The Importance of Palliative Care - Term Paper Example

? Palliative Care Palliative Care The importance of palliative care can never be over expressed regardless of an individual’s culture, age or sex. An individual who is affected by a chronic life threatening illness inevitably experiences a decline in his or her quality of life. However, several environmental factors play a role in this individual’s emotional status and attitude towards life. In addition, the hospital staff involved in the provision of care are also key in ensuring that the individual has a better quality of life in his last years (Aziz et al., 2012). In order for an individual to have a better experience, a holistic approach should be taken by the medical staff. The therapeutic intervention by nurses should address the following parameters; psychosocial, physical, cultural and spiritual. Several studies have been carried out that showed that nurses at times are unaware of the above mentioned parameters and are unable to entirely meet the needs of the patients (Aziz et al., 2012). Nurse Patient Relationship Evidence has been found that at times the patient’s quality of life may continue to deteriorate despite the fact that they have been admitted to palliative services early on in their illness. It was however discovered that the relationship between the nurse and the patient was the determining factor in the improvement of patient’s quality of life. This factor was found to create trust ad better communication between the two individuals (Aziz et al., 2012). The first aspect of palliative care that nurses should address is establishing trust with palliative care patients and their families in order to alleviate and reduce their worries towards the inevitable outcome of their terminal illness. Patients who are suffering from terminal illnesses often present certain symptoms of distress. However, these symptoms need specified management between each patient and this can be largely dependent on the cultural and religious views. These have been found to adversely affect the severity and nature of the symptoms if they are not addressed properly (Aziz et al., 2012). A nurse can familiarize herself with these aspects by better communication with the patient (Mok & Chiu, 2004). Despite the necessity to maintain professionalism, at times a nurse has to place the needs of a patient before her professional opinion .(Boog & Tester, 2008).Autonomy enables a patient to decide his or her medical care, and hence gives him the ability to refuse treatment. The intimate detail of this procedure may be altered depending on the dynamics of the patient’s family (Boog & Tester, 2008). The nurses also have to address the emotional and physical burden that is placed on the patient’s family (Mok & Chiu, 2004). They need to create a supportive system which is addressed towards both the patient and his or her family. This has been found to be more effective by adopting good listening and communication skills. A study that was carried out showed that palliative care patients have a better quality of life when they are viewed as people separate from their terminal illness (Boog & Tester, 2008). The evident from this survey also states that the dying process can be made more bearable for the patient, family members and caregivers by nurses implementing the above mentioned attributes of palliative care (Aziz et al., 2012). In depth analysis of holistic palliative care Costello estimated that approximately one million people die every week. These figures further emphasize on the importance of palliative care in the community. The initial principles of palliative care emphasize on the care for any individuals facing the end of life. Therefore, these principles have been based on holism and looking at each individual as a whole unique entity. The model for this type of palliative care is known as the whole person care model and is popular among nurses worldwide. As mentioned above, this model creates a healing and nurturing environment which enables each individual to be treated uniquely. Pelzang stated that treating an individual as a whole during his or her terminal stages of life is vital and should be an integral part in the planning and execution of treatment (Barnard & Hartfel, 2006). The nurses should also seek to gain the consent of the patients constantly throughout the treatment program. Clarke in an article stated that the majority of nurses claim to offer holistic, however, they often neglect some aspects as they do not possess sufficient knowledge on holistic care. A survey which he based his article upon found that a larger percentage of nurses were unaware of these principles and admitted that they required more education on this subject (Barnard & Hartfel, 2006). A research that was conducted by Cornell et al. concluded that end of life care was not significant in improving the quality of life in terms of side effects of the disease (Barnard & Hartfel, 2006). However, this is only one outcome and there have been several contradicting results on the same subject. The study is also not reliable as it did not evaluate the different approaches that can be taken to improve the quality of life (Barnard & Hartfel, 2006). It mainly focused on the importance of quality of life to the carer and the patient. It concluded that understanding the cultural norms of a patient and his family was essential in overcoming certain barriers in the provision of care. Taking time to assess these parameters showed to increase the patient’s trust in the nurse and he or she was more cooperative and communicative (Boog & Tester, 2008). Another aspect that was also found to be essential in palliative care is a good symptom management plan as these may be complex and numerous (Boog & Tester, 2008). This aspect requires the incorporation of several medical specialties and the nurse may need to search for consultation from other medical specialists. This should be comprehensively planned at the beginning of care and should also be continuously reviewed to ensure that there are no aspects that are being neglected and can worsen the patient’s condition. In addition, symptom management at the end of life is one of the major concerns of both the patient and his or her family. Ensuring them that this process will be thoroughly done may improve their relationship with the nurse and other caregivers. It will also make them more cooperative and improve communication which is also a key part in palliative care (Boog & Tester, 2008). Symptom Management There are also certain symptoms that nurses constantly encounter in palliative care. One symptom is pain which is common in most patients in their terminal stages of life. Others symptoms that have also been found to cause physical distress on patients include nausea, malaise, dyspnoea, and delirium (Barnard & Hartfel, 2006). In addition, total pain concept may be indicative of spiritual, social and psychological distress. It is essential in the presence of pain for nurses to be supportive and to also play an educational role. Patients often possess the misconception that pain is an indication of illness progression or a worsening condition and are stressed and may experience exaggerated symptoms. If this condition is not addressed, it may affect other interventions for the remainder of the terminal illness. A study carried out by Unruh illustrated this point as patients and family members stated that pain was the most worrying sign for them during palliative care (Barnard & Hartfel, 2006). As mentioned above, the management and control of symptoms in patients at their terminal stages of treatment is complex and requires a multifactorial approach. Factors that play a role in the control of these symptoms include religion and culture, and these have been found to have an impact on the overall nature and severity. It was found by a study carried out by Lovering that individuals from different cultures have a different perception and response to pain (Barnard & Hartfel, 2006). This study stated that individuals who have value for stoicism were less vocally expressive of pain and they often tried to endure it. An example of such individuals includes Buddhists and Hindus. However, other religions and culture were more expressive of their pain such as Muslims and Christians who often expressed their pain through praying or calling the name of a supernatural being such as Jesus, God or Allah. Gelinias et al., emphasized that nurses must be aware of all these expression in different cultural groups and not only of pain but also of other aspects of palliative care even the viewpoint of death and life in general (Barnard & Hartfel, 2006). It is important for a nurse to dismiss her personal beliefs on the subjects and base any therapeutic approach on the patient. Conclusion In summation, principles of care demand require a patient centered holistic approach and should take into consideration the physical, spiritual, and psychosocial needs. The main aim of palliative care is to improve the quality of life in a dying patient as well as assist the relatives of this patient in coping with the situation. Communication is a key aspect in this process and the nurse should also educate the patient and her family members on the progression of the disease. Studies that have been carried out have shown that there is need for improvement in palliative care as the majority of nurses did not have sufficient knowledge on the principles involved in end of life care. Areas that specifically needed further improvement include communication and nurses’ knowledge on different cultures. References Aziz, N. M., Miller, J. L., & Curtis, J. R. (2012). Palliative and end-of-life care research: Embracing new opportunities. Nursing outlook, 60(6), 384-390. Barnard, A., Hollingum, C., & Hartfiel, B. (2006). Going on a journey: understanding palliative care nursing. International journal of palliative nursing,12(1), 6-12. Boog, K. M., & Tester, C. Y. (2008). Palliative care: a practical guide for the health professional: Finding meaning and purpose in life and death. Elsevier Health Sciences Mok, E., & Chiu, P. C. (2004). Nurse–patient relationships in palliative care.Journal of advanced Nursing, 48(5), 475-483. Read More