End of life care and the approach of death.
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كُتِبَ عَلَيۡكُمۡ إِذَا حَضَرَ أَحَدَكُمُ ٱلۡمَوۡتُ إِن تَرَكَ خَيۡرًا ٱلۡوَصِيَّةُ لِلۡوَٰلِدَيۡنِ وَٱلۡأَقۡرَبِينَ بِٱلۡمَعۡرُوفِۖ حَقًّا عَلَى ٱلۡمُتَّقِينَ
it is prescribed that he should make a proper bequest to parents and close relatives- a duty incumbent on those who are mindful of God
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ شَهَٰدَةُ بَيۡنِكُمۡ إِذَا حَضَرَ أَحَدَكُمُ ٱلۡمَوۡتُ حِينَ ٱلۡوَصِيَّةِ ٱثۡنَانِ ذَوَا عَدۡلࣲ مِّنكُمۡ أَوۡ ءَاخَرَانِ مِنۡ غَيۡرِكُمۡ إِنۡ أَنتُمۡ ضَرَبۡتُمۡ فِي ٱلۡأَرۡضِ فَأَصَٰبَتۡكُم مُّصِيبَةُ ٱلۡمَوۡتِۚ تَحۡبِسُونَهُمَا مِنۢ بَعۡدِ ٱلصَّلَوٰةِ فَيُقۡسِمَانِ بِٱللَّهِ إِنِ ٱرۡتَبۡتُمۡ لَا نَشۡتَرِي بِهِۦ ثَمَنࣰ ا وَلَوۡ كَانَ ذَا قُرۡبَىٰ وَلَا نَكۡتُمُ شَهَٰدَةَ ٱللَّهِ إِنَّآ إِذࣰ ا لَّمِنَ ٱلۡأٓثِمِينَ
You who believe, when death approaches any of you, let two just men from among you act as witnesses to the making of a bequest, or two men from another people if you are journeying in the land when death approaches. Keep the two witnesses back after prayer, if you have any doubts, and make them both swear by God, ‘We will not sell our testimony for any price, even if a close relative is involved. We will not hide God’s testimony, for then we should be doing wrong.’
كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۗ وَنَبۡلُوكُم بِٱلشَّرِّ وَٱلۡخَيۡرِ فِتۡنَةࣰۖ وَإِلَيۡنَا تُرۡجَعُونَ
Every soul is certain to taste death: We test you all through the bad and the good, and to Us you will all return
كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۖ ثُمَّ إِلَيۡنَا تُرۡجَعُونَ
Every soul will taste death, then it is to Us that you will be returned
كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۗ وَإِنَّمَا تُوَفَّوۡنَ أُجُورَكُمۡ يَوۡمَ ٱلۡقِيَٰمَةِۖ فَمَن زُحۡزِحَ عَنِ ٱلنَّارِ وَأُدۡخِلَ ٱلۡجَنَّةَ فَقَدۡ فَازَۗ وَمَا ٱلۡحَيَوٰةُ ٱلدُّنۡيَآ إِلَّا مَتَٰعُ ٱلۡغُرُورِ
Every soul will taste death and you will be paid in full only on the Day of Resurrection. Whoever is kept away from the Fire and admitted to the Garden will have triumphed. The present world is only an illusory pleasure
لَا يَذُوقُونَ فِيهَا ٱلۡمَوۡتَ إِلَّا ٱلۡمَوۡتَةَ ٱلۡأُولَىٰۖ وَوَقَىٰهُمۡ عَذَابَ ٱلۡجَحِيمِ
After the one death they will taste death no more. God will guard them from the torment of Hell
Commentary on the verses above, at most two editions per verse.
