 Subjects -> OCCUPATIONS AND CAREERS (Total: 33 journals)
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- PAX volume 18 issue 6 Cover and Front matter
- PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001467
Issue No: Vol. 18, No. 6 (2020)
- Trust in the age of COVID-19
- Authors: William Breitbart
Pages: 634 - 635
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001364
Issue No: Vol. 18, No. 6 (2020)
- Adapting meaning-centered psychotherapy for World Trade Center responders
- Authors: Melissa Masterson-Duva; Peter Haugen, Aditi Werth, Alyce Foster, Emily Chassman, Kailey Roberts, Jonathan DePierro, Massielle Morales-Miller, Sandra Lowe, Hayley Pessin, Wendy Lichtenthal, William Breitbart
Pages: 636 - 643
Abstract: ObjectiveTo date, nearly 10,000 World Trade Center (WTC) responders have been diagnosed with at least one type of WTC-related cancer, and over 70 types of cancer have been related to WTC occupational exposure. Due to the observed latency period for malignancies, the WTC Health Program anticipates increases in rates of new cancer diagnoses. Given the growing number of cancer diagnoses in this population, there is an urgent need to develop a novel intervention to address the psychosocial needs of WTC responders with cancer. Meaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention originally developed to help patients with advanced cancer find and sustain meaning in life despite illness-related limitations. Existential distress and loss of meaning are critical and understudied elements of psychological health that have been widely overlooked among WTC responders with cancer.MethodWe have adapted MCP for WTC responders (MCP-WTC) for the treatment of WTC responders who have been diagnosed with WTC-certified cancers. MCP-WTC aims to target the complex crisis in meaning faced by those responders who responded to the 9/11 attacks and subsequently were diagnosed with cancer as a result of their service.ResultsWe describe the adaptation of MCP-WTC and the application of this intervention to meet the unique needs of those exposed to the terrorist attacks of September 11, 2001 (9/11), participated in the rescue, recovery, and clean-up effort at Ground Zero, and were diagnosed with WTC-related cancer. We highlight the novel aspects of this intervention which have been designed to facilitate meaning-making in the context of the patient's response to 9/11 and subsequent diagnosis of cancer.Significance of resultsThis work provides a rationale for MCP-WTC and the potential for this intervention to improve the quality of life of WTC responders and help these patients navigate life after 9/11 and cancer.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000061
Issue No: Vol. 18, No. 6 (2020)
- Feasibility and acceptability of cognitive behavioral therapy for insomnia
(CBT-I) or acupuncture for insomnia and related distress among cancer
caregivers- Authors: Allison J. Applebaum; Kara Buda, Michael A. Hoyt, Kelly Shaffer, Sheila Garland, Jun J. Mao
Pages: 644 - 647
Abstract: ObjectiveInsomnia is a common, distressing, and impairing psychological outcome experienced by informal caregivers (ICs) of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) and acupuncture both have known benefits for patients with cancer, but such benefits have yet to be evaluated among ICs. The purpose of the present study was to evaluate the feasibility, acceptability and preliminary effects of CBT-I and acupuncture among ICs with moderate or greater levels of insomnia.MethodParticipants were randomized to eight sessions of CBT-I or ten sessions of acupuncture.ResultsResults highlighted challenges of identifying interested and eligible ICs and the impact of perception of intervention on retention and likely ultimately outcome.Significance of the resultsFindings suggest preliminary support for non-pharmacological interventions to treat insomnia in ICs and emphasize the importance of matching treatment modality to the preferences and needs of ICs.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001017
Issue No: Vol. 18, No. 6 (2020)
- Current measures of distress may not account for what's most important in
existential care interventions: Results of the outlook trial- Authors: Karen E. Steinhauser; Karen M. Stechuchak, Katherine Ramos, Joseph Winger, James A. Tulsky, Maren K. Olsen
Pages: 648 - 657
Abstract: ObjectiveCompare the efficacy of two interventions addressing emotional and existential well-being in early life-limiting illness.MethodPrimary trial analysis (n = 135) included patients with advanced cancer, congestive heart failure, or end-stage renal disease; Arm 1 received the Outlook intervention, addressing issues of life completion and preparation, and Arm 2 received relaxation meditation (RM). Primary outcomes at five weeks (primary endpoint) and seven weeks (secondary): completion and preparation (QUAL-E); secondary outcomes: anxiety (POMS) quality of life (FACT-G) and spiritual well-being (FACIT-Sp) subscales of faith, meaning, and peace.ResultsAverage age was 62; 56% were post-high school-educated, 54% were married, 52% white, 44% female, and 70% had a cancer diagnosis. At baseline, participants demonstrated low levels of anxiety (
