1
|
van Veen S, Drenth H, Hobbelen H, Finnema E, Teunissen S, de Graaf E. Non-pharmacological interventions feasible in the nursing scope of practice for pain relief in palliative care patients: a systematic review. Palliat Care Soc Pract 2024; 18:26323524231222496. [PMID: 38223744 PMCID: PMC10785737 DOI: 10.1177/26323524231222496] [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: 01/27/2023] [Accepted: 12/07/2023] [Indexed: 01/16/2024] Open
Abstract
Background Palliative care patients desire more symptom management interventions that are complementary to their medical treatment. Within the multi-professional team, nurses could help support pain management with non-pharmacological interventions feasible for their practice and adaptable to palliative care patients' needs. Objectives The objective was to identify non-pharmacological interventions feasible in the nursing scope of practice affecting pain in palliative care patients. Design A systematic review. Data sources and methods A defined search strategy was used in PubMed, CINAHL, PsycINFO, and Embase. Search results were screened double-blinded. Methodological quality was double-appraised with the Joanna Briggs Institute Critical Appraisal Tools. Data were extracted from selected studies and the findings were summarized. The methodological quality, quantity of studies evaluating the same intervention, and consistency in the findings were synthesized in a best-evidence synthesis to rank evidence as strong, moderate, limited, mixed, or insufficient. Results Out of 2385 articles, 22 studies highlighted non-pharmacological interventions in the nursing scope of practice. Interventions using massage therapy and virtual reality demonstrated most evidentiary support for pain management, while art therapy lacked sufficient evidence. Mindful breathing intervention showed no significant reduction in pain. Hypnosis, progressive muscle-relaxation-interactive-guided imagery, cognitive-behavioral audiotapes, wrapped warm footbath, reflexology, and music therapy exhibited promising results in pain reduction, whereas mindfulness-based stress reduction program, aromatherapy, and aroma-massage therapy did not. Conclusion Despite not all studies reaching significant changes in pain scores, non-pharmacological interventions can be clinically relevant to palliative care patients. Its use should be discussed for its potential value and nurses to be trained for safe practice. Methodologically rigorous research for non-pharmacological interventions in nursing scope of practice for pain relief in palliative care patients is necessary. Trial registration The protocol for this study is registered in the International Prospective Register of Systematic Review (PROSPERO registration number: CRD42020196781).
Collapse
Affiliation(s)
- Suzan van Veen
- ZuidOostZorg, Center for Elderly Care, Drachten, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, University of Applied Sciences Groningen, Groningen, The Netherlands
- FAITH Research, Groningen, The Netherlands
| | - Hans Drenth
- ZuidOostZorg, Center for Elderly Care, Drachten, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, University of Applied Sciences Groningen, Groningen, The Netherlands
- FAITH Research, Groningen, The Netherlands
| | - Hans Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, University of Applied Sciences Groningen, Groningen, The Netherlands
- FAITH Research, Groningen, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Evelyn Finnema
- FAITH Research, Groningen, The Netherlands
- Research Group Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Research Group Care and Well-being, Department of Healthcare, NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands
- Health Science-Nursing Science and Education, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Saskia Teunissen
- Center of Expertise Palliative Care Utrecht, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Everlien de Graaf
- Center of Expertise Palliative Care Utrecht, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| |
Collapse
|
2
|
Sengupta J. Beyond Correct Postures and Flexible Bodies: Exploring the Relevance of Yoga in End-of-Life care. JOURNAL OF RELIGION AND HEALTH 2022; 61:2388-2397. [PMID: 34176066 DOI: 10.1007/s10943-021-01317-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
Since the mid-twentieth century, Yoga has emerged as a multi-million US dollar global fitness industry. It has drawn worldwide followers to practice postural and breathing techniques. However, the fitness model only elucidates how to live well and not how to die well. This article contends that the body-centric approach has little relevance to those who are dying. It espouses that yogic values like transcendence, holistic healing, harmony, and death-acceptance that qualify a 'good' death are regrettably lost in modern times. In conclusion, the soteriological aim needs to be retained in the modern yogic discourse to live well and die gracefully.
