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Renz M, Gloggner C, Bueche D, Renz U. Compassionate Presence in Seriously Ill Cancer Patients. Am J Hosp Palliat Care 2024; 41:1408-1422. [PMID: 38243633 DOI: 10.1177/10499091241226629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024] Open
Abstract
Background: Compassion is a relational response to patients' suffering. Palliative care focuses not only on skills but also on compassion. Nevertheless, incorporated patient perspectives are largely missing from existing research. Aim: Our mixed-method exploratory study in a major Swiss cancer center sought to better understand compassionate presence, its benefits and challenges for patients and providers (ie, close relatives, close friends, and professionals-all referred to here as providers). It also investigated providers' motivation. Method: Twelve multidisciplinary, specially trained professionals interviewed 50 patients who had received compassionate presence. All patients had advanced cancer with risk of death. Providers were also interviewed. Data on the positive and burdensome effects of compassionate presence on patients and providers were gathered using a specific protocol. This also served to record patients' characteristics and providers' motivations to give compassion and whether providers felt sustained (eg, by nature). Results: The study suggests a high impact of compassionate presence with benefits on patients (50/50) and on providers (49/50). Enhanced connectedness was evident not only in the patient-provider relationship (38/50) but also, for instance, in an increased ability to love (8/50) or in an intensified solidarity (29/50). A considerable number of patients and providers experienced mental-spiritual change but also burdensome effects (eg, ambivalences). Providers showed a range of motivations. Conclusion: Compassion is not only necessary in existential crises and near death, but also happens and takes considerable effects precisely in such situations.
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Affiliation(s)
- M Renz
- Psychooncology, Oncology and Haematology, Cantonal Hospital, St. Gallen, Switzerland
| | - C Gloggner
- Psychooncology, Oncology and Haematology, Cantonal Hospital, St. Gallen, Switzerland
| | - D Bueche
- Kliniken Valens, St. Gallen, Switzerland
| | - U Renz
- Department of Philosophy, University of Graz, Graz, Austria
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Bagherian S, Tehranineshat B, Shahbazi M, Taklif MH. Perceived compassionate care and preoperative anxiety in hospitalized patients. Nurs Ethics 2024; 31:1315-1329. [PMID: 39041777 DOI: 10.1177/09697330231197705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND Quality nursing care and ethical responses to patient pain and suffering are very important in the preoperative period. However, few studies have addressed these variables. OBJECTIVE This study aimed to examine the relationship between compassionate care and preoperative anxiety from the perspective of hospitalized patients. METHODS The current study was a cross-sectional descriptive one. The participants were selected using convenience sampling. The data were collected using a demographic questionnaire, Burnell Compassionate Care Tool, and Amsterdam Preoperative Anxiety and Information Scale (APAIS). The collected data were analyzed with SPSS software (version 22) through descriptive and inferential statistics at a significance level of 0.05 (p < .05). PARTICIPANTS AND SETTING This study was conducted on 704 candidates for surgery in the internal and surgical wards of a large teaching hospital located in the south of Iran from December 2022 to March 2023. ETHICAL CONSIDERATIONS The protocol for this study was reviewed and approved by the University Ethics Committee. FINDINGS The patients' average age was 36.61 ± 13.07. The average preoperative anxiety and need for information scores were 13.80 ± 2.66 and 7.44 ± 1.47, respectively. The average score of importance was 3.03 ± 0.19, and the average score of the extent of compassionate care provision was 1.22 ± 0.15. There was a significant relationship between preoperative anxiety with importance and the extent of compassionate care provision (r = 0.68, p < .001), r = -0.72, p < .001, respectively). A comparison of the demographic characteristics, need for information, importance, and provision of compassionate care showed that the extent of compassionate care provision had the greatest contribution in explaining preoperative anxiety (β = 0.50; p < .001). CONCLUSION Even though patients' preoperative anxiety was high and providing compassionate care in the preoperative period had a great role in relieving their anxiety, many participants appear to have received little compassionate care. To this end, nursing managers should pay attention to the quality of compassionate care in the preoperative stage. Besides, healthcare staff should receive the necessary training in compassionate nursing care.
