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Lormans T, de Graaf E, de Vries S, Leget C, Teunissen S. 'It is important to feel invited': what patients require when using the Utrecht Symptom Diary - 4 Dimensional, a qualitative exploration. Palliat Care Soc Pract 2024; 18:26323524241260426. [PMID: 38911602 PMCID: PMC11191620 DOI: 10.1177/26323524241260426] [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: 10/22/2023] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Background In palliative care, the Utrecht Symptom Diary - 4 Dimensional (USD-4D), a Dutch-adapted and validated patient-reported outcome measure, supports multidimensional symptom management through identification and monitoring of, as well as dialogue on symptoms and needs. For the USD-4D to optimally support patients' autonomy, it is essential to know what patients need to use it. Objective This study aims to identify what patients need when using the USD-4D in clinical palliative care. Design A generic qualitative design with primary and secondary analyses of semistructured interviews. Methods Patients ⩾18 years with a life-limiting illness were purposefully recruited within hospice and home care settings if they were in their last year of life as identified by the surprise question. Patients had to be aware of their life-threatening condition. Patients were selected in two tranches. In the first tranche, patients had to have completed the USD-4D at least once. The second tranche consisted of patients who were not familiar with the USD-4D in clinical practice and were interviewed in a previous study on the content validity of the USD-4D. The interviews were transcribed verbatim and were subjected to thematic analysis. Results Twenty-five patients were included (14 men, ages 44-87). Patients' needs when using the USD-4D were summarized in three themes: (1) feeling invited, (2) being aware of the purpose and function of the USD-4D, and (3) experiencing a personal and nonjudgmental approach. Conclusion For patients to optimally benefit from the USD-4D as a supportive measure of their autonomy in clinical palliative care, it is essential that they feel invited to use it. Healthcare providers are tasked with setting the right preconditions for patients to want and to be able to use the USD-4D. For patients, this means healthcare providers should always be attuned to their personal preferences when communicating the purpose and function of the USD-4D and when they enter into dialogue with them.
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Affiliation(s)
- Tom Lormans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, Utrecht 3584CG, The Netherlands
| | - Everlien de Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sita de Vries
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Carlo Leget
- Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Saskia Teunissen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Kochems K, de Graaf E, Hesselmann GM, Ausems MJE, Teunissen SCCM. Healthcare professionals' perceived barriers in providing palliative care in primary care and nursing homes: a survey study. Palliat Care Soc Pract 2023; 17:26323524231216994. [PMID: 38148895 PMCID: PMC10750550 DOI: 10.1177/26323524231216994] [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: 07/05/2023] [Accepted: 11/07/2023] [Indexed: 12/28/2023] Open
Abstract
Background Palliative care in primary care and nursing home settings is becoming increasingly important. A multidimensional palliative care approach, provided by a multiprofessional team, is essential to meeting patients' and relatives' values, wishes, and needs. Factors that hamper the provision of palliative care in this context have not yet been fully explored. Objectives To identify the barriers to providing palliative care for patients at home or in nursing homes as perceived by healthcare professionals. Design Cross-sectional survey study. Methods A convenience sample of nurses, doctors, chaplains, and rehabilitation therapists working in primary care and at nursing homes in the Netherlands is used. The primary outcome is barriers, defined as statements with ⩾20% negative response. The survey contained 56 statements on palliative reasoning, communication, and multiprofessional collaboration. Data were analyzed using descriptive statistics. Results In total, 249 healthcare professionals completed the survey (66% completion rate). The main barriers identified in the provision of palliative care were the use of measurement tools (43%), consultation of an expert (31%), estimation of life expectancy (29%), and documentation in the electronic health record (21% and 37%). In primary care, mainly organizational barriers were identified, whereas in nursing homes, most barriers were related to care content. Chaplains and rehabilitation therapists perceived the most barriers. Conclusion In primary care and nursing homes, there are barriers to the provision of palliative care. The provision of palliative care depends on the identification of patients with palliative care needs and is influenced by individual healthcare professionals, possibilities for consultation, and the electronic health record. An unambiguous and systematic approach within the multiprofessional team is needed, which should be patient-driven and tailored to the setting.
