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Physical, Psychological/Psychiatric, Social, and Spiritual Problems and Symptoms

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Textbook of Palliative Care

Abstract

The person who presents to the clinician in the palliative care setting is not only afflicted by physical symptoms. They bring with them a complex, rich but often disabling tapestry of psychological symptoms as well as social disruption and existential or spiritual symptoms such as loss of identity, meaning and purpose. Exploring these various aspects that are framed within the biopsychosocial-spiritual model seeks to address all potential interests, worries, and questions of the person and provide a full ‘scientific’ picture of each individual. This is a fundamental aspect of palliative care, to enable and support the whole person to be supported in living with a terminal illness.

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References

  • Beng KS. The last hours and days of life: a biopsychosocial–spiritual model of care. Asia Pac Fam Med. 2004;4:1–3.

    Google Scholar 

  • Borrell-Carrió F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med. 2004;2:576–82. https://doi.org/10.1370/afm.245.

    Article  PubMed  PubMed Central  Google Scholar 

  • Boston P, Bruce A, Schreiber R. Existential suffering in the palliative care setting: an integrated literature review. J Pain Symptom Manag. 2011;41(3):604–18.

    Google Scholar 

  • Breitbart W, Heller KS. Reframing hope: meaning-centered care for patients near the end of life. J Palliat Med. 2003;6(6):979–88.

    Article  PubMed  Google Scholar 

  • Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, et al. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psychooncology. 2010;19(1):21–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brisbois TD, Hutton JL, Baracos VE, Wismer WV. Taste and smell abnormalities as an independent cause of failure n food intake in patients with advanced cancer – an argument for the application of sensory science. J Palliat Care. 2006;22(2):111–4.

    PubMed  Google Scholar 

  • Burke LA, Neimeyer RA. Meaning making. In: Cobb M, Puchalski C, Rumbold B, editors. Oxford textbook of spirituality in healthcare. Oxford: Oxford University Press; 2012. p. 127–33.

    Chapter  Google Scholar 

  • Bush EG, Rye MS, Brant CR, Emery E, Pargament KI, Riessinger CA. Religious coping with chronic pain. Appl Psychophysiol Biofeedback. 1994;24(4):249–60.

    Article  Google Scholar 

  • Büssing A, Michalsen A, Balzat H-J, Grünther R-A, Ostermann T, Neugebauer EAM, Matthiessen PF. Are spirituality and religiosity resources for patients with chronic pain conditions? Pain Med. 2009;10(2):327–39.

    Article  PubMed  Google Scholar 

  • Cassell EJ. The nature of suffering and the goals of medicine. N Engl J Med. 1982;306(11):639–45.

    Article  Google Scholar 

  • Cassell EJ. The nature of suffering and the goals of medicine. New York: Oxford University Press; 1991. p. 37–44.

    Google Scholar 

  • Chochinov HM, Cann BJ. Interventions to enhance the spiritual aspects of dying. J Palliat Med. 2005;8(supplement 1):S103–15. https://doi.org/10.1089/jpm.2005.8.s-103.

    Article  PubMed  Google Scholar 

  • Corner J, Plant H, A’Hern R, Bailey C. Non-pharmacological intervention for breathlessness in lung cancer. J Palliat Med. 2016;10(4):299–05.

    Google Scholar 

  • Cotton S, Puchalski C, Sherman S, Mrus J, Peterman A, Feinberg J, et al. Spirituality and religion in patients with HIV/AIDS. J Gen Intern Med. 2006;21(0):S5–S13.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dezutter J, Robertson LA, Luyckx K, Hutsebaut D. Life satisfaction in chronic pain patients: the stress-buffering role of the centrality of religion. J Sci Study Relig. 2010;49(3):507–16.

    Article  PubMed  Google Scholar 

  • Dezutter J, Wachholtz A, Corveleyn J. Prayer and pain: the mediating role of positive re-appraisal. J Behav Med. 2011;34(6):542–9.

    Article  PubMed  Google Scholar 

  • Edwards A, Pang N, Shiu V, Chan C. The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: a meta-study of qualitative research. Palliat Med. 2010;24(8):753–70. https://doi.org/10.1177/0269216310375860.

    Article  PubMed  CAS  Google Scholar 

  • Egan R, MacLeod R, Jaye C, McGee R, Baxter J, Herbison P. What is spirituality? Evidence from a New Zealand hospice study. Mortality. 2011;16(4):307–24. https://doi.org/10.1080/13576275.2011.613267.

    Article  Google Scholar 

  • Ellis J, Lloyd-Williams M. Palliative care. In: Cobb M, Puchalski C, Rumbold B, editors. Oxford textbook of spirituality in healthcare. Oxford: Oxford University Press; 2012. p. 257–63.

