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Kim JY, Kim HS, Kang MJ, Oh HY, Jo MR. Development and Psychometric Evaluation of the End-of-Life Nursing Competency Scale for Clinical Nurses. Healthcare (Basel) 2024; 12:1580. [PMID: 39201139 PMCID: PMC11354138 DOI: 10.3390/healthcare12161580] [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: 06/22/2024] [Revised: 07/19/2024] [Accepted: 08/03/2024] [Indexed: 09/02/2024] Open
Abstract
This study aimed to develop and establish psychometric properties of the End-of-Life Nursing Competency Scale for Clinical Nurses. The initial items were derived from an in-depth literature review and field interviews. The content validation of these items was assessed over three rounds by experts in end-of-life nursing care. The study included 437 clinical nurses from four hospitals in S, E, and D cities in South Korea. The final exploratory factor analysis resulted in a scale consisting of 21 items with the following five factors that explained 68.44% of the total variance: Physical care-imminent end-of-life, legal and administrative processes, psychological care-patient and family, psychological care-nurses' self, and ethical nursing. The final model with these five subscales was validated through confirmatory factor analysis. Both item convergent-discriminant validity and known-group validity, which compared two groups based on clinical experience (p < 0.008) and working department (p < 0.008), were satisfactory. The internal consistency, as measured by Cronbach's α, ranged from 0.62 to 0.89 for the subscales and was 0.91 for the total scale. This scale has been validated as a reliable and effective instrument for clinical nurses to self-assess their end-of-life nursing competencies in a clinical setting.
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Affiliation(s)
- Ji-yeon Kim
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Gyeonggi-do, Republic of Korea; (J.-y.K.); (H.-y.O.)
| | - Hyun-sun Kim
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Gyeonggi-do, Republic of Korea; (J.-y.K.); (H.-y.O.)
| | - Mi-jung Kang
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Gyeonggi-do, Republic of Korea; (J.-y.K.); (H.-y.O.)
| | - Hee-young Oh
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Gyeonggi-do, Republic of Korea; (J.-y.K.); (H.-y.O.)
| | - Mi-rae Jo
- Department of Nursing, Jeonbuk Science College, Jeongeup-si 56204, Jeonbuk-do, Republic of Korea;
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Keiser M, Buterakos R, Stutzky H, Moran L, Hewelt D. Evaluating the FRAIL Questionnaire as a Trigger for Palliative Care Consultation After Acute Stroke. J Hosp Palliat Nurs 2023; 25:124-128. [PMID: 36989192 DOI: 10.1097/njh.0000000000000940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
The American Heart Association and the American Stroke Association jointly released guidelines stating that all patients with a new diagnosis of stroke should receive palliative care consultation starting in the acute phase of care. The purpose of this project was to increase palliative care consultation rates for patients after an acute stroke by using a frailty score to trigger a palliative care consult. Provider education on palliative care and a 5-question fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) questionnaire was delivered by a presentation, handouts, and a follow-up email using previously developed content. Patients included adults admitted to the neuroscience critical care unit of a Midwestern comprehensive stroke center with an admission diagnosis of acute stroke (n = 120). The charge nurse completed the FRAIL questionnaire as a screening tool to trigger a palliative care consult. A survey was also distributed to providers (n = 54) to understand their knowledge, thoughts, and feelings toward palliative care. There was an increase in patients who received palliative care consultation from 14.9% to 21.7% after implementation of the FRAIL questionnaire. Also, providers felt better able to provide symptom management to patients after acute stroke. Further research is necessary to determine if the FRAIL survey is an adequate trigger for palliative care consultation.
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Adeyemi OJ, Bouillon-Minois JB, Siman N, Cuthel AM, Goldfeld KS, Grudzen CR. Knowledge and Attitudes Toward Hospice and Palliative Care: Instrument Validation Among Emergency Providers. Am J Hosp Palliat Care 2023; 40:280-290. [PMID: 35549544 DOI: 10.1177/10499091221098664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Emergency providers can engage in goals of care discussions and hospice and palliative care referrals. Little is known about their knowledge and attitudes, which may influence these care practices. Objective: This study aims to re-validate the knowledge and attitude towards hospice and palliative care (KAHP) scale and assess the scale's latent constructs among emergency providers. Methods: The scale consists of ten items measured on a five-point Likert scale. Five of the ten items were reverse scored. Content validation was performed by ten experts in Hospice and Palliative Medicine and Emergency Medicine. Baseline surveys of emergency physicians, advance practice providers, and nurses conducted in the context of a pragmatic, randomized control trial were used for the item analysis and the exploratory and confirmatory factor analyses. Results: The KAHP scale is a ten-item scale scored from 10 to 50. Based on the synthesis of content validation results and the item analysis, all ten items were retained. The item and scale Content Validity Index were each .91. The reliability of the scale was .64 and the exploratory factor analysis identified three underlying constructs defined as self-rated knowledge, support for hospice and palliative care practice, and views on provider-patient communication. The presence of good model fit indices supported the structural integrity of the constructs. Conclusion: We present a validated instrument that is suitable for assessing knowledge and attitude variations toward interventions designed to improve hospice and palliative care practice among emergency providers.