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Affiliation(s)
- Katrin Kochems
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, Utrecht 3508 GA, The Netherlands
| | - Everlien de Graaf
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Saskia C. C. M. Teunissen
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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de Graaf E, Grant M, van de Baan F, Ausems M, Verboeket-Crul C, Leget C, Teunissen S. Variations in Clinical Practice: Assessing Clinical Care Processes According to Clinical Guidelines in a National Cohort of Hospice Patients. Am J Hosp Palliat Care 2023; 40:87-95. [PMID: 35531900 DOI: 10.1177/10499091221100804] [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: 12/16/2022] Open
Abstract
Background: National clinical guidelines have been developed internationally to reduce variations in clinical practices and promote the quality of palliative care. In The Netherlands, there is considerable variability in the organisation and care processes of inpatient palliative care, with three types of hospices - Volunteer-Driven Hospices (VDH), Stand-Alone Hospices (SAH), and nursing home Hospice Units (HU). Aim: This study aims to examine clinical practices in palliative care through different hospice types and identify variations in care. Methods: Retrospective cohort study utilising clinical documentation review, including patients who received inpatient palliative care at 51 different hospices and died in 2017 or 2018. Care provision for each patient for the management of pain, delirium and palliative sedation were analysed according to the Dutch national guidelines. Results: 412 patients were included: 112 patients who received treatment for pain, 53 for delirium, and 116 patients underwent palliative sedation therapy. Care was provided in accordance with guidelines for pain in 32%, 61% and 47% (P = .047), delirium in 29%, 78% and 79% (P = .0016), and palliative sedation in 35%, 63% and 42% (P = .067) of patients who received care in VDHs, SAHs and HUs respectively. When all clinical practices were considered, patient care was conducted according to the guidelines for 33% of patients in VDHs, 65% in SAHs, and 50% in HUs (P < .001). Conclusions: The data demonstrate that care practices are not standardised throughout Dutch hospices and exhibit significant variations between type of hospice.
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Affiliation(s)
- Everlien de Graaf
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, 8124University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthew Grant
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, 8124University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frederieke van de Baan
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, 8124University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marijke Ausems
- 8106The Dutch College of General Practitioners, Palliative Care Physician, Utrecht, The Netherlands
| | | | - Carlo Leget
- University of Humanistic Studies, Utrecht, The Netherlands
| | - Saskia Teunissen
- Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, 8124University Medical Center Utrecht, Utrecht, The Netherlands
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Barriers and facilitators to multidimensional symptom management in palliative care: A focus group study among patient representatives and clinicians. Palliat Support Care 2022:1-12. [PMID: 36177886 DOI: 10.1017/s147895152200133x] [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: 11/07/2022]
Abstract
OBJECTIVES It is widely acknowledged that co-occurring symptoms in patients with a psychosocial and spiritual aspects should also be considered. However, this multidimensional approach is difficult to integrate into daily practice, especially for generalist clinicians not specialized in palliative care. We aimed to identify the barriers and facilitators to multidimensional symptom management. METHODS Focus group meetings were conducted with the following stakeholders: (1) patient representatives, (2) generalist community nurses, (3) generalist hospital nurses, (4) general practitioners, (5) generalist hospital physicians, and (6) palliative care specialists. Audiotapes were transcribed verbatim and thematically analyzed. RESULTS Fifty-one participants (6-12 per group) reported barriers and facilitators with 3 main themes: multidimensional symptom assessment, initiating management of nonphysical problems, and multidisciplinary collaboration. As barriers, generalist clinicians and palliative care specialists reported that generalist clinicians often lack the communication skills to address nonphysical problems and are unaware of available resources for multidimensional symptom management. Palliative care specialists felt that generalist clinicians may be unaware that assessing nonphysical problems is important and focus on pharmacological interventions. Generalist nurses and palliative care specialists indicated that hierarchical difficulties between them and generalist physicians are barriers to multidisciplinary collaboration. Reported facilitators included using symptom assessment scales and standardized questions on nonphysical problems. SIGNIFICANCE OF RESULTS Generalist clinicians can be supported by improving their communication skills, increasing their awareness of available resources for multidimensional symptom management, and by using a standardized approach to assess all 4 dimensions of palliative care.
