The Role of Pain and Other Physical Symptoms in the Desire for Hastened Death.

2005 ◽  
pp. 95-109
Author(s):  
Barry Rosenfeld
Keyword(s):  
Physical Symptoms ◽  
Hastened Death

scholarly journals SAT0636-HPR PATIENT EXPERIENCE WITH THE PRESCRIPTION, INFORMATION AND USE OF METHOTREXATE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1277.3-1278
Author(s):  
T. Oton ◽  
L. Carmona ◽  
J. L. Andréu Sánchez
Keyword(s):  
Side Effects ◽  
Focus Groups ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Physical Symptoms ◽  
Number Of Factors ◽  
Graphic Information ◽  
Main Barrier ◽  
And Training

Background:Methotrexate (MTX) is currently a mainstream drug in the treatment of rheumatic diseases. However, the response to MTX is not universal and may be conditioned by a number of factors, among which adherence could be crucial.Objectives:The aim of this study is to explore adherence to MTX in patients with rheumatic diseases, facilitators and perceived when taking and maintaining the prescription.Methods:A qualitative study of content analysis was performed. Focus groups with patients taking either oral or subcutaneous MTX (being the main or coadjuvant treatment) for any rheumatic disease was performed. The groups were moderated by a rheumatologist that was unknown for the patients. The speech was recorded and transcribed. Subsequently, an inductive coding was performed with the help of Atlas.ti and main themes and sub-themes were extracted, with examples of verbatim anonymized speech.Results:Three focus groups were conducted, with a total of 12 participants, of whom eight were women, seven had rheumatoid arthritis, three had psoriatic arthritis, one had spondyloarthritis, and one had systemic lupus erythematosus. All patients reported an adequate adherence to treatment. The barriers identified were: information in the leaflet, technical language in the consults, difficult access to doctor´s appointment, social environment, side effects and the subcutaneous device. As facilitators, the following aspects were discussed: good predisposition of the physician, reliable graphic information, role of associations and partners support.The unmet needs detected were: problems with travelling, protocols for eventualities, absence of a plan of care, neglection of “non-physical” symptoms, disinformation on side effects and training in complementary aspects.Conclusion:Getting reliable information was the main barrier identified. The environment and side effects may also negatively impact on adherence. Shared decision making is a goal to be achieved in the future in these patients.Disclosure of Interests:Teresa Oton Consultant of: Novartis Farmaceutica, SA, Pfizer, S.L.U., Merck Sharp & Dohme España, S.A., Roche Farma, S.A, Sanofi Aventis, AbbVie Spain, S.L.U., and Laboratorios Gebro Pharma, SA (All trhough institution), Loreto Carmona Grant/research support from: Novartis Farmaceutica, SA, Pfizer, S.L.U., Merck Sharp & Dohme España, S.A., Roche Farma, S.A, Sanofi Aventis, AbbVie Spain, S.L.U., and Laboratorios Gebro Pharma, SA (All trhough institution), José Luis Andréu Sánchez: None declared

Spirituality in patients with advanced illness: The role of symptom control, resilience and social network

2016 ◽  
Vol 21 (12) ◽  
pp. 2765-2774 ◽  
Author(s):  
Miguel Fombuena ◽  
Laura Galiana ◽  
Pilar Barreto ◽  
Amparo Oliver ◽  
Antonio Pascual ◽  
...  
Keyword(s):  
Social Support ◽  
Structural Model ◽  
Symptom Control ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Advanced Illness ◽  
Cross Sectional ◽  
Palliative Care Teams ◽  
Symptomatic Control

In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.

scholarly journals Coping with Medically Unexplained Physical Symptoms: the Role of Illness Beliefs and Behaviors

2019 ◽  
Vol 26 (6) ◽  
pp. 665-672 ◽  
Author(s):  
Nicole Sullivan ◽  
L. Alison Phillips ◽  
Wilfred R. Pigeon ◽  
Karen S. Quigley ◽  
Fiona Graff ◽  
...  
Keyword(s):  
Physical Symptoms ◽  
Illness Beliefs ◽  
Medically Unexplained Physical Symptoms ◽  
Medically Unexplained ◽  
And Behaviors ◽  
Unexplained Physical Symptoms

The Second Domain of Palliative Care

2018 ◽  
Author(s):  
E. Alessandra Strada
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Treatment Adherence ◽  
Psychological Factors ◽  
Physical Symptoms ◽  
Team Work ◽  
Advanced Illness ◽  
Interdisciplinary Work ◽  
Physical Suffering

This chapter proposes palliative psychology competencies in the second domain of palliative care: physical aspects of care. It discusses the importance of interdisciplinary work in assessment and management of pain and other physical symptoms. Palliative psychologists with the necessary knowledge, skills, and attitudes can contribute greatly to team work by identifying and managing psychological factors that can contribute to the patient’s physical suffering. This chapter also briefly describes relevant approaches to dyspnea and constipation. Clinical examples of pain assessment and intervention are provided based on real case scenarios. The basics of pharmacological approaches to pain management in advanced illness are discussed, in order to facilitate the role of palliative psychologists in promoting communication and treatment adherence. The use of integrative medicine modalities to improve physical symptoms is highlighted.

scholarly journals The Role of Spiritual Care with the Introduction of an End of Life Order Set

2019 ◽  
Vol 73 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Kalli Stilos ◽  
Bill Ford ◽  
Tammy Lilien ◽  
Jennifer Moore
Keyword(s):  
End Of Life ◽  
Spiritual Care ◽  
Retrospective Chart Review ◽  
Physical Symptoms ◽  
Care Team ◽  
Spiritual Support ◽  
Dying Patients ◽  
Psychosocial Concerns ◽  
One Step

Delivering comprehensive end-of-life care to dying patients must involve addressing physical symptoms and psychosocial concerns. Care pathways have been introduced to support health care teams in delivering this care. This retrospective chart review explores the contributions of the Spiritual Care Team in the care of dying patients. They offer a range of interventions which include supportive care, religious and spiritual support. This study was one step towards appreciating the contributions of the Spiritual Care Team.

scholarly journals Understanding and Addressing the Role of Coping in Palliative Care for Patients With Advanced Cancer

2020 ◽  
Vol 38 (9) ◽  
pp. 915-925 ◽  
Author(s):  
Joseph A. Greer ◽  
Allison J. Applebaum ◽  
Juliet C. Jacobsen ◽  
Jennifer S. Temel ◽  
Vicki A. Jackson
Keyword(s):  
Palliative Care ◽  
Coping Strategies ◽  
Advanced Cancer ◽  
Physical Symptoms ◽  
Early Palliative Care ◽  
Beneficial Effects ◽  
Symptoms Of Depression ◽  
Home Based ◽  
Oncology Care

Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of such coping strategies is associated with multiple outcomes, including quality of life, symptoms of depression and anxiety, illness understanding, and end-of-life care. Accumulating data demonstrate that early palliative care, integrated with oncology care, not only improves these key outcomes but also enhances coping in patients with advanced cancer. In addition, trials of home-based palliative care interventions have shown promise for improving the ways that patients and family caregivers cope together and manage problems as a dyad. In this article, we describe the nature and correlates of coping in this population, highlight the role of palliative care to promote effective coping strategies in patients and caregivers, and review evidence supporting the beneficial effects of palliative care on patient coping as well as the mechanisms by which improved coping is associated with better outcomes. We conclude with a discussion of the limitations of the state of science, future directions, and best practices on the basis of available evidence.

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