Measuring the Level of Confidence and Identifying Gaps in Providing Palliative Care Services to Children by the Adult Palliative Care Team in the Kingdom of Saudi Arabia

Objectives: The field of pediatric palliative care (PPC) has grown in the last few years because of increased awareness of the unique requirements of children at the terminal stage. In this study, we aimed to analyze the willingness and confidence of adult palliative care physicians in Saudi Arabia who provide palliative care services to children in need. Methods: This study employed a cross-sectional design to collect data from a large sample of palliative care physicians in Saudi Arabia. This study included palliative care physicians with a Saudi license who worked in Saudi Arabia and cared for patients with palliative needs. Results: According to this study, palliative care physicians in Saudi Arabia felt unprepared to provide PPC while maintaining a good attitude toward the practice. Most palliative care physicians believed that their training was insufficient because they had little experience in this field. In addition, they are less comfortable managing pain and symptoms than interacting with families of palliative children. Conclusions: In Saudi Arabia, palliative care physicians are eager to offer PPC; however, they need requisite resources and training. In addition, we found that palliative care physicians and their patients would benefit from further support and assistance from a PPC team.

Decrease in Primary Caregivers' Quality of Life During the Care of a Relative with Palliative Care Needs: A Prospective Longitudinal Study

BACKGROUND/OBJECTIVES

The quality of life is a complex concept that is insufficiently assessed in clinical practice. It is influenced by different factors, as follows: the individual's characteristics, personal values and beliefs, physical and mental state, and relationship to other members of their community. The quality of life of the primary caregiver influences their health and the quality of their care interventions. This study aims to investigate how the quality of life of caregivers changes during palliative patients' care.

METHODS

This is a prospective longitudinal study that assesses the different aspects of the quality of life of primary caregivers who care for patients with palliative needs. The tool used in this study was the Medical Outcomes Scale-Short Form 36 (MOS-SF36).

RESULTS

This study included 140 caregivers, of which 63 were involved in the care of patients with cancer and 77 were involved in the care of patients with non-oncological diseases. Almost 9 out of 10 caregivers were a family member of the patient and over two-thirds of these were women. The caregivers of patients with non-malignant diseases had a decreased quality of life in the following aspects: limitations in their usual role due to emotional problems, social functioning, energy, and their perception of their general health. In the group of oncological patients, the caregivers displayed limitations in their daily role due to physical health, emotional problems, and social functioning.

CONCLUSIONS

The large number of responsibilities, the long time spent caring, and the uncertainty about the evolution of the disease as well as the marginalization and lack of time for oneself are some of the elements that increase caregiver burden. Along with this, the quality of life of caregivers decreases significantly in different aspects, such as physical, psycho-emotional, and social, with the perception of deteriorating general health.

The concept of holism applied in recent palliative care practice: A scoping review

BACKGROUND

Whilst there is a sense of holism existing within palliative care practice, what is not clear is the extent to which holism, as applied in recent palliative care practice, has been adequately researched. Currently, no reviews on this topic were identified through systematic and scoping review registries.

AIM

To identify and describe the available published evidence on the key features of holism and the core domains underpinning the application of holism in relation to recent palliative care practice.

DESIGN

Scoping review using the Johanna Briggs Institute design.

DATA SOURCES

MEDLINE, EMCARE, and CINAHL (Ovid), PsycINFO, SocINDEX, SCOPUS and Web of Science. (International, peer-reviewed, published papers in the English language from January 2010to December 2020).

RESULTS

Five studies met inclusion criteria. Two studies used qualitative methods, one used mixed-methods, and two were randomised controlled trials. The research investigated (1) frameworks for holistic care and (2) assessment tools applied in palliative care settings.

CONCLUSIONS

The results from the review led to identifying key features of palliative care that were presented as interconnected aspects of holistic care domains in both assessments and interventions. The literature revealed a focus on curative and biomedical approaches to disease management with holistic aspects acknowledged, but not in the forefront of core service delivery. Holism was generally conceptualised as an overarching theoretical framework to palliative care service provision and positioned as an adjunct to palliative models of care. These findings point to a gap in research that links the concept of holism to applied palliative care practices.

Factors Influencing the Quality of Life of the Primary Caregiver of a Palliative Patient: Narrative Review

Introduction: Quality of life is a difficult concept to understand and therefore difficult to evaluate. From the general definition to the individuality of the person, there are factors that positively or negatively influence quality of life. Aim: The aim is to identify the factors that influence the quality of life of primary caregivers of patients with progressive life-threatening illnesses. Methodology: PUBMED was searched to retrieve the relevant literature for our research questions used the following keywords: "Quality of life and caregiver or caretaker and palliative care or life threatening disease." Only quantitative studies containing randomized trials were included using at least one caregiver's quality-of-life tool, not older than 10 years, written in English, and with subjects older than 18 years, who considered they were involved in the active care of a palliative patient. Results: A number of 687 articles were identified from which only 38 were analyzed in detail regarding the impact of different interventions over the quality-of-life of the caregiver. The factors that influence the quality-of-life can be distributed into four areas: social, psycho-emotional, financial, and physical. The disruption of daily routine, non-existential financial resources, multiple responsibilities and psychological tension are reduce the caregiver's quality-of-life. Family involvment, knowledge about disease and treatment, abilities to communicate patient and the team and optimistic atitude improve caregiver's quality-of-life. Conclusions: The quality of life of the caregiver be improved by social, and relaxation techniques, reduction of insecurity or anxiety. Furthermore, the caregiver's quality of increases through and adequate communication diagnosis, a proper conducted treatment and education over the care maneuvers.