VigiPallia : Résultats

Recherches dans le fonds documentaire/
Toutes les bibliographies thématiques/
R/
Rapports de l'ONFV

##titre_notice##

##grp1_nom##

- ##grp2_nom## : ##grp2_synthese_detail##

##reservable_synthese##

##detail_synthese##

DETRESSE PSYCHOLOGIQUE

0 sélectionnée(s) / 274 réponse(s)

(1) 2 3 4 ... 14 > »

Emotional intelligence in neonatal intensive care unit nurses - decreasing moral distress in end-of-life care and laying a foundation for improved outcomes: an integrative review

LACEFIELD LEWIS, Stephanie
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 08/2019, vol.21, n°4, p. 250-256

Document en ligne

Thème : Soins.

FIN VIE ; NEONATALOGIE ; SOIN INTENSIF ; INFIRMIERE ; EMOTION ; SOIN INFIRMIER ; DETRESSE PSYCHOLOGIQUE

End-of-life care in the neonatal intensive care unit (NICU) is one of the most challenging practices for nurses. Negative emotions associated with moral distress often cause care to be incomplete or nurse disengagement. Emotional intelligence in nurses holds potential to address this issue, while improving patient outcomes. The purpose of this study was to critically appraise the evidence about emotional intelligence in nursing and to explore the relationship between emotional intelligence, moral distress in NICU nurses, end-of-life care, and other priority nurse and patient outcomes. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)–structured integrative review was conducted, and CINAHL, Ovid, PubMed, and other databases were searched. Twelve studies were identified as relevant to this review after exclusion criteria were applied. Evidence supports the efficacy of emotional intelligence in bedside nurses as a method of improving key nurse and patient outcomes. Additionally, research suggests that emotional intelligence can be improved by training interventions. Clinical educators should integrate emotional intelligence concepts and strategies into staff training. Further research is recommended to validate previous findings in the NICU setting. Exploration of the relationship between emotional intelligence and moral distress in NICU nurses would provide a foundation for experimental designs to evaluate the effectiveness of emotional intelligence training interventions.

Origine : journals.lww.com

Development of a clinical guide for identifying spiritual distress in family members of patients in the intensive care unit

ROZE DES ORDONS, Amanda L. ; SINCLAIR, Shane ; SINUFF, Tasnim ; GRINDROD-MILLAR, Kathleen ; STELFOX, Henry T.
JOURNAL OF PALLIATIVE MEDICINE, 02/08/2019, Pagination inconnue

Document en ligne

Thème : Psychologie, psychanalyse.

DETRESSE PSYCHOLOGIQUE ; SPIRITUALITE ; SOIN INTENSIF ; FAMILLE ; GUIDE ; SOUTIEN ; BESOIN

Background: Spirituality is important for many family members of patients in the intensive care unit (ICU). Clinicians without training in spiritual care experience difficulty identifying when family members are experiencing distress of a spiritual nature.
Objective: The purpose of this study was to develop a guide to help clinicians working in the ICU identify family members who may benefit from specialized spiritual support.
Design: ross-sectional study.
Setting/Subjects: A national sample of spiritual health practitioners, family members, and ICU clinicians.
Subjects: A panel of 21 spiritual health practitioners participated in a modified Delphi process to achieve consensus on items that suggest spiritual distress among family members of patients in the ICU through three rounds of remote review followed by an in-person conference and a final round of panelist feedback. Feedback on the final set of items was obtained from an end-user group of four family members and six ICU clinicians.
Measurements: A total of 220 items were iteratively reviewed and rated by panelists. Forty-six items were identified as essential for inclusion and developed into a clinical guide, including an introduction (n = 1), definitions (n = 2), risk factors (n = 10), expressed concerns (n = 12), emotions (n = 7) and behaviors (n = 7) that may suggest spiritual distress, questions to identify spiritual needs (n = 6), and introducing spiritual support (n = 1).
Conclusions: We have developed an evidence-informed clinical guide that may help clinicians in the ICU identify family members experiencing spiritual distress.

Origine : PubMed

The accuracy of measures in screening adults for spiritual suffering in health care settings - a systematic review

BAHRAINI, Sayna ; GIFFORD, Wendy ; GRAHAM, Ian D. ; WAZNI, Liquaa ; BREMAULT-PHILLIPS, Suzette ; HACKBUSCH, Rebekah ; DEMERS, Catrine ; EGAN, Mary
Palliative and supportive care, 07/08/2019, p. 1-14

Document en ligne

Thème : Psychologie, psychanalyse.

