The Effect Of Palliative Care Among Cancer Patients Essay Paper

The Effect Of Palliative Care Among Cancer Patients Essay Paper

Palliative care is the caring attention provided by medical professionals and other caregivers to patients with terminal illnesses and their families. This is done so that, when they receive treatment for their chronic illnesses, their quality of life (QoL) might improve. Three specific holistic care domains are given priority over the others in palliative care. The three of them are the physical, psychological, and spiritual domains (Lu et al., 2018)The Effect Of Palliative Care Among Cancer Patients Essay Paper. Cancer patients make up the majority of terminally ill patients who eventually need palliative care due to the failure of medical treatment. Despite the fact that they are frequently used interchangeably, “hospice care” and “palliative care” are not the same thing. While palliative care can also be end-of-life care, hospice care is end-of-life care. The purpose of this paper is to present a quantitative assessment of the effect of palliative care in improving QoL among cancer patients in oncology hospitals.

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Purpose Statement

Terminal cancer is a chronic illness that is draining physically, emotionally, psychologically, spiritually, and financially. The people affected are no the patients only, but also their families who mostly foot the medical bill and on whom they also depend for emotional and spiritual support. Palliative care seeks to lessen this burden by providing patient-centered care to terminally ill patients that is individualized. The care is holistic and aims at improving the QoL of the patient as well as the coping ability of their families (Abu-Odah et al., 2020)The Effect Of Palliative Care Among Cancer Patients Essay Paper. Unfortunately, palliative care is not cheap in the United States.

Because it requires taking every possible measure to ensure the patient’s comfort, palliative care is neither inexpensive nor affordable. Even though it may be obvious that the patient would die from medical ineffectiveness, this is nonetheless done. For instance, managing pain is the most important issue in palliative care (and, by extension, hospice care). Palliative care frequently includes hospice care for cancer patients. Particularly in the case of cancer patients, excruciating pain must constantly be managed at all costs. Opioid analgesics, which are very expensive, are the most effective medications at the moment for managing cancer pain. Pain treatment is essential for enhancing the quality of life (QoL) of cancer patients who are near the end of their lives, regardless of expense.

Palliative care is also emotionally taxing on the patient, their loved ones, and the caregivers. First of all, the person receiving care is constantly experiencing mental suffering despite being fully aware that their future is not promising. The healthcare professionals who are caring for the patient are required to provide counseling, comfort, and support in this situation. The patient’s family is likewise psychologically and emotionally impacted. The worst feeling of all is realizing that you are going to lose a family member and there is little you can do to stop it. As a result, both an interpersonal and social, and economic levels of impact are felt by the family. The care team must keep this in mind to ensure that all necessary measures are implemented for effective palliative care. The Effect Of Palliative Care Among Cancer Patients Essay Paper

In addition to their immediate family, the patients’ home communities typically experience socioeconomic and emotional effects as well. Everyone in the neighborhood feels vulnerable when they learn that one of their neighbors has a fatal illness. There is sympathy as well as dread. It is also not unusual for the community to be asked to give some money to assist cover the palliative care costs for one of its members due to the high expense of palliative care over the long term. Realizing this and taking action to help everyone cope better are also necessary for enhancing QoL through palliative care.

Background and Significance

According to the American Cancer Society (n.d.), in the year 2019 alone in the United States, a total of 0.6 million patient deaths resulted from various cancers. During the same period of time a total of another 1.8 million new cancer diagnoses were made in the country. Unfortunately, majority of the marginalized minority communities are the ones being affected most by these cancers due to unique social determinants of health or SDOH. These include low socio-economic status, low educational achievement, poor living and sanitary conditions, and lack of access to quality healthcare services due to poverty (Powell, 2016)The Effect Of Palliative Care Among Cancer Patients Essay Paper. A case in point is colorectal carcinoma or CRC.

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Because of the low family incomes, the lifestyle choices made by these poor communities place them at a higher risk of getting cancers such as CRC (Cruz-Correa et al., 2016). For instance, they may not afford the costly but healthy fresh fruits and vegetables regularly. Unfortunately due to the prevailing low educational achievement within the communities, any attempts at health education do not yield the desired outcomes. Cancers such as CRC can only be prevented by secondary prevention through early screening. This requires understanding from those who are being given the health education and promotion. Last but not least, the poverty within these poor communities makes them unable to afford quality healthcare or even access it in the first place. This is despite having the Affordable Care Act (ACA) 2010; since palliative care cost goes beyond what ACA covers. The Effect Of Palliative Care Among Cancer Patients Essay Paper

The circumstance described above indicates that the majority of cancer patients are typically identified at an advanced stage. This indicates that they almost always reach a terminal stage and cannot be fully treated. Palliative care is therefore crucial for enhancing QoL, and it makes considerable use of the nursing process to do so. As was previously said, one of the most important symptoms experienced by cancer patients that need to be avoided is pain (Cea et al., 2016). When methodically evaluating pain and using evidence-based practice (EBP) strategies to reduce it, the nursing process is particularly helpful. Palliative care can only help terminally sick oncology patients in hospitals by doing this.

