The Role of Palliative Care in Interstitial Lung Disease

Öz

Interstitial Lung Disease (ILD) and to address these points in detail and shed light on the applications in clinical practice.Progressive fibrotic interstitial lung diseases (ILD) are characterized by large decreases in quality of life and survival, and show similarities with certain malignancies. However, it is not easy for many patients with ILD to access palliative care. Unmet patient and caregivers’ needs include effective pharmacological and psychosocial initiatives aimed at improving quality of life throughout the course of the disease, sensitive advanced care planning, and timely patient-centered end-of-life care. The misperception that palliative care is synonymous with end-of-life care and has no previous role in the course of ILD has created a culture of neglect. If initiatives aimed at improving life expectancy are usually given priority to an individual’s health and psychosocial needs without careful consideration, therefore, the quality of life decreases, albeit unintentionally. As with malignant diseases, radical initiatives to slow the progression of the disease and palliative measures to improve the quality of life should be a priority in ILD. Effective patient-centered palliative care models should be used taking into account religious and cultural differences, as well as the variability of resources. The effective implementation of palliative care for ILD will require the multidisciplinary participation of clinicians, specialist nurses, psychologists, social workers and, in some countries, non-governmental organizations and community-based organizations with access to palliative care expertise. The aim of this review is to emphasize the importance and place of palliative care in the situation

 

İntertisyel Akciğer Hastalığında Palyatif Bakımın Yeri

Öz

İlerleyici fibrotik interstisyel akciğer hastalıkları (İAH’ler), yaşam kalitesinde ve hayatta kalma süresinde büyük azalmalarla karakterize edilir ve belirli malignitelerle benzerlikler gösterir. Ancak İAH’li birçok hastanın palyatif bakıma ulaşması kolay değildir. Hasta ve bakım vericilerin karşılanmayan gereksinimleri arasında hastalığın seyri boyunca yaşam kalitesini iyileştirmeye yönelik etkili farmakolojik ve psikososyal girişimler, hassas gelişmiş bakım planlaması ve zamanında hasta merkezli yaşam sonu bakımı yer alır. Palyatif bakımın yaşam sonu bakımla eş anlamlı olduğu ve İAH’ın seyrinde daha önce hiçbir rolü olmadığı yönündeki yanlış algı, bir ihmal kültürü yaratır. Yaşam beklentisini artırmayı amaçlayan girişimlerde, bireyin sağlık ve psikososyal ihtiyaçları göz ardı edilirse, yaşam kalitesi istemeden de olsa düşebilir. Malign hastalıklardaki gibi, İAH’ta da  hastalığın ilerlemesini yavaşlatmaya yönelik köklü girişimler ve yaşam kalitesini arttırmaya yönelik palyatif önlemler önceliklidir. Etkin hasta merkezli palyatif bakım modelleri, dini ve kültürel farklılıkların yanı sıra kaynakların değişkenliği de dikkate alınarak kullanılmalıdır. İAH için palyatif bakımın etkili bir şekilde uygulanması, hekimlerin, uzman hemşirelerin, psikologların, sosyal hizmet uzmanlarının ve bazı ülkelerde palyatif bakım uzmanlığına erişimi olan sivil toplum kuruluşlarının ve toplum temelli kuruluşların çok disiplinli katılımını gerektirecektir. Bu derlemenin amacı İnterstisyel Akciğer Hastalığı (İAH) bağlamında palyatif bakımın önemini, rolünü ve etkisini vurgulamak ve bu noktaları detaylı olarak ele alıp klinik pratikteki uygulamalara ışık tutmaktır.

 

