Talk:Palliative care

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 25 November 2019 and 21 December 2019. Further details are available on the course page. Student editor(s): CADonald. Peer reviewers: Ellenltsay.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 02:04, 18 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Mquindoy, Docwoods12, Dchnggg, Xmrlmem. Peer reviewers: Zaccarlson, Nzargham.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 06:03, 17 January 2022 (UTC)

Article Improvement

I've reviewed this article closely and feel it can use a lot of improvement. The article reads more like a mishmash of details and lacks flow. Some parts are redundant while others are clearly lacking. Here are a few suggestions, and I'm open to others' thoughts. Moksha88 (talk) 04:45, 1 December 2019 (UTC)

1. Refine article outline
2. Identify what's redundant and remove
3. Identify what's irrelevant and either move to another article or remove altogether
4. Review existing material and ensure it matches sourced material
5. Identify what's missing and find sources to support
6. Find graphics and other ways to improve aesthetics

Moksha88 (talk) 04:45, 1 December 2019 (UTC)

Edits to Page

Greetings, I will be working on this page, incorporating some of the feedback/recommendations from Moksha88 (12/2019) as well as expanding upon the "children's palliative care" section. Areas (by section) I will address include:

Introduction:

• double check and update references (especially on efficacy of palliative care).
• information is redundant and hard to read; will pare down and simplify.

Scope

• investigate the information re: palliative in the emergency department; this content seems random as is.
• American Society of Clinical Oncology recommendations, as currently written, are confusing and need to be syntactically cleaned up.
• remove info about board certification / move to history section

Terminology

• grammar / syntax of this section needs to be edited.
• remove redundant information

Comparison with Hospice

• double check and update references; many seem lacking or inaccurate (ie: reference 19).
• poor grammar / syntax in this section
• remove redundancies and clarify comments made about terminology in the US vs non-US countries

Symptoms assessment

• double check citations
• can probably be expanded upon; currently content in this section is is limited

End -of-life care

• needs to be cleaned up grammatically

Dealing with distress

• add citation to include evidence for impact of interdisciplinary addressal of distress among palliative/hospice patients

Total pain

• consider chaining this sub-header to pain and then reformatting the discussion into physical, psychosocial, and spiritual pain

Physical pain

• no major changes; could expand upon and/or link other pages if time

Psychosocial pain

• this section needs to be rewritten and clarified
• double check citations

Children’s palliative care

• add citations to terminology section
• brainstorm new sections that have more clinical relevance and are additionally useful to patients, parents, and families
• can also incorporate and link information for the children’s hospice care page

Children’s palliative care by country

• this information seems less useful (though interesting) and more focused on promoting certain projects in Australia. Overall, this section is not substantive and I would argue to remove it

History

• this section should be moved to follow either the introduction, scope, or terminology section
• overall section is heavily focused on the history of hospice as opposed to the history of the development of palliative care as a field (though those histories appear closely linked). Would restructure and refocus this section to address the aforementioned concern

Society (ambiguous and unclear label)

• rework cost section
• consider creating new title that is clearer

References

• incorporate new/updated citations
• double check current citations

External Links

• add helpful information as encountered during research process

---

CADonald (talk) 16:31, 2 December 2019 (UTC)

Hi CADonald. I'm looking forward to working together and read through your comments. I think I echo most of them. FYI, the introduction is supposed to reflect the entire article, so we should edit it last. I think we should start with drafting an outline of what the article should look like and then figure out what goes where. A lot of good comments/insights get lost in the talk page unfortunately, so I pasted all your comments as well as a template upon which we can brainstorm a strategy here. Feel free to edit that page as it's in my sandbox. Moksha88 (talk) 03:51, 3 December 2019 (UTC)

CADonald Do you have access to this book? Moksha88 (talk) 04:42, 8 December 2019 (UTC)

Hi Moksha88. Thanks for the feedback, my apologies, I am still learning how to use the Wiki-editor and am just seeing your comments. My plan is to focus on the children's section, creating a communication and symptoms assessment subsections. Otherwise, my goal is to generally clean up the grammar, citations, and and syntax of the page as I have time. I am happy to help develop a larger outline for the page although my focus will mainly be the aforementioned subsection. Also, thank you for the amazon link. I do not have a copy of the book but will try to acquire it. Thanks!

CADonald (talk) 05:44, 16 December 2019 (UTC)

No worries, it's nice to someone take an interest in an article like this one, especially in pediatric palliative care. While the book is good, Wikipedia prefers systematic reviews or meta-analyses to original research, so I'm working on getting those articles (WP:MEDASSESS). Moksha88 (talk) 02:29, 17 December 2019 (UTC)

CADonald Just looking through your edits, what's your reasoning with titling the section, "Children's palliative care" vs "Pediatric palliative care"? I figured it would be better to just mirror the same phrasing as what's used in the section itself. Moksha88 (talk) 02:33, 17 December 2019 (UTC)

Hi Moksha88 Great catch, I have adjusted accordingly! — Preceding unsigned comment added by CADonald (talk • contribs) 02:35, 20 December 2019 (UTC)

Peer Review

Hi CADonald! Great job on your thorough and extensive edits to this page. Your edits were relevant to the topic, neutral in tone, unbiased towards any particular viewpoints, and up to date. I figure you are still working on adding citations, but once you do make sure you check that the links work. Below are some specific comments for each section you edited:
Intro:

• I love the elegant one-line definition of palliative care. Great job using active voice and avoiding jargon

Scope:

