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Driller B, Maienborn C, Aasen EM, Kolstrøm A, Talseth-Palmer B, Hole T, Strømskag KE, Brenne AT. Normality and compassionate care: experiences from advanced cancer patients in their last time at home. BMC PRIMARY CARE 2024; 25:245. [PMID: 38971730 PMCID: PMC11227155 DOI: 10.1186/s12875-024-02499-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/26/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Many cancer patients prefer to receive palliative treatment at home, as it allows them to be in a familiar and comfortable environment. Integrating Advance Care Planning (ACP) into routine practice in primary healthcare helps patients and their relatives prepare for end-of-life (EoL) care in accordance with patients' preferences. This includes the option to spend their final days at home if desired. The aim of this study was to gain insights from experiences of advanced seriously ill cancer patients at home while receiving palliative treatment and being engaged in ACP within primary healthcare settings. METHOD This study employed a qualitative design, utilizing individual, semi-structured interviews that were analysed through reflexive thematic analysis, employing an abductive approach with a latent-level focus. The study included interviews with 12 participants with cancer who were receiving palliative care, had an estimated lifetime under 3 months, and had undergone an organized ACP approach in primary healthcare, documented with a palliative plan. RESULTS Participants emphasized the importance of (1) Preserving normality at home, maintaining a sense of routine, comfort, and familiarity in the face of present and future challenges. The top obstacles for success identified by participants included (1a) The challenge of deterioration and the dual aspects of (1b) The value and burden of family caregivers. Cancer treatment placed a significant demand on patients due to side effects. Family caregivers played a crucial role for participants, providing support in daily life and serving as a key factor in the overall decision to which extend they are able to involve in support and care at home in the future. (2) Compassionate health care personnel (HCP) made a difference by fostering a culture of understanding participants' concerns, fears, and preferences, which was a key element that built and maintained trust for the participants. (3) Preparing for the future, especially EoL discussions initiated by healthcare personnel, was deemed important but, at times, uncomfortable for participants as it confronted them with reality. Guidance from ACP provided them with a sense of certainty and control. CONCLUSION Preserving normality at home, along with the desire to stay at home for as long as possible, is a crucial goal for advanced cancer patients. Consistent professional communication and care in primary healthcare play a key role in building and maintaining trust, as well as fostering a sense of certainty and control for the participants.
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Affiliation(s)
- Bardo Driller
- Department of Oncology, Møre and Romsdal Hospital Trust, Ålesund, Norway.
- Department for Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway.
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Carolin Maienborn
- School of natural sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Elin Margrethe Aasen
- Department of Health Sciences Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
| | - Adriana Kolstrøm
- Home care department, Kristiansund municipality, Kristiansund N, Norway
| | - Bente Talseth-Palmer
- Department for Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- NSW Health Pathology, Newcastle, NSW, Australia
| | - Torstein Hole
- Department for Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjell Erik Strømskag
- Department of Surgery and Emergency Medicine Molde Hospital, Møre and Romsdal Hospital Trust, Molde, Norway
| | - Anne-Tove Brenne
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's Hospital, Cancer Clinic, Trondheim University Hospital, Trondheim, Norway
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Liu Y, Du S, Liu C, Xue T, Tang Y. Preference of primary care patients for home-based healthcare and support services: a discrete choice experiment in China. Front Public Health 2024; 12:1324776. [PMID: 38699415 PMCID: PMC11063295 DOI: 10.3389/fpubh.2024.1324776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
Importance This research, utilizing discrete choice experiments, examines the preferences and willingness to pay for home-based healthcare and support services among residents in China, a country grappling with severe aging population, an area often underexplored in international scholarship. Objectives This study aims to solicit the preferences of primary care patients for home-based healthcare and support services in China. Design setting and participants A discrete choice experiment (DCE) was conducted on 312 primary care patients recruited from 13 community health centers in Wuhan and Kunming between January and May 2023. The experimental choice sets were generated using NGene, covering five attributes: Scope of services, health professionals, institutions, insurance reimbursements, and visiting fees. Main outcomes and measures The choice sets were further divided into three blocks, and each participant was asked to complete one block containing 12 choice tasks. Mixed logit models were established to estimate the relevant importance coefficients of and willingness to pay for different choices, while Latent Class Logit (LCL) modeling was conducted to capture possible preferences heterogeneity. Results The relevant importance of the scope of services reached 67.33%, compared with 19.84% for service institutions and 12.42% for health professionals. Overall, respondents preferred physician-led diagnostic and treatment services. LCL categorized the respondents into three groups: Group one (60.20%) was most concerned about the scope of services, prioritizing disease diagnosis and treatment over preventive care and mental health, while group two (16.60%) was most concerned about care providers (hospitals and medical doctors were preferred), and group three (23.20%) was most concerned about financial burdens. Conclusion Primary care patients prefer physical health and medical interventions for home-based healthcare and support services. However, heterogeneity in preferences is evident, indicating potential disparities in healthcare and support at home services in China.
