bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer Pain Syndromes
Authors: Paget Daniel
Published: March 2022

Acute and chronic pain are common among patients with active cancer and contribute significantly to the burden of illness. The constellation of these pain symptoms can often suggest specific well-characterized cancer pain syndromes which have important prognostic and therapeutic implications. These syndromes may arise from any number of underlying etiologies including direct tumor invasion / encroachment, distant metastases, as well as a consequence of current or previous treatment modalities (e.g., chemotherapy or radiation). A palliative care approach to pain should involve a methodical assessment, consideration of all potential etiologies of pain, and the formulation of a multimodal treatment plan which aligns with patient goals.
Abdominal Pain in Palliative Care
Authors: Naidu Dharma , Hausdorff John
Published: March 2022

Abdominal pain is a challenging complaint with an extremely broad differential diagnosis. This chapter describes the palliative management of malignant bowel obstruction in advanced cancer. It also explores three other conditions: abdominal wall pain, centrally mediated abdominal pain syndrome, and narcotic bowel syndrome. While opioids are an important tool for the immediate relief of many serious abdominal pain syndromes, opioids are not the agents of choice in any of these three conditions. The distinguishing features and therapeutic intervention of each condition is described in this chapter.
Pain Management in Calciphylaxis
Authors: Ku Jennifer
Published: March 2022

Pain management in calciphylaxis is challenging due to the complex etiology of pain. Effective pain control requires multimodal treatment to limit further ischemic damage by inhibiting vascular calcification, minimizing thrombosis, and promoting wound healing. Efficacy of available pharmacological and nonpharmacological interventions is still unclear, with individual responses varying between patients. Other modalities for calciphylaxis pain include aggressive titration of opioids and the addition of neuropathic pain agents. As patients with calciphylaxis often have impaired renal function, all pharmacotherapeutic selection should take into consideration the need for renal dose adjustments and risk of renal toxicity. Last, discussions on goals of care are important given the rapid progression and high symptom burden of calciphylaxis. Important topics to discuss include dialysis, kidney transplantation, and end-of-life care.
Pediatric Pain
Authors: Louttit Erinn , Spruit Jessica L.
Published: March 2022

Pain in a complex pediatric patient is commonly seen by the palliative care provider. To adequately care for these patients, providers perform a systematic process of assessment followed by a stepwise approach to pain management interventions. Pediatric patients present unique challenges in pain management due to varying developmental stages, limited language development, and challenges in characterizing and localizing pain. Additionally, pediatric patients lack the insight that may be offered from older and developmentally more mature patients. Pediatric pain management plans take additional factors such as non-pain symptoms that present similar to pain into consideration and require careful consideration of medication administration routes and concentrations. Successful plans often entail pharmacological and nonpharmacological interventions and support both the child and family.
Pain Management in Liver Disease
Authors: Krichbaum Michelle , Miller Maura
Published: March 2022

Chronic liver disease accounts for approximately 1 million deaths annually, with an additional 1 million deaths from liver cancer and acute hepatitis. Accurate estimates of mortality are important in determining timing of care interventions, including pain control. End-stage liver disease can be a challenge to manage because pain and symptoms are often multifactorial, including abdominal distention, muscle cramps, dyspnea from excess fluid, altered mentation, and nociceptive, neuropathic, and visceral pain. Considerations for analgesia should account for the protein binding of medications, active or toxic metabolites, and renal adjustments if the patient progresses to hepatorenal syndrome. Interventional pain and symptom management incorporates the use of paracentesis and transjugular intrahepatic portosystemic shunts (TIPS) for the relief of suffering.
Pain Management in Chronic Kidney Disease
Authors: Born Scot , Unger Ashley , Herndon Christopher M.
Published: March 2022

End-stage renal disease (ESRD) is a common disorder leading to uncontrolled symptoms in patients requiring palliative care. Selection of analgesics for patients with chronic kidney disease is complex because consideration must be given to avoid further nephrotoxicity and prevent adverse drug events due to accumulation of the drug or its metabolites. Additionally, uremic neuropathy may further complicate treatment plans. Nonsteroidal anti-inflammatory drugs (NSAIDs), in most cases, should be avoided and the clinician should consider opioids such as fentanyl, methadone, or buprenorphine in those patients with uncontrolled pain of moderate or higher severity.
Pain Management in Mechanically Ventilated Patients
Authors: Engele Kourtney
Published: March 2022

Critically ill patients have many multifactorial reasons to be in pain and appropriate pain management is necessary to keep mechanically ventilated patients calm and comfortable while life-saving interventions are performed. While treating pain prior to the addition of a sedative medication is recommended by the available guidelines, pain management in this patient population is challenging. Since mechanically ventilated patients are often unable to communicate, pain must be evaluated by using nonverbal tools such as the Behavioral Pain Scale (BPS) or the Critical Care Pain Observation Tool (CPOT). Once pain is assessed, the clinician should review the pain regimen for the correct drug, dose, route, and frequency. Several factors must be considered, including patient-specific characteristics as well as the pharmacokinetic and pharmacodynamic parameters and potential adverse effects of each drug. Non-opioid pain medications are recommended as first-line therapy, however, because of the clinical complexity of critically ill patients, opioids are commonly utilized. Overall, while pain is difficult to treat in mechanically ventilated patients, drug- and patient-specific parameters can be used to choose the most appropriate regimen.
Pain Management in Opioid-Tolerant Patients
Authors: Abel Stephanie
Published: March 2022

