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Khemai C, Leão DLL, Janssen DJA, Schols JMGA, Meijers JMM. Interprofessional collaboration in palliative dementia care. J Interprof Care 2024; 38:675-694. [PMID: 38757957 DOI: 10.1080/13561820.2024.2345828] [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: 05/04/2022] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Interprofessional collaboration (IPC) is essential for high-quality palliative care (PC) for persons with dementia. The aim of this scoping review was to identify IPC approaches in palliative dementia care and explore the elements constituting these approaches. We performed a search in PubMed, CINAHL, and PsychINFO using the Joanna Briggs Institute Reviewers' manual and PRISMA guidelines, and conducted content analysis of the included articles. In total, 28 articles were included, which described 16 IPC approaches in palliative dementia care. The content analysis revealed three overall elements of these approaches: 1) collaborative themes, 2) collaborative processes, and 3) resources facilitating collaboration. Frequently reported collaborative themes embraced pain management and providing care in the dying phase. These themes were addressed through intertwined collaborative processes including communication, coordination, assessing and monitoring, and reflecting and evaluating. To ensure optimal IPC in palliative dementia care, various resources were required, such as PC knowledge, skills to manage symptoms, skills to communicate with collaborators, and a facilitating environment. In conclusion, the identified IPC approaches in palliative dementia care involve diverse collaborating professionals who mainly manage symptoms, prepare for the dying phase and require material and immaterial resources to enable optimal IPC in palliative dementia care.
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Affiliation(s)
- C Khemai
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - D L L Leão
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - D J A Janssen
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
- Department of Research and Development, Ciro, Horn, the Netherlands
| | - J M G A Schols
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - J M M Meijers
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
- Zuyderland Care, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
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Schultz M, Baziliansky S, Mitnik I, Ulitzur N, Campisi-Pinto S, Givoli S, Bar-Sela G, Zalman D. Some differences between social work, spiritual care, and psychology: Content variance in end-of-life conversations. Palliat Support Care 2024; 22:306-313. [PMID: 37605972 DOI: 10.1017/s1478951523000652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Within the multidisciplinary team, there can sometimes be lack of clarity as to the specific different contributions of each of the psycho-social-spiritual professionals: social workers, psychologist, and spiritual caregivers. This study examined the content of their end-of-life conversations with patients. METHODS A total of 180 patients with terminal cancer received standard multidisciplinary care, including conversations with a social worker, psychologist, and spiritual caregiver. After each patient's death, these professionals reported using a structured tool which content areas had arisen in their conversations with that patient. RESULTS Across all content areas, there were significant differences between social work and spiritual care. The difference between social work and psychology was slightly smaller but still quite large. Psychology and spiritual care were the most similar, though they still significantly differed in half the content areas. The differences persisted even among patients who spoke with more than 1 kind of professional. The 6 content areas examined proved to subdivide into 2 linked groups, where patients speaking about 1 were more likely to speak about the others. One group, "reflective" topics (inner and transpersonal resources, interpersonal relationships, one's past, and end of life), included all those topics which arose more often with spiritual caregivers or psychologists. The second group, "decision-making" topics (medical coping and life changes), was comprised of those topics which arose most commonly with social workers, bridging between the medical and personal aspects of care and helping patients navigate their new physical, psychological, and social worlds. SIGNIFICANCE OF RESULTS These findings help shed light on the differences, in practice, between patients' conversations with social workers, psychologists, and spiritual caregivers and the roles these professionals are playing; can aid in formulating individualized care plans; and strengthen the working assumption that all 3 professions contribute in unique, complementary ways to improving patients' and families' well-being.
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Affiliation(s)
- Michael Schultz
- Division of Oncology, Rambam Health Care Campus, Haifa, Israel
| | | | - Inbal Mitnik
- Division of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Nirit Ulitzur
- Division of Oncology, Rambam Health Care Campus, Haifa, Israel
| | | | - Simon Givoli
- Statistical Department, Midot Ltd., Tel Aviv, Israel
| | - Gil Bar-Sela
- Cancer Center, Emek Medical Center, Afula, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daniela Zalman
- Division of Oncology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Cadge W. Racial burdens in the work experiences of state-supported Black chaplains. J Health Care Chaplain 2023:1-10. [PMID: 37163227 DOI: 10.1080/08854726.2023.2210027] [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: 05/11/2023]
Abstract
To understand and improve the experiences of Black chaplains, it is essential to consider how they experience and are integrated into their workplaces. This article draws from interviews with ten Black chaplains in the military and prisons. In light of historic, state-sanctioned, discrimination in these institutions, we ask how these chaplains experience their workplaces racially. All experience racial burdens in the workplace as part of being the first or only Black chaplain or in response to overt racial discrimination. They identify few to no formal workplace efforts to support them as Black chaplains and spoke of resistance to informal efforts that have been tried over the years. State and federal workplaces must recognize the racial burdens Black chaplains' experiences and take action to respond to and support these systemic workplace issues.
