Early Palliative Care For Patients With Advanced Cancer: A Review Of Interventions

Summary Of Evidence

The first annotated article provides an overview about a research that was conducted on old-age patients who are at the advanced stage of cancer and are placed under palliative care. The study was conducted in Canada, at the Princess Margaret Cancer Center and it aimed at carrying out interventions so as to reduce the symptoms and enhance the quality of life of the palliative care patients (Zimmermann et al., 2014). The research proceeded with the consideration of 461 random sample participants who were reported to be at the advanced stage of cancer. Out of the considered sample size, 4-lung cancer, 4-genitourinary, 6-breast cancer, 8-gastrointestinal and 2-gynaecological tumour types were analysed in order to obtain a diverse participant sample. The inclusion criteria comprised of the patients who were terminally ill and were at the advanced stage of cancer with less than 6 months of life, whereas the exclusion criteria comprised of patients who were diagnosed under the initial stage of cancer. In order to fulfil the objective of the research of securing a quality life to the patients placed under the palliative care, thorough chronic illness management therapeutic interventions were dispensed and the post intervention the efficacy was measured on the basis of various wellness scores. The wellness scores that were analysed were the spiritual wellness scale, the Symptom assessment scale which is also known as Edmonton Symptom Assessment System, the quality of life at the end of life determining scale, the satisfaction with care scale and the cancer evaluation and medical interaction subscale (Aslakson et al., 2014). Based on the obtained score the efficacy of the chronic illness interventions were judged.  Early Palliative Care For Patients With Advanced Cancer Essay Paper

The results yielded by the sample size of (228 intervention and 223 control participants) showed the positive impact of the interventions, but at the same time there was no significant result obtained for the CARES-MIS scale. All the positive results were in favour of the group of patients that were provided interventions, however the control group showed no significant changes in the scores. It is crucial to note here that the different scores were measured at the interval of 3 months first and then again at the interval of four months. In the first case, the results did not show any significant change but in the second case, the results showed positive changes. Hence, it can be said that the paper presents an overview about incorporating chronic illness therapeutic intervention on patients placed at palliative care and the results provide a promising scenario (Higginson etal., 2014). Although, the time frame was restricted to a tenure of 6 months only, the research provides a supportive framework for further research projects on chronic illness management and palliative care (Urden et al., 2017).

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Nursing Practices For Old-Age Patients

The second annotated article provides an overview about the successful implementation of music therapy on patients placed under palliative care and reduce the sensation of pain. The research was carried out the University Hospital Case Medical Center. This research design was based on a clinical randomized trial and the inclusion criteria for the research comprised of patients experiencing severe pain in the leg and face with a very high value in the pain score card and the exclusion criteria comprised of patients with a lower pain score. The research proceeded with the objective of measuring the efficiency of non-pharmacological methods to ensure reduction of pain in leg and face in old-age patients. The study was conducted on 200 participants who were segregated into two groups. One group was administered analgesics whereas another group was given music therapy. The study proceeded for two years and the effectiveness of music therapy on the patients was accessed through the pain score card that was further analysed on the basis of statistical analysis (Gutgsell et al., 2017). Early Palliative Care For Patients With Advanced Cancer Essay Paper The results revealed a greater reduction in the group of patients who were administered music therapy with respect to the group of patients who were not administered non-pharmacological intervention. Hence, to summarise the results, it can be said that the use of non-pharmacological methods to reduce the sensation of pain in old-age patients seem to be extremely effective (Aust,2013). At the same time, the research considered a wide sample size of 200 patients and also proceeded for a time period of 2 years, which clearly makes it extremely feasible to generalise the findings of this research paper and adopt measures to implement the findings in palliative care. This paper also presents a brilliant view on the effectiveness of the non-pharmacological interventions and it has been reported that music therapy not only helps in the reduction of the severity of the symptoms such as pain and inflammation in the old-age patients but also helps in the treatment of anxiety, restlessness and depression (Lewis et al.,2016). Music therapy as well as narrative therapy has been reported to be the best non-medical interventions used in the palliative care (Bunt & Stige, 2014).

