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de Lange S, Heyns T, Filmalter C. A concept analysis of person-centred handover practices: The meaning in emergency departments. Int Emerg Nurs 2024; 74:101446. [PMID: 38677057 DOI: 10.1016/j.ienj.2024.101446] [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] [Received: 07/29/2023] [Revised: 02/22/2024] [Accepted: 03/23/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Transfer of patients from the prehospital to the in-hospital environment is a frequent occurrence requiring a handover process. Habitually, emergency care practitioners and healthcare professionals focus on patient care activities, not prioritising person-centred handover practices and not initiating person-centred care. AIM The aim of this concept analysis was to define the concept person centred handover practices. METHODS The eight steps for Walker and Avant's method of concept analysis. RESULTS Thirty-one articles were included for final review including qualitative and quantitative studies, literature reviews and audits. This concept analysis guided the development of an concept definition of person-centred handover practices between emergency care practitioners and healthcare professionals in the emergency department as person- centred handover practices are those handovers being performed while including all identified defining attributes such as structure, verbal, and written information transfer, interprofessional process, inclusion of the patient and/ or family, occurs at the bedside, without interruption. CONCLUSIONS Results suggested that person-centred handover practices involve verbal and non- verbal interprofessional communication within a specific location in the emergency department. It requires mutual respect from all professionals involved, experience and training, and the participation of the patient and / or family to improve patient outcomes and quality patient care. A definition for the concept may encourage the implementation of person-centred handover practices in emergency departments.
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Affiliation(s)
- Santel de Lange
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Private Bag x 323 Arcadia, Pretoria, 0007, South Africa.
| | - Tanya Heyns
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Private Bag x 323 Arcadia, Pretoria, 0007, South Africa.
| | - Celia Filmalter
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Private Bag x 323 Arcadia, Pretoria, 0007, South Africa.
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Peng Y, Wu H, Zhang M, Huang P. Family members' experiences of bereavement in the emergency department: A meta-synthesis of qualitative studies. DEATH STUDIES 2024:1-12. [PMID: 38459868 DOI: 10.1080/07481187.2024.2324907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
The emergency department (ED) is one of the places where patient deaths frequently occur. Understanding family members' experiences of bereavement would help provide individualized bereavement care. We conducted a meta-synthesis to synthesize family members' experiences of bereavement in the ED and assess the impact of bereavement on their lives. We searched seven international electronic databases. Five studies were selected and critically appraised. Thematic analysis was employed. Five themes (with 13 subthemes) were derived: suffering sudden changes and are severely impacted, multiple feelings and needs of waiting, final farewell, personal and family difficulties after leaving the ED, and journey through grief. Family members endured agonizing waits to see and learn more about their family members' condition. Family members reported the need for effective follow-up resources. Findings revealed that it would be helpful if the EDs could provide sensitive and respectful care to family members.
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Affiliation(s)
- Yingxin Peng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Haoming Wu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Min Zhang
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ping Huang
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
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Gustavsson K, van Diepen C, Fors A, Axelsson M, Bertilsson M, Hensing G. Healthcare professionals' experiences of job satisfaction when providing person-centred care: a systematic review of qualitative studies. BMJ Open 2023; 13:e071178. [PMID: 37295826 PMCID: PMC10277035 DOI: 10.1136/bmjopen-2022-071178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/15/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES This qualitative systematic review aimed to explore and synthesise healthcare professionals' (HCPs) experiences of job satisfaction when providing person-centred care (PCC) in healthcare settings in Europe. METHOD This systematic review of qualitative studies was followed by a thematic synthesis applying an inductive approach. Studies concerning HCPs and different levels of healthcare in Europe were eligible for inclusion. The CINAHL, PubMed and Scopus databases were searched. Study titles, abstracts and full texts were screened for relevance. Included studies were assessed for methodological quality using a quality appraisal checklist. Data were extracted and synthesised via thematic synthesis, generating analytical themes. RESULTS Seventeen studies were included in the final thematic synthesis, and eight analytical themes were derived. Most studies were conducted in Sweden and the UK and were performed in hospitals, nursing homes, elderly care and primary care. Thirteen of these studies were qualitative and four used a mixed-method design in which the qualitative part was used for analysis. HCPs experienced challenges adapting to a new remoulded professional role and felt torn and inadequate due to ambiguities between organisational structures, task-oriented care and PCC. Improved job satisfaction was experienced when providing PCC in line with ethical expectations, patients and colleagues expressed appreciation and team collaboration improved, while learning new skills generated motivation. CONCLUSION This systematic review found varied experiences among HCPs. Notably, the new professional role was experienced to entail disorientation and uncertainty; importantly, it also entailed experiences of job satisfaction such as meaningfulness, an improved relationship between HCPs and patients, appreciation and collaboration. To facilitate PCC implementation, healthcare organisations should focus on supporting HCPs through collaborational structures, and resources such as time, space and staffing. PROSPERO REGISTRATION NUMBER CRD42022304732.
