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Chatchumni M, Eriksson H, Mazaheri M. Core components of an effective pain management education programme for surgical nurses: A Delphi study*. Int J Qual Stud Health Well-being 2022; 17:2110672. [PMID: 35976037 PMCID: PMC9387314 DOI: 10.1080/17482631.2022.2110672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The critical reason for this study is the inadequate training received by surgical nurses in acute and chronic pain management nursing services for patients.
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Affiliation(s)
- Manaporn Chatchumni
- School of Nursing, Rangsit University, Pathumthani, Thailand
- Department of Health Sciences, The Swedish Red Cross University, Stockholm, Sweden
| | - Henrik Eriksson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Monir Mazaheri
- Department of Health Sciences, The Swedish Red Cross University, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Böling S, Berlin JM, Berglund H, Öhlén J. No ordinary consultation - a qualitative inquiry of hospital palliative care consultation services. J Health Organ Manag 2020; ahead-of-print. [PMID: 32744038 DOI: 10.1108/jhom-04-2020-0130] [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: 11/17/2022]
Abstract
PURPOSE Considering the great need for palliative care in hospitals, it is essential for hospital staff to have palliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care. However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need for further knowledge about the process of palliative consultations. The purpose of this study therefore was to examine how palliative consultations in hospitals are practised, as perceived by consultants and health care professionals on receiving wards. DESIGN/METHODOLOGY/APPROACH Focus groups with palliative care consultation services, health care personnel from receiving wards and managers of consultation services. Interpretive description and constant comparative method guided the analysis. FINDINGS Variations were seen in several aspects of practice, including approach to practice and represented professions. The palliative consultants were perceived to contribute by creating space for palliative care, adding palliative knowledge and approach, enhancing cooperation and creating opportunity to ameliorate transition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultation services utilised proactive practices that took the initiative in relation to the receiving wards. ORIGINALITY/VALUE A lack of policy and divergent views on how to conceptualise palliative care appeared to be associated with variations in consultation practices, tentative approaches and a bottom-up driven development. This study adds knowledge, implying theoretical transferability as to how palliative care consultations can be practised, which is useful when designing and starting new consultation services.
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Affiliation(s)
- Susanna Böling
- The Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan M Berlin
- Department of Social and Behavioural Studies, University West, Trollhättan, Sweden
| | - Helene Berglund
- The Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joakim Öhlén
- The Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
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Anxiety, depression and psychosocial needs are the most frequent concerns reported by patients: preliminary results of a comparative explorative analysis of two hospital-based palliative care teams in Germany and Japan. J Neural Transm (Vienna) 2020; 127:1481-1489. [PMID: 32419058 PMCID: PMC7578135 DOI: 10.1007/s00702-020-02186-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022]
Abstract
In the partnership between the medical departments of Würzburg University, Germany, and Nagasaki University, Japan, palliative care is a relevant topic. The aim of the study was to perform a comparative analysis of the hospital-based palliative care teams in Würzburg (PCT-W) and Nagasaki (PCT-N). Survey of staff composition and retrospective analysis of PCT patient charts in both PCTs were conducted. Patients self-assessed their symptoms in PCT-W and in Radiation Oncology Würzburg (RO-W). The (negative) quality indicator ‘percentage of deceased hospitalised patients with PCT contact for less than 3 days before death’ (Earle in Int J Qual Health Care 17(6):505–509, 2005) was analysed. Both PCTs follow a multidisciplinary team approach. PCT-N saw 410 cancer patients versus 853 patients for PCT-W (22.8% non-cancer patients). The Eastern Cooperative Oncology Group Performance Status at first contact with PCT-N was 3 or 4 in 39.3% of patients versus 79.0% for PCT-W. PCT-N was engaged in co-management longer than PCT-W (mean 20.7 days, range 1–102 versus mean 4.9 days, range 1–48). The most frequent patient-reported psychological symptom was anxiety (family anxiety: 98.3% PCT-W and 88.7% RO-W, anxiety 97.9% PCT-W and 85.9% RO-W), followed by depression (98.2% PCT-W and 80.3% RO-W). In 14 of the 148 deceased patients, PCT-N contact was initiated less than 3 days before death (9.4%) versus 121 of the 729 deceased PCT-W patients (16.6%). Psychological needs are highly relevant in both Germany and Japan, with more than 85% anxiety and depression in patients in the Japanese IPOS validation study (Sakurai in Jpn J Clin Oncol 49(3):257–262, 2019). This should be taken into account when implementing PCTs.