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Affiliation(s)
- Oluwaseun J Adeyemi
- Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA
| | - Jean-Baptiste Bouillon-Minois
- Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA
- Emergency Department55174, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nina Siman
- Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA
| | - Allison M Cuthel
- Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA
| | - Keith S Goldfeld
- Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, 12296New York University Grossman School of Medicine, New York, NY, USA
| | - Corita R Grudzen
- Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, 12296New York University Grossman School of Medicine, New York, NY, USA
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Seo NR, Yeom HE. Factors Affecting Psychological Burnout in Nurses Caring for Terminal Cancer Patients. JOURNAL OF HOSPICE AND PALLIATIVE CARE 2022; 25:159-168. [PMID: 37674666 PMCID: PMC10179995 DOI: 10.14475/jhpc.2022.25.4.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 09/08/2023]
Abstract
Purpose This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients. Methods A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-of-life care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics. Data were analyzed using descriptive statistics, the independent t-test, analysis of variance, Pearson correlation coefficients, and hierarchical linear regression analysis using SPSS for Windows (version 26.0). Results Psychological burnout was significantly correlated with end-of-life care competency (r=-0.23, P=0.003) but not with ethical dilemmas. The results of the hierarchical linear regression analysis indicated that end-of-life care competency (β=-0.280, P=0.010) and ethical dilemmas (β=0.275, P=0.037) were significant predictors of psychological burnout, after adjusting for age, religious status, clinical experience, and unit type. Conclusion The current study's findings demonstrate that end-of-life care competency and ethical dilemmas are crucial factors that affect psychological burnout in nurses who care for terminal cancer patients. Substantive education programs must be developed to improve nurses' competencies in end-of-life care and ethical dilemmas to decrease psychological burnout.
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Affiliation(s)
- Na-Ri Seo
- Department of Nursing, Gachon University Gil Medical Center, Incheon, Korea
| | - Hyun-E Yeom
- Department of Nursing, Chungnam National University, Daejeon, Korea
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Zarei F, Dehghan M, Mongolian Shahrbabaki P. The Relationship Between Perception of Good Death With Clinical Competence of End-Of-Life Care in Critical Care Nurses. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221134721. [PMID: 36252601 DOI: 10.1177/00302228221134721] [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
Providing a good death can be one of the most important goals of end-of-life care. This study aimed to investigate the relationship between the concept of good death with clinical end-of-life care competence among intensive care nurses. The participants were 279 nurses in southeast Iran. The data were collected using the Nurses' Concept of Good Death Questionnaire and the Clinical Competency of End-of-Life Care Questionnaire. There was a positive, moderate, and significant correlation between nurses' concept of good death and their clinical competence in end-of-life care. Nurses who got higher scores on the concept of good death showed higher levels of clinical competence in end-of-life care. It is possible to take steps to improve nurses' concepts and knowledge through specialized educational interventions.
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Affiliation(s)
- Fatemeh Zarei
- Department of Critical Care, Razi Nursing and Midwifery Department, Kerman University of Medical Science, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mongolian Shahrbabaki
- Department of Critical Care, Nursing Research Center, Razi Nursing and Midwifery Department, Kerman University of Medical Science, Kerman, Iran
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Wu X, Li X, Su T, Liang J, Wang L, Huang Q, Zhang J, Wang S, Wang N, Xiang R. Development and validation of a questionnaire to evaluate the knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. Nurs Open 2022; 10:673-686. [PMID: 36114724 PMCID: PMC9834548 DOI: 10.1002/nop2.1334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/11/2022] [Accepted: 08/07/2022] [Indexed: 01/19/2023] Open
Abstract
AIM To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. DESIGN A descriptive study design and STROBE checklist were applied in this research. METHODS The theoretical framework of the questionnaire was knowledge-attitude-behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed. RESULTS A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80-1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split-half reliability value of the overall questionnaire were 0.93 and 0.97, respectively. CONCLUSIONS This questionnaire has good validity and reliability, but needs further testing in multi-centered settings.
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Affiliation(s)
- Xiaofen Wu
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Xiran Li
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Ting Su
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Jin Liang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Lijie Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Qiuna Huang
- Shunde HospitalSouthern Medical UniversityFoshanChina
| | - Jiayi Zhang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Shuang Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina,School of NursingSouthern Medical UniversityGuangzhouChina
| | - Ning Wang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina
| | - Rihui Xiang
- Centre for General PracticeThe Seventh Affiliated Hospital, Southern Medical UniversityFoshanChina
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7
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Henao-Castaño ÁM, Rivera-Romero N, Garzón HPO. Health Care at the End of Life: Experience of Nurses at the Adult Intensive Care Unit. Crit Care Nurs Q 2021; 44:387-392. [PMID: 34437317 DOI: 10.1097/cnq.0000000000000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to determine the experience of the nurses who provide health care in the final stages of life in the intensive care unit for adults. The authors report the results of their study, which used a qualitative design with a phenomenological approach. Eighteen adults participated by being interviewed using semistructured questions. The nurses expressed that health care at the end of life represents an emotional and psychological burden for them. They also recognized that health care was given based on the empiricism achieved through clinical experience. In this regard, they emphasize the importance of having the proper education in this area to provide comprehensive care to the patient, the family, and the nurse.
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Affiliation(s)
- Ángela María Henao-Castaño
- Universidad Nacional de Colombia, Sede Bogotá, Colombia (Dr María Henao-Castaño and Ms Rivera-Romero); and Especialista en Cuidado Critico Adulto, Enfermero, Colombia (Ms Paola Ospina Garzón)
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8
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Tang MY, Li XL, Shi ZY, Fu WJ. Knowledge of and willingness to promote advanced care planning among oncology nurses in southwest China. Int J Palliat Nurs 2021; 26:175-182. [PMID: 32378488 DOI: 10.12968/ijpn.2020.26.4.175] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Nurses feature prominently in promoting advance care planning (ACP), but only a limited amount of relevant research has been conducted from the nurses' viewpoint, and little is known about the nurses' knowledge of and their willingness to promote ACP in China. AIMS The aims of this study were to investigate oncology nurses' knowledge of and their willingness to promote ACP, and to explore associated factors. METHODS A multi-centre study was conducted to investigate 350 nurses in the oncology departments of four university hospitals in southwestern China. Cluster sampling was used in data collection, which involved three categories of questionnaires concerning demographic characteristics, knowledge about ACP and willingness to promote ACP. Chi-squared tests and multiple linear regression were employed in data analysis. RESULTS Some 293 valid questionnaires were collected, among which, 60.1% of respondents never received palliative care education, 89.1% never received training about ACP and 72.7% had not even heard of ACP. Nurses with higher position titles (χ2=18.41, p<0.001) and longer working experience (χ2=12.25, p=0.001) were more likely to have received palliative care education; nurses with higher educational background levels (χ2=12.91, p<0.001), higher position titles (χ2=9.77, p=0.003) and longer working experience (χ2=7.92, p=0.006) were more likely to have learned about ACP; nurses with higher position titles had more access to relevant training (χ2=5.10, p=0.03). Furthermore, whether the nurse had 'heard about ACP' (B=3.113, p=0.018) and 'received training about ACP' (B=3.894, p=0.04) were both associated with their willingness to promote ACP. CONCLUSIONS The findings of this study indicated that oncology nurses were highly inclined to promote ACP, but limited by their lack of knowledge and understanding of it. Therefore, a systematic and adequate training programme about ACP for nurses is an urgent requirement to effectively enhance the implementation of ACP in China.