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Damen A, Raijmakers NJH, van Roij J, Visser A, Beuken-Everdingen MVD, Kuip E, van Laarhoven HWM, van Leeuwen-Snoeks L, van der Padt-Pruijsten A, Smilde TJ, Leget C, Fitchett G. Spiritual Well-Being and Associated Factors in Dutch Patients With Advanced Cancer. J Pain Symptom Manage 2022; 63:404-414. [PMID: 34656652 DOI: 10.1016/j.jpainsymman.2021.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022]
Abstract
CONTEXT Palliative care aims to support patients' spiritual needs with the intention of promoting their spiritual well-being (SWB), an important dimension of quality of life. SWB is one of the less-studied dimensions of QoL, particularly in a secular country such as the Netherlands. OBJECTIVES In this study we aimed to get a better understanding of SWB in Dutch patients with advanced cancer. We therefore examined its prominence and associated factors. METHODS We used the baseline data of a cohort study on experienced quality of care and quality of life (eQuiPe study), which included 1,103 patients with advanced cancer. In addition to sociodemographic and religious/spiritual characteristics, study measures comprised the SWB subscales Meaning, Peace, and Faith of the revised FACIT-Sp-12, spiritual problems and needs (PNPCsv), quality of life (EORTC-QLQ-C30) and satisfaction with healthcare professionals' interpersonal skills (INPATSAT-32). RESULTS On average, patients experienced quite a bit of Meaning (8.9, SD 2.3), a little bit to somewhat Peace (6.8, SD 2.7), and very low levels of Faith (2.9, SD 3.7). Two-thirds (71%) of patients reported one or more spiritual problems, for which the majority (54%) wanted to receive attention. In the final multivariable models, only a few factors were associated with SWB, such as greater spiritual needs with lower levels of Meaning and Peace. CONCLUSION Dutch patients with advanced cancer experience medium to low levels of Meaning, Peace, and Faith. More attention for their SWB is warranted.
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Affiliation(s)
- Annelieke Damen
- Netherlands Comprehensive Cancer Organisation (A.D., N.J.H.R.), Utrecht, The Netherlands.
| | - Natasja J H Raijmakers
- Netherlands Comprehensive Cancer Organisation (A.D., N.J.H.R.), Utrecht, The Netherlands; Netherlands Association for Palliative Care (N.J.H.R.), Utrecht, The Netherlands
| | - Janneke van Roij
- Netherlands Comprehensive Cancer Organization (IKNL) (J.V.R.), Department of Research & Development, Utrecht, The Netherlands; CoRPS - Center of Research on Psychology in Somatic Diseases (J.V.R.), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Netherlands Association for Palliative Care (PZNL) (J.V.R.), Utrecht, The Netherlands; Libra Rehabilitation and Audiology (J.V.R.), Tilburg, The Netherlands
| | - Anja Visser
- Faculty of Theology and Religious Studies (A.V.), University of Groningen, Groningen, The Netherlands
| | | | - Eveline Kuip
- Department of Medical Oncology and Anesthesiology (E.K.), Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology (H.W.M.L.), Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | | | - Tineke J Smilde
- Department of Oncology (T.J.S.), Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Carlo Leget
- Department of Care Ethics (C.L.), University of Humanistic Studies, Utrecht, The Netherlands
| | - George Fitchett
- Department of Religion (G.F.), Health and Human Values, Rush University Medical Center, Chicago, IL
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Kangasniemi M, Karki S, Voutilainen A, Saarnio R, Viinamäki L, Häggman-Laitila A. The value that social workers' competencies add to health care: An integrative review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:403-414. [PMID: 33704859 DOI: 10.1111/hsc.13266] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/05/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
Health and social care professionals' competencies have traditionally been separated because of the different aims of the two professions. These competencies need to be integrated, to make sure that seamless services are provided that meet the often complex needs of patients and clients in a coordinated and timely way. The aim of this integrative review was to identify, describe and synthetise previous studies on integrated competencies in health and social care. Electronic literature searches were carried out on the CINAHL, ProQuest, PsycInfo, PubMed, Scopus and SocIndex databases for peer-reviewed scientific papers that were published in English between 1 January 2007 and 31 December 2019. This identified 3,231 papers, after duplicates were removed, and 18 focused on the integration of social workers' competencies with health care. Other types of integration were not found. The value added by integrating social workers' competencies with health care focused on engaging working orientation, improving communication with family members, increasing understanding of service resources and mastering successful discharge procedures so that they met comprehensive, complex health and well-being needs. Social workers added value when they worked with multi-professional teams, but there were challenges to integrating competencies and these were related to professional collaboration and fragmented leadership. In future, more attention needs to be paid to diversifying and optimising the integration of professional health and social care competencies that meet clients' and patients' care and service needs. It is also vital to focus on developing the professional and leadership strategies that are needed to combine those competencies.
