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Valid instruments for assessing spiritual resources and distress in pain therapy are scarce. The Spiritual Distress and Resources Questionnaire (SDRQ) was developed to fill this gap.
The objective of this study was to investigate the SDRQ's psychometric properties.
We presented the SDRQ to 219 patients with chronic pain conditions and examined its measurement properties, namely reliability and structural, convergent and discriminant validity. To investigate test-retest reliability, the SDRQ was presented a second time to a subsample of 58 randomly selected participants.
Factor analysis required a grouping of the 22 SDRQ items into four subscales spiritual distress, spiritual coping, immanence and transcendence, the latter two representing spiritual resources. Cronbach's alpha was high for spiritual distress (0.93), transcendence (0.85), and immanence (0.81) while it was somewhat lower but still satisfactory for spiritual coping (0.70). The construct validity of the SDRQ was shown by correlations with established measures in the field. Higher levels of spiritual distress were associated with signs of more severe illness, such as emotional distress and pain intensity.
The results from this study suggest that the SDRQ is an easy-to-use, reliable and valid screening instrument for assessing spiritual distress, spiritual resources and spiritual coping in patients with chronic pain. The SDRQ has the potential to be used with patients suffering from other chronic diseases and to disseminate the palliative approach to pain treatment to other areas of medicine.
The results from this study suggest that the SDRQ is an easy-to-use, reliable and valid screening instrument for assessing spiritual distress, spiritual resources and spiritual coping in patients with chronic pain. The SDRQ has the potential to be used with patients suffering from other chronic diseases and to disseminate the palliative approach to pain treatment to other areas of medicine.
Palliative care (PC) improves outcomes in noncancer illness. We hypothesized the benefit is driven by studies of heart failure (HF) patients exclusively versus studies of other noncancer illnesses.
To assess difference in outcomes in trials with HF patients exclusively vs studies of other noncancer chronic illness.
We performed a meta-analysis of studies that assessed association of PC with hospital admissions, emergency department (ED) visits and advance care planning in noncancer chronic illness and compared studies of HF patients versus those with other noncancer chronic illness.
Our analysis included 10 HF studies (n = 4,057) and 16 non-HF studies (11 mixed conditions, 3 dementia, 2 COPD, n = 10,235). PC led to reduction in hospital admissions in HF studies (OR = 0.67 [95% CI = 0.48-0.95]) but not in other noncancer illness studies (OR = 0.86 [95% CI = 0.62-1.21]). PC intervention was nonsignificant for change in ED visits in either HF (OR = 0.70 [95% CI = 0.38-1.28]) or other noncancer studies (OR = 0.86 [95% CI = 0.69-1.07]). Increase in advance care planning was noted in both HF (OR = 4.29 [95% CI = 1.44-12.76]) and other studies (OR = 2.67 [95% CI = 1.29-5.52]). Nonsignificant reductions in symptom burden were noted for both HF-studies and non-HF studies, though overall there was a significant improvement in symptom burden (weighted mean difference -1.15 [95% CI = -1.65, -0.65]). Similar results were noted when studies of mixed populations were excluded from the non-HF studies.
PC is particularly effective at reducing potentially unwanted hospital admissions for patients with HF compared to other noncancer illnesses. selleck kinase inhibitor Our findings should further encourage efforts to increase PC access to HF patients.
PC is particularly effective at reducing potentially unwanted hospital admissions for patients with HF compared to other noncancer illnesses. Our findings should further encourage efforts to increase PC access to HF patients.
High quality communication is essential to older adults' medical decision-making, quality of life, and adjustment to serious illness. Studies have demonstrated that Geritalk, a two day (16 hours total) in-person communication skills training improves self-assessed preparedness, skill acquisition, and sustained practice of communication skills. Due to the COVID-19 pandemic, Geritalk was adapted to a virtual format (four days, 10 hours total).
Our study evaluated the change in participants' self-assessed preparedness for serious illness communication before and after the virtual course and satisfaction with the course, and compared these findings to responses from a prior in-person Geritalk course.
Geriatrics and Palliative Medicine fellows at three urban academic medical centers completed surveys, which employed five-point Likert scales, before and after the virtual course to assess satisfaction with the course and preparedness for serious illness communication.
Of the 20 virtual Geritalk participants,of care received by older adults with serious illness.
Advance care planning (ACP) becomes more relevant with deteriorating health or increasing age. People might be more inclined to engage in ACP as they feel that they are approaching end of life. The perception of approaching end of life could be quantified as subjective remaining life expectancy (SRLE).
First, to describe the prevalence of ACP with health care providers or written directives ("formal engagement in ACP") and ACP with loved-ones ("informal engagement in ACP") among older persons in the general population in The Netherlands. Second, to assess the association between SRLE and engagement in ACP.
Cross-sectional study using data from the Longitudinal Aging Study Amsterdam (LASA) measurement wave of 2015-2016. Participants (n = 1585) were aged ≥ 57 years.
Median age was 69.4 years (IQR 64.1-76.7), and median SRLE 25.9 years (17.7-36.0). Formal engagement in ACP was present in 32.6%, informal without formal engagement in 45.8%, and 21.6% was not engaged in ACP. For respondents with SRLE < 25 years, there was a nonstatistically significant association between SRLE and engagement in ACP (aOR 0.97; 95% CI 0.93-1.01; P= .088), and a statistically significant, small association with formal vs. informal engagement in ACP (aOR 0.96; 0.93-0.99; P= .009). For respondents with SRLE ≥ 25 years there was no association between SRLE and engagement in ACP.
The perception of approaching end of life is associated with higher prevalence of formal engagement in ACP, but only for those with SRLE < 25 years. For clinicians, asking patients after their SRLE might serve as a starting point to explore readiness for ACP.
The perception of approaching end of life is associated with higher prevalence of formal engagement in ACP, but only for those with SRLE less then 25 years. For clinicians, asking patients after their SRLE might serve as a starting point to explore readiness for ACP.