Palliative care

DOI: 10.1177/0269216319846440

In the face of advanced disease, patients often seek refuge in a variety of treatments to alleviate their suffering. While clinical treatments remain at the forefront of palliative care, complementary therapies like aromatherapy, massage, and reflexology have steadily gained traction among those facing life-limiting illnesses. A recent systematic review has provided fresh insight into the experiences and benefits as perceived by the patients themselves, guiding clinical practice and further research in these non-conventional treatments.

The study published in Palliative Medicine, a pivotal article co-authored by Megan M. Armstrong et al., delves into the holistic effect complementary therapies have on individuals receiving palliative care while struggling with the profound hardships of advanced cancer. The systematic review and thematic synthesis of qualitative studies were meticulously conducted with the underlying objective of exploring (1) the experiential aspects and perceived benefits and harms of incorporating aromatherapy, massage, and reflexology into palliative care, as well as (2) the preferences of patients concerning the delivery of these therapies.

Keywords

1. Palliative Care Complementary Therapies
2. Advanced Cancer Support
3. Massage in Palliative Care
4. Aromatherapy Benefits
5. Reflexology for Cancer Patients

The Study’s Findings

After an exhaustive search through databases such as MEDLINE, EMBASE, PsycINFO, among others, and a careful review of bibliographies up until June 2018, the researchers identified five qualitative studies focusing on advanced cancer cases. The review, registered at PROSPERO and funded by organizations like Marie Curie, unveiled three analytical themes:

1. Experience During the Therapy: Patients reported experiencing enhanced well-being and a sense of escapism during the sessions. These moments allowed them to temporarily divert their focus from their illness, offering much-needed respite.

2. Beyond the Complementary Therapy Session: The benefits experienced went beyond the immediate relief provided by the therapy sessions; individuals reported lasting benefits that contributed to their overall evaluation of their care and well-being.

3. Delivery of Complementary Therapy in Palliative Care: The importance of the role of therapists was underscored along with the mode of delivery of the complementary therapy. Both factors greatly contributed to the perceived value and efficacy of the treatments.

These insights are pivotal as they underscore the significant and multi-dimensional impact these complementary therapies have on individuals with advanced disease. Participants expressed that such therapies provided more than just physical relaxation; they offered emotional and psychological sustenance, providing a haven from the relentless progression of their illness.

Implications for Clinical Practice and Research

This systematic review emphasizes an essential principle in palliative care: the need to listen to and prioritize the patient’s voice in the design and delivery of therapies. Complementary therapies are not a one-size-fits-all solution; instead, they should be tailored to the individual needs and preferences of each patient. The study highlights the opportunity for these therapies to be developed in consultation with patients, ensuring their integration into care programs in a manner most beneficial to those they are intended to serve.

Clinical guidelines can draw from these findings to accommodate the inclusion of modalities such as aromatherapy, massage, and reflexology within palliative care settings. Moreover, the register of patient experiences offers a novel approach to test these therapies in future evaluations, potentially leading to enhanced therapeutic protocols and improved quality of life for patients.

The study also opens the door to the methodological rigor of incorporating qualitative research in systematic reviews, providing a rich landscape to understand complex interventions like complementary therapies. Themes identified in the qualitative synthesis offer a guide to interpret the nuances of patient experiences, which are often lost in quantitative research.

The Way Forward

Moving forward, it is essential to bridge the gap between evidence and praxis, ensuring that palliative care services are aligned with the true preferences and needs of the patients. Complementary therapies have much to offer in terms of palliative care, but their full potential can only be unlocked through a patient-centered approach—one that comprehends the full spectrum of patient experiences and integrates qualitative feedback into new standards of care.

Additional research is required to better understand the intricacies of how such therapies function at different stages of illness and to investigate any potential adverse effects they may harbor. Only through a robust and inclusive investigation can a comprehensive picture of complementary therapies in palliative care be effectively painted, allowing for a richer, more empathetic approach to end-of-life care.

Conclusion

To conclude, the systematic review led by Armstrong et al. reflects a growing recognition that palliative care needs extend beyond managing physical symptoms. Complementary therapies such as aromatherapy, massage, and reflexology have proven to be valuable additions to the arsenal of palliative care options. They possess the unique ability to not just mitigate physical suffering but also to fortify the spirit, provide solace, and enhance the quality of life for those in the twilight of their journey. The blend of science and sensitivity is poised to form the cornerstone of a new paradigm in palliative care.

References

1. Armstrong, M. M., Flemming, K., Kupeli, N., Stone, P., Wilkinson, S., & Candy, B. (2019). Aromatherapy, massage and reflexology: A systematic review and thematic synthesis of the perspectives from people with palliative care needs. Palliative Medicine, 33(7), 757–769. https://doi.org/10.1177/0269216319846440
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