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Affiliation(s)
- Wendy Cadge
- Department of Sociology, Brandeis University, Waltham, MA, USA
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Margavio Striley K, Tenzek KE, Field-Springer K. Difficult dialogues about death: applying risk orders theory to analyse chaplains’ provision of end-of-life care. HEALTH, RISK & SOCIETY 2022. [DOI: 10.1080/13698575.2022.2056582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Katie Margavio Striley
- Interpersonal Communication, Department of Communication, The University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Kelly E. Tenzek
- Department of Communication, University of Wisconsin-Milwaukee (Data Collection)1
- Department of Communication, University at Buffalo, North Campus, Buffalo, New York, USA
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Taylor EJ, Trippon M. What Chaplains Wish Nurses Knew: Findings From an Online Survey. Holist Nurs Pract 2021; 34:266-273. [PMID: 33953009 DOI: 10.1097/hnp.0000000000000401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report presents qualitative data from a larger study that sought to examine chaplain perspectives on collaboration and nurse-provided spiritual care. This cross-sectional, descriptive study used online survey methods to distribute an investigator-designed questionnaire to a convenience sample of members of the Association of Professional Chaplains (N = 298). Findings were generated by written responses to 3 open questions that were thematically analyzed, as well as 1 quantitative item. Over half of these chaplains reported they did experience nurse "gatekeeping" at least occasionally. Themes from qualitative data revealed chaplains perceive nurses: lack understanding about the role and abilities of chaplains, sometimes overstep their role or impede the work of chaplains, and allow personal "baggage" to influence their collaboration with chaplains. Likewise, however, respondents respected nurses and were eager to collaborate. Naming these challenges to nurse-chaplain collaboration allows nurses and chaplains to begin to address them.
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Hopeck P. Care workers’ experiences discussing financial issues with families facing end-of-life decisions. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2021. [DOI: 10.4081/qrmh.2020.9102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Numerous studies have confirmed the presence of financial difficulties for families when a loved one is at the end of life. However, few studies examine the discussions family members have with care workers about financial issues during end of life. The research presented here examines the experiences that care workers have with family members expressing financial concerns and how care workers respond. I conducted in-depth interviews with fifty-eight care workers, defined in this study as clergy, patient advocates, and nurses who had experiences talking with families about financial issues. Transcripts of the interviews served as the data set. I transcribed, coded and analyzed the data. Families talk about financial issues openly, although sometimes guiltily. Some families express difficulties implicitly, and in these cases, care workers often had to piece together information based on other statements and behaviors of the family. Care workers suggest solutions at the interpersonal, organizational, inter-organizational, social, and national levels. Findings also support prior research that it is important for families to have end-of-life discussions before death is imminent so that families may plan accordingly, and offer insights about care workers and their role in making financial discussions easier for families.
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Abstract
This study examines the religious/spiritual referral patterns in hospice and palliative care. Religion and death are two highly intersected topics and albeit often discussed together in hospice and palliative care, little is known about how professionals respond to religious/spiritual needs of patients/families/friends and in relation to the chaplaincy team. By means of an in-depth interviewing method, this paper reports on data from 15 hospice and palliative care professionals. Participants were recruited from across five hospice and palliative care organisations, and the data was managed and analysed with the use of NVivo. Largely, participants were keen to refer patients/families/friends to the chaplaincy team, unless the former’s faith or lack thereof did not match the chaplains, in which case referrals to a religious leader in the community were favoured. This shed light to the tendencies to homogenise religious/spiritual beliefs. The paper concludes with some implications for practice and research.