It is written for you, when death is present for one of you and he is leaving behind some good, to make a will for parents and kinsfolk honorably, as something rightfully due from the godwary. The testament of the lords of wealth is one thing, and the testament of the lords of states is some- thing else. The testament of the lords of wealth goes out from the wealth, and the testament of the poor men from the states. At the end of their lives, the rich give out one-third of their wealth,13 and the poor give out limpidness of states and truthfulness of deeds. As much as the disobedient person is afraid for himself because of his bad deeds, the recogniz- er is afraid for himself ten times more because of the truthfulness of his deeds and the limpidness of his states. But there is a difference between the two: The disobedient person is afraid of the out- come and in dread of punishment, and
(O ye who believe! Let there be witnesses between you�) [5:106]. Abu Sa'id ibn Abi Bakr al-Razi informed us> Abu 'Amr ibn Hamdan> Abu Ya'la> al-Harith ibn Shurayh> Yahya ibn Zakariyya ibn Abi Za'idah> Muhammad ibn Abu'l-Qasim> 'Abd al-Malik ibn Sa'id ibn Jubayr> his father> Ibn 'Abbas who said: �Tamim al-Dari and 'Adiyy ibn Badda' used to come to Mecca. On one occasion, a man from Quraysh, from Banu Sahm, travelled with the two of them. However, this man died in a land where there was not a single Muslim and he had to entrust them with his belongings, with the understanding that they were to be given to his family. When the two of them arrived, they gave his belongings to his family but kept to themselves a silver bowl adorned with layers of gold. They denied having seen this bowl when they were asked about it. The two men were taken to the Prophet, Allah bless him and give him peace, wh
Prescribed made obligatory for you when any of you is approached by death that is by its causes and leaves behind some good material possessions is to make testament al-wasiyyatu is in the nominative because of kutiba and is semantically connected to the particle idhā ‘when’ if the latter is adverbial; but if this latter is conditional then it al-wasiyyatu indicates the response; the response to the conditional particle in ‘if’ is in other words implied to be fa’l-yūsi ‘let him make testament’; in favour of his parents and kinsmen honourably that is justly not giving more than the allotted share of a third nor preferring the richer person — an obligation haqqan here emphasises the import of what has preceded on those that fear God this verse has been abrogated by the ‘inheritance’ verse āyat al-mīrāth see Q. 411 and by the hadīth ‘Do not make testament for one already inheriting’ as repo
O you who believe let testimony between you when death that is one of its causes draws near to one of you at the time of a bequest be that of two men of justice among you ithnāni dhawā ‘adlin minkum ‘two men of justice among you’ is the predicate expressed with the sense of an imperative in other words ‘let two men bear witness … etc.’; the genitive annexation of shahāda ‘testimony’ and bayn ‘between’ is meant to allow for a range of alternatives; hīn ‘at the time of’ is a substitute for idhā ‘when’ or an adverbial qualifier of time for the verb hadara ‘draws near’; or of two others from another folk that is from other than your own religious community if you are travelling in the land and the affliction of death befalls you. Then you shall empanel them you shall detain them tahbisūnahumā ‘you shall empanel them’ is an adjectival qualification of ākharān ‘two others’ after the mid-aftern
We have not assigned everlastingness to any mortal before thee. If thou diest, will they be everlasting? Every soul shall taste death. When a speck of truthfulness appears in someone's heart, the reality of passion for death will show its head from his spirit, for the promise of encounter is there. What sort of spirit would forget the promise of encounter? What sort of heart would seek from someplace else the repose that comes only from contemplating the Real? “The person of faith has no ease without encoun- tering his Lord.” O dervish, no good fortune is more precious than death. Those who have the religion place the crown of magnificence and generosity on their heads at the gate of death. Those who reap the fruit of the Shariah will find the sigil of good fortune at the door of death. Death is the sanctuary of “There is no god but God.” Death is the doorstep of the kingdom of the resur
Every soul shall taste of death; you shall surely be paid in full your wages the requital of your deeds on the Day of Resurrection. Whoever is moved away distanced from the Fire and admitted to Paradise will have triumphed he will have attained his ultimate wish. Living in the life of this world is but the comfort of delusion; of inanity enjoyed for a little while then perishing.
Sound narrations only, and never matched by text. A narration appears here because a compiler filed it under a chapter this subject maps to, or because someone read it and anchored it. Each row says which.
حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ " مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ".
Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that
حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم " مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ".
Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)
وَحَدَّثَنَاهُ قُتَيْبَةُ بْنُ سَعِيدٍ، حَدَّثَنَا عَبْدُ الْعَزِيزِ يَعْنِي الدَّرَاوَرْدِيَّ، ح وَحَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ حَدَّثَنَا خَالِدُ بْنُ مَخْلَدٍ، حَدَّثَنَا سُلَيْمَانُ بْنُ بِلاَلٍ، جَمِيعًا بِهَذَا الإِسْنَادِ .