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Yoong SQ, Wang W, Seah ACW, Chao FFT, Kumar N, Gan JON, Schmidt LT, Hong J, Zhang H. The impact of a student death doula service-learning experience in palliative care settings on nursing students: A pilot mixed-methods study. DEATH STUDIES 2024:1-13. [PMID: 39158318 DOI: 10.1080/07481187.2024.2391929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Through a mixed-methods approach (randomized controlled trial and thematic analysis of pre and post-service-learning reflections), this study evaluated the impact of a student death doula service-learning experience on nursing students' palliative competencies and learning experiences. The intervention group underwent a 2-day student death doula training workshop followed by a 6-month service-learning experience, while the control group received standard palliative care education. Attitudes toward the care of the dying significantly improved for the intervention group but not for compassion competence and palliative care knowledge. Six themes were developed: (1) Motivations for being a student death doula, (2) Improved perceptions of palliative care patients, (3) Perceptions of a good death, (4) Confidence in caring for palliative care patients, (5) Understanding the multifaceted nature of palliative care, and (6) Joys and challenges during service-learning. Service-learning helped students to understand palliative care patients and acquire confidence in engaging with them.
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Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Felicia Fang Ting Chao
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
| | - Nivetha Kumar
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Assisi Hospice, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Hui Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- St. Andrew's Community Hospital, Singapore
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Marshman C, Allen J, Ling D, Brand G. 'It's very values driven': A qualitative systematic review of the meaning of compassion according to healthcare professionals. J Clin Nurs 2024; 33:1647-1665. [PMID: 38240044 DOI: 10.1111/jocn.16998] [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: 06/22/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 04/04/2024]
Abstract
AIMS AND OBJECTIVES To explore the meaning ascribed to the concept of compassion by healthcare professionals. BACKGROUND Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear. DESIGN A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines. METHOD Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed. FINDINGS Seventeen papers met the inclusion criteria. An overarching theme, 'It's very values driven' underpins the four main themes identified: (1) 'It's about people and working with them': Compassion as being human, (2) 'There is this feeling': Compassion as being present, (3) 'If I don't understand them, I won't be able to help': Compassion as understanding, (4) 'Wanting to help in some way': Compassion as action. CONCLUSIONS Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice. RELEVANCE TO CLINICAL PRACTICE To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice. NO PATIENT OR PUBLIC CONTRIBUTION This systematic review had no patient or public contribution.
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Affiliation(s)
- Cameron Marshman
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Peninsula Health, Frankston, Victoria, Australia
- The Australian College of Mental Health Nurses, Deakin, Australian Capital Territory, Australia
| | - Jacqui Allen
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Debbie Ling
- Department of Social Work, Monash University, Melbourne, Victoria, Australia
- Epworth HealthCare, Melbourne, Victoria, Australia
| | - Gabrielle Brand
- Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
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Hynnekleiv II, Jensen JK, Giske T, Lausund H, Maeland E, Heggdal K. Patients' and Nurses' experiences of caring in nursing: An integrative literature review across clinical practices. J Clin Nurs 2024; 33:1233-1255. [PMID: 38093547 DOI: 10.1111/jocn.16964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/12/2023] [Accepted: 11/01/2023] [Indexed: 03/08/2024]
Abstract
AIM To summarise, interpret and synthesize research findings on patients' and nurses' experiences of caring in nursing across clinical practices. BACKGROUND Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients' and nurses' experiences of caring. DESIGN AND METHODS This integrative literature review covers papers published between 2000 and 2022. Four databases-PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)-were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA-S checklists were used. An Integrative review methodology guided the process. FINDINGS In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient-nurse relationship. CONCLUSION The experience of caring in nursing depended on nurses' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was made due to the study design.
