3. Accepted date: April 14, 2016 We also need to be able to translate this “foreign language” into lay-speak. The Logo-Test includes factors contributing to the feeling of meaningfulness and symptoms resulting from a weak sense of meaning in life - symptoms of existential frustration. Satisfaction of these needs is important in order to feel supported and accepted. In Section I (Source of meaning and values), clients had the option to answer "yes", "no" or refuse to answer nine questions in the field of family relationships, self-realization, profession, friends and the community. In the area of the clients' social needs, the need for the presence of a loving person who can be talked to, or can assist with personal hygiene, eating and such, was found to be very important. The number of those physically and mentally fit to answer the questions, totaled 32. During the process of dying, social support, communication, and involvement of family increases the level of satisfaction with care which in turn influences a person’s search for meaningfulness of life. More precisely, these different issues relate to patient end of life situational experiences which can be summarized as “(1) the experience of dependency - inability and restrictions on freedom, (2) the experience of meaning or lack of meaning, (3) the struggle for daily life and survival, (4) relations with close relatives and significant others, (5) communications with others, (6) thoughts about the future, in particular, the dying process, (7) concerns about the family, (8) feelings of guilt for former actions and present life situations, (9) thoughts about God and life after death, and (10) personal suffering” [10]. She got her Ph.D. under V.E. Published date: April 18, 2016. The study suggests that the more satisfied the dying client was with social support from relatives, the higher was the degree of meaningfulness of life (r = -0.481; sig. Another interesting finding is that the better the client is informed about their overall condition, treatment process and the issues concerning care, the higher the level of meaningfulness perceived (r = -0.426, p <0.05). If something isn’t working, we need to be prepared to switch strategies at a moment’s notice. [6] As medical social workers, we are well served if we continue our learning beyond the classroom and into palliative care practice. This study was conducted as part of the project “The Identity of Social Work in the Context of Slovakia [APVV-0524-12]” funded by the Slovak Research and Development Agency. In the second part, the questions were formulated so that the clients could express themselves in the areas of inquiry. Mikulincer M, Florian V, Hirschberger G (2003) The existential function of close relationships: introducing death into the science of love. Helping patients to decrease their negative feelings and respecting their dignity is crucial to meeting the needs of the patient. Blinderman CD, Cherny NI (2005) Existential issues do not necessarily result in existential suffering: lessons from cancer patients in Israel. If you are looking for a palliative social worker, what are some questions you can ask about these traits? • What is a creative intervention that you have used or would like to try? The instrument aims to have both research and therapeutic applicability: apart from the general sense of meaning in life of a person, the Logo-Test also attempts to provide preliminary information about specific topics to work on in a potential therapeutic process. 2015 [cited 2017 May 24]. 3. This, in turn, provided patients with a reason to live and a purpose to stay involved and live while they were dying. Balcar K (1995) Standardizace dotazníku Logo-test “na vzorku studijných ceských vysokých škol. Objective: This study discusses the social and existential aspects affecting patients during end of life care. Another way to ask about these traits might be to present a case example and ask the social worker how he or she might demonstrate these traits with this patient or in this circumstance. Assessing the palliative care needs for a patient can be carried out in any physical setting that ensures comfort and privacy and could include the patient’s home or hospital setting. Only 9% felt the most social support from the staff and 6 % did not feel any social support. In this part, clients were to indicate in which story the protagonist was "happy" and in which they were likely "to be suffering". The social worker shall engage in social and political action that seeks to ensure 4. that people have equal access to resources to meet their biopsychosocial needs in palliative Thege K, Martos T, Bachner YG, Talma Kushnir  T (2010)  Development and psychometric evaluation of a revised measure of meaning in life: The Logo-Test- R. Dobríková P (2010) Quality of life in incurable patients. ©2016 Dobríková P. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The interviews indicated that social support for dying clients is most frequently provided by family members, visits from children (son, daughter), and followed by friends and hospice staff. Social support might influence patients’ quality of life and meaningfulness of life by helping them cope more effectively with their sufferings and making them feel valued, loved, and cared for. • How do you stay current in your field? A dying person needs to feel that people immediately involved in their care see him/her as a human being until the very end; that the patient is also being kept sufficiently informed about aspects of care that affect every-day life. On the other hand, the lonelier a person felt, the lower was the perception of the meaning of life. These traits can serve as a place to start that creative drive and push our skills beyond the basics. The World Health Organization (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” [1]. The profession social work is known for its applicability in diverse fields. The research aimed to verify the level of awareness about nursing plan, medical treatment and its possible side effects, as well as socio-legal matters and the progress of care in general. Meeting patients’ social needs, 5. This may include a visit from a legal representative or person who has been officially nominated as their power of attorney. Prince-Paul M (2008) Understanding the meaning of social well-being at the end of life. Palliative care that takes a person-centred approach to care will ensure all client needs are met. Consequently, treatment care teams need to pay attention to bio-psycho-social-spiritual needs of the patient when assessing total patient care and level of perceived satisfaction. 