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Affiliation(s)
- Yaqing Liu
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sixian Du
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chaojie Liu
- Department of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Tianqin Xue
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuqing Tang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China
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Yoon S, Goh H, Yeo ZZ, Yang GM, Chong PH, Zhuang Q. Comparing situational influences on differential healthcare utilization trajectories in patients on home palliative care: A qualitative study. Palliat Support Care 2024:1-8. [PMID: 38299377 DOI: 10.1017/s1478951524000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Patients with terminal cancer receiving home palliative care present differential healthcare utilization trajectories before death. It remains unclear which situational elements influence these trajectories among disparate patient groups. The aim of this study was to compare situational influences on "persistently high" and "low stable" trajectories of healthcare utilization in patients who received palliative care support at home. METHODS Bereaved family caregivers were recruited from our prior quantitative study investigating healthcare utilization trajectories in oncology patients on home-based palliative care. In-depth interviews were conducted with 30 family caregivers. Data were analyzed using thematic analysis. RESULTS Analysis of data uncovered how the 2 utilization trajectories were influenced by the interplay of 1 or more of 4 situational elements. Perceived symptom control in patients, influenced by their determination to die at home, shapes the susceptibility to situational contingencies, resulting in differential utilization trajectories. Caregivers' mental readiness in dealing with unexpected circumstances has a significant impact on the overall manageability of care, ultimately affecting decisions related to healthcare utilization. The concordance between symptom needs and scope of homecare services in a given situation proves to be an important determinant. Lastly, perceived accessibility to informal support in times of need acts as a contextual reinforcement, either preventing or precipitating decisions regarding healthcare utilizations. SIGNIFICANCE OF RESULTS Our findings hold important implications for the provision of homecare services, in particular, the need for comprehensive assessment of end-of-life wishes during homecare enrolment and strengthening psychological preparedness of caregivers. Expansion of home-based clinical interventions tailored to high utilizers, and funding for temporary in-home respite should be considered to optimally manage potentially preventable acute healthcare utilization.
