Journal of palliative medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Supportive-affective group experience for persons with life-threatening illness: reducing spiritual, psychological, and death-related distress in dying patients.
Attention to psycho-socio-spiritual needs is considered critical by patients with life-threatening illnesses and their caregivers. Palliative care interventions that address these needs--particularly spirituality--are lacking. ⋯ The use of the LTI-SAGE model for enhancing the end-of-life illness experience is promising.
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Social work practitioners have the potential to make meaningful contributions to improving palliative and end-of-life care because of their work in varied and divergent practice settings across the lifespan, their role in addressing mental health needs, grief and psychosocial aspects of well-being, and their commitment to promoting culturally competent, effective, and humane care, particularly for the most vulnerable and oppressed members of society. The federal government and several national and professional institutes have called for steps to increase the participation of social work researchers as well as to improve the quality, quantity, and dissemination of social work research. ⋯ This research agenda should serve to stimulate social work research initiatives to improve palliative and end-of-life care, and ultimately inform direct practice, policy and professional education.
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A majority of medical students feel uncomfortable with dying patients. ⋯ A Hospice based elective can be an effective model for facilitating learning about how to approach the patient with a terminal illness.
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End-of-life care quality deficiencies have in part been linked to inadequate physician skill in the technical and communication domains of palliative care. Yet few studies have examined physicians' perspectives regarding their experiences caring for patients approaching the end of life. ⋯ Our findings suggest that physician values and physician-family interactions impact decision-making for chronically ill elderly patients. The influence of physicians' internal gauges on end-of-life care can facilitate or hinder use of palliative care as well as decision-making consistent with patients' preferences. Disparate physician and family expectations regarding their division of decision-making responsibility and patients' care outcomes may also affect decision-making. The use of communication strategies that promote alignment of these expectations may improve decision-making quality for incapacitated elderly patients.