A Brainstorm of Psychotherapeutic Ideas for Physical and Terminal Illness

PsycCRITIQUES ◽  
2005 ◽  
Vol 50 (8) ◽  
Author(s):  
Seth A. Brown
Keyword(s):  
Terminal Illness

Beyond Repair: Fathers' Personal Growth Following the Loss of a Child to a Terminal Illness

2013 ◽  
Author(s):  
Nathaniel J. Rigby ◽  
Jenny Pak ◽  
J. W. Worden ◽  
Betty Davies
Keyword(s):  
Personal Growth ◽  
Terminal Illness ◽  
Loss Of A Child

Coping with the terminal illness of a colleague in a mental health organization.

2019 ◽  
Vol 29 (2) ◽  
pp. 224-234
Author(s):  
Beatriz Gómez ◽  
Edith Vega ◽  
Diana Kirszman ◽  
Héctor Fernández-Alvarez
Keyword(s):  
Mental Health ◽  
Terminal Illness ◽  
Mental Health Organization ◽  
Health Organization

Coping with Terminal Illness: The Role of Hopeful Thinking

2002 ◽  
Vol 5 (6) ◽  
pp. 883-894 ◽  
Author(s):  
Amber Gum ◽  
C.R. Snyder
Keyword(s):  
Terminal Illness

Happiness at the end of life: A qualitative study

2021 ◽  
pp. 1-7
Author(s):  
Tan Seng Beng ◽  
Wong Ka Ghee ◽  
Ng Yun Hui ◽  
Ooi Chieh Yin ◽  
Khoo Wei Shen Kelvin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
End Of Life ◽  
Terminal Illness ◽  
Terminally Ill ◽  
Social Connections ◽  
Targeted Interventions ◽  
Pain And Suffering ◽  
The University ◽  
Eudaimonic Happiness

Abstract Objective Dying is mostly seen as a dreadful event, never a happy experience. Yet, as palliative care physicians, we have seen so many patients who remained happy despite facing death. Hence, we conducted this qualitative study to explore happiness in palliative care patients at the University of Malaya Medical Centre. Method Twenty terminally ill patients were interviewed with semi-structured questions. The results were thematically analyzed. Results Eight themes were generated: the meaning of happiness, connections, mindset, pleasure, health, faith, wealth, and work. Our results showed that happiness is possible at the end of life. Happiness can coexist with pain and suffering. Social connections were the most important element of happiness at the end of life. Wealth and work were given the least emphasis. From the descriptions of our patients, we recognized a tendency for the degree of importance to shift from the hedonic happiness to eudaimonic happiness as patients experienced a terminal illness. Significance of results To increase the happiness of palliative care patients, it is crucial to assess the meaning of happiness for each patient and the degree of importance for each happiness domain to allow targeted interventions.

Adolescent Experience With Parental Cancer and Involvement With Medical Professionals: A Heuristic Phenomenological Inquiry

2021 ◽  
pp. 074355842098544
Author(s):  
Vaida Kazlauskaite ◽  
Stephen T. Fife
Keyword(s):  
Mental Health Professionals ◽  
Health Care Professionals ◽  
Terminal Illness ◽  
Hospital Setting ◽  
Heuristic Inquiry ◽  
Medical Professionals ◽  
Medical Setting ◽  
Parental Cancer ◽  
Phenomenological Inquiry ◽  
Loved One

Experiencing the death of a loved one can be a difficult occurrence. Adolescents, in particular, experience death in a unique way. Yet there is relatively little research on adolescents’ experience with parental death and their involvement in the medical setting during a parent’s terminal illness. This qualitative study utilized heuristic inquiry, a type of phenomenological research, to investigate adolescents’ involvement in the hospital setting during parental terminal illness. Qualitative analysis of participants’ experiences resulted in two primary categories associated with adolescents’ involvement with medical professionals during parental illness: factors influencing hospital involvement and experience with health care professionals. The findings have implications for medical and mental health professionals who work with adolescent family members of terminally ill patients.

scholarly journals QOLP-26. USE OF MEDICAL ASSISTANCE IN DYING (“DEATH WITH DIGNITY”) IN WASHINGTON STATE PATIENTS WITH BRAIN TUMORS.