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001170
Issue No: Vol. 18, No. 6 (2020)
- Portuguese Patient Dignity Question: A cross-sectional study of palliative
patients cared for in primary care- Authors: Mafalda Lemos Caldas; Miguel Julião, Ana João Santos, Harvey Max Chochinov
Pages: 658 - 661
Abstract: IntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000164
Issue No: Vol. 18, No. 6 (2020)
- Social work in hospice and palliative care in Europe: Findings from an
EAPC survey- Authors: Karl W. Bitschnau; Pam Firth, Maria Wasner
Pages: 662 - 669
Abstract: ObjectivesSocial work is considered to be a key player in Hospice and Palliative Care. To prove this claim, the Social Worker Task Force within the European Association for Palliative Care (EAPC) decided to carry out a survey. The aim of this survey was to generate basic data and thus to create a basis for further development of Palliative Care Social Work (PCSW) in Europe.MethodThe online survey consisted of two parts: in Part 1, the 57 collective members of the EAPC were asked to fill in an online questionnaire containing questions about basic data. In Part 2, individual Palliative Care Social Workers (SWs) from all over Europe were asked to fill in another questionnaire with a focus on the basic conditions concerning their jobs as well, as on their tasks and roles.ResultsThirty-two collective members of the EAPC completed the online questionnaire. SWs can be found in all of the Palliative Care settings, but there are considerable differences between the countries concerning the prevalence of SWs. Only five countries (20%) reported specialized qualification training in PCSW and just around half of the responding SWs had such a specialized training. The responding SWs (n = 360) were quite content with their working conditions. Tasks concerning patient and family and tasks concerning the interprofessional team were most prominent. There is a significant role overlap with other professions.Significance of resultsThe study reveals a very mixed picture of PCSW in Europe. This could be due to the high adaptability of social work, which is to be as flexible as possible to the needs of its clients. However, significant patterns, similarities, and differences emerge. The present study may, therefore, serve as a basis for further in-depth studies.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000279
Issue No: Vol. 18, No. 6 (2020)
- “Everybody in this community is at risk of dying”: An ethnographic
exploration on the potential of integrating a palliative approach to care
among workers in inner-city settings- Authors: Kelli I. Stajduhar; Melissa Giesbrecht, Ashley Mollison, Margo d'Archangelo
Pages: 670 - 675
Abstract: ObjectiveAt the end of life, the need for care increases. Yet, for structurally vulnerable populations (i.e., people experiencing homelessness and poverty, racism, criminalization of illicit drug use, stigma associated with mental health), access to care remains highly inaccessible. Emerging research suggests that enhancing access to palliative care for these populations requires moving care from traditional settings, such as the hospital, into community settings, like shelters and onto the street. Thus, inner-city workers (ICWs) (e.g., housing support and community outreach) have the potential to play pivotal roles in improving access to care by integrating a “palliative approach to care” in their work.MethodDrawing upon observational field notes and interview data collected for a larger critical ethnographic study, this secondary thematic analysis examines ICWs’ (n = 31) experiences providing care for dying clients and garners their perspectives regarding the constraints and facilitators that exist in successfully integrating a palliative approach to care in their work.ResultsFindings reveal three themes: (1) Approaches, awareness, and training; (2) Workplace policies and filling in the gaps; and (3) Grief, bereavement, and access to supports. In brief, ICWs who draw upon harm reduction strategies strongly parallel palliative approaches to care, although more knowledge/training on palliative approaches was desired. In their continuous work with structurally vulnerable clients, ICWs have the opportunity to build trusting relationships, and over time, are able to identify those in need and assist in providing palliative support. However, despite death and dying is an everyday reality of ICWs, many described a lack of formal acknowledgement by employers and workplace support as limitations.Significance of resultsFindings contribute promising practices for enhancing equitable access to palliative care for society's most vulnerable populations by prioritizing front-line workers’ perspectives on how best to integrate a palliative approach to care where structurally vulnerable populations live and die.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000280
Issue No: Vol. 18, No. 6 (2020)
- Emotional and cognitive barriers of bereavement care among clinical staff
in hospice palliative care- Authors: Wei-Chun Lin; Sheng-Yu Fan
Pages: 676 - 682
