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Davis G, Gaskin K, Molnár G, Bentley J. Places of Farewell: A Scoping Review Exploring Factors Influencing the Choice of Place of Death for Children when Death is Expected. Compr Child Adolesc Nurs 2024:1-19. [PMID: 38995682 DOI: 10.1080/24694193.2024.2374239] [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: 11/13/2023] [Accepted: 06/18/2024] [Indexed: 07/13/2024]
Abstract
Progression of ill health and death trajectories is different for children with a non-oncology diagnosis. As previous research has focused primarily on children with cancer diagnoses, this scoping review explored what factors influence the parent and/or child's choice of place of death for a child with a non-oncological complex care condition, when death is expected. Eighteen papers were identified considering the preferred place of death. The findings were themed into 1. Diagnostic Factors; 2. Home Factors; 3. Socio-economic Factors; 4. Parent Factors. In conclusion, informed discussions with families that recognize the reason for, and the impact of their choices, are necessary not only for the preferred place of death but also end of life care.
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Affiliation(s)
- Gilda Davis
- Three Counties School of Nursing and Midwifery, University of Worcester, Worcester, UK
| | - Kerry Gaskin
- School of Nursing and Midwifery, Birmingham City University, Birmingham, UK
| | - Gyozo Molnár
- School of Sport and Exercise Science, University of Worcester, Worcester, UK
| | - Jackie Bentley
- Three Counties School of Nursing and Midwifery, University of Worcester, Worcester, UK
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2
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Liang M, Xie X, Pan Y, Cheng ASK, Ye Z. A qualitative meta-synthesis of patient dignity from the perspective of caregivers. BMC Geriatr 2023; 23:351. [PMID: 37277725 DOI: 10.1186/s12877-023-04071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND The concept of dignity remains disputed, with most studies defining dignity based on its external dimension. Although its inherent dimension is a rooted attribute of dignity, it has received scarce attention. Caregivers have close relationships with their care recipients and thus may perceive their patient's inherent as well as external dimensions of dignity. Therefore, in this study, we aimed to identify, analyze, and synthesize evidence on human dignity presented in qualitative studies from the perspective of caregivers to gain a deeper comprehension of the preservation of patients' dignity by their caregivers. METHODS A qualitative meta-synthesis was performed by searching for relevant qualitative literature via systematic electronic databases, including MEDLINE, PsycINFO, ProQuest, CINAHL, Embase, Health Source, and Web of Science, from inception to March 15, 2022. RESULTS Nine studies were eligible for inclusion and included in the meta-synthesis. Three overarching categories were identified: integrated person, "rootedness" and "growth" atmosphere, and balanced state. CONCLUSIONS Dignity is rooted in its inherent dimension, whereas its external dimension may promote individual dignity. Furthermore, caregiver-patient relationships may be a key factor linking the inherent dimension of dignity with its external dimension. Thus, further studies should focus on the mechanism of relationships in preserving dignity.
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Affiliation(s)
- Minyu Liang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiyan Xie
- Nursing Department, Home for the Aged Guangzhou, Guangzhou, Guangdong Province, China
| | - Yichao Pan
- Department of Cardiovascular Medicine, Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
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3
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Mitchell TK, Bray L, Blake L, Dickinson A, Carter B. 'I feel like my house was taken away from me': Parents' experiences of having home adaptations for their medically complex, technology-dependent child. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4639-e4651. [PMID: 35715967 PMCID: PMC10083937 DOI: 10.1111/hsc.13870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 04/28/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Technology-dependent children are a sub-population of seriously ill children with life-limiting conditions who are being cared for at home by their families. Although home-based care has been the model of care for these children since the late 1980s, there is a paucity of literature about parents' experiences of having home adaptations made to enable their home to be a place of care for their child. Using the findings from auto-driven photo-elicitation interviews conducted between August 2017 and June 2018 with 12 parents (10 mothers and 2 fathers) who have a technology-dependent child (aged 5-25 years) living in England, Scotland and Wales and David Seamon's five concepts of at-homeness (appropriation, at-easeness, regeneration, rootedness and warmth) as a conceptual framework, this paper addresses how parents' experienced home adaptations. Thematic analysis generated a meta-theme of 'Home needs to be a home for all family members' and the three key themes: (1) 'You just get told' and 'you're not involved'; (2) It's just the 'cheapest', 'quickest', 'short-term' approach; (3) Having 'control' and 'thinking things through.' The need to involve parents in decision-making about adaptations that are made to their home (family-informed design) is clear, not only from a cost-saving perspective for the state, but for creating an aesthetic and functional home that optimises health, well-being and feelings of at-homeness for the entire family.