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Affiliation(s)
| | - Cornelia van Diepen
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Andreas Fors
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Stewart-Lord A, Baillie L, Green L, Murphy F, Leary A. Implementation and perceived impact of the SWAN model of end-of-life and bereavement care: a realist evaluation. BMJ Open 2022; 12:e066832. [PMID: 36600439 PMCID: PMC9772680 DOI: 10.1136/bmjopen-2022-066832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To evaluate the End-of-Life and Bereavement Care model (SWAN) from conception to current use. DESIGN A realist evaluation was conducted to understand what works for whom and in what circumstances. The programme theory, derived from a scoping review, comprised: person and family centred care, institutional approaches and infrastructure. Data were collected across three stages (May 2021 to December 2021): semi-structured, online interviews and analysis of routinely collected local and national data. SETTING Stage 1: Greater Manchester area of England where the SWAN model was developed and implemented. Stage 2: Midlands. Stage 3: National data. PARTICIPANTS Twenty-three participants were interviewed: Trust SWAN leads, end-of-life care nurses, board members, bereavement services, faith leadership, quality improvement, medicine, nursing, patient transport, mortuary, police and coroners. RESULTS Results from all three stages were integrated within themes, linked to the mechanisms, context and outcomes for the SWAN model. The mechanisms are: SWAN is a values-based model, promoting person/family-centred care and emphasising personhood after death. Key features are: memory-making, normalisation of death and 'one chance' to get things right. SWAN is an enablement and empowerment model for all involved. The branding is recognisable and raises the profile of end-of-life and bereavement care. The contextual factors for successful implementation and sustainability include leadership, organisational support, teamwork and integrated working, education and engagement and investment in resources and facilities. The outcomes are perceived to be: a consistent approach to end-of-life and bereavement care; a person/family-centred approach to care; empowered and creative staff; an organisational culture that prioritises end-of-life and bereavement care. CONCLUSION The SWAN model is agile and has transferred to different settings and circumstances. This realist evaluation revealed the mechanisms of the SWAN model, the contextual factors supporting implementation and perceived outcomes for patients, families, staff and the organisation.
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Affiliation(s)
- Adele Stewart-Lord
- Institute of Health and Social Care, London South Bank University, London, UK
| | - Lesley Baillie
- Institute of Health and Social Care, London South Bank University, London, UK
| | - Laura Green
- School of Health Sciences, Divisionof Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Fiona Murphy
- Palliative /End of Life /Bereavement, Northern Care Alliance NHS Foundation Trust, Salford, UK
- Corporate Services, Liverpool Royal Foundation Trust, Liverpool, UK
| | - Alison Leary
- Institute of Health and Social Care, London South Bank University, London, UK
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Walsh A, Bodaghkhani E, Etchegary H, Alcock L, Patey C, Senior D, Asghari S. Patient-centered care in the emergency department: a systematic review and meta-ethnographic synthesis. Int J Emerg Med 2022; 15:36. [PMID: 35953783 PMCID: PMC9367087 DOI: 10.1186/s12245-022-00438-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-centered care (PCC) is an emerging priority in many healthcare settings but lacks clarity in the emergency department (ED). It is of interest to know what PCC practices are most important to patients to better their experience. The objective of this study was to conduct a mixed-methods systematic review of PCC in the ED. METHODS We used stakeholder and patient engagement to consult with clinicians, subject-matter experts, patient partners, and community organizations to determine patient needs. We examined all articles in the ED context with PCC as the intervention. Two independent reviewers screened 3136 articles and 13 were included. A meta-ethnographic analysis was conducted to determine common themes of PCC. RESULTS Themes included emotional support, communication, education, involvement of patient/family in information sharing and decision making, comfort of environment, respect and trust, continuity, and transition of care. Challenges in the ED reflected a lack of PCC. Moreover, implementation of PCC had many benefits including higher patient satisfaction with their care. Though there were commonalities of PCC components, there was no consistently used definition for PCC in the ED. CONCLUSION The findings of this review support the evidence that PCC is of high value to the ED setting and should be standardized in practice.
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Affiliation(s)
- Anna Walsh
- Centre for Rural Health Studies, Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, Newfoundland and Labrador, Canada
| | - Elnaz Bodaghkhani
- Emergency Medicine Department, The University of British Columbia, Vancouver, Canada
| | - Holly Etchegary
- Centre for Rural Health Studies, Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, Newfoundland and Labrador, Canada
| | - Lindsay Alcock
- Health Sciences Library, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, Newfoundland and Labrador, Canada
| | - Christopher Patey
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, Newfoundland and Labrador, Canada
| | - Dorothy Senior
- Community Scholar with Center for Rural Health Studies, Discipline of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Shabnam Asghari
- Centre for Rural Health Studies, Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, Newfoundland and Labrador, Canada.
- Department of Family Medicine, Centre for Rural Health Studies Faculty of Medicine, Memorial University of Newfoundland and Labrador Health Sciences Centre, 300 Prince Philip Drive, NL, A1B 3V6, St. John's, Canada.
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Green L, Stewart-Lord A, Baillie L. End-of-life and immediate postdeath acute hospital interventions: scoping review. BMJ Support Palliat Care 2022:bmjspcare-2021-003511. [PMID: 35896320 DOI: 10.1136/spcare-2021-003511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Hospital remains the most common place of death in the UK, but there are ongoing concerns about the quality of end-of-life care provision in this setting. Evaluation of interventions in the last days of life or after a bereavement is methodologically and ethically challenging. AIM The aim was to describe interventions at the very end of life and in the immediate bereavement period in acute hospitals, with a particular focus on how these are evaluated. METHOD A scoping review was conducted. Studies were restricted to peer-reviewed original research or literature reviews, published between 2011 and 2021, and written in the English language. Databases searched were CINAHL, Medline and Psychinfo. RESULTS From the search findings, 42 studies were reviewed, including quantitative (n=7), qualitative (n=14), mixed method (n=4) and literature reviews (n=17). Much of the current research about hospital-based bereavement care is derived from the intensive and critical care settings. Three themes were identified: (1) person-centred/family-centred care (memorialisation), (2) institutional approaches (quality of the environment, leadership, system-wide approaches and culture), (3) infrastructure and support systems (transdisciplinary working and staff support). There were limited studies on interventions to support staff. CONCLUSION Currently, there are few comprehensive tools for evaluating complex service interventions in a way that provides meaningful transferable data. Quantitative studies do not capture the complexity inherent in this form of care. Further qualitative studies would offer important insights into the interventions.