The treatment of acute pain in patients who are opioid tolerant is a challenge. This pain is often acute on chronic and intensified by baseline tolerance and hyperalgesia from both the opioids and the chronic pain. This chapter reviews strategies for approaching acute pain assessment, optimizing non-opioid and nonpharmacologic therapies, and the importance of evaluating pain etiology, as well as an assessment of the concept of “total pain” and tailoring therapies accordingly. It will also address considerations for when pain is not resolved, or is even worsened, by escalating doses of opioid. The treatment of acute pain in patients on medication for opioid use disorder (MOUD) is outside the scope of this chapter. However, most concepts apply, and references are provided if further reading is needed to accommodate better insight on how to proceed with the inpatient management of the MOUD regimen.
Preexisting Implanted Pumps
Authors: Loitman Jane E.
Published: March 2022

Intrathecal pumps can be beneficial for end-of-life care. Ten percent of patients with cancer pain do not respond to systemic analgesics alone. Additionally, patients tend to have poorer outcomes when they experience neuropathic pain, incidental pain, and mucocutaneous ulcers. Intrathecal pumps can provide analgesia when systemic agents fail. Morphine, ziconotide, and baclofen have been approved by the US Food and Drug Administration for use in an intrathecal pump, but numerous other agents been historically used. Intrathecal analgesia may have opioid-sparing effects and thus fewer adverse reactions. Understanding this technology is beneficial to the patient and is not a significant financial burden if the pump was placed previously. Hospice and palliative care providers are unlikely to place the pumps, may recommend them, and should definitely understand how to titrate and refill medications in them. A general knowledge of medication choices and combinations is beneficial. This chapter provides an overview the common agents and concentrations used in intrathecal pumps.
Atlas of EEG, Seizure Semiology, and Management
Authors: Abou-Khalil Bassel , Misulis Karl Edward , Sonmezturk Hasan , Ess Kevin C.
Published: March 2022

Atlas of EEG, Seizure Semiology, and Management presents the essential knowledge and tools needed for understanding, performing, interpreting, and using electroencephalography (EEG) as a tool for patient care. The book begins with a discussion of the scientific basis of EEG activity and EEG recording, followed by details on the performance of various studies used in clinical practice. A large segment focuses on clinical features of seizures and epilepsies, including details of the new classification schemes. More than 500 images are used to discuss normal and abnormal EEG patterns and clinical features of seizures and epilepsies, including localization and physiology. While most of the book concerns patients of all ages, one section focuses on pediatric EEG and epilepsy. Management sections discuss specific treatments of seizures and epilepsies, including the physiology and pharmacology of rational therapy, recommended dosing and monitoring, and surgical and nonmedical therapy. Also included are discussions on the differential diagnosis of seizures, approach to nonepileptic events, and impact of comorbidities. After presentation of core material, many teaching cases presented and discussed by the authors.
Physiology
Authors: Misulis Karl E.
Published: March 2022

In this chapter, the basic science of electroencephalogram (EEG) signal generation is discussed, beginning with an overview of cellular neurophysiology as it applies to EEG. The neurophysiology of excitable tissue is key to both brain functions and to EEG recordings.
Electronics
Authors: Misulis Karl E.
Published: March 2022

The basic science of electronics and how electronics are used in electroencephalographic (EEG) equipment is presented in this chapter. It begins with a review of basic atomic physics as it pertains to electronics. Then the basic science of electronic devices is discussed. The general physical properties of current flow in biologic tissues are comparable to those in electrical devices, although the systems are far different. The chapter moves from basic theory to the granular mechanisms of function of EEG equipment.
Generators of EEG Activity
Authors: Misulis Karl E.
Published: March 2022

Generators of electroencephalographic (EEG) activity are discussed in this chapter, beginning with the neurophysiological substrate of normal potentials including some normal rhythms. Subsequently, the known physiology behind the generation of some key abnormal EEG potentials is presented.
Definitions
Authors: Misulis Karl E. , Abou-Khalil Bassel
Published: March 2022

This introductory chapter provides a detailed discussion of seizure semiology and classification. Key terms and concepts are defined and discussed in regard of their importance for clinical electroencephalogram (EEG) practice.
Seizure Classification
Authors: Abou-Khalil Bassel
Published: March 2022