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Washington KT, Alaniz Staner LM, Collie BE, Craig KW, Demiris G, Oliver DP. Toward a Practice-Informed Agenda for Hospice Intervention Research: What Are Staff Members' Biggest Challenges? Am J Hosp Palliat Care 2020; 38:467-471. [PMID: 32757823 DOI: 10.1177/1049909120948222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The translation of evidence-based interventions into routine hospice care is impeded by numerous barriers, including a disconnect between research priorities and clinical care. To inform the development of a more practice-informed agenda for hospice intervention research, our team conducted a qualitative descriptive study, posing the following research questions: 1) How do hospice staff members describe their most significant work-related challenges? and 2) What regulatory changes do hospice staff members report would most improve hospice care? To answer these research questions, we interviewed 22 hospice staff members and then conducted a template analysis of the interview content. In doing so, we identified themes that described challenges in 5 key areas: time, documentation, professional roles, recruitment and retention, and burn-out. In addition, we identified a perceived need among hospice staff members for more regulatory flexibility and clarity. Based on our findings, we conclude that a practice-informed agenda for hospice intervention research includes the development and testing of interventions that increase efficiency, explicitly speak to the humanity of hospice care, and elevate the roles of all members of the interdisciplinary team.
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Affiliation(s)
- Karla T Washington
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA
| | - Leticia M Alaniz Staner
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA.,Supportive and Palliative Care Program, 14716University of Missouri Health Care, MO, USA
| | - Benjamin E Collie
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA.,Supportive and Palliative Care Program, 14716University of Missouri Health Care, MO, USA
| | - Kevin W Craig
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA.,Supportive and Palliative Care Program, 14716University of Missouri Health Care, MO, USA
| | - George Demiris
- Department of Biobehavioral Health Sciences, 6572University of Pennsylvania School of Nursing, PA, USA.,Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, PA, USA
| | - Debra Parker Oliver
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA
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Reeves E, Schweighoffer R, Liebig B. An investigation of the challenges to coordination at the interface of primary and specialized palliative care services in Switzerland: A qualitative interview study. J Interprof Care 2020; 35:21-27. [PMID: 32101081 DOI: 10.1080/13561820.2020.1724085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Good coordination of healthcare services is vital for ensuring health cost efficiency and high-quality care for patients. It is especially important in the context of palliative care as services are often highly fragmented due to a combination of diverse professional groups, organizations, and approaches to care. However, the coordination of services in this field is often evaluated as insufficient. Little is known about the challenges to coordination in this sector in Switzerland. The present study addresses this gap in research by investigating the challenges to coordination at the interface of palliative care services in Switzerland. Interviews (n = 24) with 38 healthcare practitioners working in palliative care in four cantons (Basel-City, Lucerne, Ticino, and Vaud) form the basis for this investigation. The selected cantons not only represent French, Italian, and German language regions of Switzerland but also represent diverse rural, urban, and historical contexts. Expert interviews are analyzed using structural content analysis. Three clusters of challenges to coordination were identified in the data: (1) organizational challenges to coordination, which relate to explicit forms of coordination; (2) relational challenges to coordination; and (3) structural challenges to coordination, which relate to implicit forms of coordination. The study reveals a need for better financial support for coordination in palliative care and a stronger focus on interprofessional coordination in educating professionals in palliative care. Future research on how to further foster good team coordination practices between primary and specialized palliative services merits further investigation. Since these findings are indicative of areas for improvement for coordination at the interface of Swiss palliative care services, they are of particular interest for healthcare practitioners, policymakers, and researchers involved in the evolution of coordinative practice.
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Affiliation(s)
- Emily Reeves
- Fakultät Für Psychologie, Universität Basel , Basel, Switzerland
| | | | - Brigitte Liebig
- Fachhochschule Nordwestschweiz FHNW, Hochschule Für Angewandte Psychologie , Olten, Switzerland
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10
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Multidisciplinary staff perspectives on the integration of spiritual care in a new setting: Israel. Palliat Support Care 2019; 18:431-436. [PMID: 31699183 DOI: 10.1017/s1478951519000877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Integrating spiritual care into multidisciplinary care teams has seen both successful thoughtful collaboration and challenges, including feelings of competition and poor cross-disciplinary understanding. In Israel, where the profession is new, we aimed to examine how spiritual care is perceived by other healthcare professionals learning to integrate spiritual caregivers into their teams. METHOD Semi-structured qualitative interviews of 19 professionals (seven physicians, six nurses, three social workers, two psychologists, and one medical secretary) working with spiritual caregivers in three Israeli hospitals, primarily in oncology/hematology. The interviews were transcribed and subjected to thematic analysis. RESULTS Respondents' overall experience with adding a spiritual caregiver was strongly positive. Beneficial outcomes described included calmer patients and improved patient-staff relationships. Respondents identified reasons for a referral not limited to the end of life. Respondents distinguished between the role of the spiritual caregiver and those of other professions and, in response to case studies, differentiated when and how each professional should be involved. CONCLUSION Despite its relative newness in Israel, spiritual care is well received by a wide variety of professionals at those sites where it has been integrated. Steps to improve collaboration should include improving multidisciplinary communication to broaden the range of situations in which spiritual caregivers and other professionals work together to provide the best possible holistic care.
