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MacMartin M, Zhang J, Barnato A. The role of specialty palliative care interdisciplinary team members in acute care decision support: a qualitative study protocol. BMC Palliat Care 2024; 23:5. [PMID: 38166884 PMCID: PMC10763013 DOI: 10.1186/s12904-023-01328-9] [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] [Received: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Specialty palliative care interdisciplinary teams (IDT) can play an important role in supporting patients and family members during acute care decision-making. Despite guidelines and evidence emphasizing decision-making support as a key domain of specialty palliative care, little is known about how decision-making support is actually implemented by specialty palliative care IDTs. This study aims to (1) describe the structure and processes of inpatient decision-making support delivered by specialty palliative care IDT, and (2) examine the perspectives of IDT members on their role in this decision-support. METHODS A team of clinician and non-clinician researchers will conduct non-participant observation ethnography at a single medical center in northern New England. The ethnography will focus on the work of IDT members in supporting decision making, particularly elements of specialty palliative care that have limited descriptions in the literature (e.g. systems and processes of care). Observations of formal and informal interactions between IDT members and clinical encounters will be conducted at one site over four months. Participants include patients, care partners, non-specialty palliative care providers, and specialty palliative care IDT members. Additionally, we will conduct semi-structured interviews with IDT members across three geographically diverse specialty palliative care teams across the United States to explore providers' first-person perspective on their roles and function in decision-making support for hospitalized patients. Field notes and transcripts from observation and interviews will be uploaded to Dedoose software for management and thematic analysis following an inductive approach. DISCUSSION To our knowledge, this will be the first observational study of the roles of interdisciplinary specialty palliative care teams. Results from this research will support further investigation into implementation of decision-making support across different types of medical teams.
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Affiliation(s)
- Meredith MacMartin
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
- Section of Palliative Care, Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
| | - Jingyi Zhang
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Amber Barnato
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Section of Palliative Care, Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
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2
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Cardoso AR, Remondes-Costa S, Veiga E, Almeida V, Rocha J, Teixeira RJ, Macedo G, Leite M. Meaning of Life Therapy: A Pilot Study of a Novel Psycho-Existential Intervention for Palliative Care in Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231209654. [PMID: 37884277 DOI: 10.1177/00302228231209654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Intervention in Palliative Care aims to provide physical, psychosocial, and spiritual relief for patients and family members. Brief interventions with a psycho-existential approach have shown positive responses; however, cultural adaptations are needed. This pilot study aimed to develop the Meaning of Life Therapy (MLT), a novel psycho-existential intervention, rooted in the Dignity Therapy, Life Review, and Meaning-Centered Psychotherapy. MLT was culturally adapted to the Portuguese context to include questions about forgiveness, apology, reconciliation, farewell, and a legacy document, i.e., the Life Letter. Nine PC cancer patients answered a 14-question MLT protocol, intended to help patients find purpose and meaning in life. Eight themes emerged: Family, Preservation of Identity, Life Retrospective, Clinical Situation, Achievements, Socio-Professional Valorization, Forgiveness/Apology/Reconciliation, and Saying Goodbye. MLT has proved its ability to respond to the psycho-existential needs of PC patients. Further studies should be conducted to gain extensive knowledge of the effectiveness of culturally responsive interventions.
