The Potential Role of Psychosocial Rehabilitation in Palliative Care

Abstract

Palliative care is an integrated approach that promotes the quality of life of patients and families who are confronted with the physical, psychosocial and spiritual problems associated with a life-threatening illness. 1 The palliative patient is not necessarily a terminal patient (estimated prognosis of 3-6 months), or a moribund or agonising patient (estimated prognosis of days or hours). 1 According to the World Health Organization (WHO) and the National Plan of Palliative Care, palliative care: affi rms life and accepts death as a natural process, without trying to delay the process; constitutes a global and holistic approach to the patients suffering from a physical, psychological, social and spiritual point of view; seeks the wellbeing and quality of life of the patient; is centered on the needs of patients and their families, life and death; should not be restricted to terminally ill and agonised patients; and, should be addressed by a multidisciplinary team. 1,2 The person with a life-threatening illness feels in total pain. 1 Patients with an advanced life-limiting illness experience great suffering, a complex negative state of malaise (bodily, affective, cognitive, spiritual) characterised by feeling threatened and destroyed in the integrity or continuity of their existence, a sensation of powerlessness to face this threat and an exhaustion of their personal and psychosocial resources. 1 The main sources of suffering in palliative care patients are poorly controlled symptoms, loss of autonomy and dependence on others, alterations in body image, loss of social roles and status, impairment in interpersonal relationships, feelings of abandonment, changes in expectations and future plans, and loss of dignity and meaning of life. 1 In most cases, palliative patients have severe functional and cognitive limitations requiring support in basic needs, such as hygiene, food, money, medication and mobility, relying on others for daily life activities, with increasing dysfunctionality and psychological repercussions. 2 According to number 7 of the Administrative Rule 66/2018 in Diário da República (Portugal), 3 a palliative care unit must ensure: permanent medical and nursing care; psychological intervention for patients, relatives and professionals; social intervention and support; support and intervention in mourning; spiritual intervention; complementary examinations; prescription and administration of drugs contained in the National Formulary of Medicines; hygiene, comfort and food; conviviality and leisure; training in palliative care; and, assistance in the area of palliative care for health professionals, namely primary, hospital and continuing healthcare. 3 Psychosocial rehabilitation can be understood as, 'a comprehensive and continuous process that provides individuals with disability due to mental illness the opportunity to achieve the greatest possible functioning potential (in the Palliative care is an approach to incurable and/or severe disease with limited prognosis, aiming to relieve the suffering a...

Clinical Practice Guidelines for mental health and well-being in patients with chronic medical illnesses

“…[ 42 ] According to another definition palliative care is “an integrated approach that promotes the QoL of patients and families who are confronted with the physical, psychosocial and spiritual problems associated with a life-threatening illness” . [ 43 ] It is further elaborated as a form of care that “affirms life and accepts death as a natural process without trying to delay the process and constitutes a global and holistic approach to the patients suffering from a physical, psychological, social and spiritual point of view; seeks the well-being and QoL of the patient, is centered on the needs of patients and their families, life and death, that should not be restricted to terminally ill and agonized patients and should be addressed by a multidisciplinary team”. It is critical to remember that palliative care is focused on the patient's requirements, not on the likelihood of recovery.…”

Multiresistente Erreger in der stationären Palliativmedizin

“…Bei der Palliativmedizin geht es nicht nur ausschließlich um Patient*innen mit einer geschätzten Lebenserwartung von wenigen Stunden oder Monaten [2]. Die Aufgabe der Palliativmedizin besteht nicht darin, das Sterben zu beschleunigen oder zu verändern [3].…”

“…Auf einer Palliativstation müssen neben der ständigen medizinischen und pflegerischen Versorgung auch soziale Interaktion und Unterstützung sowie Geselligkeit und Freizeit sichergestellt werden [2], um der psychischen Belastung entgegenzuwirken. Eine psychische Belastung bezieht sich auf einen Zustand des emotionalen Leids, das durch das Auftreten von Depression und Angst gekennzeichnet ist [9].…”

Role of Counseling Therapy for Psychosocial Development of Adults with Hearing Loss: A Critical Review

“…The community-based rehabilitation model has the potential to expand. Different rehabilitation services like yoga & physical exercise, peer discussions, trainings include with living skills, social skills, vocational skills, social skills, individual and family counseling can lead to psychosocial rehabilitation people diagnosed with psychosis, bipolar, schizophrenia, depression and intellectual disability (Almada, Casquinha, Cotovio, Santos, & Caixeiro, 2018;McKay, Nugent, Johnsen, Eaton, & Lidz, 2018). Barton (2018), Systematic review found that psychosocial interventions & counseling to infertile patients helps to improve wellbeing and pregnancy rates.…”