    Chapter  Google Scholar 

  • Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36. https://doi.org/10.1126/science.847460.

    Article  PubMed  CAS  Google Scholar 

  • Engel GL. The clinical application of the biopsychosocial model. J Med Philos. 1981;6(2):101–24. https://doi.org/10.1093/jmp/6.2.101.

    Article  CAS  PubMed  Google Scholar 

  • Frankl VE. Man’s search for meaning. Boston: Beacon Press; 2006.

    Google Scholar 

  • Glaus A, Crow R, Hammond S. Fatigue in healthy and cancer patients. 1. A qualitative study on conceptual analysis. Pflege. 1999;12:11–9.

    Article  CAS  PubMed  Google Scholar 

  • Keefe FJ, France CR. Pain: biopsychosocial mechanisms and management. Curr Dir Psychol Sci. 1999;8:137–41.

    Article  Google Scholar 

  • Kelly E. Competencies in spiritual care education and training. In: Cobb M, Puchalski C, Rumbold B, editors. Oxford textbook of spirituality in health care. Oxford: Oxford University Press; 2012. p. 435–49.

    Chapter  Google Scholar 

  • Kinsman RA, Spector SL, Shucard DW, Luparello TJ Observations on patterns of subjective symptomatology of acute asthma. Psychosom Med. 1974;36(2):129–43.

    Google Scholar 

  • Kinsman RA, Dahlem NW, Spector S, Saudenmayer H. Obervations on subjective symptomatology, coping behavior, and medical decisions in asthma. Psychosom Med. 1977;39(2):102–19.

    Google Scholar 

  • la Cour P, Hvidt NC. Research on meaning-making and health in secular society: secular, spiritual and religious existential orientations. Soc Sci Med. 2010;71(7):1292–9.

    Article  PubMed  Google Scholar 

  • Loeser JD, Melzack R. Pain: an overview. Lancet. 1999;353:1607–9.

    Article  CAS  PubMed  Google Scholar 

  • Mahmoud FA, Aktas A, Walsh D, Hullihen BA. Pilot study of taste changes among hospice inpatients with advanced cancer. Am J Hosp Palliat Med. 2011;28(7):487–92.

    Article  Google Scholar 

  • McClement SE, Degner LF, Harlos MS. Family beliefs regarding the nutritional care of a terminally ill relative: a qualitative study. J Palliat Med. 2003;6(5):737–48.

    Article  PubMed  Google Scholar 

  • McSherry W, Jamieson S. An online survey of nurses’ perceptions of spirituality and spiritual care. J Clin Nurs. 2011;20:1757–67. https://doi.org/10.1111/j.1365-2702.2010.03547.x.

    Article  PubMed  Google Scholar 

  • Meares CJ. Primary caregiver perceptions of intake cessation in patients who are terminally ill. Oncol Nurs Forum. 1997;24:1751–7.

    PubMed  CAS  Google Scholar 

  • Moreira-Almeida A, Koenig HG. Religiousness and spirituality in fibromyalgia and chronic pain patients. Curr Pain Headache Rep. 2008;12:327–32.

    Article  PubMed  Google Scholar 

  • Muldoon M, King N. Spirituality, health care, and bioethics. J Relig Health. 1995;34:329–50.

    Article  PubMed  Google Scholar 

  • Mustian KM, Alfano CM, Heckler C, Kleckner AS, Kleckner IR, Leach CR, Mohr D, Palesh OG, Peppone LJ, Piper BF, Scarpato J, Smith T, Sprod LK, Miller SM. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol. 2017;3:961–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Passik SD, Kirsh KL, Donaghy K, et al. Patient-related barriers to fatigue communication. Initial validation of the fatigue management barriers questionnaire. J Pain Symptom Manag. 2002;24:481–93.

    Article  Google Scholar 

  • Puchalski C. Spirituality and end-of-life care: a time for listening and caring. J Palliat Med. 2002;5(2):289–94.

    Article  PubMed  Google Scholar 

  • Puchalski C, Romer AL. Taking a spiritual history allows clinicians to understand patients more fully. J Palliat Med. 2000;3(1):129–37.

    Article  CAS  PubMed  Google Scholar 

  • Radbruch L, Strasser F, Elsner F, et al. Fatigue in palliative care patients – an EAPC approach. Palliat Med. 2008;22:13–32.

    Article  PubMed  Google Scholar 

  • Rippentrop AE. A review of the role of religion and spirituality in chronic pain populations. Rehabil Psychol. 2005;50(3):278–84.

    Article  Google Scholar 

  • Saunders C. Care of the dying. 3. Control of pain in terminal cancer. Nurs Times. 1959;23:1031–2.