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Affiliation(s)
- Ana Rita Cardoso
- Casa de Saúde do Telhal, Instituto São João de Deus, Lisboa, Portugal
| | - Sónia Remondes-Costa
- Department of Education and Psychology, School of Human and Social Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Elisa Veiga
- Faculty of Education and Psychology, Universidade Católica Portuguesa, Research Centre for Human Development, Porto, Portugal
| | - Vera Almeida
- Department of Social and Behavioural Sciences, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
| | - José Rocha
- Department of Social and Behavioural Sciences, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
| | - Ricardo João Teixeira
- CINEICC- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
- REACH - Mental Health Clinic, Porto, Portugal
| | - Gerly Macedo
- Clinical and Health Psychology Unit, Psychiatry and Mental Health Service, Hospital da Senhora de Oliveira de Guimarães, Guimarães, Portugal
| | - Manuela Leite
- Department of Social and Behavioural Sciences, University Institute of Health Sciences(IUCS), CESPU, Gandra, Portugal
- iHealth4Well-being - Innovation in Health and Well-Being, Research Unit, Instituto Politécnico de Saúde do Norte, CESPU, Penafiel, Portugal
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Silva HLM, Valério PHM, Barreira CRA, Peria FM. Filling gaps in experiences religious understanding of people living with cancer in palliative care: a phenomenological qualitative study. BMC Palliat Care 2023; 22:127. [PMID: 37667276 PMCID: PMC10478484 DOI: 10.1186/s12904-023-01254-w] [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] [Received: 01/08/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND According to a phenomenology of contemporary religion, the analysis of religious experiences finds that they are part of an individual's search for something powerful that overcomes him seeking not only a need, but the meaning of all existence. The present study aims to contribute to a deeper understanding of the religious experiences of people living with cancer in palliative care (PC) and fill gaps in access to experience, with regard to how it was properly lived. METHODS A qualitative, phenomenological, cross-sectional study was conducted with 14 people living with cancer undergoing PC at two outpatient clinics of a public hospital. The experiences were accessed through in-depth interviews and the results were analysed according to the principles of classical phenomenology. RESULTS The patients confidently surrendered to the divine, attributing to it the power of continuity of life or not, which sustained them and launched them into horizons of hope, directing them to possibilities of achieving meaning in life, which it fed back their faith and to continue living, opening them up to an intense perception of the value of life. CONCLUSIONS The religious positions of confident surrender to the divine, to his will and a belief in his intervention, regardless of the outcome, opened possibilities to patients for the belief in the continuity of life by the power of faith. This position allowed the patients in this study to visualize achievements in the present and in the future, opening a horizon of hope, meaning and value of living. This study showed how this elements are presented and sustained, providing subsidies to health professionals seeking to provide more holistic care.
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Affiliation(s)
- Hellen Luiza Meireles Silva
- Department of Medical Images, Hematology and Clinical Oncology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- Rua Amadeu Amaral, 340, ap 112, Vila Seixas, Ribeirão Preto, SP, Brazil.
| | | | | | - Fernanda Maris Peria
- Department of Medical Images, Hematology and Clinical Oncology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Lau IS, Kraljevic Z, Al-Agil M, Charing S, Quarterman A, Parkes H, Metaxa V, Sleeman K, Gao W, Dobson RJB, Teo JT, Hopkins P. Natural language word embeddings as a glimpse into healthcare language and associated mortality surrounding end of life. BMJ Health Care Inform 2021; 28:e100464. [PMID: 34711578 PMCID: PMC8557276 DOI: 10.1136/bmjhci-2021-100464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/08/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To clarify real-world linguistic nuances around dying in hospital as well as inaccuracy in individual-level prognostication to support advance care planning and personalised discussions on limitation of life sustaining treatment (LST). DESIGN Retrospective cross-sectional study of real-world clinical data. SETTING Secondary care, urban and suburban teaching hospitals. PARTICIPANTS All inpatients in 12-month period from 1 October 2018 to 30 September 2019. METHODS Using unsupervised natural language processing, word embedding in latent space was used to generate phrase clusters with most similar semantic embeddings to 'Ceiling of Treatment' and their prognostication value. RESULTS Word embeddings with most similarity to 'Ceiling of Treatment' clustered around phrases describing end-of-life care, ceiling of care and LST discussions. The phrases have differing prognostic profile with the highest 7-day mortality in the phrases most explicitly referring to end of life-'Withdrawal of care' (56.7%), 'terminal care/end of life care' (57.5%) and 'un-survivable' (57.6%). CONCLUSION Vocabulary used at end-of-life discussions are diverse and has a range of associations to 7-day mortality. This highlights the importance of correct application of terminology during LST and end-of-life discussions.
