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Importance of Training

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Challenges to the Global Issue of End of Life Care

Part of the book series: Advancing Global Bioethics ((AGBIO,volume 17))

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Abstract

This chapter addresses the importance of a proper training for health care professionals facing end of life care issues. A significant psychological and moral distress is associated with the management both of dying patients and of patients with progressive degenerative diseases without hope of definitive healing. The above distress involves not only physicians working in the Intensive Care Units (ICU) but also various health care figures acting in residential long-term care settings, with difficulties being peculiar to each specific context. The chapter address the main concern faced by Health Care Assistants in End-of-Life Care and highlights the importance of a preparatory training allowing the professionals to acquire specific skills and coping strategies, which are essential for an effective and evidenced-based management of the patients. The need for a specific training is even more evident if we consider the progressive aging of the population, with a growing need for End-of-Life Care assessments and a worldwide social and psychological burden. Nevertheless, the necessity of a specific training addressing end of life issues is still underestimated with medical students being mainly involved in saving lives and little or nothing trained in facing patients’ death.

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References

  • Abel, J., A. Kellehear, and A. Karapliagou. 2018 Apr. Palliative care-the new essentials. Annals of Palliative Medicine 7 (Suppl 2): S3–S14.

    Article  Google Scholar 

  • Austin, C.L., R. Saylor, and P.J. Finley. 2017 Jul. Moral distress in physicians and nurses: Impact on professional quality of life and turnover. Psychological Trauma 9 (4): 399–406.

    Article  Google Scholar 

  • Back, A.L. 2020 Mar 20. Patient-clinician communication issues in palliative care for patients with advanced cancer. Journal of Clinical Oncology 38 (9): 866–876.

    Article  Google Scholar 

  • Boss, R.D., N. Hutton, P.K. Donohue, and R.M. Arnold. 2009 Sep. Neonatologist training to guide family decision making for critically ill infants. Archives of Pediatrics & Adolescent Medicine 163 (9): 783–788.

    Article  Google Scholar 

  • Brighton, L.J., and K. Bristowe. 2016 Aug. Communication in palliative care: Talking about the end of life, before the end of life. Postgraduate Medical Journal 92 (1090): 466–470.

    Article  Google Scholar 

  • Downar, J., P. Wegier, and P. Tanuseputro. 2019 Sep. Early identification of people who would benefit from a palliative approach-moving from surprise to routine. JAMA Netw Open 2 (9): e1911146.

    Google Scholar 

  • Gawande, A. 2014. Being mortal: Medicine and what matters in the end. Metropolitan Books/Henry Holt and Company.

    Google Scholar 

  • Gelhaus, P. 2012a May. The desired moral attitude of the physician: (I) empathy. Medicine, Health Care, and Philosophy 15 (2): 103–113.

    Article  Google Scholar 

  • Gelhaus, P. 2012b Nov. The desired moral attitude of the physician: (II) compassion. Medicine, Health Care, and Philosophy 15 (4): 397–410.

    Article  Google Scholar 

  • Gelhaus, P. 2013 May. The desired moral attitude of the physician: (III) care. Medicine, Health Care, and Philosophy 16 (2): 125–139.

    Article  Google Scholar 

  • Jameton, A. 1984. Nursing practice, the ethical issues. Englewood Cliffs: Prentice Hall.

    Google Scholar 

  • O'Donnell, P., A. Farrar, K. BrintzenhofeSzoc, A.P. Conrad, M. Danis, C. Grady, C. Taylor, and C.M. Ulrich. 2008. Predictors of ethical stress, moral action and job satisfaction in health care social workers. Social Work in Health Care 46 (3): 29–51.

    Article  Google Scholar 

  • Henner, N., and R.D. Boss. 2017 Mar. Neonatologist training in communication and palliative care. Seminars in Perinatology 41 (2): 106–110.

    Article  Google Scholar 

  • You, J.J., P. Dodek, F. Lamontagne, J. Downar, T. Sinuff, X. Jiang, A.G. Day, and D.K. Heyland. 2014 Dec 9. For the ACCEPT Study Team and the Canadian Researchers at the End of Life Network (CARENET). What really matters in end-of-life discussions? Perspectives of patients in hospital with serious illness and their families. CMAJ 186 (18): E679–E687.

    Article  Google Scholar 

  • Lind, G. 2000. Moral regression in medical students and their learning environment. Revista Brasileira De Educacao Medica 24 (3): 24–33.

    Google Scholar 

  • Mehlis, K., E. Bierwirth, K. Laryionava, F.H.A. Mumm, W. Hiddemann, and P. Heußner. 2018 Dec. Winkler EC High prevalence of moral distress reported by oncologists and oncology nurses in end-of-life decision making. Psycho-Oncology 27 (12): 2733–2739.

    Article  Google Scholar 

  • Ouchi, K., Strout, T., Haydar, S., et al. 2019. Association of emergency clinicians’ assessment of mortality risk with actual 1-month mortality among older adults admitted to the hospital. JAMA Netw Open 2 (9): e1911139.

    Google Scholar 

  • Owen, A.M., M.R. Coleman, M. Boly, M.H. Davis, S. Laureys, and J.D. Pickard. 2007 Aug. Using functional magnetic resonance imaging to detect covert awareness in the vegetative state. Archives of Neurology 64 (8): 1098–1102.