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii180-ii180
Author(s):  
Jerome Graber ◽  
Kaite Sofie ◽  
Lynne Taylor
Keyword(s):  
Brain Tumors ◽  
Terminal Illness ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
High Grade Glioma ◽  
Washington State ◽  
Medical Assistance ◽  
Death With Dignity ◽  
Medical Assistance In Dying ◽  
Diagnosis Of Cancer

Abstract Since 2009, Washington State has had a “Death with Dignity” (DWD) process whereby people with a terminal illness may legally obtain a prescription for medications that will end their life. Patients initiate a voluntary request from two physicians certifying they have a prognosis < 6 months, are aware of other palliative care options, and have capacity without the comorbidity of a psychiatric diagnosis. Since 2015, over 200 people annually have used the DWD process in Washington. Other papers have described the characteristics of people using DWD with a diagnosis of cancer or amyotrophic lateral sclerosis (ALS) but none have specifically looked at patients with brain tumors (BT) who used DWD. We describe 20 people with BT who accessed DWD since 2015 at our center. Median age at the time of death was 51 (range 38-79) and 75% were men. Glioblastoma was the diagnosis in 10 (50%), anaplastic glioma in 8 (40%), grade II astrocytoma in 1, and a presumed high-grade glioma by imaging in 1. Median Karnofsky Performance Status (KPS) was 90 at diagnosis (range 50-100) and 70 at DWD request (range 40-90). Standard radiation (RT) and chemotherapy was used by 17 (85%) prior to DWD request, while 3 patients (15%, ages 70-79, KPS 50-90) requested DWD immediately after diagnosis and did not undergo further treatment. Pain was present in 4 patients (20%), 2 using opioids (10%). Six patients (30%) continued tumor treatments after approval for DWD. Median OS was 22 months (range 2-285) and 24 months excluding patients who declined treatment (range 8-285). Most glioma patients in our cohort requested DWD after undergoing chemoradiation, pain was uncommon and rarely severe, and survival from diagnosis was comparable to standard therapy. As access to medical assistance in dying continues, further research is needed on its utilization for people with brain tumors.

Economic impact of sudden cardiac arrest

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Paratz ◽  
L Rowsell ◽  
J Ball ◽  
D Zentner ◽  
S Parsons ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Economic Impact ◽  
Terminal Illness ◽  
Sudden Cardiac Arrest ◽  
Economic Security ◽  
Funding Source ◽  
Economic Modelling ◽  
Markov Modelling ◽  
Healthcare Budget ◽  
Returning To Work

Abstract Background Each year, there are approximately 5,000 out-of-hospital cardiac arrests (OHCAs) in the state of Victoria, Australia (population 6.4 million, state healthcare budget AUD$2.9 billion / €1.8billion). Mortality from OHCA approaches ninety percent. High mortality rates and survivors not returning to work is likely to have an adverse effect on the Victorian economy but this has not been previously investigated. Purpose To model the economic impact of OHCA mortality and survivors not returning to work. Methods Data on all OHCAs transported by Ambulance Victoria from July 2017- June 2018 in Victoria, Australia was collected, including age, gender, survival to hospital, survival to discharge, and survival to 12 months. Cases were excluded if arrest was precipitated by trauma, exsanguination, overdose, terminal illness, hanging, SIDS, electrocution, sepsis, respiratory causes, drowning, or neurological causes. Pre-arrest employment status of patients was modelled using the Australian Bureau of Statistics Economic Security dataset, which provides contemporary employment rates for gender-matched five-year cohorts for Australians aged 15–79 years. For survivors to 12 months, pre-arrest and post-arrest work status were confirmed. Economic impact was then calculated to a five year horizon utilizing a Markov model with probabilistic sensitivity analysis. Results 4,934 arrests meeting the inclusion criteria were transported by Ambulance Victoria in twelve months, of whom 4,639 were determined to be cardiac arrests without any exclusion criteria as a precipitant. 695 patients survived to hospital (15.0%), and 325 to discharge (7.0%). At 12 months, 303 patients were alive (6.5% of overall cases, 93.2% of those discharged from hospital). Economic modelling of age and gender-matched data indicated that 1516 patients (35%) would have been employed pre-cardiac arrest, but only 216 survivors (4.7%) would be employed at five years post-arrest. Using Markov modelling incorporating estimated earnings and the pre-determined value of a statistical life, the annual economic burden of cardiac arrest approximated AUD$4 billion (€2.5 billion) at a five-year horizon. Conclusion The annual economic impact of cardiac arrest in Victoria, Australia is approximately AUD$4 billion (€2.5 billion) in a five-year horizon. As the annual Victorian state budget for all healthcare is AUD$2.93 billion (€1.8 billion), our data suggests that the economic impact of cardiac arrest is under-appreciated. Therefore, research in this area and providing state-of-the-art care for all cardiac arrest patients should be a healthcare priority. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC/NHF Postgraduate Scholarship, RACP JJ Billings Scholarship

