PROGRAM: PALLIATIVE CARES. Course 2012-2013 INTRODUCTION The demand of prepared professional is greater everyday to provide the best comfort to the patient at the end of his/her life. Nowadays, the 80% of terminally ill patients die in hospital and the others need good support at home. This makes that everyday more prepared professionals are needed to care patients at the end of their lives. Given this reality, this subject aims to provide basic theoretical and practical elements to deal with advanced and terminal disease in the context of nursing care. Code 100426 Subject Palliative Cares Course 2012-13. C3, S6 Language Catalan - Spanish Credits Credits ECTS 6 Faculty Nursing Department Nursing Qualification Nursing graduation Typology Optional LECTURERS Eva Figuera Collada (coordinator of the subject) Ramon Colell Brunet Telephone number 973702453 E-mail eva.figuera@infermeria.udl.cat ramon.colell@infermeria.udl.cat Office s localization 1.14 Query s schedule To fix Transverse competences 1.- Master Information and Communication Technologies OBJECTIVE: learn to use Sakai properly. 2.- Know the basis of palliative cares OBJECTIVE: assess the importance of patient s care in the process of dying. 3.- Establish an effective communication in the context of advanced and terminal disease OBJECTIVE: know the foundations of communication in the context of advanced and terminal disease. 4.- Asses the importance of emotional support in the process of dying OBJECTIVE: know the main manifestations on the impact of death and how to help emotionally the patient, the family and the team.
Specific competences 1.- Know the features of terminal disease - Assess the socio-cultural aspects of death. - Know the evolution of the dying process from an anthropological aspect. - Know the history and the evolution of the Hospice movement. 2.- Know the basic principles of Palliative cares - Identify the fundamentals and pillars of palliative cares. - Assess the objectives of palliative cares. 3.- Know the main symptoms of Palliative cares - Identify the features of the main symptoms in PC. - Know the pharmacological and non-pharmacological treatments of the main symptoms in PC. 4.- Promote the management of basic emotional aspects related with terminal disease - Assess the importance of the impact in the dying process of the patient, family and team. - Analyze the psychosocial factors involved in the dying process. - Identify the need for emotional support to the patient s family in the terminal disease. - Know the role of social work in palliative care team. - Know the role of Physiotherapy in the dying process. 5.- Know the stages in the mourning process - Identify the normal process of mourning. - Identify the complicated or pathological mourning. - Know techniques in order to help developing a properly mourning. 6.- Assess the need of psychosocial support of cancer patients - Assess the need of emotional support in patients with cancer. - Know the activities of Spanish Association Against Cancer (SAAC)
Subject s objectives Thematic unit l: introduction to the history and fundamentals of palliatives cares (PC) - Anthropology of death - Begging of palliatives cares in Europe and Spain - Fundamentals of palliative care - Principles of PC - Goals of palliative care Thematic unit ll: psychosocial aspects of the dying process - The losses over the life - The fears in the dying process - The impact of death in the patient, family and the team - Psychosocial factors involved in the dying process - Handling the emotional situation in the patient, family and the team - The spiritual support in the dying process - Ethics and PC Thematic unit lll: Pain treatment in palliative cares - Psychosocial factors involved in pain intensity - Steps and procedures to assess the pain - The WHO scale and medication in the treatment of pain - Alternatives to treat the pain - Nursing cares in the treatment of pain Thematic unit lv: Dealing with the main symptoms in the dying process - Treatment of gastrointestinal symptoms - Treatment of respiratory symptoms - Treatment of malignant wounds - Treatment of neuropsychological symptoms - Treatment of anorexia, asthenia and xerostomy - Treatment of constipation - Cares of the mouth - Dealing with the process suffering Thematic unit V: Administration of drugs - Subcutaneously - Orally - Workshop: infusers Thematic unit Vl: Communication-information in the dying process - Principles of communication information in the dying process - The therapeutic communication in palliative cares - How to give bad news in the dying process - What, how and when give information to the patient and family - The conspiracy of silence - The Buckman s protocol to give bad news - Thematic unit Vll: Dying process in children