DETRESSE PSYCHOLOGIQUE ; SPIRITUALITE ; REVUE LITTÉRATURE

OBJECTIVE: Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence of the accuracy of measures used to screen adults for spiritual suffering.
METHODS: A systematic review of the literature. We searched five scientific databases to identify relevant articles. Two independent reviewers screened, extracted data, and assessed study methodological quality.
RESULTS: We identified five articles that yielded information on 24 spiritual screening measures. Among all identified measures, the two-item Meaning/Joy & Self-Described Struggle has the highest sensitivity (82-87%), and the revised Rush protocol had the highest specificity (81-90%). The methodological quality of all included studies was low.
SIGNIFICANCE OF RESULTS: While most of the identified spiritual screening measures are brief (comprised 1 to 12 items), few had sufficient accuracy to effectively screen patients for spiritual suffering. We advise clinicians to use their critical appraisal skills and clinical judgment when selecting and using any of the identified measures to screen for spiritual suffering.

Origine : PubMed

Exploring and managing the impostor phenomenon in palliative care - a case series

LAWTON, Andrew J. ; LAWTON, Christopher W. ; DIETZ, Sarah Scott B. ; STEVENS, Erin E. ; WEIS, Jo M.
JOURNAL OF PALLIATIVE MEDICINE, 13/08/2019, Pagination inconnue

Document en ligne

Thème : Ethique et déontologie.

DEMARCHE PALLIATIVE ; ETUDE CAS ; MEDECIN ; ETHIQUE ; RESSENTI ; DETRESSE PSYCHOLOGIQUE

The impostor phenomenon (IP) describes the experience of questioning one's abilities and fearing exposure as an intellectual fraud, despite objective evidence of success. The IP has been identified in high-achieving professionals across a variety of disciplines, including clinical medicine, and can be associated with significant anxiety and psychological distress. In this series, we present three authentic cases that demonstrate how the IP may manifest in palliative care practice. Acknowledging the current emphasis on clinician wellness and burnout, we suggest that the IP may be one important source of distress for many early-career clinicians in palliative care. With the physician as the focus of each case, we explore the difficult emotions faced and highlight how palliative care clinicians may be uniquely vulnerable to the IP. We then identify concrete strategies to help clinicians manage feelings of IP and enhance their professional well-being.

Origine : PubMed

Spiritual distress in family members of critically ill patients - perceptions and experiences

ROZE DES ORDONS, Amanda L. ; STELFOX, Henry T. ; SINUFF, Tasnim ; GRINDROD-MILLAR, Kathleen ; SMIECHOWSKI, Jennifer ; SINCLAIR, Shane
JOURNAL OF PALLIATIVE MEDICINE, 13/08/2019, Pagination inconnue

Document en ligne

Thème : Soins.

DETRESSE PSYCHOLOGIQUE ; SPIRITUALITE ; FAMILLE ; ACCOMPAGNEMENT ; RECHERCHE QUALITATIVE ; SOIN INTENSIF

Background: Spiritual distress among family members of patients in the intensive care unit (ICU) has not been well characterized. This limits clinicians' understanding of how to best offer support.
Objective: To explore how family members experience spiritual distress, and how it is recognized and support offered within the ICU context.
Design: A qualitative study involving interviews and focus groups between May 2016 and April 2017.
Setting/Subjects: Family members of ICU patients (n = 18), spiritual health practitioners (n = 10), and an interprofessional group of clinicians who work in the ICU (n = 32).
Measurements: Transcribed data were analyzed using interpretive description.
Results: The experience of spiritual distress was variably described by all three groups through concepts, modulators, expressions and manifestations, and ways in which spiritual distress was addressed. Concepts included loss of meaning, purpose and connection, tension in beliefs, and interconnected distress. Modulators were related to the patient and family context, the ICU context, and the relational context. Expressions and manifestations were unique and individual, involving verbal expressions of thoughts and emotions, as well as behavioral manifestations of coping. Clinical strategies for addressing spiritual distress were described through general principles, specific strategies for discussing spiritual distress, and ways in which spiritual support can be offered.
Conclusions: Our study provides a rich description of how spiritual distress is experienced by family members of ICU patients, and how spiritual health practitioners and clinicians recognize spiritual distress and offer support. These findings will help inform clinician education and initiatives to better support families of critically ill patients.