2. Moreover, Schwartz and Frohner [4] found that the more social support a patient perceived, the less pain suffered, and the better he/she assessed general health and well-being. Some clients like to talk to anyone who shows a willingness to listen or offer advice (22%). advertisements. World Health Organization (2014) WHO Definition of Palliative Care. Sherbourne CD, Stewart AL (1991) The MOS social support survey. The points of interest were as follows: whether there is a relationship between social support and the meaningfulness of life of the dying client; whether the satisfaction with the fulfillment of their bio-psycho-socio-spiritual needs affects the meaning of life of the dying; and finally, whether there is a link between the client's level of awareness and their perception of the meaning of life. We need to be able to synthesize medical knowledge and connect it to our social work skills. We need to enhance our ability to respond to people’s individual wishes so that we can provide quality and respectful care. It is a given that we need to advocate for our patients and families. This study has several limitations. Here are five of those: 1. In contrast to hospice care, palliative care is offered at any stage of illness: in conjunction with life-prolonging therapy or as comfort care at the end of life. Answers have again been evaluated separately. Flexibility. Existential philosophers described existential issues to be related primarily to four basic aspects with which each terminally ill patient must struggle: meaninglessness, loss of freedom, existential isolation, and death anxiety [9]. • Seek supervision. In addition, all opinions expressed on this blog are probably wrong, and should never be taken as medical advice in any form. The last part of the research (Table 1) focused on the fulfillment of bio-psycho-socio-spiritual needs of the patient. It was found that the more satisfied the dying client was with the fulfillment of needs, the higher was the purpose in life (r = -0.381, sig. This information is important for the larger hospice and/or palliative care team to develop an effective and compassionate care plan. Who should undertake the assessment? Helgeson [3] suggests that social relationships put patients in a better mood and provide them with a sense of identity and companionship. We need to be leaders in our organizations, not just in social work, and we need to ask for more than just leadership tasks. Frankl VE (2010) Vôla k zmyslu (The Will to Meaning). The social worker shall advocate for the needs, decisions, and rights of clients in palliative and end of life care. 1. As for biological needs, clients in the study found it very important to be "in no pain" (it must be said that this was an important point for all respondents, that is for 100% of clients), which in fact is the goal of hospice care - to guarantee that the client will not suffer unbearable pain. The patient’s current health and social care team is responsible for ensuring that the assessment takes place. These factors further increase the effect of fear and suffering on the dying, and thus hinder peaceful death. American Academy of Hospice and Palliative Medicine; Center to Advance Palliative Care; Hospice and Palliative Nurses Association; Last Acts Partnership; National Hospice and Palliative Care Organization. needs and preferences 66 2B Respect the person’s lifestyle, social, cultural and spiritual choices and An ability to change masks. are identified as needing palliative care while in a hospital. Financial and social protection systems need to take into account the human right to palliative care for poor and marginalized population groups. Frankl’s [11] existential analysis and logo therapy strengthen the concept of human participation in addressing adverse social situations, especially in crisis. Incurable illnesses change the social status of the patient. • How do you build trust with your clients? Having one's social needs met also helps prevent problems such as loneliness, depression and anxiety. Results of another research study conducted by Drageset et al. Having close family and friends near if they wish. Social needs. Palliative care aims to provide a holistic approach to supporting people with life-limiting illnesses and this, therefore, includes the social aspects of a life. Meeting patients’ spiritual needs, 6. Based on the statistical verification of the level of research validity by means of a reliability test, we can conclude that the questions in the questionnaire are sufficiently consistent, as Cronbach α = 0.86. = 0.031, p <0.05). Using a team approach, palliative care addresses the needs of patients and their families, including bereavement counselling if necessary. A similar research project conducted by Dobríková [17] suggests that social support is most often provided by the daughter. Besides pain, and other devastating symptoms and complications, patients may suffer from the undesirable effects of the disease which affects the patient’s appearance; the loss of social, professional, and familial roles; the ability to remain independent and function normally, and most importantly the perception of the future. Client was mentally unfit to participate in the research (16, 8.56). Ask questions of the group or of individuals. They may need to speak about their concerns, fears, hopes, and expectations on numerous occasions to clarify and make sense of a world gone awry. The following are physical needs for the patient. The social components of a person’s life have the ability to either contribute to or alleviate suffering. All rights reserved. Q1: Very high level of "sense of fulfillment", Q2 + Q3: Medium level of "sense of fulfillment", Q4 (D9 + D10): Impaired "sense of fulfillment", D9: Low "sense of fulfillment" - Existential frustration, D10: Very low "sense of fulfillment" - Massive existential frustration. Three basic research questions were established for the research study. According to Sherbourne and Stewart [2], social support serves various dimensions including (1) emotional support which is defined as being empathetic and understanding, having positive affect, and encouraging the expression of feelings; (2) providing aid and assistance such as transportation, financial and/or housekeeping help is considered as instrumental support; (3) informational support involves offering information, guidance, and advice; and (4) affectionate support which consists of having someone who expresses love and affection. 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