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Mabunda NF. Nurses' perceptions of involving family members in the care of mental health care users. Curationis 2024; 47:e1-e9. [PMID: 39099289 PMCID: PMC11304185 DOI: 10.4102/curationis.v47i1.2538] [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: 08/30/2023] [Revised: 03/28/2024] [Accepted: 04/25/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Family involvement in mental health care is a therapeutic intervention in the management of mental illness. The global concern in long-term mental health is that families find it difficult to accept mental illness when their loved ones are admitted to receive care, treatment and rehabilitation. OBJECTIVES To describe nurses' perceptions of involving family members in the care of mental health care users in long-term institutions. METHOD A quantitative descriptive design was used. The population comprised nurses working at three mental health institutions (MHIs). Probability simple random sampling was used to select 360 respondents. Data were collected using self-administered questionnaires. RESULTS The findings revealed that most (86.9%) of the nurses acknowledged that challenges affect families' involvement in mental health care. A total of 91.4% of nurses complained that family members' involvement was insufficient and (80.6%) indicated that poor family contact affects the provision of quality mental health care. Therefore, the respondents believed that the families' involvement has an impact on the management of mental illness. CONCLUSION Engaging family members in mental health care helps both health professionals and families to participate in patient-centred care and mental health care services. However, MHCUs benefit when their families are involved.Contribution: The study contributed to mental health nursing as its results can be used to measure the quality of health services improvements, by involving the family members during hospitalisation of their loved ones for mental health care.
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Affiliation(s)
- Nkhensani F Mabunda
- Department of Nursing, Faculty of Health Care Sciences, Sefako Makgatho Health Science University, Pretoria.
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Elina H, Sofia E, Tricia CS, Jaana-Maija K, Katariina K, Anu SJ. Patients Receiving Palliative Care and Their Experiences of Encounters With Healthcare Professionals. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:497-513. [PMID: 35235482 PMCID: PMC11100268 DOI: 10.1177/00302228221077486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The study aimed to explore experiences of encounters with health care professionals among patients receiving palliative cancer care in specialist palliative care inpatient units. A qualitative explorative study design was conducted in a specialist palliative care inpatient setting. Data collection was implemented using semi-structured individual interviews (20 palliative care cancer patients) and analysed with inductive content analysis. Palliative care patients experienced both meaningful and disrespectful encounters with healthcare professionals. The meaningful encounters encompassed authentic and supportive experiences, while the disrespectful encounters included indifferent and inadequate experiences. Caring for a patient receiving palliative care requires care beyond tending to a patient's physical needs. Patients should be encountered holistically and as equal human beings without highlighting their roles as patients. The healthcare professionals and the organisations should also acknowledge the importance of time and effort spent for encounters and conversations with the patients instead of concentrating resources mainly on physical care.
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Affiliation(s)
- Haavisto Elina
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland
- Department of Nursing Science, University of Turku, Finland
- Satakunta Central Hospital, Pori, Finland
| | - Eriksson Sofia
- Finno-Ugrian and Scandinavian Studies, Faculty of Arts, University of Helsinki, Finland
| | | | | | | | - Soikkeli-Jalonen Anu
- Finno-Ugrian and Scandinavian Studies, Faculty of Arts, University of Helsinki, Finland
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Taheri-Ezbarami Z, Jafaraghaee F, Sighlani AK, Mousavi SK. Core components of end-of-life care in nursing education programs: a scoping review. BMC Palliat Care 2024; 23:82. [PMID: 38549106 PMCID: PMC10976691 DOI: 10.1186/s12904-024-01398-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND So far, there have been many studies on end-of-life nursing care education around the world, and in many cases, according to the cultural, social, and spiritual contexts of each country, the results have been different. The present study intends to gain general insight into the main components of end-of-life care in nursing education programs by reviewing scientific texts and the results of investigations. METHODS This study was a scoping review conducted with the Arksey and O'Malley methodology updated by Peters et al. First, a search was made in Wos, ProQuest, Scopus, PubMed, Science Direct, Research Gate, and Google Scholar databases to find studies about end-of-life care education programs. Then, the screening of the found studies was done in four stages, and the final articles were selected based on the inclusion and exclusion criteria of the studies. Due to the nature of the research, editorials, letters, and commentaries were excluded. The screening steps are shown in the PRISMA-ScR diagram. RESULTS 23 articles related to end-of-life care education programs were reviewed. The studies included eleven descriptive and cross-sectional studies, two qualitative studies, eight interventional studies, one concept analysis article, and one longitudinal study. By summarizing the data from the studies, six themes were obtained as the main components of end-of-life care education: principles of end-of-life care, communication skills, physical considerations, psychosocial and spiritual considerations, ethical considerations, and after-death care. CONCLUSION End-of-life care is one of the most challenging nursing care in the world. Since many nurses are not prepared to provide such care, the information obtained from this review can help nursing education and treatment managers develop more comprehensive training programs to improve the quality of end-of-life care.
