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Palliative Care for Chronic Diseases
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Palliative Care for Chronic Diseases

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 7391

Special Issue Editors

Dr. Michael Connolly

E-Mail Website
Guest Editor
1. School of Nursing Midwifery and Health Systems, Health Sciences Centre, University College Dublin, D04 V1W8 Dublin, Ireland
2. Our Lady’s Hospice & Care Services, Harold’s Cross, D6W RY72 Dublin, Ireland
Interests: palliative care; spirituality
Special Issues, Collections and Topics in MDPI journals
Dr. Mary Ryder

E-Mail Website
Guest Editor
School of Nursing Midwifery and Health Systems, Health Sciences Centre, University College Dublin, D04 V1W8 Dublin, Ireland
Interests: nursing; chronic illness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The World Health Organization defines palliative care as an approach that improves quality of life for patients and their families who are faced with the problems associated with living with a life-limiting condition. Palliative care focusses on the relief of suffering through the assessment and management of complex symptoms that can be physical, psychological, social or spiritual. Relief of such suffering requires attention to person-centred care, where the patient and their family are involved and are part of all decisions regarding their health. This must also include the patient’s wishes and preferences for care and treatment at all times. A key principle of palliative care is that it is applicable at any point along the disease trajectory. Indeed, access to palliative care—including end-of-life care—has been identified as a human right (Brennan, 2007), and irrespective of diagnosis, prognosis, geographic location, gender, sexual orientation and civil status, patients and their families have a right to ethical palliative care, which incorporates individual needs and includes consideration of wishes and preferences for care, including place of care. 

This Special Issue will explore palliative care for chronic disease, examining the key issues that arise for patients and their families in receipt of palliative and end-of-life care. 

Articles for this Special Issue may focus on issues that arise for patients with chronic disease and their families from diverse and varying cultural and ethnic backgrounds, and how these may influence health-related decision making.  

Through these explorations, this Special Issue will draw attention to, and deepen our understanding of, palliative care for chronic disease.

You may choose our Joint Special Issue in Healthcare.

Dr. Michael Connolly
Dr. Mary Ryder
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • palliative care
  • chronic disease
  • supportive care
  • complex symptoms

Published Papers (4 papers)