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Affiliation(s)
- Laura Green
- Faculty of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Adele Stewart-Lord
- Department of Allied Health Sciences, London South Bank University, London, UK
| | - Lesley Baillie
- Florence Nightingale Foundation Chair, London South Bank University, London, UK
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Emergency Room Nurses’ Experiences in Person-Centred Care. NURSING REPORTS 2022; 12:472-481. [PMID: 35894035 PMCID: PMC9326738 DOI: 10.3390/nursrep12030045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 11/17/2022] Open
Abstract
Implementing person-centred care is often considered difficult in congested emergency rooms. The purpose of this study was to understand person-centred care experienced by emergency room nurses in depth and examine the essence of emergency room nurses’ lived experience of the person- centred care. Eight nurses working in the emergency room of a large hospital in South Korea and who had over six months of experience were surveyed via semi-structured interviews in February 2019. The data were transcribed and analysed using Colaizzi’s framework. The major findings related to person-centred care experiences among emergency room nurses were: (1) feeling distanced from patients; (2) guilt and frustration; (3) accepting patients’ symptoms and emotions as they are; (4) person-centred care as a domain of nursing that cannot be replaced by machines; and (5) nursing as an art wherein the minutest details make a difference. Providing person-centred practice in the emergency room is difficult, but it will not only improve the quality of patient care but also increase the job satisfaction of nurses. Based on an in-depth understanding of person-centred care experienced by emergency nurses, it will contribute to enhancing the quality of nursing care in the emergency room.
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Boven C, Dillen L, Van den Block L, Piers R, Van Den Noortgate N, Van Humbeeck L. In-Hospital Bereavement Services as an Act of Care and a Challenge: An Integrative Review. J Pain Symptom Manage 2022; 63:e295-e316. [PMID: 34695567 DOI: 10.1016/j.jpainsymman.2021.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
CONTEXT Globally, people most often die within hospitals. As such, healthcare providers in hospitals are frequently confronted with dying persons and their bereaved relatives. OBJECTIVES To provide an overview of the current role hospitals take in providing bereavement care. Furthermore, we want to present an operational definition of bereavement care, the way it is currently implemented, relatives' satisfaction of receiving these services, and finally barriers and facilitators regarding the provision of bereavement care. METHODS An integrative review was conducted by searching four electronic databases, from January 2011 to December 2020, resulting in 47 studies. Different study designs were included and results were reported in accordance with the theoretical framework of Whittemore and Knafl (2005). RESULTS Only four articles defined bereavement care: two as services offered solely post loss and the other two as services offered pre and post loss. Although different bereavement services were delivered the time surrounding the death, the follow-up of bereaved relatives was less routinely offered. Relatives appreciated all bereavement services, which were rather informally and ad-hoc provided to them. Healthcare providers perceived bereavement care as important, but the provision was challenged by numerous factors (such as insufficient education and time). CONCLUSION Current in-hospital bereavement care can be seen as an act of care that is provided ad-hoc, resulting from the good-will of individual staff members. A tiered or stepped approach based on needs is preferred, as it allocates funds towards individuals-at-risk. Effective partnerships between hospitals and the community can be a useful, sustainable and cost-effective strategy.
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Affiliation(s)
- Charlotte Boven
- Department of Geriatric Medicine (C.B., R.P., N.V.D.N., L.V.H.), Ghent University Hospital, Ghent, Belgium.
| | - Let Dillen
- Department of Geriatric Medicine and Palliative Care Unit (L.D.), Ghent University Hospital, Ghent, Belgium
| | - Lieve Van den Block
- End-of-life Care Research Group (L.V.D.B.), Vrije Universiteit Brussel (VUB) & Ghent University, Brussels Health Campus (Building C), Laarbeeklaan 103, 1090 Brussels, Belgium & Campus Ghent University Hospital (Entrance 42 K3), Ghent, Belgium; Department of Family Medicine and Chronic Care (L.V.D.B.), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ruth Piers
- Department of Geriatric Medicine (C.B., R.P., N.V.D.N., L.V.H.), Ghent University Hospital, Ghent, Belgium
| | - Nele Van Den Noortgate
- Department of Geriatric Medicine (C.B., R.P., N.V.D.N., L.V.H.), Ghent University Hospital, Ghent, Belgium
| | - Liesbeth Van Humbeeck
- Department of Geriatric Medicine (C.B., R.P., N.V.D.N., L.V.H.), Ghent University Hospital, Ghent, Belgium
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9
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Erikson AE, Puntillo KA, McAdam JL. Bereavement Experiences of Families in the Cardiac Intensive Care Unit. Am J Crit Care 2022; 31:13-23. [PMID: 34972855 DOI: 10.4037/ajcc2022859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Losing a loved one in the intensive care unit is associated with complicated grief and increased psychologic distress for families. Providing bereavement support may help families during this time. However, little is known about the bereavement experiences of families of patients in the cardiac intensive care unit. OBJECTIVE To describe the bereavement experiences of families of patients in the cardiac intensive care unit. METHODS In this secondary analysis, an exploratory, descriptive design was used to understand the families' bereavement experiences. Families from 1 cardiac intensive care unit in a tertiary medical center in the western United States participated. Audiotaped telephone interviews were conducted by using a semistructured interview guide 13 to 15 months after the patient's death. A qualitative, descriptive technique was used for data analysis. Two independent researchers coded the interview transcripts and identified themes. RESULTS Twelve family members were interviewed. The majority were female (n = 8, 67%), spouses (n = 10, 83%), and White (n = 10, 83%); the mean age (SD) was 58.4 (16.7) years. Five main themes emerged: (1) families' bereavement work included both practical tasks and emotional processing; (2) families' bereavement experiences were individual; (3) these families were resilient and found their own resources and coping mechanisms; (4) the suddenness of a patient's death influenced families' bereavement experiences; and (5) families' experiences in the intensive care unit affected their bereavement. CONCLUSIONS This study provided insight into the bereavement experiences of families of patients in the cardiac intensive care unit. These findings may be useful for professionals working with bereaved families and for cardiac intensive care units considering adding bereavement support.