Collapse
Affiliation(s)
- Jaydeep Sengupta
- Department of Anthropology & Tribal Studies, Sidho-Kanho-Birsha University, Purulia, West Bengal, 723104, India.
| |
Collapse
|
3
|
Potvin N, Hicks M, Kronk R. Music Therapy and Nursing Cotreatment in Integrative Hospice and Palliative Care. J Hosp Palliat Nurs 2021; 23:309-315. [PMID: 33631776 PMCID: PMC8248250 DOI: 10.1097/njh.0000000000000747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Integrative hospice and palliative care is a philosophy of treatment framing patients as whole persons composed of interrelated systems. The interdisciplinary treatment team is subsequently challenged to consider ethical and effective provision of holistic services that concomitantly address these systems at the end of life through cotreatment. Nurses and music therapists, as direct care professionals with consistent face-to-face contact with patients and caregivers, are well positioned to collaborate in providing holistic care. This article introduces processes of referral, assessment, and treatment that nurses and music therapists may engage in to address family support, spirituality, bereavement, and telehealth. Clinical vignettes are provided to illustrate how cotreatment may evolve and its potential benefits given diverse circumstances. As part of this framing, music therapy is positioned as a core-rather than alternative or complementary-service in hospice that satisfies the required counseling services detailed in Medicare's Conditions of Participation for hospice providers. The systematic and intentional partnering of nurses and music therapists can provide patients and caregivers access to quality comprehensive care that can cultivate healthy transitions through the dying process.
Collapse
|
4
|
Lin YJ, Chang HT, Lin MH, Chen RY, Chen PJ, Lin WY, Hsieh JG, Wang YW, Hu CC, Liou YS, Chiu TY, Tu CY, Wang YJ, Cheng BR, Chen TJ, Chen FP, Hwang SJ. Professionals' experiences and attitudes toward use of Traditional Chinese Medicine in hospice palliative inpatient care units: A multicenter survey in Taiwan. Integr Med Res 2021; 10:100642. [PMID: 33163357 PMCID: PMC7607421 DOI: 10.1016/j.imr.2020.100642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care. METHODS This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson's Chi-square test and Fisher's exact test. RESULTS A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care. CONCLUSIONS Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.
Collapse
Affiliation(s)
- Yu-Jia Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiao-Ting Chang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Hwai Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ru-Yih Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ping-Jen Chen
- Department of Family Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jyh-Gang Hsieh
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Ying-Wei Wang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chung-Chieh Hu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Sheng Liou
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Yi Tu
- Department of Family Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Yi-Jen Wang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bo-Ren Cheng
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
5
|
Sagha Zadeh R, Capezuti E, Eshelman P, Woody N, Tiffany J, Krieger AC. Non-pharmacological solutions to sleep and circadian rhythm disruption: voiced bedside experiences of hospice and end-of-life staff caregivers. BMC Palliat Care 2018; 17:131. [PMID: 30579339 PMCID: PMC6303860 DOI: 10.1186/s12904-018-0385-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 12/09/2018] [Indexed: 12/29/2022] Open
Abstract
Background Sleep disturbance is a significant issue, particularly for patients with advanced terminal illness. Currently, there are no practice-based recommended approaches for managing sleep and circadian disruptions in this population. To address this gap, a cross-sectional focus group study was performed engaging 32 staff members at four hospices/end-of-life programs in three demographically diverse counties in New York State. Methods Participants responded to structured open-ended questions. Responses were transcribed and subjected to qualitative content analysis. The themes and recommendations for improved practice that emerged were tabulated using Atlas TI qualitative software. Results This report details the experiences of hospice and end-of-life care staff in managing sleep and circadian disruptions affecting patients and analyzes their recommendations for improving care. Caregivers involved in the study described potential interventions that would improve sleep and reduce circadian disruptions. They particularly highlighted a need for improved evaluation and monitoring systems, as well as sleep education programs for both formal and informal caregivers. Conclusions The voiced experiences of frontline hospice and end-of-life caregivers confirmed that disruption in sleep and circadian rhythms is a common issue for their patients and is not effectively addressed in current research and practice. The caregivers’ recommendations focused on management strategies and underscored the need for well-tested interventions to promote sleep in patients receiving end-of-life care. Additional research is needed to examine the effectiveness of systematic programs that can be easily integrated into the end-of-life care process to attenuate sleep disturbances.
