الفهرس 
ContentOnly 14 pages are availabe for public view
 |  | from | 181 |  |  |
| | | from | 181 | | |
Abstract
Palliative care (PC) is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness through the prevention and relief of suffering by means of early identification, impeccable assessment and treatment of pain and other problems like physical, psychosocial and spiritual‖ [World Health Organization, (2012)]
Palliative care is Patient and family- centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice. [Pittsburgh, PA., (2013)]
Palliative care include the following principles: symptom management; advanced care planning; family-centered care; emotional; psychosocial; social and spiritual care; facilitating communication; awareness of ethical issues; and caring for the care giver. [Morton, P.G., Fontaine, D.K., (2013)]
Comprehensive palliative care will take the following issues into account for each patient. Physical issue, Person‘s cancer advances, he or she may experience a number of symptoms. These symptoms may include pain, loss of appetite, fatigue, weakness, weight loss, constipation, trouble breathing, confusion, nausea, vomiting, cough and a dry or sore throat. All of these symptoms can be managed with appropriate management. A person who has cancer shouldn’t try to ”be strong” and tolerate pain or other symptoms. This can have a negative effect on the person’s physical and emotional state. A person who has cancer should tell the doctor about any symptoms he or she is having. Emotional and coping issue, Palliative care specialists can provide resources to help patients and families deal with the emotions that come with a cancer diagnosis and cancer treatment. Practical issue, Cancer patients may have financial and legal worries, insurance questions, employment concerns, and concerns about completing advance directives. To ease the burden, the palliative care team may assist in coordinating the appropriate services. Spiritual issue, with a cancer diagnosis, patients and families often look more deeply for meaning in their lives. Some find the disease brings them more faith, whereas others question their faith as they struggle to understand why cancer happened to them. An expert in palliative care can help people explore their beliefs so that they can find a sense of peace. [Family doctor organization, (2014), National cancer institute, (2010)]
Effective approaches to palliative care are available to improve the quality of life for cancer patients. The world health organization ladder for cancer pain is a relatively inexpensive yet effective method for relieving cancer pain in about 90% of patients. [World Health Organization, (2014)]
The world health organization define the palliative care strongly promotes the family, and it is important that the family‘s needs are addressed and they have access the sufficient levels of practical and emotional support to allow them to perform the role of carer. [Kearney, N., etal., (2006)]
Palliative care services have the potential to benefit family members as well. One study done by Lautrette, at 2007 A. in the intensive care unit (ICU) showed a 24% reduction of post traumatic depression syndromes (PTSD) symptoms in family members when communication was enhanced compared to controls by using a communication intervention. [Lautrette, A., Darmon, etal, (2007)]
There are many studies that show the benefits of palliative care. Studies have shown that patients who had hospital-based palliative care visits spent less time in intensive care units and were less likely to be re-admitted to the hospital after they went home. Studies have also shown that people with chronic illnesses like cancer who get palliative care have less severe symptoms. They have better quality of life, less pain, less shortness of breath, less depression, and less nausea. Their medical care tends to better align with their values, goals, and preferences. Their families also feel more satisfied. Study done by Jennifer S., at 2010 stated that patients with metastatic non–small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving routine care, despite the fact that fewer patients in the early palliative care group than in the routine care group received aggressive end-of-life care (33% vs. 54%), median survival was longer among patients receiving early palliative care (11.6 months vs. 8.9 months). study done by researchers at Massachusetts General Hospital at2010 found that lung cancer patients receiving early palliative care intervention experienced less depression, improved quality of life and survived for approximately 2.7 months longer. [American cancer society, 2015, Jennifer S. etal, (2010), Center to advance palliative care, (2010)]
An effective nursing assessment involves systematic approach to identifications of problems and source of concern and distress to the patient and family. It is the key to establishing an appropriate care plan aimed at addressing the issues affecting quality of life. Stages of assessment include a careful review of the medical note, a brief interview with patient and rapid appraisal of the clinical situation, and comprehensive focused assessment. [Kearney, N., Richardson, A., Foubert, J., (2006)]
Nurses play a central role in palliative and end-of-life care. Nursing roles include developing plans of care, and guidance and support for patients and families. [Karkada, S., (2011)]
Nurses are given palliative care must first develop a relationship of trust to relate with patient and family member, promote hope for patient, pain and symptoms management by medication and non-pharmacological method as meditation, breathing exercise and skin care, maintain dignity and self-esteem by providing spiritual care, prevent feeling of isolation, use gentle touch during care, support family member provides information about home care services. [Potter, A.P., Perry, A.G., Stockert P.A., Hall A., (2011)]