    Google Scholar 

  • Saunders C. Care of patients suffering from terminal illness at St Joseph’s Hospice, Hackney, London. Nurs Mirror. 1964a;14:vii–x.

    Google Scholar 

  • Saunders C. The symptomatic treatment of incurable malignant disease. Prescribers’ J. 1964b;4(4):68–73.

    Google Scholar 

  • Selman L, Harding R, Gysels M, Speck P, Higginson IJ. The measurement of spirituality in palliative care and the content of tools validated cross-culturally: a systematic review. J Pain Symptom Manag. 2011;41(4):728–53.

    Article  Google Scholar 

  • Siddall PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anaesth Analg. 2004;99:510–20.

    Article  Google Scholar 

  • Siddall PJ, McIndoe L, Austin P, Wrigley PJ. The impact of pain on spiritual well-being in people with a spinal cord injury. Spinal Cord 2017;55(1):105–11.

    Google Scholar 

  • Singer T, Seymour B, O’Doherty J, Kaube H, Dolan RJ, Frith CD. Empathy for pain involves the affective but not sensory components of pain. Science. 2004;303:1157–62.

    Article  CAS  PubMed  Google Scholar 

  • Skevington SM, Pilaar M, Routh D, Macleod RD. On the language of breathlessness. Psychol Health. 1997;12(5):677–89.

    Google Scholar 

  • Sloan RP, Bagiella E, Powell T. Religion, spirituality, and medicine. Lancet. 1999;353(9153):664–7.

    Article  CAS  PubMed  Google Scholar 

  • Smith RC. The biopsychosocial revolution. J Gen Intern Med. 2002;17(4):309–10. https://doi.org/10.1046/j.1525-1497.2002.20210.x.

    Article  PubMed Central  Google Scholar 

  • Sulmasy D. A biopsychosocial-spiritual model for the care of patients at the end of life. The Gerontologist. 2002;42(3):24–33.

    Article  PubMed  Google Scholar 

  • Turk DC. The role of psychological factors in chronic pain. Acta Anaesthesiol Scand. 1999;43:885–8.

    Article  CAS  PubMed  Google Scholar 

  • Twycross R. Symptom management in advanced cancer. Oxford: Radcliffe Press; 1995.

    Google Scholar 

  • Vachon M, Fillion L, Achille M. A conceptual analysis of spirituality at the end of life. J Palliat Med. 2009;12(1):53–9. https://doi.org/10.1089/jpm.2008.0189.

    Article  PubMed  Google Scholar 

  • Wachholtz AB, Keefe FJ. What physicians should know about spirituality and chronic pain. South Med J. 2006;99(10):1174–5.

    Article  PubMed  Google Scholar 

  • Wachholtz A, Pearce M, Koenig H. Exploring the relationship between spirituality, coping, and pain. J Behav Med. 2007;30(4):311–8.

    Article  PubMed  Google Scholar 

  • Weiss RJ. The biopsychosocial model and primary care. Psychosom Med. 1980;42(1):123–30. Retrieved from http://www.psychosomaticmedicine.org/content/42/1/123.full.pdf+html.

    Article  CAS  PubMed  Google Scholar 

  • Zinnbauer BJ, Pargament BJ, Scott AB. The emerging meanings of religiousness and spirituality: problems and prospects. J Pers. 1999;67(6):889–919. https://doi.org/10.1111/1467-6494.00077.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pain Management, HammondCare, Sydney, NSW, Australia

    Philip J. Siddall

  2. Sydney Medical School – Northern, University of Sydney, Sydney, NSW, Australia

    Philip J. Siddall

  3. Palliative Care, HammondCare and University of Sydney, Sydney, NSW, Australia

    Roderick D. MacLeod

Authors
  1. Philip J. Siddall
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  2. Roderick D. MacLeod
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Correspondence to Philip J. Siddall .

Editor information

Editors and Affiliations

  1. HammondCare Learning and Research Centre, Greenwich Hospital, Greenwich, NSW, Australia

    Roderick Duncan MacLeod

  2. Vrije Universiteit Brussel, VUB-UGent End-of-Life Care Research Grou Vrije Universiteit Brussel, Brussels, Belgium

    Lieve Van den Block

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Siddall, P.J., MacLeod, R.D. (2018). Physical, Psychological/Psychiatric, Social, and Spiritual Problems and Symptoms. In: MacLeod, R., Van den Block, L. (eds) Textbook of Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-31738-0_9-1

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  • DOI: https://doi.org/10.1007/978-3-319-31738-0_9-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31738-0

  • Online ISBN: 978-3-319-31738-0

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

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