Related Experiment Video
Updated: Mar 30, 2026
12:24
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
6.3K
Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study
Barbara Kimbell1, Kirsty Boyd2, Marilyn Kendall1
1Primary Palliative Care Research Group, Centre of Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
BMJ Open
|November 21, 2015
Summary
Uncertainty pervades advanced liver disease care, impacting patients, lay carers, and professionals. Addressing this uncertainty is crucial for effective supportive and palliative care planning.
Area of Science:
- Hepatology
- Palliative Care
- Qualitative Research
Background:
- Advanced liver disease is a growing health concern with complex patient and carer needs.
- Supportive and palliative care for this group are often neglected.
- Understanding patient and carer experiences is vital for improving care.
Purpose of the Study:
- To explore the experiences and support needs of patients with advanced liver disease.
- To understand the needs of their lay and professional carers.
- To inform improvements in supportive and palliative care.
Main Methods:
- Multiperspective, serial qualitative in-depth interviews with patients, lay carers, and healthcare professionals.
- Grounded theory analysis of interview data.
- Study conducted in primary and secondary care settings.
Main Results:
- Uncertainty was a dominant theme throughout the illness trajectory for patients, lay carers, and professionals.
- Uncertainty stemmed from the disease's nature, unpredictable prognosis, and communication issues.
- While acute medical care was coordinated, ongoing care lacked structure, impacting coping and care planning.
Conclusions:
- Pervasive uncertainty significantly impacts living, dying, and caring in advanced liver disease.
- Healthcare professionals should acknowledge and constructively address uncertainty.
- Anticipatory care planning, or 'just in case' planning, is essential for timely supportive and palliative care.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
256
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
256
01:29Chronic Pancreatitis II: Collaborative Care
479
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
479
01:28Esophageal Varices-II: Clinical Features and Management
756
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
756
01:27Nursing Ethical Principles II
2.6K
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
2.6K
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
335
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
335