This hadith has been narrated by Sulaiman b. Bilal with the same chain of transmitters
وَحَدَّثَنَا أَبُو بَكْرٍ، وَعُثْمَانُ، ابْنَا أَبِي شَيْبَةَ ح وَحَدَّثَنِي عَمْرٌو النَّاقِدُ، قَالُوا جَمِيعًا حَدَّثَنَا أَبُو خَالِدٍ الأَحْمَرُ، عَنْ يَزِيدَ بْنِ كَيْسَانَ، عَنْ أَبِي حَازِمٍ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم " لَقِّنُوا مَوْتَاكُمْ لاَ إِلَهَ إِلاَّ اللَّهُ " .
Abu Huraira reported Allah's Messenger (ﷺ) as saying:Exhort to recite" There is no god but Allah" to those of you who are dying
حَدَّثَنَا أَبُو بِشْرٍ، بَكْرُ بْنُ خَلَفٍ وَمُحَمَّدُ بْنُ بَشَّارٍ قَالاَ حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ، حَدَّثَنَا عَبْدُ الْحَمِيدِ بْنُ جَعْفَرٍ، عَنْ أَبِيهِ، عَنْ حَكِيمِ بْنِ أَفْلَحَ، عَنْ أَبِي مَسْعُودٍ، عَنِ النَّبِيِّ ـ صلى الله عليه وسلم ـ قَالَ " لِلْمُسْلِمِ عَلَى الْمُسْلِمِ أَرْبَعُ خِلاَلٍ يُشَمِّتُهُ إِذَا عَطَسَ وَيُجِيبُهُ إِذَا دَعَاهُ وَيَشْهَدُهُ إِذَا مَاتَ وَيَعُودُهُ إِذَا مَرِضَ " .
It was narrated from Abu Mas’ud that the Prophet (ﷺ) said:“The Muslim has four things due from the Muslim: He should answer [by saying Yarhamuk-Allah (may Allah have mercy on you)] to him if he sneezes (and says Al-Hamdulillah); he should accept his invitation if he invites him; he should attend his funeral if he dies; and he should visit him if he falls sick.”
حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا مُحَمَّدُ بْنُ بِشْرٍ، عَنْ مُحَمَّدِ بْنِ عَمْرٍو، عَنْ أَبِي سَلَمَةَ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ ـ صلى الله عليه وسلم ـ " خَمْسٌ مِنْ حَقِّ الْمُسْلِمِ عَلَى الْمُسْلِمِ رَدُّ التَّحِيَّةِ وَإِجَابَةُ الدَّعْوَةِ وَشُهُودُ الْجِنَازَةِ وَعِيَادَةُ الْمَرِيضِ وَتَشْمِيتُ الْعَاطِسِ إِذَا حَمِدَ اللَّهَ " .
It was narrated from Abu Hurairah that the Messenger of Allah (ﷺ) said:“Five are the rights of the Muslim: Returning his greeting, accepting his invitation; attending his funeral; visiting the sick; and answering (saying Yarhamuk-Allah) to the one who sneezes, if he praises Allah (says Al-Hamdu Lillah).”
Arabic originals, reached through the subject’s Arabic senses. Interpretive sources, never proof of a ruling.
الباب الثالث في سكرات الموت وشدته وما يستحب من الأحوال عند الموت
| الباب الثالث في سكرات الموت وشدته وما يستحب من الأحوال عنده
ومن أقسام الخائفين، من يخاف سكرات الموت وشدته، أو سؤال منكر ونكير، أو عذاب القبر.
فهذه سكرات الموت على أولياء الله وأحبابه في حالنا ونحن المنهمكون في المعاصي وتتوالى علينا مع سكرات الموت بقية الدواهي فإن دواهي الموت ثلاث
قد عرفت فيما سبق أحوال الميت فى سكرات الموت وخطره فى خوف العاقبة ثم مقاساته لظلمة القبر وديدانه ثم لمنكر ونكير وسؤالهما ثم لعذاب القبر وخطره إن كان مغضوبا عليه
إحداهما أعظم، وهو أن يغلب على القلب والعياذ بالله شك، أو جحود عند سكرات الموت وأهواله، فيقتضي ذلك العذاب الدائم.
Peer-reviewed work held with its DOI and abstract, labelled with the study design its publication types report. None of it has been read or assessed, so nothing here may be cited as showing anything. Retracted work is held for the record but never listed; a review that a later version replaced is listed under its replacement and marked.
Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature.: Objectives: Published research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks. Methods: The scoping review method was
Good end-of-life care in nursing home according to the family carers' perspective: A systematic review of qualitative findings.: Background: Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. Aim: To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual model of good end-of-life care according to the family perspective. Design: Systematic review (PROSPERO no. 95581) with meta-aggregation method. Data sources: Five electronic databas
Defining priorities for improving end-of-life care in Canada.: Background: High-quality end-of-life care should be the right of every Canadian. The objective of this study was to identify aspects of end-of-life care that are high in priority as targets for improvement using feedback elicited from patients and their families. Methods: We conducted a multicentre, cross-sectional survey involving patients with advanced, life-limiting illnesses and their family caregivers. We administered the Canadian Health Care Evaluation Project (CANHELP) questionnaire along
Advance Care Planning, Palliative Care, and End-of-life Care Interventions for Racial and Ethnic Underrepresented Groups: A Systematic Review.: Context: Persons from underrepresented racial and ethnic groups experience disparities in access to and quality of palliative and end-of-life care. Objectives: To summarize and evaluate existing palliative and end-of-life care interventions that aim to improve outcomes for racial and ethnic underrepresented populations in the United States. Methods: We conducted a systematic review of the literature in the English language from four databases through January 2020. Peer-reviewed studies that impl
Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.: Importance: Previous studies report associations between medical utilization at the end-of-life (EoL) and religious coping and spiritual support from the medical team. However, the influence of clergy and religious communities on EoL outcomes is unclear. Objective: To determine whether spiritual support from religious communities influences terminally ill patients' medical care and quality of life (QoL) near death. Design, setting, and participants: A US-based, multisite cohort study of 343 pati
Death anxiety interventions in patients with advanced cancer: A systematic review.: Background: Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice. Aim: To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety. Data sources: MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existe
Perinatal bereavement care during COVID-19 in Australian maternity settings.
Objectives: Perinatal bereavement care is a complex area of practice. The COVID-19 pandemic led to reconfiguration of maternity and perinatal bereavement care services. This study explores Australian health care providers' perspectives of the impact of COVID-19 on the provision of respectful and supportive care following stillbirth or neonatal death. Methods: Members of a perinatal bereavement care network were consulted at the commencement of the pandemic in Australia using an online feedback form. Respondents provided ratings and free-text comments on the impact of COVID-19 on implementation of 49 recommendations contained in the Perinatal Society of Australia and New Zealand/Stillbirth Centre of Research Clinical Practice Guideline for Respectful and Supportive Perinatal Bereavement Care. Results: Responses were received from 35 health care providers who provided perinatal bereavement…
matched on Hospice Care (mesh)
The experiences of palliative care professionals and their responses to work-related stress: A qualitative study.
Objectives: Previous qualitative research has demonstrated that palliative care professionals (PCPs) deal with a wide array of emotionally challenging issues associated with the care they provide. Although previous research has identified self-care strategies PCPs engage in, there is a lack of focus on what responses are helpful and/or unhelpful. The aim of the current study is to understand and describe the experiences of PCPs and to explore the helpful and unhelpful responses to work-related stress they employ. Design: This was a qualitative study of the experiences of working PCPs in a hospice setting. Methods: Nine semi-structured interviews were conducted and subsequently analysed using the framework method. Results: The current study revealed five overarching themes: (1) Sources of Meaning and Purpose (making a difference, personal growth), (2) Sources of Stress (emotional challeng…
matched on Palliative Care (mesh)
Exploring dementia care competence of nurses working in acute care settings.
Aims and objectives: To examine the current status of dementia care competence of nurses working in acute care settings as well as the relationship between competence and demographic attributes. Background: Most people with dementia are older individuals when they are admitted to unfamiliar acute care settings for treatment, and they are prone to displaying BPSD. If nurses working in acute care settings are not sufficiently competent in dementia care, providing proper patient care is difficult. Design: The study used a one-sample descriptive-correlation design. Methods: This study enrolled nurses at two medical centres in southern Taiwan as the research participants and performed a stratified random sampling according to the units where they served. The Dementia Care Competence Scale was used for data collection. An independent samples t test, ANOVA and Pearson's product-moment correlati…
matched on Palliative Care (mesh)
Management of Cancer and Health After the Clinic Visit: A Call to Action for Self-Management in Cancer Care.