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Affiliation(s)
| | - Jørghild K Jensen
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Tove Giske
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Hilde Lausund
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Elisabeth Maeland
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Kristin Heggdal
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
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Liang M, Liang J, Xu J, Chen Q, Lu Q. Experience of multidisciplinary medical teams on humanistic palliative care in oncology wards: a descriptive qualitative study in Southern China. BMJ Open 2024; 14:e074628. [PMID: 38413159 PMCID: PMC10900382 DOI: 10.1136/bmjopen-2023-074628] [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: 04/13/2023] [Accepted: 01/19/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVES This study aimed to explore the experiences of multidisciplinary medical teams in implementing humanistic palliative care within the oncology ward. DESIGN Purposive and snowball sampling methods were used in this qualitative study, which involved conducting semistructured interviews to gather personal experiences from members of multidisciplinary medical teams providing humanistic palliative care in the oncology ward. SETTING The research was conducted in the oncology ward of a tertiary hospital located in Foshan, China. PARTICIPANTS Participants included 4 doctors, 12 nurses and 2 medical social workers who form the multidisciplinary medical team responsible for delivering humanistic palliative care to patients with cancer in oncology wards. RESULTS Phenomenological qualitative analysis yielded 3 main themes and 9 subthemes. The identified themes were as follows: (1) conceptual change, (2) concrete actions and (3) facilitators and barriers to the implementation of humanistic palliative care. CONCLUSION The findings suggest a need for strengthening humanistic consciousness among multidisciplinary palliative care teams working in oncology wards, although there has been a gradual improvement in humanistic care behaviours. Furthermore, facilitators and barriers coexist in the implementation of humanistic palliative care. Efforts should be directed towards refining mechanisms that promote humanistic palliative care, fostering the enthusiasm of healthcare professionals, conducting systematic training to enhance their humanistic care abilities and striving for improvements in the quality of medical services for the benefit of both patients and their families.
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Affiliation(s)
- Mengna Liang
- School of Nursing, Guangdong Pharmaceutical University, Guangdong, China
- The Sixth Affiliated Hospital, South China University of Technology, Foshan, China
| | - Jingzhang Liang
- The Sixth Affiliated Hospital, South China University of Technology, Foshan, China
| | - Jiefang Xu
- The Sixth Affiliated Hospital, South China University of Technology, Foshan, China
| | - Qian Chen
- School of Nursing, Guangdong Pharmaceutical University, Guangdong, China
| | - Qiaocong Lu
- School of Nursing, Guangdong Pharmaceutical University, Guangdong, China
- The Sixth Affiliated Hospital, South China University of Technology, Foshan, China
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Jaramillo M. Holistic nursing can improve family engagement. Nursing 2023; 53:37-39. [PMID: 37856299 DOI: 10.1097/01.nurse.0000978864.81948.c4] [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: 10/21/2023]
Abstract
ABSTRACT Family engagement is relevant to patient outcomes and ensures patient efficacy, support, and quality of life. Such engagement is facilitated by holistic nursing methods. This article discusses the importance of and barriers to family engagement and practical strategies for its implementation.
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Rahnama M, Abdollahimohammad A, Asadi-Bidmeshki E, Shahdadi H. Nurses' Caring Experiences for Dying Patients: A Meta-Synthesis Review. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231206513. [PMID: 37837313 DOI: 10.1177/00302228231206513] [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: 10/16/2023]
Abstract
Nurses play an important role in caring for dying patients. The ability to face a dying patient is a vital necessity and skill for nurses. Nurses' experiences in dealing with dying patients help to identify the factors affecting nursing care. Therefore, this meta-synthesis explains nurses caring experiences for dying patients. In this meta-synthesis review, English qualitative articles related to nurses' caring experiences with dying patients that were published in Google Scholar, PubMed, Web of Science, Scopus, and CINAHL databases were selected. The results presented in 4 themes and 4 sub-themes, including (i) dual parallel nursing care (patient care and family care), (ii) conflict between nurses' beliefs and care duties, (iii) care reflections on the nurse (positive and negative care reflection, and (iv) coping strategies of nurses. This study shows that nurses provide diverse care to dying patients and their families, which has had positive and negative reflections on their personal and professional lives. Nurses sometimes had a conflict with their beliefs and treatment protocols, which hesitate to perform the treatment. Although nurses use various coping strategies when caring for dying patients and their families, they need more strategies to cope with multi-faceted physical, mental, spiritual, educational, and management issues.