Seizure classification is key to arriving at the correct diagnosis of not only seizures but also epilepsies. Seizure classification schemes have evolved, and this chapter presents the most recent scheme, the one used by most epilepsy centers.
Seizure Semiology by Seizure Type and Seizure Localization
Authors: Abou-Khalil Bassel
Published: March 2022

The new proposal of seizure classification by the International League Against Epilepsy (ILAE) has suggested dividing focal and generalized-onset seizures and seizures of unknown origin into a number of different categories or subclassifications. Correct classification of seizures is essential to diagnosis, and seizure semiology is leveraged to arrive at the correct diagnosis for our patients. We can first approach the diagnosis by evaluating seizure type and subsequently seizure localization. Extensive data have allowed us to draw accurate neuroanatomical and neurophysiological conclusions from an appropriate determination of seizure type. This chapter presents a detailed breakdown of the new classification ILAE scheme with helpful information for determining correct seizure classification.
EEG Basics
Authors: Misulis Karl E. , Abou-Khalil Bassel
Published: March 2022

The basics of understanding and interpreting an electroencephalogram (EEG) consist of the details of performance, analysis, and interpretation. This begins with technical methodology for performance of the studies. Subsequently the EEG findings are analyzed and finally interpreted in the context of the patient’s clinical presentations.
Abnormal EEG in Epilepsy
Authors: Abou-Khalil Bassel
Published: March 2022

Abnormalities seen in the electroencephalogram (EEG) are identified as nonepileptiform or epileptiform. This chapter discusses the EEG in epilepsy, including epileptiform discharges and ictal discharges. The role of EEG in the diagnosis and management of epilepsy is first discussed, followed by a detailed discussion of individual patterns.
Status Epilepticus
Authors: Sonmezturk Hasan H.
Published: March 2022

Status epilepticus is a neurologic emergency and, when suspected, should be evaluated and treated as an emergency. This chapter discusses the different forms of status epilepticus including convulsive and nonconvulsive status epilepticus, and also details the corresponding historical terminology for the various presentations of status epilepticus.
Advanced Techniques
Authors: Sonmezturk Hasan H.
Published: March 2022

Advanced techniques in electroencephalography (EEG) include several intraoperative techniques, usually used in monitoring for the development of deficits while the patient cannot be easily examined. Critical care monitoring is commonly used to follow encephalopathy and investigate seizures whether convulsive or nonconvulsive. This chapter presents some common advanced techniques in EEG and discusses their role in patient management.
Overview
Authors: Misulis Karl E. , Sonmezturk Hasan H.
Published: March 2022

Not all events that are at first considered to be seizures turn out to be so. This chapter discusses multiple diagnoses of physiologic and psychologic origin which can be mistaken for seizures. Detailed clinical and laboratory evaluation is necessary to distinguish between these possibilities. Despite efforts, however, many patients who carry the diagnosis of epilepsy have alternative diagnoses.
Syncope
Authors: Misulis Karl E.
Published: March 2022

Syncope is commonly misdiagnosed as seizure, and patients with recurrent syncope can carry the diagnosis of epilepsy. This is especially true since there can be motor activity associated with syncope. This chapter discusses causes and manifestations of syncope and differentiation of syncope from seizures.
Other Disorders Mistaken for Seizures
Authors: Misulis Karl E.
Published: March 2022

The differential diagnosis of seizures includes principally psychogenic nonepileptic events and syncope, but also a host of other behaviors and events that can resemble seizures. Movement disorders are prominent among these. This chapter discusses some of these other disorders, including sleep disorders, behavior disorders, transient ischemic attacks (TIAs), transient global amnesia, and drug-induced encephalopathy.
Management of Adult Seizures/Epilepsy
Authors: Abou-Khalil Bassel
Published: March 2022

The management of adult seizures and epilepsy includes a multimodal approach with antiseizure medications (ASMs) as a backbone. The specific agent(s) selected depend on the seizure and epilepsy type, patient comorbidities, and social specifics such as ability of the patient to afford the medication and comply with its use. This chapter discusses the continuum of decisions that must be made when treating seizures, from when to treat, to the selection of first-line and subsequent lines of therapy for specific types of epilepsies, dosing and titration of ASMs, and, ultimately, the discontinuation of ASM therapy.
Pediatric Teaching Case Discussions with Dr. Ess
Authors: Ess Kevin C.
Published: March 2022

This chapter presents a series of three cases from the teaching files of Dr. Ess, who is Director of Pediatric Neurology at Vanderbilt Children’s Hospital.
The How and Especially Why Clinicians Should Do a Spiritual Assessment, United States
Authors: Hunsberger Joann B. , Crowe Thomas Y. , Cooper Rhonda S. , Smith Thomas J.
Published: March 2022