Collapse
Affiliation(s)
- Rana Sagha Zadeh
- Health Design Innovations Lab (affiliated with Cornell's Institute for Healthy Futures), Design and Environmental Analysis, Cornell University, 2425 Martha Van Rensselaer Hall, Ithaca, NY, 14853-4401, USA.
| | - Elizabeth Capezuti
- W.R. Hearst Foundation Chair in Gerontology, Hunter College of the City University of New York, New York, NY, USA
| | - Paul Eshelman
- Health Design Innovations Lab (affiliated with Cornell's Institute for Healthy Futures), Design and Environmental Analysis, Cornell University, 2425 Martha Van Rensselaer Hall, Ithaca, NY, 14853-4401, USA
| | - Nicole Woody
- Healthcare Strategy & Operations Consultant, New York, NY, USA
| | - Jennifer Tiffany
- Cornell University Cooperative Extension-NYC Programs, Outreach and Community Engagement, Bronfenbrenner Center for Translational Research, Ithaca, NY, USA
| | - Ana C Krieger
- Center for Sleep Medicine, Weill Cornell Medical Center, New York, NY, USA
| |
Collapse
|
6
|
Rahim-Jamal S, Sarte A, Kozak J, Bodell K, Barroetavena MC, Gallagher R, Leis A. Hospice Residents’ Interest in Complementary and Alternative Medicine (Cam) at end of Life: A Pilot Study in Hospice Residences in British Columbia. J Palliat Care 2018. [DOI: 10.1177/082585971102700209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While complementary and alternative medicine (CAM) can improve quality of life at end of life, little research exists on hospice residents’ interest in using and sharing CAM experiences with a partner/friend/other family member. A pilot study conducted in British Columbia, Canada explored the extent of hospice residents’ interest and openness to CAM use. A convenience sample of 48 hospice residents from 9 hospice sites completed questionnaire-based interviews. The majority of participants were Caucasian women over 60 years old. 81 percent expressed interest in receiving CAM; 79 percent used CAM prior to entering the hospice setting. 50 percent of those interested in using CAM felt their partner/friend/other family member would also be interested in receiving CAM, and half of that 50 percent reported personal interest in sharing the experience. Reasons reported for CAM interest were to enhance well-being, relaxation, and for pain relief. Further research could explore how resi-dent-caregiver dyads may benefit from shared CAM experiences over the illness trajectory.
Collapse
Affiliation(s)
- Sherin Rahim-Jamal
- S Rahim-Jamal (corresponding author) Centre for Healthy Aging at Providence, 4865 Heather Street, Vancouver, British Columbia, Canada V5Z 0B3
| | - Ann Sarte
- A Sarte Centre for Healthy Aging at Providence, Vancouver, British Columbia, Canada
| | - Jean Kozak
- School of Population and Public Health, University of British Columbia, and Centre for Healthy Aging at Providence, Vancouver, British Columbia, Canada
| | - Kathy Bodell
- Fraser Health Authority, Maple Ridge, British Columbia, Canada; MC Barroetavena: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maria Cristina Barroetavena
- Fraser Health Authority, Maple Ridge, British Columbia, Canada; MC Barroetavena: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Romayne Gallagher
- Divisions of Residential and Palliative Care, Department of Family & Community Medicine, Providence Health Care, and Division of Palliative Care, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne Leis
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
7
|
Coelho A, Parola V, Cardoso D, Bravo ME, Apóstolo J. Use of non-pharmacological interventions for comforting patients in palliative care: a scoping review. ACTA ACUST UNITED AC 2018; 15:1867-1904. [PMID: 28708751 DOI: 10.11124/jbisrir-2016-003204] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Palliative care aims to provide the maximum possible comfort to people with advanced and incurable diseases. The use of non-pharmacological interventions to promote comfort in palliative care settings has been increasing.However, information on implemented and evaluated interventions, their characteristics, contexts of application, and population is scattered in the literature, hampering the formulation of accurate questions on the effectiveness of those interventions and, consequently, the development of a systematic review. OBJECTIVE The objective of this scoping review is to examine and map the non-pharmacological interventions implemented and evaluated to provide comfort in palliative care. INCLUSION CRITERIA TYPES OF PARTICIPANTS This scoping review considered all studies that focused on patients with advanced and incurable diseases, aged 