requires health professionals to consider systems in a way that redefines family, addresses legal concerns, and responds with options of care unlike those of their heterosexual counterparts. With recent changes in societal attitudes and some progress in addressing legal concerns, hospice and palliative care organizations now have a unique opportunity to lead the health care community by pioneering culturally sensitive and appropriate methods to better serve this population.

Keywords: Lesbian, Gay. Bisexual and Transgender (LGBT).Health disparities.Hospice.Older adults.Palliative care.End-of-life.Cultural sensitivity.
Challenges in Palliative Care Research: Experience from a Randomized Controlled Trial in Refractory Cancer Cachexia

Challenges in Palliative Care Research: Experience from a Randomized Controlled Trial in Refractory Cancer Cachexia

Authors: Joanne Reid
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Abstract

There is a paucity of research studies in palliative care with less than 1% of clinical trials being relevant to the hospice and palliative care setting.1 Difficulties in conducting studies with this client group such as recruitment, retention, methodological and ethical issues are well documented within the literature.1,2-6 Nonetheless, conducting research with palliative populations is necessary to ensure the development of evidence based policies and services which reflect and respond to the needs of this vulnerable and often underserved population. Previous research has demonstrated that palliative care patients7,8 and their families9 are willing to be involved in palliative care research and the onus to conduct high quality rigorous research with this client group lies with researchers.10 It is only through actively engaging in research with the palliative population that we can build an evidence base that will contribute to the development of evidence based policies, protocols and treatments and allow health care professionals to consistently respond to palliative patients and their families in order to maximise their quality of life as they approach the end of their lives.

Keywords:
Initial Impressions and Review of Literature Concerning Factors Affecting the Use of Palliative Care Assessment Tools in an African Setting

Initial Impressions and Review of Literature Concerning Factors Affecting the Use of Palliative Care Assessment Tools in an African Setting

Authors: John K. Weru
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Abstract

Introduction: Quality palliative care encompasses early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.1 Despite the importance of symptom assessment in palliative care, use of assessment tools in practice is limited.2 The aim of this study was to assess factors that influence use of symptom assessment tools. Methodology: 1:1 interviews were conducted using a guideline developed by the researcher. Ten participants who met the inclusion criteria were interviewed. The data was recorded and then transcribed with topics and issues being isolated and grouped together into themes. Findings: The themes were perception of palliative care, communication, practical concerns and emotions associated with use of assessment tools, spirituality and cultural compatibility with assessment tools, resources, policies and training. Conclusion: Lack of quality education in palliative care coupled with incompatibility of current tools with cultural and religious practices is a major hindrance to use of assessment tools. Poor communication among clinicians negatively affects use of assessment tools.

Keywords: Palliative care.Measures.Assessment tools.Palliative care practice.
The Role of Dose-Dense Neo Adjuvant Triple H Therapy, Hugs, Humor and Humility: Palliative Medicine, Oncology,and the Human Spirit – A Clinician’s Journey

The Role of Dose-Dense Neo Adjuvant Triple H Therapy, Hugs, Humor and Humility: Palliative Medicine, Oncology,and the Human Spirit – A Clinician’s Journey

Authors: Doron Feinsilber
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Abstract

The road to becoming a medical oncologist is a unique lattice of spiritual academic stamina. The roots of my academic and spiritual journey began well into my childhood when I was raised in a kind, warm, and genuine family. My mother and father, both immigrants who came from Israel with hardly a formal education or command of the English language came to the United States to provide a greater life for the next generation. As a child, when neither my siblings nor I could no longer receive academic help from our parents after the fourth grade, sometimes I would see other children in my class getting help from parents who were doctors, lawyers, engineers, and university professors. Despite this, however, what helped motivate my success more than anything was the loving reassurance from my parents.

Keywords: Neo Adjuvant Triple H Therapy.Palliative Medicine.Oncology.
Transforming End-of-Life Care

Transforming End-of-Life Care

Authors: Eun Hee Oh
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Abstract

Currently, hospice care which focuses on caring for a terminally ill person delivers holistic, supportive, interdisciplinary, and patient-centered management. There have been numerous efforts to establish hospice care for people who are in the end-stage of their illness. Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual (WHO). Hospice care which is a subset of palliative care focuses on controlling pain and other symptoms of illness so patients can remain as comfortable as possible near the end of life. The meaning of hospice care throughout this study is a supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life.

