End of life care and the approach of death.
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576 to 600 of 969Hendrickson KC (2009)reviewMEDLINE-indexed journal, not yet read by usPalliative & supportive care73 citations Morbidity, mortality, and parental grief: a review of the literature on the relationship between the death of a child and the subsequent health of parents.
Objective: This review was undertaken to analyze the research to date and identify areas for future research regarding the associations between parental grief after the death of a child and the subsequent health of the parents, including both their mortality and morbidity risks.
Methods: Relevant literature was identified through a search of OVID-Medline, CINAHL, and PsycINFO using variations of the terms "parental grief and bereaved parents" combined with "health," "illness," "morbidity," and "mortality." Additionally, bibliographies of selected articles were reviewed to identify additional sources. The final sample includes 17 articles.
Results: The literature search revealed a paucity of publications on the topic. However, it also showed that the studies that have been done examining the relationship between parental grief and health outcomes have produced conflicting results in almos…
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Bodner E (2009)reviewMEDLINE-indexed journal, not yet read by usInternational psychogeriatrics51 citations On the origins of ageism among older and younger adults.
Background: Ageism is apparent in many social structures and contexts and in diverse forms over the life cycle. This review discusses the development and consequences of ageism toward elderly people by others of any age, according to the Terror Management Theory (TMT) and the Social Identity Theory (SIT).
Method: A systematic search of the literature was carried out on the social and psychological origins of ageism in younger and older adults.
Results: Studies on the reasons for ageism among older adults point to attitudes that older adults have toward their own age group, while studies on ageism in young adults explain it as an unconscious defensive strategy which younger adults use against death anxiety. In other words, TMT can serve as a suitable framework for ageism in younger adults, and SIT appears to explain ageism in older adults.
Conclusions: A dissociation of the linkage betwee…
matched on Attitude to Death (mesh)
Attitudes toward death criteria and organ donation among healthcare personnel and the general public.
Objective: To examine attitudes toward death criteria and their relation to attitudes and behaviors regarding organ donation.
Data sources: This article reviews empirical studies on the attitudes of healthcare personnel and the general public regarding death criteria and organ donation.
Study selection and data extraction: The review was restricted to studies that had as a primary focus attitudes toward 1 or more of the following 3 specific criteria for determining death: (1) brain death, the irreversible loss of all functions of the entire brain; (2) higher brain death, the loss of cerebral cortex function alone; and (3) the circulatory-respiratory criteria commonly used in donation after cardiac death.
Data synthesis: Studies consistently show that the general public and some medical personnel are inadequately familiar with the legal and medical status of brain death; attitudes toward …
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Redefining caregiver strain for family caregivers in end-of-life care in Hong Kong.
Objectives: Caregiving for family members at their end of life is stressful. Caregivers' strain, burden, or stress has been measured in various geographical and sociodemographic contexts. The concept of stress, burden, and strain are sometimes used interchangeably. By analysing the factor structure of the Chinese version of the Modified Caregiver Strain Index (C-M-CSI), this study aimed to examine the caregiving strain concept and its demographic correlates.
Methods: A sample of 453 family caregivers of patients with a terminal illness in Hong Kong was employed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. In addition, generalized linear models (GLM) were used to examine the demographic correlates.
Results: The EFA yielded a 3-factor model termed "Perception of Caregiving," "Empathetic Strain," and "Adjustment Demand." This 3-factor model expla…
matched on Terminal Care (mesh), end of life (text), terminal illness (text)
Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C): Rationale and Overview.
Objective: The multidimensional burden that results from providing care to a patient with cancer is well documented and a growing number of psychosocial interventions have been developed to address this burden. None, however, target existential distress, a critical, common element - and potentially driving mechanism - of caregiver burden. Meaning-Centered Psychotherapy (MCP) is a structured psychotherapeutic intervention originally developed by our group to target existential distress and spiritual well-being among patients with advanced cancer. We are currently developing Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C). The objective of this qualitative study is to describe the application of MCP to the unique experience of caregivers of patients with advanced cancer.