With a diagnosis of cancer or other advanced disease, patients ask existential questions leading to spiritual distress, wondering what they have done to cause the disease and what their death will look like [39,5]. Health care providers (HCPs) can broaden their patient care from focusing only on the medical issues by understanding and incorporating patients’ spirituality into care planning and allowing space for spiritual and religious practices such as prayer or meditation. Several tools are available to assist HCPs in making spiritual assessments such as FICA (Faith, Importance/Influence, Community, Action in Care)[19] and HOPE (Hope, Organized religion, Personal spirituality/Practices, Effects on medical care) [11]. These acronyms are used to organize and structure open-ended questions during the spiritual assessment. HCPs may be hesitant to ask questions about religiosity and spirituality, concerned that they don’t have time, afraid that the patient may ask the same questions of them, or apprehensive that they don’t have the expertise to answer questions related to religion and spirituality [25,26]. HCPs generally will find that these conversations don’t take as much time as presumed and that hospital chaplains are available for referrals for those with deeper spiritual concerns and distress. Patients may not welcome questions about spirituality and religiosity during a routine office visit, but as they become more ill, or arrive at end of life (EOL), many welcome such inquiries [36]. While spiritual assessments do not change the course of the disease, they build trust between HCPs and patients and create a holistic care paradigm for patient physical and spiritual well-being, improving quality of life [6], defending against EOL hopelessness and despair and enhancing communication [4].
Cultural Challenges in Providing Psychosocial-Spiritual Support to Children with Cancer and Their Families, Turkey
Authors: Kebudi Rejin , Cakir Fatma Betul , Büyükkapu Sema Bay
Published: March 2022

Survival rates for pediatric cancer have improved significantly over the past few decades. However, the journey from diagnosis to treatment and then follow-up is challenging. Families of children with cancer struggle with an acute life-altering disease as well as with long-term possible chronic complications. In most types of pediatric cancer, the duration of the treatment is long and both the child and caregivers may spend many months in the hospital, which affects the child, their entire family, and those close to the child. The care of a child with cancer must be family-centered, and it is essential to understand the cultural background of the family. Cultural differences should be respected throughout all interactions—while informing the patient and family of the diagnosis, during treatment, and at the end of life. Psychosocial support must be provided to the child, family, and health care staff. Palliative care (PC) is a set of approaches that aims to improve the physical, social, and psychological well-being of both the patient and the family. PC should begin at diagnosis and continue throughout treatment until the end of life. Health care professionals should be sensitive to and tolerant of various traditions or religious beliefs in order to meet the needs of patients and families.
Healing the Psychological and Emotional Aspects of Cancer, Jordan
Authors: Al Qadire Mohammad
Published: March 2022

Cancer is a devastating and burdensome disease affecting all aspects of patients’ and their families’ lives. Patients with cancer are subjected to various types of treatment modules including, but not limited to, surgery, chemotherapy, radiotherapy, immunotherapy and hormonal therapy. Such treatments cause many annoying and difficult-to-treat symptoms that may also result from the disease itself. For the past few decades, cancer treatments have remained focused mainly on the physical aspects of disease, with less attention paid to the psychological and emotional dimensions of the cancer experience. Psychological aspects are usually compromised by the diagnosis and treatment of cancer. The most common psychological disorders experienced by cancer patients include adjustment disorders, anxiety, and depression. To manage any of these disorders, screening is a crucial step in clinical practice in oncology. Then, at-risk patients need to be subject to a full assessment interview to set up a care plan and start treatment, either pharmacological or nonpharmacological. This chapter highlights the importance of considering cultural issues when planning psychological care for patients with cancer and presents a suggested framework for managing psychological disorders in clinical practice.
The Psychosocial Burden of Cancer in Sexual and Gender Minority Patients, United States
Authors: Almodallal Yahya , Jatoi Aminah
Published: March 2022

The term sexual and gender minority (SGM) refers to individuals whose sexual orientation, gender identity or expression, or reproductive development differs from that of the population at large. From a cancer perspective, these patients appear to be at higher risk for certain malignancies, with at times poorer outcomes. This work critically examines the published literature on psychosocial outcomes of cancer patients who identify as belonging to an SGM group.
Spiritual and Religious Impacts on Advanced Cancer Care in Australia
Authors: O’Callaghan Clare , Michael Natasha , Kissane David
Published: March 2022

Pastoral and spiritual care are important dimensions of the care of patients with advanced cancer in Australian palliative care. This chapter examines the perceptions of 271 patients and 109 caregivers about the place of spirituality/religion in their lives, whether it supported coping, their level of spiritual well-being, and the impact of spiritual support from hospitals and local communities. A Spiritual Concerns Checklist was developed and validated to screen for unidentified spiritual concerns. Two-thirds of the respondents considered spirituality important to them and one-third unimportant; yet over three-quarters of them viewed spiritual care as an appropriate service to provide, and two-thirds reported at least one spiritual concern. These findings suggest that the concept of “hospitality” provides an ethos of care and routine screening for spiritual concerns is an important element of spiritual care. Together, they respectfully convey humanistic medicine based on person- and family-centered care. These dimensions of care are suitable for the increasingly multicultural and secular Australian society.
The Influence of Spirituality on Quality of Life during Cancer, United States
Authors: Brant Jeannine M. , Isozaki Annette Brant
Published: March 2022