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Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, SingHealth, Singapore, Singapore
| | - Hendra Goh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | | | - Grace Meijuan Yang
- Division of Supportive & Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Qingyuan Zhuang
- Division of Supportive & Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
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Guo J, Xu X, Liu C, Wang Y, Chen Y. Perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer: a qualitative study in mainland China. BMC Palliat Care 2024; 23:16. [PMID: 38212798 PMCID: PMC10785499 DOI: 10.1186/s12904-024-01347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Despite being driven by a strong sense of duty and familial obligation, providing care for patients nearing the end of life poses challenges for family caregivers. Telemedicine has rapidly gained traction as a transformative approach to healthcare delivery, offering an array of benefits that could be particularly valuable in end-of-life care. However, research on the perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer is limited. Therefore, this study aims to explore the perspectives and preferences of telemedicine-based services among family caregivers of patients with end-of-life cancer and provide a framework for developing and executing a tailored telemedicine-based end-of-life care program that addresses the unique needs of family caregivers in mainland China. METHOD A descriptive phenomenological approach was used. Family caregivers were selected using purposive sampling at a tertiary cancer hospital. One-on-one semi-structured interviews were conducted with the participants from November to December 2022. Colaizz's method was used to analyze the interviews. RESULTS Fourteen participants participated in interviews. Three themes and ten subthemes were identified: motivation to receive telemedicine services (relief from the burden of home care; access to professional health care services), supportive care needs for telemedicine services (support for symptom management; negative emotional adjustment; death education; daily life care guidance), and functional expectations of telemedicine service platforms (ease of use; real-time online guidance and response; personalized automatic reminder; targeted matching push of health knowledge). CONCLUSION Family caregivers expressed interest in telemedicine-based services and identified various care needs before receiving telemedicine services. The findings of this study can help policymakers and healthcare providers develop more effective and culturally appropriate telemedicine-based service programs that can better support family caregivers of end-of-life cancer patients.
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Affiliation(s)
- Junchen Guo
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
- School of Nursing, University of South China, No.28, Changsheng West Road, Hengyang, 421001, Hunan, China
| | - Xianghua Xu
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Chaoyi Liu
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Ying Wang
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Yongyi Chen
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China.
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Liu J, Li JF, Li XX, Wu YP, Li SR, Li LY, Zhou HP. Awareness of Hospice Care Among Community-Dwelling Elderly Participants. Res Theory Nurs Pract 2023; 37:386-400. [PMID: 37591529 DOI: 10.1891/rtnp-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Background and Purpose: The main goal of hospice care is to improve the quality of life for people who are at the end-of-life phase. However, investigations on the awareness of hospice care among community-dwelling elderly participants are limited. This work aimed to reveal the awareness status of hospice care and explore the factors influencing the awareness rate among elderly participants. Methods: A questionnaire survey was conducted among individuals aged 60 years and above. Results: A total of 4,969 individuals aged 60 years and above were randomly selected from 48 primary medical institutions in Handan. The awareness rate of hospice care in the baseline survey was 19.3% (n = 959). All included individuals were divided into two groups in accordance with their awareness of hospice care. The awareness of hospice care among participants with low educational level, living alone, and afraid of talking about death was low (p < .05). Implications for Practice: The level of awareness of hospice care among community-dwelling elderly participants is low. The influencing factors included educational level, living status, and fear of talking about death. The community-dwelling elderly participants' awareness of hospice care must be improved. It is recommended that public medical education and training should be enhanced to improve knowledge and awareness of hospice care among community-dwelling elderly residents with low educational level, living alone, and afraid of talking about death.