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Affiliation(s)
- Tracy Karen Mitchell
- Faculty of Health, Social Care and MedicineEdge Hill UniversityOrmskirkLancashireUK
- Present address:
Department of Public Health, Policy and Systems, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
| | - Lucy Bray
- Faculty of Health, Social Care and MedicineEdge Hill UniversityOrmskirkLancashireUK
| | - Lucy Blake
- Faculty of Health, Social Care and MedicineEdge Hill UniversityOrmskirkLancashireUK
- Present address:
Department of Health and Social SciencesUniversity of the West of England (UWE)BristolUK
| | | | - Bernie Carter
- Faculty of Health, Social Care and MedicineEdge Hill UniversityOrmskirkLancashireUK
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Shaw T, Berkel C, Bernatavicius W, Berger K. "If We Build It, Will They Come?" A Cohort Study of Family Utilization of a Pediatric-Specific Hospice Home. J Palliat Med 2022; 25:1361-1366. [PMID: 35363045 DOI: 10.1089/jpm.2021.0513] [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: 11/13/2022] Open
Abstract
Objective: To determine whether families would make use of a pediatric-specific inpatient hospice facility for end-of-life care for children. Background: Location of end-of-life care and death are important considerations when treating children with life-limiting conditions. There is very limited research on utilization of an inpatient hospice facility for end-of-life care if a pediatric-specific facility is available. We examined changes in family utilization of inpatient hospice services with the availability of an inpatient pediatric hospice facility (PHF). Methods: We conducted a retrospective cohort study with data collected on location of end-of-life care and death five years prior to and five years following the opening of a PHF that receives referrals from a large children s hospital in United States. Two data sources from the hospice organization were used: (1) a dataset on origins and outcomes of referrals to pediatric inpatient hospice care and (2) a dataset on location of death for all pediatric patients who had any contact with the hospice system. Chi-square analyses were conducted to assess the associations between the PHF opening and referral outcomes and location of death. Results: Significant results were found with respect to both referral outcomes and location of death. Engagement in inpatient hospice care increased between 2- and 10-fold following the opening of the inpatient PHF. The percent of patients who died in an inpatient hospice unit also increased significantly with the opening of the pediatric facility. Discussion: Results of this study show that providers are more likely to refer, and families are more likely to use inpatient hospice services when pediatric facilities are available. These results are important for establishing an evidence base in support for increasing access to PHFs.
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Affiliation(s)
- Tressia Shaw
- Department of Palliative Care, Phoenix Children's Hospital, Phoenix, Arizona, USA.,Hospice of the Valley, Phoenix, Arizona, USA
| | - Cady Berkel
- Department of Palliative Care, Phoenix Children's Hospital, Phoenix, Arizona, USA.,College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Wendy Bernatavicius
- Department of Palliative Care, Phoenix Children's Hospital, Phoenix, Arizona, USA.,Hospice of the Valley, Phoenix, Arizona, USA
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Mitchell TK, Bray L, Blake L, Dickinson A, Carter B. 'It doesn't feel like our house anymore': The impact of medical technology upon life at home for families with a medically complex, technology-dependent child. Health Place 2022; 74:102768. [PMID: 35219047 DOI: 10.1016/j.healthplace.2022.102768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/18/2021] [Accepted: 02/11/2022] [Indexed: 11/16/2022]
Abstract
The study aimed to identify how medical technology impacts upon the home and life at home. Inductive auto-driven photo-elicitation or semi-structured interviews were conducted with technology-dependent children/young people (n = 2) and their family members (n = 15) from 10 families. Thematic analysis generated three themes: Altered physicality and look of the home; Altered sounds in the home; and 'It's worth it! Technology enables us to stay as a family'. Fundamentally, the detrimental impacts of living with medical technology were perceived as worth it as these enabled their child to be at home. Home was not home, and families were incomplete without their child at home.