Origine : PubMed

Vers une nouvelle compréhension de la présence infirmière en soins palliatifs

GOYETTE, Christine ; VACHON, Mélanie
LES CAHIERS FRANCOPHONES DE SOINS PALLIATIFS, Publications Michel Sarrazin, 2019, vol.19, n°1, p. 48-59

Thème : Soins. Cote : 00.07CAH

CANADA ; INFIRMIERE ; DEMARCHE PALLIATIVE ; RELATION INTERPERSONNELLE ; DETRESSE PSYCHOLOGIQUE ; TEMPS ; RECHERCHE QUALITATIVE ; RESSENTI

Cet article est le premier d'une série de deux qui abordent l'expérience de la présence d'infirmières en soins palliatifs (SP) dans le cadre de la programmation de recherche SATIN II (Fillion et collab., 2017). Dans cette étude qualitative, nous nous sommes intéressées à l'expérience de la présence telle que vécue et comprise par les infirmières en SP au regard des enjeux actuels du travail en SP au Québec. Huit infirmières qui oeuvraient exclusivement dans un service de SP spécialisés ont été rencontrées. Des entretiens semi-structurés ont été conduits avant et après la participation à une intervention de groupe sur le sens et la pleine conscience offerte dans le cadre de la programmation de recherche SATIN II (Fillion et collab., 2017). Cet article se limite au temps 1 de l'étude. Notre analyse phénoménologique-interprétative (Smith et Osborn, 2007) a révélé que les participantes vivaient et comprenaient initialement la présence comme 1) une mise au diapason et 2) une rencontre avec l'autre et 3) d'un besoin de maîtriser le temps. Notre étude a également démontré que l'expérience de la présence peut (re)donner un sens au travail en SP. Finalement, nous avons pu élaborer une définition de la présence qui pourrait faciliter l'enseignement, l'apprentissage et le développement de la présence chez les infirmières de toutes disciplines.

Propofol-based palliative sedation to treat antipsychotic-resistant agitated delirium

COVARRUBIAS-GÓMEZ, Alfredo ; LÓPEZ COLLADA-ESTRADA, Maria
Journal of pain and palliative care pharmacotherapy, 02/10/2017, vol.31, n°3-4, p. 190-194

Document en ligne

Thème : Médicaments - Pharmacie. Cote : 00.07JPP

DELIRE ; PRISE EN CHARGE ; DETRESSE PSYCHOLOGIQUE ; AGITATION ; SEDATION PALLIATIVE ; THERAPEUTIQUE MEDICAMENTEUSE

Delirium is a common problem in terminally ill patients that is associated with significant distress and, hence, considered a palliative care emergency. The three subtypes of delirium are hyperactive, hypoactive, and mixed, depending on the level of psychomotor activity and arousal disturbance. When agitated delirium becomes refractory in the setting of imminent dying, the agitation may be so severe that palliative sedation (PS) is required. Palliative sedation involves the administration of sedative medications with the purpose of reducing level of consciousness for patients with refractory suffering in the setting of a terminal illness. Propofol is a sedative that has a short duration of action and a very rapid onset. These characteristics make it relatively easy to titrate. Reported doses range from 50 to 70 mg per hour. The authors present a case of antipsychotic-resistant agitated delirium treated with a propofol intravenous infusion.

Origine : CrossRef

Courses of change in good emotional preparedness for death and accurate prognostic awareness and their associations with psychological distress and quality of life in terminally ill cancer patients' last year of life

TANG, Siew Tzuh ; CHOU, Wen-Chi ; CHANG, Wen-Cheng ; CHEN, Jen-Shi ; HSIEH, Chia-Hsun ; WEN, Fur-Hsing ; CHUNG, Shih-Chi
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 02/07/2019, Pagination inconnue

Document en ligne

Thème : Soins.

CONSCIENCE ; PRONOSTIC ; ETAPE MOURIR ; ETUDE LONGITUDINALE ; PHASE TERMINALE ; CANCER ; REPRESENTATION MORT ; DETRESSE PSYCHOLOGIQUE ; EMOTION ; ANXIETE ; DEPRESSION ; QUALITE VIE