- Experience of death in children and the family - Communication in the dying process of children - Emotional support to children at the end of his/her life - Emotional support to family Thematic unit Vlll: The process of mourning - General aspects of the mourning process - Grief and personality - Factors that may hinder the development of mourning - Types of mourning - Techniques to overcome grief Thematic unit lx: Social work in palliative care - Fundamentals of social work in the context of terminal disease - General aspects of home care - Support for patient and family at home - How to break conspiracy of silence at home Thematic unit X: Physiotherapy in palliative care - Fundamentals of Physiotherapy in the context of advanced and terminal disease - Usefulness of Physiotherapy in palliative care Thematic unit Xl: Holistic care to patient with cancer - General aspects to consider in caring patient with cancer - Holistic care to patient with cancer - Volunteering in the support of the patient with cancer - The Simonton s method and others, as psychosocial support in the cancer s treatment METHODOLOGY The subject has two very different parts from a methodological aspect. 70% of classes will be developed through masterly lessons in order to teach the main subject s contents, the remaining 30% will be done through a work in group. Depending on the features of the theory to develop in a practical level, different methodologies will be used, among others, written exercises which will help to make a personal reflection on the content to develop, dynamics and role-plays of real situations on relationship between patients and future professional nursing. Creativity will be promoted when developing concrete theoretical concepts. +
EVALUATION There are three ways to evaluate the subject: 20% Attendance to classes Although attendance is not obligatory, in this subject the need to work in team will be promoted. If classes are not attended, the subject s contents will be more difficult when making the work in group. For that reason, students have to participate in the theoretical-practical dynamics that will take place. Taking into account the last point, it will be obligatory to attend a minimum of 12 classes. If just 8 or less classes are attended, the average of the final mark could not be done. On the other hand, 0.25 points will be deducted for each absent day of class. The way to overcome this absence to more of 8 classes will be by making a written exam which will consist on answering 20 short questions related with the subject s contents. There will be just one possibility to justify the absence, if is in case of that a student have to attend an event related with the School of Nursing or in case of illness. 40% of the final mark belongs to the exposition in class of the work in group. The lecturer and classmates will make the evaluation of the work. The final mark will be the same for all the members of the group. A minimum mark of 5 is required to make the average with the other parts of the subject. The remaining 40% of the mark belongs to a written test with short answers related to the theory. A minimum mark of 5 is required to make the average with the other parts of the subject. To pass the subject it is needed a mark of 5. In case that the three test weren t done, there will be a final written exam of the contents of the subject. BASIC BIBLIOGRAPHY Colell, R. (2010) Psicología de las relaciones humanas. Lleida: deparís. Colell, R. (2008). Enfermería y cuidados paliativos. Lleida: PPU. Colell R. Relación entre la inteligencia emocional y la motivación para trabajar en cuidados paliativos en estudiantes de enfermería. Med.Pal 2006; Vol.13, pp.186-191. Colell, R. y Limonero, J. T. (2003). Qué preocupa al cuidador del enfermo oncológico? Rev. ROL Enf. 26(2):92-92. Colell, R.; Limonero, J. T. y Otero, M. D. (2003). Actitudes y emociones en estudiantes de enfermería ante la muerte y la enfermedad terminal. Investigación en Salud, Vol. V, nº 2, 104-112.
Colell, R y Fontanals, A. Principios de comunicación: cómo dar malas noticias. Clínica Rural, 1996, 454, 5-15. Díaz I. (2004). I ara, on es? Com ajudar els nens i els adolescents a entendre la mort. Barcelona: Viena Edicions Neimeyer, R.A. (1997). Métodos de evaluación de la ansiedad ante la muerte. Paidos: Barcelona. Neimeyer, R. (2007). Aprender de la pérdida. Madrid: Paidós. Kübler Ross, E. (1969). Sobre la muerte y los moribundos. Traducción, (1994). Barcelona: Grijalbo. Pangrazzi,A. (1993). La pérdida de un ser querido. Madrid: Ediciones Paulinas. www.alfinlibros.com