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Hamano J, Haruta J, Ishimaru N, Otsuka T, Den N, Sakato K, Kimura T, Yamamoto R. A comprehensive view to reflection on the palliative care approach for family medicine residents: A modified Delphi method. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1704137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Jun Hamano
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Junji Haruta
- Department of General Medicine and Primary Care, University of Tsukuba Hospital, Tsukuba, Japan
| | - Naoto Ishimaru
- Department of General Internal Medicine, Akashi Medical Center, Akashi, Japan
| | | | - Naoko Den
- Tokyo Hokuto Medical cooperative association Oji co-op hospital, Japan
| | | | - Takuma Kimura
- Department of Community Medicine, Kitasato University School of Medicine, Japan
| | - Ryo Yamamoto
- Department of Palliative Medicine, Saku Central Hospital Advanced Care Center, Japan
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Sakashita A, Kizawa Y, Kato M, Akizuki N, Nakazawa Y, Kaizu M, Yano K, Sato T, Tokoro A. Development of a Standard for Hospital-Based Palliative Care Consultation Teams in Japan Using a Modified Delphi Method. J Pain Symptom Manage 2018; 56:746-751.e5. [PMID: 30145212 DOI: 10.1016/j.jpainsymman.2018.08.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 11/27/2022]
Abstract
CONTEXT Hospital-based palliative care consultation teams (PCCTs) are rapidly being disseminated throughout Japan. The roles of PCCTs have changed during the past decade, particularly with the introduction of a modified national cancer care act to promote early palliative care and integrated oncology and palliative care. OBJECTIVES This study aimed to develop a consultation team standard for hospital-based palliative care in Japan. METHODS We developed a provisional standard based on literature review and used a modified questionnaire-based Delphi method. Our Delphi panel comprises 20 experts selected from all relevant disciplines. RESULTS All experts selected responded to the surveys over all rounds, and 14 of the 20 participated in the panel meeting. In the first round, 79 of 109 statements were judged to be appropriate, and 30 of 109 statements led to disagreements. About 16 of those 30 statements underwent minor revision, 1 was divided into two statements, and 13 remained unchanged. We then added six statements based on a discussion among participants and authors. In addition, based on comments from an external reviewer, we revised the standard, resulting in four statements being combined into two for a new total of 114 statements. In the second round, 108 of 114 statements were judged to be appropriate, and in the third round, none of the six controversial statements were judged to be appropriate. The final version comprises 108 statements. CONCLUSION We developed a standard for PCCTs in Japanese cancer hospitals. This standard provides a useful guide for clinical activities and a tool to evaluate quality of palliative care.
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Affiliation(s)
- Akihiro Sakashita
- Department of Palliative Medicine, Kobe University School of Medicine, Chuo-ku, Kobe, Hyogo, Japan.
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University School of Medicine, Chuo-ku, Kobe, Hyogo, Japan
| | - Masashi Kato
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Nobuya Akizuki
- Psycho-Oncology Division, Chiba Cancer Center, Chiba, Japan
| | - Yoko Nakazawa
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Mikiko Kaizu
- Graduate School of Health Management, Doctoral Program, Keio University, Tokyo, Japan
| | | | - Tetsumi Sato
- Division of Palliative Medicine, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine and Supportive and Palliative Care Team, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
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Jünger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med 2017; 31:684-706. [PMID: 28190381 DOI: 10.1177/0269216317690685] [Citation(s) in RCA: 746] [Impact Index Per Article: 106.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. AIM To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. DESIGN A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE. DATA SOURCES Original articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting. RESULTS A total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'. CONCLUSION Substantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.
