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Meghani SH, Mooney-Doyle K, Barnato A, Colborn K, Gillette R, Harrison KL, Hinds PS, Kirilova D, Knafl K, Schulman-Green D, Pollak KI, Ritchie CS, Kutner JS, Karcher S. Lessons Learned Establishing the Palliative Care Research Cooperative's Qualitative Data Repository. J Pain Symptom Manage 2024:S0885-3924(24)00797-8. [PMID: 38825257 DOI: 10.1016/j.jpainsymman.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 06/04/2024]
Abstract
Data sharing is increasingly an expectation in health research as part of a general move toward more open sciences. In the United States, in particular, the implementation of the 2023 National Institutes of Health Data Management and Sharing Policy has made it clear that qualitative studies are not exempt from this data sharing requirement. Recognizing this trend, the Palliative Care Research Cooperative Group (PCRC) realized the value of creating a de-identified qualitative data repository to complement its existing de-identified quantitative data repository. The PCRC Data Informatics and Statistics Core leadership partnered with the Qualitative Data Repository (QDR) to establish the first serious illness and palliative care qualitative data repository in the U.S. We describe the processes used to develop this repository, called the PCRC-QDR, as well as our outreach and education among the palliative care researcher community, which led to the first ten projects to share the data in the new repository. Specifically, we discuss how we co-designed the PCRC-QDR and created tailored guidelines for depositing and sharing qualitative data depending on the original research context, establishing uniform expectations for key components of relevant documentation, and the use of suitable access controls for sensitive data. We also describe how PCRC was able to leverage its existing community to recruit and guide early depositors and outline lessons learned in evaluating the experience. This work advances the establishment of best practices in qualitative data sharing.
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Affiliation(s)
- Salimah H Meghani
- Department of Biobehavioral Health Sciences NewCourtland Center for Transitions and Health (S.H.M), Leonard Davis Institute of Health Economics; University of Pennsylvania, Philadelphia, PA
| | - Kim Mooney-Doyle
- Department of Family and Community Health (K.M.D), School of Nursing, University of Maryland, Baltimore, MD
| | - Amber Barnato
- Department of Medicine, The Dartmouth Institute for Health Policy and Clinical Practice (A.B), Geisel School of Medicine, Section of Palliative Care, Dartmouth Health, Hanover, NH
| | - Kathryn Colborn
- Department of Medicine (K.C), School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Riley Gillette
- Adult and Child Center for Outcomes Research and Delivery Science (R.G), University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Krista L Harrison
- Department of Medicine, Division of Geriatrics (K.L.H), Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA
| | - Pamela S Hinds
- Department of Nursing Science, Interim Director (P.S.H), Center for Translational Research, Director, Professional Practice and Quality, Research Integrity Officer, William and Joanne Conway Chair in Nursing Research, Children's National Hospital, Professor of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC
| | - Dessi Kirilova
- Qualitative Data Repository (D.K), Syracuse University, Syracuse, NY
| | - Kathleen Knafl
- FAAN. School of Nursing (K.K), University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Kathryn I Pollak
- Department of Population Health Sciences (K.I.P), Duke University School of Medicine, Cancer Prevention and Control, Duke Cancer Institute, Durham, NC
| | - Christine S Ritchie
- Harvard Medical School (C.S.R), Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston MA
| | - Jean S Kutner
- Department of Medicine (J.S.K), University of Colorado School of Medicine, Aurora, CO and
| | - Sebastian Karcher
- Department of Political Science and Qualitative Data Repository (S.K), Syracuse University, Syracuse, NY.
