Physical, psychological, social, and spiritual aspects of end-of-life trajectory among patients with advanced cancer: A phenomenological inquiry.

The study examined and described the perspectives of people living with advanced cancer and the changes over time in their needs and experiences. This paper reports the accounts of 11 terminally-ill people who gave a total of 25 in-depth interviews. Participants were recruited when they began receiving home hospice care service, and they were followed up over time, as their disease progressed. Framework method was used to organize the data and identify themes. The findings highlighted that end-of-life care needs to be holistic, encompassing physical, psychological, social, and spiritual needs, as well as dynamic along the course of disease progression.

Developing Evidence-Based Clinical Guidelines in Palliative Care for Home Care Setting in India.

BACKGROUND: Clinical guidelines can improve care and reduce variations in practice. With the growth of The Jimmy S Bilimoria Foundation's PALCARE, a home-based palliative care service launched in December 2015, the foundation felt a need for locally relevant, clinical guidelines to ensure consistency and reliabilty of its service. A Clinical Consultative Committee (CCC) comprising of experienced palliative care professionals, from within and outside India, was constituted to help with the development of robust, evidence-based multidisciplinary clinical guidelines relevant to the delivery of palliative care for adults in a home care setting in Mumbai, India, which could be applied to other similar settings in India and elsewhere. METHODOLOGY AND DEVELOPMENT: The CCC developed 39 guidelines under eight categories; using a structured process from the initial draft to its finalization. The CCC vetted each of the guidelines over monthly Skype meetings for validity, relevance, local applicability and reproducibility. Feedback from the PALCARE team was also incorporated. Thirty-nine clinical guidelines relevant to adult palliative care services in home care setting were developed. These have been discussed and found useful by the PALCARE team. The guidelines are available on the PALCARE website for use by wider professional audience. CONCLUSION: Development of clinical guidelines locally for palliative care in a home care setting in response to a felt need to ensure quality care and reduce variation in practice has been beneficial in clinical care. It has proved to be a good teaching resource too. Regular audits to measure practice against these guidelines will ensure better patient outcomes.