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Affiliation(s)
- Saskia Jünger
- 1 Institute of General Practice, Hannover Medical School, Hannover, Germany
- 6 Research Unit Ethics, University Hospital Cologne, 50923 Cologne, Germany
| | - Sheila A Payne
- 2 International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Jenny Brine
- 3 Lancaster University Library, Academic Services, Lancaster University, Lancaster, UK
| | - Lukas Radbruch
- 4 Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Germany
- 5 Zentrum für Palliativmedizin, Malteser Krankenhaus Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Germany
| | - Sarah G Brearley
- 2 International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
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Berendt J, Stiel S, Simon ST, Schmitz A, van Oorschot B, Stachura P, Ostgathe C. Integrating Palliative Care Into Comprehensive Cancer Centers: Consensus-Based Development of Best Practice Recommendations. Oncologist 2016; 21:1241-1249. [PMID: 27440065 DOI: 10.1634/theoncologist.2016-0063] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/17/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND International associations admit that specialized palliative care (SPC) is an obvious component of excellent cancer care. Nevertheless, gaps in integration at the international level have been identified. Recommendations for integrating SPC in clinical care, research, and education are needed, which are subject of the present study. MATERIALS AND METHODS A Delphi study, with three written Delphi rounds, including a face-to-face-meeting with a multiprofessional expert panel (n = 52) working in SPC in 15 German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid was initiated. Initial recommendations are built on evidence-based literature. Consensus was defined in advance with ≥80% agreement based on the question of whether each recommendation was unambiguously formulated, relevant, and realizable for a CCC. RESULTS A total of 38 experts (73.1%) from 15 CCCs performed all three Delphi rounds. Consensus was achieved for 29 of 30 recommendations. High agreement related to having an organizationally and spatially independent palliative care unit (≥6 beds), a mobile multiprofessional SPC team, and cooperation with community-based SPC. Until round 3, an ongoing discussion was registered on hospice volunteers, a chair of palliative care, education in SPC among staff in emergency departments, and integration of SPC in decision-making processes such as tumor boards or consultation hours. Integration of SPC in decision-making processes was not consented by a low-rated feasibility (76.3%) due to staff shortage. CONCLUSION Recommendations should be considered when developing standards for cancer center of excellence in Germany. Definition and implementation of indicators of integration of SPC in CCCs and evaluation of its effectiveness are current and future challenges. IMPLICATIONS FOR PRACTICE General and specialized palliative care (SPC) is an integral part of comprehensive cancer care. However, significant diversity concerning the design of SPC in the German Comprehensive Cancer Center (CCC) Network led to the establishment of consensual best practice recommendations for integration of SPC into the clinical structures, processes, research, and education throughout the CCC network. The recommendations contribute to a greater awareness relating to the strategic direction and development of SPC in CCCs. The access to information about SPC and access to offers regarding SPC shall be facilitated by implementing the recommendations in the course of treatment of patients with cancer.
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Affiliation(s)
- Julia Berendt
- Department of Palliative Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Erlangen, Germany
| | - Stephanie Stiel
- Department of Palliative Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Erlangen, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, University Hospital of Cologne and Centre for Integrated Oncology Cologne/Bonn, Bonn, Germany
| | - Andrea Schmitz
- Interdisciplinary Center for Palliative Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Birgitt van Oorschot
- Interdisciplinary Center for Palliative Medicine, Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany
| | - Peter Stachura
- Department of Palliative Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Erlangen, Germany
| | - Christoph Ostgathe
- Department of Palliative Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Erlangen, Germany
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Rassouli M, Sajjadi M. Palliative Care in Iran: Moving Toward the Development of Palliative Care for Cancer. Am J Hosp Palliat Care 2014; 33:240-4. [PMID: 25492970 DOI: 10.1177/1049909114561856] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cancer is the third leading cause of death in Iran and its incidence has been increasing in recent years. Patients' quality of life is altered rather enormously due to cancer, which doubles the importance of and the need for providing palliative care in Iran. Although many steps have been taken toward the development and providing of palliative care in Iran, there is still a large gap between the status quo and the desirable state. This study presents the current state of palliative care for cancer patients and discusses the barriers, challenges and outlook of palliative care in Iran. If infrastructural projects that have recently been launched prove successful, proper advancement toward the providing of palliative care services in Iran will then not far on the horizon.
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Affiliation(s)
- Maryam Rassouli
- Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moosa Sajjadi
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
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Maeda I, Tsuneto S, Miyashita M, Morita T, Umeda M, Motoyama M, Kosako F, Hama Y, Kizawa Y, Sasahara T, Eguchi K. Progressive development and enhancement of palliative care services in Japan: nationwide surveys of designated cancer care hospitals for three consecutive years. J Pain Symptom Manage 2014; 48:364-73. [PMID: 24439846 DOI: 10.1016/j.jpainsymman.2013.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/11/2013] [Accepted: 09/15/2013] [Indexed: 11/28/2022]
Abstract
CONTEXT Policymaking plays an important role in national palliative care services. The Japanese Cancer Control Act was implemented in 2006. OBJECTIVES To evaluate changes in the structure and processes of palliative care services after implementation of the Cancer Control Act. METHODS We conducted annual nationwide surveys in designated cancer care hospitals (DCCHs, n = 349) between 2008 and 2010. The 65-item questionnaire was divided into seven domains: institutional framework, information to patient and family, practice of palliative care, activities of the palliative care teams (PCTs), members of PCTs, regional medical cooperation, and education. Increasing trends were tested using generalized estimating equation models. RESULTS The response rates were ≥ 99%. All domains showed an increasing trend (P < 0.001). There were significant increases in full-time PCT physicians (27.4%-45.7%, P(trend) < 0.001), full-time PCT nurses (38.9%-88.0%, P(trend) < 0.001), and the median number of annual referrals to PCTs (60-80 patients, P < 0.001). Essential drugs were available in most DCCHs from baseline. Although outpatient clinics increased significantly (27.0%-58.9%, P(trend) < 0.001), community outreach programs did not (9.0%-12.6%, P = 0.05). Basic education was actively introduced for in-hospital physicians and nurses (78.2% and 91.4% in 2010), but often unavailable for regional health care providers (basic education for regional physicians and nurses: 63.9% and 71.1% in 2010). CONCLUSION The Cancer Control Act promoted the development and enhancement of palliative care services in DCCHs. Regional medical cooperation and education are the future challenges of palliative care in Japan.
