December Digest of News for Palliative Care Specialists

Every month, the PACED team prepares a digest of international materials and news about palliative care.
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Doctors' emotional decisions regarding treatment tactics do not lead to relief in the end-of-life period for patients
The author reflects on why doctors often continue treating a patient in situations where providing a peaceful end at home would be a better alternative.
The doctor's motivation of "never giving up" may seem like a virtue and is often encouraged by the patient's loved ones. However, in the case of an incurably ill patient, such a decision can be likened to participating in a lottery where victory goes to one out of a million participants.
The author calls for public awareness and new approaches in clinical care for doctors and patients, helping to deal with the emotions that fuel decisions about futile end-of-life treatments.


"Palliative care education in undergraduate nursing programs still requires refinement”. What can be improved?
Nurses, as the most extensive professional group in healthcare, play a crucial role in ensuring high-quality palliative care. Therefore, they should have sufficient education and competencies to work with the most challenging patients.
Minna Hökkä, a leader in palliative care in Finland, conducted an interesting study in collaboration with colleagues on the needs of nursing students. All respondents' answers were categorised into three groups: statements indicating the importance of a palliative care course, students' preferences for types and formats of education, and factors contributing to or hindering palliative care education. Read about the results in this article.

What did the assessment of the educational needs of nurses working with terminally ill newborns reveal?
In the 20th century, the quality of medical care for infants significantly improved, but some still die due to prematurity, infections, or multiple congenital anomalies. In a study conducted in Saudi Arabia, 200 nurses with a minimum of 5 years of experience in neonatal care were surveyed. Of them, 72.8% stated that they had received no training in palliative care.
Read the article to discover what knowledge is critically lacking in mid-level medical professionals in neonatal palliative care.


Spiritual support at the end of life

In the team of specialists providing support to terminally ill individuals, there are sometimes practitioners of spiritual care. What is the essence of their work? How do they differ from psychologists or clergy? What competencies do such specialists possess?
Emma Abman, a spiritual care practitioner from Massachusetts, USA, sheds light on these questions. She reflects on why working with palliative patients is a privilege and how the patient's religious or secular tradition provides comfort and becomes a way to interpret life experiences.

Acupuncture and massage reduce pain intensity among patients with advanced cancer
The fight against pain syndrome holds a special place in palliative care. Multimodal analgesia, which involves the use of various analgesic drugs in combination with non-pharmacological methods, has long been included in recommendations for specialists. The latter include massage and acupuncture.
At Memorial Sloan Kettering Cancer Center (USA), the impact of these methods on the pain levels of nearly three hundred patients with advanced cancer has been studied for several years. The results are impressive: patients reported a significant reduction in pain levels, improvements in sleep, reduced fatigue, and enhanced quality of life.