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Affiliation(s)
- Ivan Shun Lau
- Kings College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | - Zeljko Kraljevic
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Mohammad Al-Agil
- Kings College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | | | | | | | - Victoria Metaxa
- Kings College Hospital, King's College Hospital NHS Foundation Trust, London, UK
- School of Medical Education, King's College London, London, UK
| | - Katherine Sleeman
- Department of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Wei Gao
- Department of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Richard J B Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James T Teo
- Kings College Hospital, King's College Hospital NHS Foundation Trust, London, UK
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Phil Hopkins
- Intensive Care Medicine, Anaesthesia and Trauma, King's College Hospital NHS Foundation Trust, London, UK
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Philip J, Collins A, Phillips J, Luckett T, Morgan DD, Lobb EA, DiGiacomo M, Kochovska S, Brown L, Currow DC. The Development of the Australian National Palliative Care Clinical Studies Collaborative "Integrating Qualitative Research into Clinical Trials Framework". J Palliat Med 2020; 24:331-337. [PMID: 33085551 DOI: 10.1089/jpm.2020.0480] [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: 11/13/2022] Open
Abstract
Qualitative methodologies have multiple contributions to health research, including improving baseline understanding in new areas of enquiry; questioning existing assumptions; understanding viewpoints of specific subgroups; and offering complex, contextual information. While the role of qualitative research within mixed methods approaches is well documented, the contribution to clinical trial design and conduct is less well recognized. The Australian Palliative Care Clinical Studies Collaborative and Cancer Symptom Trials have developed a framework to detail how qualitative research might contribute to each key aspect of clinical trials. This practical framework provides real-world examples, including sample qualitative questions, to consider at each phase of controlled clinical trial development. As the number of randomized clinical trials in palliative care increases, a readily accessible approach to integrating qualitative research into clinical trial design and conduct is needed so that its full potential for improving study recruitment, conduct, outcomes, interpretation, and implementation may be realized.
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Affiliation(s)
- Jennifer Philip
- Faculty of Medicine, Dentistry and Health Sciences, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Anna Collins
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Phillips
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Tim Luckett
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Deidre D Morgan
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah, Kogarah, New South Wales, Australia.,School of Medicine, University of Notre Dame, Darlinghurst, New South Wales, Australia
| | - Michelle DiGiacomo
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Slavica Kochovska
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Linda Brown
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,Hull York Medical School, University of Hull, Hull, United Kingdom
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The value of the ethnographic approach to research issues in palliative care. Curr Opin Support Palliat Care 2020; 13:337-343. [PMID: 31689271 DOI: 10.1097/spc.0000000000000460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Qualitative research in the field of palliative care allows for a crucial study of the final stage of life from a social point of view and cultural perspective. This review evaluates the advantages and challenges of applying an ethnographic approach to palliative care research. RECENT FINDINGS Thirteen ethnographic articles on organization or quality of care, decision-making, delirium, death, and the process of dying, were reviewed. Most studies use interviews, participant observation, and field notes as their primary data collection techniques. In ethnographic research, cultural issues, relationships and interactions of a group, the meanings and perceptions of the participants, the communication process, and the use of language in a particular and natural context were analyzed. Data collection and information analysis took an average of 14 months in the included studies. SUMMARY The ethnographic method, applied with rigor, is valuable in the analysis of a real phenomenon if the particular context in which the study developed is well defined. With an ethnographic approach, researchers can uncover cultural nuances that evidence different realities.
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Annemans M, Coomans K, Heylighen A. Building scale and well-being in a hospice: a qualitative exploration. BMJ Support Palliat Care 2020; 12:e505-e509. [DOI: 10.1136/bmjspcare-2019-002151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/17/2020] [Accepted: 04/22/2020] [Indexed: 11/04/2022]
Abstract
ObjectiveThis study explored how built space plays out in palliative care, focusing on spatial aspects that could support or hamper patients’, relatives’ and caregivers’ well-being.MethodsThis study was conducted in a freestanding small-scale hospice combining a residential part for eight guests with a day-care part for groups of about five persons. Observations were combined with semistructured, individual interviews with eight guests (sometimes accompanied by relatives) and three focus-group interviews with staff, volunteers and relatives. All interviews were audio-recorded and transcribed verbatim. Data were analysed based on the Qualitative Analysis Guide of Leuven.ResultsThe most important spatial aspects that impact on physical and social well-being in palliative care turned out to be the building scale and physical proximity. The small-scale setting counters the (often negative) association of palliative care with hospital environments. When the medical condition of the guest allows, it makes communal or outdoor spaces reachable, which enhances emotional and social well-being. In worse conditions, it still makes that care and nature are always nearby. The compactness of communal spaces intensifies social contacts.ConclusionsThe building scale and physical proximity play out in the relationship between the building and its surroundings, between the residential and the day-care parts and among people within the building. Future research could investigate to what extent these spatial aspects are relevant in more conventional palliative care units or even in general hospital wards.
