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Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly. The term geriatrics originates from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". It aims to promote health by preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.
In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
Dame Cicely Mary Strode Saunders was an English nurse, social worker, physician and writer. She is noted for her work in terminal care research and her role in the birth of the hospice movement, emphasising the importance of palliative care in modern medicine, and opposing the legalisation of voluntary euthanasia.
Nursing theory is defined as "a creative and conscientious structuring of ideas that project a tentative, purposeful, and systematic view of phenomena". Through systematic inquiry, whether in nursing research or practice, nurses are able to develop knowledge relevant to improving the care of patients. Theory refers to "a coherent group of general propositions used as principles of explanation".
Helen Lorraine (Cook) Erickson is the primary author of the modeling and role-modeling theory of nursing. Her work, co-authored with Evelyn Tomlin and Mary Ann Swain, was published in the 1980s and derived from her experience in clinical practice. In 2006 she edited a book that provides additional information describing the relationships among soul, spirit, and human form.
End-of-life care refers to health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.
The Liverpool Care Pathway for the Dying Patient (LCP) was a care pathway in the United Kingdom covering palliative care options for patients in the final days or hours of life. It was developed to help doctors and nurses provide quality end-of-life care, to transfer quality end-of-life care from the hospice to hospital setting. The LCP is no longer in routine use after public concerns regarding its nature. Alternative pathways are now in place to ensure patients are able to have dignity in their final hours of life. Hospitals were also provided cash incentives to achieve targets for the number of patients placed on the LCP.
In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.
Diane E. Meier, an American geriatrician and palliative care specialist. In 1999, Dr. Meier founded the Center to Advance Palliative Care, a national organization devoted to increasing access to quality health care in the United States for people living with serious illness. She continues to serve as CAPC's Director Emerita and Strategic Medical Advisor. Meier is also Vice-Chair for Public Policy, Professor of Geriatrics and Palliative Medicine and Catherine Gaisman Professor of Medical Ethics at the Icahn School of Medicine at Mount Sinai Hospital in New York City. Meier was founder and Director of the Hertzberg Palliative Care Institute at the Icahn School of Medicine in New York City from 1997 to 2011.
May Louise Hinton-Wykle, is an American nurse, gerontologist, educator, researcher, and the first African-American Marvin E. and Ruth Durr Denekas Endowed Chair at the Frances Payne Bolton School of Nursing of Case Western Reserve University. Wykle also serves as a professor at Georgia Southwestern State University and teaches Geriatric Nursing, Mental Health Nursing, Nursing Administration, and Minority Student Recruitment and Retention.
Holistic nursing is a way of treating and taking care of the patient as a whole body, which involves physical, social, environmental, psychological, cultural and religious factors. There are many theories that support the importance of nurses approaching the patient holistically and education on this is there to support the goal of holistic nursing. The important skill to be used in holistic nursing would be communicating skills with patients and other practitioners. This emphasizes that patients being treated would be treated not only in their body but also their mind and spirit.. Holistic nursing is a nursing speciality concerning the integration of one's mind, body, and spirit with his or her environment. This speciality has a theoretical basis in a few grand nursing theories, most notably the science of unitary human beings, as published by Martha E. Rogers in An Introduction to the Theoretical Basis of Nursing, and the mid-range theory Empowered Holistic Nursing Education, as published by Dr. Katie Love. Holistic nursing has gained recognition by the American Nurses Association (ANA) as a nursing specialty with a defined scope of practice and standards. Holistic nursing focuses on the mind, body, and spirit working together as a whole and how spiritual awareness in nursing can help heal illness. Holistic medicine focuses on maintaining optimum well-being and preventing rather than just treating disease.
Deathbed phenomena refers to a range of experiences reported by people who are dying. There are many examples of deathbed phenomena in both non-fiction and fictional literature, which suggests that these occurrences have been noted by cultures around the world for centuries, although scientific study of them is relatively recent. In scientific literature such experiences have been referred to as death-related sensory experiences (DRSE). Dying patients have reported to staff working in hospices they have experienced comforting visions.
Empowered Holistic Nursing Education - Mid-range Nursing Theory
Kolcaba's theory of comfort explains comfort as a fundamental need of all human beings for relief, ease, or transcendence arising from health care situations that are stressful. Comfort can enhance health-seeking behaviors for patients, family members, and nurses. The major concept within Katharine Kolcaba's theory is the comfort. The other related concepts include caring, comfort measures, holistic care, health seeking behaviors, institutional integrity, and intervening variables.
The role of spirituality in health care has received significant research attention due to its benefits for patients and health care professionals. Integrating spirituality in healthcare can enhance healthcare professionals' ability to communicate effectively with patients and families. It can also have a positive impact on the health and well-being of patients due to its potential to enhance patients' ability to cope with illness and achieve better physical and mental health outcomes. As per 2014, more than 70 medical schools in the United States offer courses on spirituality and medicine. The Association of American Medical Colleges has co-sponsored, with the National Institute for Healthcare Research, four conferences, on curricular development in spirituality and medicine since 1997.
Margaret Ruth McCorkle FAAN, FAPOS was an American nurse, oncology researcher, and educator. She was the Florence Schorske Wald Professor of Nursing at the Yale School of Nursing.
References
- ↑ March, A; McCormack, D (Mar–Apr 2009), "Nursing theory-directed healthcare: modifying Kolcaba's comfort theory as an institution-wide approach", Holistic Nursing Practice, 23 (2): 75–80, doi:10.1097/hnp.0b013e3181a1105b, PMID 19258847
- 1 2 3 4 Kolcaba, Katharine (2003). Comfort Theory and Practice: A Vision for Holistic Health Care and Research. Springer. ISBN 9780826116338.
- ↑ Sitzman, Kathleen; Eichelberger, Lisa Wright (2015). Understanding the Work of Nurse Theorists. Jones & Bartlett Learning. ISBN 9781284113112.
- ↑ Snowden, Austyn; Donnell, Allan; Duffy, Tim (2014). Pioneering Theories in Nursing. Andrews UK Limited. ISBN 9781856424806.
- ↑ Masters, Kathleen (2013). Role Development in Professional Nursing Practice. Jones & Bartlett Publishers. p. 73. ISBN 9781449681982.
- ↑ Kolcaba, Katharine (2001-03-01). "Evolution of the mid range theory of comfort for outcomes research". Nursing Outlook. 49 (2): 86–92. doi:10.1067/mno.2001.110268. ISSN 0029-6554. PMID 11309563.
- 1 2 Kolcaba, K (2001). "Evolution of mid-range theory of comfort for outcomes research". Nursing Outlook. 49 (2): 86–92. doi:10.1067/mno.2001.110268. PMID 11309563.
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