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Affiliation(s)
- Alyssa E. Erikson
- Alyssa E. Erikson is an associate professor, California State University, Monterey Bay, California
| | - Kathleen A. Puntillo
- Kathleen A. Puntillo is a professor emeritus, University of California, San Francisco, California
| | - Jennifer L. McAdam
- Jennifer L. McAdam is a professor, Samuel Merritt University, San Mateo, California
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Robinson J, Frey R, Raphael D, Old A, Gott M. Difficulties in navigating the intersection of generalist and specialist palliative care services: A cross-sectional study of bereaved family's experiences of care at home in New Zealand. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:133-141. [PMID: 33894085 DOI: 10.1111/hsc.13381] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
A generalist-specialist model of palliative care is well established as a framework for the provision of community care in resource-rich countries. However, evidence is lacking regarding how the model is experienced by family carers and the extent to which access to both generalist and specialist palliative care is equitable. A cross-sectional postal survey was undertaken to explore bereaved family's experiences of generalist palliative care and its intersection with hospice services in the last 3 months of life. A modified version of the Views of Informal Carers-Evaluation of Services survey was sent to 4,778 bereaved family. Data were collected between February 2017 and October 2018. Chi-square was utilised to identify factors that impacted on experiences of generalist palliative care; analysis of free text data comprising 45,823 words was undertaken using a directed content analysis approach. Eight hundred and twenty-six questionnaires were returned (response rate = 21%). Seventy per cent of people (n = 579) spent some time at home in the last 3 months prior to death. People who received support from hospice were more likely to receive support from multiple other services. Those who received no community services were less likely to feel supported by their general practitioner, less likely to spend the last 2 days of life or die at home. Feeling supported had a strong association with services working well together, being involved in decision-making and being aware of the poor prognosis. The provision of palliative care is complicated by a lack of integration with specialist palliative care and may be the basis of continuing inequities in the provision of community care at the end of life. The assumption at a policy level that "generalists" are willing and able to play a key role in palliative care provision needs to be further challenged.
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Affiliation(s)
- Jackie Robinson
- School of Nursing, University of Auckland, Auckland, New Zealand
- Auckland District Health Board, Auckland, New Zealand
| | - Rosemary Frey
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Deborah Raphael
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Andrew Old
- Waitemata District Health Board, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, University of Auckland, Auckland, New Zealand
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11
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Duque-Ortiz C, Arias-Valencia MM. The family in the intensive care unit in the face of a situational crisis. ENFERMERIA INTENSIVA 2022; 33:4-19. [PMID: 35168927 DOI: 10.1016/j.enfie.2021.02.001] [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] [Received: 01/15/2020] [Accepted: 02/10/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE to explore the experience of family members of a relative hospitalised in the Intensive Care Unit and recognise their emotions and needs and describe the phases or milestones they go through and the strategies they use to cope with the situations that arise. METHOD Qualitative study developed under the grounded theory method proposed by Anselm Strauss and Juliet Corbin. During the period from July 2017 to July 2019, semi-structured interviews were conducted with 26 relatives of hospitalised patients in fifteen third-level private clinics in the city of Manizales and Medellín, Colombia. In the latter, 200 h of participant observation were performed in ICUs of two private third-level clinics. The analysis procedure consisted of a microanalysis of the data and the process of open, axial, and selective coding of the information was continued. RESULTS We identified that the experience of relatives when they accompany their sick relative in the Intensive Care Unit is represented in two categories: family disorganisation which is characterised by generating a change and mismatch in family dynamics and, family reorganisation in which a restoration of order is sought to cope with the situation. CONCLUSIONS The family in the Intensive Care Unit develops a situational crisis characterised by intense, varied, and negative emotions and needs that wear down the relatives. Faced with this, family members undertake a reorganisation process to restore the order of family dynamics to cope with the situation and overcome difficulties.
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Affiliation(s)
- C Duque-Ortiz
- Universidad Pontificia Bolivariana, Medellín, Colombia.
| | - M M Arias-Valencia
- Grupo de Investigación Políticas y Servicios de Salud, Universidad de Antioquia, Medellín, Colombia
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12
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Wang CP, Hung FM, Ling MS, Chiu HY, Hu S. Factors associated with critical care nurses' acute stress disorder after patient death. Aust Crit Care 2021; 35:402-407. [PMID: 34419340 DOI: 10.1016/j.aucc.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In intensive care units, patient death can have a negative psychological influence on the patient's nurse. However, how the frequency of events and factors contributed to acute stress among nurses remains unknown. OBJECTIVE The objective of this study was to explore the prevalence of and the factors affecting acute stress disorder among intensive care unit nurses after their patient death. METHODS Nurses from five adult intensive care units whose patient had died during the nurses' working shift were recruited from July 2018 to April 2019. Bryant's Acute Stress Disorder Scale, the Beck Anxiety Inventory, and the Beck Depression Inventory-II were used to measure acute stress, depression, and anxiety. Descriptive statistics, chi-square tests, independent sample t-tests, and stepwise logistic regression were used for data analysis. RESULTS In total, 119 nurses were enrolled. Nearly one in three nurses (29.4%) had suffered from acute stress disorder after their patient had died. Nurses experienced a higher risk of acute stress disorder when their patients underwent cardiopulmonary resuscitation before death (odds ratio [OR] = 13.75, 95% confidence interval [CI]: 2.59-72.95), when their patients died unexpectedly (OR = 4.88, 95% CI: 1.16-20.56), and when they experienced verbal abuse from the patient family at the patient death (OR = 4.61, 95% CI: 1.18-18.05) compared with their counterparts. CONCLUSION Intensive care unit nurses often experience acute stress disorder after their patient death. The nurses of patients who underwent cardiopulmonary resuscitation before death and/or who died unexpectedly and/or nurses who were subjected to verbal abuse by the patient's family were at higher risk of acute stress disorder. A comprehensive program aimed at improving the knowledge, skills, and resilience of nurses is needed.
