The World Health Organization defines palliative care as an approach that involves health professionals giving support to patients who are living with or without chronic illness, and their families to cope up with various stressful situations. This type of care is associated with various attitudes and principles, such as the dimension of consent. Regarding consent, the approach recommends patients’ engagement in treatment once they have made a decision on a given intervention. Self-awareness is an antecedent, which mirrors a nurse’s capability to put himself or herself in a patient’s situation. A consequential belief in palliative care is improving the quality of care to patients and their families by engaging them in pain relief programs. Palliative care is related to Kolcaba’s theory, which states that comfort is a fundamental need of human beings for ease or relief arising for stressful healthcare situations. As a nursing practitioner, I would apply the concept when offering holistic care to patients who seek end-life care and trying to cope with chronic illnesses.
The World Health Organization (WHO) defines palliative care as an approach that improves the quality of life of patients and their families facing the problems or challenges associated with a particular life-threatening illness, through the prevention and relief of suffering. The approach achieves its objective through early identification and impeccable assessment and treatment of pain and other problems including physical, spiritual, or psychological problems (Chauhan & Mosenthal, 2019). Palliative care primarily provides patients with relief for pain and other distressing symptoms, and it neither intends to hasten nor postpone death. Rather, it offers support system to the family of a patient to cope with a particular illness or bereavement; integrates the psychological and spiritual aspects of patient care; offers support to the patients to help them maintain a healthy life until death (Hawryluck, 2007). Palliative care also helps to improve the quality of life of patients and positively influence the course of a particular illness and uses a team approach to address the needs of patients and their families related to a given disease.
Palliative care incorporates the whole spectrum of care including medical, nursing, psychological, spiritual, and cultural aspects. The approach of palliative care is associated with various attitudes and principles. Palliative care is associated with a caring attitude (Breitbart, 2014): the approach demands having concern for to the patients and it involves factors such as compassion, sensitivity, and empathy. Palliative care also involves a non-judgmental approach in which patients are equally treated equally, rather than discriminated against based on various factors such as beliefs, ethnic backgrounds, race, and others (Breitbart, 2014). Regarding caring attitude, palliative care is largely concerned with addressing all areas in which patients experience problems, and they are not limited to nursing, medical, and social work challenges. Moreover, this type of care is associated with coordination of care (Breitbart, 2014). The approach requires an effective organization of work of the members of inter professional team to provide the best care to patients with or without chronic illness, and provide maximum support the families of the patients to cope with such stressful situations. Palliative care is also associated with cultural considerations (Brooke, 2013). It acknowledges that various factors such as ethnic, racial, religious and other cultural factors can significantly influence patients’ suffering and attitudes. Thus, it asserts that there is a need for nurses to treat cultural differences amongst the patients with respect and treatment be planned in a culturally sensitive manner.
Palliative care is also associated with the dimension of consent. It recommends patients’ engagement in treatment once they have made a decision related to the given intervention. It also requires that in a case a patient is in critical condition and is unable to make a decision related to whether or not to engage in a particular treatment, his or her close family member make decisions for the patient (Breitbart, 2014). Close family members are also allowed to make decisions related to treatment procedures for children. moreover, this approach to care allows patients to choose the site of care that they feel will significantly improve their health outcomes (Brooke, 2013). Another attribute of palliative care is effective communication. The approach involves good communication practices between health professionals, patients, and their families. Good communication helps in building strong relationships between health professionals and patients and amongst the health professionals themselves, which are necessary for effective treatment.
Antecedent and Consequence
Palliative care is associated with various antecedents and consequences. A precursor to palliative care nursing is self-awareness. Self-awareness is antecedent, which mirrors a nurse’s capability to put himself or herself in a patient’s situation (Brooke, 2013). A nurse’s capacity to self-reflect and willfully face his or her values, spirituality, and beliefs about death is a valuable aspect in the development of professional healthcare as it ensures that the nurse respects patients’ cultural differences, rather than discriminate against them based on various factors. Indeed, recognition is fundamental in the delivery of high-quality palliative care to the patients (Brooke, 2013). A consequential belief in palliative care is improving the quality of care to patients and their families by engaging them in pain relief programs; helping them to cope up with various challenging situations they are experiencing; improving their self-esteem; and respecting patients’ cultural backgrounds and differences.