Individuals with cancer and their families assume responsibility for management of cancer as an acute and chronic disease. Yet, cancer lags other chronic diseases in its provision of proactive self-management support in routine, everyday care leaving this population vulnerable to worse health status, long-term disability, and poorer survival. Enabling cancer patients to manage the medical and emotional consequences and lifestyle and work changes due to cancer and treatment is essential to optimizing health and recovery across the continuum of cancer. In this paper, the Global Partners on Self-Management in Cancer puts forth six priority areas for action: Action 1: Prepare patients and survivors for active involvement in care; Action 2: Shift the care culture to support patients as partners in cocreating health and embed self-management support in everyday health-care provider practices a…
matched on Palliative Care (mesh)
Psychoneuroimmunology and oncology nursing: a theoretical study.
Objective: To discuss the evolution of research in cancer psychoneuroimmunology, the advances in the management of neuropsychological symptom clusters and their interface with mid-range theories, and practical applications in Nursing. Method: This is a theoretical-reflective study anchored in recent literature, as well as in the critical analysis of the authors. Results: This is a promising field of investigation, which emphasizes the complexity and interaction of symptoms, the interrelationships among them, the factors influencing them, and their consequences. Subsidized by mid-range theories in Nursing, such as the Theory of Unpleasant Symptoms and the Theory of Symptom Management, analyses of these interrelationships support Oncology Nursing diagnoses and interventions. Conclusion: An innovative approach is proposed to qualify Oncology Nursing care based on the integration of recent a…
matched on Palliative Care (mesh)
Enhancing Connections-Palliative Care: A Quasi-Experimental Pilot Feasibility Study of a Cancer Parenting Program.
Background: In 2018, >75,000 children were newly affected by the diagnosis of advanced cancer in a parent. Unfortunately, few programs exist to help parents and their children manage the impact of advanced disease together as a family. The Enhancing Connections-Palliative Care (EC-PC) parenting program was developed in response to this gap. Objective: (1) Assess the feasibility of the EC-PC parenting program (recruitment, enrollment, and retention); (2) test the short-term impact of the program on changes in parent and child outcomes; and (3) explore the relationship between parents' physical and psychological symptoms with program outcomes. Design: Quasi-experimental two-group design employing both within- and between-subjects analyses to examine change over time and change relative to historical controls. Parents participated in five telephone-delivered and fully manualized behavioral …
matched on Palliative Care (mesh)
Delivering Challenging News: An Illness-Trajectory Communication Curriculum for Multispecialty Oncology Residents and Fellows.
Introduction: Published curricula to teach communication skills for postgraduate fellows in oncology are few in number despite the fact that oncologists conduct many difficult discussions with their patients and their families. Such discussions may include disclosing initial diagnosis or relapse of a patient's cancer or relaying a poor prognosis or change to palliative care. Methods: An eight-module course on communication in oncology practice was delivered over 2 months for palliative and oncology fellows and radiation oncology residents. Learners were given a precourse survey in which they were asked to rate their proficiency in various communication tasks. Each learner then participated in a videotaped precourse objective structured clinical exam (OSCE) on breaking bad news with standardized patients (SPs). The course took place over 8 weeks with weekly didactics and role-play. At the…
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The Relational Potential Standard: Rethinking the Ethical Justification for Life-Sustaining Treatment for Children with Profound Cognitive Disabilities.
In this era of rapidly advancing biomedical technologies, it is not unusual for parents of children with profound cognitive disabilities to ask clinicians to provide invasive life-sustaining treatments. Parental requests for such interventions pose a moral dilemma to the treating medical team, as there may be a discrepancy between the team's perception of the child's best interest and the apparent rationale underlying a parent's request. This gap highlights the limitation of the best interest standard in cases where, due to a neurodevelopmental disorder or brain injury, the child's capabilities are severely limited and their interests may be difficult to discern. The harm principle is also inadequate for decision-making in response to these parental requests. To address these limitations, and inspired in part by John Arras's work on the relational potential standard, we propose an integr…
matched on Terminal Care (mesh)
Mindfulness-Based stress reduction in early palliative care for people with metastatic cancer: A mixed-method study.
Objectives: To explore the impact of a Mindfulness-Based Stress Reduction (MBSR) intervention for people with metastatic cancer integrated in Early Palliative Care (EPC). Design: Mixed-method study. Settings/location: EPC Service integrated with Oncology Unit, Carpi General Hospital, Italy from January to October 2017. The MBSR intervention took place inside the hospital. Subjects: Study participation was offered to 25 consecutive people referred to the EPC service. Inclusion criteria: people with metastatic cancer between 18 and 75 years old; informed consent. Exclusion criteria: Performance Status <60% according to Karnofsky scale; active psychiatric disorder. 20 patients were included in the study. Intervention: The adapted program consists of 8 meetings for 2.5 h once a week, a 4.5 h session between the 6th and 7th weeks and 0.5 h home practice daily. The following mindfulness practi…
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Care quality following intrauterine death in Spanish hospitals: results from an online survey.