PICOT Question

In the context of this paper, the clinical practice problem that was identified was a poor QoL experienced by cancer patients that are admitted in oncology hospitals. According to Stannard (2021), the first important step in the process of using evidence-based interventions is correctly identifying the practice problem. This is what enables the commencement of a formal clinical inquiry with the aim of searching for current scientific and scholarly literature that supports particular interventions (Melnyk & Fineout-Overholt, 2019)The Effect Of Palliative Care Among Cancer Patients Essay Paper. This eventually leads to the formation of a PICOT question (Twa, 2016). It is this PICOT question that provides the search terms and phrases used in looking for evidence from scholarly literature. The PICOT question in this case was:

In terminally ill cancer patients admitted to oncology hospitals (P), does effective and consistent palliative care (I) compared to usual care (C) result in an improved quality of life (O) within a timeframe of three months (T)?

Table 1

The PICOT elements for palliative care vs. usual care among terminally ill cancer patients being treated in oncology hospitals

P	Population	Terminally ill cancer patients admitted to oncology hospitals
I	Intervention	Effective and consistent multidisciplinary palliative care
C	Comparison	Usual medical and nursing care given to cancer patients that is not necessarily palliative in nature
O	Outcome	An improved quality of life (QoL) as evidenced by the patient’s comfort and freedom from pain; as well as their family’s improved coping.
T	Timeframe	A timeframe of three (3) months

Literature Review

The literature search strategy in the case of this research involved going through reputable research databases to find evidence that supports palliative care. This is the proposed intervention that is expected to improve the QoL of the terminally ill cancer patients. The PICOT question above provided the search terms and phrases that were used in the search. They were “cancer,” “terminally ill,” “palliative care,” and “improved quality of life.” The Effect Of Palliative Care Among Cancer Patients Essay Paper

The electronic databases that are the repositories of published scientific and professional journal articles that were used stand out. They were ProQuest, Cochrane Database of Systematic Reviews, PubMed, CINAHL, and Embase. The Boolean operator “AND” was used to combine the terms and phrases before inserting them in the search engines of the databases. A total of 2008 articles were retrieved. But on filtering out the older ones, the abstracts, and the non-English results what remained were 67 articles. These were further analyzed and only 33 full text articles written in English and that specifically addressed the PICOT question were left. A few of these are looked at below.

The study by Abu-Odah et al. (2020) was a systematic review of reviews. This means that it provides the highest possible level of evidence in support of palliative care as a tool for improving the QoL of oncology patients. It specifically looked at the barriers that prevent effective palliative care for the poor and marginalized in resource-poor settings. The authors searched for the articles to review from the databases namely EMBASE, CINAHL, PsychINFO, Cochrane, SCOPUS, PubMed, and Web of Sciences.

They accepted fourteen reviews for their systematic review. The results of the review of reviews indicated the most significant challenges that are preventing effective palliative care for the low-income and middle-income populations. These include a lack of enough medications for symptoms relief (such as pain relief), lack of training and specialization, misunderstandings between caregivers and patients/ their families about the aims of treatment, insufficient infrastructure for palliative care, and a lack of national plans that are comprehensive for the effective implementation of palliative care. The Effect Of Palliative Care Among Cancer Patients Essay Paper

Gofton et al. (2018) on their part looked at the challenges that are confronting caregivers of palliative care in neurologic oncology. They used a grounded theory methodology to carry out the research. This study from the outset realised the importance of palliative care in terminally ill cancer patients with brain malignancies. As such they set out to unravel the challenges that are faced in its effective implementation. The results showed that these challenges included communication problems due to language impairment, cognitive impairment, the uncertainty of prognosis, lack of homogeneous information and knowledge among providers and caregivers, and what they term as “existential distress” that is specific to cancers of a neurologic origin.