An example of a model case in regard to the concept of palliative care is when a nurse practitioner (NP) who works in a critical care setting decides to engage in the treatment of a terminally ill patient. The terminally ill patient, in this case, is Mr. Jones who has been living with cancer for quite a while. the nurse practitioner decides that he needs to engage the patient in cancer stage IV diagnosis. Considering that the patient has been previously diagnosed with HIV and AIDS, the NP decides to engage the patient and the family in discussions related to chemotherapy treatment and hospice palliative. The nurse practitioner first builds an effective relationship with the patient and the family and earns their trust. The NP then offers a therapeutic session to the patient and the family on how to deal with the issue at hand and enables to relieve the patient of the pain. While attending to the patient and the family in this case, the nurse practitioner demonstrates that he values the needs of his clients, and tries to ensure that the patient’s concerns are met and answered. Besides, throughout the education and communication process, the nurse practitioner attempts to show compassion and tries to fit into the patient’s and family’s situation.
Theoretical Applications of Palliative Care
The concept of palliative care is closely related to Kolcaba’s theory of comfort. Kolcaba asserts that comfort is a fundamental need of human beings for ease or relief of pain arising from stressful healthcare situations. Moreover, comfort tends to enhance health-seeking behaviors for nurses, patients, and their family members (Tk & Chandran, 2017). According to Tk & Chandran (2017), the theory primarily explores the four nursing aspects, including physical, social, psychospiritual, and environmental factors. Kolcaba argues that to reduce pain amongst the patients, there is a need to provide them with comfort in the four areas. Furthermore, the outcome of comfort is attained when the nursing interventions are effective (Tk & Chandran, 2017). The theory is closely relates to palliative care, which also addresses all areas in which patients experience challenges and not necessarily the nursing and social work problems alone. Palliative care also addresses issues such as the environmental, psychospiritual, and physical problems that patients may have encountered, and which may have resulted in their suffering (Yennurajalingam & Bruera, 2018). Lastly, this approach to care involves various practices such as pain relief and therapeutic sessions that allow nurses to offer comfort to patients and their families to enable them to cope with the illness.
Nurses have many responsibilities when it comes to delivering end-of-life care, including having a sensitive conversation with patients and their close family members about their care and preferences, recognizing any changes in condition, and offering support to patients and family members in coping with a particular health condition. My findings from the analysis of the concept of palliative care is that to help improve the health outcomes of individuals living with chronic illnesses, nurse practitioners should offer them comfort. Comfort is a way of offering relief to the pain that the patients and their close family members encounter in dealing with a particular illness. As a nurse practitioner, I will be expected to apply the concept when offering care to patients at the end of their life, for instance, by holistic care. Moreover, in the process of providing holistic care, I will have to demonstrate compassion and respect the patients’ cultural differences, beliefs, and values. Regarding my findings about the concept of palliative care, they apply to my nursing practice as they guide me on what conduct I should demonstrate while delivering care to patients and their families. Some of the aspects I have found related to the concept is that I should respect patients’ cultural differences, treat them equally, offer them support in form of comfort, and maximize support to their family members to cope with the stressful health situations they may encounter. Taking that approach may help to improve health status of patients and their families as well. In regard to families, the approach may help to improve their health status by protecting them stressful situations.
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Chauhan, D., & Mosenthal, A. C. (2019). Palliative Care and Cardiovascular Surgery. Surgical Palliative Care, 213–222. https://doi.org/10.1093/med/9780190858360.003.0018
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Yennurajalingam, S., & Bruera, E. (2018). Hospice and palliative medicine and supportive care flashcards. New York, NY: Oxford University Press.