Abstract：
OBJECTIVE:Palliative, end-of-life care (PEOLC) providers are poorly resourced in addressing the needs of patients with mental health challenges, and the dying experiences of this cohort-particularly those with a comorbid, chronic and persistent mental illness (CPMI)-are poorly documented. We sought to explore the experiences of PEOLC providers with regard to caring for patients with mental health challenges, and gather insights into ways of improving accessibility and quality of PEOLC for these patients. METHOD:Twenty providers of PEOLC, from different disciplines, took part in semi structured interviews. The data were coded and analyzed using a reflexive, inductive-deductive process of thematic analysis. RESULTS:The most prominent issues pertained to assessment of patients and differential diagnosis of CPMI, and preparedness of caregivers to deliver mental health interventions, given the isolation of palliative care from other agencies. Among the assets mentioned, informal relationships with frontline caregivers were seen as the main support structure, rather than the formal policies and procedures of the practice settings. Strategies to improve mental health care in PEOLC centered on holistic roles and interventions benefiting the entire palliative population, illustrating the participants saw little point in compartmentalizing mental illness, whether diagnosed or not. SIGNIFICANCE OF RESULTS:Continuity of care and personal advocacy can significantly improve quality of life for end-of-life patients with mental health challenges, but bureaucracy and disciplinary siloing tend to isolate these patients and their caregivers. Improved interdisciplinary connectivity and innovative, hybridized roles encompassing palliation and psychiatry are 2 strategies to address this disconnect, as well as enhanced training in core mental health care competencies for PEOLC providers.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Park T,Hegadoren K,Workun Bdoi
10.1177/0825859720951360subject
Has Abstractpub_date
2020-08-18 00:00:00pages
825859720951360eissn
0825-8597issn
2369-5293pub_type
杂志文章abstract：BACKGROUND:One challenge for those who manage amyotrophic lateral sclerosis (ALS) is to understand patients' needs. AIM:The aim of this study was to examine the needs of Singapore ALS patients from their perspective as well as that of their caregivers and healthcare professionals in order to develop a template for bet...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/082585971503100304
更新日期：2015-01-01 00:00:00
abstract：:COVID-19 has stressed the healthcare system in ways our society has not seen before. Less visibly, elderly patients and their caregivers have been stressed as well, both by the virus and by the public health measures required to slow its spread. After months of isolating, patients with dementia and their caregivers ar...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859720984567
更新日期：2021-01-12 00:00:00
abstract：UNLABELLED:In Poland, medical curricula cover palliative care for adults, not for children. This paper evaluates feedback of students who participated in a pilot pediatric palliative care education program. METHOD:An anonymous questionnaire was designed for the students; they were asked to assess each aspect of the pr...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:A strong and often polarized debate has taken place during recent years concerning the consequences of dehydration in the terminally ill patient. When a patient has a severely restricted oral intake or is found to be dehydrated, the decision to administer fluids should be individualized and made on the basis of a care...
journal_title：Journal of palliative care
pub_type： 杂志文章,评审
doi：
更新日期：1998-07-01 00:00:00
abstract：AIM:The aim of this study was to characterize the attitudes of older adults on an inpatient palliative care unit toward complementary and alternative medicine (CAM) therapies. METHODS:A consecutive sample of 33 inpatients (61 to 98 years old) completed a questionnaire that examined their attitudes toward CAM to determ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：:This multi-centre study of adjuvant "burst" ketamine in palliative care in-patients documents its effectiveness, duration of pain relief, and adverse effects (AE) profile. Patients received a three-to-five day continuous subcutaneous infusion (CSCI) of ketamine escalated from 100 to 300 to 500 mg/24 hours if required....
journal_title：Journal of palliative care
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：2010-10-01 00:00:00
abstract：:When dying patients are young adults or have a contagious disease, nursing staff may feel acutely uncomfortable and the patients may become isolated and alone. Nurses who work in palliative care units (PCU) develop special interactive skills that are generally acknowledged but not clearly defined or understood. Admiss...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:Patients with advanced chronic obstructive pulmonary disease (COPD) have a significant symptom burden despite maximal medical therapy, yet few are referred for concomitant palliative care. OBJECTIVE:To evaluate the utilization and impact of palliative care on the location of death and to identify clinical v...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859719851486
更新日期：2019-07-02 00:00:00
abstract：INTRODUCTION:Health system restructuring combined with the preferences of many terminally ill care recipients and their caregivers has led to an increase in home-based palliative care, yet many care recipients die within institutional settings such as hospitals. This study sought to determine the place of death and its...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：:Historically, health and social care professionals have described their lack of competence and confidence in many aspects of palliative care, and have recognized the need for increased educational opportunities, where new skills can be acquired and existing knowledge consolidated. Redressing these omissions has led to...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
abstract：:This paper addresses the music therapy process specific to one subgroup of the general population identified as having terminal illness. This subgroup includes individuals who are impoverished, homeless, and do not have someone to provide them with care at the end of life. Based upon her clinical work at Malachi House...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2001-10-01 00:00:00
abstract：:Professional caregivers for cancer patients are at high risk for work-related stress, but it is not clear how this relates to exposure to death and dying, and to professional satisfaction. This study compares work-related stress and staff satisfaction on an academic acute palliative care unit (PCU) with that on a medi...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2007-04-01 00:00:00
abstract：:Informal hospice caregivers play a key role in managing patients' pain at home, but lack of adherence to doctor-prescribed analgesic regimens and medication errors are significant barriers to truly effective pain management. A digital pain diary may improve caregiver management of pain at home; however, most digital p...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859717722466
更新日期：2017-04-01 00:00:00
abstract：:The principle of double effect is widely used to permit the administration of narcotics and sedatives with the intent to palliate dying patients, even though the administration of these drugs may cause hastening of death. In recent medical literature, this principle's validity has been severely criticized, causing hea...
