Psychiatry and Terminal Illness

Chochinov, Harvey Max

doi:10.1177/070674370004500204

Cited by 36 publications

(12 citation statements)

References 73 publications

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“…A significant number of cancer patients report feelings of being a burden to others (Chochinov & Cann 2005)hopelessness or demoralization [i.e. 23% to 58% (Cohen et al 1996;Fehring et al 1997;Chochinov 2000)] and losing one's will to live or expressing a heightened desire for death and a propensity to wish a hastened death [i.e. 23% to 58% (Cohen et al 1996;Fehring et al 1997;Chochinov 2000)] and losing one's will to live or expressing a heightened desire for death and a propensity to wish a hastened death [i.e.…”

Section: Existential Distress Of Cancer Patientsmentioning

confidence: 99%

Alleviating existential distress of cancer patients: can relational ethics guide clinicians?

Leung

Esplen

2010

European Journal of Cancer Care

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Most people have a heightened awareness of death at the moment they receive a cancer diagnosis. Medical treatment attempts to demystify and manage death, yet surprisingly, care that alleviates existential distress is the least provided psychosocial care. A review of empirical research [quantitative and qualitative studies (n = 85) and seven literature reviews] was conducted to explore the experiences of clinicians (primarily nurses) working with cancer patients who experience existential distress. This paper summarizes clinicians' experiences with cancer patients who face the threat of mortality. Given that the majority of literature was found to be in nursing, emphasis in this paper tends to be on nurses' experiences. However, findings are suggested to have implications for other clinicians who deal with similar concerns. A lens of relational ethics was inductively found to organize and highlight problems and gaps that originate from interpersonal concerns. This paper describes four themes requiring further research and education related to existential distress: engagement, embodiment, environment and mutual respect. Implications for oncology care are suggested at the micro-, meso- and macro-levels to encourage clinicians to ethically respond to patients' existential distress needs.

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Section: Existential Distress Of Cancer Patientsmentioning

confidence: 99%

Alleviating existential distress of cancer patients: can relational ethics guide clinicians?

Leung

Esplen

2010

European Journal of Cancer Care

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“…It is also clear that the distinction between somatic distress and psychological or spiritual disquietude becomes less clear and increasingly entangled as death draws near. 1 Yet, there is an inclination for care providers to parse these out, focusing on those things that seem within our grasp to attenuate, while neglecting those we sense are beyond reach. There is, however, growing awareness in palliative care that patients must not only be made to feel more comfortable, but more broadly, provided with comfort.…”

Section: Introductionmentioning

confidence: 99%

Dying, Dignity, and New Horizons in Palliative End-of-Life Care

Chochinov

2006

CA: A Cancer Journal for Clinicians

286

200

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Palliative care practitioners are now better able than ever before to ameliorate endof-life symptom distress. What remains less developed, however, is the knowledgebase and skill set necessary to recognize, assess, and compassionately address the psychosocial, existential, and spiritual aspects of the patient's dying experience. This review provides an overview of these areas, focusing primarily on empirical data that has examined these issues. A brief overview of psychiatric challenges in end-of-life care is complemented with a list of resources for readers wishing to explore this area more extensively. The experience of spiritual or existential suffering toward the end of life is explored, with an examination of the conceptual correlates of suffering. These correlates include:hopelessness, burden to others, loss of sense of dignity, and desire for death or loss of will to live. An empirically-derived model of dignity is described in some detail, with practical examples of diagnostic questions and therapeutic interventions to preserve dignity. Other interventions to reduce existential or spiritual suffering are described and evidence of their efficacy is presented. The author concludes that palliative care must continue to develop compassionate, individually tailored, and effective responses to the mounting vulnerability and increasingly difficult physical, psychosocial, and spiritual challenges facing persons nearing the end of life.

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“…He/she can make a comprehensive assessment of the psychosocial and spiritual issues and the impact of physical problems and medical interventions on the mental health of the patient in end of life. He/she can distinguish between distress and clinically significant depressive and anxiety disorders and delirium, commonly seen in terminal illness and EOLC (Chochinov, 2000[7]).…”

Section: Role Of Psychiatry In End-of-life Carementioning

confidence: 99%

End-of-Life Care and Psychiatry: Current Trends and Future Directions in India

Deodhar

2016

Mens Sana Monogr

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Although 80% of the deaths worldwide occur in middle- and low-income countries such as India, there is less awareness of end-of-life care (EOLC) for people with chronic, serious, progressive, or advanced life-limiting illnesses, including dementia. EOLC involves good communication, clinical decision-making, liaison with medical teams and families, comprehensive assessment of and specialized interventions for physical, psychological, spiritual, and social needs of patients and their caregivers. The psychiatrist can play a significant role in each of the above domains in EOLC. The current trends in India are examined, including ambiguities between EOLC and euthanasia. Future directions include formulating a national EOLC policy, providing appropriate services and training. The psychiatrist should get involved in this process, with major responsibilities in providing good quality EOLC for patients with both life-limiting physical illnesses and severe mental disorders, supporting their caregivers, and ensuring dignity in death.

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Psychiatry and Terminal Illness

Abstract: While psychiatry has made tremendous inroads toward providing care to patients throughout the life cycle, its presence is only just beginning to be felt in end-of-life care. Within the domain of palliative care, psychiatry has an expanded and important role to play.

Cited by 36 publications

References 73 publications

Alleviating existential distress of cancer patients: can relational ethics guide clinicians?

Alleviating existential distress of cancer patients: can relational ethics guide clinicians?

Dying, Dignity, and New Horizons in Palliative End-of-Life Care

End-of-Life Care and Psychiatry: Current Trends and Future Directions in India

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