Methods: A case study of a participant from an initial MCP-C group is presented, with a focus on the applic…
matched on Palliative Care (mesh), terminal illness (text), Existentialism (mesh)
A Qualitative Study of How Hospice Workers Cope With Their Level of Exposure to Death.
ObjectiveTo identify whether hospice workers hold unique and theoretically-informative perspectives about death, especially as they relate to terror management processes. MethodTwelve hospice workers from two hospices in Tucson, Arizona, United States, participated in semi-structured interviews. Interview and analytic practices were guided by Grounded Theory (Glaser & Strauss, 1967).ResultsThree categories were identified in relation to death attitudes: effects of chronic confrontation with death; reasons for working in hospice; and perceptions of death in others. ConclusionsTwo theoretically informative trends appeared. First, hospice workers largely manage death anxiety as identified by existing literature with the notable exception that hospice workers overall seem to integrate death and dying into their worldviews as a meaningful category, as opposed to avoiding thinking about death.…
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Frequency, intensity, and correlates of spiritual pain in advanced cancer patients assessed in a supportive/palliative care clinic.
Objective: Regular assessments of spiritual distress/spiritual pain among patients in a supportive/palliative care clinic (SCPC) are limited or unavailable. We modified the Edmonton Symptom Assessment Scale (ESAS) by adding spiritual pain (SP) to the scale (0 = best, 10 = worst) to determine the frequency, intensity, and correlates of self-reported SP (≥1/10) (pain deep in your soul/being that is not physical) among these advanced cancer patients.
Method: We reviewed 292 consecutive consults of advanced cancer patients (ACPs) who were evaluated at our SCPC between October of 2012 and January of 2013. Symptoms were assessed using the new instrument (termed the ESAS-FS).
Results: The median age of patients was 61 (range = 22-92). Some 53% were male; 189 (65%) were white, 45 (15%) African American, and 34 (12%) Hispanic. Some 123 of 282 (44%) of ACPs had SP (mean (95% CI) = 4(3.5-4.4). Adva…
matched on Palliative Care (mesh), Attitude to Death (mesh)
Medical students' views and ideas about palliative care communication training.
This study focused on the undergraduate medical student to identify views and ideas held toward palliative care communication training, pedagogical approaches to this training, and its perceived effectiveness and use in the medical field. Two focus groups consisting of fourth-year medical students were conducted, and their responses were analyzed using grounded theory categorization. Results indicated that students: (a) prefer to learn nonverbal communication techniques, (b) believe that natural ability and experience outweigh communication curriculum, (c) view the skill of breaking bad news as largely dependent on knowledge and expertise, and (d) prefer curriculum on palliative care and hospice to consist of information (eg, advance directives) rather than communication skills. Implications for these interpretive themes are discussed as well as future research and practice.
matched on Palliative Care (mesh), Attitude to Death (mesh)
Creating a curtain of protection: nurses' experiences of grief following patient death.
Purpose: To describe the lived experience of nurses surrounding the death of their patients.
Design: A qualitative phenomenologic approach was used for the interview and analysis framework. Methods to ensure trustworthiness and rigor were incorporated into the design.
Methods: Using semistructured interviews and phenomenologic concepts, the investigators interviewed 11 registered nurses where data was analyzed using methods of Heideggerian hermeneutical analysis and van Manen's progression of reflection, description, writing, and rewriting.
Findings: Four themes were identified: (a) Reciprocal relationship transcends professional relationship; (b) initial patient death events are formative; (c) nurses' coping responses incorporate spiritual worldviews and caring rituals; and (d) remaining "professional" requires compartmentalizing of experience.
Conclusions: Nurses create a curtain of pr…
matched on Terminal Care (mesh), Attitude to Death (mesh)
Unrecognized contributions of families in the intensive care unit.
Objective: To describe the contributions to care that family members perform while their loved one is at high risk of dying in the intensive care unit.
Design: Exploratory, descriptive analysis.
Setting: Two intensive care units at a tertiary medical center in the western United States.
Participants: Through purposive sampling, 25 family members of 24 ICU patients at high risk of dying participated in the study.