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Affiliation(s)
- Tracy Karen Mitchell
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, UK.
| | - Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, Lancashire, UK
| | - Lucy Blake
- Department of Health and Social Sciences, University of the West of England (UWE), Bristol, UK
| | | | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, Lancashire, UK
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Murphy M, Hill K, Begley T, Brenner M, Doyle C. Respite Care for Children with Complex Care Needs: A Literature Review. Compr Child Adolesc Nurs 2021:1-10. [PMID: 33620262 DOI: 10.1080/24694193.2021.1885523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
Children with complex care needs form a diverse population with a variety of health and social care requisites in the presence of a range of complex symptoms and diagnoses. An exploratory literature review with a systematic search of the current qualitative literature was undertaken to explore parents' perceptions and evaluation of respite care services for children with complex needs. A systematic search was undertaken using a pre-defined search strategy in six databases; CINAHL, EMBASE, PsycINFO, Applied Social Sciences Index & abstracts and Web of Science. Studies were screened using inclusion criteria and eight studies were included in the review. These were analyzed using thematic analysis based on Braun and Clarke framework. Findings identified that there was a limited availability of respite care services for children with complex needs. Parents' perceived that respite was beneficial for themselves, their child and other siblings in the family. Barriers to accessing respite were also identified. It is recommended that respite services should be flexible and appropriate to the family's needs. A combination of in home and out of home services that are responsive to families' needs and are flexible would be optimal. Qualitative research is considered most suitable to obtain the views of parents of children with complex needs. Further research is recommended in this area, particularly in determining how services may improve and what the views of children using the respite services and their siblings are regarding respite.
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Affiliation(s)
- Maryanne Murphy
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Katie Hill
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Thelma Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Maria Brenner
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Carmel Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Rao SR, Gupta M, Salins N. The Concept of Respite in Palliative Care: Definitions and Discussions. Curr Oncol Rep 2021; 23:25. [PMID: 33559761 DOI: 10.1007/s11912-021-01015-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE OF THE REVIEW The definition of respite care remains unclear and its purpose and effectiveness are unproven till date. This paper reviews the current evidence regarding definition and efficacy of respite care, as well as the different programs, models, and interventions employed to deliver the same. RECENT FINDINGS A scoping search identified the relevant literature to be included in the review. The current evidence reiterates the lack of clarity in defining and delineating the purpose of respite care. Recent empirical evidence supports the effectiveness of respite care with clear benefits for the carers, patients, their families, and the healthcare system. Along with inpatient, home, and hospice care, respite care is considered as an essential component of palliative care. Evidence, although weak, supports the efficacy of respite care. High-quality studies with clear outlining of the scope of the services and resolution of ambiguities pertaining to its definition are warranted to fill the gaps in knowledge.
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Affiliation(s)
- Seema Rajesh Rao
- Department of Palliative Medicine and Supportive Care Kasturba Medical College and Hospital, Manipal Academy of Higher Education (MAHE), Tiger Circle Road, Madhav Nagar, Manipal, Udupi District, Karnataka, 576104, India. .,APHN Palliative Medicine Consultant for Lien Collaborative for Palliative Care, Singapore, Singapore. .,Honorary Tutor, School of Medicine, Cardiff University, Cardiff, UK.
| | - Mayank Gupta
- Department of Palliative Medicine and Supportive Care Kasturba Medical College and Hospital, Manipal Academy of Higher Education (MAHE), Tiger Circle Road, Madhav Nagar, Manipal, Udupi District, Karnataka, 576104, India
| | - Naveen Salins
- Department of Palliative Medicine and Supportive Care Kasturba Medical College and Hospital, Manipal Academy of Higher Education (MAHE), Tiger Circle Road, Madhav Nagar, Manipal, Udupi District, Karnataka, 576104, India.,Honorary Tutor, School of Medicine, Cardiff University, Cardiff, UK
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8
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Heggs K. Research roundup. Int J Palliat Nurs 2019; 25:255-257. [PMID: 31116659 DOI: 10.12968/ijpn.2019.25.5.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- Karen Heggs
- Lecturer in Adult Nursing Division of Nursing, Midwifery and Social Work, School of Health Sciences
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