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Affiliation(s)
- Meng-Yan Tang
- Master's Student, School of Nursing, Sichuan University, China
| | - Xiao-Ling Li
- Professor, School of Nursing, Sichuan University; Department of Nursing, West China Hospital of Sichuan University, China
| | - Zheng-Yan Shi
- Master's Student, School of Nursing, Sichuan University, China
| | - Wen-Jing Fu
- Master's Student, School of Nursing, Sichuan University, China
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9
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Scheinberg-Andrews C, Ganz FD. Israeli Nurses' Palliative Care Knowledge, Attitudes, Behaviors, and Practices. Oncol Nurs Forum 2021; 47:213-221. [PMID: 32078607 DOI: 10.1188/20.onf.213-221] [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
OBJECTIVES To describe and compare self-perceived end-of-life (EOL) knowledge, attitudes, behaviors, and practices of intensive care unit (ICU) nurses compared to oncology nurses. SAMPLE & SETTING 126 Israeli nurses (79 oncology nurses and 47 ICU nurses) who were members of the Israel Association of Cardiology and Critical Care Nurses and the Israeli Oncology Nurses Organization. METHODS & VARIABLES This cross-sectional study used an online survey to gather demographic information, clinical setting, and study measures (EOL knowledge, attitudes, behaviors, and practices). RESULTS Oncology nurses and ICU nurses showed moderate levels of self-perceived knowledge and attitudes toward palliative care; however, their self-reported behaviors were low. Oncology nurses scored slightly higher than ICU nurses on knowledge and attitudes but not behaviors, although the difference was not statistically significant. IMPLICATIONS FOR NURSING Contrary to the current authors' expectations, oncology nurses and ICU nurses have similar levels of knowledge, attitudes, and behaviors regarding palliative care. Nurses in both settings need to be better trained and empowered to provide such care.
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Montagnini M, Smith HM, Price DM, Strodtman L, Ghosh B. An Instrument to Assess Self-Perceived Competencies in End-of-Life Care for Health Care Professionals: The End-of-Life Care Questionnaire. Am J Hosp Palliat Care 2021; 38:1426-1432. [PMID: 33787330 DOI: 10.1177/10499091211005735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE We describe the development and the psychometric properties of an instrument to assess self-perceived EOL care competencies for healthcare professionals: The End-of-Life Care Questionnaire (EOL-Q). METHODS The EOL-Q consists of 28 questions assessing knowledge, attitudes and behaviors with subscale items addressing seven domains of care: decision-making, communication, continuity of care, emotional support for patients/families, symptom management, spiritual support for patients/families, and support for clinicians. The EOL-Q was used to assess competencies of 1,197 healthcare professionals from multiple work units at a large medical center. Cronbach's alpha coefficients were calculated for the survey and subscales. A factor analysis was also conducted. RESULTS Internal consistency reliability was for was high for the total scale (0.93) and for the subscales addressing knowledge, behaviors, decision-making, communication, emotional support and symptom management (0.84-0.92); and moderate (>0.68) for the attitudes and continuity of care subscales. The factor analysis demonstrated robust consolidation of the communication and continuity of care subscales (eigenvalue 9.47), decision-making subscale (eigenvalue 3.38), symptom management subscale (eigenvalue 1.51), and emotional and spiritual support subscales (eigenvalue 1.13). CONCLUSION Analysis of the psychometric properties of the EOL-Q care across settings supports its reliability and validity as a measure of self-perceived EOL care competencies in the domains of communication and continuity of care, decision-making, symptom management, and emotional and spiritual support. The EOL-Q displays promise as a tool for use in a variety of educational, research, and program development initiatives in EOL care.