Interventions: None.
Measurements and results: A qualitative, descriptive technique was used for data analysis. Three independent raters coded transcripts of audiotaped interviews with family members about their experiences in the ICU. Recurring themes were categorized into roles that family members take on while their loved one is in the ICU. These work roles consisted of active presence, patient protector, facilitator, historian, coach, and voluntary caregiver.
Conclusions: Fam…
matched on Terminal Care (mesh), Attitude to Death (mesh)
Trends in Advance Care Planning in Patients With Cancer: Results From a National Longitudinal Survey.
Importance: Advance care planning (ACP) may prevent end-of-life (EOL) care that is nonbeneficial and discordant with patient wishes. Despite long-standing recognition of the merits of ACP in oncology, it is unclear whether participation in ACP by patients with cancer has increased over time.
Objectives: To characterize trends in durable power of attorney (DPOA) assignment, living will creation, and participation in discussions of EOL care preferences and to explore associations between ACP subtypes and EOL treatment intensity as reflected in EOL care decisions and terminal hospitalizations.
Design, setting, and participants: We analyzed prospectively collected survey data from 1985 next-of-kin surrogates of Health and Retirement Study (HRS) participants with cancer who died between 2000 and 2012, including data from in-depth "exit" interviews conducted with the surrogates after the parti…
matched on Terminal Care (mesh), end of life (text)
A developmental approach to mentalizing communities: I. A model for social change.
A developmental model is proposed applying attachment theory to complex social systems to promote social change. The idea of mentalizing communities is outlined with a proposal for three projects testing the model: ways to reduce bullying and create a peaceful climate in schools, projects to promote compassion in cities by a focus of end-of-life care, and a mentalization-based intervention into parenting style of borderline and substance abusing parents.
matched on Terminal Care (mesh), end of life (text)
Integration of Psychosocial Theory into Palliative Care: Implications for Care Planning and Early Palliative Care.
Palliative care improves patients' symptoms, quality of life and family satisfaction with caregiving, reduces hospital admissions and promotes alignment of medical care with the patient's needs and goals. This article proposes the utility of integrating three psychosocial theories into standard palliative care with implications for care planning, early palliative care and optimizing quality of life. First, Control Theory focuses on the complex juxtaposition of promoting agency/empowerment in patients and carers and coping with often highly uncertain outcomes. Second, Optimal Matching Theory accounts for the alignment of need and provision of care to potentiate the quality of life effects of supportive care in a complex social process involving health care providers, patients and carers. Third, Hope Theory represents a dynamic process, which is marked by variation in the qualities of hope…
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Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature.
Many studies on spiritual care in palliative care are performed in the US, leaving other continents unexplored. The objective of this systematic review is to map the recent studies on spiritual care in palliative care in Europe. PubMed, CINAHL, ATLA, PsycINFO, ERIC, IBSS, Web of Science, EMBASE, and other databases were searched. Included were European studies published in a peer-reviewed journal in 2015, 2016, or 2017. The characteristics of the included studies were analyzed and a narrative synthesis of the extracted data was performed. 53 articles were included. Spiritual care was seen as attention for spirituality, presence, empowerment, and bringing peace. It implied creative, narrative, and ritual work. Though several studies reported positive effects of spiritual care, like the easing of discomfort, the evidence for spiritual care is low. Requirements for implementation of spiritu…
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Communication Skills: Delivering Bad News, Conducting a Goals of Care Family Meeting, and Advance Care Planning.
Primary care clinicians face difficult conversations with patients across the life cycle. As clinicians care for patients in different health states, the focus of these challenging conversations shifts. Even the most skilled clinicians struggle to find the right words at the right time in these scenarios. This article focuses on communication skills to make difficult conversations easier, whether through assigning a health care proxy, breaking bad news, having conversations about serious illness, or leading a family meeting to discuss goals of care.
matched on Advance Care Planning (mesh)
Advance care planning in the elderly.