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11
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Hopeck P. Care Providers' Integration of Family Requests in End-of-life Communication: Understanding What to Do and Why to Do It. HEALTH COMMUNICATION 2018; 33:1277-1283. [PMID: 28820620 DOI: 10.1080/10410236.2017.1351273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
End-of-life situations are fraught with challenges for patients, family members, and individuals working at the patient's bedside. Care workers must address needs of the patient, as well as his or her distressed family members. This article is an inductive investigation of care workers' (nurses, patient advocates, and clergy) experiences with end-of-life discussions when the family asks to "do everything." Participants also noted resistance to hospice in some of these encounters based on pre-existing connotations of hospice held by the family members. The article concludes with a discussion about how identifying end-of-life terms may be transformed to be more accessible for family members.
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Affiliation(s)
- Paula Hopeck
- a Department of Communication Studies , Bloomsburg University of Pennsylvania
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12
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Abstract
With an increasing number of terminal patients in the United States dying in the context of hospice, the role that hospice chaplains play in providing spiritual care for patients and their families is important to examine. The hospice chaplain role requires careful navigation of the development of relationships that may end abruptly, the expectations of hospice organizations, and the needs of both patients and families. The current study uses the concept of competing role dialectics to further our understanding of the challenges chaplains face as they enact this crucial role. Data from 45 current and former hospice chaplains reveal four major role tensions hospice chaplains must develop strategies to handle: fostering relationships versus fostering autonomy, acting as team members versus acting as individuals, serving the family unit as a whole versus serving particular family members, and following the agendas of patients and families versus following one's own agenda.
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13
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Hopeck P, Harrison TR. Reframing, Refocusing, Referring, Reconciling, and Reflecting: Exploring Conflict Resolution Strategies in End-of-Life Situations. HEALTH COMMUNICATION 2017; 32:240-246. [PMID: 27177189 DOI: 10.1080/10410236.2015.1099509] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Many problems can occur between family members at the end of a patient's life, resulting in conflict that others-the nurses, patient advocates, clergy, and social workers involved in the case-must resolve. This article explores the strategies used by those individuals to resolve conflict. Using grounded practical theory as a theoretical and methodological framework, qualitative interviews (n = 71) revealed how they manage family conflict at the end of life. The management styles include reframing, refocusing, referring, reconciling, and reflecting (the "5 Rs"). These strategies provide a conflict management typology for those who work with families during end-of-life situations.
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Affiliation(s)
- Paula Hopeck
- a Department of Languages, Cultures, and Communication , Stephen F. Austin State University
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Ferrell B, Wittenberg E, Battista V, Walker G. Nurses' Experiences of Spiritual Communication with Seriously III Children. J Palliat Med 2016; 19:1166-1170. [PMID: 27754765 DOI: 10.1089/jpm.2016.0138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The goal of this study was to explore nurse experiences in communication with children about spiritual topics in order to develop training in this area. BACKGROUND Although spiritual care is essential in pediatric palliative care, few providers receive training about communication with ill children about spirituality. METHODS Researchers developed a brief survey to prompt nurses to reflect on pediatric palliative care experiences that included spiritual discussions. Nurses attending training courses voluntarily submitted stories. Qualitative data were thematically analyzed by members of the research team, consisting of two researchers with expertise in palliative care, spirituality, and communication and two expert pediatric palliative care clinicians. RESULTS Nurses' spiritual conversations with children revealed that children question God and the reason for their illness, have a desire to talk about the afterlife as a way of understanding their limited lifespan, and to share descriptions of an afterlife, in these cases described as heaven. Nurses conveyed the importance of being present and engaging in spiritual communication with children. DISCUSSION Communication training is needed and should prepare providers to respond to a child's spiritual questioning, assist parents when the child initiates discussion about the afterlife, and help parent and child understand the spiritual meaning of their illness. Chaplains serve as spiritual care experts and can help train nurses to screen for spiritual distress, have greater competence in spiritual communication, and to collaborate with chaplains in care. Quality palliative care is incomplete without attention to spiritual care.
