Trajectory of psychosocial symptoms among home care patients with cancer at end‐of‐life

2020 ◽  
Author(s):  
Hsien Seow ◽  
Tara Stevens ◽  
Lisa C. Barbera ◽  
Fred Burge ◽  
Kimberlyn McGrail ◽  
...  
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Patients With Cancer

Planning for the End of Life with the Home Care Client

1994 ◽  
Vol 22 (1-2) ◽  
pp. 147-160 ◽  
Author(s):  
Eileen R. Chichin ◽  
Leah Ferster ◽  
Natalie Gordon
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Home Care Client

Delirium in Patients with Cancer at the End of Life

2000 ◽  
Vol 8 (4) ◽  
pp. 172-177 ◽  
Author(s):  
Janet L. Cobb ◽  
Michael J. Glantz ◽  
Patrice K. Nicholas ◽  
Edward W. Martin ◽  
Alexandra Paul-Simon ◽  
...  
Keyword(s):  
End Of Life ◽  
Patients With Cancer

Corresponding about death: Analyzing letters from patients with cancer to medical students.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11021-11021
Author(s):  
Tianyi Zhang ◽  
Mekaleya Tilahun ◽  
Cynthia Perlis ◽  
Sam Brondfield
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
Death And Dying ◽  
Severe Illness ◽  
Clinical Environment ◽  
Patients With Cancer ◽  
Coping Process ◽  
Award Winning ◽  
Multiple Paths ◽  
One Year

11021 Background: Clinicians frequently discuss death and dying with patients who have cancer. However, the doctor-patient hierarchy and the unfamiliar clinical environment may prevent these patients from discussing death and dying authentically. Patients may feel more comfortable expressing themselves when given the time and space to write at home. Firefly, an award-winning program at UCSF, facilitates written correspondence between patients with cancer and medical students over the course of one year. Firefly’s archive contains thousands of patient letters and constitutes a unique resource for analyzing authentic patient expression outside of the clinical context. The aim of the current study is to improve curricula pertaining to severe illness and end-of-life by providing educators with an analysis of authentic patient perspectives about death and dying expressed in these letters. Methods: We (two medical students, an expressive artist, and an oncologist) read all Firefly letters written by patients between 2014 and 2019 and identified 12 patients whose letters meaningfully discussed death or dying. We performed a thematic analysis of these letters using the Buckman three-stage model of dying as a reference. Results: Four themes emerged: turmoil; grief; making peace; and past, present and future. The first three themes aligned with the Buckman stages. The fourth theme—past, present and future—spanned the three stages and also elaborated the Buckman model by describing multiple paths that patients may take after passing through these stages. Conclusions: The authentic ways in which patients with cancer discussed death and dying in their letters provided deep insight into their coping process. The Buckman model appears useful for framing death and dying from the patient perspective but may not fully reflect modern oncologic care in which many patients live for years beyond a severe or terminal diagnosis. Educators can use the identified themes to shape medical school curricula pertaining to severe illness and end-of-life care.

scholarly journals Relationship between doctors and patients in the end of life process in palliative care and dysthanasia

2021 ◽  
Vol 18 (1) ◽  
pp. 193-205
Author(s):  
Cynthia De Freitas Melo ◽  
Maria Rannielly de Araujo Lima Magalhães ◽  
Liza Maria Studart de Meneses ◽  
Railda Sabino Fernandes Alves ◽  
Ana Cristina Eberhardt Lins ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Point Of View ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Life Process ◽  
Patients With Cancer ◽  
Therapeutic Choice ◽  
Probabilistic Sample ◽  
Descriptive Survey

Introduction: In the course of an illness, when the patient receives a poor prognosis, he can be assisted with dysthanasia or palliative care. The therapeutic choice and the adherence to it are related, among other factors, to the quality of the doctor-patient relationship. The objective of this study was to evaluate the patients’ point of view of the doctor-patient relationship in the end of life process, and compare scores between patients in palliative care and those experiencing dysthanasia. Method: The design was a descriptive survey with a non-probabilistic sample composed of 234 patients with cancer in the end of life process: 117 in palliative care and 117 expriencing dysthanasia. Two instruments were used: a biodemographic questionnaire and the Questionnaire for Assessing the Doctor-Patient Relationship in the End of Life Process, and data were analyzed using descriptive and bivariate statistics in the Statistical Package for the Social Sciences software. Results: The results showed good evaluations of the doctor-patient relationship. Palliative care patients attributed better scores in terms of time dedicated, attention, confidence, understanding and communication; and patients experiencing dysthanasia made better assessments in terms of frequency of visits and continuity of care. Conclusion: It is concluded that this study represents an advance in studies on the subject and indicates that patients in palliative care perceive the doctor-patient relationship more positively than patients undergoing dysthanasia. It stressed that it is necessary to invest in training medical students and professionals to carry out interventions that prioritize the use of their oldest, simplest and most powerful technology: the relationship between professionals and patients.

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