Background: The objective of the study was to evaluate practices in Spanish hospitals after intrauterine death in terms of medical/ technical care and bereavement support care. Methods: A cross-sectional descriptive study using an online self-completion questionnaire. The population was defined as women who had experienced an intrauterine fetal death between sixteen weeks and birth, either through spontaneous late miscarriage/stillbirth or termination of pregnancy for medical reasons. Respondents were recruited through an online advertisement on a stillbirth charity website and social media. The analysis used Pearson's chi-squared (p ≤ 0.05) test of independence to cross-analyse for associations between objective measures of care quality and independent variables. Results: Responses from 796 women were analysed. Half of the women (52.9%) had postmortem contact with their baby. 30.4% left…
matched on Hospice Care (mesh)
Adapting Meaning-Centered Psychotherapy in Advanced Cancer for the Chinese Immigrant Population.
The Chinese immigrant community faces multiple barriers to quality cancer care and cancer survivorship. Meaning-centered psychotherapy (MCP) is an empirically-based treatment shown to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in advanced cancer patients. However, it has not yet been adapted for racial and ethnic minority populations for whom the concept of "meaning" may likely differ from that of westernized White populations. In this study, we conducted a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer, in accordance with Bernal et al. ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. We conducted interviews until saturation with 11 key Chinese-serving community leaders and health professiona…
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Mindful Self-Care and Secondary Traumatic Stress Mediate a Relationship Between Compassion Satisfaction and Burnout Risk Among Hospice Care Professionals.
Background: Effective self-care in hospice is anecdotally proclaimed to reduce burnout risk. Yet, the topic has received little empirical attention. Purpose: This study developed a model for predicting burnout risk from compassion satisfaction (CS), secondary traumatic stress (STS), and mindful self-care. Participants: Hospice care professionals (n = 324). Design: Cross-sectional self-report survey. Results: Mindful self-care was correlated with CS ( r = 0.497, p < .01), Burnout ( r = -0.726, p < .01), and STS ( r = -0.276, p < .01). A multiple regression model indicated that the combined effect of CS, STS, and mindful self-care explained 73.7% of the variance in Burnout. Mindful self-care and STS mediated a relationship between CS and Burnout. Each self-care category was statistically significant protective factors against burnout risk ( p < .01). Associations with Burnout in order of s…
matched on Hospice Care (mesh)
Identifying the Population with Serious Illness: The "Denominator" Challenge.
Background: To ensure seriously ill people and their families receive high-quality primary and specialty palliative care services, rigorous methods are needed to prospectively identify this population. Objective: To define and operationalize a definition of serious illness for the purpose of identifying patients and caregivers who need primary or specialty palliative care services. Design/setting: Two stages of work included (1) building expert consensus around a conceptual definition of serious illness and (2) using the National Health and Aging Trends Study linked to Medicare claims data to test a range of operational definitions composed of diagnoses, utilization, and markers of care needs. Measurements: One-year outcomes included mean total Medicare costs, mortality, and percent hospitalized, as well as those reporting ≥2 measures of need and functional impairment. Sensitivity, speci…
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PARENTS 2 study protocol: pilot of Parents' Active Role and ENgagement in the review of Their Stillbirth/perinatal death.
Background: The perinatal mortality review meeting that takes place within the hospital following a stillbirth or neonatal death enables clinicians to learn vital lessons to improve care for women and their families for the future. Recent evidence suggests that parents are unaware that a formal review following the death of their baby takes place. Many would welcome the opportunity to feedback into the meeting itself. Parental involvement in the perinatal mortality review meeting has the potential to improve patient satisfaction, drive improvements in patient safety and promote an open culture within healthcare. Yet evidence on the feasibility of involving bereaved parents in the review process is lacking. This paper describes the protocol for the Parents' Active Role and Engangement iN the review of their Stillbirth/perinatal death study (PARENTS 2) , whereby healthcare professionals' a…
matched on Hospice Care (mesh)
The relationship between physical and psychological symptoms and health care utilization in hospitalized patients with advanced cancer.