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Affiliation(s)
- Jun Liu
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Jun-Fang Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Xiao-Xiao Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Yi-Ping Wu
- Department of Neurology, Handan Central Hospital, Handan, China
| | - Shu-Rui Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Li-Yang Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Hai-Ping Zhou
- Department of Ageing and Health, Medical Association of Handan, Handan, China
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Alhalabi MN, Khalaf IA, Zeilani RS, Bawadi HA, Musa AS, Nashwan AJ. Palliative care needs of Jordanian women's experience of living with stroke: a descriptive phenomenological study. BMC Palliat Care 2023; 22:106. [PMID: 37507696 PMCID: PMC10375733 DOI: 10.1186/s12904-023-01216-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Stroke is a prevalent neurological disease that can have a profound impact on women's physical, psychosocial, and spiritual well-being. In many cases, women living with stroke may have marginalized palliative care needs that are often not adequately addressed by healthcare providers. Unfortunately, the experience of women with stroke and their specific palliative care needs have been largely overlooked in research conducted in Jordan. AIM The purpose of this study is to examine the specific palliative care needs of women who have experienced a stroke and are currently living in Jordan. By conducting this research, we aim to identify the various physical, emotional, social, and spiritual needs of women with stroke and gain a better understanding of how these needs can be addressed through palliative care interventions. METHODS This research utilized a phenomenological descriptive study approach to explore the experiences of twelve women recruited from the outpatient clinic of rehabilitation centers. The data was collected through semi-structured interviews. The analysis was conducted using the method of Colaizzi (1978), which involves identifying significant statements, extracting meanings, and formulating an exhaustive description of the phenomenon under study. RESULTS The study findings uncovered three primary themes that reflect the palliative care needs of women who are currently living with stroke in Jordan, including (1) Spiritual practices, beliefs, and needs; (2) Coping with distressing symptoms; and (3) Managing the delivery of unfavorable news. DISCUSSION This study provides valuable insights into the experiences of Jordanian women living with stroke, highlighting the far-reaching consequences of this condition on various aspects of their lives. The findings reveal that stroke has a significant impact on women's physical, emotional, social, and spiritual well-being, with many facing unmet palliative care needs. By illuminating these challenges, our study underscores the importance of taking a holistic approach to stroke care that addresses the multifaceted needs of women living with stroke. Healthcare providers must consider these findings and integrate palliative care interventions into treatment plans to improve the quality of life of women living with stroke in Jordan. CONCLUSION This study provides valuable insights into the palliative care needs of women who have experienced a stroke. Our findings highlight the importance of addressing women's physical, psychosocial, and spiritual needs as part of a comprehensive approach to stroke care. We recommend integrating palliative care interventions into rehabilitation programs to improve the quality of life of women living with stroke in Jordan. By doing so, we can address the pain and complications that can arise from stroke, while also providing holistic support to address the emotional and spiritual impact of the illness. This approach has the potential to improve outcomes for women living with stroke and enhance their overall well-being.
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Affiliation(s)
- Marwa Nayef Alhalabi
- Department of Adult Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Inaam Abdulla Khalaf
- Department of Maternal and Child Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Ruqayya Sayed Zeilani
- Department of Adult Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Hala Ahmad Bawadi
- Department of Maternal and Child Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Ahmad S Musa
- Department of Adult Health Nursing, Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
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Fhoula B, Hadid M, Elomri A, Kerbache L, Hamad A, Al Thani MHJ, Al-Zoubi RM, Al-Ansari A, Aboumarzouk OM, El Omri A. Home Cancer Care Research: A Bibliometric and Visualization Analysis (1990-2021). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13116. [PMID: 36293702 PMCID: PMC9603182 DOI: 10.3390/ijerph192013116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Home cancer care research (HCCR) has accelerated, as considerable attention has been placed on reducing cancer-related health costs and enhancing cancer patients' quality of life. Understanding the current status of HCCR can help guide future research and support informed decision-making about new home cancer care (HCC) programs. However, most current studies mainly detail the research status of certain components, while failing to explore the knowledge domain of this research field as a whole, thereby limiting the overall understanding of home cancer care. We carried out bibliometric and visualization analyses of Scopus-indexed papers related to home cancer care published between 1990-2021, and used VOSviewer scientometric software to investigate the status and provide a structural overview of the knowledge domain of HCCR (social, intellectual, and conceptual structures). Our findings demonstrate that over the last three decades, the research on home cancer care has been increasing, with a constantly expanding stream of new papers built on a solid knowledge base and applied to a wide range of research themes.