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Affiliation(s)
- Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Suyen Karki
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Ari Voutilainen
- Faculty of Health Sciences, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Leena Viinamäki
- Doctor of Social Sciences (Social Policy), Lapland University of Applied Sciences, Kemi, Finland
| | - Arja Häggman-Laitila
- Chief Nursing Officer, Department of Nursing Science, City of Helsinki, Social and Health Care, University of Eastern Finland, Kuopio, Finland
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Lormans T, de Graaf E, van de Geer J, van der Baan F, Leget C, Teunissen S. Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness. Palliat Med 2021; 35:1071-1098. [PMID: 33876676 PMCID: PMC8189005 DOI: 10.1177/02692163211010384] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients' expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions. AIM To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature. DESIGN A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571). DATA SOURCES The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients' perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools. RESULTS Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death. CONCLUSION What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients' linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients' needs and enables interdisciplinary teamwork to allocate patient-tailored care.
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Affiliation(s)
- Tom Lormans
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | - Everlien de Graaf
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | | | | | - Carlo Leget
- University of Humanistic Studies, Utrecht, the Netherlands
| | - Saskia Teunissen
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
- Academic Hospice Demeter, De Bilt, the Netherlands
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van Klinken M, de Graaf E, Bressers R, Koorn R, van der Baan F, Teunissen S. What do Future Hospice Patients Expect of Hospice Care: Expectations of Patients in the Palliative Phase Who Might be in Need of Hospice Care in the Future: A Qualitative Exploration. Am J Hosp Palliat Care 2020; 37:439-447. [PMID: 31818118 PMCID: PMC7168802 DOI: 10.1177/1049909119893358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Hospice care (HC) in the Netherlands is available for patients with life expectancies <3 months. Little is known about expectations of patients who might be in need of HC. This study aims to gain insight into expectations of patients regarding HC in order to ameliorate HC to become driven by patient needs. DESIGN A generic qualitative study, using semistructured interviews and thematic analysis, is performed in the Netherlands from January to June 2018. A purposeful sample of 13 participants was drawn. RESULTS Participants expected hospice admission only when the burden became unbearable and a home death cannot be reached. Participants expected a homely atmosphere, where one can continue the life lived at home as much as possible. Participants supposed empathic professional caregivers, capable of providing appropriate care. The general practitioner is expected to stay involved in the care process due to the mutual trust. Medical and daily care are required to be provided by competent professionals, where volunteers are expected to provide supportive care. All caregivers are supposed to provide a listening ear and "being there" for participants. Social care and spiritual care are generally projected to be private matters, unless it is requested. CONCLUSIONS Patients in the palliative phase who might be in need of HC have specific expectations. Perceptions of HC in the public domain should be nuanced in response to these expectations, and information provision on HC should be improved. Then, expectations could be met to make HC more driven by patient needs and future oriented.