BACKGROUND: Emotional preparedness for death is a distinct but related concept to prognostic awareness (PA). Both allow patients to prepare psychologically and interpersonally for death but they have primarily been examined in cross-sectional studies.
OBJECTIVE: To (1) explore the courses of change in good emotional preparedness for death and accurate PA and (2) evaluate their associations with severe anxiety symptoms, severe depressive symptoms, and quality of life (QOL) in cancer patients' last year.
METHODS: For this prospective, longitudinal study, we consecutively recruited 277 terminally ill cancer patients. Aims 1 and 2 were examined by univariate and multivariate generalized estimating equation analyses, respectively.
RESULTS: The prevalence of good emotional preparedness for death was 54.43%–65.85% in the last year, with a significant decrease only 91–180 vs. 181–365 days before death (odds ratio [95% CI] = 0.67 [0.47, 0.97]). Good emotional preparedness for death was associated with a lower likelihood of severe anxiety symptoms (adjusted odds ratio [95% CI] = 0.47 [0.27, 0.79]) and severe depressive symptoms (0.61 [0.39, 0.95]), but not with quality of life (ß [95% CI] = 0.49 [-2.13, 3.11]). However, accurate PA improved substantially (55.12%–70.73%) as death approached and accurate PA was positively associated with severe depressive symptoms (2.63 [1.63, 4.25]).
CONCLUSIONS: Good emotional preparedness for death and accurate PA remained largely stable and improved substantially, respectively, in cancer patients' last year. Both measures were significantly associated with psychological distress. Healthcare professionals should not only cultivate accurate PA but also promote cancer patients' emotional preparedness for death, which may improve their psychological well-being.

Origine : PubMed

Spiritual coping and psychological symptoms as the end approaches - a closer look on ambulatory palliative care patients

GRYSCHEK, Guilherme ; MACHADO, Danusa De Almeida ; OTUYAMA, Leonardo Jun ; GOODWIN, Christian ; LIMA, Maria Cristina Pereira
Psychology, health and medicine, 09/07/2019, p. 1-8

Document en ligne

Thème : Psychologie, psychanalyse.

SPIRITUALITE ; COPING ; SYMPTOME ; PSYCHOLOGIE ; DEPRESSION ; HOSPITALISATION JOUR ; DEMARCHE PALLIATIVE ; ECHELLE MESURE ; EVALUATION ; PATIENT ; DETRESSE PSYCHOLOGIQUE ; ANXIETE

Palliative care providers must seek to improve quality of life despite their patients' life-threating diseases, based on the concept of total pain, which includes physical, psychological and spiritual pain. Understanding the relationship between spiritual coping and psychological symptoms (especially depressive symptoms) could help healthcare teams better address patients' needs. Across-sectional survey with aconvenient sample of ambulatory palliative care patients investigated their psychological pain through the Hospital Anxiety and Depressive (HAD) scale and their use of spirituality using the Brief Religious/spiritual coping (BriefRCOPE) scale. Alinear regression model, using the HADS-depression as outcome variable and the BriefRCOPE as the independent variable, adjusting for confounding variables, investigated the possible association between these variables. Due to methodological limitations, just 40 out 130 potential participants were assessed, with 40percent showing depressive symptoms. In regression model, depressive and anxiety symptoms were significantly associated with each other (p = 0.037 and 0.015, respectively) and negative religious/spiritual coping was associated with depressive symptoms (p = 0.033). This study found asignificant relationship between psychological pain and negative spiritual coping mechanisms. Palliative care professionals should be trained to address patients' total pain and spiritual needs, supporting their ability to cope with their suffering.

Origine : PubMed

What young people need when a family member dies of cancer

MCDONALD, Fiona E. J. ; PATTERSON, Pandora ; TINDLE, Richard
Supportive care in cancer, 06/07/2019, p. 1-8

Document en ligne

Thème : Deuil et travail du deuil.

JEUNE ADULTE ; BESOIN ; CANCER ; DEUIL ; PERSONNE ENDEUILLEE ; ADOLESCENT ; DETRESSE PSYCHOLOGIQUE ; PARENT ; FAMILLE ; FRATRIE

Purpose: This study uses the newly developed Bereaved Cancer Needs Inventory to identify the unmet psychosocial needs of adolescents and young adults who have experienced the death of a parent or sibling to cancer, and to explore the relationship between unmet needs and psychological distress.
Methods: In total, 278 bereaved offspring and 38 bereaved siblings (12–25 years) completed the 58-item Bereaved Cancer Needs Inventory (BCNI) and the Kessler psychological distress scale (K10).
Results: Bereaved offspring reported 27 unmet needs on average (SD = 16.87, range: 0–58); 94% indicated at least one unmet need, with 80% indicating 10 or more needs. Bereaved siblings reported 23 unmet needs on average (SD = 17.30, range: 0–57); 97% indicated at least one unmet need, with 68% indicating 10 or more needs. For both bereaved offspring and siblings, the needs for “support from other young people” and “time out and recreation” were most frequently reported as unmet. Approximately half of all participants reported high to very high levels of psychological distress. There was a significant positive relationship between the number of unmet needs and the psychological distress score on the K10 for both groups.
Conclusions: Bereaved offspring and bereaved siblings report unmet psychosocial needs across many domains, which are associated with their levels of psychological distress. Findings suggest the BCNI may be used by healthcare professionals to identify unmet needs and direct clients to the appropriate services, resources, or support; with the intent to reduce their risk of mental illness and psychological distress.