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Affiliation(s)
- Boutheina Fhoula
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Majed Hadid
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Adel Elomri
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Laoucine Kerbache
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Anas Hamad
- Pharmacy Department, National Center for Cancer Care & Research, Hamad Medical Corporation, Doha 3050, Qatar
| | | | - Raed M. Al-Zoubi
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
- Department of Biomedical Sciences, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar
- Department of Chemistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Abdulla Al-Ansari
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Omar M. Aboumarzouk
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
- College of Medicine, QU-Health, Qatar University, Doha 2713, Qatar
- School of Medicine, Dentistry and Nursing, The University of Glasgow, Glasgow G12 8QQ, UK
| | - Abdelfatteh El Omri
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
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The Implementation of Palliative Home Care in Southeast Asian Countries: An Integrative Review. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223221113858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In Asia where family caregiving is part of the culture, palliative home care becomes the most suitable service to keep patients close to their family and to reduce costs. There is a wide variety of palliative home care services due to different cultures and levels of involvement of the family. This review aims to explore the implementation of palliative home care in East and Southeast Asian countries. The articles reviewed in this study were obtained from 3 electronic databases: EbscoHost, PubMed, and Scopus. Journal articles that discussed palliative home care for patients with cancer in East and Southeast Asia countries were included. Review papers were excluded. Seven studies were used in the current review. In general, there are 6 services provided for palliative home care in this region, which are daily activity living care, planning and preparation for palliative home care, education and counseling, patients’ follow-up, symptom management, and direct care for family. Most of the programs involve family caregivers during the treatment. The palliative home care team consists of at least a doctor and a nurse. Symptom management is the most common service and direct care for family is the least offered palliative home care service in this region. Alleviating symptoms is one of the targets in palliative care, therefore involving family in symptom management for palliative home care is fundamental. Although caregiving is part of the culture, family members need to be supported to maintain their quality of life.
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Cao Z, Wang Y, Zhang H. "It's a Tall Order but I'll Try": a qualitative study on Chinese nurses' cognition and experience responding to cancer patients' requests to hasten death. Support Care Cancer 2022; 30:7509-7515. [PMID: 35665858 DOI: 10.1007/s00520-022-07192-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/30/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to understand the cognition and experience of oncology nurses in China when responding to a patient's request to hasten death, to describe the obstacles that prevent their response, and to provide suggestions for dealing with the patient's request. METHODS Researchers conducted a qualitative study that consisted of open-ended, semi-structured interviews with 18 registered nurses who had more than 5 years of working experience in the oncology department at a large-scale urban hospital. We analyzed these data for content and themes. RESULTS How to deal with patients' requests to hasten death is a problem often encountered and handled by nurses in the Department of Oncology. Nurses have a certain understanding of the patients' requests to hasten death. This study abstracts four themes: (1) the nurses' cognition of the "Accelerate the process of death"; (2) the methods they use to deal with the patients' requests to hasten death; (3) the obstacles that prevent nurses from fulfilling the patients' requests to hasten death; and (4) their suggestions for improvement. CONCLUSION Nurses have a deep understanding of the real thoughts of patients who make a death request, and they hope to provide the corresponding psychological support and physical care. However, the lack of relevant knowledge, policy support, and cooperation of patients' families are obstacles that prevent them from taking action. Therefore, increasing relevant training for nurses, encouraging multi-department cooperation, and developing standardized nursing processes may lay a foundation for oncology nurses to better undertake and guide such conversations.
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Affiliation(s)
- Zhaoming Cao
- Department of Nursing, Nursing College of Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning, China
| | - Yingchun Wang
- Department of Oncology Department, Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Huijun Zhang
- Department of Nursing, Nursing College of Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning, China.