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Kim B, Lee J, Choi YS. Public awareness of advance care planning and hospice palliative care: a nationwide cross-sectional study in Korea. BMC Palliat Care 2023; 22:205. [PMID: 38151721 PMCID: PMC10752019 DOI: 10.1186/s12904-023-01333-y] [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: 09/14/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023] Open
Abstract
CONTEXT Advance care planning (ACP) and hospice palliative care (HPC) have potential benefits for individuals and health systems. Public awareness of them might increase their acceptance. OBJECTIVES To examine public awareness of ACP and HPC and related factors including individuals' experience of health care among Korean population. METHODS A cross-sectional study based on a nationally representative sample was conducted. Data from participants aged 15 years or older were examined. Socio-demographic characteristics, health-related factors, health care experience in the past year, and awareness of ACP and HPC were analyzed. Subgroup analysis was conducted to determine associations between specific experiences during outpatient visit and awareness of ACP and HPC. RESULTS Of a total of 13,546 subjects, 39.3% and 35.7% reported awareness of ACP and HPC, respectively. About half (48.6%) of participants reported that they were completely unaware of ACP or HPC. Recent outpatient visit was positively associated with HPC awareness. Participants were more likely to recognize ACP or HPC if they had experience in hospitalization and health checkup over the past year and had trust in the medical system. Conversely, participants who had inadequate health care access due to cost burden showed low awareness of ACP and HPC. CONCLUSION There was a lack of public awareness of ACP and HPC. There were significant differences depending on various factors, especially individual health care experiences. Appropriate interventions are needed to facilitate discussion of ACP and HPC, thereby increasing public awareness.
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Affiliation(s)
- Boram Kim
- Division of Health Policy, Bureau of Health Policy, Ministry of Health and Welfare, Sejong-si, Republic of Korea
| | - Junyong Lee
- Department of Family Medicine, Veterans Health Service (VHS) Medical Center, Seoul, Republic of Korea
| | - Youn Seon Choi
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
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Back AL, Wax JS, Rossi RD, Shaw K, Grant MS, Zaltman L. What Patients and Caregivers Experience When They Receive Palliative Care: A Study Eliciting Metaphors That Could Shape Public Messaging. J Palliat Med 2023. [PMID: 37126403 DOI: 10.1089/jpm.2023.0009] [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: 05/02/2023] Open
Abstract
Many patients who could benefit from Palliative Care do not receive services because of lack of awareness or misconceptions. This high level of public unfamiliarity combined with inaccurate beliefs equating Palliative Care with dying calls for public messaging designed to increase public familiarity and correct misconceptions. A barrier to widespread public messaging, however, is the scarcity of messages developed with empirical research in public perceptions of the lived experience of receiving palliative care. In this report, we describe qualitative research aimed at identifying the "deep metaphors" associated with palliative care, to provide an empirical foundation for further creative work. We interviewed 8 patients receiving palliative care and 8 caregivers using a qualitative method, Zaltman Metaphor Elicitation Technique, that is specially designed to reveal unconscious metaphors and socially shared associations that participants held about experiencing palliative care. Study participants likened the onset of serious illness as a massive disruption resulting in stunning losses with far-reaching consequences. What serious illness "took away" from them was a sense of certainty about where their lives were going, and these participants described experiencing (1) shame and embarrassment about what was happening to them; (2) a sense that no one was listening to them; (3) feeling lost and uncertain about what to do, feeling stuck; and (4) losing parts of their identity to illness. What they felt in need of, to counter what had been taken away, was (1) validation for what they were going through; (2) agency to determine their own quality of life and have input into their care; (3) guidance to access a network of resources; and (4) regeneration of their self-worth, resulting in a new version of their identity. This research provides guidance for message developers on frames, language, and visuals for future campaigns designed to create public interest in palliative care.