Background: Patients with advanced cancer often experience frequent and prolonged hospitalizations; however, the factors associated with greater health care utilization have not been described. We sought to investigate the relation between patients' physical and psychological symptom burden and health care utilization. Methods: We enrolled patients with advanced cancer and unplanned hospitalizations from September 2014-May 2016. Upon admission, we assessed physical (Edmonton Symptom Assessment System [ESAS]) and psychological symptoms (Patient Health Questionnaire 4 [PHQ-4]). We examined the relationship between symptom burden and healthcare utilization using linear regression for hospital length of stay (LOS) and Cox regression for time to first unplanned readmission within 90 days. We adjusted all models for age, sex, marital status, comorbidity, education, time since advanced cancer d…
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Meaningful Communication Before Death, but Not Present at the Time of Death Itself, Is Associated With Better Outcomes on Measures of Depression and Complicated Grief Among Bereaved Family Members of Cancer Patients.
Context: Few studies have explored the clinical significance of the family's presence or absence at the moment of a patient's death and meaningful communication (saying "goodbye") in terms of post-bereavement outcomes. Objectives: To explore the potential association between the family's depression/complicated grief and their presence at the moment of a patient's death and the patient's communication with the family. Methods: A nationwide questionnaire survey was conducted on 965 family members of cancer patients who had died at palliative care units. Results: More than 90% of family members wished to have been present at the moment of death (agree: 40%, n = 217; strongly agree: 51%, n = 280); 79% (n = 393) thereof were present. Families' presence at death was not significantly associated with the occurrence of depression and complicated grief, but the dying patient's ability to say "goo…
matched on Palliative Care (mesh)
Portuguese validation of the Prolonged Grief Disorder Questionnaire-Predeath (PG-12): Psychometric properties and correlates.
Objective: This study aimed to contribute to the validation of the Portuguese version of the Prolonged Grief Disorder Questionnaire-Predeath (PG-12), examining its psychometric properties, including factorial, discriminant, and predictive validity. The prevalence of predeath prolonged grief disorder (PGD) and its psychosocial correlates were also analyzed. Method: The PG-12 was assessed in a sample of family caregivers (FCs) of oncological patients in palliative care. The factorial and discriminant validity of the PG-12 were evaluated by confirmatory factor analysis. The prevalence of predeath PGD was calculated and correlated with sociodemographic characteristics, perception of illness, intensity of care, coping, and caregiver burden. Prospective data were used to assess predictive validity. Results: The sample was composed of 94 FCs, mostly female (78.8%) and daughters (61.3%), with a …
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State of the Science of Spirituality and Palliative Care Research Part II: Screening, Assessment, and Interventions.
The State of the Science in Spirituality and Palliative Care was convened to address the current landscape of research at the intersection of spirituality and palliative care and to identify critical next steps to advance this field of inquiry. Part II of the SOS-SPC report addresses the state of extant research and identifies critical research priorities pertaining to the following questions: 1) How do we assess spirituality? 2) How do we intervene on spirituality in palliative care? And 3) How do we train health professionals to address spirituality in palliative care? Findings from this report point to the need for screening and assessment tools that are rigorously developed, clinically relevant, and adapted to a diversity of clinical and cultural settings. Chaplaincy research is needed to form professional spiritual care provision in a variety of settings, and outcomes assessed to as…
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Distress, delay of gratification and preference for palliative care in men with prostate cancer.
Background: Patient-centered cancer care standards include routine psychosocial distress screening and referral for supportive care services. Although many cancer patients report psychosocial distress that could be alleviated by supportive services including palliative care, patients often decline such services for reasons that are poorly understood. Research on decision-making suggests that during periods of acute distress, individuals have more difficulty prioritizing long-term over immediate gains. Thus, distressed cancer patients may prioritize immediate gains (e.g., avoidance of palliative care discussions in the moment) over longer-term gains (e.g., improved quality of life in the future). Method: This study investigated the associations between psychosocial distress, difficulties with delay of gratification (tendency to prioritize short-term over longer-term gains), and preference…
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Patients' understanding of treatment goals and disease course and their relationship with optimism, hope, and quality of life: a preliminary study among advanced breast cancer outpatients before receiving palliative treatment.