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Affiliation(s)
- Chao-Ping Wang
- Department of Nursing, Far Eastern Memorial Hospital, Taipei, Taiwan.
| | - Fang-Ming Hung
- Surgical Intensive Care Unit, Department Surgical Intensive Care Unit, Far Eastern Memorial Hospital, Taipei, Taiwan.
| | - Mao-Sheng Ling
- Surgical Intensive Care Unit, Department Surgical Intensive Care Unit, Far Eastern Memorial Hospital, Taipei, Taiwan.
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Sophia Hu
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Emotional and cognitive barriers of bereavement care among clinical staff in hospice palliative care. Palliat Support Care 2021; 18:676-682. [PMID: 32295666 DOI: 10.1017/s147895152000022x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Bereavement care is one of the major components of hospice palliative care. Previous studies revealed the barriers to the success of the system, including lack of time or support from mental health professionals. Few studies have explored the intrapersonal barriers to bereavement care by clinical staff. The aims of the study were to explore (1) the emotional and cognitive barriers of bereavement care by hospice palliative care staff and (2) the demographic and work characteristics related to these emotional and cognitive barriers. METHOD The participants were clinical staff (n = 301) who were working in hospice palliative care units, including hospice wards, home care, and hospital-based palliative care teams. Their professional backgrounds included physicians (n = 12), nurses (n = 172), social workers (n = 59), psychologists (n = 34), spiritual care specialists (n = 15), and others (n = 9). A cross-sectional design was used and a standardized questionnaire including emotional and cognitive barriers was developed. Information on demographic and work characteristics was also collected. Content validity index, an exploratory factor analysis, and multiple regression analysis were conducted. RESULTS One emotional barrier, "negative emotional reactions" (13 items, Cronbach's α = 0.92), and three cognitive barriers, "lack of ability" (7 items, Cronbach's α = 0.85), "belief in avoidance" (5 items, Cronbach's α = 0.86), and "outcome expectancy" (4 items, Cronbach's α = 0.85) were identified. Clinical staff who had higher working stress, lower self-rated ability for bereavement care, and higher negative impact from major life loss tended to have higher emotional and cognitive barriers. SIGNIFICANCE OF RESULTS Clinical staff should be aware of intrapersonal barriers to bereavement care. Educational programs should be developed to improve the ability to engage in bereavement care.
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Fan SY, Lin WC. An educational bereavement program to decrease clinical staff's barriers and improve self-efficacy of providing bereavement care. Support Care Cancer 2021; 30:835-841. [PMID: 34390399 DOI: 10.1007/s00520-021-06497-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Clinicians face personal barriers that impede the provision of bereavement care and require education in hospice care. This study aims to investigate the effects of an educational bereavement program on emotional and cognitive barriers, self-efficacy, and professional quality of life among clinicians in hospice care. METHODS A pretest-posttest design was implemented. A total of 194 clinicians with working experience in hospice care were recruited. The participants underwent a 12-h workshop. The content included lectures, role-play, and group discussion. Emotional and cognitive barriers, self-efficacy, and professional quality of life were measured before and after the program and at 3-month follow-up. RESULTS After the educational program, negative emotional barriers (F (2, 386) = 17.07, p < 0.001), lack of ability (F (2, 386) = 20.11, p < 0.001), belief in avoidance (F (2, 386) = 7.10, p = 0.001), outcome expectancy (F (2, 386) = 11.32, p < 0.001), and burnout (F (2, 386) = 5.59, p = 0.005) decreased significantly. Self-efficacy (F (2, 386) = 5.37, p = 0.006) and compassion satisfaction (F (2, 386) = 127.99, p < 0.001) increased significantly. CONCLUSION The educational program addressed personal barriers to bereavement care. Role-play and group discussion about emotional and cognitive barriers can reduce barriers and improve self-efficacy in clinicians in hospice care.
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Affiliation(s)
- Sheng-Yu Fan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan City, 701, Taiwan.
| | - Wei-Chun Lin
- Department of Hematology and Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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Walker W, Efstathiou N. Support after patient death in the intensive care unit: Why 'I' is an important letter in grief. Nurs Crit Care 2021; 25:266-268. [PMID: 32815295 DOI: 10.1111/nicc.12534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Wendy Walker
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
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Al-Shamaly HS. A focused ethnography of the culture of inclusive caring practice in the intensive care unit. Nurs Open 2021; 8:2973-2985. [PMID: 34318598 PMCID: PMC8510735 DOI: 10.1002/nop2.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/05/2021] [Accepted: 07/10/2021] [Indexed: 11/16/2022] Open
Abstract
Aim To explore and understand the culture of nurses' multidimensional “caring‐for” practice in intensive care unit (ICU). Design A focused ethnography. Methods Data were collected from 35 Registered Nurses through participant observations, field notes, documentation reviews, interviews, informal conversations and Participants' additional information forms over 6 months in one ICU. Thematic data analysis was used. Findings Different dimensions of nursing caring in ICU were found. The inclusivity of a culture of nurses' “caring‐for” involved the following: oneself, patients and their families, different colleagues, and caring as ecological consciousness in the ICU environment and organization.
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Duque-Ortiz C, Arias-Valencia MM. The family in the intensive care unit in the face of a situational crisis. ENFERMERIA INTENSIVA 2021; 33:S1130-2399(21)00058-4. [PMID: 34090762 DOI: 10.1016/j.enfi.2021.02.003] [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: 01/15/2020] [Revised: 11/24/2020] [Accepted: 02/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore the experience of family members of a relative hospitalized in the intensive care unit and recognize their emotions and needs and describe the phases or milestones they go through and the strategies they use to cope with the situations that arise. METHOD Qualitative study developed under the grounded theory method proposed by Anselm Strauss and Juliet Corbin. During the period from July 2017 to July 2019, semi-structured interviews were conducted with 26 relatives of hospitalized patients in fifteen third-level private clinics in the city of Manizales and Medellín, Colombia. In the latter, 200 hours of participant observation were performed in ICUs of two private third-level clinics. The analysis procedure consisted of a microanalysis of the data and the process of open, axial, and selective coding of the information was continued. RESULTS We identified that the experience of relatives when they accompany their sick relative in the intensive care unit is represented in two categories: family disorganization which is characterized by generating a change and mismatch in family dynamics and, family reorganization in which a restoration of order is sought to cope with the situation. CONCLUSIONS The family in the intensive care unit develops a situational crisis characterized by intense, varied, and negative emotions and needs that wear down the relatives. Faced with this, family members undertake a reorganization process to restore the order of family dynamics to cope with the situation and overcome difficulties.
