The diagnosis of a terminal illness is a scary time for thousands of people a year. By receiving such a diagnosis, the end is almost certainly near, and the options for patients are limited. Palliative care is slowly turning into one of the more popular options, as on average it is cheaper for patients and their families, and can achieve great results in areas like quality of life and preparedness for the end. Through a team of doctors, nurses, and psychologists, patients are afforded resources that they would not normally have, and can improve the patient’s quality of life for them and their family. Palliative care is specialized to each patient based on their disease, so it is more efficient due to its specialization, including pain management being implemented and other helpful ideas. The goal of palliative care is no longer the aggressive treatment of the disease at the expense of the patient’s life, but shifts towards more comfort care, which is treatment with the patient’s quality of life at the forefront. This includes patient input on pain medication and physical therapy as well as mental services.
In a study performed by the Cleveland clinic, a group of lung cancer patients were split in half, and half received early referral to palliative care, while the others did not and went a more traditional hospice route (Rowland 2010). The idea of this study was to test whether the early enrollment would prove beneficial to patients, and how this would affect their quality of life. This study was considered due to earlier research that suggested that palliative care had in fact lowered costs for patients, but more extensive research into palliative care was needed in order to bridge the gap between those results and the process behind them. Research has shown that “ only 14% of people needing palliative care at the end of life received it” (Al-Mahrezi 2016), proving that further research and recognition is needed to advance the field in the public eye. This study is one of the first to go in depth and truly examine the efficiency of the palliative care process, and brings to light novel results that helped propel more extensive palliative care research and programs.
The study was performed over a 12-week period, in which both sets of patients were monitored and asked to complete tests and surveys as the time and treatments went by. The meetings were either monthly or more frequently if requested by the patients or the oncology team. This led to roughly four data points for each patient over the entire study. Patients were subjected to a Quality of Life baseline before the treatment started, and during the meetings would take this Functional Assessment of Cancer Therapy-Lung (FACT-L) tool in order to help researchers gauge how patients were doing. The researchers also used the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS) in order to measure other factors of life, including pain management, depression, and anxiety levels (Rowland 2010). The results of these tests and questions were averaged among groups and then compared to the opposite group in order to see if there is a difference, and what that difference may suggest. It was found that the early referral group had higher score on all of the tests, and so palliative care was shown to be a clear benefit to patients in the study (Rowland 2010). This research backs up recommendations by other organizations that “recommend that palliative care referrals be made early in the course of a progressive, debilitating illness, regardless of the patient’s life expectancy” (Rowland 2010), and “recommend palliative care as an essential component of comprehensive cancer care.” (Rowland 2010)
A limitation that was stated by the researchers was they wondered whether the results could partially be attributed to the extended time spent with clinicians by patients, and not the actual referral to the program (Rowland 2010). Patients in the study were also predominantly white, which does not show a great range of patients compared to the population of the United States. A new study, with more diversity, and more equal clinician involvement could help remedy these flaws in the initial design. The last major flaw is that all the results were subjective as they were all patient feedback. Human input can be erroneous and subjective from person to person, so the results may be skewed due to this. There is not an easy fix to this, but researchers should note this in the future.
This research plays a large role in the future, due to its fact to improve the life of terminal patients, and save them and their family money in such a trying time. Families would be more comforted enrolling a sick family member in palliative care once they realize that the patient’s quality of life would be maximized by such enrollment. It is important to bring awareness to palliative care in order to stress these points and to give patients and their families more hope.
This would be important because being faced with terminal illness is a fear that many people have, and having the ability to combat this disease and its symptoms more effectively would help placate that fear. This also extends to family members and friends that may face such hardship and how this research may help their suffering. This may help to give people more time with their loved ones at the end, and to extend the amount of time that their ill relative has low pain and better feeling. This is also a relatively new field of study that not many people are aware about, so learning more can help bring awareness to the field and help bring in funding for such departments. By raising awareness this can help extend lives of loved ones and help mitigate their suffering which is a blessing by itself.
Rowland K, Schumann S-A. PURLs. Palliative care: earlier is better. The journal of family practice. 2010;59(12):695–698.
Al-Mahrezi A, Al-Mandhari Z. Palliative Care: Time for Action. Oman medical journal. 2016 May [accessed 2021 Feb 8]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852088/
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Palliative care featured art 2018. Palliativenursing.net. [accessed 2021 February 23]. Digital image of word art about palliative care. http://www.palliativenursing.net/what-is-palliative-care/