Spirituality is an important quality of life domain, and spiritual wellness is an integral part of holistic health in patients with cancer. The concept of total pain, coined by Dame Cicely Saunders, implies that suffering involves all aspects of an individual, including physical, emotional, social, and spiritual domains as they are interrelated and interconnected. Within this paradigm, cancer care should address all domains of suffering as well. Healing the spirit can lead to alleviated pain and relief of other deleterious symptoms and emotional and social distress. This chapter discusses the importance of incorporating spirituality into cancer care. Terms and concepts important to this discussion are defined. Components of screening and assessing spirituality are included, along with tools that can aid clinicians in gathering spiritual insights to inform care in the clinical setting. Interventions for clinicians and others trained in spiritual care are described along with outcomes of spiritual wellness. Limitations with current studies are also delineated, along with recommendations for future research. Finally, two case studies illustrate the impact and importance of integrating spirituality into cancer care.
Suffering and Compassion
Authors: Balducci Lodovico
Published: March 2022

To highlight the meaning of Middle East Cancer Consortium (MECC), I ask the readers to accompany me through the MECC experience. MECC recognizes that suffering is a universal human experience, irrespective of ethnic or religious boundaries. Thus, the management of suffering may provide a hostility-torn world with a common goal. The management of suffering involves the development of compassion, which is a universal language, accessible to individuals who are unable to understand each other’s idioms, as there is more to a language than the spoken word. Thus, MECC is a laboratory of compassion with the mission to bring peace by privileging the healing of the patient over the cure of the disease. The war-torn Middle East represents the ideal ground for testing the viability of the MECC mission. Although MECC does not endorse any specific religion, MECC supports the religious hypothesis as it holds compassion to be a transcendent experience.
The Role of Spirituality among Palliative Care Patients in Poland, Poland
Authors: Pawlikowski Jakub , Krajnik Małgorzata , Kotlińska-Lemieszek Aleksandra
Published: March 2022

All persons have their own set of values, beliefs, and convictions. Whole-person and culturally sensitive health care, particularly at the end of life, should respect patients’ spiritual needs. In the early 1990s, the inclusion of palliative care (PC) within Poland’s public health care system was preceded by a voluntary hospice movement initiated by Catholic church. Spiritual care, as an important component of the holistic approach, has since been deeply grounded in PC. Spiritual support for seriously ill patients is provided as pastoral care as well as support ensured by different members of an interprofessional team, with an important role for psychologists and volunteers. In recent years, a pioneering spiritual care program for medical students was introduced, and some research projects regarding spirituality in medicine have been initiated. In 2015, the Polish Association for Spiritual Care in Medicine was established to promote implementing spiritual care into practice, education, and research.
The Impact of Culture and Beliefs on Cancer Care
Authors: Rassouli Maryam , Farahan Azam Shirinabadi , Mojen Leila Khanali , Ashrafizadeh Hadis
Published: March 2022

Although cancer is considered a treatable disease today, as a result of scientific and technological advances, attitudes toward the disease and its management in each country are influenced by the cultural and religious situations and beliefs of the society, in addition to its economic, political, and health status. The historical background of this disease in Iran dates back to more than a thousand years ago and has been treated by traditional Iranian physicians ever since. Therefore, this disease is still seen as a stigma, taboo, a divine test, and predestination, and its management is not possible without considering cultural and social aspects. Cancer should be investigated from individual, family and social perspectives in Iran. On the other hand, ethical and legal issues associated with cancer care, such as hiding the truth and end-of-life care, are also among challenging factors for health care professionals. In this chapter, while studying the cultural variables affecting the different stages of the disease, including diagnosis, treatment, death, and mourning, a review of the traditional Iranian medicine is done along with its cancer-related principles that are rooted in this medicine. The impact of spirituality and religion on different aspects of the disease is also examined. It is hoped that health care professionals will be able to provide transcultural care effectively by having knowledge regarding these variables.
Spiritual Healing in Cancer Care
Authors: Rao Seema Rajesh , Viswanath Vidya , Simha Srinagesh
Published: March 2022

Religious and cultural perspectives influence how patients cope with disease, view death and dying, and derive meaning and purpose in life. This chapter will familiarize palliative care providers with the various nuances of pain, suffering, and healing in Hinduism, one of the oldest and the third largest religions in the world. Hinduism can be described more as a way of life than as a single organized religion. Karma (consequences of action), dharma (righteous action), samsara (cycle of birth and rebirth), and moksha (liberation from the cycle of rebirth) are some of the fundamental concepts in Hinduism. Hindu traditions propagate acceptance of suffering as a consequence of karma in the current or past life. Current suffering is not random or a punishment, but a repayment of debt incurred for past negative behavior. Hindus believe that all things are manifestations of God, including pain and suffering, and are an essential part of life. Suffering is viewed as an opportunity to progress along the spiritual path. For a Hindu, dharma and moksha provide meaning and purpose in life; karma attributes a positive meaning to the suffering; pursuit of purusharthas (life goals) helps in maintaining connectedness to those around, rituals reestablish connectedness with the transcendent, while nonattachment helps in reconnecting with oneself, and the understanding of samsara promotes death acceptance. Despite being important areas of patients’ and caregivers’ lives, religion and spirituality are not often discussed in health care. This chapter attempts to acquaint health care providers with Hindu traditions and beliefs so that spiritual care harmonized to patient’s preferences can be provided.
The Impact of Chinese Culture and Faith in Cancer Care, China
Authors: Tang Lili , Pang Ying , Yi He
Published: March 2022