Anahtar Kelimeler

• Interstitial lung diseases
• palliative care
• pulmonary rehabilitation

Kaynakça

1. Abou-Rizk J., Alameddine M., Naja F. (2016). Prevalence and characteristics of CAM use among people living with HIV and AIDS in Lebanon: Implications for patient care. Evidence-Based Complementary and Alternative Medicine, 2016, 1–11. https://doi.org/10.1155/2016/5013132
2. Barnes, K., Ball, L., Desbrow, B., Alsharairi, N., & Ahmed, F. (2016). Consumption and reasons for use of dietary supplements in an Australian university population. Nutrition, 32(5), 524–530.
3. Berman, A. T., Snyder, S., & Frandsen, D. (2022). Culturally responsive nursing care. In A. T. Berman, S. Snyder, & D. Frandsen (Eds.), Kozier & Erb’s fundamentals of nursing: Concepts, process, and practice (11th ed., pp. 397–417). Pearson Education Limited.
4. Campinha-Bacote, J. (2011). Delivering patient-centered care in the midst of a cultural conflict: The role of cultural competence. Online Journal of Issues in Nursing, 16(2), 1–8. https://doi.org/10.3912/OJIN.Vol16No02Man05
5. Çekiç, Ş., Canıtez, Y., Çiçek, F., Karalı, Y., Karalı, Z., & Sapan, N. (2020). Çocukluk çağı alerjik hastalıklarında tamamlayıcı ve alternatif tıp kullanımının araştırılması. Osmangazi Tıp Dergisi, 43(1), 76–81.
6. Değer, V. B. (2018). Transcultural nursing. In Nursing (pp. 39–63). IntechOpen. https://doi.org/10.5772/intechopen.74990
7. Eid A. M., Jaradat N. (2020). Public knowledge, attitude, and practice on herbal remedies used during pregnancy and lactation in West Bank Palestine. Frontiers in Pharmacology, 11, 46. https://doi.org/10.3389/fphar.2020.00046
8. Ekor, M. (2014). The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Frontiers in Pharmacology, 4, 177.

