Palliative, Rehabilitation and Continuing Care

Introduction to Palliative, Rehabilitation and Continuing Care

Palliative care is an integral component of nursing and focuses on providing nursing care to the terminally ill and old patients and is therefore often also termed as the end of life care (Vuksanovic et al., 2017). The purpose of palliative care is to provide mental support with physical aid to ill patients to ensure their wellbeing and overall beneficence. This support is often provided by active listening, developing strong relationships with patients through rapport building and the development of mutual trust and respect through dignified care (Rudilla et al., 2017). 

The purpose of this review is to find suitable literature to assert the importance of dignity in the nursing care practice for palliative patients. This review will also provide a discussion based on the studies assessed in this review to assert the importance of compassion, dignity, and competent care in palliative care settings. 

Literature Review of Palliative, Rehabilitation and Continuing Care

Theme 1: Application of Dignity Therapy 

Rodriguez et al. (2018) conducted a structured review for analysis for the importance of dignity therapy in palliative care and asserted that application of dignity therapy as an intervention was highly successful and helped in the improvement of the quality of care provided to the patients. A meta-analysis to assess the impact of dignity therapy in palliative care for cancer patients was also conducted by Xiao et al. (2019). The data was collected from 13 databases and 8 studies were chosen for the criteria selected that revealed that dignity related distress is common in palliative care centres and therefore, it is important for the patients to carers to use dignified and respectful practices in care to minimise the psychological stress of the patients. A qualitative analysis was also conducted by Vuksanovic et al. (2017) that studied on 56 patients and highlighted how application of dignity therapy helped in boosting confidence and provided emotional support to the patients in palliative care units. 

Theme 2: Quality of Life and Dignity 

Campo et al. (2019) performed an observation qualitative study to assess the impact of dignity and care on the quality of life of the patients in the palliative care setting. The study elucidated that quality of life of patients that are critically ill with diseases like ALS requires immense psychological support and assisted by dignified care practices that adhere to mutual respect and shared decision-making processes. Rudilla et al. (2015) also performed an insightful analysis to assess the dignity at the end of life through Palliative patient’s dignity scale (PPDS) and asserted the importance of dignified care practices in the palliative care settings. The study asserts that the patients require emotional support and assistance and is established in healthcare practice by enabling competence, communication skills, and empathetic, person-centred approach for patients in the palliative care units. de Voogd et al. (2020) also provided insights on how dignity from both formal and informal caregivers affect the overall quality of life of the patient through a retrospective analysis of 51 patients in the palliative care setting and asserted that it is important to develop mutual respect, practice competence, and dignity while caring for a palliative patient to ensure psychological support and improve the quality of life

Table: Theme summary of articles studied.

Articles studied

Common Theme

1. Rodriguez et al. (2018)

2. Campo et al. (2017)

3. Vuksanovic et al. (2017)

4. Xiao et al. (2019)

5. de Voogd et al. (2020)

6. Rudilla et al. (2017)

Shared

Decision-Making

*

*

*

*

Dignity therapy

*

*

*

Person centred care

*

*

*

*

*

*

Rapport building

*

*

Effective communication

*

*

*

*

Discussion on Palliative, Rehabilitation and Continuing Care

The authors in this study assert the significance of practising dignity while providing care to palliative patients. Patients that suffer from terminal illnesses or are old, require additional support and care for their well being as it helps them to develop confidence and provides psychological support required for health management (Campo et al., 2017). The authors in the studies argue that is suitable for the nurses to comply to the dignified code of conduct while treating the patients and managing the health conditions in a palliative care setting through the development of competence and respect for the patients (Vuksanovic et al., 2017). 

The authors also argue that it is also important for the healthcare professionals to not possess any prejudice and treat all the patients with dignity and respect and work for their beneficence (Xiao et al., 2019). Person-centred care is promoted in the palliative care settings and it is suggested that feedbacks are frequently collected from patients and their allies through scales like Palliative patient’s dignity scale to assess the performance of care workers (Rudilla et al., 2017). This ensures that the patient needs are addressed and there is strong communication with a trustworthy relationship between the healthcare service provider and the patient for the highest quality of care (de Voogd et al., 2020). 

The practice of dignity therapy and competent care has also been vividly discussed by the authors and is known to help patients in palliative care centres to boost their confidence and promote wellness. This is done by the provision of psychological support and immense care with mutual respect and dignity developed through trustworthy relationships between the healthcare professionals and the patients (Rodriguez et al., 2018). Dignified nursing in palliative care is thus also known to improve the overall quality of life of the patients by ensuring better care and service (Vuksanovic et al., 2017). 

Conclusion on Palliative, Rehabilitation and Continuing Care

This report summarises and articulates the research done by several authors associated with the impact of dignity in palliative care services. The studies selected in this review assert that dignified care practices ensure that the patient feels supported and can communicate their needs more effectively and eventually resulting in rapport building and improved quality of care. This paper also summarises the common themes that are explored in the listed research of the review and identifies the focal points to develop a discussion for the same. 

References for Palliative, Rehabilitation and Continuing Care

Campo, Y., Homedes, C., Lazaro, A., Alarcón, R., Campo, D., Riera, M., ... & Casasnovas, C. (2017). Observational study of patients in Spain with amyotrophic lateral sclerosis: correlations between clinical status, quality of life, and dignity. BMC Palliative Care, 16(1), 75.

de Voogd, X., Willems, D., Torensma, M., Onwuteaka-Philipsen, B., & Suurmond, J. (2020). Dignity of informal caregivers of migrant patients in the last phase of life. A qualitative study. BMC Palliative Care, 18(1), 115.

Rodriguez, A., Smith, J., & McDermid, K. (2018). Dignity therapy interventions for young people in palliative care: a rapid structured evidence review. International Journal of Palliative Nursing, 24(7), 339-349.

Rudilla, D., Oliver, A., Galiana, L., & Barreto, P. (2016). A new measure of home care patients' dignity at the end of life: The Palliative Patients' Dignity Scale (PPDS). Palliative & Supportive Care, 14(2), 99-108.

Söderman, A., Östlund, U., Harstäde, C. W., & Blomberg, K. (2020). Dignity-conserving care for persons with palliative care needs—identifying outcomes studied in research: An integrative review. Palliative & Supportive Care, 1-19.

Vuksanovic, D., Green, H., Morrissey, S., & Smith, S. (2017). Dignity therapy and life review for palliative care patients: a qualitative study. Journal of Pain and Symptom Management, 54(4), 530-537.

Xiao, J., Chow, K. M., Liu, Y., & Chan, C. W. (2019). Effects of dignity therapy on dignity, psychological well‐being, and quality of life among palliative care cancer patients: A systematic review and meta‐analysis. Psycho‐oncology, 28(9), 1791-1802.

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