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Affiliation(s)
- Isseki Maeda
- Department of Palliative Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | - Satoru Tsuneto
- Department of Palliative Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Mitsunori Miyashita
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Megumi Umeda
- Palliative Care Partners Co., Ltd., Minato-ku, Tokyo, Japan
| | - Miwa Motoyama
- Department of Palliative Care, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
| | - Fumie Kosako
- Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan
| | - Yoshihisa Hama
- Department of Surgery, Nagano Red Cross Hospital, Nagano, Nagano, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Tomoyo Sasahara
- Faculty of Medicine, Division of Health Innovation and Nursing, University of Tsukuba, Ibaraki, Japan
| | - Kenji Eguchi
- Division of Medical Oncology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
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Kikukawa M, Stalmeijer RE, Emura S, Roff S, Scherpbier AJJA. An instrument for evaluating clinical teaching in Japan: content validity and cultural sensitivity. BMC MEDICAL EDUCATION 2014; 14:179. [PMID: 25164309 PMCID: PMC4167259 DOI: 10.1186/1472-6920-14-179] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 08/08/2014] [Indexed: 05/24/2023]
Abstract
BACKGROUND Many instruments for evaluating clinical teaching have been developed but almost all in Western countries. None of these instruments have been validated for the Asian culture, and a literature search yielded no instruments that were developed specifically for that culture. A key element that influences content validity in developing instruments for evaluating the quality of teaching is culture. The aim of this study was to develop a culture-specific instrument with strong content validity for evaluating clinical teaching in initial medical postgraduate training in Japan. METHODS Based on data from a literature search and an earlier study we prepared a draft evaluation instrument. To ensure a good cultural fit of the instrument with the Asian context we conducted a modified Delphi procedure among three groups of stakeholders (five education experts, twelve clinical teachers and ten residents) to establish content validity, as this factor is particularly susceptible to cultural factors. RESULTS Two rounds of Delphi were conducted. Through the procedure, 52 prospective items were reworded, combined or eliminated, resulting in a 25-item instrument validated for the Japanese setting. CONCLUSIONS This is the first study describing the development and content validation of an instrument for evaluating clinical teaching specifically tailored to an East Asian setting. The instrument has similarities and differences compared with instruments of Western origin. Our findings suggest that designers of evaluation instruments should consider the probability that the content validity of instruments for evaluating clinical teachers can be influenced by cultural aspects.
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Affiliation(s)
- Makoto Kikukawa
- />Department of Medical Education, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka, 81-8582 Kyushu, Japan
| | - Renee E Stalmeijer
- />Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sei Emura
- />Centre for Graduate Medical Education Development and Research, Saga University Hospital, Saga, Japan
| | - Sue Roff
- />The Centre for Medical Education, Dundee Medical School, Dundee, Scotland
| | - Albert JJA Scherpbier
- />Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Ise Y, Morita T, Katayama S, Kizawa Y. The activity of palliative care team pharmacists in designated cancer hospitals: a nationwide survey in Japan. J Pain Symptom Manage 2014; 47:588-93. [PMID: 24018207 DOI: 10.1016/j.jpainsymman.2013.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 05/03/2013] [Accepted: 05/04/2013] [Indexed: 10/26/2022]
Abstract
CONTEXT The role of pharmacists in palliative care has become more important now that they are able to provide medication review, patient education, and advice to physicians about a patient's pharmacotherapy. However, there is little known about pharmacists' activity on palliative care teams. OBJECTIVES The present study aimed to examine the clinical, educational, and research activities of pharmacists on palliative care teams and pharmacist-perceived contributions to a palliative care team or why they could not contribute. METHODS We sent 397 questionnaires to designated cancer hospitals, and 304 responses were analyzed (response rate 77%). RESULTS Of the pharmacists surveyed, 79% and 94% reported attending ward rounds and conferences, respectively. Half of the pharmacists provided information/suggestions to the team about pharmacology, pharmaceutical production, managing adverse effects, drug interactions, and/or rotation of drugs. In addition, 80% of the pharmacists organized a multidisciplinary conference on palliative care education. Furthermore, 60% of the pharmacists reported on palliative care research to a scientific society. Seventy percent of the pharmacists reported some level of contribution to a palliative care team, whereas 16% reported that they did not contribute, with the main perceived reasons for no contribution listed as insufficient time (90%) and/or staff (68%). CONCLUSION In Japan, pharmacists exercise a moderate level of clinical activity on palliative care teams. Many pharmacists believe that they contribute to such a team and generally place more emphasis on their educational and research roles compared with clinical work.