China is a historical Eastern country with a very special culture. The Chinese mainland population, with its 56 ethnic groups, has rich and varied cultural beliefs and values. Chinese culture and beliefs influence cancer care in various aspects. The attitude about death, self-concept, and filial piety culture in Chinese culture all affect how bad news in cancer care is communicated to both patient and family. Family plays a greater role in breaking bad news, decision making, and spiritual care than is the case in Western countries. More research evidence and training are needed to explore the special aspects of Chinese culture and beliefs and thereby improve cancer care in China.
A Jewish Israeli Case Study in End-of-Life Spiritual Care for a Cancer Patient, Israel
Authors: Schultz Michael
Published: March 2022

Few case studies of spiritual care for Jewish or Israeli patients have been published to date. This end-of-life case study describes a series of spiritual care visits with a 55-year-old traditional, though not religious, Jewish Israeli oncology patient in the last month of his life and, separately, with his sister. Some of the key themes that arose were forgiveness, being honest with ourselves, legacy, and the ability to change, even at the end of one’s life. Spiritual care modalities employed included Psalms, prayer, song, use of self, text study, guided imagery and facilitating mourning. The content and dynamic of the visits are described, and their impact is assessed retrospectively.
Existentialism and Spirituality in the Healing Process of Cancer Patients, United Kingdom and United States
Authors: Namisango Eve , Matovu Lawrence , Harding Richard , Berger Ann
Published: March 2022

When patients are confronted with terminal illnesses, they engage their existential and spiritual faculties in order to continue to search for meaning and purpose in their lives. As such, the World Health Organization’s definition for health recognizes existential/spiritual well-being as an important domain. Existential/spiritual well-being is also a recognized health outcome in cancer patients. Unmet spiritual needs could result in loss of self-worth, loss of interest in life, despair, hopelessness, and sadness which all compromise the compliance with treatment and outcomes of care. Existential/spiritual well-being shapes the spiritual healing process in cancer patients and is now recognized as complementary/alternative treatment for psychological distress. The existential and spiritual construct of patients and their families is shaped and affected by social, cultural, philosophical, and religious values. This chapter discusses spiritual/existential well-being and healing in cancer care and highlights the priorities of health systems for strengthening access to culturally sensitive existential/spiritual care for cancer patients. The content is based on global literature, our ongoing research on this theme and our experience in delivering palliative care.
Psychosocial-Spiritual Healing
Authors: Weru John K. , Nafula Esther W.
Published: March 2022

Culture is a collective way of life characterized by a set of patterns of knowledge, beliefs, and behaviors. The concept of culture in relation to cancer is poorly understood. In sub-Saharan Africa, there are many communities with major cross-cultural differences. These variations greatly influence health-seeking behavior and treatment choices. Many patients with cancer are still diagnosed late in their illness due to poorly structured screening and referral systems. Traditional healers are a big part of African society, as they are often the first point of contact for cancer patients. These healers are considered to have received healing powers from God and are an essential part of traditional African religion. They use herbal treatments, ancestral incantation, as well as other religious healing practices to provide treatment. Generally, patients only seek professional medical advice after treatment from traditional healers has failed. Spirituality is difficult to define, but generally refers to a connection with a larger reality. Its aim is to give meaning to life through religion, meditation, or art. The predominant religions practiced in Africa are Christianity, Islam, Hinduism, and traditional religions. The basic concept of spirituality is based on giving meaning to every situation in life, and cancer patients often seek meaning in their disease. Religion is a way of coping with the distressing diagnosis of cancer and has been associated with better psychological well-being. Religion and culture often overlap, as they each define a community’s way of life.
Psychosocial Aspects of Breast Cancer
Authors: Ozkan Sedat
Published: March 2022