Abstract: ObjectiveBereavement care is one of the major components of hospice palliative care. Previous studies revealed the barriers to the success of the system, including lack of time or support from mental health professionals. Few studies have explored the intrapersonal barriers to bereavement care by clinical staff. The aims of the study were to explore (1) the emotional and cognitive barriers of bereavement care by hospice palliative care staff and (2) the demographic and work characteristics related to these emotional and cognitive barriers.MethodThe participants were clinical staff (n = 301) who were working in hospice palliative care units, including hospice wards, home care, and hospital-based palliative care teams. Their professional backgrounds included physicians (n = 12), nurses (n = 172), social workers (n = 59), psychologists (n = 34), spiritual care specialists (n = 15), and others (n = 9). A cross-sectional design was used and a standardized questionnaire including emotional and cognitive barriers was developed. Information on demographic and work characteristics was also collected. Content validity index, an exploratory factor analysis, and multiple regression analysis were conducted.ResultsOne emotional barrier, “negative emotional reactions” (13 items, Cronbach's α = 0.92), and three cognitive barriers, “lack of ability” (7 items, Cronbach's α = 0.85), “belief in avoidance” (5 items, Cronbach's α = 0.86), and “outcome expectancy” (4 items, Cronbach's α = 0.85) were identified. Clinical staff who had higher working stress, lower self-rated ability for bereavement care, and higher negative impact from major life loss tended to have higher emotional and cognitive barriers.Significance of resultsClinical staff should be aware of intrapersonal barriers to bereavement care. Educational programs should be developed to improve the ability to engage in bereavement care.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S147895152000022X
Issue No: Vol. 18, No. 6 (2020)
- The relationship between caregivers’ perceptions of end-of-life care in
long-term care and a good resident death- Authors: Eunyoung Lee; Tamara Sussman, Sharon Kaasalainen, Pamela Durepos, Lynn McCleary, Abigail Wickson-Griffiths, Rennie Bimman
Pages: 683 - 690
Abstract: ObjectiveQuality end-of-life (EOL) care is critical for dying residents and their family/friend caregivers. While best practices to support resident comfort at EOL in long-term care (LTC) homes are emerging, research rarely explores if and how the type of care received at EOL may contribute to caregivers’ perceptions of a good death. To address this gap, this study explored how care practices at EOL contributed to caregivers’ perceptions of a good resident death.MethodThis study used a retrospective cross-sectional survey design. Seventy-eight participants whose relative or friend died in one of five LTC homes in Canada completed self-administered questionnaires on their perceptions of EOL care and perceptions of a good resident death.ResultsOverall, caregivers reported positive experiences with EOL care and perceived residents to have died a good death. However, communication regarding what to expect in the final days of life and attention to spiritual issues were often missing components of care. Further, when explored alongside direct resident care, family support, and rooming conditions, staff communication was the only aspect of EOL care significantly associated with caregivers’ perceptions of a good resident death.Significance of resultsThe findings of this study suggest that the critical role staff in LTC play in supporting caregivers’ perceptions of a good resident death. By keeping caregivers informed about expectations at the very end of life, staff can enhance caregivers’ perceptions of a good resident death. Further, by addressing spiritual issues staff may improve caregivers’ perceptions that residents were at peace when they died.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000292
Issue No: Vol. 18, No. 6 (2020)
- “I want to go home”: How location at death influences caregiver
well-being in bereavement- Authors: Deborah P. Waldrop; Jacqueline M. McGinley
Pages: 691 - 698
Abstract: ObjectivesGoal concordant or congruent care involves having expressed wishes upheld. Yet, the preferred location for end-of-life care may be unaddressed. Caregiver–patient congruence between preferred and actual locations of care may influence the quality of life in bereavement. The study aimed to explore how the congruence between caregiver–patient preferred and actual locations of death influenced well-being in bereavement.MethodsMixed methods were employed. In-depth in-person interviews were conducted with 108 bereaved caregivers of a hospice patient about 4 months after the death. An interview guide was used to collect quantitative and qualitative data: demographics, decision-making, Core Bereavement Items (CBI), Health Related Quality of Life, and perspectives on the end-of-life experiences. Data were analyzed with a convergent mixed methods one-phase process.ResultsPatient preference–actual location congruence occurred for 53%; caregiver preference–actual location congruence occurred for 74%; caregiver–patient preference and