The latest medical research on Hospice And Palliative Medicine

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about hospice and palliative medicine gathered by our medical AI research bot.

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The Effect of Death Anxiety on Psychosocial Adjustment in Individual With Chronic Obstructive Pulmonary Disease.

Indian Journal of Palliative Care

This study was carried out in a descriptive manner to determine the effect of death anxiety on psychosocial adjustment in patients with chronic obstructive pulmonary disease (COPD).

The study was carried out on 150 inpatients and outpatients who were being treated at the thoracic diseases department of a state hospital during January 1- April 20, 2016. Personal information form, death anxiety scale (DAS) and psychosocial adjustment to illness scale-self report (PAIS-SR) were used for data acquisition. The data were analysed through IBM Statistical Package for the Social Sciences 22 software.

The DAS score average of the patients was determined as 6.96 ± 3.45, PAIS-SR total score average was determined as 67.54 ± 14.96. A positive and statistically significant relationship was determined between the death anxiety of the patients and their psychosocial adjustments (P < 0.05).

It can be concluded as a result of the study that the death anxieties of COPD patients are at a moderate level, that their psychosocial adjustments to the disease are at a bad level and that their psychosocial adjustments to the illness and to life are disrupted with increasing death anxiety. Psychiatry nurses can contribute to increasing the psychosocial adjustment to the illness of the patient by helping the patient and his/her family in adjusting to the changes in their life styles, preventing non-beneficial adjustments, developing the coping skills of the patient and his/her family and accordingly making the necessary planning.

Herth Hope Index: A Psychometric Evaluation Study within a Sample of Greek Patients with Cancer.

Indian Journal of Palliative Care

This study aims to develop the Greek version of the Herth Hope Index (HHI) and assess its psychometric properties to a palliative care patient sample, using a cross-sectional design.

The HHI was translated into Greek (HHI-Gr) using the 'forward-backward' procedure. It was administered to 130 eligible cancer patients, while for the stability of patients' responses, 40 of these patients completed the HHI-Gr 3 days later. Along with the HHI-Gr, patients also completed the Hospital Anxiety and Depression Scale (HADS) and the Beck Hopelessness Scale (BHS). The HHI-Gr internal consistency reliability (Cronbach's a), stability (intraclass correlation coefficient [ICC]), factor structure (factor analysis) and convergent validity (correlation with the HADS and the BHS questionnaires) were examined using the Eastern Cooperative Oncology Group (ECOG) performance status.

The HHI-Gr yielded a one-factor model and a Cronbach alpha (0.860) with excellent internal consistency reliability and stability ICC (>0.90). Satisfactory convergent validity was supported by the correlation analysis between the HHI-Gr and BHS (r = 0.718, P < 0.001). Overall test-retest reliability was satisfactory with a range between 0.77 and 0.96 (P < 0.001).

These results demonstrate that the HHI-Gr is an instrument with satisfactory psychometric properties and is a valid research tool for the measurement of the levels of hope among Greek oncology patients.

Identifying the Needs Based on the Patients' Performance Status for Palliative Care Team: An Observational Study.

Indian Journal of Palliative Care

The study aim was to determine the association between patient performance status (PS) and the contents of a palliative care team (PCT) intervention. Identifying intervention requirements for differing PS may help to provide appropriate palliative care in under-resourced facilities.

We collected data from medical records of inpatients (n = 496) admitted to PCT services at a centre for palliative care at Kindai University Hospital, Japan, from April 2017 to March 2019. We analysed the content of PCT activities according to each PS using Pearson's Chi-square test.

The following PCT activities were provided in full regardless of PS: Gastrointestinal symptoms, depression, medical staff support, food and nutrition support and oral care. The following PCT responses were associated with PS: Pain, respiratory symptoms, fatigue, insomnia, anxiety, delirium, decision-making support, family support and rehabilitation. PS3 patients tended to receive those PCT interventions associated with PS, except for anxiety and fatigue. PS4 patients received PCT interventions for respiratory symptoms, delirium and family support. Patients with good PS (0-1) tended to receive PCT interventions for anxiety.

This study demonstrated that there were different needs for different PS. The results may allow for efficient interventions even in facilities with limited resources.

The Introduction and Experiences of Methadone for Treatment of Cancer Pain at a Low-resource Governmental Cancer Center in India.