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Affiliation(s)
| | - Heather M Smith
- Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Deborah M Price
- 16121University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Linda Strodtman
- 16121University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Bidisha Ghosh
- 16121University of Michigan School of Nursing, Ann Arbor, MI, USA
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Vivekananda K, Parratt C, Tucker M, Leonard R. The impact of online death literacy education on psychology students to have better end‐of‐life conversations. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kitty Vivekananda
- Counselling and Psychology Programs, Faculty of Education, Monash University, Melbourne, Victoria, Australia,
| | - Carrie Parratt
- Counselling and Psychology Programs, Faculty of Education, Monash University, Melbourne, Victoria, Australia,
| | - Mignon Tucker
- Counselling and Psychology Programs, Faculty of Education, Monash University, Melbourne, Victoria, Australia,
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Kim LH, Kim SY, Kim S, Kim HA, Yang HJ, Lee KM, Lee SY, Lee KH, Kim JH. A Mixed Method Study for Exploring the Difficulties in End-of-Life Care and End-of-Life Care Competency in Nurses Who Take Care of Cancer Patients. ASIAN ONCOLOGY NURSING 2021. [DOI: 10.5388/aon.2021.21.2.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lae Hee Kim
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Su Yeon Kim
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Shin Kim
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Hyun A Kim
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Hwa Jeong Yang
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Kyoung Min Lee
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Su Yeon Lee
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Kyung Hee Lee
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Jeong Hye Kim
- Department of Clinical Nursing, University of Ulsan, Seoul, Korea
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Eltaybani S, Igarashi A, Yamamoto-Mitani N. Palliative care in adult intensive care units: A nationwide survey. Nurs Crit Care 2020; 26:315-325. [PMID: 33107206 DOI: 10.1111/nicc.12565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are no data on the provision of palliative nursing care in Egyptian adult intensive care units (ICUs). The Palliative and End-Of-Life (PEOL) Care Index is reliable and content valid; however, its construct and criterion validities have not been examined. AIMS AND OBJECTIVES First, to assess palliative care education, practice, and perceived competence among adult ICU nurses in Egypt. Second, to explore factors related to palliative care nursing practice and perceived competence. Third, to assess the construct and criterion validities of the PEOL Care Index. DESIGN A cross-sectional survey. METHODS Nurse managers and staff nurses in 33 adult ICUs completed self-administered questionnaires. The questionnaires assessed nurses' palliative care practice and perceived competence. A multilevel regression analysis was used to determine the best predictors of palliative care practice and perceived competence. Theory evidence construct validity and predictive criterion validity of the PEOL Care Index were examined. RESULTS Thirty-three nurse managers and 403 staff nurses participated in the study-response rate = 100% and 72.5%, respectively. On a 0-100 scale, the mean scores of undergraduate education, practice, and perceived competence were 54.0 ± 18.7, 49.7 ± 18.1, and 54.5 ± 17.0, respectively. Palliative care practice was significantly related to receiving in-service training on palliative care or end-of-life care (regression coefficients: 3.39), higher job satisfaction (0.97), and higher organizational support (1.85). Palliative care perceived competence was significantly related to older nurses' age (0.20), higher job satisfaction (0.97), and higher palliative care undergraduate education (0.63). CONCLUSIONS Palliative care education, practice, and perceived competence among adult ICU nurses in Egypt are inadequate, especially in terms of spiritual and cultural care. The PEOL Care Index is construct and criterion valid. RELEVANCE TO CLINICAL PRACTICE Palliative care education should begin in nursing schools and extend through clinical in-services. Guidelines should be developed to maximize staff collaboration and the utilization of chaplains in ICUs.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan.,Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
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Jeong DI, Eun Y. Factors Affecting the End-of Life Care Competency of Tertiary Hospital Nurses. HAN'GUK HOSUP'ISU WANHWA UIRYO HAKHOE CHI = THE KOREAN JOURNAL OF HOSPICE AND PALLIATIVE CARE 2020; 23:139-150. [PMID: 37497367 PMCID: PMC10332723 DOI: 10.14475/kjhpc.2020.23.3.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/28/2020] [Accepted: 08/07/2020] [Indexed: 07/28/2023]
Abstract
Purpose The purpose of this study was to investigate the levels of end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; and end-of-life care obstacles and supportive behaviors among tertiary care nurses. Methods The participants were 150 nurses at a tertiary hospital in Jinju, Korea. The data collected using a questionnaire were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression in SPSS for Windows version 24.0. Results The mean (±SD) score of end-of-life care competency was 3.63 (±0.53) on a 5-point scale. A significant difference in end-of-life care competency was found according to whether nurses had experienced the death of a family member or acquaintance (P=0.029). According to stepwise multiple regression analysis, the factors affecting end-of-life care competency were the frequency of end-of-life care supportive behaviors (β=0.38, P<0.001), experience with advance directives (β=0.29, P<0.001), and marriage (β=0.15, P=0.039). This model had an explanatory power of 27.9% (F=18.87, P<0.001). Conclusion In order to improve nurses' end-of-life care competency, it is important to strengthen end-of-life care supportive behaviors by exposing nurses to those behaviors and providing frequent experience with advance directives.
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Affiliation(s)
- Da-In Jeong
- Department of Nursing, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Eun
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
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Calle MC, Pareja SL, Villa MM, Román-Calderón JP, Lemos M, Navarro S, Krikorian A. Interactions Between Intensive Care and Palliative Care Are Influenced by Training, Professionals' Perceptions and Institutional Barriers. J Palliat Care 2020; 37:545-551. [PMID: 32812496 DOI: 10.1177/0825859720951361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is growing interest in the use of a Palliative care approach in Intensive care. However, it tends to remain inconsistent, infrequent or non-existent, as does its acceptance by intensive care physicians. This study sought to explore the perceptions, level of knowledge, perceived barriers, and practices of physicians regarding palliative care practices (PC) in Intensive Care Units (ICU). METHODS Descriptive-correlational study. Participating physicians working in ICU in Colombia (n = 101) completed an ad hoc questionnaire that included subscales of perceptions, knowledge, perceived barriers, and PC practices in ICU. A Structural Equation Model (PLS-SEM) was used to examine the reciprocal relationships between the measured variables and those that could predict interaction practices between the 2 specialties. RESULTS First, results from the measurement model to examine the validity and reliability of the latent variables found (PC training, favorable perceptions about PC, institutional barriers, and ICU-PC interaction practices) and their indicators were obtained. Second, the structural model found that, a greater number of hours of PC training, a favorable perception of PC and a lower perception of institutional barriers are related to greater interaction between PC and ICU, particularly when emotional or family problems are detected. CONCLUSIONS PC-ICU interactions are influenced by training, a positive perception of PC and less perceived institutional barriers. An integrated ICU-PC model that strengthens the PC training of those who work in ICU and provides clearer guidelines for interaction practices, may help overcome perceived barriers and improve the perception of the potential impact of PC.