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Affiliation(s)
- Betty Ferrell
- 1 Division of Nursing Research and Education, City of Hope National Medical Center , Duarte, California
| | - Elaine Wittenberg
- 1 Division of Nursing Research and Education, City of Hope National Medical Center , Duarte, California
| | - Vanessa Battista
- 2 Clinical Faculty, Boston College William F. Connell, School of Nursing, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Gay Walker
- 3 Hospice and Pediatric Palliative Care, Providence Trinity Care Hospice , Torrance, California
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Wittenberg E, Ferrell B, Goldsmith J, Ragan SL, Paice J. Assessment of a Statewide Palliative Care Team Training Course: COMFORT Communication for Palliative Care Teams. J Palliat Med 2016; 19:746-52. [DOI: 10.1089/jpm.2015.0552] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elaine Wittenberg
- Division of Nursing Research and Education, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Betty Ferrell
- Division of Nursing Research and Education, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Joy Goldsmith
- Department of Communication, University of Memphis, Memphis, Tennessee
| | - Sandra L. Ragan
- Department of Communication, University of Oklahoma, Norman, Oklahoma
| | - Judith Paice
- Hematology/Oncology Department, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Kobayashi R, McAllister CA. Hospice Core Professions' Views on Interdisciplinary Teams: A Qualitative Investigation. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2016; 12:214-230. [PMID: 27462950 DOI: 10.1080/15524256.2016.1201565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The hospice interdisciplinary team (IDT) has been recognized as an ideal model for interprofessional collaboration. To address the manner in which interdisciplinary practices are perceived by team members, this study explored profession-based similarities and differences in perceptions among the four core hospice IDT members (physicians, nurses, social workers, and spiritual care providers) as well as experiences on the IDT. Semistructured interviews with 20 hospice professionals, 5 from each profession, were completed. Findings suggested that while hospice professions share some perceptions and experiences about hospice team membership, strengths of and barriers to teamwork, and individual members' contribution to the team, significant profession-based differences exist largely in the area of hospice team membership beyond the core members, type of language and descriptions used, perceptions of causes and effects of barriers to teamwork, and understandings of how team effectiveness is evaluated. Changes at the team-based, organizational, policy, and educational levels are needed to further maximize strengths of individual hospice IDT member and team qualities.
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Affiliation(s)
- Rie Kobayashi
- a School of Social Work , Eastern Washington University , Cheney , Washington , USA
| | - Carolyn A McAllister
- b School of Social Work , California State University , San Bernardino , California , USA
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Moore AR, Bastian RG, Apenteng BA. Communication Within Hospice Interdisciplinary Teams: A Narrative Review. Am J Hosp Palliat Care 2015; 33:996-1012. [PMID: 26518351 DOI: 10.1177/1049909115613315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hospice care is coordinated through an interdisciplinary team (IDT), which assures that a holistic care plan based on the patient's wishes is implemented. The extent to which an IDT provides quality care may be associated with how effectively they communicate within the team as well as with patients, caregivers, and families. This review seeks to characterize communication strategies among hospice IDT members and to determine how such strategies impact patient care. Although the existing literature sheds some light on communication within hospice IDTs, further research is needed. Inquiry into the communicative process of IDTs in settings other than team meetings, such as during patient visits or informal settings, would provide a more comprehensive representation of how communication influences IDT dynamics and overall team functioning.
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Affiliation(s)
- Angela R Moore
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Randi Ginger Bastian
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Bettye A Apenteng
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Cramer EM, Tenzek KE, Allen M. Recognizing Success in the Chaplain Profession: Connecting Perceptions With Practice. J Health Care Chaplain 2015; 21:131-50. [DOI: 10.1080/08854726.2015.1071543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lysaght Hurley S, Barg FK, Strumpf N, Ersek M. Same agency, different teams: perspectives from home and inpatient hospice care. QUALITATIVE HEALTH RESEARCH 2015; 25:923-931. [PMID: 25294344 PMCID: PMC4454620 DOI: 10.1177/1049732314554091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Tremendous growth in hospice over the past 30 years in the United States has increased the number of terminally ill patients dying at home. Recently, however, more hospice patients are dying at inpatient facilities. To understand the varying perceptions about care in the home and inpatient hospice, we conducted semistructured interviews with 24 interdisciplinary team (IDT) members and analyzed the data using the constant comparative method. Core interdisciplinary tasks, including identifying the focus of energy, tailoring family caregiver involvement, acknowledging who is in charge, and knowing both sides differed in the home and inpatient settings. Despite the overarching umbrella of hospice care, home and inpatient hospice settings create different foci for IDT members, burdens and privileges for family caregivers, and control of the care plan. Key differences between home and inpatient hospice processes of care highlight the complexity of patient-centered end-of-life care in the United States.
