J Palliat Care
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This article reports on a preliminary study of the experiences and perceptions of palliative care clinicians in developing capacity for effective, sustainable practice in their work with people who have refractory suffering. Members of a purposive sample of 17 clinicians (10 nurses, 5 doctors, and 2 allied health professionals) were either interviewed (13) or responded to an online questionnaire (4). The study's findings provide insight into these palliative care clinicians' experiences and their perceptions of the capabilities they require, effective learning methods for developing these capabilities, and the supports that can facilitate this capacity building.
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This paper describes the quality of life and symptom burden of 211 cancer patients admitted to an acute palliative care unit (PCU) in a comprehensive cancer centre. Participants completed the McGill Quality of Life Questionnaire (MQOL), Edmonton Symptom Assessment Scale (ESAS), Short Orientation-Memory-Concentration Test, and Palliative Performance Scale within 24 hours of admission to the PCU. The mean MQOL total was 6.1 +/- 1.4, and the mean single-item scale score was 4.9 +/- 2.4. ⋯ Women and younger patients reported a lower quality of life (QoL) and a higher symptom burden. Regression and correlational analyses highlighted the importance of the existential and psychological domains to overall QoL. These findings emphasize the need for interdisciplinary, collaborative approaches to managing the complex physical, psychosocial, and existential needs of cancer patients admitted to acute PCUs.
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Multicenter Study Comparative Study
Quality of life in terminally ill cancer patients: contributors and content validity of instruments.
Over the last few decades, improvement in the quality of life (QOL) of cancer patients has received a lot of attention in oncology. This study aims to further explore what factors terminally ill cancer patients report as influencing their QOL. ⋯ The results support previous work identifying domains important to the QOL of terminally ill patients with cancer, but they also identify "finances" as a new domain. Based on these findings, we suggest including "finances" in QOL instruments for the terminally ill as an experimental domain.
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Health system restructuring combined with the preferences of many terminally ill care recipients and their caregivers has led to an increase in home-based palliative care, yet many care recipients die within institutional settings such as hospitals. This study sought to determine the place of death and its predictors among palliative care patients with cancer. ⋯ Place of death is influenced by the socio-demographic characteristics of patients, the characteristics of their caregivers, and health service factors. Palliative care programs need to tailor services to men and those living alone in order to reduce institutional deaths.
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This study holistically explores the experience of dying and end-of-life care for older persons with dementia in long-term care (LTC) from the perspective of care providers. Using a focused ethnography methodology, seven researchers interviewed LTC staff, residents' families, volunteers, management staff, and spiritual advisers/clergy over a five-day period. Research was guided by two key questions: What is the dying experience of people living in LTC from the perspective of different care providers? and, What are the salient issues in providing palliative care for elderly people dying in LTC? Based on a thematic analysis of verbatim data, three common themes were identified: tension between completing job tasks on time and "being there" for residents; the importance of family-like bonds between front-line staff and residents; and the importance of communication among staff and between staff and residents and their families at the end of life. Findings are discussed in relation to their implications for policies and practices that can support whole-person care and ultimately a good death for residents of LTC facilities.