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Affiliation(s)
- Zahra Taheri-Ezbarami
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Fateme Jafaraghaee
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Seyed Kazem Mousavi
- Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran.
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Tsemach R, Aharon AA. Decision-making process regarding passive euthanasia: Theory of planned behavior framework. Nurs Ethics 2024:9697330241238346. [PMID: 38449448 DOI: 10.1177/09697330241238346] [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: 03/08/2024]
Abstract
BACKGROUND Nurses have an essential role in caring for end-of-life patients. Nevertheless, the nurse's involvement in the passive euthanasia decision-making process is insufficient and lower than expected. OBJECTIVES To explore factors associated with nurses' intention to be involved in non-treatment decisions (NTD) regarding passive euthanasia decision-making versus their involvement in the palliative care of patients requesting euthanasia, using the Theory of Planned Behavior (TPB) framework. DESIGN A cross-sectional study utilizing a random sample. PARTICIPANTS AND RESEARCH CONTEXT The study was conducted in one of the largest hospitals in Israel among 125 nurses employed in internal and surgical care wards. Data was collected through face-to-face interviews between March and April 2019. METHOD A closed structured questionnaire was developed according to TPB instructions. A paired sample t test and two multiple hierarchical regressions were conducted. Variance explained (R2) and the significance of F change were calculated for each regression. The study used the STROBE statement guideline. ETHICAL CONSIDERATIONS The study was approved by the hospital's Helsinki Committee (#20.11.2017). FINDINGS A paired sample t test revealed that nurses' involvement in the palliative care of patients requesting passive euthanasia was significantly higher than in NTD regarding euthanasia. Regression analyses revealed that nurses' position and attitudes explain their intention to be involved in decision-making; attitudes and perceived behavioral control explain nurses' intention to be involved in the care of patients requesting euthanasia. CONCLUSIONS According to the TPB, nurses' attitudes explained their intention to participate in decision-making regarding passive euthanasia. It is recommended to enhance open discussion of this complex issue to encourage nurses' willingness to participate in NTD decision-making regarding euthanasia.
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Kero J, Koivisto JM, Kuusisto A, Kesonen P, Haavisto E. Nursing interventions for dyspnoea management among inpatients with cancer in palliative care. Int J Palliat Nurs 2024; 30:87-98. [PMID: 38407153 DOI: 10.12968/ijpn.2024.30.2.87] [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: 02/27/2024]
Abstract
BACKGROUND Dyspnoea, a commonly reported symptom among patients with cancer, necessitates the need for appropriate non-pharmacological interventions for its management and suitable assessment scales. AIMS To explore the nursing interventions and assessment scales for managing dyspnoea in patients with cancer receiving palliative care. METHODS Systematic review. Five databases (CINAHL Complete, PubMed, Web of Science, Scopus and the Cochrane Central Register of Controlled Trials) were searched, and seven studies were identified. Only studies that comprised randomised controlled trials (RCTs), non-randomised controlled trials or quasi-experimental settings were included. FINDINGS Nursing interventions, that support a patient's physical breathing and mental functioning, are effective in managing dyspnoea. It is crucial to use both subjective and physical assessment methods to accurately measure the outcomes of these interventions. CONCLUSION These interventions have been proven to be effective, with outcomes centred on changes in physiological measurements and patients' subjective expressions.
