PURPOSE: The purpose of this study was to analyze the concept, 'palliation', in order to enhance understanding of palliative care and ultimately lead to the provision of timely quality palliative care. METHOD: This study used Walker and Avant's methods for concept analysis. RESULT: The defining attributes of palliation identified in this study were 1) being limited, 2) responsiveness, 3) leading to positive effects, 4) relativity, and 5) being unsettled. The antecedents of palliation were 1) a problematic condition, 2) appropriate management for the problematic condition, and 3) interaction between the problematic condition and the appropriate management. The consequences of palliation included 1) improvement of a problematic condition and 2) dependency on a management of the problematic condition. CONCLUSION: Although further studies are required to refine the diverse attributes of the concept of palliation, according to this concept analysis of palliation, palliative care should be introduced at the early stage of disease and constantly provided for the improvement of its negative symptoms.
Palliative Care

PURPOSE: The aim of this study was to discuss challenges for hope seeking intervention based on individual experience (HSIBIE) in palliative care, assuming that hope is an individualized unique, subjective, and dynamic experience. METHODS: Literature, including analysis and discussion, was reviewed to identify limitations and ways to develop HSIBIE. RESULTS: This study identified following challenges: 1. Hope was often described and utilized as a standardized unified structure with varying attributes or mono-structure emphasizing a realistic hope, or both of them (relativism vs. monism) in one literature. This challenge is represented as a problem in conceptualization. 2. Few studies discussed various patterns of hope or individuals' unique experiences in palliative care. 3. The HSIBIE and the method for the HSIBIE have been rarely discussed. CONCLUSION: A problem in conceptualization is often related to fixed ideas formed over a long period and used in a closed circle of scholars and professionals. Therefore, such fixed ideas should be openly challenged with fresh perspectives. The second issue requires a cross-cultural studies of various hope experiences in palliative care, which can be used for effective and appropriate HSIBIE.
Palliative Care

No abstract available.
Palliative Care*

Introduction: Awareness for paediatric palliative care has resulted in the impetus for paediatrician-led palliative care services across Malaysia. However, there is paucity of local data on patients receiving hospital-based paediatric palliative care. We aim to review the clinical spectrum of patients referred to these services. Methods: An observational study of children aged between 0-18 years receiving palliative care at 13 hospitals between 1st January and 31st December 2014 was carried out. Results: There were 315 patients analysed, 90 (28.6%) and 46 (14.6%) were neonates and adolescents respectively. The main ICD-10 diagnostic categories for all patients were identified to be ‘Congenital malformations, deformations and chromosomal abnormalities’ 117 (37.1%), ‘Diseases of nervous system’ 76 (24.1%) and ‘Neoplasms’ 60 (19.0%). At referral 156 (50%) patients had holistic needs assessments. Patients with ‘Diseases of nervous system’ were assessed to have significantly more physical needs than the other two diagnostic categories. Majority of patients who knew of their diagnosis and prognosis were those with malignancy. Over a fifth of referrals were at their terminal admission. Of 144 who died, 111 (77.1%) had advanced care plans. There was bereavement follow-up in 98 (68.1%) patients. Conclusion: Patients referred for palliative care have varied diagnoses and needs. To ensure all paediatricians are competent to deliver quality care to all children, further education and training initiatives is imperative.
Palliative Care

No abstract available.
Hospices ; Palliative Care

No abstract available.
Hospices* ; Korea* ; Palliative Care*

Humans ; Palliative Care ; Telemedicine

BACKGROUND

Rolling out palliative pain management had been challenging in the wards due to the hesitancy of nurses in carrying out opioid administration. Studies and daily practices in the hospital show that lack of knowledge, fear of handling opioids and low confidence are some of the barriers in managing palliative care patients efficiently. Through coaching and appropriate training, nursing knowledge, and confidence level in patient care are bolstered.

This study determined the effect of physician’s coaching in addressing hesitancy in opioid administration among QMMC nurses involved in palliative care.

This action research study utilized convergent parallel, mixed methods design with 28 ward nurses handling palliative care referrals. Participants were randomly assigned in the control (lecture only) and intervention (lecture with coaching) groups. Both groups answered a self-administered questionnaire and underwent interviews pre- and post-interventions. The intervention group had additional coaching prior to post-test and final interview.

Baseline characteristics were similar. The control (lecture only) and intervention (lecture with coaching) groups showed a significant difference in improved practices (p < 0.01) and increase in knowledge (p < 0.00) post-interventions. Qualitative analysis of post-intervention responses indicated increased confidence, reduced doubts, and a better understanding of opioid administration.

It is critical to remove the barriers to opioid administration in order to expand patients’ access to effective drugs. Increased knowledge and understanding resulted in a confident and informed attitude towards opioid administration. Continuing education with coaching can effectively minimize nurses’ hesitation to administer opioids.

Background: Palliative care is an approach which improves the quality of life of patients and their families facing life-threatening illness, through the prevention, assessment and treatment of pain and other physical, psychosocial and spiritual problems. The Palliative and Hospice Care Act was enacted to improve quality of life of terminally- ill patient, however, the readiness of general practitioner to participate in palliative care is still a critical issues. Objectives: This study aimed to identify factors affecting provision of palliative care, as perceived by primary care physicians in Ilocos Norte. Methods: The study is a descriptive-comparative research utilizing the purposive sampling technique in selecting the participants. It used a structured survey questionnaire in google form and was sent through email. For participants having difficulty with online platform, printed questionnaire was distributed. Data gathered was entered and analyzed using Microsoft Excel. Specifically, mean, standard deviation was used for descriptive statistics and spearman correlation for inferential statistics was utilized. Results As to the knowledge of the primary care physicians, this study showed that they are knowledgeable as to the definition and objectives of palliative care. The study able to assess factors affecting the provision of palliative care in five (5) domains. Among the domains it was noted that national, regional and local healthcare networking and healthcare team are perceived challenges in provision of palliative care among the primary care physicians of Ilocos Norte.
Palliative Care ; Physicians, Primary Care

BACKGROUND

Th Philippines has faced challenges in quality end-of-life care and ranks poorly on the 2015 Quality of Death Index. This study explores the perceptions of a good death among patients, caregivers, and bereaved family members within the Palliative and Hospice Care Program of Ospital ng Makati.

The research aimed to offer insights into the factors that influence end-of-life care preferences in the Philippine context.

The study involved 38 participants – patients, caregivers, and bereaved family members. It adapted and modified the Good Death Inventory, a validated scale with 47 questions covering 18 domains related to end-of-life care.

Results show significant differences in perceptions of a good death among patients, caregivers, and bereaved family members. Maintaining hope and pleasure, having control over the future, and a good relationship with medical staff were identified as top priorities while dying in a favorite place was of lower importance. Caregivers and bereaved members valued patient autonomy, with higher importance placed on being respected as an individual and feeling that one’s life is worth living. Additionally, spiritual comfort was more significant for caregivers and bereaved family members. The study highlights the importance of understanding distinct preferences in the context of end-of-life care. The findings also call for longer data collection periods, larger sample sizes, and potential qualitative research methods.

By addressing these nuances, healthcare providers can better improve end-of-life care, ensuring that patients and their families experience a more positive and meaningful transition at this crucial stage of life.