Key components of advance care planning (ACP) for the elderly include choosing a surrogate decision maker, identifying personal values, communicating with surrogates and clinicians, documenting wishes in advance directives, and translating values and preferences for future medical care into medical orders. ACP often involves multiple brief discussions over time. This article outlines common benefits and barriers to ACP in primary care, and provides practical approaches to integrating key ACP components into primary care for older adults. Opportunities for multidisciplinary teams to incorporate ACP into brief clinic visits are highlighted.
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Advance care planning for people with dementia: a review.
Background: Few people with dementia have made advance plans for their health care. Advance care planning (ACP) is a process of discussion between an individual and their care providers that takes account of wishes and preferences for future care. We aimed to examine the facilitators and inhibitors to ACP in people with dementia. We also aimed to identify key themes in the literature and critically review the methodologies used.
Methods: We systematically searched the English language literature including PubMed, CINAHL, AMED, PsychINFO, EMBASE and BNI. We included empirical studies which reported the characteristics of the patient population, the type of advance care planning used and the study setting, and which involved people with dementia, family members or professional carers.
Results: We identified 17 studies (11 quantitative methods, one qualitative and five mixed methods). We fo…
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Meaning of Life Therapy: A Pilot Study of a Novel Psycho-Existential Intervention for Palliative Care in Cancer.
Intervention in Palliative Care aims to provide physical, psychosocial, and spiritual relief for patients and family members. Brief interventions with a psycho-existential approach have shown positive responses; however, cultural adaptations are needed. This pilot study aimed to develop the Meaning of Life Therapy (MLT), a novel psycho-existential intervention, rooted in the Dignity Therapy, Life Review, and Meaning-Centered Psychotherapy. MLT was culturally adapted to the Portuguese context to include questions about forgiveness, apology, reconciliation, farewell, and a legacy document, i.e., the Life Letter. Nine PC cancer patients answered a 14-question MLT protocol, intended to help patients find purpose and meaning in life. Eight themes emerged: Family, Preservation of Identity, Life Retrospective, Clinical Situation, Achievements, Socio-Professional Valorization, Forgiveness/Apolog…
matched on Palliative Care (mesh), Palliative Care (keyword)
Addressing the spiritual needs of patients with serious illness in Lebanon: perspectives and practices of palliative care professionals.
Background: Spiritual care is an essential component of palliative care, supporting the existential and spiritual wellbeing of patients with serious illnesses. Yet, its effective implementation remains challenging in many healthcare systems. This study examines the experiences and practices of palliative care clinicians in Lebanon, a country characterized by religious diversity, high religiosity, and a complex political landscape.
Methods: A qualitative focus group study rooted in constructionist ontology. Palliative care clinicians were recruited from community and acute settings in Lebanon. Data were analyzed using reflexive thematic analysis.
Results: Three overarching themes: (1) the political context and religious tensions create sensitivities around spiritual care provision, (2) existing spiritual assessment tools are incompatible with local needs, and (3) the desire to safeguard t…
matched on Palliative Care (mesh), Palliative Care (keyword)
The influence of the hidden curriculum on the risk of burnout in junior doctors in a palliative medicine rotation - a qualitative exploratory study.
Background: Palliative Care (PC) provides person-centred care for patients with life-limiting diseases and their families. Studies have shown that healthcare professionals delivering PC are predisposed to moral distress and burnout due to constant exposure to death and dying and aspects of the hidden curriculum (HC) through which culture and values are transmitted implicitly. However, there are limited studies focusing on the latter through the lens of junior doctors. Using the Ring Theory of Personhood (RToP) and the Krishna-Pisupati Model (KPM), which categorize and map conflicts between personal and professional values, beliefs, and principles within the four domains of personhood, this study investigates the impact of palliative care experiences on the risk of burnout in junior doctors.
Methods: This qualitative exploratory study was conducted at the Division of Supportive and Pallia…
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Spiritual Well-Being, Religiosity, Quality of Life, Distress, Social Support, Depression, and Anxiety Among English- and Arabic-Speaking Muslim Americans With Advanced Cancer: A Cross-Sectional Study.