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Affiliation(s)
- Johanna Kero
- PhD Candidate, Department of Nursing Science, Tampere University, Tampere, Finland
| | - Jaana-Maija Koivisto
- Associate Professor, Department of Health Science, Tampere University, Tampere, Finland; Faculty of Medicine, University of Helsinki, Finland
| | - Anne Kuusisto
- Postdoctoral Researcher, Department of Nursing Science, University of Turku, Turku, Finland; Wellbeing Services County, Satakunta, Satasairaala Central Hospital Pori, Finland
| | - Pauliina Kesonen
- PhD Candidate, Department of Health Science, Tampere University, Tampere, Finland
| | - Elina Haavisto
- Professor, Department of Health Science, Tampere University, Tampere, Finland; Pirkanmaa Wellbeing Services County, Finland
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Kero J, Koivisto J, Lee SH, Haavisto E. Nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care. Nurs Open 2024; 11:e2038. [PMID: 38268248 PMCID: PMC10697120 DOI: 10.1002/nop2.2038] [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: 03/06/2022] [Revised: 06/05/2023] [Accepted: 10/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To explore nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care. DESIGN A descriptive qualitative design. METHODS Seven focus groups were conducted with nurses (n = 27) from five specialized palliative care wards in four hospitals in south and southwest Finland. The focus groups were conducted between June and November 2019, and the transcripts were analysed using inductive analysis. RESULTS The findings revealed three categories: recognizing dyspnoea is a multi-faceted problem, dealing with the complexity of assessment of dyspnoea and strategies for relieving dyspnoea. Nurses perceived the complexity of dyspnoea as a symptom and emphasized the importance of utilizing patients' subjective experiences and consistent assessment scales to determine its severity. Furthermore, nonpharmacological interventions are as pertinent as pharmacological and medical interventions. The findings can assist nurses in selecting appropriate interventions for dyspnoea care, ultimately enhancing the quality of patient care and patient safety.
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Affiliation(s)
- Johanna Kero
- Department of Nursing ScienceTampere UniversityTampereFinland
| | - Jaana‐Maija Koivisto
- Department of Nursing ScienceTampere UniversityTampereFinland
- Smart Services Research UnitHäme University of Applied SciencesHämeenlinnaFinland
| | - Siew Hwa Lee
- School of Nursing, Midwifery and Paramedic PracticeRobert Gordon UniversityAberdeenUK
| | - Elina Haavisto
- Department of Nursing ScienceTampere UniversityTampereFinland
- Tampere University HospitalTampereFinland
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Li WY, Fang Y, Liang YQ, Zhu SQ, Yuan L, Xu Q, Li Y, Chen YL, Sun CX, Zhi XX, Li XY, Zhou R, Du M. Building bridges of excellence: a comprehensive competence framework for nurses in hospice and palliative care-a mixed method study. BMC Palliat Care 2023; 22:197. [PMID: 38087276 PMCID: PMC10714629 DOI: 10.1186/s12904-023-01318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Hospice and Palliative Care (HPC) is in high demand in China; however, the country is facing the shortage of qualified HPC nurses. A well-suited competence framework is needed to promote HPC human resource development. Nevertheless, existing unstandardized single-structured frameworks may not be sufficient to meet this need. This study aimed at constructing a comprehensive multi-structured HPC competence framework for nurses. METHODS This study employed a mixed-method approach, including a systematic review and qualitative interview for HPC competence profile extraction, a two-round Delphi survey to determine the competences for the framework, and a cross-sectional study for framework structure exploration. The competence profiles were extracted from publications from academic databases and interviews recruiting nurses working in the HPC field. The research team synthesized profiles and transferred them to competences utilizing existing competence dictionaries. These synthesized competences were then subjected to Delphi expert panels to determine the framework elements. The study analyzed theoretical structure of the framework through exploratory factor analysis (EFA) based on a cross-sectional study receiving 491 valid questionnaires. RESULTS The systematic review involved 30 publications from 10 countries between 1995 and 2021, while 13 nurses from three hospitals were interviewed. In total, 87 and 48 competence profiles were respectively extracted from systematic review and interview and later synthesized into 32 competences. After the Delphi survey, 25 competences were incorporated into the HPC competence framework for nurses. The EFA found a two-factor structure, with factor 1 comprising 18 competences namely Basic Competences; factor 2 concluding 7 competences namely Developmental Competences. CONCLUSIONS The two-factor HPC competence framework provided valuable insights into the need and directions of Chinese HPC nurses' development.