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Affiliation(s)
- C Duque-Ortiz
- Universidad Pontificia Bolivariana, Medellín, Colombia.
| | - M M Arias-Valencia
- Grupo de Investigación Políticas y Servicios de Salud, Universidad de Antioquia, Medellín, Colombia
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Xu T, Wang Y, Wang R, Lamb KV, Ren D, Dai G, Wang L, Yue P. Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study. Scand J Caring Sci 2020; 35:1226-1239. [PMID: 33615516 DOI: 10.1111/scs.12941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients. AIM To describe the caring ability of nurses and its potential predictors in China. METHODS From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted. RESULTS Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho' norm, an international scoring standard of nurse's caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance. CONCLUSIONS Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.
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Affiliation(s)
- Tianmeng Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Yongli Wang
- Yuetan Community Health Service Center, Fuxing Hospital of Capital Medical University, Beijing, China
| | - Rongjin Wang
- School of Nursing, Capital Medical University, Beijing, China
| | - Karen V Lamb
- College of Nursing, Rush University, Chicago, IL, USA
| | - Dianxu Ren
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Guizhi Dai
- Community Health Care Service Center of Dongcheng District, Beijing, China
| | - Li Wang
- Fangzhuang Community Health Care Service Center of Fengtai District, Beijing, China
| | - Peng Yue
- School of Nursing, Capital Medical University, Beijing, China
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20
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Eltaybani S, Igarashi A, Yamamoto-Mitani N. Assessing the Palliative and End-of-Life Care Education-Practice-Competence Triad in Intensive Care Units: Content Validity, Feasibility, and Reliability of a New Tool. J Palliat Care 2020; 36:234-242. [PMID: 32779529 DOI: 10.1177/0825859720948972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To date, a comprehensive, psychometrically robust instrument to assess palliative and end-of-life (PEOL) care education, practice, and perceived competence among intensive care unit (ICU) nurses does not exist. OBJECTIVE To examine content validity and reliability of a proposed instrument to assess the PEOL care education-practice- competence triad among ICU nurses. METHODS An international modified e-Delphi and a cross-sectional pilot questionnaire survey. The Delphi involved 23 panelists from 11 countries. The pilot study involved 40 staff nurses and 3 nurse managers from 3 adult ICUs in a randomly selected hospital in Egypt. An instrument was developed and judged for content validity by international panelists, and then pretested in a pilot study, where data were collected at 2 time points using self-administered questionnaires, followed by cognitive interviews. Test-retest reliability was examined using intraclass correlation (ICC), standard error of measurement (SEM), and repeatability coefficient (RC). RESULTS The panelists confirmed content validity of the proposed instrument, and staff nurses confirmed its comprehensibility. At the level of the instrument's total scores, the lowest ICC was .9 (95% confidence interval: .8-.9); and the highest SEM and RC were 4.8 and 13.3, respectively. CONCLUSIONS The PEOL Care Index is a comprehensive, comprehensible, content valid, and reliable instrument to assess the PEOL care education-practice-competence triad among ICU nurses. Construct and criterion validities need to be confirmed in future studies. Applicability of the PEOL Care Index in different settings and cultures needs to be examined.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-Term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan.,Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria Governorate, Egypt
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-Term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-Term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
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Carlsson N, Bremer A, Alvariza A, Årestedt K, Axelsson L. Losing a close person following death by sudden cardiac arrest: Bereaved family members' lived experiences. DEATH STUDIES 2020; 46:1139-1148. [PMID: 32755272 DOI: 10.1080/07481187.2020.1799453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The death of a close person has profound impact on people's lives, and when death is sudden there are no possibilities to prepare for the loss. The study aimed to illuminate meanings of losing a close person following sudden cardiac arrest. A qualitative interpretive design was used, and twelve bereaved family members were interviewed. The results show a transition from pending between life and sudden loss during resuscitation and proceeding with life after the sudden loss. These results of being in liminality illuminate the family members' essential narration and the importance of compassionate care throughout this challenging transition.
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Affiliation(s)
- Nina Carlsson
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | - Anders Bremer
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | - Anette Alvariza
- Department of Health Care Sciences/Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Capio Geriatrics, Palliative Care Unit, Dalen Hospital, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
- The Research Section, Region Kalmar County, Kalmar, Sweden
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Erikson A, McAdam J. Bereavement Care in the Adult Intensive Care Unit. Crit Care Nurs Clin North Am 2020; 32:281-294. [DOI: 10.1016/j.cnc.2020.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Duque-Ortiz C, Arias-Valencia MM. Nurse-family relationship. Beyond the opening of doors and schedules. ENFERMERIA INTENSIVA 2020; 31:192-202. [PMID: 32276810 DOI: 10.1016/j.enfi.2019.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/16/2019] [Accepted: 09/25/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Care in the Intensive Care Unit involves contemplating, among other dimensions of the patient, the family. For this, it is necessary for the nurse to establish relationships with the patient's relatives. OBJECTIVE To identify the way in which the nurse-family relationship is established in the adult ICU, as well as the conditions, elements and factors that favour or hinder it. METHOD Integrative narrative review of the scientific literature. The databases consulted were Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Scholar and Scielo. Articles in English and Spanish published between 2014 and 2018 were searched. The descriptors and formulas used were selected according to the acronym Population and their problems, Exposure and Outcomes or themes- PEO. The population comprised ICU nurses and the relatives of patients in critical condition; Adult Intensive Care Unit exposure or context; the expected results, and how they are related. For the methodological evaluation, the STROBE guide was used for observational articles, PRISMA for review articles, COREQ for qualitative articles and CASPe for articles derived from projects. RESULTS We identified 214 articles, of which 63 were selected to be included in the review. The central themes identified were: the ICU environment and its effects on the family, empathy as an indicator of relationship, interaction as a means of relating, communication as the centre of relationships and barriers to the establishment of relationships. CONCLUSIONS The nurse-family relationship in the Intensive Care Unit is based on interaction and communication amidst human, physical, regulatory and administrative barriers. Improving the nurse-family relationship contributes to the humanization of Adult Intensive Care Units.