Origine : PubMed

Emotional intelligence in neonatal intensive care unit nurses - decreasing moral distress in end-of-life care and laying a foundation for improved outcomes: an integrative review

LEWIS, Stephanie Lacefield
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 08/2019, vol.21, n°4, p. 250-256

Thème : Psychologie, psychanalyse.

NEONATALOGIE ; SOIN INTENSIF ; COPING ; DETRESSE PSYCHOLOGIQUE ; FIN VIE ; INFIRMIERE

Les soins palliatifs - une histoire de conflit entre toute puissance et condition d’existence en détresse ?

AVEROUS, Véronique
JALMALV JUSQU A LA MORT ACCOMPAGNER LA VIE, 06/2019, vol.N° 137, n°2, p. 11-23

Document en ligne

Thème : Psychologie, psychanalyse. Cote : 00.07JAL

CONFLIT VALEUR ; PSYCHISME ; DEMARCHE PALLIATIVE ; PULSION MORT ; PULSION VIE ; DETRESSE PSYCHOLOGIQUE

Le conflit psychique se manifeste lorsque des exigences internes contraires s'opposent comme celles des pulsions de vie et des pulsions de mort. Les soins palliatifs, tissés de contradictions, de forces qui s'affrontent et d'ambivalences multiples, ne peuvent échapper au conflit. Si leur nécessité n'est plus à démontrer, la confrontation à la détresse que la déchéance, le sentiment d'indignité et l'approche de la mort génèrent reste profondément problématique.

Origine : www.cairn.info

Caregiver exposure to critical events and distress in home-based palliative care in Germany a cross-sectional study using the stressful caregiving adult reactions to experiences of dying (scared) scale

GALATSCH, Michael ; PRIGERSON, Holly G. ; SCHNEPP, Wilfried ; ZU SAYN-WITTGENSTEIN, Friederike ; LI, Jian
BMC palliative care, 24/01/2019, vol.18, n°1, p. 1-8

Document en ligne

Thème : Soins. Cote : eD02.03.03

FAMILLE ; ACCOMPAGNEMENT ; DOMICILE ; PRISE EN CHARGE ; ALLEMAGNE ; STRESS ; ECHELLE MESURE ; PERSONNE AGEE ; DETRESSE PSYCHOLOGIQUE

BACKGROUND: Lay family caregivers of patients receiving palliative care often confront stressful situations in the care of their loved ones. This is particularly true for families in the home-based palliative care settings, where the family caregivers are responsible for a substantial amount of the patient's care. Yet, to our knowledge, no study to date has examined the family caregivers' exposure to critical events and distress with home-based palliative care has been reported from Germany. Therefore, we attempt to assess family caregiver exposure to the dying patient's critical health events and relate that to the caregiver's own psychological distress to examine associations with general health within a home-based palliative care situation in Germany.
METHODS: A cross-sectional study was conducted among 106 family caregivers with home-based palliative care in the Federal State of North Rhine Westphalia, Germany. We administered the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale. Descriptive statistics and linear regression models relating general health (SF-36) were used to analyze the data.
RESULTS: The frequency of the caregiver's exposure, or witness of, critical health events of the patient ranged from 95.2% "pain/discomfort" to 20.8% "family caregiver thought patient was dead". The highest distress scores assessing fear and helpfulness were associated with "family caregiver felt patient had enough'" and "family caregiver thought patient was dead". Linear regression analyses revealed significant inverse associations between SCARED critical health event exposure frequency (beta=.408, p=.025) and total score (beta=.377, p=.007) with general health in family caregivers.
CONCLUSIONS: Family caregivers with home-based palliative care in Germany frequently experience exposure to a large number of critical health events in caring for their family members who are terminally ill. These exposures are associated with the family caregiver's degree of fear and helplessness and are associated with their worse general health. Thus the SCARED Scale, which is brief and easy to administer, appears able to identify these potentially upsetting critical health events among family caregivers of palliative care patients receiving care at home. Because it identified commonly encountered critical events in these patients and related them to adverse general health of family caregivers, the SCARED may add to clinically useful screens to identify family caregivers who may be struggling.

