psychological resilience; psychology; Religion; Social Support; adolescent; Adult; Aged; clinical trial; Cross-Sectional Studies; cross sectional study; emotion; Female; Human; Male; Middle Aged; multicenter study; Palliative therapy; social support; Terminal Care; terminally ill patient; very elderly; Young Adult
Description
In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Purpose: There is lack of standardized resident' curriculum or training for the rapidly emerging field of pediatric end of life care. Goal: To assess pediatric residents' perception of their clinical competence with end of life care and their education needs. To identify an opportunity for improving residents' education and training. Methods: End of life resident assessment survey published by D Weissman was used for evaluation. The survey is divided into 2 domains: clinical competency and education needs. Each domain is subdivided into communication skills and symptom management section. Results: Twenty pediatric residents returned the survey, 8 PGY1, 4 PGY2, and 8 PGY3. PGY1 reported the lowest average score (2.56 of 4), with improving score as we moved to PGY3 (3.1 of 4). Regarding competence with domain of communication skills, they reported significantly lower average score 58% compared to 69% for symptoms management (P < .5). The lowest percentage score among all residents was in discussing home hospice referral 52%, followed by the shift from curative to comfort care and withdrawal of support 54%, then DNR 55%. They felt more competent in giving bad news 72% and best in talking to children in age appropriate manner 91%. This was supported by the high percentage (83%) request of education in those areas. For the symptom management domain, the lowest percentage score among all residents was in management of terminal delirium (40%), followed by terminal dyspnea (48%), using adjuvant analgesics (68%) while they felt comfortable with using opioid analgesic (85%). The highest requested education was for the areas of managing delirium (82%) and dyspnea (81%), followed by hydration and feeding at end of life (68%). Conclusions: There is a major gap in the resident self-assessment in end of life communication skills and symptoms management. This present an improvement opportunity that can translate into better care for children at end of life.
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
OBJECTIVES: A key aim of palliative care is to improve the quality-of-life of people with a life-threatening illness. Occupational therapists are well positioned to contribute to this aim due to their broad range of interventions, client-centeredness and focus on occupation. However, there is a limited understanding of how occupational therapy contributes to the end-of-life experience, which is crucial to providing optimal care. The aim of this study is to investigate the lived experience of occupational therapy in palliative care for people with a life-threatening illness. METHOD: A hermeneutic interpretive phenomenological approach was adopted. Semi-structured interviews were conducted with eight participants recruited from inpatient and outpatient sectors of a specialist palliative care hospital in Sydney, Australia. RESULTS: The two themes developed from participant responses were: (1) occupational therapy provides comfort and safety and (2) trusting the occupational therapist to know what is needed. SIGNIFICANCE OF RESULTS: This study gives insight into the ways in which people with a life-threatening illness experience occupational therapy in palliative care. In addition, it provides a starting point to guide practice that is attentive to the needs of people with a life-threatening illness at end-of-life, thus enhancing client-centered care.
Rights
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).