Indian Journal of Palliative Care

This study aimed to describe the clinical experience of the health-care professionals (HCPs) responsible for the introduction of methadone, for the treatment of complex cancer pain, at a low-resource hospital in India in a patient-group, burdened by illiteracy, and low socio-economic status.

Ten HCPs: Four medical doctors, four nurses, one pharmacist, and one hospital administrator were interviewed. The interviews are examined using a qualitative conventional content analysis.

The interviews showed a confidence amongst the HCPs, responsible for the safe introduction of methadone in a stressful and low-resource surrounding, to patients with cancer pain and the different aspects of methadone, as initiation, titration, and maintenance of treatment.

Introduction of methadone for cancer pain management is safe and feasible although low resources in a challenging hospital setting and care environment.

Caring and Conflict-Palliative Care in the Armed Forces: The Challenges for Caregivers.

Indian Journal of Palliative Care

In India, Palliative care remains inaccessible, especially in remote areas. This study aimed at exploring the experience of caregivers related to arranging palliative care at home, for personnel and family members of an armed force.

Qualitative study based on thematic analysis of semi-structured interviews with adult caregivers - either serving personnel or their dependent family members.

Lack of palliative care in rural areas makes arranging home care challenging for Indian caregivers, especially in armed forces. The families stay alone and personnel cannot be there to look after loved ones. Constraints of leave, financial and legal problems, frequent movement and social isolation disrupt care as well as family and community support systems, leading to psycho-social problems and stress for the serving personnel as well as families. Educating staff, integrating palliative care into existing medical services, coordinating with other agencies to increase awareness and provide care at home, access to opioids, timely leave, reimbursement of expenses, increased family accommodation, guidance about benefits, and considerate implementation of transfer policy can help mitigate some of their problems.

These caregivers face physical exhaustion, psycho-social, financial, legal, and spiritual issues- some common to all rural Indians and others unique to the armed forces. Understanding their experiences will help the providers find solutions, especially in relation to the unique needs of the men in uniform.

Correlation between Symptom Burden and Perceived Distress in Advanced Head and Neck Cancer: A Prospective Observational Study.

Indian Journal of Palliative Care

Head and neck cancer (HNC) account for major cancer burden in the Indian population. Patients often present with a diversity of distressing physical and psychological symptoms, significantly affecting their quality of life. This study aims to determine the correlation between symptom cluster and perceived distress in such patients.

This single center prospective observational study was done on 175 adults advanced HNC patients referred to palliative medicine outpatient clinic. Patients fulfilling eligibility criteria were regularly assessed for their symptoms and distress at baseline and followed up at days 7, 14, and 28.

Most patients belong to the age group of 40-50 years and having a diagnosis carcinoma of the tongue. The most common symptoms presented were pain, tiredness, loss of appetite, and feeling of well-being. We observed statistically significant correlation between total ESAS score and distress levels in patients at days 0, 7, and 14, respectively, (P = 0.003 vs. 0.0004 vs. 0.002). However, at day 28, no such statistically significant correlation was found (P = 0.085) suggesting attention to other factors during assessment.

Outpatient palliative care consultations have shown significant improvement in symptom and distress score. Perceived distress in a person can not only be related to physical symptoms. Acute control of symptom may uncover underlying psychosocial and spiritual issues which need to be addressed promptly for better quality of life.

Predictive Factors for Cardiopulmonary Resuscitation Failure.

Indian Journal of Palliative Care

Patients with chronic diseases are often admitted to the hospital through the emergency room of the hospital because of complaints of dyspnoea, urinary retention, decreased consciousness and cardiac arrest requiring resuscitation. The purpose of this study is to find predictive factors for failure of cardiopulmonary resuscitation (CPR) in patients of chronic diseases.

This cross-sectional study took medical records of patients who were carried out from primary healthcare center in Yogyakarta from 2017 to 2019. Bivariate statistical analysis used Fisher's exact test to determine the relative risk; if P < 0.25, then multivariate analysis with logistic regression continued with the backward method to obtain the odds ratio (OR).

The results indicate that cardiac arrest patients with sepsis are most likely to fail at CPR, whereas male patients are 9.1 times (OR 9.1); patients with acidosis, 8.1 times (OR 8.1); and patients with asystole heart rhythm, 7.8 times (OR 7.8, P < 0.05). We can conclude that male patients with sepsis, acidosis or asystole heart rhythm will almost certainly fail to receive resuscitation.