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Affiliation(s)
| | - Frances K Barg
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Mary Ersek
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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20
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Perechocky A, DeLisser H, Ciampa R, Browning J, Shea JA, Corcoran AM. Piloting a medical student observational experience with hospital-based trauma chaplains. JOURNAL OF SURGICAL EDUCATION 2014; 71:91-95. [PMID: 24411430 DOI: 10.1016/j.jsurg.2013.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 06/24/2013] [Accepted: 07/01/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Medical students have typically received relatively modest training in approaches for engaging the concerns of patients and families facing life-threatening situations and terminal illnesses. We propose that medical students would perceive benefits to their communication skills, understanding of the role of the chaplain, and knowledge of emotional and spiritual needs of grieving patients and families after shadowing hospital-based trauma chaplains whose work focuses on emergency department traumas and intensive care units. METHODS The authors developed a pilot program in which medical students shadowed a trauma chaplain during an on-call shift in an urban level 1 trauma center. Students subsequently completed an evaluative survey of their experience. RESULTS Of 21 participants, 14 (67%) completed the questionnaire. Students observed an average of 1.50 traumas and 3.57 interactions with patients or families. One-third of the students witnessed a death. More than 90% of respondents agreed or strongly agreed that (1) the program provided them with a greater understanding of how to engage patients and families in difficult conversations; (2) they learned about the chaplain's role in the hospital; and (3) the experience was useful for their medical education, careers, and personal development. About two-thirds (9/14) perceived that they learned how to discuss spirituality with patients and families. All recommended the experience be part of the medical school curriculum. DISCUSSION Observational experiences with hospital-based trauma chaplains might be an effective nondidactic approach for teaching medical students effective communication with patients and families, collaboration with chaplains, and spirituality in patient care.
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Affiliation(s)
- Andrew Perechocky
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Boston Medical Center, Boston, Massachusetts.
| | - Horace DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ralph Ciampa
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - James Browning
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Judy A Shea
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amy M Corcoran
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Kobayashi R, McAllister CA. Similarities and Differences in Perspectives on Interdisciplinary Collaboration Among Hospice Team Members. Am J Hosp Palliat Care 2013; 31:825-32. [DOI: 10.1177/1049909113503706] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study surveyed 4 core hospice professionals (physicians, nurses, social workers, and chaplains) on their perceived level of interdisciplinary collaboration, the influences of interdisciplinary collaboration, and job satisfaction to determine potential similarities and differences based on profession and various demographic characteristics of the members or member hospices. Analysis found that there are overall no differences based on demographic characteristics. Differences between professions, while few, were largely in the area of perceptions on relationships between members of the hospice team. Specifically, social workers appear to perceive themselves as less connected to the other members of the interdisciplinary team, an area theorized to influence interdisciplinary collaboration. Difference between professions was also found in job satisfaction. Implications for hospice practice and interdisciplinary education are discussed.
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Wittenberg-Lyles E, Oliver DP, Demiris G, Cunningham CP. Sharing atrocity stories in hospice: A study of niceness message strategies in interdisciplinary team meetings. PROGRESS IN PALLIATIVE CARE 2013; 19:172-176. [PMID: 21909193 DOI: 10.1179/1743291x11y.0000000011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The telling of atrocity stories offers therapeutic benefits to healthcare providers. Transcripts of hospice interdisciplinary team (IDT) meetings were used to analyze strategies for telling atrocity stories in the performance of symbiotic niceness through criticism. Symbiotic niceness draws upon niceness messages to establish reciprocal niceness by others in order to facilitate emotional labor. In IDT meetings the two predominant strategy types used were indirect and direct criticism. Nurses and medical directors engaged in niceness message strategies mostly about patients and other healthcare professionals. The study concludes that hospice IDT meetings are a venue for team members to communicate symbiotic niceness through emotional labor.