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Affiliation(s)
- Anthony L Back
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jacob S Wax
- Olson Zaltman Associates, Pittsburgh, Pennsylvania, USA
| | | | - Kathy Shaw
- Olson Zaltman Associates, Pittsburgh, Pennsylvania, USA
| | - Marian S Grant
- University of Maryland, School of Nursing, Baltimore, Maryland, USA
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Bérubé A, Tapp D, Dupéré S, Plaisance A, Bravo G, Downar J, Couture V. Do Socioeconomic Factors Influence Knowledge, Attitudes, and Representations of End-of-Life Practices? A Cross-Sectional Study. J Palliat Care 2022:8258597221131658. [PMID: 36237145 DOI: 10.1177/08258597221131658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Access to palliative and end-of-life (EOL) care might be influenced by knowledge, attitudes, and representations of these practices. Socioeconomic factors might then affect what people know about EOL care practices, and how they perceive them. This study aims to compare knowledge, attitudes, and representations regarding EOL practices including assisted suicide, medical assistance in dying, and continuous palliative sedation of adults, according to socioeconomic variables. METHODS A cross-sectional community-based questionnaire study featuring two evolving vignettes and five end-of-life practices was conducted in Quebec, Canada. Three sample subgroups were created according to the participants' perceived financial situation and three according to educational attainment. Descriptive analysis was used to compare levels of knowledge, attitudes, and representations between the subgroups. RESULTS Nine hundred sixty-six (966) people completed the questionnaire. Two hundred and seventy participants (28.7%) had a high school diploma or less, and 42 participants (4.4%) were facing financial hardship. The majority of respondents supported all end-of-life options and the loosening of eligibility requirements for medical assistance in dying. Differences between subgroups were minor. While respondents in socioeconomically disadvantaged subgroups had less knowledge about EOL practices, those with lower educational attainment were more likely to be in favor of medical assistance in dying, and less likely to favor continuous palliative sedation. CONCLUSIONS People living with situational social and economic vulnerabilities face multiple barriers in accessing health care. While they may have poorer knowledge about EOL practices, they have a positive attitude towards medical assistance in dying and assisted suicide, and a negative attitude towards continuous palliative sedation. This highlights the need for future research and interventions aimed at empowering this population and enhancing their access to EOL care.
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Affiliation(s)
- A Bérubé
- Faculty of Nursing, 4440Laval University, Pavillon Ferdinand-Vandry, local A-3645-D, Quebec City, QC, Canada
- Cardiology Department, Quebec Heart and Lung Institute Research Center-Laval University, Quebec City, QC, Canada
| | - D Tapp
- Faculty of Nursing, 4440Laval University, Pavillon Ferdinand-Vandry, local A-3645-D, Quebec City, QC, Canada
- Cardiology Department, Quebec Heart and Lung Institute Research Center-Laval University, Quebec City, QC, Canada
| | - S Dupéré
- Faculty of Nursing, 4440Laval University, Pavillon Ferdinand-Vandry, local A-3645-D, Quebec City, QC, Canada
| | - A Plaisance
- Faculty of Nursing, 4440Laval University, Pavillon Ferdinand-Vandry, local A-3645-D, Quebec City, QC, Canada
- Cardiology Department, Quebec Heart and Lung Institute Research Center-Laval University, Quebec City, QC, Canada
| | - G Bravo
- Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC, Canada
| | - J Downar
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - V Couture
- Faculty of Nursing, 4440Laval University, Pavillon Ferdinand-Vandry, local A-3645-D, Quebec City, QC, Canada
- Population Health and Optimal Health Practices Axis, Research Center of the CHU de Québec-Université Laval, Quebec, QC, Canada
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Ramos-Vera C, Krikorian A, Vallejos Saldarriaga J. Factors related to positive attitudes toward palliative care: Direct and indirect effects of self-care self-efficacy, knowledge, and beliefs. Palliat Support Care 2022; 21:1-7. [PMID: 35894093 DOI: 10.1017/s1478951522000864] [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: 11/06/2022]
Abstract
CONTEXT Knowledge, beliefs, and attitudes toward palliative care (PC) constitute barriers to its access. Few studies have focused on the intrinsic relationship between these variables, and none has examined the relationship between them and self-care self-efficacy. OBJECTIVE To examine the direct and indirect effects of self-care self-efficacy, knowledge, and beliefs on attitudes toward PC. METHODS A cross-sectional predictive study was conducted. Self-care self-efficacy, knowledge, attitudes, and beliefs about PC were analyzed using information from the Health Information National Trends Survey (HINTS 5, cycle 2, 2018). Data from 1,162 participants were considered. Structural equation modeling (SEM) was used to represent the statistical mediation model with latent and observable variables. RESULTS The structural model presents positive coefficients indicating that self-care self-efficacy significantly predicts knowledge (β = 0.127, p < 0.001) and beliefs (β = 0.078, p = 0.023). Similarly, knowledge is associated with attitudes (β = 0.179, p < 0.001) and beliefs (β = 0.213, p < 0.001). The beliefs measure is also significantly related to attitudes (β = 0.474, p < 0.001). In addition, this structural multiple mediation model shows optimal goodness-of-fit indices: χ2/df = 3.49, CFI = 0.983, TLI = 0.976, RMSEA = 0.046 [90% CI: 0.037-0.056], SRMR = 0.038. CONCLUSION Self-care self-efficacy is significantly associated with knowledge and beliefs about PC, which in turn are related to each other. Altogether, these variables predict positive attitudes toward PC. Understanding the relationship between these variables is relevant for targeting-specific populations and designing timely strategies to improve access to PC.