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Affiliation(s)
- Mozhgan Rahnama
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Elaheh Asadi-Bidmeshki
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Hossein Shahdadi
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
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Keyvanloo Shahrestanaki S, Rafii F, Ashghali Farahani M, Najafi Ghezeljeh T, Amrollah Majdabadi Kohne Z. Contributing factors involved in the safety of elderly people with chronic illness in home healthcare: a qualitative study. BMJ Open Qual 2023; 12:e002335. [PMID: 37451802 PMCID: PMC10351293 DOI: 10.1136/bmjoq-2023-002335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Patients receiving home care are often elderly people with chronic illnesses that increasingly experience patient safety barriers due to special care needs. OBJECTIVE The present study was conducted to determine the factors involved in the safety of elderly patients with chronic illnesses receiving home care. METHODS A qualitative study with a conventional content analysis method was conducted in home care agencies of Tehran, Iran from August 2020 to July 2022. For data generation, semistructured interviews were conducted with 11 nurses, 2 nurse assistants, 1 home care inspector (an expert working at the deputy of treatment) and 3 family caregivers. Moreover, four observational sessions were also held. Data analysis was done using the five-step Graneheim and Lundman method. RESULTS According to the results, the facilitators of the safety of the elderly patients with chronic illnesses included the family's participation, nurse's competence, efficiency of the home care agency management and patient's participation in patient safety. The barriers to patient safety included problems created by the family, nurse's incompetence, inefficiency of the home care agency, patient's prevention of patient safety, home care setting limitations and health system limitations. CONCLUSION The majority of the factors involved in the safety of elderly patients with chronic diseases receiving home care had dual roles and could serve as a double-edged sword to guarantee or hinder patient safety. Identification of the facilitators and barriers can assist nurses and the healthcare system in planning and implementing patient safety improvement programmes for elderly patients with chronic illnesses.
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Affiliation(s)
| | - Forough Rafii
- Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Mansoureh Ashghali Farahani
- Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh
- Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
- Professor, Cardiovascular Nursing Research Center, Rajai Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Landstad BJ, Kvangarsnes M. Physicians' narratives of communication with patients and their relatives in different phases of the palliative pathway. BMJ Open 2023; 13:e065681. [PMID: 37328175 PMCID: PMC10277073 DOI: 10.1136/bmjopen-2022-065681] [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: 06/17/2022] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVES To explore physicians' experiences of the communication with patients and their relatives in the different phases of the palliative pathway. METHODS Purposeful sampling was employed to recruit a total of 13 oncologists and general practitioners who engaged in palliative care. A qualitative study with a narrative approach was conducted. Interviews with physicians working in primary and specialist healthcare were conducted via Skype Business in the spring of 2020. The interview guide had open-ended questions with each interview lasting between 35 and 60 min. RESULTS Communication between the physicians, their patients and their relatives was contextual and changed depending on the phase in the palliative pathway. In the first phase, physicians told us that patients and their relatives experienced an emotional shock. Transitioning from the curative to palliative phase was difficult, which emphasised the need for trust through communication. In the middle phase, they revealed that communication about the death process became the priority: what was probably going to happen, the family's role in what was going to happen and perhaps, depending on the illness, any medical decisions that needed to be made. It was important for the physicians to communicate information about the palliative pathway while providing the relatives with knowledge that facilitated any decision making. In the terminal phase, physicians employed a compassionate approach, as bereaved family members needed to process their feelings of guilt and grief. CONCLUSIONS The study gives new insight into communication with patients and their relatives during different phases of the palliative pathway, from the physician's perspective. The findings may help physicians improve the quality of communication with patients and their relatives over these vulnerable pathways. The findings also have practical implications in training contexts. The study reveals ethical dilemmas in physicians' communication with patients and their relatives during a palliative pathway.