Perceptions of and coping mechanisms for cancer are directly influenced by culture, values, and belief systems. In this regard, the Turkish culture is unique, bridging conservative Islamic beliefs with contemporary Western ways of thinking. In this study, the changing attitudes toward cancer and the factors pertaining to them are discussed within cultural, social, and spiritual contexts. There was once a widespread sense of fatalism and silence surrounding cancer. With increasing modernization, migration to cities, higher educational levels and prosperity, and the growth of Westernization and a participatory society, perceptions and responses have changed. Cancer is now a disease that is openly discussed, and the sense of fatalism is becoming less prevalent. Medical and scientific attitudes play a significant role in treatment, and the family institution also has a clear supportive function. Family, as well as religious attitudes and beliefs, go a long way in preserving hope. Length of life is perceived as more important than quality of life. In treating the disease, cure comes before aesthetic concerns. The importance of science in the perception of disease has become more prevalent. Fatalistic or religious attitudes do not play much of a role in undermining treatment. In Turkish culture, cancer is viewed with an understanding that resynthesizes beliefs, science, and human values.
Cancer Pain Care in French-speaking African Countries and Access to Analgesics
Authors: Hadjiat Yacine , Perrot Serge , Toufiq Jallal , Ntizimira Christian
Published: March 2022

The management and treatment of pain is a human rights issue, yet the barriers to providing access to optimal treatment are diverse and pervasive. While access to financial resources is often cited as a major barrier to access to medication for pain management, little research has been done on the cultural and emotional barriers that may hamper access and use in French-speaking countries in Africa. This is a significant gap as cultural behaviors and beliefs on pain and perceptions of opioid analgesics impact the development of public health policy and regulation, leading to prescriptive and restrictive policies, lack of access to education and skills training, and further entrenching of cultural beliefs. Overall, there is a dearth of research in this area, making recommendations for policy, regulation, aid, and support difficult. Further, the lack of comprehensive evidence provides a challenge for tracking and evaluating public health programs across the continent in a standardized manner and in accordance with international guidelines.
Islamic Cultural-Spiritual Guidance in Caring for Cancer Patients, Iraq
Authors: Fadhil Samaher A. , Ghali Hasanein H.
Published: March 2022

The cultural and religious backgrounds of every patient, family, and community present challenges to the delivery of health services to cancer patients. People’s attitudes toward the intrusion of cancer are often influenced by their beliefs and social and cultural norms and may even differ among people of the same ethnic background, according to their level of education, inclination, socioeconomic status, and life experiences. A cancer diagnosis affects the physical, psychological, social, and spiritual health of patients and their families as well as the emotional and spiritual health of their caregivers. Ultimately, understanding the nuances in the cultural and spiritual values, perspectives, and beliefs of each patient is crucial for providing appropriate health care in a culturally competent manner. Islam is the second-most populous religion and is practiced predominantly in the Middle East, South Asia, Southeast Asia, and Africa. Islamic communities are growing fast in the West and in the United States. Spirituality in Islam is based on faith in God (Allah) and is usually derived from the classic Islamic teachings. Patients rely on religious beliefs and rituals to help them cope with illness. The Quran provides much guidance for health and spiritual coping. This chapter reviews the aspects of spiritual care in an Islamic context, their impact on providing appropriate health care to cancer patients and their role in alleviating suffering and promoting health.
The Impact of Culture and Belief on Cancer Care in Costa Rica, Costa Rica
Authors: Ramírez Ana Barrantes , Herrera Isaías Salas
Published: March 2022

In colonial times, new diseases emerged, creating new challenges for recovery of health utilizing various applications, ranging from rituals such as ceremonies and use of medicinal plants to the discovery of new drugs and technology. In the past, people believed that sickness could be healed with medicinal plants, rituals, or any other kind of cure, even if they were not realistic. Nowadays, we still see these practices in parts of the world population. Costa Rica has been improving its approach to treating illnesses such as cancer and is a leader in Central America in adopting good medical practices. In Costa Rica, as in other Latin American countries, cancer is one of the main causes of death, severely affecting both patients and their families. Cancer is a life-changing diagnosis for anyone, and palliative care can provide much needed support, physically and spiritually, to the patient and family.
Reflections on Middle Eastern Cultural Perspectives in Cancer Care
Authors: Al-Zadjali Manal A. , Brown Anna E. , Al Amri Warda A. , Al Balushi Amal J. , Al Ghafri Thamra S. , Al Hasani Nabiha S.
Published: March 2022

In Middle Eastern countries, cultural traditions, values, and beliefs play significant roles in decision making about cancer care, prevention, diagnosis, and management. As cultural factors are involved at every stage of cancer care from prevention to palliative care and they pose challenges that can influence cancer related behaviours in Middle Eastern countries, in cancer care, these factors should be addressed in all efforts to prevent and control the disease. This chapter focuses on a number of cultural factors relating to cancer care including family, family values and dynamics, religion and spiritual needs, stigma and social values, taboos about death and dying, and communication with patients. The reflections contained in this chapter offer insights into some of the ways the culture of Middle Eastern countries influences cancer care and how it affects the patients’ and their families’ attitudes and choices regarding this care. Reflections on these cultural perspectives suggest that if cancer care in Middle Eastern countries is to be improved, health professionals need to be aware of, and be sensitive to cultural factors and balance respect for patients’ cultural perspectives with the need to provide effective care and improve patient outcomes.
Sociocultural Context and Its Impact on Communication, India
Authors: Salins Naveen , Simha Srinagesh
Published: March 2022