location of death occurred for 48%. Participants who reported some type of incongruence demonstrated higher levels of distress, including more days of being physically and emotionally unwell and more intense bereavement symptoms. The Acute Separation subscale and CBI total scores demonstrated significant differences for participants who experienced incongruence compared with those who did not. Preference location congruence themes emerged: (1) caregiver–patient location congruence, (2) caregiver–patient location incongruence, and (3) location informed bereavement.ConclusionsCongruence between a dying person's preferred and actual locations at death has been considered good care. There has been little focus on the reciprocity between caregiver–patient wishes. Discussing preferences about the place of end-stage care may not make location congruence possible, but it can foster shared understanding and support for caregivers’ sense of coherence and well-being in bereavement.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000176
Issue No: Vol. 18, No. 6 (2020)
- Psychometric properties of the Korean version of the positive aspects of
caregiving scale for family caregivers of people with amyotrophic lateral
sclerosis- Authors: Hyeon Sik Chu; Young Ran Tak
Pages: 699 - 706
Abstract: ObjectiveMany caregivers report finding positive meanings in their caregiving roles and activities. The positive aspects of caregiving (PAC) scale was designed to measure positive appraisals of caregiving. This study assessed the reliability and validity of the Korean version of the PAC for family caregivers of people with amyotrophic lateral sclerosis (ALS).MethodThe instrument's content and semantic equivalence were established using translation and back translation of the PAC. A convenience sample of 127 family caregivers of patients with ALS in Korea was recruited. Content, construct, and convergent validity of the Korean PAC were evaluated. Cronbach's α was used to assess reliability. This study used secondary data; the primary study received approval from the Institutional Review Board of H Hospital, from where data were collected. The consent forms did not mention the future use of data. Therefore, we have applied for approval regarding this study's protocol and exemption from informed consent.ResultsThe Cronbach's α was 0.92, and internal consistency was acceptable. Exploratory factor analysis supported the construct validity with a two-factor solution explaining 74.73% of the total variance. Regarding convergent validity, the Korean PAC score negatively correlated with caregiver burden and depression and positively with self-rated health status. We were unable to evaluate the suitability of the suggested structural dimensionality through confirmatory factor analysis. Furthermore, as we used secondary data, we could not assess retest reliability for the evaluation of the scale's stability.Significance of resultsThe Korean PAC was found to be an applicable instrument with satisfactory reliability and validity and suitable for further use as a measure for positive appraisals of caregiving for family caregivers of people with ALS. It may be effective for measuring caregivers’ psychological resources.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000371
Issue No: Vol. 18, No. 6 (2020)
- Validity and reliability of the Turkish version of the Nurse Spiritual
Care Therapeutics Scale- Authors: Hakime Aslan; Ümmühan Aktürk, Behice Erci
Pages: 707 - 712
Abstract: ObjectiveThis study was conducted to evaluate the validity and reliability of the “Nurse Spiritual Care Therapeutics Scale” in Turkish nurses.MethodThis study was a psychometric design. A convenience sample of 249 nurses working at the Malatya Training Research Hospital completed a structured questionnaire including demographic characteristics and the Nurse Spiritual Care Therapeutics Scale (NSCTS) between August and October 2018. Principal components analysis, internal consistency reliability, and Cronbach's α were used to measure the psychometric properties of the items of the scale.ResultsIn the evaluation of construct validity, identified one factor with eigenvalues greater than 1 explained 50.83% of the total variance. The Cronbach's α value of the scale is 0.86.Significance of resultsThe present study provides evidence of NSCTS's validity, reliability, and acceptability. The scale can be used by Turkish nurses. This scale should be further evaluated with a larger sample in different regions in Turkey and various populations. The scale has potential applications for use both in research and as a screening tool in clinical settings.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000267
Issue No: Vol. 18, No. 6 (2020)
- Mapping palliative and end of care research in Australia (2000–2018)
- Authors: H. Khalil; A. Downie, E. Ristevski
Pages: 713 - 721