Origine : PubMed

The effectivness of a strengths-oriented therapeutic conversation intervention on perceived support, well-being and burden among family caregivers in palliative home-care

PETURSDOTTIR, Asta B. ; SVAVARSDOTTIR, Erla Kolbrun
Journal of advanced nursing, 04/06/2019, Pagination inconnue

Document en ligne

CANCER ; FAMILLE ; AIDANT NATUREL ; DETRESSE PSYCHOLOGIQUE ; SOIN DOMICILE ; INFIRMIERE ; MORBIDITE

AIMS: To evaluate the effectiveness of a two-session multicomponent family strengths- oriented therapeutic conversation intervention among family caregivers of an individual with advanced/final stage cancer during ongoing palliative home-care.
BACKGROUND: Family caregivers of patients in the advanced/final phases of cancer, experience multifaceted psychological distress and morbidity. Psychosocial interventions improve the well-being of family members who are caring for their close relative.
DESIGN: A pre-experimental design with a one-group pre-test/posttests measurements.
METHODS: Forty-eight family caregivers were assigned to receive two 60-90 min sessions of the intervention. The primary outcome was perceived emotional and cognitive support and psychological well-being, measured at baseline (T1). Then the participants were offered the first session of the intervention. About one week later, the second session was administered. The participants answered the same questionnaires again (T2) and then 2-4 weeks later (T3). The guideline; Criteria for Reporting Development and Evaluation of Complex Interventions 2, guided the reporting of the study.
RESULTS: Family caregivers reported significantly higher emotional and cognitive support post-intervention (T2) and (T3). They also reported significantly reduced stress symptoms at (T3) and reduced caregiver burden post-intervention (T2) and at (T3).
CONCLUSION: The provision of the intervention contributed to extending knowledge about the usefulness of family conversations in the context of advanced/final stage cancer care.
IMPACT: There is a lack of knowledge regarding the benefit of therapeutic conversations interventions for family caregivers. The therapeutic conversation intervention offered, resulted in perceived support, decreased stress and decreased caregiving demands among caregivers in palliative home-care. This article is protected by copyright. All rights reserved.

Origine : PubMed

Pain and distress management in palliative neonatal care

GARTEN, Lars ; BÜHRER, Christoph
Seminars in fetal and neonatal medicine, 20/04/2019, Pagination inconnue

Document en ligne

Thème : Médecine.

NEONATALOGIE ; DEMARCHE PALLIATIVE ; CONTROLE DOULEUR ; DETRESSE PSYCHOLOGIQUE ; CONTROLE SYMPTOME ; ARRET THERAPEUTIQUE ; NUTRITION ; HYDRATATION ; RECOMMANDATION

Palliative care concentrates on preventing and relieving suffering by reducing the severity of disease symptoms. Consistent treatment of pain and distress must therefore be an integral component of every palliative care concept. In this review non-pharmacological and pharmacological measures for pain and distress management in the context of palliative neonatal care are summarised. Furthermore, recommendations are given focusing on two special palliative neonatal care settings: compassionate extubation and withdrawing artificial nutrition and hydration.

How specialist palliative care nurses identify patients with existential distress and manage their needs

FAY, Zara ; OBOYLE, Colm
International Journal of Palliative Nursing, 02/05/2019, vol.25, n°5, p. 233-243

Document en ligne

Thème : Soins.

INFIRMIERE ; DEMARCHE PALLIATIVE ; IDENTIFICATION ; DETRESSE PSYCHOLOGIQUE ; BESOIN FONDAMENTAL ; RECHERCHE QUALITATIVE

BACKGROUND: Existential distress is a term used when patients who are coming towards the end of their lives exhibit profound suffering, related particularly to their thoughts on life and existence. The clinical expression of this phenomenon has not been widely researched, and so specialist palliative care nurses were asked how they identify and manage this patient cohort.
AIMS: To explore how palliative-care nurses identify patients with existential distress and manage their needs.
METHODS: A qualitative descriptive design with thematic content analysis of transcribed interviews.
FINDINGS: Behavioural changes, agitation, social withdrawal and communication difficulties are identified as indicators of possible existential distress. Susceptible patient groups are identified. Nurses acknowledged that caring for patients with existential distress can be emotionally demanding. Being present and building relationships with patients are identified as enabling meaning-making. Sedation for refractory distress is seen as a last resort.
CONCLUSION: Early identification of existential distress by carers could enable timely intervention (counselling, psychotherapy and or spiritual guidance) to improve the patients' quality of life in the terminal phase of their illness and avoid intractable or refractory existential distress that may necessitate palliative sedation.