For Lu et al. (2018) they wrote an expert opinion piece on the development and challenges of palliative care in China. From the outset, the unequivocally state that palliative care (and hospice care – which is technically a part and parcel of palliative care) are effective in improving the QoL of cancer patients. They also go ahead to opine that effective palliative care also helps in reducing healthcare costs and reducing the number of days the cancer patient stays in the hospital. This is significant given that palliative care is also concerned with the psychological, socio-economic, and emotional wellbeing of the patient and their family.

Throughout the article, the success of palliative care in China is attributed to concerted efforts at training healthcare providers, educating the patient population, secondary prevention through screening, and effective government policy. That palliative care and by extension hospice care is effective in alleviating suffering and improving the QoL of terminally ill cancer patients is not in doubt in the article. The Effect Of Palliative Care Among Cancer Patients Essay Paper

The role played by music in palliative care in improving the quality of life of terminally ill cancer patients is assessed by Pommeret et al. (2019) in their study. They used semi-structured interviews with two artists performing for the cancer patients at given times. An inductive approach and verbatim accounts were used to analyze the data that was collected.

The results showed that generally music brought joy to the cancer patients and made them forget their suffering. However, it also reminded the patients of their current dependence and their inability to function independently as they used to do before. This brought some emotional difficulties. For this reason the authors recommend further studies to ascertain whether indeed music as part of palliative care helps improve the QoL of terminally ill cancer patients.

The last but not least article retrieved was that by Voumard et al. (2018). They address the strategies used to provide effective geriatric palliative care as well as its challenges. The authors agree that indeed palliative care is the best strategy to increase life satisfaction or improve the QoL of terminally ill geriatric cancer patients. The challenges they point out include a lack of ethical practice, limited creativity by caregivers, and poor and non-inclusive decision making amongst others.

Evidence-Based Practice or EBP Standard

The EBP standard confirms the appropriateness of an intervention as a befitting evidence-based intervention in a given situation. In this case, the evidence from scholarly literature clearly shows that palliative care us indeed effective in improving the QoL of terminally ill cancer patients across the lifespan. This EBP standard is that:

Palliative care that is comprehensive and holistic must be given to all terminally ill cancer patients and their families while the patient is in the hospital.
The caregivers’ emotional and psychological wellbeing must also not be forgotten lest they become overwhelmed and compromise the quality of the expected patient outcomes. This may require staff counseling and transformational leadership. The Effect Of Palliative Care Among Cancer Patients Essay Paper

Summary and Implications

In summary, palliative care is an effective intervention for all terminally ill cancer patients. This is because it improves their QoL and makes life more bearable both for the patients and their families. There is enough scholarly evidence that supports the effectiveness of this intervention as has been demonstrated in this paper. What this means for practice is that all oncology practitioners will have to consistently use and diversify palliative care interventions that include pain relief. This they will have to do only through the prism of evidence-based practice or EBP anchored on clinical inquiry.

References

Abu-Odah, H., Molassiotis, A., & Liu, J. (2020). Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: A systematic review of reviews. BMC Palliative Care, 19(55), 1-16. https://doi.org/10.1186/s12904-020-00558-5

American Cancer Society (n.d.). Cancer facts & figures 2019. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2019.html#:~:text=Estimated%20numbers%20of%20new%20cancer,incidence,%20mortality,%20and%20survival%20statistics

Cea, M.E., Reid, M.C., Inturrisi, C., Witkin, L.R., Prigerson, H.G., & Bao, Y. (2016). Pain assessment, management, and control among patients 65 years or older receiving hospice care in the U.S. Journal of Pain and Symptom Management, 52(5), 663-672. https://doi.org/10.1016/j.jpainsymman.2016.05.020

Cruz-Correa, M., Cordero, F., Betancourt, J.P., Diaz-Algorri, Y., Lopez, S.M., Rivera, M., & Rodriguez-Quilichini, S. (2016). Implementation and outcomes of a community-based educational program for colorectal cancer prevention in Hispanics. Journal of Family Medicine and Disease Prevention, 2(3). https://doi.org/10.23937/2469-5793/1510042 The Effect Of Palliative Care Among Cancer Patients Essay Paper

Gofton, T.E., Chum, M., Schulz, V., Gofton, B. T., Sarpal, A., & Watling, C. (2018). Challenges facing palliative neurology practice: A qualitative analysis. Journal of the Neurological Sciences, 385, 225–231. https://doi.org/10.1016/j.jns.2017.12.008

Lu, Y., Gu, Y., & Yu, W. (2018). Hospice and palliative care in China: Development and challenges. Asia-Pacific Journal of Oncology Nursing, 5(1), 26-32. https://doi.org/10.4103/apjon.apjon_72_17

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4^th ed. Wolters Kluwer.