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Affiliation(s)
- Cristian Ramos-Vera
- Research Area, School of Health Sciences, Universidad César Vallejo, Lima, Peru
- Sociedad Peruana de Psicometría, Lima, Peru
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
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Marcewicz L, Kunihiro SK, Curseen KA, Johnson K, Kavalieratos D. Application of Critical Race Theory in Palliative Care Research: A Scoping Review. J Pain Symptom Manage 2022; 63:e667-e684. [PMID: 35231591 DOI: 10.1016/j.jpainsymman.2022.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
CONTEXT Structural racism negatively impacts individuals and populations. In the medical literature, including that of palliative care, structural racism's influence on interracial differences in outcomes remains poorly examined. Examining the contribution of structural racism to outcomes is paramount to promoting equity. OBJECTIVES We examined portrayals of race and racial differences in outcomes in the palliative care literature and created a framework using critical race theory (CRT) to aid in this examination. METHODS We reviewed the CRT literature and iteratively developed a rubric to examine when and how differences between races are described. Research articles published in The Journal of Pain and Symptom Management presenting empiric data specifically including findings about racial differences were examined independently by three reviewers using the rubric. RESULTS Fifty-seven articles met inclusion criteria. Articles that specifically described racial differences were common in the topic areas of quality (75% of articles), hospice (53%), palliative care services (40%) and spirituality/religion (40%). The top three reasons posited for racial differences were patient preference (26%), physician bias (23%), and cultural barriers (21%). Using the CRT rubric we found that 65% of articles posited that a racial difference was something that needed to be rectified, while articles rarely provided narrative (5%) or other data on perspectives of people of color (11%) to explain assumptions about differences. CONCLUSION Palliative care research frequently highlights racial differences in outcomes. Articles that examine racial differences often assume that differences need to be fixed but posit reasons for differences without the narratives of those most affected by them.
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Affiliation(s)
- Lawson Marcewicz
- Division of Palliative Medicine (L.M., S.K.K., K.A.C., D.K.), Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA; Atlanta VA Health Care System (L.M.), Decatur, Georgia, USA.
| | - Susan K Kunihiro
- Division of Palliative Medicine (L.M., S.K.K., K.A.C., D.K.), Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Kimberly A Curseen
- Division of Palliative Medicine (L.M., S.K.K., K.A.C., D.K.), Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Khaliah Johnson
- Division of Pediatric Palliative Medicine (K.J.), Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Dio Kavalieratos
- Division of Palliative Medicine (L.M., S.K.K., K.A.C., D.K.), Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
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Desai AV, Klimek VM, Wan PJ, Heinberg A, Anderson KL, Bernal C, Nelson JE. Palliative Medicine in Myelodysplastic Syndromes: Patients and Caregivers - A Qualitative Study. BMJ Support Palliat Care 2021:bmjspcare-2020-002865. [PMID: 33903261 PMCID: PMC8546005 DOI: 10.1136/bmjspcare-2020-002865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/20/2021] [Accepted: 03/30/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Evidence-based guidelines call for integration of palliative care within oncology from diagnosis. Misperceptions about palliative care have impeded implementation. Prior research has not examined perceptions about 'palliative care' versus 'supportive care' among patients and caregivers to whom this care is introduced routinely as part of comprehensive cancer care. We conducted a qualitative study of patients with myelodysplastic syndromes (MDS) and their informal caregivers to elicit perceptions of 'palliative care' and 'supportive care' before and after they received integrated primary/specialist palliative care from diagnosis. METHODS Patients with newly diagnosed MDS and caregivers were interviewed about their understanding of 'palliative care' and 'supportive care' at diagnosis and follow-up. Interviews were audio-recorded, transcribed, and analysed by an interdisciplinary team. RESULTS Forty-eight interviews were conducted in total, including with 21 patients and 13 caregivers at diagnosis, and 10 patients and 4 caregivers at follow-up. Initially, 28/34 participants (82%) associated 'palliative care' with death or fear/alarm. At follow-up, 11/14 participants (79%) recognised that 'palliative care' is not only for terminally ill patients, yet 13/14 participants (93%) still felt apprehensive about the term. Initially, 24/34 participants (71%) felt 'supportive care' sounded 'positive' and 12/14 participants (86%) reported this at follow-up. No participant associated 'supportive care' with death or fear/alarm at either time point. Among participants who had a preference, 'supportive care' was the preferred term initially and at follow-up. CONCLUSIONS Patients with MDS and caregivers receiving integrated primary/specialist palliative care from diagnosis responded more favourably to and felt less apprehensive about 'supportive care', initially and at follow-up.
