International Journal of Environmental Research and Public Health

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Special Issue Editors

Dr. Esther-Lee Marcus

E-Mail Website
Guest Editor

Geriatric Department Herzog Hospital, Jerusalem 9103702, Israel
Interests: dementia; bioethics; end-of-life care; infections in long-term-care facilities; medical humanities; life-sustaining therapy

Dr. Adir Shaulov

E-Mail Website
Guest Editor

Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
Interests: hematology; palliative medicine; end-of-life care

Special Issue Information

Dear Colleagues,

Palliative care has made giant strides over the past 30 years, with inpatient and outpatient programs offering ever more upstream services throughout Europe and North America. In parallel, research is providing direction to improve symptom management and demonstrate the value of early palliative care. However, as a field, palliative care faces multiple financial, administrative, educational, and clinical challenges, which have intensified during the COVID-19 pandemic.

Many areas of the world have limited access to palliative care, and even in countries with better services patients with chronic diseases such as renal failure, heart failure, and dementia continue to have limited access. Rigorous data on the benefits of advance care planning as well as treatment practices are lacking.

We invite authors to submit high-quality research for a Special Issue of International Journal of Environmental Research and Public Health on the subject of “Palliative Care and Patient Health—Meeting Future Challenges.” This Issue will include qualitative and quantitative research (original articles, critical reviews, research notes, and short communications) on various aspects of palliative care and the challenges it faces throughout the world and in various settings.

Dr. Esther-Lee Marcus
Dr. Adir Shaulov
Guest Editors

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Keywords

advance care planning
aging population
end-of-life
palliative care
symptom management

Published Papers (2 papers)

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Research

15 pages, 366 KiB

Open AccessArticle

The Cognitive Aspect of Hope in the Semantic Space of Male Patients Dying of Cancer

by Bożena Baczewska, Krystyna Wojciechowska, Beata Antoszewska, Maria Malm and Krzysztof Leśniewski

Int. J. Environ. Res. Public Health 2023, 20(2), 1094; https://doi.org/10.3390/ijerph20021094 - 08 Jan 2023

Cited by 2 | Viewed by 1382

Abstract

The aim of this study is to characterize the cognitive aspect of the semantic space of hope in patients in the terminal stage of cancer. This was confirmed in the research on hope by C. R. Snyder and B. Schrank. Hope is of great importance in all the great world religions and belief systems, both as regards a personal God or impersonal deities. Hoping is a human capacity with varying affective, cognitive and behavioral dimensions. Psychological, pedagogical (particularly in the framework of special needs pedagogy and thanatological pedagogy) and theological reflection on hope can provide support for dying people. In order to conduct the research, the semantic differential research method was selected. The research technique employed was a therapeutic conversation, and the research tool was the B.L. Block’s DSN-3 test. The DSN-3 test allows one to assess hope in the semantic space in three aspects: cognitive, emotional and functional. For the purposes of this study, only the cognitive aspect was taken into account. The study was begun on 1 April 2010 and ended in the last days of December 2020. It included 110 male patients in the terminal stage of cancer. The youngest respondent was 19 years old and the oldest was 94 years old. The surveyed men most often perceived hope in the semantic space in the cognitive aspect as more true, wise, meaningful and real than false, stupid, meaningless and deceptive. Their attitude to hope was, therefore, more affirmative than negative. The research did not reveal the importance of the age of the respondents on the degree of affirmation/negation of hope in the cognitive aspect in the semantic space; however, men in the period of late maturity and professional activity expressed the lowest level of the affirmation of hope. It is worthwhile to conduct further research concerning hope in other aspects (especially emotional and functional) in the semantic space in order to use the obtained results to consider what to take into account when providing patients in the terminal stage of cancer with better personalized holistic care than before. Full article

(This article belongs to the Special Issue Palliative Care and Patient Health—Meeting Future Challenges)

15 pages, 369 KiB

Open AccessArticle

Do Perceptions about Palliative Care Affect Emergency Decisions of Health Personnel for Patients with Advanced Dementia?

by Meira Erel, Esther-Lee Marcus, Samuel N. Heyman and Freda DeKeyser Ganz

Int. J. Environ. Res. Public Health 2022, 19(16), 10236; https://doi.org/10.3390/ijerph191610236 - 17 Aug 2022

Cited by 1 | Viewed by 1507

Abstract

Decision analysis regarding emergency medical treatment in patients with advanced dementia has seldom been investigated. We aimed to examine the preferred medical treatment in emergency situations for patients with advanced dementia and its association with perceptions of palliative care. We conducted a survey of 159 physicians and 156 nurses from medical and surgical wards in two tertiary hospitals. The questionnaire included two case scenarios of patients with advanced dementia presenting gastrointestinal bleeding (scenario I) or pneumonia (scenario II) with a list of possible interventions and 11 items probing perceptions towards palliative care. Low burden interventions such as laboratory tests and intravenous administration of antibiotics/blood were preferred. Palliative measures such as analgesia/sedation were chosen by about half of the participants and invasive intervention by 41.6% (gastroscopy in scenario I) and 37.1% (intubation/mechanical ventilation in scenario II). Medical ward staff had a more palliative approach than surgical ward staff in scenario I, and senior staff had a more palliative approach than junior staff in scenario II. Most participants (90.4%) agreed that palliative care was appropriate for patients with advanced dementia. Stress in caring for patients with advanced dementia was reported by 24.5% of participants; 33.1% admitted fear of lawsuit, 33.8% were concerned about senior-level responses, and 69.7% were apprehensive of family members’ reaction to palliative care. Perceptions of health care workers towards palliative care were associated with preferred treatment choice for patients with advanced dementia, mainly in scenario II. Attitudes and apprehensions regarding palliative care in these situations may explain the gap between positive attitudes towards palliative care and the chosen treatment approach. Acquainting emergency care practitioners with the benefits of palliative care may impact their decisions when treating this population. Full article

(This article belongs to the Special Issue Palliative Care and Patient Health—Meeting Future Challenges)

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