journal_title：Journal of palliative care
pub_type： 杂志文章,评审
doi：
更新日期：2000-10-01 00:00:00
abstract：:The essential mandate of medicine is the relief of suffering. However, the quest for an integrated model towards a conceptualization of suffering is still ongoing and empirical studies are few. Qualitative inquiry using 31 in-depth interviews and content analysis was carried out between 1999 and 2001 in 26 patients di...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2004-04-01 00:00:00
abstract：:In 2006, the Indian Health Service (IHS) and the National Cancer Institute (NCI) collaborated to develop an interdisciplinary palliative training program for health professionals in the Indian health system. Their goal was to improve clinician knowledge and skills in palliative care, to train future trainers, and to i...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：:This article describes two young, potentially curable patients who chose a course of treatment that ultimately resulted in death. Their choice was in part influenced by the prospect of the disfiguring surgery that would have been required for cure. In the first patient this would have meant massive head and neck surge...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:Little is known about current practice in using the anticonvulsant gabapentin in the management of cancer-related neuropathic pain. OBJECTIVES:The main objective of this study was to describe the pattern of gabapentin use as an adjuvant analgesic for cancer-related neuropathic pain in patients admitted to a...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2003-10-01 00:00:00
abstract：BACKGROUND:The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by pa...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859718769099
更新日期：2018-07-01 00:00:00
abstract：:Family care giving is important for the quality of life of terminally ill patients and their family members. Although family caregivers are generally eager to provide palliative care, at some point it may become too demanding, and then volunteers can make a difference. This four-study paper presents the experiences of...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2009-04-01 00:00:00
abstract：PURPOSE:The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. METHODS:The sample consisted of 120 patients with advanced cancer. The self-administered questionnair...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859718759882
更新日期：2018-04-01 00:00:00
abstract：:The emphasis of palliative care has been to support both patients and their family caregivers, and to maintain the caregivers' involvement through the patient's illness and death. This study challenges the assumption that people with amyotrophic lateral sclerosis (ALS) and those who care for them at home have a simila...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：:There may be quantitatively more cancer in the developing world, Africa included, than in the developed world. Unlike in the developed world, cancer patients in Africa present for treatment at a late stage and therefore most of them have pain. Yet, the most commonly used modality for treatment of the cancer pain is dr...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1989-06-01 00:00:00
abstract：:Families of patients are well poised to comment on the end-of-life (EOL) care received by those patients and can provide feedback to care providers and decision makers. To better understand family-member evaluations of the quality of in-patient EOL care, this study draws on qualitative interview data (n = 24) to ident...
journal_title：Journal of palliative care
pub_type： 杂志文章,多中心研究
doi：
更新日期：2011-01-01 00:00:00
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journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859720923435
更新日期：2020-05-10 00:00:00
abstract：:There has been little research into pressure ulcer prevention and treatment in hospices. In this study, interviews with hospice directors of clinical services and direct-care nurses were analyzed using qualitative methods. Several general themes were found. Both pressure ulcer prevention and treatment can be painful t...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2003-04-01 00:00:00
abstract：:The study assessed the components of high-quality HIV palliative care using the multidimensional model of quality assessment developed by Maxwell (4). Data collection consisted of interviews with individual subjects and focus groups. The interviews took place in three London health authorities. Seven service users and...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:The anniversary of a death is perceived as a difficult time by the majority of closely bereaved relatives and friends. Bereavement anniversary cards are supportive and useful in the context of wider follow-up. This study identified no strong predictors to indicate those for whom such a card would be inappropriate. Sev...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1995-10-01 00:00:00
abstract：AIM:Physical activity (PA) has a positive effect on the cardiorespiratory fitness, lung cancer symptoms, and quality of life of lung cancer patients. The aim of our study was to identify barriers to, and facilitators of PA in lung cancer patients. METHODS:We collected data from five patients diagnosed with primary, ad...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/082585971503100204
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:Although religiousness is a strong predictor of attitudes towards physician-assisted suicide (PAS), Oregon hospice chaplains express wide variation in their opposition to or support for legalized PAS. We explored factors associated with chaplains' views on PAS. METHODS:A mailed survey to chaplains from 51 O...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2006-07-01 00:00:00