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Affiliation(s)
- Anjali V Desai
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Virginia M Klimek
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Peter J Wan
- Touro College of Osteopathic Medicine, New York, New York, USA
| | | | | | - Camila Bernal
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Judith E Nelson
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Medicine, Weill Cornell Medical College, New York, New York, USA
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Chen G, Hong YR, Wilkie DJ, Kittleson S, Huo J, Bian J. Geographic Variation in Knowledge of Palliative Care Among US Adults: Findings From 2018 Health Information National Trends Survey. Am J Hosp Palliat Care 2021; 38:291-299. [PMID: 32757758 PMCID: PMC7855289 DOI: 10.1177/1049909120946266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Public knowledge and awareness of palliative care (PC) is important to its effective use. However, it remains unclear whether the geographic variation in knowledge of PC exits in the United States. This study examined the national geographic variation in knowledge of PC. METHODS The study sample was obtained from the 2018 National Cancer Institute's Health Information National Trends Survey. Basic knowledge of PC, goal concordant treatment, misconceptions, and primary information source of PC were compared across 4 census regions. Multivariable logistic regression was used to examine factors associated with awareness of PC among 9 census divisions. RESULTS A total of 3194 respondents (weighted sample size: 229 591 005) were included in this study. Overall, 29% of all respondents reported having knowledge of PC; 32.9% of those residing in Northeast had some knowledge of PC, followed by 30.8% in the South, 26.2% in Midwest, and 25.6% in West. By census divisions, respondents residing in 3 divisions were more likely to have PC knowledge (New England, odds ratio: 3.06, 95% CI: 1.48-6.32, P = .003; South Atlantic, odds ratio: 1.96, 95% CI: 1.15-3.35, P = .014; Pacific, odds ratio: 1.86, 95% CI: 1.12-3.09, P = .018) compared to those in the Mountain division. CONCLUSIONS The variation of PC knowledge on census division and state level in 2018 was consistent with the real-world geographic disparities in the availability of PC programs. These findings represent an opportunity for minimizing the gap of geographic disparity by initiating strategic programs and promoting PC programs nationwide.
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Affiliation(s)
- Guanming Chen
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Sheri Kittleson
- Division of Palliative Care, Department of Medicine, Gainesville, FL, USA
| | - Jinhai Huo
- US Health Economics and Outcomes Research at Bristol-Myers Squibb, Gainesville, NJ, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
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Xiao J, Brenneis C, Ibrahim N, Bryan A, Fassbender K. Definitions of Palliative Care Terms: A Consensus-Oriented Decision-Making Process. J Palliat Med 2021; 24:1342-1350. [PMID: 33601982 DOI: 10.1089/jpm.2020.0679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Lack of consistency in palliative care language can serve as barriers when designing, delivering, and accessing high-quality palliative care services. Objective: To develop a consensus-driven and evidence-based palliative care glossary for the Health Standards Organization Palliative Care Services National Standard of Canada (CAN/HSO 13001:2020). Design: Content analysis of the Palliative Care Services standard was used to refine a list of terms. Environmental scan and rapid review were used for identification of concepts and definitions. Two meetings of consultation based on the modified Delphi approach took place among a working committee consisting of 12 health care providers, administrators, academics, and patient/family representatives. Results: Palliative approach to care, quality of life, pain and symptom management, caregivers, palliative care, life-limiting illness, and serious illness were defined by modification/adoption of existing definitions. Conclusion: A glossary of key palliative care terms was developed and included in the HSO Palliative Care Services standard, which will facilitate communication using consistent language across care settings.