18 years or older, assisted by palliative care teams. CONCEPT This scoping review considered all studies that addressed non-pharmacological interventions implemented and evaluated to provide comfort for patients with advanced and incurable diseases.It considered non-pharmacological interventions implemented to provide not only comfort but also well-being, and relief of pain, suffering, anxiety, depression, stress and fatigue which are comfort-related concepts. CONTEXT This scoping review considered all non-pharmacological interventions implemented and evaluated in the context of palliative care. This included home care, hospices or palliative care units (PCUs). TYPES OF SOURCES This scoping review considered quantitative and qualitative studies, and systematic reviews. SEARCH STRATEGY A three-step search strategy was undertaken: 1) an initial limited search of CINAHL and MEDLINE; 2) an extensive search using all identified keywords and index terms across all included databases; and 3) a hand search of the reference lists of included articles.This review was limited to studies published in English, Spanish and Portuguese in any year. EXTRACTION OF RESULTS A data extraction instrument was developed. Two reviewers extracted data independently. Any disagreements that arose between the reviewers were resolved through discussion, or with a third reviewer. When necessary, primary authors were contacted for further information/clarification of data. PRESENTATION OF RESULTS Eighteen studies were included covering 10 non-pharmacological interventions implemented and evaluated to provide comfort. The interventions included one to 14 sessions. The interventions lasted between five and 60 minutes. Most of the interventions were implemented in PCUs and hospice settings. Ten of the 18 interventions were implemented and evaluated exclusively in cancer patients. CONCLUSIONS Ten non-pharmacological interventions were identified, of which the most common were music therapy and massage therapy. Their characteristics differed significantly across interventions and even in the same intervention. They were mostly implemented in palliative care units and hospices, and in patients with a cancer diagnosis. These data raise questions for future primary studies and systematic reviews. IMPLICATIONS FOR RESEARCH Future research should focus on the implementation of interventions not only with cancer patients but also with non-cancer patients and patients receiving palliative care at home. Systematic reviews on the effect of massage therapy and music therapy should be conducted.
Collapse
Affiliation(s)
- Adriana Coelho
- 1Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal 2Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal 3Department of Nursing, University of Lleida, Lleida, Spain; GRECS Research Group, Institute of Biomedical Research of Lleida, Lledia, Spain 4Portugal Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence
| | | | | | | | | |
Collapse
|
8
|
Marchand LR. Palliative and End-of-Life Care. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00082-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
9
|
Berger CC, Cheston S, Stewart-Sicking J. Experiences of Healing Touch and Counseling on a Bereaved Population: A Grounded Theory. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2016. [DOI: 10.1080/15401383.2016.1201032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Rayner JA, Bauer M. “I Wouldn’t Mind Trying It. I’m in Pain the Whole Time”: Barriers to the Use of Complementary Medicines by Older Australians in Residential Aged-Care Facilities. J Appl Gerontol 2016; 36:1070-1090. [DOI: 10.1177/0733464816629852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Older people living in the community use complementary medicine (CM) to manage the symptoms of chronic illness; however, little is known about CM use by older people living in care settings. Using focus groups and individual interviews, this study explored the use of CM from the perspective of 71 residents, families, and health professionals from six residential aged-care facilities in Victoria, Australia. Residents used CM to manage pain and improve mobility, often covertly, and only with the financial assistance of their families. Facility policies and funding restrictions constrained CM use at the individual and facility level. An absence of evidence to support safety and efficacy coupled with the risk of interactions made doctors wary of CM use in older people. These findings have relevance for the large number of CM using “baby-boomers” as they move into residential aged-care.