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Affiliation(s)
- Wei-Ying Li
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
| | - Ying Fang
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
| | - Yi-Qing Liang
- School of Medicine, Jiangsu University, Zhenjiang, 212000, China
| | - Shu-Qin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China.
| | - Ling Yuan
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing, 210008, P. R. China.
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China.
| | - Yue Li
- Jiangsu Institute of Quality and Standardization, Nanjing, 210029, China
| | - Yin-Long Chen
- Jiangsu Institute of Quality and Standardization, Nanjing, 210029, China
| | - Chang-Xian Sun
- School of Health Sciences, Jiangsu Vocational Institute of Commerce, Nanjing, 211168, China
| | - Xiao-Xu Zhi
- Nursing Department, Jiangsu Cancer Hospital and Nanjing Medical University Affiliated Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, 210009, China
| | - Xiao-Yan Li
- Hospice Unit, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Rong Zhou
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
| | - Mai Du
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
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Mathiesen KL, Lindberg E, Nässén K, Cowdell F, Palmér L. "A becoming in the meeting": the interpretations of competence in home care from the perspectives of older people and registered nurses - a meta-ethnography. Int J Qual Stud Health Well-being 2023; 18:2262170. [PMID: 37771312 PMCID: PMC10543340 DOI: 10.1080/17482631.2023.2262170] [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: 04/06/2023] [Accepted: 09/09/2023] [Indexed: 09/30/2023] Open
Abstract
AIM The aim of this meta-ethnography was to identify and synthesize qualitative studies focusing on older people's and registered nurses' interpretations of competence in home care. METHODS The meta-ethnography followed the six phases developed by Noblit and Hare (1988). RESULTS In Phase 6, the translation process of the included studies, three themes were identified: i) temporality-the feeling of being of value; ii) dignity-a person, not just a patient; and iii) mutuality of being-togetherness. A synthesis was developed, and the phrase "a becoming in the meeting" emerged. CONCLUSION The sense of becoming includes progress, which means becoming something other than before in relation with others and refers to what constitutes the meeting between the older person and the registered nurse working in home care. Competence originates from becoming in the meeting, and registered nurses should therefore value what they do and hold on to this aspect of caring competence that centres on a caring relationship. It is important for registered nurses working in home care to be able to cultivate a caring relationship.