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18 pages, 703 KiB  
Article
“Dignity as a Small Candle Flame That Doesn’t Go Out!”: An Interpretative Phenomenological Study with Patients Living with Advanced Chronic Obstructive Pulmonary Disease
by Carlos Laranjeira and Marília Dourado
Int. J. Environ. Res. Public Health 2022, 19(24), 17029; https://doi.org/10.3390/ijerph192417029 - 18 Dec 2022
Cited by 1 | Viewed by 2196
Abstract
Long-term illness, such as chronic obstructive pulmonary disease (COPD), can expose people to existential suffering that threatens their dignity. This qualitative study explored the lived experiences of patients with advanced COPD in relation to dignity. An interpretative phenomenological approach based on lifeworld existentials [...] Read more.
Long-term illness, such as chronic obstructive pulmonary disease (COPD), can expose people to existential suffering that threatens their dignity. This qualitative study explored the lived experiences of patients with advanced COPD in relation to dignity. An interpretative phenomenological approach based on lifeworld existentials was conducted to explore and understand the world of the lived experience. Twenty individuals with advanced COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stages III and IV) were selected using a purposive sampling strategy. In-depth interviews were used to collect data, which were then analysed using Van Manen’s phenomenology of practice. The existential experience of dignity was understood, in essence, as “a small candle flame that doesn’t go out!”. Four intertwined constituents illuminated the phenomenon: “Lived body–balancing between sick body and willingness to continue”; “Lived relations–balancing between self-control and belongingness”; “Lived Time–balancing between past, present and a limited future”; and “Lived space–balancing between safe places and non-compassionate places”. This study explains how existential life phenomena are experienced during the final phases of the COPD trajectory and provides ethical awareness of how dignity is lived. More research is needed to investigate innovative approaches to manage complex care in advanced COPD, in order to assist patients in discovering their inner resources to develop and promote dignity. Full article
(This article belongs to the Special Issue Palliative Care for Chronic Diseases)
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12 pages, 737 KiB  
Article
Analysis of Palliative Care Utilization and Medical Expenses among Patients with Chronic Diseases in Taiwan: A Population-Based Cohort Study
by Hui-Mei Lin, Yen-Chun Huang, Chieh-Wen Ho and Mingchih Chen
Int. J. Environ. Res. Public Health 2022, 19(19), 12646; https://doi.org/10.3390/ijerph191912646 - 3 Oct 2022
Cited by 2 | Viewed by 1549
Abstract
Palliative care (PC) is an important alternative treatment for patients with chronic diseases, particularly for those in the later stages of disease progression. This is because these diseases are often irreversible, with progressive worsening of symptoms. By encouraging the use of tranquility resources [...] Read more.
Palliative care (PC) is an important alternative treatment for patients with chronic diseases, particularly for those in the later stages of disease progression. This is because these diseases are often irreversible, with progressive worsening of symptoms. By encouraging the use of tranquility resources for good death and spiritual relief, PC can reduce the physical and psychological burden on patients at the end of their lives. Currently, most discussions on PC have focused on patients with cancers, and few have further discussed the differences in medical expenses between PC and emergency treatment in patients with chronic diseases at the end of their lives. This study analyzed the top three chronic diseases in patients who used PC resources in the past decade and identified the impact of emergency treatment on mean survival time and medical expenses based on the medical records from the National Health Insurance Research Database. In total, 4061 patients with chronic diseases who were admitted to hospice wards were included in this study; of them, 85 patients still received emergency treatment, including urinary catheterization, nasogastric intubation, and respirator use, at the end of their lives. The mean survival time of patients aged 50–64 years who received emergency treatment was longer than that of the same age group who did not receive emergency treatment. Different comparisons of the mean survival time and medical expenses using real-world data provides important insights regarding PC management that may assist in establishing health policies in the future. Full article
(This article belongs to the Special Issue Palliative Care for Chronic Diseases)
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12 pages, 330 KiB  
Article
Strengthening Community End-of-Life Care through Implementing Measurement-Based Palliative Care
by Margaret H. Sandham, Emma Hedgecock, Mevhibe Hocaoglu, Celia Palmer, Rebecca J. Jarden, Ajit Narayanan and Richard J. Siegert
Int. J. Environ. Res. Public Health 2022, 19(13), 7747; https://doi.org/10.3390/ijerph19137747 - 24 Jun 2022
Cited by 1 | Viewed by 1729
Abstract
The increasing demand for palliative care in New Zealand presents a potential threat to the quality of service delivery. One strategy to overcome this is through the implementation of valid and reliable patient-reported outcome measures. This mixed-methods study aimed to (1) implement measurement-based [...] Read more.
The increasing demand for palliative care in New Zealand presents a potential threat to the quality of service delivery. One strategy to overcome this is through the implementation of valid and reliable patient-reported outcome measures. This mixed-methods study aimed to (1) implement measurement-based palliative care (MBPC) in a community palliative care service in Auckland, New Zealand; (2) evaluate the clinical utility of MBPC perceived by clinicians; (3) describe patient characteristics as measured by the Integrated Palliative Care Outcome Scale (IPOS), the Australasian Modified Karnofsky Performance Scale (AKPS), and Phase of Illness (POI); and (4) evaluate the internal consistency of the IPOS. Participants were over 18 years of age from a community outpatient palliative care service. In a phased approach to implementation, healthcare staff were educated on each instrument used for patient assessment. Uptake and internal consistency were evaluated through descriptive statistics. An interpretive descriptive methodology was used to explore the clinical utility of MBPC through semi-structured interviews with seven clinical staff members. Individual patient assessments (n = 1507) were undertaken predominantly on admission, with decreasing frequency as patients advanced through to the terminal phase of their care. Mean total IPOS scores were 17.97 (SD = 10.39, α = 0.78). The POI showed that 65% of patients were in the stable phase, 20% were in the unstable phase, 9% were in the deteriorating phase, and 2% were in the terminal phase. Clinicians reported that MBPC facilitated holistic and comprehensive assessments, as well as the development of a common interdisciplinary language. Clinicians expressed discomfort using the psychosocial and spiritual items. Measurement-based palliative care was only partially implemented but it was valued by staff and perceived to increase the quality of service delivery. Future research should determine the optimal timing of assessments, cultural responsivity for Māori and Pacific patients, and the role of MBPC in decision support for clinicians. Full article
(This article belongs to the Special Issue Palliative Care for Chronic Diseases)

Other

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6 pages, 303 KiB  
Brief Report
Consideration of Symptom Management in Advanced Heart Failure
by Michael Connolly and Mary Ryder
Int. J. Environ. Res. Public Health 2022, 19(22), 15160; https://doi.org/10.3390/ijerph192215160 - 17 Nov 2022
Viewed by 1357
Abstract
This work provides an opinion on palliative care for people with heart disease. The work focuses on the management of key symptoms associated with both end stage heart disease, applying a palliative approach and suggesting treatment options. The work also indicates the potential [...] Read more.
This work provides an opinion on palliative care for people with heart disease. The work focuses on the management of key symptoms associated with both end stage heart disease, applying a palliative approach and suggesting treatment options. The work also indicates the potential for greater collaboration of specialist teams including specialist palliative care in the assessment and management of patients with complex needs as they progress through their disease trajectory. The practical application of evidence-based guidelines and recommendations is key to the successful individualised management of complex symptoms. Full article
(This article belongs to the Special Issue Palliative Care for Chronic Diseases)
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