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- Albinsson, L, et al.
(author)
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A palliative approach to existential issues and death in end-stage dementia care
- 2002
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In: Journal of palliative care. - : SAGE Publications. - 0825-8597 .- 2369-5293. ; 18:3, s. 168-174
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate how, in relation to the palliative philosophy of care, municipal staff caring for patients with dementia deal with existential issues, the dying process, and bereavement follow up with next of kin. Methods: Thirty-one semi-structured interviews were performed and analyzed using a modified phenomenographic method. Results: Those interviewed experienced existential issues as difficult to handle, and they felt lost. Three patterns of answers emerged: 1) attempting to minimize or ignore the issue, 2) pleading, in relation to the patient, that no one has control over issues concerning life and death, and 3) showing affection for the patient. When faced with dying patients, they made things easier for the family, and their goal was that the patient should not be left alone. No systematic bereavement follow up of next of kin occurred. Discussion: Suggestions are made for improving municipal care, and applying palliative care principles for patients dying of dementia.
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- Andersson, Sofia, et al.
(author)
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Translation, Adaptation, and Validation of the Swedish Serious Illness Conversation Guide
- 2024
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In: Journal of Palliative Care. - : Sage Publications. - 0825-8597. ; 39:1, s. 21-28
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Journal article (peer-reviewed)abstract
- Objective: To translate and adapt the Serious Illness Conversation Guide for use within the Swedish healthcare setting and examine the validity and acceptability of the Swedish Serious Illness Conversation Guide. Methods: Three rounds of cognitive interviews were conducted (T1-3); patients (T1 n = 11; T2 n = 10; T3 n = 8), family members (T1 n = 5; T2 n = 2; T3 n = 2), and healthcare professionals (T1 n = 6; T2 n = 6; T3 n = 5). The guide was iteratively adapted based on interview feedback, clinical experience, and the literature. The guide was tested on training days with physicians and nurses. Results: The Swedish Serious Illness Conversation Guide was found to be useful in supporting serious illness conversations. Clinicians reported that some questions were emotionally challenging. Explicit questions about prognosis and timing were excluded. Instead, the dual approach of "hoping for the best and preparing for the worst" was used to explore patients' thoughts about the future. Conclusions: Patients, family members, and healthcare professionals found the Swedish Serious Illness Conversation Guide to be appropriate, sensitive, and responsive to their needs. The Swedish Serious Illness Conversation Guide may facilitate a more health-promoting approach to serious illness conversations. Further research is needed to understand the impact of these conversations on person-centered and goal-concordant care.
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| 4. |
- Berggren, E, et al.
(author)
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Symptom Burden in Patients With Home Care Who Are at Risk for Malnutrition: A Cross-Sectional Study
- 2020
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In: Journal of palliative care. - : SAGE Publications. - 2369-5293 .- 0825-8597. ; 35:2, s. 103-109
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Journal article (peer-reviewed)abstract
- In Sweden, patients in early palliative stages of illness are cared for in primary care and often offered home care. Many are older and at risk for malnutrition, but little is known about their symptom burden and nutritional problems. This cross-sectional study divided older patients in home care into those with and without risk for malnutrition and compared symptom burden in the 2 groups. Participants were patients in Stockholm County (n = 121) in early palliative stages of disease cared for at home by primary care professionals from 10 health-care centers. The Mini Nutritional Assessment (MNA) was used to identify risk for malnutrition. Symptoms and/or nutritional status in patients with and without risk were assessed with the Functional Assessment of Anorexia/Cachexia Therapy (FAACT), Patient-Generated Subjective Global Assessment Short Form (PG-SGA), and Edmonton Symptom Assessment System (ESAS). Forty-two percent of the patients were at risk for malnutrition (MNA). Appetite ( P = .012), tiredness ( P = .003), and anxiety ( P = .008) were worse in these patients than in those without risk (ESAS; significance level, P ≤ .015). Patients at risk were also more concerned about how thin they looked ( P = .006), agreed more strongly that their family or friends were pressuring them to eat ( P = .000; FAACT; significance level, P ≤ .029), had a higher symptom burden ( P = .005), had lower physical activity ( P = .000), and more lost weight over time ( P = .032; PG-SGA; significance level, P ≤ .040). This study adds a more detailed picture of the symptom burden in older patients at risk for malnutrition. Such information is needed to identify risk for malnutrition earlier and improve patients’ health.
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| 9. |
- Dahlin, Y, et al.
(author)
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Patients' experiences of physical therapy within palliative cancer care
- 2009
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In: Journal of palliative care. - : SAGE Publications. - 0825-8597 .- 2369-5293. ; 25:1, s. 12-20
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Journal article (peer-reviewed)abstract
- Few studies have analyzed patients’ experiences of physical therapy within palliative cancer care. Objective: To describe how patients with incurable cancer experience physical therapy. Method: Seventeen patients were interviewed. Data was analyzed according to a contextual analysis within a phenomenographic approach. Result: Two aspects were identified: “clear and satisfactory” and “unclear and unsatisfactory”. Descriptive categories were: “participation”, “motivation and encouragement”, “independence”, “relief and well-being”, “security and hope”, “unclear part of the care”, and “insufficient number of interventions”. “Participation” was a core category interrelated with patient satisfaction. Conclusion: Physical therapy was important: it enabled independence, provided relief from distressing symptoms, and offered support. However, communication and coordination within the palliative care team has to improve if it is to minimize the negative impact of symptom distress on patient well-being and quality of life. Also, physical therapists must develop strategies for patient empowerment and methods for assessing and evaluating qualitative aspects of physical therapy in palliative cancer care.
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