Views of Registered Dietitians Compared to Speech-Language Pathologists on Artificial Nutrition and Hydration at the End of Life

2021 ◽  
pp. 104990912199431
Author(s):  
Molly K Bigford ◽  
Roschelle Heuberger ◽  
Erica Raymond ◽  
Viki Shayna ◽  
James Paauw
Keyword(s):  
End Of Life ◽  
Terminal Illness ◽  
Descriptive Analysis ◽  
Study Patient ◽  
Artificial Nutrition ◽  
Speech Language Pathologists ◽  
Artificial Nutrition And Hydration ◽  
Nutrition And Hydration ◽  
Evidenced Based ◽  
Registered Dietitian Nutritionists

Objective: To analyze and compare the knowledge and opinions of registered dietitian nutritionists (RDNs) about artificial nutrition and hydration (ANH) in a terminal illness. Beliefs of speech-language pathologists (SLPs) were also considered and compared against RDN data. Methods: This is a descriptive analysis utilizing survey responses from RDNs and SLPs regarding ANH in a case study patient with advanced dementia. Results: There was a strong belief among RDNs that ANH at end of life (EOL) would improve nutritional status, although a correlation was found between those in favor of ANH and believing it was ethical to withhold ANH at EOL (R2 = 0.109, p = 0.002). Responses indicated that SLPs need more education regarding ANH techniques, while RDNs felt ANH would improve aspiration risk. Place of employment, religion and age of respondents were also found to impact beliefs. Conclusion: Clinicians, specifically RDNs, working with patients at EOL need more evidenced-based education on the risks and benefits of ANH. Decisions regarding care of patients at EOL should be void of clinicians’ personal bias which may affect ethical treatment in the clinical setting. Further controlled trials must be performed before claims can be made regarding ANH at EOL.

Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners

2011 ◽  
Vol 9 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Claire E. Johnson ◽  
Afaf Girgis ◽  
Christine L. Paul ◽  
David C. Currow
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Advanced Cancer ◽  
Terminal Illness ◽  
Symptom Control ◽  
Physical Symptoms ◽  
Care Physician ◽  
Self Report ◽  
Psychosocial Needs ◽  
Consultative Service

AbstractObjective:Late or non-referral of patients to specialist palliative care (SPC) services may affect patients' and their carers' quality of care. General practitioners (GPs) are key professionals in linking people with SPC. The aim of this article is to assess GPs' perceptions and SPC referrals for their patients with advanced cancer and differences between metropolitan (M GPs) and non-metropolitan GPs (NM GPs).Method:Self-report survey mailed to a stratified random sample of 1,680 Australian GPs was used.Results:Thirty-one percent (469) of eligible GPs returned surveys. More M GPs than NM GPs reported referring >60% of their patients for SPC (p = 0.014); and that a more comprehensive range of SPC services was available. The most frequently reported referral prompts were: presence of terminal illness (M GPs, 71%, NM GPs, 66%, ns (not significant)); future need for symptom control (69% vs. 59%, ns) and uncontrolled physical symptoms (63% vs. 54%, ns). Reasons for not referring were: doctor's ability to manage symptoms (62% vs. 68%, ns) and the absence of symptoms (29% vs. 18%, p = 0.025). Higher referral was associated with: having a palliative care physician or consultative service available; agreeing that all patients with advanced cancer should be referred, and agreeing that with SPC, the needs of the family are better met.Significance of results:Referrals for SPC were primarily disease-related rather than for psychological and emotional concerns. Measures are needed to encourage referrals based upon psychosocial needs as well as for physical concerns, and to support GPs caring for people with advanced cancer in areas with fewer comprehensive SPC services.

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