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Affiliation(s)
| | | | | | | | | | - Stella Navarro
- School of medicine, Universidad CES, Medellín, Colombia.,Clínica Universitaria Bolivariana, Medellín, Colombia
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, 28025Universidad Pontificia Bolivariana, Medellín, Colombia
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Eltaybani S, Igarashi A, Yamamoto-Mitani N. Assessing the Palliative and End-of-Life Care Education-Practice-Competence Triad in Intensive Care Units: Content Validity, Feasibility, and Reliability of a New Tool. J Palliat Care 2020; 36:234-242. [PMID: 32779529 DOI: 10.1177/0825859720948972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To date, a comprehensive, psychometrically robust instrument to assess palliative and end-of-life (PEOL) care education, practice, and perceived competence among intensive care unit (ICU) nurses does not exist. OBJECTIVE To examine content validity and reliability of a proposed instrument to assess the PEOL care education-practice- competence triad among ICU nurses. METHODS An international modified e-Delphi and a cross-sectional pilot questionnaire survey. The Delphi involved 23 panelists from 11 countries. The pilot study involved 40 staff nurses and 3 nurse managers from 3 adult ICUs in a randomly selected hospital in Egypt. An instrument was developed and judged for content validity by international panelists, and then pretested in a pilot study, where data were collected at 2 time points using self-administered questionnaires, followed by cognitive interviews. Test-retest reliability was examined using intraclass correlation (ICC), standard error of measurement (SEM), and repeatability coefficient (RC). RESULTS The panelists confirmed content validity of the proposed instrument, and staff nurses confirmed its comprehensibility. At the level of the instrument's total scores, the lowest ICC was .9 (95% confidence interval: .8-.9); and the highest SEM and RC were 4.8 and 13.3, respectively. CONCLUSIONS The PEOL Care Index is a comprehensive, comprehensible, content valid, and reliable instrument to assess the PEOL care education-practice-competence triad among ICU nurses. Construct and criterion validities need to be confirmed in future studies. Applicability of the PEOL Care Index in different settings and cultures needs to be examined.
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Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-Term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan.,Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria Governorate, Egypt
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-Term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-Term Care Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
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Ganz FD, Ben Nun M, Raanan O. Introducing palliative care into the intensive care unit: An interventional study. Heart Lung 2020; 49:915-921. [PMID: 32723616 DOI: 10.1016/j.hrtlng.2020.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many Intensive Care Unit (ICU) deaths include patient and family suffering. While there is a need to include palliative care in the ICU, such care is often unavailable. OBJECTIVES To determine whether a course in ICU Palliative Care was associated with changes in participants' palliative care knowledge, attitudes and practices. METHODS Four cohorts of a national Israeli course in ICU palliative care (N = 122) were followed. Data were collected on the first and last day of a six-month course and 2-5 years later. RESULTS Statistically significant differences were found in palliative care attitudes and practices, with knowledge levels and quality of death and dying stable after course completion. Participants reported obtaining knowledge and skills necessary to introduce palliative care but were thwarted by organizational barriers. CONCLUSIONS The course was successful in building participants capacity to provide palliative care however; barriers made introduction of palliative care into the ICU difficult.
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Affiliation(s)
- Freda DeKeyser Ganz
- Hadassah Hebrew University School of Nursing, Kiryat Hadassah, PO Box 12000, Jerusalem 91120, Israel and Jerusalem College of Technology, Jerusalem, Israel.
| | - Maureen Ben Nun
- Belinson Medical Center, Surgical Intensive Care Unit, Petach Tikva, Israel.
| | - Ofra Raanan
- Sheba Medical Center, School of Nursing, Tel Hashomer, Israel.
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Price DM, Wyse DM, Conrad CM, Harden KL, Montagnini M, Ghosh B. Creating a Sustainable Palliative Care Education Conference for Healthcare Professionals. J Nurses Prof Dev 2020; 36:82-87. [PMID: 31977759 DOI: 10.1097/nnd.0000000000000611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An interprofessional conference that addressed basic palliative care knowledge and skills was implemented annually at a large, academic healthcare institution. The conference significantly influenced participant's self-perceived competencies in the delivery of quality palliative care. This conference led to a sustainable program of palliative care initiatives consisting of a yearly workshop for nurses focused on palliative care core competencies and a biennial interprofessional conference designed to facilitate networking and address significant topics in palliative care.
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Affiliation(s)
- Deborah M Price
- Deborah M. Price, DNP, RN, is Clinical Assistant Professor, University of Michigan School of Nursing, Ann Arbor. Diane M. Wyse, MSN, RN-BC, is Education Specialist, Michigan Medicine, Ann Arbor. Christine M. Conrad, MSN, RN, CNS-BC, OCN, is Education Specialist, Michigan Medicine, Ann Arbor. Karen L. Harden, DNP, RN, AOCNS, BMTCN, is Clinical Assistant Professor, University of Michigan School of Nursing, Ann Arbor. Marcos Montagnini, MD, FACP, is Professor of Medicine, University of Michigan School of Medicine, Ann Arbor. Bidisha Ghosh, MS, is Statistician Intermediate, University of Michigan School of Nursing, Ann Arbor
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Soikkeli‐Jalonen A, Stolt M, Hupli M, Lemetti T, Kennedy C, Kydd A, Haavisto E. Instruments for assessing nurses’ palliative care knowledge and skills in specialised care setting: An integrative review. J Clin Nurs 2020; 29:736-757. [DOI: 10.1111/jocn.15146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/12/2019] [Accepted: 11/24/2019] [Indexed: 12/29/2022]
Affiliation(s)
| | - Minna Stolt
- Department of Nursing Science Finland and Researcher Turku University Hospital University of Turku Turku Finland
| | - Maija Hupli
- Department of Nursing Science University of Turku Turku Finland
| | - Terhi Lemetti
- Department of Nursing Science Helsinki University Hospital University of Turku Turku Finland
| | - Catriona Kennedy
- School of Nursing and Midwifery Robert Gordon University Aberdeen UK
- Department of Nursing and Midwifery The University of Limerick Limerick Ireland
| | - Angela Kydd
- School of Nursing and Midwifery Robert Gordon University Aberdeen UK
| | - Elina Haavisto
- Department of Nursing Science Satakunta Central Hospital University of Turku Turku Finland
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Rajdev K, Loghmanieh N, Farberov MA, Demissie S, Maniatis T. Are Health-Care Providers Well Prepared in Providing Optimal End-of-Life Care to Critically Ill Patients? A Cross-Sectional Study at a Tertiary Care Hospital in the United States. J Intensive Care Med 2018; 35:1080-1094. [PMID: 30501452 DOI: 10.1177/0885066618811794] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is important for health-care providers to be comfortable in providing end-of-life (EOL) care to critically ill patients and realizing when continuing aggressive measures would be futile. Therefore, there is a need to understand health-care providers' self-perceived skills and barriers to providing optimum EOL care. A total of 660 health-care providers from medicine and surgery departments were asked via e-mail to complete an anonymous survey assessing their self-reported EOL care competencies, of which 238 responses were received. Our study identified several deficiencies in the self-reported EOL care competencies among health-care providers. Around 34% of the participants either disagreed (strongly disagree or disagree) or were neutral when asked whether they feel well prepared for delivering EOL care. Around 30% of the participants did not agree (agree and strongly agree) that they were well prepared to determine when to refer patients to hospice. 51% of the participants, did not agree (agree and strongly agree) that clear and accurate information is delivered by team members to patients/family. The most common barrier to providing EOL care in the intensive care unit was family not accepting the patient's poor prognosis. Nursing staff (registered nurse) had higher knowledge and attitudes mean competency scores than the medical staff. Attending physicians reported stronger knowledge competencies when compared to residents and fellows. More than half of the participants denied having received any previous training in EOL care. 82% of the participants agreed that training should be mandatory in this field. Most of the participants reported that the palliative care team is involved in EOL care when the patient is believed to be terminally ill. Apart from a need for a stronger training in the field of EOL care for health-care providers, the overall policies surrounding EOL and palliative care delivery require further evaluation and improvement to promote better outcomes in caring patients at the EOL.
