The Difference Between Palliative Care and End of Life Care: More than Semantics

Krau, Stephen D.

doi:10.1016/j.cnur.2016.07.002

Cited by 33 publications

(26 citation statements)

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“…End-of-life (EOL) care includes physical, emotional, social, and spiritual support for patients and their families." End-of-life care is a portion of palliative care that is directed toward the care of persons who are nearing end of life [1]. Palliative care is fundamental to health and human dignity and is a basic human right.…”

Section: Introductionmentioning

confidence: 99%

“…The National Cancer Institute describes end-of-life care as “care given to people who are near the end of life and have stopped treatment to cure or control their disease. End-of-life (EOL) care includes physical, emotional, social, and spiritual support for patients and their families.” End-of-life care is a portion of palliative care that is directed toward the care of persons who are nearing end of life [ 1 ]. Palliative care is fundamental to health and human dignity and is a basic human right.…”

Section: Introductionmentioning

confidence: 99%

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Attitudes of registered nurses about the end – of – life care in multi-profile hospitals: a cross sectional survey

2020

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Background: End-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason why it is very important to assess all barriers to end-of-life care and to provide safe and quality services to patients. This study was aimed at describing nurses' attitudes in providing end-of-life care and exploring barriers and facilitating behaviors of nurses in multi-profile hospitals in Eastern Europe. Methods: A descriptive, correlational design was applied in this study, using a cross-sectional survey of 1320 registered nurses within 7 hospitals in Lithuania. Results: Registered nurses working in the three different profiles emphasized safe and effective care and the importance of meeting the patient's spiritual needs at the end of life. The main barriers assigned by nurses caring for patients at the end of life were angry family members, inadequate understanding of nursing care by the patient's relatives; lack of time to talk to patients, lack of nursing knowledge to deal with the bereaved patient's family, lack of evaluation of nurses' opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. The main facilitating behaviors to improve nursing care were end-of-life training, volunteering, and family involvement. Conclusions: Spiritual needs were identified by nurses as the primary needs of patients at the end of life. Familyrelated barriers remain one of the main barriers to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitudes of registered nurses about the end – of – life care in multi-profile hospitals: a cross sectional survey

2020

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“…ICU palliative care has received support from major intensive care organizations such as the American Association of Critical Care Nurses () and the Society of Critical Care Medicine (). ICU palliative care at the end of life also includes the component of decision‐making, where patients and families decide on the goals of treatment (Krau, ). Such decisions include whether to resuscitate or not to resuscitate a patient or to withdraw treatment such as ventilation, should the need arise.…”

Section: Introductionmentioning

confidence: 99%

Nurses' perceptions of intensive care unit palliative care at end of life

Ganz

Sapir

2018

Nursing in Critical Care

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Background Significant barriers can block the provision of palliative care at the end of life in the intensive care unit (ICU). However, the relationship between perceptions of ICU quality palliative care and barriers to palliative care at the end of life is not well documented. Aims and objectives To describe ICU nurses' perceptions of quality palliative end‐of‐life care, barrier intensity and frequency to palliative care and their association with one another. Design This was a descriptive, correlational, cross‐sectional design. Methods A convenience sample of 126 ICU nurses from two hospitals in Israel was recruited for the study. Participants completed three pencil‐and‐paper questionnaires (a personal characteristics questionnaire, the Quality of Palliative Care in the ICU and a revised Survey of Oncology Nurses' Perceptions of End‐of‐Life Care). Respondents were recruited during staff meetings or while on duty in the ICU. Ethical approval was obtained for the study from participating hospitals. Results The item mean score of the quality of palliative end‐of‐life care was 7·5/10 (SD = 1·23). The item mean barrier intensity and frequency scores were 3·05/5 (SD = 0·76) and 3·30/5 (SD = 0·61), respectively. A correlation of r = 0·46, p < 0·001 was found between barrier frequency and intensity and r = −0·19, p = 0·04 between barrier frequency and quality palliative end‐of‐life care. Conclusions ICU nurses perceived the quality of palliative care at the end of life as moderate despite reports of moderate barrier levels. The frequency of barriers was weakly associated with quality palliative end‐of‐life care. However, barrier intensity did not correlate with quality palliative end‐of‐life care at a statistically significant level. Further research that investigates other factors associated with quality ICU palliative care is recommended. Relevance to clinical practice Barriers to palliative care are still common in the ICU. Increased training and education are recommended to decrease barriers and improve the quality of ICU palliative care.

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“…The World Health Organization defines palliative care as a multidisciplinary approach “[…] that improves the quality of life of patients and their families facing the problem associated with life-threatening illness.” 11 This includes—but is not limited to—end-of-life or hospice care, which in some countries is restricted to the last 6 months of life. 12,13 Hence, in an end-of-life situation, interventions in palliative care need to adapt to specific requirements that may include physical weakness, mental deficits, rapidly changing physical states, and a very limited amount of time to work with a patient. 14 Therefore, the conception and evaluation of brief interventions may become particularly relevant.…”

Section: Introductionmentioning

confidence: 99%

Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis

et al. 2019

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Background: Patients with a terminal disease report a high need for psychosocial and spiritual support. Previous literature reviews on psychosocial interventions in palliative care were restricted to certain subtypes of techniques, included a wide range of patients, conditions, and settings, or required a number of sessions unrealistic to be achieved in patients nearing the end of their lives. Aim: The aim of this study was to review and synthesize the evidence on brief psychosocial interventions (i.e. four sessions or less and less than 21 days) for patients receiving palliative treatment. Design: We performed a systematic review and meta-analysis in accordance with standard guidelines and a pre-registered protocol (PROSPERO: CRD42018082713). Data sources: Electronic databases, journals, and references were searched for controlled clinical trials. We used the Cochrane criteria to assess the risk of bias within studies. Results: In total, 15 studies met the eligibility criteria and reported the effects of 17 interventions and a total of 1248 patients. The most frequently used techniques were life review techniques and music therapy. After exclusion of outliers, psychosocial interventions showed to be superior with regard to the improvement of quality of life (effect size = 0.36, confidence interval = 0.08 to 0.64), and the reduction of emotional (effect size = −0.51, confidence interval = −0.77 to −0.26) and existential distress (effect size = −0.40, confidence interval = −0.71 to −0.07) compared to the control groups. Conclusion: Brief psychosocial interventions can improve clinically relevant health outcomes and should therefore be made available for patients receiving palliative care.

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The Difference Between Palliative Care and End of Life Care: More than Semantics

Cited by 33 publications

References 0 publications

Attitudes of registered nurses about the end – of – life care in multi-profile hospitals: a cross sectional survey

Attitudes of registered nurses about the end – of – life care in multi-profile hospitals: a cross sectional survey

Nurses' perceptions of intensive care unit palliative care at end of life

Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis

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