Scheme The Most Effective Telomerase Email Campaign

It is apparent from our findings that quality EOL care extends beyond managing the physical pain, which is often the primary focus of providers; indeed, quality also includes a holistic perspective of care, psychoTelomerase spiritual needs and a dedicated healthcare team. Although the patient was the focus of most of the statements made by respondents, certain emerging concepts invoked both the patient and the family as the unit of care, specifically those concepts relating to facilitating preparedness, establishing trust and providing care options. Also, over a third of respondents distinctly mentioned involving and supporting the family. Some minor variations in the inclusion of family in the conceptualisations of what matter most were found according to professional role; perceptions that may be related to the typical nature, intensity and setting of patient interactions for a given role. In particular, the nurses were more likely to allude to the impact of EOL on the informal care providers and family. This trend may be attributed to more one-on-one time in patients�� homes and with family members. As a result, this lends to more time building relationships, understanding burden and/or needs beyond those of the patient, and ultimately the perceived importance of considering the family members throughout the EOL journey. The domains proposed by other studies focused on institutional settings are largely congruent to our findings in the home setting. A recent study by Vedel et al,18 in France, asked 61 palliative care patients, caregivers and providers structured questions as to whether specified elements of care are important to them. The researchers found four major critical dimensions of quality palliative care: comprehensive support for the patients; clinical management including pain control; involvement of families; and the care provided to the imminently dying person. Similarly, a review of quality death and dying research by Hales et al,13 of patient and provider perspectives, concluded that this is a subjective and multidimensional phenomenon represented by physical, psychological, social and spiritual experiences, as well as the nature of healthcare, life closure and death preparation, and the circumstances of death. A major limitation of our study is that we did not directly include the perspectives of patients or family caregivers. Other studies have found that providers tend to place the greatest importance on process of care and symptom treatment, whereas patients want to be comfortable but may also have concerns that are more existential in nature.13 18 29 Further, it is possible that the perspectives captured here may be different in other countries and cultures. Of note, many of the respondents are solely involved in specialised palliative care services that support patients in the home, services that not always available to all EOL patients in Ontario or elsewhere.