Origine : PubMed

A qualitative study to assess collusion and psychological distress in cancer patients

SUTAR, Roshan ; CHANDRA, Prabha S. ; SESHACHAR, Prabha ; GOWDA, Linge ; CHATURVEDI, Santosh K.
Indian journal of palliative care, 06/2019, vol.25, n°2, p. 242-249

Document en ligne

Thème : Soins. Cote : eD02.04.01

RECHERCHE QUALITATIVE ; DETRESSE PSYCHOLOGIQUE ; CANCER ; DEMARCHE PALLIATIVE ; INDE ; COMMUNICATION ; PREVALENCE ; QUESTIONNAIRE ; PATIENT ; FAMILLE ; RELATION MEDECIN PATIENT ; RELATION PATIENT FAMILLE ; RELATION INTERPERSONNELLE

Introduction: Collusion is frequently encountered but least studied entity in palliative care services in India. Impact of collusion is manifold and identifying it requires good communication skills. Once identified, it gives an indication for existing healthy versus developing unhealthy collusion to be dealt within families.
Objective: The objective of this study was to identify the prevalence of collusion and its clinical and psychological correlates among patients and caregivers in a palliative cancer care.
Materials and Methods: We describe systematic identification and unraveling of collusion across multiple levels in a palliative cancer care eventually drafting an algorithm to unravel the collusion. Patients and families were recruited from in-patient palliative care services after obtaining written informed consent. Qualitative interviews were conducted using collusion questionnaire, EQ5D, Visual Analog Scale, and NIMHANS psychiatric morbidity screen.
Results: Among 62 cancer families interviewed, we identified that 71% collusion exists between doctor and patient, 61.3% between doctor and caregiver, and 75.83% between patient and caregiver. Around 50% collusions were unraveled systematically. Collusion was more prevalent in patients with rapid progression of illness (<6 months), patients with poor coping skills, and preference of being interviewed alone.
Conclusion: This statistics suggests that collusion goes unnoticed in terminal illnesses and communication skills play a major role in identifying and dealing with collusion. This also unearths need to formulate interview techniques and structured assessment tools or questionnaire in palliative cancer care which are sparse.

Origine : PubMed

Medical students' experiences of moral distress in end-of-life care

THURN, Tamara ; ANNESER, Johanna
JOURNAL OF PALLIATIVE MEDICINE, 21/05/2019, Pagination inconnue

Document en ligne

Thème : Soins.

ETUDIANT ; MEDECINE ; DETRESSE PSYCHOLOGIQUE ; FIN VIE ; QUESTIONNAIRE ; ALLEMAGNE

Background: Moral distress is a frequent phenomenon in end-of-life care. It occurs when one knows the morally correct response to an ethically challenging situation, but cannot act because of internal or external constraints. Medical students-having a perceived low level in the hospital hierarchy-may be particularly vulnerable to moral distress.
Objective: To assess the frequency and intensity of medical students' moral distress occurring in end-of-life care.
Design: We developed a questionnaire describing 10 potentially morally distressing scenarios in end-of-life care.
Setting: The questionnaire was distributed to all fourth-year students of a German medical school.
Measurements: We asked students (1) if they had ever witnessed the described scenarios and (2) to rate the extent (numeric rating scale 0-4) of moral distress for each situation.
Results: Of 340 students, 217 (64%) completed the survey. On average, students had experienced 2.51 morally distressing situations (standard deviation = ±2.23). The majority of students (N = 163, 75%) had experienced at least one morally distressing situation. Providing futile care with the basic intention to make money was the item with the highest levels of experienced distress (2.88 ± 1.05), witnessed by 54 (25%) participants. Twenty-five students (12%) reported that they had thought about dropping out of medical school or choosing a nonclinical specialty because of moral distress.
Conclusions: Medical students experience moral distress regularly and most frequently in scenarios of futile care. This may be an underestimated factor for medical school attrition. Interventions should identify the sources of moral distress and empower students to address their moral concerns.

Origine : PubMed

Moral distress and attitudes about timing related to comfort care for hospitalized patients - a survey of inpatient providers and nurses

BENDER, Melissa A. ; ANDRILLA, C. Holly A. ; SHARMA, Rashmi K. ; HURD, Caroline ; SOLVANG, Nicole ; MAE-BALDWIN, Laura
The American journal of hospice and palliative care, 09/04/2019, Pagination inconnue

Document en ligne

Thème : Soins.