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Fan R, Yang S, Bu X, Chen Y, Wang Y, Shen B, Qiu C, Li X. Symptomatic Features and Factors Associated With Do-Not-Resuscitate Consent in Advanced Cancer Patients Admitted to Palliative Care Ward. Am J Hosp Palliat Care 2022; 39:1312-1324. [PMID: 35041534 DOI: 10.1177/10499091211068824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to conduct a retrospective cross-sectional study to investigate the prevalence of symptoms and symptom clusters on sociodemographic and disease characteristics, as well as factors associated with Do-Not-Resuscitate (DNR) consent. Advanced cancer patients were enrolled between 2018 and 2020 with available data. Demographic and clinical data were obtained for analysis from Hospital Information System (HIS) in China. Symptom clusters were extracted by hierarchical cluster analysis. Chi-square test and multiple logistic regression were conducted to investigate the prevalence characteristics of symptoms and influencing factors of DNR consent, respectively. 798 advanced cancer patients were enrolled. The most prevalent symptoms were pain (93%), anorexia (36.5%), and sleep disorders (34.2%). High heart rate was associated with poor performance status and more symptoms. Three clusters were extracted: fatigue-related, respiratory-circulatory system, and digestive system symptom clusters. The incidence of symptoms was statistically significant in age, gender, education level, residence, BMI, performance status, distress score, ADL, and primary pain level. The DNR signature rate was 15.5%. Female, distant metastasis, in-ward rescue, and appearance of dyspnea were independent influencing factors of DNR signature.Chinese hospitalized cancer patients had more symptoms burden that were influenced by various demographic characteristics, especially pain and fatigue-related symptoms. Concerning the trajectory of vital signs is important among advanced cancer patients. The DNR signature rate was lower and our finding indicating an urgency to accurately assess the prognosis and give more palliative care education to enhance DNR rates and early signing in Chinese context.
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Affiliation(s)
- Rongrong Fan
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Siyu Yang
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Xiaofan Bu
- 12570Xiangya Nursing School of Central South University, Changsha, China
| | - Yongyi Chen
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Ying Wang
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Boyong Shen
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Cuiling Qiu
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Xuying Li
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
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Zhu S, Zhu H, Zhang X, Liu K, Chen Z, Yang X, Sun C, Xie W, Xu Q, Li W, Pang D, Cui Y, Wang H. Care needs of dying patients and their family caregivers in hospice and palliative care in mainland China: a meta-synthesis of qualitative and quantitative studies. BMJ Open 2021; 11:e051717. [PMID: 34740931 PMCID: PMC8573656 DOI: 10.1136/bmjopen-2021-051717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the care needs of dying patients and their family caregivers in hospice and palliative care in mainland China. METHODS A search for English and Chinese quantitative and qualitative studies was performed using the following English databases: PubMed (Medline), CINAHL and PsycINFO, as well as Chinese databases: SinoMed and CNKI. The records were independently screened by two reviewers and critiqued using Joanna Briggs Institute Critical Appraisal tools. All quantitative data were transformed into qualitative data, which were converted into textual descriptions. Due to the diversity of included studies, a three-step analysis was performed: narrative summary, thematic analysis and presentation of integrated results in a narrative form. The qualitative findings were pooled using the meta-aggregation approach. RESULTS The literature search identified 2964 papers after removing duplicates, from which 18 were included (9 quantitative and 9 qualitative studies). All studies were conducted in mainland China. Quantitative studies involved cross-sectional surveys, and qualitative studies involved interviews for data collection. Two synthesised results of patients' needs were identified, including needs to be comfortable and experience a good death. Another two synthesised results of family caregivers' needs included needs to care for and improve the quality of life of patients, and to care for themselves well. CONCLUSION This study identified that patients and family caregivers have an increasing demand for professional care at the end of life. Professionals, especially nurses, should enact a patients' demand-centred practice to overcome the challenges of organisation, education, emotion and communication to provide high-quality end-of-life care.
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Affiliation(s)
- Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xintong Zhang
- Emergency, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Kouying Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zumei Chen
- China Jiliang University Hospital, Hangzhou, Zhejiang, China
| | - Xiaowen Yang
- Nanjing Medical University Library, Nanjing, Jiangsu, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Vocational Institute of Commerce, Nanjing, Jiangsu, China
| | - Weiping Xie
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiying Li
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
- Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University Health Science Centre, Beijing, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Wang
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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