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Walls M, Claffey A, Mockler D, Galvin M. Working with people living with motor neurone disease and the impact on professionals' emotional and psychological well-being: A scoping review. Palliat Med 2024:2692163241291745. [PMID: 39520111 DOI: 10.1177/02692163241291745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
BACKGROUND Integrated multidisciplinary care is required to manage the progressive and debilitating symptoms associated with motor neurone disease. Professionals can find providing the level of care required by this population clinically and emotionally challenging. To support those working with these patients it is important to understand the experience of the entire multidisciplinary team involved and the impact of working with motor neurone disease on their emotional and psychological well-being. AIM To identify what is known about (1) healthcare professionals' experience of working with motor neurone disease and (2) the impact of this work on their emotional and psychological well-being. DESIGN Scoping review. Review protocol registered on Open Science Framework. SOURCES Five electronic databases were searched in January 2023 and 2024. Grey literature and hand searches were completed. RESULTS Fifty-one sources published between 1990 and 2023 were included. A total of 1692 healthcare professionals are represented. Three main categories were identified: (1) The demands of providing motor neurone disease care. (2) Factors influencing professionals' ability to provide desired levels of care. (3) The emotional impact of working with motor neurone disease. Subcategories are depicted within these. CONCLUSION Positive experiences included job satisfaction, enhanced perspective and receiving gratitude, while negative implications such as stress, emotional exhaustion and burnout also featured. The demands of motor neurone disease patient care, the organisation of services and resources required to meet patient and family needs and the emotional burden for professionals involved, warrant greater recognition in clinical practice, guidelines and future research.
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Affiliation(s)
- Megan Walls
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
| | - Austin Claffey
- Institute of Health and Social Care, London South Bank University, London, UK
| | - David Mockler
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
| | - Miriam Galvin
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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THEME 12 CLINICAL MANAGEMENT AND SUPPORT. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:287-319. [PMID: 39508673 DOI: 10.1080/21678421.2024.2403309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2024]
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Bai W, Liu H, Ding J, Zhang H, Johnson CE, Cook A. Palliative care needs and utilisation of specialist services for people diagnosed with motor neuron disease: a national population-based study. BMJ Open 2024; 14:e082628. [PMID: 39122386 PMCID: PMC11331903 DOI: 10.1136/bmjopen-2023-082628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION There is a growing emphasis on the importance of the availability of specialist palliative care for people with motor neuron disease (MND). However, the palliative care needs of this population and the utilisation of different specialist services remain poorly defined. OBJECTIVES To (1) describe clinical characteristics, symptom burden and functional levels of patients dying with MND on their admission to palliative care services; (2) determine factors associated with receiving inpatient or community palliative care services. DESIGN An observational study based on point-of-care assessment data from the Australian Palliative Care Outcomes Collaboration. PARTICIPANTS A total of 1308 patients who received palliative care principally because of MND between 1 January 2013 and 31 December 2020. MEASURES Five validated clinical instruments were used to assess each individual's function, distress from symptoms, symptom severity and urgency and acuity of their condition. RESULTS Most patients with MND had no or mild symptom distress, but experienced a high degree of functional impairment. Patients who required 'two assistants for full care' relative to those who were 'independent' (OR=11.53, 95% CI: 4.87 to 27.26) and those in 'unstable' relative to 'stable' palliative care phases (OR=16.74, 95% CI: 7.73 to 36.24) were more likely to use inpatient versus community-based palliative care. Associations between the use of different palliative care services and levels of symptom distress were not observed in this study. CONCLUSIONS Patients with MND were more likely to need assistance for decreased function and activities of daily living, rather than symptom management. This population could have potentially been cared for in the palliative phase in a community setting if greater access to supportive services were available in this context.