Collapse
|
11
|
Coelho A, Parola V, Cardoso D, Escobar M, Apóstolo J. The use of non-pharmacological interventions for the comfort of patients in palliative care: a scoping review protocol. ACTA ACUST UNITED AC 2016; 14:64-77. [DOI: 10.11124/jbisrir-2016-2440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
12
|
Work environment facilitators to the availability of complementary and alternative therapies in perinatal hospices. J Hosp Palliat Nurs 2015; 17:391-396. [PMID: 26877713 DOI: 10.1097/njh.0000000000000167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Increasingly, patients and clinicians are considering palliative care interventions during pregnancy for the maternal-fetal dyad, when a life-limiting diagnosis is confirmed. Nurses are at the forefront of providing hospice and palliative care that includes planning interventions for infants nearing the end of life. However, little is known about the work environment facilitators to the availability of complementary and alternative medicine (CAM) therapies. Using a national database of perinatal hospice and palliative care providers, we described the types of CAM therapies available and explored the influence of the nurse work environment on the availability of CAM therapies with multivariate regression analysis. This study showed that having an education environment where clinicians are trained, along with a highly educated RN support staff, and a BSN educated staff were critical to the availability of CAM therapies. The clinical implications for hospice and palliative nurses caring for infants and their families were discussed.
Collapse
|
13
|
Burns DS, Perkins SM, Tong Y, Hilliard RE, Cripe LD. Music Therapy is Associated With Family Perception of More Spiritual Support and Decreased Breathing Problems in Cancer Patients Receiving Hospice Care. J Pain Symptom Manage 2015; 50:225-31. [PMID: 25839735 DOI: 10.1016/j.jpainsymman.2015.02.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 02/13/2015] [Accepted: 02/18/2015] [Indexed: 11/16/2022]
Abstract
CONTEXT Music therapy is a common discretionary service offered within hospice; however, there are critical gaps in understanding the effects of music therapy on hospice quality indicators, such as family satisfaction with care. OBJECTIVES The purpose of this study was to examine whether music therapy affected family perception of patients' symptoms and family satisfaction with hospice care. METHODS This was a retrospective, cross-sectional analysis of electronic medical records from 10,534 cancer patients cared for between 2006 and 2010 by a large national hospice. Logistic regression was used to estimate the effect of music therapy using propensity scores to adjust for non-random assignment. RESULTS Overall, those receiving music therapy had higher odds of being female, having longer lengths of stay, and receiving more services other than music therapy, and lower odds of being married/partnered or receiving home care. Family satisfaction data were available for 1495 (14%) and were more likely available if the patient received music therapy (16% vs. 12%, P < 0.01). There were no differences in patient pain, anxiety, or overall satisfaction with care between those receiving music therapy vs. those not. Patients who received music therapy were more likely to report discussions about spirituality (odds ratio [OR] = 1.59, P = 0.01), had marginally less trouble breathing (OR = 0.77, P = 0.06), and were marginally more likely to receive the right amount of spiritual support (OR = 1.59, P = 0.06). CONCLUSION Music therapy was associated with perceptions of meaningful spiritual support and less trouble breathing. The results provide preliminary data for a prospective trial to optimize music therapy interventions for integration into clinical practice.
Collapse
Affiliation(s)
- Debra S Burns
- School of Engineering and Technology at IUPUI, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA.
| | - Susan M Perkins
- Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| | - Yan Tong
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Larry D Cripe
- Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| |
Collapse
|
14
|
Dain AS, Bradley EH, Hurzeler R, Aldridge MD. Massage, Music, and Art Therapy in Hospice: Results of a National Survey. J Pain Symptom Manage 2015; 49:1035-41. [PMID: 25555445 PMCID: PMC4480160 DOI: 10.1016/j.jpainsymman.2014.11.295] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 11/19/2014] [Accepted: 11/22/2014] [Indexed: 10/24/2022]
Abstract
CONTEXT Complementary and alternative medicine (CAM) provides clinical benefits to hospice patients, including decreased pain and improved quality of life. Yet little is known about the extent to which U.S. hospices employ CAM therapists. OBJECTIVES To report the most recent national data regarding the inclusion of art, massage, and music therapists on hospice interdisciplinary teams and how CAM therapist staffing varies by hospice characteristics. METHODS A national cross-sectional survey of a random sample of hospices (n = 591; 84% response rate) from September 2008 to November 2009. RESULTS Twenty-nine percent of hospices (169 of 591) reported employing an art, massage, or music therapist. Of those hospices, 74% employed a massage therapist, 53% a music therapist, and 22% an art therapist, and 42% expected the therapist to attend interdisciplinary staff meetings, indicating a significant role for these therapists on the patient's care team. In adjusted analyses, larger hospices compared with smaller hospices had significantly higher odds of employing a CAM therapist (adjusted odds ratio 6.38; 95% CI 3.40, 11.99) and for-profit hospices had lower odds of employing a CAM therapist compared with nonprofit hospices (adjusted odds ratio 0.52; 95% CI 0.32, 0.85). Forty-four percent of hospices in the Mountain/Pacific region reported employing a CAM therapist vs. 17% in the South Central region. CONCLUSION Less than one-third of U.S. hospices employ art, massage, or music therapists despite the benefits these services may provide to patients and families. A higher proportion of large hospices, nonprofit hospices, and hospices in the Mountain/Pacific region employ CAM therapists, indicating differential access to these important services.