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Affiliation(s)
- Jingjie Xiao
- Covenant Health Palliative Institute, Grey Nuns Community Hospital, St. Marguerite Health Services Center, Edmonton, Alberta, Canada
| | - Carleen Brenneis
- Covenant Health Palliative Institute, Grey Nuns Community Hospital, St. Marguerite Health Services Center, Edmonton, Alberta, Canada
| | - Nadine Ibrahim
- Standards and Evidence Development Team, Global Programs Department, Health Standards Organization, Ottawa, Ontario, Canada
| | - Alyssa Bryan
- Standards and Evidence Development Team, Global Programs Department, Health Standards Organization, Ottawa, Ontario, Canada
| | - Konrad Fassbender
- Covenant Health Palliative Institute, Grey Nuns Community Hospital, St. Marguerite Health Services Center, Edmonton, Alberta, Canada.,Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
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10
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Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults. Palliat Support Care 2020; 19:515-523. [PMID: 33234188 DOI: 10.1017/s1478951520001200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. METHOD Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann-Whitney U test. RESULTS There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). SIGNIFICANCE OF RESULTS This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.
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Farrell MJ. The Combative Language of Cancer: A Plea for an Armistice. J Clin Oncol 2020; 38:3449-3451. [PMID: 32749943 DOI: 10.1200/jco.20.01146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Matthew J Farrell
- Providence St Vincent Medical Center, Internal Medicine Residency Program, Portland, OR
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12
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Grant MS, Back AL, Dettmar NS. Public Perceptions of Advance Care Planning, Palliative Care, and Hospice: A Scoping Review. J Palliat Med 2020; 24:46-52. [PMID: 32614634 DOI: 10.1089/jpm.2020.0111] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Although access to advance care planning (ACP), palliative care, and hospice has increased, public attitudes may still be barriers to their optimal use. Purpose: To synthesize empirical research from disparate sources that describes public perceptions of ACP, palliative care, and hospice in ways that could inform public messaging. Data Sources: Searches of PubMed and other databases were made from January 2011 to January 2020. Study Selection: Studies reporting survey or interview data with the public that asked specifically about awareness and attitudes toward ACP, palliative care, or hospice were included. Data Extraction and Synthesis: Two reviewers independently screened citations, read full texts, and performed data abstraction. Twelve studies met inclusion criteria and included >9800 participants. For ACP, 80% to 90% of participants reported awareness, and a similar proportion considered it important, but only 10% to 41% reported having named a proxy or completed a written document. For palliative care, 66% to 71% of participants reported no awareness of palliative care, and those who reported awareness often conflated it with end-of-life care. However, after being prompted with a tested definition, 95% rated palliative care favorably. For hospice, 86% of participants reported awareness and 70% to 91% rated it favorably, although 37% held significant misconceptions. Limitations: A limited number of studies met inclusion criteria, and some were published in nonpeer reviewed sources. The studies reflect public perceptions pre-COVID-19. Conclusion: Consumer perceptions of ACP, palliative care, and hospice each have a distinct profile of awareness, perceptions of importance, and reports of action taking, and these profiles represent three different challenges for public messaging.
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Affiliation(s)
- Marian S Grant
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Anthony L Back
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Nicole S Dettmar
- Northwest Center for Public Health Practice, University of Washington, Seattle, Washington, USA
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13
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Hong YR, Huo J. Trends in U.S. Population Interest in Palliative Care and Its Association With Prevalence of Palliative Care Programs in U.S. States. J Pain Symptom Manage 2020; 60:e89-e91. [PMID: 32240753 DOI: 10.1016/j.jpainsymman.2020.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Young-Rock Hong
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
| | - Jinhai Huo
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
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