DETRESSE PSYCHOLOGIQUE ; HOPITAL ; PERSONNEL MEDICAL ; INFIRMIERE ; SOIN CONFORT ; TRAJECTOIRE MALADIE

CONTEXT: Providing nonbeneficial care at the end of life and delays in initiating comfort care have been associated with provider and nurse moral distress.
OBJECTIVE: Evaluate provider and nurse moral distress when using a comfort care order set and attitudes about timing of initiating comfort care for hospitalized patients.
METHODS: Cross-sectional survey of providers (physicians, nurse practitioners, and physician assistants) and nurses at 2 large academic hospitals in 2015. Providers and nurses were surveyed about their experiences providing comfort care in an inpatient setting.
RESULTS: Two hundred five nurse and 124 provider surveys were analyzed. A greater proportion of nurses compared to providers reported experiencing moral distress "some, most, or all of the time" when using the comfort care order set (40.5% and 19.4%, respectively, P = .002). Over 60% of nurses and providers reported comfort care was generally started too late in a patient's course, with physician trainees (81.4%), as well as providers (80.9%) and nurses (84.0%) < 5 years from graduating professional school most likely to report that comfort care is generally started too late.
CONCLUSIONS: The majority of providers and nurses reported that comfort care was started too late in a patient's course. Nurses experienced higher levels of moral distress than providers when caring for patients using a comfort care order set. Further research is needed to determine what is driving this moral distress in order to tailor interventions for nurses and providers.

Origine : PubMed

Spiritual well-being mediates the association between attachment insecurity and psychological distress in advanced cancer patients

SCHEFFOLD, Katharina ; PHILIPP, Rebecca ; VEHLING, Sigrun ; KORANYI, Susan ; ENGELMANN, Dorit ; SCHULZ-KINDERMANN, Frank ; HÄRTER, Martin ; MEHNERT-THEUERKAUF, Anja
Supportive care in cancer, 18/03/2019, p. 1-9

Document en ligne

Thème : Psychologie, psychanalyse.

SPIRITUALITE ; BIEN ETRE ; BESOIN SECURITE ; DETRESSE PSYCHOLOGIQUE ; CANCER ; ALLEMAGNE ; EVALUATION ; DEPRESSION ; ANXIETE

PURPOSE: The diagnosis of a terminal disease bears existential challenges, which activate the attachment system. Attachment insecurity, as well as existential resources, such as spiritual well-being, influences patients' extent of psychological distress. Knowledge about the interrelation of these constructs is limited. Based on current research, we assume spiritual well-being to mediate the association of attachment insecurity and psychological distress.
METHODS: We obtained data from the baseline measurement of a randomized controlled trial in advanced cancer patients. Patients were sampled from the University Medical Centers of Hamburg and Leipzig, Germany. Main outcome measures included the Patient Health Questionnaire (PHQ-9), the Death and Dying Distress Scale (DADDS), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), and the Experience in Close Relationships Scale (ECR-M16) for assessing attachment insecurity. We tested the mediation hypothesis with two regression analyses using bootstrapping procedure.
RESULTS: A total of 190 patients were included. Spiritual well-being mediated the association of attachment insecurity and depression (R2 = 11%), as well as death anxiety (R2 = 15%), in fearful-avoidant attached patients. Neither dismissingly nor preoccupied attached patients differ in terms of spiritual well-being and psychological distress in comparison with secure attached patients.
CONCLUSION: Spiritual well-being plays a relevant role in advanced cancer patient's mental health through mediating the association of attachment and psychological distress. Developing a better understanding of the interdependency of the constructs of spiritual well-being and attachment can help to develop individually tailored advanced cancer care programs and psychotherapeutic interventions.

Origine : PubMed

(1) 2 3 4 ... 14 > »

Confirmer la suppression du commentaire

Actions

Voir la sélection

Déplier les références

Replier les références

Envoyer par Mail

Imprimer la sélection

Imprimer les premières

Sauvegarder les premières

Envoyer les premières par mail

Affiner votre recherche

ANXIETE CANCER DEMARCHE PALLIATIVE DEPRESSION DETRESSE PSYCHOLOGIQUE EVALUATION FAMILLE FIN VIE INFIRMIERE MORT PATIENT PHASE TERMINALE QUALITE VIE SOUFFRANCE PSYCHIQUE SYMPTOME

Type de document

Article

237

Brochure

Contribution congrès

Extrait ouvrage

Mémoire ou Thèse

Monographie

N special periodique

Synthèse documentaire

Vidéo