Pommeret, S., Chrusciel, J., Verlaine, C., Filbet, M., Tricou, C., Sanchez, S., & Hannetel, L. (2019). Music in palliative care : A qualitative study with patients suffering from cancer. BMC Palliative Care, 18(78), 1-6. https://doi.org/10.1186/s12904-019-0461-2

Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 24(1), 5-10. http://dx.doi.org/10.1891/1078-4535.22.1.5

Stannard, D. (2021). Problem identification: The first step in evidence‐based practice. AORN Journal, 113(4), 377–378. https://doi.org/10.1002/aorn.13359

Twa, M.D. (2016). Evidence-based clinical practice: Asking focused questions (PICOT). Optometry and Vision Science, 93(10), 1187–1188. https://doi.org/10.1097/OPX.0000000000001006

Voumard, R., Truchard, E.R., Benaroyo, L., Borasio, G.D., Büla, C., & Jox, R.J. (2018). Geriatric palliative care: A view of its concept, challenges and strategies. BMC Geriatrics, 18(1), 1-6. https://doi.org/10.1186/s12877-018-0914-0

Master’s in Oncology & Palliative Care Nursing

: Research Methods for Cancer Nurses

Assignment Guidelines

The assignment for this module is a research proposal of up to 2,500 words and is worth 100% of

the module mark.

Formative assessment

During classroom sessions, you will receive formative feedback from your peers and staff as your

ideas for the research proposal develop. There will also be an opportunity for formal feedback on

research ideas using an electronic formative feedback sheet. We encourage you to think about

issues that interest you and that you would like to explore further in your dissertation.

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Summative assessment

You are required to submit a proposal for your research (dissertation). Your Research Proposal must

include the following sections: The Effect Of Palliative Care Among Cancer Patients Essay Paper

Research Question

This should state what you will investigate. Your question should be clear, concise and focused.

The Purpose/Goal of your research

This should include your intended audience (who will be most interested in your findings), and what

you hope to achieve with your research, both of which should relate to your research question.

Theoretical Framework & Research Design

It is important to know the themes and concepts underpinning your research, and to make it clear

how you will investigate your topic using this theoretical approach. Will you be investigating

individuals’ feelings and narratives? Will you be measuring the statistical significance of a particular

group’s views or testing the feasibility of a clinical intervention? Your research design should include

the purpose, methods, assumptions and limitations of your research.

Literature Review

This section must include a brief summary and analysis of existing knowledge that points out the

links between this past work and the research you plan to conduct. It should introduce the overall

topic, connect your planned research to previous research in the area and justify the importance of

and need for the research question you will investigate. Be concise and only refer to literature that

helps you build the case for your study.

Population and Sample

Define who will be included in your study, and who will not. The population or sample you

investigate needs to match your research question and must be available for you to study. Consider

the impact of variables such as age, gender, clinical role/status, or professional setting. The Effect Of Palliative Care Among Cancer Patients Essay Paper

Master’s in Oncology & Palliative Care Nursing

Ethical Considerations

Explain how you will obtain ethical approval for your study. You should also discuss how you will

maintain confidentiality of data and the identity of your participants. You should include a draft copy

of your completed ethical approval application form as an appendix.

Plan for Data Collection

Discuss what type of data you will collect, including any data collection tools (including interview

schedules) that you will use. You may use an already validated tool or need to design one yourself. The Effect Of Palliative Care Among Cancer Patients Essay Paper

Plan for Data Analysis

Your data may be qualitative or quantitative, or a mix of both. You should outline the method you

plan to use to analyse your data. For example, statistical tests or an appropriate method for

analyzing subjective feelings, values and narratives from qualitative data. Look for studies that might

wish to replicate, but always refer the reader to the original paper that you used.

Dissemination of Findings

You should outline your plans to disseminate your findings. These might include presenting your

findings to staff and/or manager where you work, writing a paper for publication, or presenting your

research at a conference.

Presentation and submission of your work

Words in excess of 2,500 words will not be marked.

For submission your work should be:

word processed

include a word count for the assignment

use an appropriate font (e.g. Arial, Times New Roman, Calibri)

use a font size of 12pt, and margins of at least 2.5cm

use line spacing of at least 1.5

have page numbers in the footer of each page

indicate titles and subtitles by e.g. use of bold type

Please utilise the APA 6 th referencing system in your work.

The submission deadline for your research proposal is midday on 1^st December 2022. The Effect Of Palliative Care Among Cancer Patients Essay Paper