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Bischoff KE, Zapata C, Sedki S, Ursem C, O'Riordan DL, England AE, Thompson N, Alfaro A, Rabow MW, Atreya CE. Embedded palliative care for patients with metastatic colorectal cancer: a mixed-methods pilot study. Support Care Cancer 2020; 28:5995-6010. [PMID: 32285263 DOI: 10.1007/s00520-020-05437-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/27/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE Palliative care is recommended for patients with metastatic cancer, but there has been limited research about embedded palliative care for specific patient populations. We describe the impact of a pilot program that provided routine, early, integrated palliative care to patients with metastatic colorectal cancer. METHODS Mixed methods pre-post intervention cohort study at an academic cancer center. Thirty control then 30 intervention patients with metastatic colorectal cancer were surveyed at baseline and 1, 3, 6, 9, and 12 months thereafter about symptoms, quality-of-life, and likelihood of cure. We compared survey responses, trends over time, rates of advance care planning, and healthcare utilization between groups. Patients, family caregivers, and clinicians were interviewed. RESULTS Patients in the intervention group were followed for an average of 6.5 months and had an average of 3.5 palliative care visits. At baseline, symptoms were mild (average 1.85/10) and 78.2% of patients reported good/excellent quality-of-life. Half (50.9%) believed they were likely to be cured of cancer. Over time, symptoms and quality-of-life metrics remained similar between groups, however intervention patients were more realistic about their likelihood of cure (p = 0.008). Intervention patients were more likely to have a surrogate documented (83.3% vs. 26.7%, p < 0.0001), an advance directive completed (63.3% vs. 13.3%, p < 0.0001), and non-full code status (43.3% vs. 16.7%, p < 0.03). All patients and family caregivers would recommend the program to others with cancer. CONCLUSIONS We describe the impact of an embedded palliative care program for patients with metastatic colorectal cancer, which improved prognostic awareness and rates of advance care planning.
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Affiliation(s)
- Kara E Bischoff
- Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, Box 0131, 533 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Carly Zapata
- Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, Box 0131, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Sarah Sedki
- Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, Box 0131, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Carling Ursem
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - David L O'Riordan
- Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, Box 0131, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | | | - Nicole Thompson
- Osher Center for Integrative Medicine, Department of Medicine, University of California. San Francisco, San Francisco, CA, USA
| | - Ariceli Alfaro
- Division of Hematology and Oncology, Department of Medicine and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Michael W Rabow
- Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, Box 0131, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Chloe E Atreya
- Division of Hematology and Oncology, Department of Medicine and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
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Breen LJ, Johnson AR, O'Connor M, Howting D, Aoun SM. Challenges in Palliative Care Research on Family Caregivers: Who Volunteers for Interviews? J Palliat Med 2020; 24:112-115. [PMID: 32255736 DOI: 10.1089/jpm.2019.0672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: Interviews are a common method of data collection in palliative care research because they facilitate the gathering of rich, experiential data that are important for theory and practice. What is less clear is the extent to which those interviewed are representative of the larger group. Objective: The aim of this study was to determine if family caregivers who volunteer to be interviewed were similar or different to those who do not. Design: This study used data from the Caregiving and Bereavement study, a prospective, longitudinal mixed-methods study of family caregivers' general health, quality of life, and grief. Setting/Subjects: The 16 caregivers who volunteered to be interviewed were compared to the 20 who did not. Measurements: Comparisons were made in terms of the caregivers' demographic characteristics as well as measures of their quality of life, general health, general grief, and caregiver prolonged grief (i.e., before death). Results: Compared to caregivers who did not volunteer for an interview, those who volunteered were significantly older and reported less caregiver prolonged grief. Logistic regression showed that for each 1-unit increase in the caregiver prolonged grief score, individuals were 13% less likely to agree to an interview. Conclusions: Research findings based upon family caregivers who volunteer for research interviews might not provide a full picture of their experiences and needs. Researchers are encouraged to consider strategies that sample broadly and promote the participation of the full range of family caregivers in research to address the neglected areas of pre- and postdeath bereavement care.