9. Fabry, Lindy; McDermott, Sandi; Wilford, Brandi DNP, RN. Culturally Competent Care for Diverse Populations: A Review of Transcultural Nursing Education. Advanced Emergency Nursing Journal 46(3):p 274-282, July/September 2024. | DOI: 10.1097/TME.0000000000000526
10. Farling, K. B. (2017). Bladder cancer: Risk factors, diagnosis, and management. The Nurse Practitioner, 42(3), 26–33. https://doi.org/10.1097/01.NPR.0000512251.61454.5c
11. Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L., Piñeros, M., Znaor, A., Soerjomataram, I., & Bray, F. (2024). Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer. https://gco.iarc.who.int/today
12. GLOBOCAN. (2022). Bladder cancer fact sheet. https://gco.iarc.who.int/media/globocan/factsheets/cancers/30-bladder-fact-sheet.pdf
13. Güveli, H., Uzsoy, A., Özlü, T., Kenger, E., & Ergün, C. (2021). Onkoloji hastalarında tamamlayıcı ve alternatif tıp kullanım sıklığının ve diyet yaklaşımlarının belirlenmesi. Avrupa Bilim ve Teknoloji Dergisi, (21), 307–312.
14. Hall H., Brosnan C., Frawley J., Wardle J., Collins M., Leach M. (2018). Nurses’ communication regarding patients’ use of complementary and alternative medicine. Collegian, 25(3), 285–291. https://doi.org/10.1016/j.colegn.2017.09.001
15. Kang, Y., Park, C., Lee, H., Kang, S., Cheon, C., & Kim, B. (2023). Natural products as new approaches for treating bladder cancer: From traditional medicine to novel drug discovery. Pharmaceutics, 15(4), 1117. https://doi.org/10.3390/pharmaceutics15041117
16. Kaseb, H., Leslie, S., Soon-Sutton, T., & Aeddula, N. (2024). Bladder cancer. In StatPearls. StatPearls Publishing.
17. Kelsall-Knight L. (2022). Practising cultural humility to promote person and family-centred care. Nursing Standard, 37(2), 28–34. https://doi.org/10.7748/ns.2022.e11880
18. Khan, M. A. A., Khalid, M., & Malik, O. (2025). The safety of herbal medicines in low- and middle-income countries (LMICs): Current landscape and promoting pharmacovigilance practices. Journal of Pharmaceutical Policy and Practice, 18(1), Article 2574651. https://doi.org/10.1080/20523211.2025.2574651
19. Kongkaew, C., Phan, D. T. A., Janusorn, P., & Mongkhon, P. (2024). Estimating adverse events associated with herbal medicines using pharmacovigilance databases: A systematic review and meta-analysis. JMIR Public Health and Surveillance, 10(1), e63808. https://doi.org/10.2196/63808
20. Kwame A., Petrucka P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(1), 158. https://doi.org/10.1186/s12912-021-00684-2
21. Lee, J. Y., Jun, S. A., Hong, S. S., Ahn, Y. C., Lee, D. S., & Son, C. G. (2016). Systematic review of adverse effects from herbal drugs reported in randomized controlled trials. Phytotherapy Research, 30(9), 1412-1419.
22. Leininger, M. (2002). The theory of culture care and the ethnonursing research method. In M. Leininger & M. McFarland (Eds.), Transcultural nursing: Concepts, theories, research, and practice (3rd ed., pp. 71–81). McGraw-Hill.
23. Leininger, M. M. (2006). Culture care diversity and universality: A worldwide nursing theory. Jones & Bartlett Learning.
24. Leyva-Moral J. M., Tosun B., & Gomez-Ibanez R. (2023). From a learning opportunity to a conscious multidimensional change: A metasynthesis of transcultural learning experiences among nursing students. BMC Nursing, 22(1), 356. doi:10.1186/s12912-023-01521-4
25. Maroyi, A. (2013). Traditional use of medicinal plants in south-central Zimbabwe: Review and perspectives. Journal of Ethnobiology and Ethnomedicine, 9(1), 31.
26. National Cancer Institute. (2023). What is bladder cancer? https://www.cancer.gov/types/bladder
27. Ng, C. Y. J., Zhao, Y., Wang, N., et al. (2024). A multi-center cross-sectional study of Chinese herbal medicine–drug adverse reactions using active surveillance in Singapore’s Traditional Chinese Medicine clinics. Chinese Medicine, 19, 44. https://doi.org/10.1186/s13020-024-00915-z
28. Roy, A., Verma, S., Pandey, P., Acharyya, R., Singh, M., Mahapatra, A., … Memon, A. (2025). The cultural significance of medicinal plants in literature and traditional medicine: A review of geographic distribution, health benefits and marketing strategies. International Journal of Scientific Research and Technology.
29. Setyawati A, Yusuf S, Jafar N, Sagita RW. Exploring herbal remedy utilization for wound healing: Patterns, patient preferences, and implications for nursing practice. International Journal of Nursing Knowledge. 2024;35(4):363-374. doi:10.1111/2047-3095.12454
30. Silverman, D. T., Koutros, S., Figueroa, J. D., Prokunina-Olsson, L., & Rothman, N. (2018). Bladder cancer. In M. J. Thun, M. S. Linet, C. Cerhan, C. Haiman, & D. Schottenfeld (Eds.), Cancer epidemiology and prevention (4th ed., pp. 977–996). Oxford University Press. https://doi.org/10.1093/oso/9780190238667.003.0052
31. Singh, V. K., Singh, R., Kumar, S., & Kushwaha, A. (2026). Incidence and Clinical Impact of Adverse Reactions Associated with Herbal Medicines. International Journal of Drug Delivery Technology, 16(8s), 390–397. https://doi.org/10.25258/ijddt.16.8s.52
32. Solak, Y., Kaya, E., & Yoldaşcan, B. (2020). Aile sağlığı merkezine başvuranların bitkisel ürünler ve bitkisel tedaviler ile ilgili bilgi ve tutumları. Fırat Tıp Dergisi, 25(4), 213–218.
33. Tanrıverdi, G. (2017). Approaches and recommendations for improving cultural competence in nursing. Florence Nightingale Journal of Nursing, 25(3), 227–236. https://doi.org/10.17672/fnjn.343261
34. Tsele-Tebakang T., Morris-Eyton H., Pretorius E. (2022). Herb-drug interactions: Perception and revelations of nurses in primary healthcare clinics, South Africa. International Journal of Africa Nursing Sciences, 16, 100409. https://doi.org/10.1016/j.ijans.2022.100409
35. Valešić, M., Čivljak, M., & Puljak, L. (2025). Informed consent and ethics committee involvement in case reports and case series: A cross-sectional meta-research study. BMC Medical Ethics, 26(1), 64. https://doi.org/10.1186/s12910-025-01226-0
36. van Wyk, A. S., & Prinsloo, G. (2020). Health, safety and quality concerns of plant-based traditional medicines and herbal remedies. South African Journal of Botany, 133, 54–62.