    Article  Google Scholar 

  • Pistoia, F., S. Sacco, J. Stewart, M. Sarà, and A. Carolei. 2016 Oct. Disorders of consciousness: Painless or painful conditions?-Evidence from neuroimaging studies. Brain Sciences 8: 6(4).

    Google Scholar 

  • Pistoia, F., S. Sacco, M. Sarà, M. Franceschini, and A. Carolei. 2015a Jan. Intrathecal baclofen: Effects on spasticity, pain, and consciousness in disorders of consciousness and locked-in syndrome. Current Pain and Headache Reports 19 (1): 466.

    Article  Google Scholar 

  • Pistoia, F., S. Sacco, M. Franceschini, M. Sarà, C. Pistarini, B. Cazzulani, I. Simonelli, P. Pasqualetti, and A. Carolei. 2015b May 15. Comorbidities: A key issue in patients with disorders of consciousness. Journal of Neurotrauma 32 (10): 682–688.

    Article  Google Scholar 

  • Pistoia, F., A. Carolei, Y.G. Bodien, S. Greenfield, S. Kaplan, S. Sacco, C. Pistarini, A. Casalena, A. De Tanti, B. Cazzulani, G. Bellaviti, M. Sarà, and J. Giacino. 2019 Oct 17. The comorbidities coma scale (CoCoS): Psychometric properties and clinical usefulness in patients with disorders of consciousness. Frontiers in Neurology 10: 1042.

    Article  Google Scholar 

  • Sandeberg, M., C. Bartholdson, and P. Pergert. 2020 Jan 13. Important situations that capture moral distress in paediatric oncology. BMC Medical Ethics 21 (1): 6.

    Article  Google Scholar 

  • Sandeberg, M., M. Wenemark, C. Bartholdson, K. Lützén, and P. Pergert. 2017 Feb 20. To change or not to change – translating and culturally adapting the paediatric version of the moral distress scale-revised (MDS-R). BMC Medical Ethics 18 (1): 14.

    Article  Google Scholar 

  • Sarà, M., F. Pistoia, G. Cernera, and S. Sacco. 2008 Mar. The consciousness dilemma: Feel or feel of feeling? Arch Neurol 65 (3): 418.

    Article  Google Scholar 

  • Sarà, M., and F. Pistoia. 2012 May 5. Bedside detection of awareness in the vegetative state. Lancet 379 (9827): 1702–1703.

    Article  Google Scholar 

  • Sarà M., and F. Pistoia. 2010 Apr. Defining consciousness: Lessons from patients and modern techniques. Journal of Neurotrauma 27 (4): 771–773.

    Google Scholar 

  • Teike Lüthi, F., M. Bernard, M. Beauverd, C. Gamondi, A.S. Ramelet, and G.D. Borasio. 2020 Feb 12. IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): Item generation, content and face validity of a new interprofessional screening instrument. BMC Palliative Care 19 (1): 19.

    Article  Google Scholar 

  • Scarponi, F., M. Zampolini, C. Zucchella, S. Bargellesi, C. Fassio, F. Pistoia, and M. Bartolo. 2019 Apr. C.I.R.C.LE study group. Identifying clinical complexity in patients affected by severe acquired brain injury in neurorehabilitation: A cross sectional survey. European Journal of Physical and Rehabilitation Medicine 55 (2): 191–198.

    Article  Google Scholar 

  • Schnakers, C., C. Chatelle, A. Vanhaudenhuyse, S. Majerus, D. Ledoux, M. Boly, M.A. Bruno, P. Boveroux, A. Demertzi, G. Moonen, and S. Laureys. 2010 Feb. The nociception coma scale: A new tool to assess nociception in disorders of consciousness. Pain 148 (2): 215–219.

    Article  Google Scholar 

  • Vrijmoeth, C., M.G. Christians, D.A. Festen, M. Groot, A. van der Heide, C.C. van der Rijt, M. Tonino, and M.A. Echteld. 2016 Nov. Physician-reported symptoms and interventions in people with intellectual disabilities approaching end of life. Journal of Palliative Medicine 19 (11): 1142–1147.

    Article  Google Scholar 

  • World Health Organization. (2013). WHO Definition of Palliative Care. Retrieved from http://www.who.int/cancer/palliative/definition/en

  • Zylberman, R., A. Carolei, S. Sacco, P. Mallia, and F. Pistoia. 2016 Jan. An innovative model of a home-like environment for people in vegetative and minimally conscious states. Neurohospitalist 6 (1): 14–19.

    Article  Google Scholar 

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Authors and Affiliations

  1. Neurological Institute, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy

    Francesca Pistoia

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  1. Francesca Pistoia
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Correspondence to Francesca Pistoia .

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Editors and Affiliations

  1. Medical School, University of Malta, Msida, Malta

    Pierre Mallia

  2. Australian National University, Canberra, Australia

    Nathan Emmerich

  3. Institute of Ethics, Dublin City University, Dublin, Ireland

    Bert Gordijn

  4. Neurological Institute, University of L’Aquila, Coppito, L’Aquila, Italy

    Francesca Pistoia

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Pistoia, F. (2022). Importance of Training. In: Mallia, P., Emmerich, N., Gordijn, B., Pistoia, F. (eds) Challenges to the Global Issue of End of Life Care. Advancing Global Bioethics, vol 17. Springer, Cham. https://doi.org/10.1007/978-3-030-86386-9_11

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