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Affiliation(s)
- Lauren J Breen
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Andrew R Johnson
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Moira O'Connor
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Denise Howting
- Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia.,Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
| | - Samar M Aoun
- Public Health Palliative Care Unit, La Trobe University, Melbourne, Victoria, Australia
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Roider-Schur S, Rumpold T, Kirchheiner K, Masel EK, Nemecek R, Amering M, Watzke H, Schrank B. Migrate your mind: the role of palliative care in transcultural cancer treatment : A qualitative analysis. Wien Klin Wochenschr 2019; 131:191-199. [PMID: 30997564 PMCID: PMC6520309 DOI: 10.1007/s00508-019-1474-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/15/2019] [Indexed: 12/02/2022]
Abstract
Background In increasingly multi-ethnic societies fostering cultural awareness and integration of immigrants is not only a political duty but also an obligation for social and healthcare systems. Importantly, cultural beliefs and needs strongly impact on the quality of life of cancer patients and may become even more crucial at the end of life. However, to date, ethnic and cultural aspects of palliative care are insufficiently researched. Methods This qualitative study at the Medical University of Vienna included 21 staff members from different disciplines in oncology and palliative care working with patients with various cultural backgrounds at the end of life. Semi-structured interviews were performed to gain insights into specific aspects of palliative care that are important in the clinical encounter with terminally ill cancer patients with migrant backgrounds and their relatives. Results Interviews revealed specific aspects of palliative care, which fell into four fundamental categories and were all perceived as beneficial in the clinical encounter with migrant clients: (A) structural and (B) personal conditions of the palliative care setting, (C) specific care and treatment intentions and (D) personnel requirements and attitudes. Conclusion This study revealed first insights into possibilities and prospects of transcultural palliative care for migrants and their relatives. The results might have important implications for the end of life care in this growing population.
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Affiliation(s)
- Sophie Roider-Schur
- Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. .,Clinical Division of Oncology, Department of Internal Medicine I, Sankt Josef Hospital Vienna, Auhofstraße 189, 1130, Vienna, Austria.
| | - Tamara Rumpold
- Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Kathrin Kirchheiner
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Eva Katharina Masel
- Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Romina Nemecek
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - Michaela Amering
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Herbert Watzke
- Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Beate Schrank
- Department of Psychiatry and Psychotherapy, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria
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Bužgová R, Kozáková R, Juríčková L. The unmet needs of family members of patients with progressive neurological disease in the Czech Republic. PLoS One 2019; 14:e0214395. [PMID: 30908542 PMCID: PMC6433266 DOI: 10.1371/journal.pone.0214395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/11/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Caring for patients with a progressive neurological disease (PND) causes stress that may impact on the state of health as well as the quality of life of the caring family. OBJECTIVE The aim of the study was to explore the unmet needs of the family members of patients with PND in advanced stages. METHODS Grounded theory (constructivist approach) was used to conceptualize the patterns of unmet care needs. Data collection methodology involved focus groups (n = 4) and interviews, in which a total of 52 people participated (patients, family members, and professionals). RESULTS Based on the data analysis, three domains (family situation, role of the caregiver, and professional help) were identified, which illustrate the unmet needs. In particular, lack of information about the disease and available support available resulted in a deterioration mutual understanding between the patient, family, and the medical staff; also increased stress for the caregiver, and lowered quality of life for the caring family. CONCLUSION Family members expect health workers to provide them with support, which includes informing them about the possible help available from the health and social welfare systems.
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Affiliation(s)
- Radka Bužgová
- Department of Nursing and Midwifery, Faculty of medicine, University of Ostrava, Ostrava, Czech Republic
| | - Radka Kozáková
- Department of Nursing and Midwifery, Faculty of medicine, University of Ostrava, Ostrava, Czech Republic
| | - Lubica Juríčková
- Department of Nursing and Midwifery, Faculty of medicine, University of Ostrava, Ostrava, Czech Republic
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