Abstract: ObjectiveThe objective of this study is to map the existent research undertaken in Australia into broad thematic areas and identify the characteristics of the studies and areas of future research in the literature.MethodsA scoping review methodology was employed to map the current areas of research undertaken in Australia since January 2000 until the end of December 2018 according to years of publications, types of studies, populations studied, research themes, and areas of focus.ResultsOur review identified 1,405 Australian palliative care research publications between January 2000 and December 2018. Nearly 40% of the studies were quantitative (39%) and a third were qualitative studies (31%). The remainder of the studies were reviews, mixed methods, quality improvement projects, and others. One-third (30%) of the research was done with carers' participants followed by nurses (22%) and doctors and physicians (18%). The most frequently reported diagnosis in the studies was cancer with 42% of the publication total. The most frequently explored theme was physical symptoms (such as pain, breathlessness, nausea, delirium, and dyspnea) with a total of 16% of all articles followed by communication (15%). There was a large gap to the next most frequently explored theme with service delivery (9%) and coordination of care (8%). Assessment of patients (7%), end-of-life decision-making (6%), and rural/regional (6%) all produced a similar number of publications. Very few studies addressed topics such as quality of life, E-Health, after-hours care, spirituality, and health economics. Moreover, there were only 15 (1%) studies focused on the last days of life.Significance of the resultsThe current review presented a comprehensive search of the literature across almost two decades in Australia in the palliative care setting. It has covered a breadth of research topics and highlighted urgent areas for further research.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951519001111
Issue No: Vol. 18, No. 6 (2020)
- Dignity-conserving care for persons with palliative care needs —
identifying outcomes studied in research: An integrative review- Authors: Annika Söderman; Ulrika Östlund, Carina Werkander Harstäde, Karin Blomberg
Pages: 722 - 740
Abstract: ObjectivesWith people living longer, palliative care may be required for lengthier periods of time. This puts demands on healthcare organizations to provide optimal palliative care. Maintaining dignity is central for any person's health and quality of life, but especially for a person with palliative care needs. Dignity-conserving care needs to be evaluated to increase knowledge about outcomes and how to assess these. The purpose of this integrative review was to identify outcomes studied within dignity-conserving care and how these have been operationalized.MethodsAn integrative review was conducted in 26 quantitative or mixed-method studies and study protocols. Thematic synthesis with an abductive approach was used for analysis.ResultsSeven themes of studied outcomes were identified, as well as four cluster themes: themes related to Illness-Related Concerns, themes related to the Dignity-Conserving Repertoire, themes related to the Social Dignity Inventory, and themes regarding Overarching Dignity Issues. Most outcomes studied dealt with Illness-Related Concerns within the themes of “Performance, symptoms and emotional concerns” and “End-of-life and existential aspects”. Themes linked to the Social Dignity Inventory had the lowest number of outcomes studied. Outcomes regarding overarching dignity issues such as “Dignity-related distress” and “Quality of life” were common. However, the results lacked concrete communication outcomes.Significance of resultsThe results will underpin future research in which dignity-conserving care is implemented and evaluated, and contribute to the provision of evidence-based palliative care. A greater focus on outcomes within cluster themes related to the Dignity-Conserving Repertoire and the Social Dignity Inventory is needed, as is more focus on communication outcomes.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000139
Issue No: Vol. 18, No. 6 (2020)
- Instruments for pain assessment in patients with advanced dementia: A
systematic review of the evidence for Latin America- Authors: Silvia Mercedes Coca; Roberto Ariel Abeldaño Zuñiga
Pages: 741 - 747
Abstract: ObjectivePain treatment is an essential component of care for elderly patients with advanced dementia. The objective of this study was to identify and analyze the different scales used for pain assessment in elderly persons diagnosed with dementia, in the literature available at the Latin American level.MethodA systematic review was performed on the existing scales for pain assessment in elderly people diagnosed with Alzheimer's disease, vascular dementia, and dementia with Lewy bodies.Results226 articles were retrieved from the PUBMED, BIREME, and Scielo databases, of which a total of 10 articles entered the systematic review. The instruments identified in these publications were PAINAD, Abbey, McGill, and PACSLAC, while the Colored Pain Scale, Faces Pain Scale, and VAS scales were used as the silver standard. In Spanish, the Abbey scale, and in Portuguese, the PACSLAC scale showed the best reliability and validity coefficients.Significance of resultsIt is concluded that there are only two appropriate scales for the assessment of pain in people with dementia in the region of interest of this study. It is recommended to generate more evidence for a more accurate assessment of pain in people with dementia.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S147895151900107X