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Affiliation(s)
- Elaine Wittenberg-Lyles
- Markey Cancer Center & Department of Communication, University of Kentucky, 800 Rose Street, Lexington KY 40536,
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23
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Olshever A. Integration of groupwork theory and hospice interdisciplinary team practice. ACTA ACUST UNITED AC 2012. [DOI: 10.1921/095182411x636536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Cockell N, Mcsherry W. Spiritual care in nursing: an overview of published international research. J Nurs Manag 2012; 20:958-69. [DOI: 10.1111/j.1365-2834.2012.01450.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2012] [Indexed: 02/03/2023]
Affiliation(s)
- Nell Cockell
- Department of Spiritual and Pastoral Care; South Warwickshire Foundation Trust; Warwickshire; UK
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25
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Pesut B, Reimer-Kirkham S, Sawatzky R, Woodland G, Peverall P. Hospitable hospitals in a diverse society: from chaplains to spiritual care providers. JOURNAL OF RELIGION AND HEALTH 2012; 51:825-36. [PMID: 20838896 DOI: 10.1007/s10943-010-9392-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The chaplain's role in health care services has changed profoundly within the contexts of managerial and fiscal constraints, and increasingly pluralistic and secularized societies. Drawing from a larger study that examined religious and spiritual plurality in health care, we present findings regarding the contributions of chaplains or spiritual care providers (SCPs) as they are referred to more recently, in Canadian institutional health care contexts. Qualitative analyses of interviews with 14 employed SCPs and 7 volunteers provided insights about legitimizing and crafting the role of SPCs, becoming part of the health care team, and brokering diversity. Implications are discussed in relation to role clarification and policy development for truly hospitable health care.
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Affiliation(s)
- Barbara Pesut
- School of Nursing FIN 344, University of British Columbia Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada.
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26
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Cramer EM, Tenzek KE. The Chaplain Profession from the Employer Perspective: An Analysis of Hospice Chaplain Job Advertisements. J Health Care Chaplain 2012; 18:133-50. [DOI: 10.1080/08854726.2012.720548] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Youngwerth J, Twaddle M. Cultures of Interdisciplinary Teams: How to Foster Good Dynamics. J Palliat Med 2011; 14:650-4. [DOI: 10.1089/jpm.2010.0395] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Martha Twaddle
- Rush University School of Medicine, Midwest Palliative & Hospice CareCenter, Glenview, Illinois
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29
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O'Connor M, Fisher C. Exploring the Dynamics of Interdisciplinary Palliative Care Teams in Providing Psychosocial Care: “Everybody Thinks that Everybody Can Do It and They Can't”. J Palliat Med 2011; 14:191-6. [DOI: 10.1089/jpm.2010.0229] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Moira O'Connor
- WA Centre for Cancer and Palliative Care and Curtin Health and Innovation Research Institute (CHIRI), Curtin University, Perth, Western Australia, Australia
| | - Colleen Fisher
- School of Population Health, UWA, Person, Western Australia, Australia
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30
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Bentur N, Resnizky S. Challenges and achievements in the development of spiritual-care training and implementation in Israel. Palliat Med 2010; 24:771-6. [PMID: 20847089 DOI: 10.1177/0269216310380490] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In recent years, pioneering spiritual-care training programs and services have been developed in Israel. This paper examines the implementation of the training programs and the challenge of integrating program graduates in the healthcare services. The information was collected through in-depth interviews with 12 students and graduates and the directors of the three training programs. All the interviews were transcribed in full and analyzed using qualitative study methods. The interviewees emphasized the importance of practical experience, although many of them encountered some degree of antagonism during their training or placement. Continuation of personal counseling and supervision after the conclusion of the program is also essential. Some were worried that they would not find work or were concerned about negotiations with potential employers. Evidently, the implementation of spiritual-care education must continue apace and careful consideration be given to optimizing its acceptance by the establishment.
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Affiliation(s)
- Netta Bentur
- Myers-JDC-Brookdale Institute, Center for Research on Aging, Israel.