Sepsis or septic shock, the male gender, acidosis, and asystole rhythm can be determinants of mortality in patients with chronic diseases who undergo CPR. It is necessary for one to test the application of the checklist or data from other hospitals and score the predictive factors to make the determination of the success of CPR easier.

Psychosocial Adjustments after Advanced Laryngeal Cancer Treatment - A Systematic Review.

Indian Journal of Palliative Care

Psychosocial adjustments are alterations needed by a person after a life-altering event. The present review explored the psychosocial adjustments a...

Maggots in the Intercostal Drain: Case Report of a Rare Presentation with a Brief Review of Literature.

Indian Journal of Palliative Care

Maggots are dipterous larvae of flies. Infestation of vertebrate animals (including humans) by maggots is termed as Myiasis. Warm and Humid climate...

Psychosocial Challenges in Palliative Care: Bridging the Gaps Using Digital Health.

Indian Journal of Palliative Care

Psychosocial health is a major palliative care concern globally. Patients and caregivers engaged in palliative care may experience deteriorated men...

The Challenges, Coping Mechanisms, and the Needs of the Inhospital Parents Caring for Children with Life-limiting Neurological Disorders: A Qualitative Study.

Indian Journal of Palliative Care

Parents who have children with complex lifelong and life-limiting neurological conditions experienced many stresses and anxieties throughout their lives as caregivers. However, this information is still very limited. The study aimed to explore the challenges faced by parents with children who have complex neurological conditions, their coping strategies, needs, and expectations.

A semi-structured, in-depth interviews were conducted in the either Malay or English language among the parents of children with complex lifelong neurological conditions and have been on long-term in-patient hospital care. The interviews were audio-recorded and transcribed for thematic analysis. The qualitative study was conducted from October to November 2016 at the Paediatric Institute of Hospital Kuala Lumpur. Grounded theory was used to examine the qualitative data with inductive and deductive types of coding. The transcripts were read repeatedly to allow familiarity to the themes presented by the participants. Further discussions were conducted among the researchers to triangulate the information.

A total of 11 parents were interviewed for this study. The thematic analysis resulted in 8 challenges: Physical wellbeing, Environment, Relationship, Financial, Occupational, Rational, Mental, and Spiritual. Coping strategies comprised problem focused issues related to the key challenges in the caregivers' context. Similar to the needs and expectations, the key themes were derived from the key understandings of the challenges and looking at the palliative care impacts for these children.

There are various challenges faced by parents of children with life-limiting neurological disorders. Physical, Environment, Relationship, Financial, Occupational, Rational, Mental, and Spiritual Wellbeing can be a platform for the assessment of the caregivers' needs and the planning for palliative care support.

Effect of Meditation and Breathing Exercises on the Well-being of Patients with SARS-CoV-2 Infection under Institutional Isolation: A Randomized Control Trial.

Indian Journal of Palliative Care

The corona virus disease-19 (COVID-19) pandemic has affected every domain of human health be it physical or mental. The uncertainty of disease progression in patients with SARS-CoV-2 infection can lead to major psychological and psychiatric concerns that should not be overlooked. The interventions should be directed to the vulnerable population to help them mitigate the stress and anxiety caused by the infection and isolation. We evaluated the effect of meditation and breathing exercises on the well-being of patients with SARS-CoV-2 infection under institutional isolation.

We conducted a randomized control trial on 84 subjects, 18 years and above, asymptomatic, or mildly symptomatic SARS-CoV-2 infected patients under institutional isolation. Subjects were randomly and equally divided into a control group and interventional group. We measured the depression, anxiety, and stress levels as well as quality of sleep in patients after 7 days of meditation and breathing exercises in the intervention group versus standard care in the control group.

Meditation and breathing exercises had a statistically significant effect on the depression level (P < 0.001), stress level (P = 0.004), and the quality of sleep [trouble falling asleep (P = 0.007), trouble staying asleep (P = 0.004), and feel tired after waking up in the morning (P = 0.003)]. Further, the positive effect of intervention on the level of anxiety in patients under isolation was also observed; however, the difference was not found to be statistically significant (P = 0.528).

Meditation and breathing exercises have positive effects on depression, stress levels, and quality of sleep in COVID-19 positive patients under strict institutional isolation.