Issue No: Vol. 18, No. 6 (2020)
- Expression of existential suffering in two patients with advanced cancer
in an acute palliative care unit- Authors: Michael Tang; Nhu-Nhu Nguyen, Eduardo Bruera, Kimberson Tanco, Marvin Delgado-Guay
Pages: 748 - 750
Abstract: BackgroundRecognizing and managing existential suffering remains challenging. We present two cases demonstrating how existential suffering manifests in patients and how to manage it to alleviate suffering.Case descriptionCase 1: A 69-year-old man with renal cell carcinoma receiving end-of-life care expressed fear of lying down “as he may not wake up.” He also expressed concerns of not being a good Christian. Supportive psychotherapy and chaplain support were provided, with anxiolytic medications as needed. He was able to express his fear of dying and concern about his family, and Edmonton Symptom Assessment System scores improved. He died peacefully with family at bedside. Case 2: A 71-year-old woman presented with follicular lymphoma and colonic obstruction requiring nasogastric drain of fecaloid matter. Initially, she felt that focusing on comfort rather than cure symbolized giving up but eventually felt at peace. Physical symptoms were well-controlled but emotionally she became more distressed, repeatedly asking angrily, “Why is it taking so long to die'.” She was supported by her family through Bible readings and prayers, but she was distressed about being a burden to them. An interdisciplinary approach involving expressive supportive counseling, spiritual care, and integrative medicine resulted in limited distress relief. Owing to increasing agitation, the patient and family agreed to titrate chlorpromazine to sedation. Her family was appreciative that she was restful until her death.ConclusionExistential suffering manifests through multiple domains in each patient. A combination of pharmacologic and non-pharmacologic techniques may be needed to relieve end-of-life suffering.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001121
Issue No: Vol. 18, No. 6 (2020)
- Hypercalcemia due to methadone-induced adrenal insufficiency in a case of
oral cancer- Authors: Ankit Sharma; Mahajan Jitendra Subhash, Anuja Pandit, Swati Bhan, Sushma Bhatnagar
Pages: 751 - 753
Abstract: A 31-year-old patient of post-surgical recurrent buccal carcinoma (post-chemo and radiotherapy) on multimodal analgesia with methadone, paracetamol and gabapentin presented to pain clinic with occasional bleeding from tumor area and incidental hypercalcemia. The hypercalcemia was attributed to adrenal insufficiency due to methadone, with no other obvious reasons identified for hypercalcemia or adrenal insufficiency. The patient was managed with the change of opioid, regular aseptic wound dressings and management of hypercalcemia with hydration, calcitonin and steroid therapy. Hypercalcemia in a cancer patient can have multiple other causes like hypercalcemia of malignancy and primary or secondary parathyroid carcinoma. A strong clinical suspicion and appropriate battery of tests may be required to arrive at the diagnosis. Prompt management, including identification and management of the primary pathology along with aggressive hydration with hormonal therapy, may prove to be life-saving.
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001133
Issue No: Vol. 18, No. 6 (2020)
- The Redeemer of Grand Street
- Authors: William Breitbart
Pages: 754 - 756
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001030
Issue No: Vol. 18, No. 6 (2020)
- The need for a universal language during the COVID-19 pandemic: Lessons
learned from the Middle East Cancer Consortium (MECC)- Authors: Michael Silbermann; Ann Berger
Pages: 757 - 758
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520001054
Issue No: Vol. 18, No. 6 (2020)
- The right to live in peace … and to die in peace as well
- Authors: Verónica Rojas; Ariel Pasmiño, Alejandra Palma
Pages: 759 - 759
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S147895152000019X
Issue No: Vol. 18, No. 6 (2020)
- Palliative care for all: An international health education challenge
- Authors: Stephen Mason; Piret Paal, Frank Elsner, Cathy Payne, Julie Ling, Antonio Noguera, Daniela Mosoiu
Pages: 760 - 762
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000188
Issue No: Vol. 18, No. 6 (2020)
- A Nurse's Love
- Authors: Ijeoma Julie Eche
Pages: 763 - 763
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S1478951520000048
Issue No: Vol. 18, No. 6 (2020)
- Adapting meaning-centered psychotherapy for World Trade Center responders
– CORRIGENDUM- Authors: Melissa Masterson-Duva; Peter Haugen, Aditi Werth, Alyce Foster, Emily Chassman, Kailey Roberts, Jonathan DePierro, Massielle Morales-Miller, Sandra Lowe, Hayley Pessin, Wendy Lichtenthal, William Breitbart
Pages: 764 - 764
PubDate: 2020-12-01T00:00:00.000Z
DOI: 10.1017/S147895152000067X
Issue No: Vol. 18, No. 6 (2020)
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Hybrid journal (It can contain Open Access articles)
