Palliative care: the need of the modern era

Abstract

There is a great need for palliative care in the modern era of medicine. Despite medical advances, patients with life-limiting illnesses still suffer significantly. Palliative care emerged a half century ago as an ethos based on compassion and care for patients and their families to relieve their suffering. It entails a paradigm shift from the biomedical model to the biopsychospiritual model. Palliative care is recognised by the World Health Organization as an essential part of the continuum of universal health coverage. In 2014, the World Health Assembly approved a resolution on "Strengthening of palliative care as a component of comprehensive care throughout the life course". Despite Hong Kong's relatively good local palliative care service coverage for patients who died of cancer and end-stage renal failure, service gaps for palliative care do exist among our ageing population with non-malignant life-limiting illnesses. We strongly urge the Hong Kong Government to develop our local palliative care policy in response to the World Health Assembly's resolution. Growing international and local evidence demonstrates the impacts of palliative care on patient outcomes, caregivers, and health care. Such outcomes can be service-based, disease-based, or symptom/suffering-based. The goal of palliative care is to relieve health-related suffering. Evidence-based management of pain, breathlessness, and psychospiritual suffering are discussed. Care in the end-of-life phase should be an integral part of palliative care, promoting patient choice, advance care planning, and good death.

Knowledge, attitude, confidence, and educational needs of palliative care in nurses caring for non-cancer patients: a cross-sectional, descriptive study

“…Palliative care has been proposed as a continuous care model beginning at disease diagnosis and continuing through the patients’ end-of-life (EOL) [ 2 ]. The need for palliative care is increasing worldwide because of population aging, an increased prevalence of chronic diseases, and increased interest in quality of life [ 3 – 5 ]. For example, based on an analysis of mortality statistics in England and Wales from 2006 to 2014, 160,000 more people annually will need palliative care by 2040, if the current mortality trend continues [ 6 ].…”

Pharmacists’ knowledge, attitude and involvement in palliative care in selected tertiary hospitals in southwestern Nigeria

“…Even though it may be expected that managing patients with lifelimiting illness especially at the end of life can be emotionally draining [2,5,6], palliative care providers should not allow his/her emotion to affect the therapeutic relationship with the patients, thus the need to develop appropriate communication skills and approach to handle the psychosocial aspect of care. Palliative care is an approach to care that emphasize the relief of patients from all forms of suffering and pain including physical, psychological, social, as well as spiritual discomfort [2,[6][7][8]. In addition to possessing effective communication skills by the pharmacists, clinical experience especially in pain management and symptom control is equally important.…”

“…The growing number of people living with life-limiting illness is a global health concern that may necessitate a paradigm shift towards provision of palliative care service by all healthcare professionals regardless of the practice settings [1][2][3][4]. Current estimate suggests that approximately 75% of people approaching the end-oflife may benefit from palliative care [4], with international and local evidence demonstrating the impact of palliative care on patient outcomes, caregiver and healthcare [2].…”

“…The growing number of people living with life-limiting illness is a global health concern that may necessitate a paradigm shift towards provision of palliative care service by all healthcare professionals regardless of the practice settings [1][2][3][4]. Current estimate suggests that approximately 75% of people approaching the end-oflife may benefit from palliative care [4], with international and local evidence demonstrating the impact of palliative care on patient outcomes, caregiver and healthcare [2]. Palliative care is a patient-and familycentred approach to care focusing on quality of life and relief of symptoms [5][6][7], thus, it is a complex health discipline that requires extensive collaboration and teamwork among healthcare professionals, patients and caregivers [6,8,9].…”

Loneliness and Dying as Issues of Public Concern in Sweden

“…In the study, the authors claim that there are risks when transferring "one joint idea" for end-of-life care from developed to developing countries, and that the plurality of local problems within end-of-life care should be in focus, rather than striving towards universality. The concept "evidence-based medicine" (Greenhalgh & Russell 2009) has increasingly been endorsed within palliative care (Visser, Hadley & Wee 2015;Aoun & Nekolaichuk 2014;Higginson 1999;Chan 2018). Several studies highlight, however, that the "evidence" on outcomes of palliative care is scarce and focusing on ensuring evidence-based care is difficult in the context of palliative care.…”