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Affiliation(s)
- C Duque-Ortiz
- Universidad Pontificia Bolivariana, Medellín, Colombia.
| | - M M Arias-Valencia
- Grupo de Investigación en Políticas y Servicios de Salud, Universidad de Antioquia, Medellín, Colombia
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Zhang H, Hu M, Zeng L, Ma M, Li L. Impact of death education courses on emergency nurses' perception of effective behavioral responses in dealing with sudden death in China: A quasi-experimental study. NURSE EDUCATION TODAY 2020; 85:104264. [PMID: 31759242 DOI: 10.1016/j.nedt.2019.104264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/29/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Nurses in emergency departments have to provide rescue care and life support for moribund patients, but also emotional support to patients' relatives. On the other hand, emergency nurses are also the most vulnerable to the sudden death of patients. Nurses working in the emergency department were invited to participate in a death education course. OBJECTIVE To explore the impact of a death education course on the emergency nurses' perception of effective behavioral responses in dealing with sudden death. DESIGN A quasi-experimental study. SETTINGS A level A tertiary general hospital in China. PARTICIPANTS A total number of 34 emergency nurses who met the inclusion criteria were randomly selected from the emergency department. METHODS Participants received a death education course of 20 credit hours based on dealing with a sudden-death model. The general data questionnaire and the Chinese version of the list proposed by Fraser & Atkins were completed before the intervention and six weeks post-intervention. The scores of each item in the effective behavioral response to the sudden death questionnaire of the emergency nurses before and after the intervention were compared. RESULTS After the intervention, the nurses considered that 10 items were relatively helpful (above 4 points) and 2 items relatively less helpful (<3 points). The post-intervention average scores of all items were higher than the pre-intervention ones, and there were significant differences in the scores of the 13 items pre- and post-intervention. CONCLUSION The death education course enhanced emergency nurses' perceptions of effective behavioral responses in dealing with sudden death, which contributes to the improvement of the quality of their work.
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Affiliation(s)
- Huilin Zhang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Muli Hu
- Department of Scientific Research, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liyun Zeng
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingdan Ma
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lezhi Li
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Goode D, Black P, Lynch J. Person-centred end-of-life curriculum design in adult pre-registration undergraduate nurse education: A three-year longitudinal evaluation study. NURSE EDUCATION TODAY 2019; 82:8-14. [PMID: 31408835 DOI: 10.1016/j.nedt.2019.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/30/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The need to provide quality end-of-life care is universally accepted. International research and policies encourage innovative ways that effective culturally appropriate care can be provided. Higher education institutions and practice settings are tasked with ensuring that nurse graduates have the knowledge, skills and insight to deliver person-centred end-of-life care. RESEARCH AIMS AND OBJECTIVES The aim was to explore student evaluation of end-of-life care learning within a three-year undergraduate adult nursing degree programme. Objectives were to assess student perceptions of the content and level of learning achieved, explore usefulness of learning, highlight areas that were most useful, and identify suggestions to improve learning. DESIGN A 3-year quantitative longitudinal design was used. A questionnaire containing open and closed questions was designed to incorporate the personal and professional learning strategies indicated by the Nursing and Midwifery Council (NMC) (2010). SETTING AND PARTICIPANTS The evaluation was completed at the same time point over a three-year period from April 2015-April 2017. The participants were year three student nurses, from 3 consecutive years, enrolled on a pre-registration adult nursing course at one university. There was a 66% response rate (n = 336). METHODS Participant information sheets and questionnaires were distributed and time to complete them facilitated. Responses from closed questions were coded and analysed using descriptive statistics (SPSS 24) and thematic analysis used for open questions. RESULTS Students expressed satisfaction with their learning, 88.7-97% of students reported a positive impact on their knowledge. They developed an understanding of the impact the nurse can have on the patient and family experience, reporting more confidence and competence in most aspects of end-of-life care. They noted improved ability to utilise this in their subsequent practice experience 88.1-97%. CONCLUSIONS Structured end-of-life care within the curriculum is essential to equip graduate nurses to provide effective evidence informed care. Planning should continue for curriculum development that encompasses person-centred end-of-life care across cultures.
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Affiliation(s)
- Debbie Goode
- Ulster University, Northland Road, L/Derry, BT487JL.