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Affiliation(s)
- Merel van Klinken
- Center of Expertise Palliative Care Utrecht, General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Everlien de Graaf
- Center of Expertise Palliative Care Utrecht, General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Rick Bressers
- Center of Expertise Palliative Care Utrecht, General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Remco Koorn
- Center of Expertise Palliative Care Utrecht, General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Frederieke van der Baan
- Center of Expertise Palliative Care Utrecht, General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Saskia Teunissen
- Center of Expertise Palliative Care Utrecht, General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
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Koorn RM, van Klinken M, de Graaf E, Bressers REGW, Jobse AP, van der Baan F, Teunissen SCCM. Who Are Hospice Patients and What Care Is Provided in Hospices? A Pilot Study. Am J Hosp Palliat Care 2020; 37:448-454. [PMID: 31835931 PMCID: PMC7168801 DOI: 10.1177/1049909119889004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Hospices provide multidimensional care. In the Netherlands, patients with <3 months estimated life expectancy have access to hospice care. Insight into patients admitted to hospices and the care provided is lacking. In preparation for a national multicenter study, a pilot study was performed. Objective: The primary objective was to test the appropriateness of the study procedures and the availability of hospice patient records (HPRs), and patient and care characteristics. Method: A cross-sectional pilot study was performed using a descriptive exploratory design. Sixteen hospices were invited to participate, and HPRs from 8 deceased patients per hospice were selected. Data were collected using self-developed electronic case report forms. Outcomes: (1). Appropriateness of procedures: availability of HPRs and identified barriers and strategies. (2) Availability of patient and care characteristics in HPRs. Results: In total, 104 HPRs of patients from 13 hospices were enrolled. Various types of HPRs were found with different availabilities: nurses’ records were most available (98%) compared to volunteers’ records (62%). Overarching barriers were as follows: ethical issues, lack of knowledge, and lack of communication. Information about the illness was most available (97%), whereas descriptions of experienced symptoms were least available (10%). Conclusion: Collecting HPRs is difficult and time-consuming. Specifically, data from separate records of home care nurses and general practitioners were difficult to come by. Patient and care characteristics were alternately present, which led to an extension of data collection in HPRs to 3 time periods. Piloting is essential to adjust study procedures and outcome measures to ensure a feasible national multicenter hospice study.
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Affiliation(s)
- Remco M Koorn
- Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, the Netherlands
| | | | - Everlien de Graaf
- Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, the Netherlands
| | - Rick E G W Bressers
- Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, the Netherlands
| | - Adri P Jobse
- Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, the Netherlands
| | | | - Saskia C C M Teunissen
- Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, the Netherlands
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Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature. Med Sci (Basel) 2019; 7:medsci7020025. [PMID: 30736416 PMCID: PMC6409788 DOI: 10.3390/medsci7020025] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 01/15/2019] [Accepted: 02/05/2019] [Indexed: 12/28/2022] Open
Abstract
Many studies on spiritual care in palliative care are performed in the US, leaving other continents unexplored. The objective of this systematic review is to map the recent studies on spiritual care in palliative care in Europe. PubMed, CINAHL, ATLA, PsycINFO, ERIC, IBSS, Web of Science, EMBASE, and other databases were searched. Included were European studies published in a peer-reviewed journal in 2015, 2016, or 2017. The characteristics of the included studies were analyzed and a narrative synthesis of the extracted data was performed. 53 articles were included. Spiritual care was seen as attention for spirituality, presence, empowerment, and bringing peace. It implied creative, narrative, and ritual work. Though several studies reported positive effects of spiritual care, like the easing of discomfort, the evidence for spiritual care is low. Requirements for implementation of spiritual care in (palliative) care were: Developing spiritual competency, including self-reflection, and visibility of spirituality and spiritual care, which are required from spiritual counselors that they participated in existing organizational structures. This study has provided insight into spiritual care in palliative care in Europe. Future studies are necessary to develop appropriate patient outcomes and to investigate the effects of spiritual care more fully.
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