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Affiliation(s)
- Bodil J Landstad
- Faculty of Human Science, Mid Sweden University, Ostersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Ostersund, Sweden
| | - Marit Kvangarsnes
- Department of Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
- Unit of Research, Møre og Romsdal Hospital Trust, Alesund, Norway
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Watts E, Patel H, Kostov A, Kim J, Elkbuli A. The Role of Compassionate Care in Medicine: Toward Improving Patients' Quality of Care and Satisfaction. J Surg Res 2023; 289:1-7. [PMID: 37068438 DOI: 10.1016/j.jss.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/12/2023] [Accepted: 03/19/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Despite its description as a cornerstone of a healthcare provider's professional identity, the impact of compassionate care on various aspects of medicine has been poorly defined. In this review, we aimed to elucidate the role of compassionate care in various aspects of medicine and healthcare delivery. METHODS Four databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol for a literature review regarding compassionate care and its intersection with medical education, patient-provider communication, patient care, and clinical outcomes, patient and provider characteristics, telemedicine and artificial intelligence, caregiver compassion fatigue, and cost of care. RESULTS Twenty-two articles met the inclusion criteria. Analysis revealed that clinical outcomes are correlated with the degree of patients' perception of empathy and compassion from their providers. Along with enhanced patient outcomes, compassionate care was shown to reduce the costs of care, compassion fatigue and burnout, and the number of malpractice claims. However, compassion can be perceived differently among patients of various cultural and ethnic backgrounds. Compassion training sessions can be implemented among residents in surgical and nonsurgical medical specialties to improve perceived compassion. Furthermore, the use of telehealth modalities may positively or negatively impact compassionate care, requiring further exploration. CONCLUSIONS Compassionate care plays a crucial role in improving patient care and clinical outcomes while reducing caregiver burnout and the risk of malpractice litigation. However, a lack of compassion training and caregiver compassion fatigue may detract from the delivery of effective compassionate care.
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Affiliation(s)
- Emelia Watts
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Heli Patel
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Anthony Kostov
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Jason Kim
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Adel Elkbuli
- Division of Trauma and Surgical Critical Care, Department of Surgery, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida.
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Norinder M, Axelsson L, Årestedt K, Grande G, Ewing G, Alvariza A. Enabling professional and personal growth among home care nurses through using the Carer Support Needs Assessment Tool Intervention—An interpretive descriptive study. J Clin Nurs 2022. [DOI: 10.1111/jocn.16577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/19/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Maria Norinder
- Department of Health Care Sciences, Palliative Research Centre Marie Cederschiöld University Stockholm Sweden
- Capio Palliative Care Dalen Hospital Stockholm Sweden
| | - Lena Axelsson
- Department of Nursing Science Sophiahemmet University Stockholm Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences Linnaeus University Kalmar Sweden
- Department of Research Region Kalmar County Kalmar Sweden
| | - Gunn Grande
- Division of Nursing, Midwifery & Social Care, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - Gail Ewing
- Centre for Family Research University of Cambridge Cambridge UK
| | - Anette Alvariza
- Department of Health Care Sciences, Palliative Research Centre Marie Cederschiöld University Stockholm Sweden
- Stockholms Sjukhem, Research and Development Unit/Palliative Care Stockholm Sweden
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Devery K, Yin H, Rawlings D. End-of-Life Essentials education modules: a quality and safety initiative to improve health professionals end-of-life care knowledge, skills, attitude and confidence. BMJ Open Qual 2022. [PMCID: PMC9454072 DOI: 10.1136/bmjoq-2022-001925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background There is a need for expanded end-of-life (EOL) care education and resources for health professionals in acute hospitals to help them increase EOL care skills and knowledge, and build capacity and confidence to provide high-quality EOL care. End-of-Life Essentials (EOLE) is an Australian government-funded project, which offers free peer-reviewed online education modules and implementation resources on EOL care to health professionals in acute hospitals, aiming to help support the provision of high-quality EOL care. Methods The development of EOLE education modules included seven major steps and two peer-review processes. In total, ten EOLE education modules and associated toolkits had been developed by the end of 2018. To evaluate the effectiveness of EOLE education modules, premodule and postmodule survey data from all ten modules and registration data were extracted from the EOLE learning management system for a 4-month period. The significance of difference in learners’ self-perceived EOL care knowledge, skills, attitude and confidence before and after module learning were tested by Wilcoxon Signed Ranks Tests. Results Results from Wilcoxon Signed Ranks Tests revealed statistically significant improvement in learners’ self-perceived EOL care knowledge, skill, attitude and confidence after completion of EOLE modules regardless of their discipline (p<0.001). The learners from different disciplines also reported a high level of intention (median=4, IQR=1) to change their practice after completion of EOLE module learning. Conclusion The evaluation results show a positive impact of EOLE module learning on allied health professionals, doctors and nurses, suggesting that EOLE could be a reliable and accessible online EOL care education resources for health professionals of all disciplines to improve their EOL care knowledge, skills and confidence, build up their capacities in providing quality EOL care to patients and their families, in turn, improve the quality and safety of EOL care in health settings.