• it may make more sense to re-order the first two paragraphs so that you start by defining when palliative care is appropriate and follow with examples, as opposed to the other way around. For instance, say "Historically, [….] but it is now applied to the management of any serious condition that [….]. This includes individuals with severe heart failure, […]"

Terminology:

• I like the bullet point & bold font organization of this section! To further simplify the language here, in the first sentence you can rephrase to "social, emotional, and spiritual support".
• Consider streamlining the definition for Life-threatening conditions to "life-threatening illnesses or conditions for which medical treatment…".
• Under End-of-life care, you may want to replace the "be" verb in "may or may not be palliative care" to something more precise, such as "be the same as", "entail", or "include" and also maybe add a note such as "Refer to Palliative care versus hospice care section below"

Palliative care versus hospice care:

• Are you still planning on updating references, or are you planning to just link to external Wikipedia articles (ie. Medicare, Medicaid, etc)?
• Great job improving grammar and syntax.
• You may want to go through again to simplify the language (ie. replace terms that general public may not understand such as: "mitigate," "in tandem," "curative therapies," "prognostication," "vernacular," "synonymous," "contingent"). Some ideas for how to replace: "at same time," "mean the same thing," "depends upon."

Pediatric palliative care: make sure to use active voice and consistent verbs ("management of" vs "supporting") where possible.

--Ellenltsay (talk) 14:58, 15 December 2019 (UTC)

Hi Ellenltsay, Thanks for the excellent suggestions! To respond to each of your bullets points: Scope: I agree with your ordering of sentences in scope and have adjusted accordingly. Terminology: I agree that “Life-threatening conditions” can be streamlined and have adjusted accordingly. I agree that the “end of life” definition can be more precise and have updated accordingly. Palliative care versus hospice care: I will try to simply language for a wider audience. Pediatric palliative care: I will try to simply the sentences and maintain an active voice. CADonald (talk) 02:40, 20 December 2019 (UTC)

Hi CADonald, I agree with one of the two edits you made to 'Terminology.' Thank you for fixing the inaccuracy regarding EOL care and palliative care, an unfortunately common misconception. Regarding mortality, it's awkward to say, "illnesses or conditions that pose significant mortality to an individual," because mortality (i.e. death) is itself a significant event. Morbidity could be substituted for mortality, but I don't have access to the referenced text and will see if I can find a better definition. For now, it's more precise to say LTCs have a higher risk of mortality. Hope this makes sense. Moksha88 (talk) 20:54, 20 December 2019 (UTC)

On second thought, I think the current Terminology section could be simplified. The reference you are using is dated from 2005, which is at least a decade old and doesn't reflect developments in the field. The use of LTC/LSC has been replaced by the term, "serious illness," as reflected by some of the more recent literature (Page 8). I will go ahead and update this section. Moksha88 (talk) 03:44, 21 December 2019 (UTC)

On third thought, there's a glossary section in that document I shared with you to see if there are additional terms in there that might be worth including here (Page 60), but I think we might be better off just scrapping the entire Terminology section. I added the definition of serious illness under 'Scope' because without understanding this term, we can't define palliative care. EOL is already mentioned in this paragraph, and I don't think we need to define it. Hospice is then discussed in the section below, and I feel bereavement care is beyond the scope of someone seeking an introduction to the field. Moksha88 (talk) 04:40, 21 December 2019 (UTC)

Pediatric Palliative Care: Sources

CADonald, I was looking over the newly added material. Some of the references you cited are original research (WP:MEDREV), especially since some of them are older than a decade which is ample time for a systematic review or meta-analysis to be published. Have you found any to incorporate? Most of one for which I'm waiting pertain to adults, but I can see if my peer has any relevant to pediatrics. Moksha88 (talk) 04:09, 19 December 2019 (UTC)

"LTCs or LSCs"?

I don't know who wrote the phrase "Palliative care is potentially appropriate for any individual with an LTCs or LSCs...." I've searched the article content and cannot find "LTCs" or "LSCs" defined or explained anywhere in the article. Can the author of this information clarify what these terms mean for the context of the article? — Preceding unsigned comment added by VdkaShaker (talk • contribs) 19:23, 28 February 2020 (UTC)

Good catch, VdkaShaker. I removed that statement altogether. Terminology is outdated and not reflected in current palliative care guidelines. "Serious illness" is the preferred term. Moksha88 (talk) 23:15, 28 February 2020 (UTC)

Defining Palliative Care

@Espoo: I saw your revision of the first sentence (here), and I wanted to better understand your reasoning. I feel this revision is more confusing and imprecise because palliative care is not just limited to symptomatic treatment. Could you produce the material referenced by the first sentence so we could review it together to see how we could better reword it? Thank you. Moksha88 (talk) 13:42, 12 April 2020 (UTC)

American-centric article?

There's only one headline related to the history of pallative care, and it is explicitly only about the US. The article should be extended for experience of more countries. --Misiek1997 (talk) 11:29, 14 October 2020 (UTC)

Have renamed section to just "History", changed opening sentence, and tagged to be {{globalize}}d Little pob (talk) 11:53, 6 July 2022 (UTC)

Wiki Education assignment: Global Poverty and Practice

This article was the subject of a Wiki Education Foundation-supported course assignment, between 17 January 2023 and 19 May 2023. Further details are available on the course page. Student editor(s): Keerthikonda (article contribs). Peer reviewers: AleutianTea.

— Assignment last updated by Ozioma00 (talk) 21:28, 24 April 2023 (UTC)