Keywords: End-of-Life Care.Palliative care.Hospice care.
Integrating Complementary Medicine in Palliative Care: A Call for an Inter-Disciplinary Collaboration

Integrating Complementary Medicine in Palliative Care: A Call for an Inter-Disciplinary Collaboration

Authors: Michael Silbermann
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Abstract

The interplay between complementary medicine and palliative care, both of which emphasize a patient-centered approach in order to improve quality of life-related concerns, is extremely important in the oncology setting. The integration of evidence-based complementary medicine therapies within conventional palliative care can expand the available treatment options, especially for chemotherapy-induced toxicities for which conventional medicine options are often limited. The integration of complementary medicine in palliative care may also provide an opportunity to address the bio-psycho-social-cultural-spiritual perspectives of care among those patients and caregivers for whom traditional medicine plays and important role in their health belief model. This integration should evolve as an inter-disciplinary process, as opposed to the intra-disciplinary approach which is being taken in most oncology settings. The inter-disciplinary approach recognizes the variance in approach to patient care, while facilitating a multi-disciplinary approach and enabling specialists from both domains to provide care based on their clinical expertise as well as their perceived health-belief models of care.

Keywords: Complementary Medicine.Palliative Care.Inter-Disciplinary Collaboration
Morphine Mouthwash in Oral Mucositis: A Mini Review

Morphine Mouthwash in Oral Mucositis: A Mini Review

Authors: Rakesh Garg
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Abstract

Oral mucositis is a frequent adverse effect of chemotherapy and radiation therapy in cancer patients. The mucositis impacts overall quality of life (QoL) by producing pain with variable intensity leading to difficulty in oral intake, lack of sleep, etc. A multimodal therapy is advocated for management of oral mucositis in cancer patients and includes certain preventive and therapeutic interventions aiming at symptom control. The systemic analgesics are frequently used but may be associated various side effects associated with analgesics including opioid. The use of oral submucosal route for opioids has been advocated in view of existence of peripheral opioid receptors for its analgesic property. We review the literature for use of morphine mouthwash for management of painful oral mucosisits.

Keywords: Morphine.Mouthwash.Adverse effects.Mucositis. Cancer.
Role of Steroids in Malignant Bowel Obstruction

Role of Steroids in Malignant Bowel Obstruction

Authors: Rakesh Garg
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Abstract

Various cancers such as ovarian, stomach, colon or pancreas may present with mechanical bowel obstruction. This may be partial or total depending on the pathology and extent of the disease. On presentation, the patient requires appropriate assessment and management as per underlying pathology and assessment findings. Comprehensive medical and surgical management strategies are required to manage malignant bowel obstruction effectively. Steroids have been reported for their beneficial use in malignant bowel obstruction. We review the usefulness of steroids in patients presenting with malignant bowel obstruction.

Keywords: Malignant Bowel Obstruction (MBO).Steroids.Cancer.
A Feasibility Study to Investigate the Effect of Nutritional Support for Advanced Cancer Patients in an Inpatient Hospice in Japan

A Feasibility Study to Investigate the Effect of Nutritional Support for Advanced Cancer Patients in an Inpatient Hospice in Japan

Authors: Koji Amano
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Abstract

Backgrounds: There has been no prospective study to investigate the effect of nutritional support for advanced cancer patients in inpatient hospices. Therefore, we conducted a prospective observational study to explore the feasibility of investigating the effect of nutritional support for advanced cancer patients in an inpatient hospice. Methods: We prospectively collected the following data: performance status, results of blood tests, calorie and protein intake, body weight, skeletal muscle mass, and Functional Assessment of Anorexia/Cachexia Therapy (FAACT) on the 1st day of admission and every 2 weeks. All patients were followed-up to their discharge or 4 weeks. Primary endpoint was percentage of patients who completed the intervention. Secondary endpoints were overall survival and improvement of Karnofsky Performance Status (KPS) in the 2nd week. Subgroup analysis was performed by dividing patients into 3 groups with change of KPS in the second week (improving, maintaining, and deteriorating KPS groups). Results: A total of 43 patients met the inclusion criteria, and among them, 14 refused to participate. Thus, 29 were analyzed in the present study. The percentage of patients who completed the intervention in the 2nd week was 93.1% and in the 4th week 44.8%. Sixteen patients, 55.2%, were alive 4 weeks. The KPS improvement rate was 41.4%. The 29 patients were divided into improving KPS (n=12), maintaining KPS (n=9), and deteriorating KPS (n=8). All patients in improving KPS and 4 patients in maintaining KPS were alive 4 weeks. Survival decreased with deterioration of KPS . Calorie/protein sufficiency rate and FAACT score of patients in improving KPS group temporarily improved in the 2nd week. Conclusions: This study indicated the feasibility of conducting trials to investigate the effect of nutritional support for advanced cancer patients in an inpatient hospice.

Keywords: Advanced cancer patient.Inpatient hospice.Nutritional support.Feasibility.Cancer cachexia.

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