Therefore it can be concluded that patients placed under the palliative care have a wide range of complications that are to be addressed using the best nursing practices (Clements-Cortes, 2016). While dealing with the old-age patients, nursing professionals have to be extremely sympathetic and understanding (Warth et al., 2014). It is important to understand the patients placed under the palliative care are at their terminal age and are subjected to chronic illness therapeutic interventions and long term care. It is important to state here that while designing chronic illness interventions for the elderly patients, efforts are undertaken to successfully reduce the manifestation of symptoms because complete cure at the terminal age is not possible (Archie et al., 2013). All interventions are aimed at reducing the drastic effect of the symptoms causing pain and suffering (Basch et al., 2016).

Importance Of Emotional Well-Being For Family Members

Additionally it is also important for the care givers to be empathetic and considerate towards the patients as old age and fear of death in itself are extremely challenging for the patients to come to terms with or comply with (Warth et al., 2015). Therefore it is vital for the team of care givers to practice compassion along with the devised intervention procedure (Slocum-Gori et al., 2013). In addition to this, it should also be stated that palliative care does not only focus on the patients but also deals with the emotional well being of the family members who are related to the patient. The whole idea is to be able to reduce the painful symptoms of the critically ill patients and improve their quality of life to an extent that it provides an amount of relief to the immediate family members of the patients as well (Dobrina et al., 2014). It has been often seen that the primary care providers of the patients that is the immediate family members often end up emotionally disturbed on seeing their loved ones suffer so much and at the same time, terminal sickness proves to be an additional burden in terms of mental and emotional exhaustion as well as heavy financial expenditure (Kavalierators et al., 2014). Hence the idea is to design interventions appropriately so as to improve the quality of life of the patient as well as the family members.

References:

Archie, P., Bruera, E., & Cohen, L. (2013). Music-based interventions in palliative cancer care: a review of quantitative studies and neurobiological literature. Supportive Care in Cancer, 21(9), 2609-2624.

Aslakson, R., Cheng, J., Vollenweider, D., Galusca, D., Smith, T. J., & Pronovost, P. J. (2014). Evidence-based palliative care in the intensive care unit: a systematic review of interventions. Journal of palliative medicine, 17(2), 219-235.

Aust, M. P. (2013). Critical care nursing: a holistic approach,pp-49-50

Basch, E., Deal, A. M., Kris, M. G., Scher, H. I., Hudis, C. A., Sabbatini, P., … & Chou, J. F. (2016). Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. Journal of Clinical Oncology, 34(6), 557.

Bunt, L., & Stige, B. (2014). Music therapy: An art beyond words. Routledge,pp-110

Clements-Cortés, A. (2016). Development and efficacy of music therapy techniques within palliative care. Complementary therapies in clinical practice, 23, 125-129.

Dobrina, R., Tenze, M., & Palese, A. (2014). An overview of hospice and palliative care nursing models and theories. International journal of palliative nursing, 20(2), 75-81.

Gutgsell, K. J., Schluchter, M., Margevicius, S., DeGolia, P. A., McLaughlin, B., Harris, M., … & Wiencek, C. (2013). Music therapy reduces pain in palliative care patients: a randomized controlled trial. Journal of Pain and Symptom Management, 45(5), 822-831.

Higginson, I. J., Bausewein, C., Reilly, C. C., Gao, W., Gysels, M., Dzingina, M., … & Moxham, J. (2014). An integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness: a randomised controlled trial. The Lancet Respiratory Medicine, 2(12), 979-987.

Kavalieratos, D., Mitchell, E. M., Carey, T. S., Dev, S., Biddle, A. K., Reeve, B. B., … & Weinberger, M. (2014). “Not the ‘grim reaper service’”: an assessment of provider knowledge, attitudes, and perceptions regarding palliative care referral barriers in heart failure. Journal of the American Heart Association, 3(1), e000544.

Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2016). Medical-Surgical Nursing-E-Book: Assessment and Management of Clinical Problems, Single Volume. Elsevier Health Sciences,pp 77-79

Slocum-Gori, S., Hemsworth, D., Chan, W. W., Carson, A., & Kazanjian, A. (2013). Understanding compassion satisfaction, compassion fatigue and burnout: A survey of the hospice palliative care workforce. Palliative medicine, 27(2), 172-178.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical Care Nursing-E-Book: Diagnosis and Management. Elsevier Health Sciences,pp 110-111

Warth, M., Keßler, J., Hillecke, T. K., & Bardenheuer, H. J. (2015). Music therapy in palliative care: A randomized controlled trial to evaluate effects on relaxation. Deutsches Ärzteblatt International, 112(46), 788.  Early Palliative Care For Patients With Advanced Cancer Essay Paper