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Affiliation(s)
- Kartikeya Rajdev
- Department of Medicine, Northwell Health Staten Island University Hospital, Staten Island, NY, USA
| | - Nina Loghmanieh
- Department of Palliative Medicine, Northwell Health Staten Island University Hospital, Staten Island, NY, USA
| | - Maria A Farberov
- Department of Medicine, Northwell Health Staten Island University Hospital, Staten Island, NY, USA
| | - Seleshi Demissie
- Department of Biostatistics, Northwell Health Staten Island University Hospital, Staten Island, NY, USA
| | - Theodore Maniatis
- Department of Pulmonary and Critical Care Medicine, Northwell Health Staten Island University Hospital, Staten Island, NY, USA
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Price DM, Strodtman LK, Montagnini M, Smith HM, Ghosh B. Health Professionals Perceived Concerns and Challenges in Providing Palliative and End-of-Life Care: A Qualitative Analysis. Am J Hosp Palliat Care 2018; 36:308-315. [DOI: 10.1177/1049909118812193] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The Institute of Medicine identifies that quality palliative/end-of-life (EOL) care should be provided to patients with serious, life-limiting illnesses and their families by competently prepared health professionals. Purpose: This study assessed perceived concerns of health professionals pertaining to the delivery of palliative/EOL care in the hospital setting. The specific aim was to determine thematic concerns in the delivery of palliative/EOL care which emerged from respondents’ impressions of a memorable palliative/EOL patient experience. Methods: Interdisciplinary health professionals at a large academic health system in the Midwest were surveyed to reflect upon a memorable palliative/EOL life care patient situation (positive or negative). A Thematic Analysis approach was used to code qualitative responses to 4 open-ended questions and then extract themes and subthemes from the coded data. Results: Concerns identified by participants (N = 425) emerged around 7 themes including communication (97%), decision-making/care planning (75%), education needs (60%), EOL care (48%), ethics (24%), satisfaction with care (9%), and spiritual/cultural sensitivity (6%). Conclusion: Challenges exist in the delivery of quality palliative/EOL care in the hospital setting which may be addressed through educational initiatives that focus on recognition of cultural influences on care preferences, improving communication between patients/families and providers, education about the differences between palliative and EOL care, and increased competency of health providers in having EOL/goals-of-care discussions. Health professionals must recognize the benefit of collaborative palliative care in order to meet patient and family needs holistically and comprehensively.
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Affiliation(s)
| | | | - Marcos Montagnini
- Division of Geriatric and Palliative Medicine, University of Michigan School, and Ann Arbor VA Healthcare System, Ann Arbor, MI, USA
| | - Heather M. Smith
- Psychiatry and Behavioral Medicine, Medical College of Wisconsin, and VA Medical Center, Milwaukee, WI, USA
| | - Bidisha Ghosh
- University of Michigan School of Nursing, Ann Arbor, MI, USA
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Price DM, Kocan MJ. Clinical Nurse Specialists Fostering Palliative Care Skills. AACN Adv Crit Care 2018; 29:84-90. [PMID: 29496716 DOI: 10.4037/aacnacc2018286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Deborah M Price
- Deborah M. Price is Clinical Assistant Professor, University of Michigan School of Nursing, 426 N Ingalls Street #4122, Ann Arbor, MI 48109 . Mary Jo Kocan is Clinical Nurse Specialist, Neuroscience ICU/Stroke Unit, University of Michigan Health System, Ann Arbor, Michigan
| | - Mary Jo Kocan
- Deborah M. Price is Clinical Assistant Professor, University of Michigan School of Nursing, 426 N Ingalls Street #4122, Ann Arbor, MI 48109 . Mary Jo Kocan is Clinical Nurse Specialist, Neuroscience ICU/Stroke Unit, University of Michigan Health System, Ann Arbor, Michigan
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Montagnini M, Smith HM, Price DM, Ghosh B, Strodtman L. Self-Perceived End-of-Life Care Competencies of Health-Care Providers at a Large Academic Medical Center. Am J Hosp Palliat Care 2018; 35:1409-1416. [DOI: 10.1177/1049909118779917] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. Objective: To assess health-care professionals’ self-perceived competencies regarding the provision of EOL care in hospitalized patients. Methods: Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. Results: A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Conclusions: Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.