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Affiliation(s)
- Kim Devery
- Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
- Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, South Australia, Australia
| | - Huahua Yin
- Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| | - Deb Rawlings
- Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
- Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, South Australia, Australia
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Tarberg AS, Thronaes M, Landstad BJ, Kvangarsnes M, Hole T. Physicians' perceptions of patient participation and the involvement of family caregivers in the palliative care pathway. Health Expect 2022; 25:1945-1953. [PMID: 35765248 PMCID: PMC9327811 DOI: 10.1111/hex.13551] [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: 01/03/2022] [Revised: 05/01/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Patient participation is essential for quality palliative care, and physicians play a crucial role in promoting participation. This study explores physicians' perceptions of patients and family caregivers' involvement in the different phases of the palliative pathway and employs a qualitative design with thematic analysis and a hermeneutic approach. Methods A purposive sampling included physicians who worked in different phases of the palliative pathway. In‐depth, semi‐structured interviews were conducted with 13 physicians in Norway between May and June 2020. Results Three main themes illustrate physicians' perceptions of patients' and family caregivers' involvement: (1) beneficence for the patient and the family caregivers in the early phase, (2) autonomy and shared decision‐making in the middle phase, and (3) family involvement in the terminal phase. Conclusion The physicians perceived bereavement conversations as essential, particularly if the pathway had been challenging. They also perceived patient participation and family caregivers' involvement as contextual. The results reveal that participation differs across the different phases of the palliative pathway. This type of knowledge should be included in the education of health‐care professionals. Future research should explore elements vital to successful patient participation and family involvement in the different phases of care. Patient or Public Contributions Family caregivers were involved in a previous study through individual interviews. The same interview guide used for the family caregivers was used when interviewing the physicians. The family caregivers' contribution led to nuanced questions in the interviews with the physicians, questions leaning on their stories told.
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Affiliation(s)
- Anett S Tarberg
- Medical Department, Møre og Romsdal Hospital Trust, Ålesund, Norway.,Department of Clinical and Molecular Medicine, European Palliative Care Centre (PRC), Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
| | - Morten Thronaes
- Department of Clinical and Molecular Medicine, European Palliative Care Centre (PRC), Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Cancer Clinic, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bodil J Landstad
- Department of Health Sciences, Mid Sweden University, Ostersund, Sweden.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,Unit of Research, Education and Development, Ostersund Hospital, Ostersund, Sweden
| | - Marit Kvangarsnes
- Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Fagavdelinga, Møre og Romsdal Hospital Trust, Ålesund, Norway
| | - Torstein Hole
- Department of Research and Innovation, Fagavdelinga, Møre og Romsdal Hospital Trust, Ålesund, Norway.,Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Kwon S, Kim M, Choi S. Ethical dilemmas and care actions in nurses providing palliative sedation. Nurs Ethics 2022; 29:1220-1230. [PMID: 35728273 DOI: 10.1177/09697330221105639] [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: 11/16/2022]
Abstract
BACKGROUND Recently, palliative care is increasingly important, with an emphasis on the process of dying with dignity. However, nurses who care for such patients experience the associated ethical dilemmas. OBJECTIVE To explore the meaning of nurses' experiences in dealing with ethical dilemmas in relation to palliative sedation. RESEARCH DESIGN A qualitative research design was employed with a thematic analysis approach. PARTICIPANTS AND RESEARCH CONTEXT Using purposive sampling, 15 nurses, working at palliative care units for at least 1 year, were recruited as participants. Data were collected using unstructured in-depth interviews, and data collection and analysis was performed simultaneously. ETHICAL CONSIDERATIONS Ethical approval was obtained from the authors' institutional review