| | - Pauline Black
- Ulster University, Magee Campus, Northland Road, Derry, Co Londonderry. BT48 7JL
| | - Jacinta Lynch
- Ulster University, Magee Campus, Northland Road, Derry, Co Londonderry. BT48 7JL
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Fridh I, Åkerman E. Family‐centred end‐of‐life care and bereavement services in Swedish intensive care units: A cross‐sectional study. Nurs Crit Care 2019; 25:291-298. [DOI: 10.1111/nicc.12480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Isabell Fridh
- Faculty of Caring Science, Work Life and Social WelfareUniversity of Borås Borås Sweden
- Department of Anesthesiology and Intensive CareSahlgrenska University Hospital Gothenburg Sweden
| | - Eva Åkerman
- Intensive Care Unit, Department of Perioperative Medicine and Intensive CareKarolinska University Hospital Stockholm Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet Stockholm Sweden
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Affiliation(s)
- Wendy Walker
- Reader in Acute and Critical Care Nursing, Institute of Health, University of Wolverhampton, UK. Editorial Intern, Nursing in Critical Care
| | - Josef Trapani
- Lecturer in Nursing, Faculty of Health Sciences, University of Malta. Editorial Intern, Nursing in Critical Care
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Lederman Z. Family for Life and Death: Family Presence during Resuscitation. INTERNATIONAL JOURNAL OF FEMINIST APPROACHES TO BIOETHICS 2019. [DOI: 10.3138/ijfab.12.2.09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The dilemma of whether to allow relatives to see or even touch their loved one while she undergoes cardiopulmonary resuscitation (CPR) has been discussed for roughly four decades. However, Family Presence During Adult Resuscitation (FPDR) is still not widely implemented. In this paper, I espouse relational autonomy to make a case for a clinical approach of family-centered care and FPDR. In recent years, family-centered care (FCC) has gained increasing support. I argue that relational autonomy provides a conceptual framework for both FCC and FPDR. In turn, FCC provides a plausible clinical approach to justify FPDR, while the empirical evidence that supports FPDR provides a useful example to justify FCC.
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The state of bereavement support in adult intensive care: A systematic review and narrative synthesis. J Crit Care 2019; 50:177-187. [DOI: 10.1016/j.jcrc.2018.11.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/12/2018] [Accepted: 11/21/2018] [Indexed: 11/21/2022]
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Jang K, Choe K. Bereavement experiences after the unexpected death of an older family member in the emergency department. Int Emerg Nurs 2018; 42:7-11. [PMID: 30392923 DOI: 10.1016/j.ienj.2018.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 10/05/2018] [Accepted: 10/21/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Kyeongmin Jang
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea
| | - Kwisoon Choe
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea.
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Donnelly S, Prizeman G, Coimín DÓ, Korn B, Hynes G. Voices that matter: end-of-life care in two acute hospitals from the perspective of bereaved relatives. BMC Palliat Care 2018; 17:117. [PMID: 30340568 PMCID: PMC6195738 DOI: 10.1186/s12904-018-0365-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/20/2018] [Indexed: 11/16/2022] Open
Abstract
Background End-of-life care (EoLC) is an experience that touches the lives of everyone. Dying in an acute hospital is a common occurrence in developed countries across the world. Previous studies have shown that there is wide variation in EoLC and at times is experienced as being of poor quality. Assessing and measuring the quality of care provided is a key component of all healthcare systems. This paper reports on the qualitative analysis of open-ended free text questions that were asked as part of a post-bereavement survey conducted in two adult acute hospitals in Ireland. Methods This was a quantitative descriptive post-bereavement postal survey, gathering data retrospectively from relatives or friends of patients who died, utilising an adapted version of the VOICES (Views of Informal Carers - Evaluation of Services) questionnaire. VOICES MaJam has 29 core questions, seven questions requesting personal demographic information and four open-ended questions gathering descriptive data about the care experience during the patient’s last admission to hospital. A total of 356 valid questionnaires were returned. Qualitative data were managed, coded and analysed with NVivo 10, using a template analysis framework approach. Results Three quarters (75%: n = 268) responded to at least one of the open-ended questions. Several key themes emerged, indicating areas that require particular attention in EoLC. Two themes relate to how care needs are met and how the hospital environment has a critical influence on EoLC experiences. The remaining three themes relate more to the interpersonal context including whether patients are treated with dignity and respect, the psychological, emotional and spiritual needs of patients and their family members and communication. Conclusions Acute hospitals need to ensure that patients and their relatives receive high quality EoLC. Seeking the views of bereaved relatives should be considered by all hospitals and healthcare settings to ascertain the quality of care at end of life. This study contributes to our understanding and knowledge of what good EoLC looks like and where care can be improved, thus enabling hospitals to direct and inform quality improvement.
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Affiliation(s)
- Sarah Donnelly
- School of Social Policy, Social Work and Social Justice, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Geraldine Prizeman
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland
| | - Diarmuid Ó Coimín
- Mater Misericordiae University Hospital, Quality and Patient Safety Directorate, Eccles Street, Dublin 7, Ireland
| | - Bettina Korn
- 1st Floor CEO Building, St. James's Hospital, James Street, Dublin 8, Ireland
| | - Geralyn Hynes
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland
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Hunter D, McCallum J, Howes D. Compassion in emergency departments. Part 3: enabling and supporting delivery of compassionate care. Emerg Nurse 2018; 26:28-31. [PMID: 30299006 DOI: 10.7748/en.2018.e1776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/09/2022]
Abstract
In the final part of this three-part series, David Hunter and colleagues analyse the factors that enable and support delivery of compassionate care in emergency departments (EDs). Part one reported findings from doctoral-level research that explored nursing students' experiences of compassionate care in EDs, while part two considered the barriers to such care identified by the students. This article highlights and celebrates the ways in which emergency nurses provide compassionate care despite the challenges they face.
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Affiliation(s)
- David Hunter
- Adult health, University of the West of Scotland, Renfrewshire, Scotland
| | | | - Dora Howes
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
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Raymond A, Lee SF, Bloomer MJ. Understanding the bereavement care roles of nurses within acute care: a systematic review. J Clin Nurs 2017; 26:1787-1800. [DOI: 10.1111/jocn.13503] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Anita Raymond
- School of Nursing and Midwifery; Monash University; Frankston Australia
- Federation University Australia; Churchill Australia
| | - Susan F Lee
- School of Nursing and Midwifery; Monash University; Frankston Australia
| | - Melissa J Bloomer
- School of Nursing and Midwifery; Deakin University and Centre for Quality and Patient Safety Research; Geelong Australia
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Zhao J, Gao S, Wang J, Liu X, Hao Y. Differentiation between two healthcare concepts: Person-centered and patient-centered care. Int J Nurs Sci 2016. [DOI: 10.1016/j.ijnss.2016.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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