Collapse
Affiliation(s)
- Aleksandra S Dain
- Icahn School of Medicine at Mount Sinai, New York, New York, USA; James J. Peters VA, Bronx, New York, USA
| | - Elizabeth H Bradley
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Rosemary Hurzeler
- The John D. Thompson Hospice Institute for Education, Training, and Research, Inc., Branford, Connecticut, USA
| | | |
Collapse
|
15
|
Dunning T, Savage S, Duggan N, Martin P. Palliative and end of life care for people with diabetes: a topical issue. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/dmt.14.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
16
|
Olotu BS, Brown CM, Barner JC, Lawson KA. Factors associated with hospices' provision of complementary and alternative medicine. Am J Hosp Palliat Care 2013; 31:385-91. [PMID: 23689364 DOI: 10.1177/1049909113489873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is limited research about the provision of complementary and alternative (CAM) in US hospices. The purpose of this study was to assess the factors that influence hospices' likelihood of providing CAM therapies. Mail surveys were sent to 369 hospices in Texas; 61 were returned undelivered, yielding a total usable response rate of 35.7% (n = 110) after an initial and one follow-up mail out. Binary logistic regression was used to assess whether the likelihood of offering CAM is related to hospice's age, geographic location, agency type, profit orientation, Medicare certification, and number of patients served annually. Results showed that profit orientation and the number of patients served by hospices were significantly related to the probability that hospices will offer CAM. Specifically, the odds of offering CAM in not-for-profit hospices were approximately 4 times higher than that in for-profit hospices (odds ratio [OR] = 3.77, P = .022, 95% confidence interval [CI] = 1.2, 11.8). In addition, for every 100 patients served by the hospices, the odds of offering CAM increases by 13% (OR = 1.13, P = .015, 95% CI = 1.02, 1.25). In conclusion, CAM offering by hospices is related to hospices' profit orientation status and number of patients served but is not related to other measured characteristics of hospices.
Collapse
Affiliation(s)
- Busuyi S Olotu
- 1Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | | | | | | |
Collapse
|
17
|
Olotu BS, Brown CM, Lawson KA, Barner JC. Complementary and alternative medicine utilization in Texas hospices: prevalence, importance, and challenges. Am J Hosp Palliat Care 2013; 31:254-9. [PMID: 23625931 DOI: 10.1177/1049909113486535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to describe the prevalence, importance, and challenges of complementary and alternative medicine (CAM) utilization in Texas hospices. Mail surveys were sent to 369 hospices in Texas, and 110 useful surveys were returned. Results showed that a majority (n = 62, 56.4%) of hospices offer CAM to their clients, with the most popularly offered CAMs being massage, music, and relaxation therapies. Despite the availability of CAM services in most hospices, and that the utilization of CAM has the potential to improve overall quality of life of patients, our results showed that a sizeable proportion of patients in these hospices are not utilizing the provided CAMs. Funding and personnel constraints were substantial obstacles to offering CAM.
Collapse
Affiliation(s)
- Busuyi S Olotu
- 1Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | | | | | | |
Collapse
|
18
|
Dorfman J, Denduluri S, Walseman K, Bregman B. The Role of Complementary and Alternative Medicine in End-of-Life Care. Psychiatr Ann 2012. [DOI: 10.3928/00485713-20120323-09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
19
|
Marchand LR. End-of-Life Care. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00064-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|