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Affiliation(s)
- Karoline Lang Mathiesen
- Faculty of Caring Science, Work Life and Social Welfare, Doctoral student, University of Borås, Borås, Sweden
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås,BoråsSweden
| | - kristina Nässén
- Faculty of Caring Science, Work Life and Social Welfare, Senior lecturer, University of Borås, BoråsSweden
| | - Fiona Cowdell
- Professor of Nursing and Health Research and NIHR Knowledge Mobilisation Research Fellow, Birmingham City University, BirminghamUK
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Gattinger H, Ott S, Maurer C, Marty-Teuber B, Hantikainen V, Fringer A. Effect of an educational intervention on nurses' competence in activities of daily living support in end-of-life care using a pretest-posttest repeated measures design. BMC Palliat Care 2023; 22:119. [PMID: 37605181 PMCID: PMC10464419 DOI: 10.1186/s12904-023-01232-2] [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: 09/24/2022] [Accepted: 07/23/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Most patients in specialized palliative care units need nursing support to perform activities of daily living (ADL), such as using a toilet or transferring out of a bed or chair. To deliver high-quality ADL support that facilitates patients' movement and protects nurses' musculoskeletal health, nurses need appropriate knowledge and skills. The objective of this study is to investigate the impact of education based on the "Advanced Kinaesthetics in Palliative care (AdKinPal) program" on the competence in Kinaesthetics, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints of nurses from specialist palliative care units. METHODS A pretest-posttest repeated measures design was applied. The study took place in three specialised units for palliative care in Switzerland between June 2018 and April 2020. All the nurses who worked in participating wards (n = 62) and fulfilled the inclusion criteria were asked to participate. The intervention - the AdKinPal program - is an education-based training program conducted for six months. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, repeated measurement analysis of variance (ANOVA) and independent-samples t-tests, we analysed the participants' demographic characteristics as well as developments over time and relationships between the three outcome variables: Kinaesthetics competence, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints. RESULTS Fifty-nine nurses and one physiotherapist participated, and 38 participants (63%) responded to all three questionnaires. The AdKinPal training improved the nurses' perceived Kinaesthetics competence and self-efficacy regarding ADL support in end-of-life care. Participants who reported lower back, neck or shoulder pain had a significantly lower Kinaesthetics competence. CONCLUSIONS The AdKinPal program can raise nurses' Kinaesthetics competence. Thereby, patients' autonomy and quality of life could be supported, and symptom management could be enhanced in a holistic manner. Furthermore, the AdKinPal program fosters nurses' self-efficacy in ADL support in end-of-life care. A strong sense of self-efficacy enhances professional well-being in many ways. Additionally, the nursing staff's musculoskeletal health can be promoted by enhancing their Kinaesthetics competence. TRIAL REGISTRATION DRKS00015908. Registration Date 23.11.2018.
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Affiliation(s)
- Heidrun Gattinger
- Institut of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, Rosenbergstrasse 59, St. Gallen, Postfach, St. Gallen, 9001, Switzerland.
| | - Stefan Ott
- School of Management, Eastern Switzerland University of Applied Sciences, Rosenbergstrasse 59, St. Gallen, Postfach, St. Gallen, 9001, Switzerland
| | - Carola Maurer
- Institut of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, Rosenbergstrasse 59, St. Gallen, Postfach, St. Gallen, 9001, Switzerland
| | | | - Virpi Hantikainen
- Department of Nursing Science, University of Turku, Turku, Turun yliopisto, 20014, Finland
| | - André Fringer
- ZHAW School of Health Sciences, Institute of Nursing, Katharina-Sulzer-Platz 9, Winterthur, 8400, Switzerland
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Implementation and evaluation of an end-of-life care education program for oncology nurses working in medical-surgical wards: A quasi-experimental study. Heliyon 2023; 9:e14096. [PMID: 37025828 PMCID: PMC10070522 DOI: 10.1016/j.heliyon.2023.e14096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/10/2023] Open
Abstract
Background The issue of a good death for cancer patients is becoming more prevalent. Hence, nurses' end-of-life work performance and stress levels in medical-surgical wards can significantly impact the quality of life of cancer patients and their caregivers. This study aimed to develop an end-of-life care education program for nurses taking care of cancer patients in medical-surgical ward and verify the program's preliminary effect. Method Quasi-experimental research using a one-group pretest-posttest design was carried out for this study. The end-of-life care manual for nurses in general wards were developed through expert validation. Initial in-person and follow-on online self-education sessions were conducted based on the end-of-life care manual. A total of 70 nurses participated in the end-of-life care education program. End-of-life care stress and end-of-life care performance were measured as preliminary program effects. An online survey was conducted before the initial in-person education and after the follow-up online education. Results The end-of-life care education program effectively improved general ward nurses' end-of-life care performance. This performance was improved in the physical and psychological domains. However, this program did not improve the nurses' performance in end-of-life care in the spiritual domain. Furthermore, it did not effectively reduce the stress on end-of-life care, indicating that improvements should be made. Conclusions The improvement of effective end-of-life care education programs for nurses caring for cancer patients in general wards is required. Most importantly, efforts at the hospital organization level are necessary to reduce the stress of end-of-life care by improving the working environment. Additionally, it is necessary to conduct preemptive tailored intervention programs for nurses, such as a resilience improvement program.