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Affiliation(s)
- Marcos Montagnini
- Division of Geriatric and Palliative Medicine, University of Michigan, and Ann Arbor VA Healthcare System, Ann Arbor, MI, USA
| | - Heather M. Smith
- Psychiatry and Behavioral Medicine, Medical College of Wisconsin, and VA Medical Center, Milwaukee, WI, USA
| | | | - Bidisha Ghosh
- University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Linda Strodtman
- University of Michigan School of Nursing, Ann Arbor, MI, USA
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24
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Price DM, Strodtman L, Montagnini M, Smith HM, Miller J, Zybert J, Oldfield J, Policht T, Ghosh B. Palliative and End-of-Life Care Education Needs of Nurses Across Inpatient Care Settings. J Contin Educ Nurs 2018; 48:329-336. [PMID: 28658501 DOI: 10.3928/00220124-20170616-10] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/20/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Educating nurses about palliative and end-of-life (EOL) care is a high priority in health care settings. The purpose of this study was to assess nurses' perceived competency regarding the provision of palliative and EOL care to hospitalized patients. METHOD This study surveyed nurses from 25 pediatric and adult acute and intensive care units (ICU; N = 583) Quantitative data analysis was descriptive and correlational. Qualitative data analysis identified themes of participant concerns. RESULTS Data analysis revealed that perceived competency in palliative and EOL care is significantly higher in the ICU nurses (p <.0001). Mean scores were significantly higher when nurses had more than 10 years of experience (p <.0001). Open-ended responses indicated concerns regarding improved communication behaviors, decision making, and facilitation of continuity of care. CONCLUSION The results provide guidance for development of palliative and EOL care nursing education programs tailored to address specific unit needs according to staff characteristics, patient population focus of care, and acuity level of care. J Contin Educ Nurs. 2017;48(7):329-336.
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Harden K, Price D, Duffy E, Galunas L, Rodgers C. Palliative Care: Improving Nursing Knowledge, Attitudes, and Behaviors. Clin J Oncol Nurs 2017; 21:E232-E238. [DOI: 10.1188/17.cjon.e232-e238] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Evaluation of COMFORT in Strengthening Perceived Communication Confidence of Advanced Practice Registered Nurses. J Hosp Palliat Nurs 2017. [DOI: 10.1097/njh.0000000000000309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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An Evidence-Based Practice Approach to End-of-Life Nursing Education in Intensive Care Units. J Hosp Palliat Nurs 2016. [DOI: 10.1097/njh.0000000000000254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nellis ME, Howell JD, Ching K, Bylund C. The Use of Simulation to Improve Resident Communication and Personal Experience at End-of-Life Care. J Pediatr Intensive Care 2016; 6:91-97. [PMID: 31073430 DOI: 10.1055/s-0036-1584684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 02/12/2016] [Indexed: 10/21/2022] Open
Abstract
Pediatric residents report they are not sufficiently trained to communicate with families at a child's death. We performed a study to prove feasibility and assess whether simulation improves their communication and experience. Residents were assigned to intervention using simulation or control group. Communication was assessed by standardized patients and audiotapes of simulated encounters when they delivered bad news. Residents' perceptions of their communication were polled. The majority reported they never witnessed end-of-life discussions. All residents perceived themselves to be more capable at pronouncing the death of a child, and informing a family of a death after participating in either the interventional simulation or a bereavement retreat. Despite training within a pediatric intensive care unit, pediatric residents have little exposure to end-of-life discussions. Pediatric end-of-life simulation increases exposure of residents to end-of-life care and improves residents' perceptions of their communication.
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Affiliation(s)
- Marianne E Nellis
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medical College, New York, New York, United States
| | - Joy D Howell
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medical College, New York, New York, United States
| | - Kevin Ching
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Weill Cornell Medical College, New York, New York, United States
| | - Carma Bylund
- Department of Medical Education, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar
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30
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The Art of Healing. J Hosp Palliat Nurs 2016. [DOI: 10.1097/njh.0000000000000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Coffey A, McCarthy G, Weathers E, Friedman MI, Gallo K, Ehrenfeld M, Chan S, Li WHC, Poletti P, Zanotti R, Molloy DW, McGlade C, Fitzpatrick JJ, Itzhaki M. Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries. Int J Nurs Pract 2016; 22:247-57. [PMID: 26823112 PMCID: PMC5066738 DOI: 10.1111/ijn.12417] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 09/18/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Abstract
Nurses' knowledge regarding advance directives may affect their administration and completion in end‐of‐life care. Confidence among nurses is a barrier to the provision of quality end‐of‐life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end‐of‐life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross‐sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end‐of‐life and more comfortable stopping preventive medications at end‐of‐life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end‐of‐life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end‐of‐life care.
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Affiliation(s)
- Alice Coffey
- Senior Lecturer /Director International Programmes, School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - Geraldine McCarthy
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - Elizabeth Weathers
- Research Assistant, Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - M Isabel Friedman
- Clinical Education Specialist, Center for Learning and Innovation, North Shore-LIJ Health System, Lake Success, New York, USA
| | - Katherine Gallo
- Senior Vice President, Chief Learning Officer, Center for Learning and Innovation, North Shore-LIJ Health System, Lake Success, New York, USA
| | - Mally Ehrenfeld
- Associate Professor, Head of School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sophia Chan
- Professor in Nursing and Director of Research, School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | - William H C Li
- Assistant Professor, Director of Master of Nursing Programme, School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | - Piera Poletti
- Director, CEREF Centre for Research & Continuing Education, Padova, Italy
| | - Renzo Zanotti
- Associate Professor and Dean, Master in Nursing Sciences, Padua University, Padua, Italy
| | - D William Molloy
- Consultant in Geriatric Medicine, Centre of Gerontology and Rehabilitation, St. Finbarr's Hospital, Cork, Ireland
| | - Ciara McGlade
- Research Fellow and Consultant in Geriatric Medicine, Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | - Joyce J Fitzpatrick
- Elizabeth Brooks Ford Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michal Itzhaki
- Lecturer, Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Piedrafita-Susín AB, Yoldi-Arzoz E, Sánchez-Fernández M, Zuazua-Ros E, Vázquez-Calatayud M. [Nurses' perception, experience and knowledge of palliative care in intensive care units]. ENFERMERIA INTENSIVA 2015; 26:153-65. [PMID: 26242205 DOI: 10.1016/j.enfi.2015.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 06/01/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adequate provision of palliative care by nursing in intensive care units is essential to facilitate a "good death" to critically ill patients. OBJECTIVE To determine the perceptions, experiences and knowledge of intensive care nurses in caring for terminal patients. METHODOLOGY A literature review was conducted on the bases of Pubmed, Cinahl and PsicINFO data using as search terms: cuidados paliativos, UCI, percepciones, experiencias, conocimientos y enfermería and their alternatives in English (palliative care, ICU, perceptions, experiences, knowledge and nursing), and combined with AND and OR Boolean. Also, 3 journals in intensive care were reviewed. RESULTS Twenty seven articles for review were selected, most of them qualitative studies (n=16). After analysis of the literature it has been identified that even though nurses perceive the need to respect the dignity of the patient, to provide care aimed to comfort and to encourage the inclusion of the family in patient care, there is a lack of knowledge of the end of life care in intensive care units' nurses. CONCLUSION This review reveals that to achieve quality care at the end of life, is necessary to encourage the training of nurses in palliative care and foster their emotional support, to conduct an effective multidisciplinary work and the inclusion of nurses in decision making.
