Assessing existential suffering in people in palliative care: a narrative review
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Abstract
Theoretical Framework: Existential suffering (ES) in palliative care patients addresses fundamental issues related to the meaning of life, fear of death and loss of purpose. Despite its importance, the adequate assessment of ES remains underexplored in clinical practice. The existing literature points to the need for robust methods and instruments for assessing ES in palliative contexts. This study aims to fill this gap by reviewing the methods and instruments used to assess ES in people in palliative care (PC). Objective: To identify the methods and instruments used to assess ES in palliative care patients. Methodology: A qualitative study was carried out through a narrative review in the PubMed, Cochrane Library and EBSCOhost databases. Eleven articles responding to the study’s objective were selected. Results and Discussion of Results: The review identifies the Existential Distress Scale (EDS), the Patient Dignity Inventory (PDI-IT) and the Demoralization Scale (DS-II) as effective tools for the comprehensive assessment of ES in PC. Additionally, the Care, Assistance/Help, Stress, Hopes/Fears (CASH) and Meaning and Existential Purpose (EMAP) are valued for their effectiveness in facilitating communication and complex decision making. However, it is imperative that these tools are continually developed and validated to maintain their relevance and effectiveness in varied cultural and clinical contexts, ensuring constant adaptations in the face of cultural diversity and different clinical practices. Conclusion: Accurate assessment of ES is essential for improving the quality of care. This study highlights the comprehensiveness of some instruments in simplifying the assessment of ES and in making complex decisions. However, it is crucial to continue developing and adapting these instruments to ensure their applicability and effectiveness in different cultural and clinical contexts.
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