Regional cultures, ethnicities, diverse languages, societal attitudes, and lifestyles underpin the fabric of sociocultural context. Comprehension of this diversity in a multicultural society facilitates communication. Sociocultural context impacts communication in all phases of illness trajectory in cancer. In the early and maintenance phase, it impacts attitudes toward disclosure of cancer-related diagnosis and prognosis. There is a vast disparity in how diagnosis and prognosis are communicated in various cultures. In the decompensation phase, the communication often centers around beliefs about the cause and meaning of illness. Different cultures provide diverse views related to health, cause of illness, and death. In the dependency phase, communication often revolves around the meaning of pain and suffering. Some cultures express emotions in an exaggerated manner in the presence of pain and suffering, but others exhibit stoicism and restraint. In the decline and terminal phase, communications pertain to sociocultural attitudes toward death and dying. In a multicultural society, health care providers have to deal with the cultural diversity of cancer patients, and understanding the sociocultural context during communication improves therapeutic outcomes and minimizes disparities in medical care.
Breast Cancer Survivorship in Nigeria
Authors: Asuquo Eme , Salako Omolola , Mbangsi Therese , Absolom Kate , Ebenso Bassey , Okunade Kehinde , Adeleke Temitope , Allsop Matthew J.
Published: March 2022

In sub-Saharan Africa, breast cancer is the primary cause of cancer morbidity and the second-most common cause of cancer mortality. An evolving, and now distinct phase along the cancer care continuum in terms of health care and research is survivorship. The broad definition of the term survivorship includes people who have been diagnosed with cancer, are currently living with it, or have not had any recurrence of cancer for a defined period of time. Limited literature from sub-Saharan Africa highlight treatment-induced long-term physical and psychological complications, alongside impact across social and spiritual domains for women with breast cancer. There is a need to better understand the experiences of women with breast cancer to guide advocacy and the development of locally appropriate responses for acute, extended, and permanent survivorship. This chapter presents narrative accounts of breast cancer survivors from Lagos, Nigeria, detailing their experiences from diagnosis to the present and outlining the culture and beliefs pertaining to living with cancer. The narratives of survivors are combined with existing literature, highlighting emerging patient- and service-level approaches to improving care and its coordination for women with breast cancer in Nigeria.
The Contribution of Spiritual, Religious, and Customary Heritage to the Personalization of Modern Oncology in Multiethnic Societies of Developing Countries
Authors: Cicmil-Sarić Nada , Raspopović Milena , Murić Damira
Published: March 2022

Just a few decades ago, death was considered and accepted as an expected part of human existence: people were dying of old age and/or severe illness. The new age has brought a new concept: to delay aging and dying for as long as possible. Most of the once-incurable, life-threatening diseases, which include malignancies, have today become chronic diseases and their poor prognoses—terminal condition and fatal outcome—are difficult or impossible for a large part of the population to accept. A holistic and multidisciplinary approach to the cancer patient has become increasingly complex due to the application of personalized medicine: the right medicine, for the right patient, at the right time. Surgery, oncological radiology, and medical oncology are on this path and are combined with modern diagnostics, especially genetics, but also with new domains: ethical, legislative, sociological, economic, customary, and spiritual. Success in determining the genetic map of humans has brought about emotional, psychological, cultural, and religious dilemmas. Spirituality is ubiquitous in sufferers of all nations, races, ages, and, regardless of different religious formats, it sets a need, almost an imperative, to create spiritual care teams (SCTs,). Developing countries have largely overcome the low-level state of enlightenment of certain communities which, even today, perceive cancer as God’s will, punishment, or destiny. On the other hand, their transition in some countries takes a very long time. They have not yet reached the level of a developed consumer society, and some have fallen into the trap of class stratification, corruption, and discrimination. Comprehensive, targeted individualization for each oncology patient is crucial to the final outcome of the malignant disease.
Jamaican Cultural and Spiritual Guidance in Caring for Cancer Patients, Jamaica
Authors: Spence Dingle , Brown Kari , Smith Steven , Grant Dorothy , Picking David
Published: March 2022

Jamaica’s geographic location and place in modern history has made the country a nest for the development of rich and diversely informed cultural traditions and beliefs, and these traditions continue to influence attitudes toward health in Jamaican society today. Many Jamaican people rely on traditional knowledge, unique dietary practices, and the use of medicinal plants for their health care. Interestingly, many of these practices occur unknown to, and without guidance from, conventional health care providers, highlighting the lack of consensus and acceptance within the medical community of integrative approaches to care. In cancer care, this disparity is brought into even sharper focus. Equally important is the value of understanding the roles played by religion and spirituality and their influence on how people respond to a diagnosis of cancer. This chapter explores the cultural and religious factors modifying cancer care in Jamaica, providing a review of the current understanding of these factors and possible solutions to a culturally targeted holistic approach to cancer care.