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Affiliation(s)
- Wenhui Bai
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Huiqin Liu
- Health Management Center, Department of Cardiology, Central South University Third Xiangya Hospital, Changsha, Hunan, China
| | - Jinfeng Ding
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongmei Zhang
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Claire E Johnson
- The Palliative Aged Care Outcomes Program, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Angus Cook
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Beyermann A, Asp M, Godskesen T, Söderman M. Nurses' challenges when supporting the family of patients with ALS in specialized palliative home care: A qualitative study. Int J Qual Stud Health Well-being 2023; 18:2238984. [PMID: 37490576 PMCID: PMC10405765 DOI: 10.1080/17482631.2023.2238984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
PURPOSE Being a family member to someone who has amyotrophic lateral sclerosis (ALS) is demanding and often requires sacrificing a lot. Family members can experience fatigue, anxiety, guilt and need support. The aim was to explore registered nurses' (RNs') experiences of providing support to the families of patients with ALS within specialized palliative home care (SPHC). METHODS A qualitative explorative design. Interviews were conducted with RNs (n = 11) from five SPHCs in Sweden and analysed using qualitative content analysis. RESULTS The results emerged in the following categories:"To support in an increasingly difficult everyday life", based on the sub-categories: "Creating a trusting relationship", "Balancing between the needs of patients and their families", and "Sharing knowledge about dying to the families";"To support in emotionally challenging situations", based on the sub-categories: "Harbouring family members' difficult feelings", "Providing support even though the situation is unpleasant" and "Being able to give support by receiving confirmation and support from others". CONCLUSIONS RNs working in SPHC have an important role in providing support in several ways to the families of patients with ALS, through facilitating their everyday life and giving emotional support when needed, based on the needs of both patients and the families.
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Affiliation(s)
- Alexandra Beyermann
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Margareta Asp
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Tove Godskesen
- Palliative Research Centre, Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mirkka Söderman
- Senior Lecturer, Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden, ORCID, 0000-0001-5391-623X
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Brewah H, Borrett K, Tavares N, Jarrett N. Perceptions of people with motor neurone disease, families and HSCPs: a literature review. Br J Community Nurs 2022; 27:188-198. [PMID: 35353593 DOI: 10.12968/bjcn.2022.27.4.188] [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: 11/11/2022]
Abstract
Motor neurone disease or amyotrophic lateral sclerosis is a rapidly progressive terminal neurodegenerative condition caused by degeneration of the upper and lower motor neurones in the central nervous system of the brain. The effects of motor neurone disease are multifaceted, leading to many adjustments in everyday life. This literature review asked what the experiences of people living with motor neurone disease was before and during the COVID-19 pandemic and during the COVID-19 pandemic, especially in terms of their condition and the support they received from health and social care services. A key theme identified was lack of knowledge among professionals when they cared for people living with motor neurone disease and their families. This lack of knowledge often resulted in delayed diagnosis and poor standards of care. COVID-19 impacted on the care of people living with motor neurone disease and their families, and there is a paucity of evidence on how services were perceived by these groups during the COVID-19 pandemic. The experiences of people living with motor neurone disease and their families are currently missing in the literature. In conclusion, further studies are required to include care of people living with motor neurone disease and their families.
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Affiliation(s)
- Helen Brewah
- Queen's Nurse, Florence Nightingale Scholar and PhD student, University of Portsmouth
| | - Kevin Borrett
- Mental Health Governance Lead, Solent NHS Trust, and PhD Supervisor, University of Portsmouth
| | - Nuno Tavares
- Supervisor and Senior Teaching Fellow, Faculty of Science and Health, University of Portsmouth
| | - Nikki Jarrett
- Course Lead for Professional Doctorate in Health and Social Care, University of Portsmouth
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Warrier MG, Sadasivan A, Johnson J, Vengalil S, Nalini A, Thomas PT. Integrated Home-Based Palliative Care in Motor Neuron Disease: A Case Report from Low- Middle Income Country. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2021; 17:262-266. [PMID: 34152942 DOI: 10.1080/15524256.2021.1938344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In many international care guidelines, multidisciplinary palliative care forms a key to optimum management in Motor Neuron Disease (MND). We describe the home-based palliative care interventions for a client with MND and his family from a Low and Middle-income country context. This report also discusses the advantages and challenges of the same with suggestions for sustaining the quality of care for neuro palliative conditions.