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Affiliation(s)
- Yuya Ise
- Department of Pharmaceutical Services, Nippon Medical School Hospital, Tokyo, Japan.
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Shirou Katayama
- Department of Pharmaceutical Services, Nippon Medical School Hospital, Tokyo, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Kizawa Y, Tsuneto S, Tamba K, Takamiya Y, Morita T, Bito S, Otaki J. Development of a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan: a modified Delphi method. Palliat Med 2012; 26:744-52. [PMID: 21920987 DOI: 10.1177/0269216311410346] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is currently no consensus syllabus of palliative medicine for undergraduate medical education in Japan, although the Cancer Control Act proposed in 2007 covers the dissemination of palliative care. AIM To develop a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan using a modified Delphi method. DESIGN We adopted the following three-step method: (1) a workshop to produce the draft syllabus; (2) a survey-based provisional syllabus; (3) Delphi rounds and a panel meeting (modified Delphi method) to produce the working syllabus. Educators in charge of palliative medicine from 63% of the medical schools in Japan collaborated to develop a survey-based provisional syllabus before the Delphi rounds. A panel of 32 people was then formed for the modified Delphi rounds comprising 28 educators and experts in palliative medicine, one cancer survivor, one bereaved family member, and two medical students. RESULTS The final consensus syllabus consists of 115 learning objectives across seven sections as follows: basic principles; disease process and comprehensive assessment; symptom management; psychosocial care; cultural, religious, and spiritual issues; ethical issues; and legal frameworks. Learning objectives were categorized as essential or desirable (essential: 66; desirable: 49). CONCLUSIONS A consensus syllabus of palliative medicine for undergraduate medical education was developed using a clear and innovative methodology. The final consensus syllabus will be made available for further dissemination of palliative care education throughout the country.
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Affiliation(s)
- Yoshiyuki Kizawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.
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Nakazawa Y, Miyashita M, Morita T, Misawa T, Tsuneto S, Shima Y. The Current Status and Issues Regarding Hospital-based Specialized Palliative Care Service in Japanese Regional Cancer Centers: A Nationwide Questionnaire Survey. Jpn J Clin Oncol 2012; 42:432-41. [DOI: 10.1093/jjco/hys022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rayner L, Price A, Hotopf M, Higginson IJ. Expert opinion on detecting and treating depression in palliative care: A Delphi study. BMC Palliat Care 2011; 10:10. [PMID: 21619580 PMCID: PMC3125275 DOI: 10.1186/1472-684x-10-10] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 05/27/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of best practice recommendations for the European Palliative Care Research Collaborative clinical practice guideline on managing depression in palliative care. METHODS 18 members of an international, multi-professional expert group completed a structured questionnaire in two rounds, rating their agreement with proposed items on a scale from 0-10 and annotating with additional comments. The median and range were calculated to give a statistical average of the experts' ratings. RESULTS There was contention regarding the benefits of screening, with 'routine informal asking' (median 8.5 (0-10)) rated more highly than formal screening tools such as the Hospital Anxiety and Depression Scale (median 7.0 (1-10). Mirtazapine (median 9 (7-10) and citalopram (median 9 (5-10) were the considered the best choice of antidepressant and cognitive behavioural therapy (median 9.0 (3-10) the best choice of psychological therapy. CONCLUSIONS The range of expert ratings was broad, indicating discordance in the views of experts. Direct comparative data from randomised controlled trials are needed to strengthen the evidence-base and achieve clarity on how best to detect and treat depression in this setting.
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Affiliation(s)
- Lauren Rayner
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, UK
- Department of Psychological Medicine, The Institute of Psychiatry, King's College London, UK
| | - Annabel Price
- Department of Psychological Medicine, The Institute of Psychiatry, King's College London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, The Institute of Psychiatry, King's College London, UK
| | - Irene J Higginson
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, UK
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