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11
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Alshehri HH, Wolf A, Öhlén J, Olausson S. Healthcare Professionals' Perspective on Palliative Care in Intensive Care Settings: An Interpretive Descriptive Study. Glob Qual Nurs Res 2022; 9:23333936221138077. [PMID: 36507302 PMCID: PMC9729985 DOI: 10.1177/23333936221138077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/24/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
There is a growing need to integrate palliative care into intensive care units and to develop appropriate knowledge translation strategies. However, multiple challenges persist in attempts to achieve this objective. In this study, we aimed to explore intensive care professionals' perspectives on providing palliative and end-of-life care within an intensive care context. We used an interpretive description approach and interviewed 36 intensive care professionals at four hospitals in Saudi Arabia. Our findings reflect a discourse about end-of-life care driven by a do-not-resuscitate classification and challenges associated with family involvement in care goals. We provide key insights of importance for the development of strategies for the integration and knowledge translation of palliative care into intensive care contexts.
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Affiliation(s)
- Hanan Hamdan Alshehri
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- Hanan Hamdan Alshehri, University of Gothenburg Sahlgrenska Academy, Box 457 405 30 Göteborg, Goteborg 405 30, Sweden. Emails: ;
| | - Axel Wolf
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital/Östra, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- University of Gothenburg and Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Surakka LK, Hökkä M, Törrönen K, Mäntyselkä P, Lehto JT. Paramedics' experiences and educational needs when participating end-of-life care at home: A mixed method study. Palliat Med 2022; 36:1217-1227. [PMID: 35922966 DOI: 10.1177/02692163221105593] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Paramedics face end-of-life care patients during emergency calls and more recently through planned protocols. However, paramedics experiences and educational needs concerning preplanned end-of-life care at home remain largely unknown. AIM To describe experiences and educational needs of the paramedics included in the end-of-life care protocol. DESIGN A mixed method study with a questionnaire including open ended questions and numeric evaluations on a Likert scale. SETTING/PARTICIPANTS The questionnaire was delivered to and answered by all the 192 paramedics working in North Karelia fire and rescue department during the time of the data collection in 2017. RESULTS Over 80% of the paramedics agreed that the protocol helped them to take care of the patients and to improve the quality of end-of-life care. Visits to the patients were considered useful and the end-of-life care as a meaningful work by 76.5% and 62.5% of the paramedics, respectively. The paramedics expressed challenges in psychosocial aspects, communication, symptom management, and their role in end-of-life care. Encountering and communication with the families as well as managing the most common symptoms were emphasized as educational needs. Using a patient controlled analgesia device emerged as an example of practical educational aspect. CONCLUSIONS Paramedics considered end-of-life care at home meaningful but called for more competency in supporting and encountering the families and in symptom management. Our results can be utilized when developing end-of-life care protocols and education for the paramedics. Patients' and families' views on the paramedics' participation in end-of-life care should be evaluated in the future.