board. All participants provided informed consent. For the face-to-face interview, the South Korean standard COVID-19 quarantine guidelines, such as mandatory masking and social distancing, were followed. RESULTS Dilemmas raised by patients, were related to concerns about appropriate drug dose; dilemmas raised by nurses, were related to passive care, sense of guilt for failure to predict death, and colleague's disrespectful attitudes toward patients; dilemmas from patients' families were related to demands for palliative sedation and reversal of those demands. Care actions to deal with ethical dilemmas comprised evidence-based care, person-centered thinking, reflecting on the death situation, compassion, providing explanation and help to family members. CONCLUSION Nurses' ethical dilemmas were pre-dominantly influenced by themselves, rather than by the patients or their families, especially if they felt they could not do their best for patients. The core concept of care actions to deal with the ethical dilemmas, was person-centered care and compassion. Then, how patients and their family members perceive person-centered care and compassion, should be further explored to improve palliative sedation.
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Affiliation(s)
- Sinyoung Kwon
- Department of Nursing, 250458Gangdong University, Eumseong-gun, Chungcheongbuk-do, Korea
| | | | - Sujin Choi
- 35031Woosuk University, Wanju, Jeollabuk-do, Korea
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Malenfant S, Jaggi P, Hayden KA, Sinclair S. Compassion in healthcare: an updated scoping review of the literature. Palliat Care 2022; 21:80. [PMID: 35585622 PMCID: PMC9116004 DOI: 10.1186/s12904-022-00942-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/05/2022] [Indexed: 11/28/2022] Open
Abstract
Background A previous review on compassion in healthcare (1988-2014) identified several empirical studies and their limitations. Given the large influx and the disparate nature of the topic within the healthcare literature over the past 5 years, the objective of this study was to provide an update to our original scoping review to provide a current and comprehensive map of the literature to guide future research and to identify gaps and limitations that remain unaddressed. Methods Eight electronic databases along with the grey literature were searched to identify empirical studies published between 2015 and 2020. Of focus were studies that aimed to explore compassion within the clinical setting, or interventions or educational programs for improving compassion, sampling clinicians and/or patient populations. Following title and abstract review, two reviewers independently screened full-text articles, and performed data extraction. Utilizing a narrative synthesis approach, data were mapped onto the categories, themes, and subthemes that were identified in the original review. Newly identified categories were discussed among the team until consensus was achieved. Results Of the 14,166 number of records identified, 5263 remained after removal of duplicates, and 50 articles were included in the final review. Studies were predominantly conducted in the UK and were qualitative in design. In contrast to the original review, a larger number of studies sampled solely patients (n = 12), and the remainder focused on clinicians (n = 27) or a mix of clinicians and other (e.g. patients and/or family members) (n = 11). Forty-six studies explored perspectives on the nature of compassion or compassionate behaviours, traversing six themes: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Four studies reported on the category of educational or clinical interventions, a notable decrease compared to the 10 studies identified in the original review. Conclusions Since the original scoping review on compassion in healthcare, while a greater number of studies incorporated patient perspectives, clinical or educational interventions appeared to be limited. More efficacious and evidence-based interventions or training programs tailored towards improving compassion for patients in healthcare is required. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00942-3.
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Affiliation(s)
- Sydney Malenfant
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.,Section of Palliative Care, Department of Family Medicine, Alberta Health Services, Zone, Calgary, Canada
| | - Priya Jaggi
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Shane Sinclair
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada. .,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada. .,Division of Palliative Medicine Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
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