Objective: To learn about spiritual and psychosocial palliative care needs of Muslim Americans with advanced cancer.
Methods: A cross-sectional English/Arabic (patient preference) survey was conducted with 120 Muslim Americans with advanced cancer in New York City (2022-2023). Survey instruments included Functional Assessment of Cancer Therapy-General (FACT-G, quality of life), Hospital Anxiety and Depression Scale (HADS-2 subscales), Medical Outcomes Study (MOS-emotional, tangible, affectionate support, positive social interactions), Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing (FACIT-SP-spiritual wellbeing, Modified Duke Religious Index (DUREL-religious involvement), Distress Thermometer and Problems List.
Results: Most participants were from South Asia (30.8%), Middle East/North Africa (30.8%), and US (21.7%). On average, patients had high quality of life (FACT…
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Bennemann ACK, Paiva CE, Julião M, Chochinov HM, Marques C, Costa RFA, Oliveira LC, Uchida Miwa M, Trevizan FB, Valentino TCO, Paiva BSR (2024)MEDLINE-indexed journal, not yet read by usPalliative & supportive care2 citations Translation and cross-cultural adaptation of the Posthumous Dignity Therapy Schedule of Questions to Brazilian Portuguese.
Objectives: Dignity Therapy (DT) is a brief form of psychotherapy that helps people with life-threatening illnesses and their loved ones cope with emotional pain and demoralization. Unfortunately, not everyone has the opportunity to receive DT during their lifetime. Posthumous Dignity Therapy (PDT) was then devised to be administered to bereaved family members. However, PDT has not yet been validated or studied in the specific cultural and linguistic context of Portuguese-Brazilians. This study aims to fill this gap by validating PDT for the Portuguese (Brazilian) context.
Methods: Using Beaton's methodology, including the processes of translation, synthesis, back-translation, evaluation by an expert committee, and pre-testing, the PDT Schedule of Questions underwent validation and cultural adaptation. The research was conducted in a Palliative Care Unit at a tertiary cancer hospital in …
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Moral uncertainty and distress about voluntary assisted dying prior to legalisation and the implications for post-legalisation practice: a qualitative study of palliative and hospice care providers in Queensland, Australia.
Objectives: There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD.
Design: The study used a qualitative approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collect…
matched on Hospice Care (mesh), Palliative Care (keyword)
Prevalence and predictors of compassion satisfaction, secondary traumatic stress, and burnout among Chinese hospice nurses: A cross-sectional study.
Aim: To explore the prevalence and predictors of compassion satisfaction, secondary traumatic stress, and burnout among Chinese hospice nurses.
Background: Because of prolonged and continual contact with suffering, deaths, and grief, hospice nurses may be vulnerable to emotional burdens and have difficulty maintaining their professional quality of life.
Methods: A cross-sectional study was conducted. A total of 478 hospice nurses were selected from 24 medical institutions in Sichuan province. Demographic, work-related information and work-related trauma questionnaire, the Chinese version of the Interpersonal Reactivity Index, the Chinese version of the Emotion Regulation Questionnaire, and the Chinese version of the Professional Quality of Life Scale for Nurses were used for collecting data.
Results: The mean scores of compassion satisfaction, secondary traumatic stress, and burnout were…
matched on Hospice Care (mesh), Hospice Care (keyword)
Giving and receiving thanks: a mixed methods pilot study of a gratitude intervention for palliative patients and their carers.
Background: Psychological research examining the nature and workings of gratitude has burgeoned over the past two decades. However, few studies have considered gratitude in the palliative care context. Based on an exploratory study which found that gratitude was correlated with better quality of life and less psychological distress in palliative patients, we designed and piloted a gratitude intervention where palliative patients and a carer of their choice wrote and shared a gratitude letter with each other. The aims of this study are to establish the feasibility and acceptability of our gratitude intervention and provide a preliminary assessment of its effects.
Methods: This pilot intervention study adopted a mixed-methods, concurrent nested, pre-post evaluation design. To assess the intervention's effects, we employed quantitative questionnaires on quality of life, quality of relations…
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