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Affiliation(s)
- A B Piedrafita-Susín
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España.
| | - E Yoldi-Arzoz
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - M Sánchez-Fernández
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - E Zuazua-Ros
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - M Vázquez-Calatayud
- Área de Investigación, Formación y Desarrollo en Enfermería, Clínica Universidad de Navarra, Pamplona, España
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Tsutsumi K, Sekido K. Relationship of Clinical Nursing Competence to Nursing Occupational Experience in Hospice/Palliative Care Nurses in Japan. Health (London) 2015. [DOI: 10.4236/health.2015.72032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Erickson JM, Blackhall L, Brashers V, Varhegyi N. An interprofessional workshop for students to improve communication and collaboration skills in end-of-life care. Am J Hosp Palliat Care 2014; 32:876-80. [PMID: 25172781 DOI: 10.1177/1049909114549954] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Interprofessional care is critical for patients at the end of life (EOL), but programs to teach communication skills to medical and nursing students are rare. The aims of this study were to determine whether an interprofessional workshop improves (1) student attitudes toward teamwork and (2) self-efficacy for communicating in difficult situations. Nursing and medical students attended a workshop with collaborative role play of an EOL conversation. Before the workshop, students showed different attitudes toward teamwork and collaboration and varying levels of confidence about communication skills. After the workshop, both groups reported more positive attitudes toward teamwork but a mixed picture of confidence in communication. Experiential interprofessional education workshops enhance perceptions about the benefits of teamwork, but further teaching and evaluation methods are needed to maximize the effectiveness.
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Affiliation(s)
- Jeanne M Erickson
- University of Wisconsin-Milwaukee College of Nursing, Milwaukee, WI, USA
| | - Leslie Blackhall
- University of Virginia School of Medicine, Section of General Medicine, Charlottesville, VA, USA
| | - Valentina Brashers
- University of Virginia Schools of Medicine and Nursing, Charlottesville, VA, USA
| | - Nikole Varhegyi
- University of Virginia School of Medicine, Department of Public Health Sciences, Charlottesville, VA, USA
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Wechter E, O'Gorman DC, Singh MK, Spanos P, Daly BJ. The Effects of an Early Observational Experience on Medical Students’ Attitudes Toward End-of-Life Care. Am J Hosp Palliat Care 2013; 32:52-60. [DOI: 10.1177/1049909113505760] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
End-of-life care is paramount in maintaining the quality of life of the terminally ill, protecting them from unnecessary treatment, and controlling costs incurred in their care. Training doctors to be effective end-of-life caregivers begins in medical school. A survey design was used to collect data from 166 first-year medical students before and after exposure to hospice or palliative care through an early clinical exposure program. Data demonstrated that students had a significant change in attitude scores after the observational experience ( P < .05). Providing students with the opportunity to observe and participate in end-of-life care has a positive effect on attitudes toward the care of dying persons. We recommend that direct exposure to end-of-life care practices be incorporated early in the medical school curriculum.
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Affiliation(s)
- Elizabeth Wechter
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | | | - Pete Spanos
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Barbara J. Daly
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Penny DJ, Shekerdemian LS. The American Heart Association's recent scientific statement on cardiac critical care: implications for pediatric practice. CONGENIT HEART DIS 2012; 8:3-19. [PMID: 23280102 DOI: 10.1111/chd.12028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2012] [Indexed: 10/27/2022]
Abstract
A writing group sponsored by the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, the Council on Clinical Cardiology, the Council on Cardiovascular Nursing, and the Council on Quality of Care and Outcomes Research of The American Heart Association has recently formulated a roadmap to meet the changing needs of the patient with cardiovascular disease requiring critical care. Although this roadmap has been formulated primarily to address the care needs of the adult with critical cardiovascular disease, it contains useful lessons pertinent to the care of the patient with pediatric and congenital cardiovascular disease. In this document, we have examined The Statement and applied its framework to the evolving field of pediatric cardiac critical care.
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Affiliation(s)
- Daniel J Penny
- Division of Cardiology, Texas Children's Hospital, Houston, TX 77030, USA.
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Morrow DA, Fang JC, Fintel DJ, Granger CB, Katz JN, Kushner FG, Kuvin JT, Lopez-Sendon J, McAreavey D, Nallamothu B, Page RL, Parrillo JE, Peterson PN, Winkelman C. Evolution of Critical Care Cardiology: Transformation of the Cardiovascular Intensive Care Unit and the Emerging Need for New Medical Staffing and Training Models. Circulation 2012; 126:1408-28. [DOI: 10.1161/cir.0b013e31826890b0] [Citation(s) in RCA: 199] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Current World Literature. Curr Opin Support Palliat Care 2012; 6:402-16. [DOI: 10.1097/spc.0b013e3283573126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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