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Affiliation(s)
- Manjusha G Warrier
- Department of Psychology, Christ University (Deemed to be University), Bengaluru, India
| | - Arun Sadasivan
- Department of Counselling Psychology, Sampurna Montfort College, Bengaluru, India
| | - Jeremy Johnson
- School of Medicine, Cardiff University, Cardiff, United Kingdom of Great Britain and Northern Ireland
- Karunashraya, Bangalore Hospice Trust, Bengaluru, India
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Genuis SK, Luth W, Campbell S, Bubela T, Johnston WS. Communication About End of Life for Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review of the Empirical Evidence. Front Neurol 2021; 12:683197. [PMID: 34421792 PMCID: PMC8371472 DOI: 10.3389/fneur.2021.683197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined. Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations. Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative data extraction and analysis was conducted on 211 articles with qualitative analysis on a subset of 110 articles that focused primarily on health communication. Analyses summarized article characteristics, themes, and recommendations. Results: Analysis indicated a multidisciplinary but limited evidence base. Most reviewed articles addressed end-of-life communication as a peripheral focus of investigation. Generic communication skills are important; however, substantive and sufficient disease-related information, including symptom management and assistive devices, is critical to discussions about end of life. Few articles discussed communication about specific end-of-life options. Communication recommendations in analyzed articles draw attention to communication processes, style and content but lack the systematized guidance needed for clinical practice. Conclusions: This review of primary research articles highlights the limited evidence-base and consequent need for systematic, empirical investigation to inform effective communication about end of life for those with amyotrophic lateral sclerosis. This will provide a foundation for actionable, evidence-based communication guidelines about end of life. Implications for research, policy, and practice are discussed.
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Affiliation(s)
- Shelagh K. Genuis
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Westerly Luth
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Tania Bubela
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Wendy S. Johnston
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Harris DA, Jack K, Wibberley C. Making her end of life her own: further reflections on supporting a loved one with motor neurone disease. Int J Palliat Nurs 2020; 25:284-292. [PMID: 31242093 DOI: 10.12968/ijpn.2019.25.6.284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND People can live for many months without knowing why their body is failing prematurely before being diagnosed with motor neurone disease (MND); a terminal neurodegenerative disease which can be experienced as 'devastating' for the person and their family. AIM This study aimed to explore the meaning of supporting a loved one with MND to die. METHODS This study uses reflection and autobiographical story to connect with broader cultural, political and social meaning and understandings of dying. FINDINGS Four themes were identified relating to the end-of-life trajectory of MND. Loss of person (lived body experienced in silence); loss of relationships (lived relations are challenged); loss of home and loss of time (lived space and lived time take on new meaning); loss of future (dying-facing it alone). CONCLUSION Dying with MND is a complex phenomenon. When a person can no longer move and communicate, relationships between those involved in end-of-life care are challenging. A person with MND needs the support from those acting as power of attorney to make their end of life their own, and they themselves need support to find meaning in their suffering. This autoethnographic reflection provides vicarious experiences for nurses and other healthcare professionals working with people with MND and similar conditions.
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Affiliation(s)
- Denise Andrea Harris
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester
| | - Kirsten Jack
- Reader in Learning and Teaching Development Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester
| | - Christopher Wibberley
- Principal Lecturer, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester
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Ethical challenges in tracheostomy-assisted ventilation in amyotrophic lateral sclerosis. J Neurol 2018; 265:2730-2736. [DOI: 10.1007/s00415-018-9054-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/07/2018] [Accepted: 09/07/2018] [Indexed: 12/11/2022]
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