Purpose: The aims of this study were to explore advanced breast cancer patients' knowledge of treatment intent and expectation of illness course and to evaluate their relationship with optimism, hope, and quality of life (QoL). Methods: Patients with advanced breast cancer (n = 55) who were treated in the ambulatory clinic of the University of Hacettepe were included in the study. They completed Life Orientation Scale, The Hope Scale, and the European Organization for Research and Treatment of Cancer Quality of Life questionnaires. The data regarding the knowledge of illness progression and the perceptions of therapy intent were assessed using self-administered open-ended questionnaires that were answered by the patients. Results: The data revealed that 58.2 % of the patients had an inaccurate perception of treatment intent, believing the aim of treatment was cure, whereas only 38.2 % of…
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Building Resiliency in a Palliative Care Team: A Pilot Study.
Context: Palliative care clinicians (PCCs) are vulnerable to burnout as a result of chronic stress related to working with seriously ill patients. Burnout can lead to absenteeism, ineffective communication, medical errors, and job turnover. Interventions that promote better coping with stress are needed in this population. Objectives: This pilot study tested the feasibility of the Relaxation Response Resiliency Program for Palliative Care Clinicians, a program targeted to decrease stress and increase resiliency, in a multidisciplinary cohort of PCCs (N = 16) at a major academic medical center. Methods: A physician delivered the intervention over two months in five sessions (12 hours total). Data were collected the week before the program start and two months after completion. The main outcome was feasibility of the program. Changes in perceived stress, positive and negative affect, persp…
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A review of patients with advanced cervical cancer presenting to palliative care services at Queen Elizabeth Central Hospital in Blantyre, Malawi.
Background: Cervical cancer is the commonest cancer affecting women in Malawi, which has the highest rate of this disease in the world. Most cases are diagnosed at an advanced stage. Aim: To describe the symptom burden, palliative care interventions, and outcomes of cervical cancer patients who entered care at Tiyanjane Clinic in Blantyre, Malawi, between January and December 2012. Methods: We reviewed the case files of 72 patients presenting to our hospital-based palliative care service over one year. Results: The mean age was 49.5 years. Twenty-six patients (36%) were HIV-positive and the majority of these (n = 22; 85%) were on antiretroviral medication at presentation to palliative care. Pain (n = 66; 92%), vaginal discharge (n = 44; 61%), and unpleasant odour (n = 37; 51%) were commonly reported. Over a third of patients (n = 26; 36%) reported pain in two or more sites. Fourteen pati…
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Anxiety and fear of cancer recurrence and its association with supportive care needs and health-care service utilization in cancer patients.
Purpose and methods: We investigated the relationship between fear of cancer recurrence (FCR), anxiety, supportive care needs, and utilization of health-care services in a mixed sample of 335 cancer patients. We used validated questionnaires including the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the General Anxiety Disorder Scale (GAD-7) and the Supportive Care Needs Survey (SCNS-SF34). Health-care services utilization was measured by a self-constructed questionnaire recording the use of 22 health and supportive care offers. Results: In our sample, 3.9% of patients were classified as having high anxiety and 5.1% had high FCR. Patients reported the highest unmet supportive care needs in the domain health system and information followed by psychological needs. Integrated care and complementary support services were the most frequently used (32%) followed by medical (31%), p…
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Coping with physical and psychological symptoms: a qualitative study of advanced lung cancer patients and their family caregivers.
Purpose: Advanced lung cancer patients have high rates of multiple physical and psychological symptoms, and many of their family caregivers experience significant distress. However, little is known about strategies that these patients and their family caregivers employ to cope with physical and psychological symptoms. This study aimed to identify strategies for coping with various physical and psychological symptoms among advanced, symptomatic lung cancer patients and their primary family caregivers. Methods: Patients identified their primary family caregiver. Individual semi-structured qualitative interviews were conducted with 21 advanced, symptomatic lung cancer patients and primary family caregivers. Thematic analysis of interview data was framed by stress and coping theory. Results: Patients and caregivers reported maintaining a normal routine and turning to family and friends for s…
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Impact of a pediatric quality of life program on providers' moral distress.
Purpose: To evaluate the impact of the introduction of a new pediatric palliative care program on the pattern of moral distress in pediatric healthcare providers (HCPs). Study design and methods: We used a before and after cross-sectional survey design to study the impact of the Pediatric Quality of Life (QoL) Program on the moral distress of pediatric HCPs at a single center. Moral distress is measured in both intensity and frequency. The sample came from lists of all pediatric providers (nurses, physicians, social workers, therapists, dieticians, chaplains, administrators) serving the inpatient and outpatient pediatric areas of a southeastern academic tertiary medical center. Results: The intensity of moral distress from situations focused on "individual responsibility" and "not in the best interest of the patient" were similar before and after program implementation, but the intensity…
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