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Affiliation(s)
- Leena K Surakka
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Siun Sote - North Karelia Social and Health Services Joint Authority, Palliative Care Center, Joensuu, Finland
| | - Minna Hökkä
- Kajaani University of Applied Sciences, Kajaani, Finland.,Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Kari Törrönen
- Fire and Rescue Department, Siun Sote - North Karelia Social and Health Services Joint Authority, Joensuu, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Juho T Lehto
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Oncology, Palliative Care Centre, Tampere University Hospital, Tampere, Finland
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. Accessibility of care plan information from previous treatment setting in palliative care unit: A qualitative study. Nurs Open 2022; 10:498-508. [PMID: 36053745 PMCID: PMC9834523 DOI: 10.1002/nop2.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/15/2022] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To describe accessibility of care plan information from patients' previous treatment setting in palliative care. DESIGN A qualitative descriptive study. METHODS A total of 33 nurses, social workers and physicians were interviewed. Data were analysed by deductive and inductive content analysis. The Fit between Individuals, Task and Technology (FITT) framework was used as a deductive analysis framework. RESULTS Individual-task Fit was described in relation to professional-specific care plan information in palliative care and use of time to obtain care plan information. Individual-technology Fit was described in relation to health informatics competencies and HIS usability. Task-technology Fit was described in relation to interoperability between care settings and healthcare providers and lack of interoperability between care settings and healthcare providers. RELEVANCE TO CLINICAL PRACTICE The study confirms the need to review the HIS as a whole from a holistic and patient-oriented perspective to ensure the continuity of palliative care.
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Affiliation(s)
- Anne Kuusisto
- Department of Nursing ScienceUniversity of Turku FinlandTurkuFinland,Satakunta Hospital DistrictPoriFinland
| | - Kaija Saranto
- Department of Health and Social ManagementUniversity of Eastern FinlandKuopioFinland
| | - Päivi Korhonen
- Department of General Practice, Turku University HospitalUniversity of TurkuTurkuFinland
| | - Elina Haavisto
- Department of Nursing ScienceUniversity of Turku FinlandTurkuFinland,Satakunta Hospital DistrictPoriFinland,Department of Health SciencesTampere UniversityTampereFinland
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Hökkä M, Melender HL, Lehto JT, Kaakinen P. Palliative Nursing Competencies Required for Different Levels of Palliative Care Provision: A Qualitative Analysis of Health Care Professionals' Perspectives. J Palliat Med 2021; 24:1516-1524. [PMID: 33720785 DOI: 10.1089/jpm.2020.0632] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background: Nurses must possess adequate competencies to provide high-quality palliative care. Earlier statements have described certain competencies that are relevant for palliative care, yet only limited empirical research has focused on the perspective of health care professionals to clarify which competencies are required for different levels of palliative care provision. Objective: The aim was to describe the required palliative nursing competencies of registered nurses aligned to different levels of palliative care provision, from the perspectives of multiprofessional groups. Design: A qualitative study design. Setting/Subjects: A purposive sample of professionals, working in different levels of palliative care across various settings in Finland, was used to gain information about the aim of the study (n = 222). Measurements: Content analysis was applied to describe the competencies of registered nurses. Results: Competencies relevant to basic palliative care were categorized under 17 main categories, which included a total of 75 subcategories. "Competence in managing the most common symptoms" was the main category that contained the largest number of reduced expressions (f = 75). An analysis of specialist palliative care data yielded 10 main categories, including 49 subcategories, with "Competence in maintaining expertise and taking care of own well-being at work" containing the most reduced expressions. Conclusion: The study provided new knowledge; more specifically, competencies related to encounters and maintaining hope were described as palliative care nursing competences. The results can be used to ensure that palliative nursing education focuses on the competences that are necessary in practice.
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Affiliation(s)
- Minna Hökkä
- Kajaani University of Applied Sciences, Kajaani, Finland.,University of Oulu Research Unit of Nursing Science and Health Management, Oulu, Finland
| | | | - Juho T Lehto
- Faculty of Medicine and Health Technology, Tampere University, Finland.,Palliative Care Centre, Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - Pirjo Kaakinen
- University of Oulu Research Unit of Nursing Science and Health Management, Oulu, Finland
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