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31
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Bentur N, Resnitzky S, Sterne A. Attitudes of stakeholders and policymakers in the healthcare system towards the provision of spiritual care in Israel. Health Policy 2010; 96:13-9. [DOI: 10.1016/j.healthpol.2009.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 11/29/2009] [Accepted: 12/06/2009] [Indexed: 11/27/2022]
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Oliver DP, Tatum P, Kapp JM, Wallace A. Interdisciplinary Collaboration: The Voices of Hospice Medical Directors. Am J Hosp Palliat Care 2010; 27:537-44. [DOI: 10.1177/1049909110366852] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The value of interdisciplinary collaboration is a significant aspect of the palliative care philosophy, as identified by the founder of the modern hospice movement Cecily Saunders. The purpose of this descriptive study was to explore the experiences of hospice medical directors within this collaborative context. Open-ended interviews with 17 hospice medical directors were done and their responses were thematically analyzed. These narratives present a very positive collaborative experience by these medical directors in their hospice settings. Assisting medical directors to find time and financial opportunities for professional development and support within their role was found to be an opportunity to further improve collaboration.
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Affiliation(s)
- Debra Parker Oliver
- Curtis W. and Ann H. Long Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA,
| | - Paul Tatum
- Curtis W. and Ann H. Long Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
| | - Julie M. Kapp
- Curtis W. and Ann H. Long Department of Family and Community Medicine, University of Missouri, Columbia, MO, USA
| | - Audrey Wallace
- School of Medicine, University of Missouri, Columbia, MO, USA
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33
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Wittenberg-Lyles E, Parker Oliver D, Demiris G, Regehr K. Interdisciplinary collaboration in hospice team meetings. J Interprof Care 2010; 24:264-73. [PMID: 19995271 PMCID: PMC2854854 DOI: 10.3109/13561820903163421] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hospice and palliative care teams provide interdisciplinary care to seriously-ill and terminally-ill patients and their families. Care teams are comprised of medical and non-medical disciplines and include volunteers and lay workers in healthcare. The authors explored the perception of collaboration among hospice team members and actual collaborative communication practices in team meetings. The data set consisted of videotaped team meetings, some of which included caregiver participation, and team member completion of a survey. Findings revealed that the team's reflection on process was most likely to occur in team meetings, however least likely to occur when caregivers were present. Although team members had a high perception of interdependence and flexibility of roles, this was less likely to be enacted in team meetings with and without the presence of caregivers. Caregiver participation in team meetings had a positive impact on collaborative communication and the potential benefit of caregiver inclusion in team meetings is explored.
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Affiliation(s)
- Elaine Wittenberg-Lyles
- Department of Communication Studies, University of North Texas, PO Box 305268, Denton, TX 76203-5268, USA.
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34
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Pesut B, Fowler M, Reimer-Kirkham S, Taylor EJ, Sawatzky R. Particularizing spirituality in points of tension: enriching the discourse. Nurs Inq 2009; 16:337-46. [DOI: 10.1111/j.1440-1800.2009.00462.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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35
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Kuziemsky CE, Borycki EM, Purkis ME, Black F, Boyle M, Cloutier-Fisher D, Fox LA, MacKenzie P, Syme A, Tschanz C, Wainwright W, Wong H. An interdisciplinary team communication framework and its application to healthcare 'e-teams' systems design. BMC Med Inform Decis Mak 2009; 9:43. [PMID: 19754966 PMCID: PMC2753306 DOI: 10.1186/1472-6947-9-43] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 09/15/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are few studies that examine the processes that interdisciplinary teams engage in and how we can design health information systems (HIS) to support those team processes. This was an exploratory study with two purposes: (1) To develop a framework for interdisciplinary team communication based on structures, processes and outcomes that were identified as having occurred during weekly team meetings. (2) To use the framework to guide 'e-teams' HIS design to support interdisciplinary team meeting communication. METHODS An ethnographic approach was used to collect data on two interdisciplinary teams. Qualitative content analysis was used to analyze the data according to structures, processes and outcomes. RESULTS We present details for team meta-concepts of structures, processes and outcomes and the concepts and sub concepts within each meta-concept. We also provide an exploratory framework for interdisciplinary team communication and describe how the framework can guide HIS design to support 'e-teams'. CONCLUSION The structures, processes and outcomes that describe interdisciplinary teams are complex and often occur in a non-linear fashion. Electronic data support, process facilitation and team video conferencing are three HIS tools that can enhance team function.
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Affiliation(s)
- Craig E Kuziemsky
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada.
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36
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Oliver DP, Tatum P. The Medical Director as a Member of the Hospice Team. J Am Med Dir Assoc 2009; 10:292-4. [DOI: 10.1016/j.jamda.2009.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 03/03/2009] [Indexed: 10/20/2022]
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