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Chiang SW, Lu SF, Wu SC, Peng TC. The Experiences of Nursing Managers in Implementing Palliative Care in Long-Term Care Facilities. J Multidiscip Healthc 2023; 16:4053-4070. [PMID: 38116302 PMCID: PMC10729680 DOI: 10.2147/jmdh.s442467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
Purpose The purpose of this study was to explore the experiences of nursing managers in implementing palliative care in long-term care facilities and to provide recommendations for managers who plan to introduce palliative care into their facilities. Methods This study used semi-structured interviews and grounded theory methodology, with purposive sampling. A total of 11 long-term care facilities in eastern Taiwan that had implemented palliative care were selected, and 11 facility nursing managers participated in in-depth, face-to-face interviews. Results The introduction of palliative care in long-term care facilities can be divided into four stages: (1) the opportunity for change, (2) playing a supportive role, (3) a new collaboration model, and (4) facility transformation. The core category shared by the participants may be summed up as "the palliative care captain in the facility". It reflects the spirit of the successful implementation of palliative care by managers in long-term care facilities. Conclusion The study reveals that during the initial phases of implementing palliative care, the palliative care teams assume a crucial leadership role, while the facilities play a supportive role. At this stage, managers should focus on personnel training and addressing internal issues within the facilities to facilitate successful collaboration with the palliative care teams. In the later stages, the facilities transition from a supportive role to one of independence, marking a critical juncture for the facilities' potential stable development. During this period, managers are tasked not only with establishing the facilities' own palliative care team but also with facilitating the transformation of staff from learners to instructors. Finally, even after successful implementation, managers must contemplate how to innovate and set more ambitious goals.
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Affiliation(s)
- Shu-Wan Chiang
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
| | - Shiou-Fang Lu
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
| | - Shu-Chen Wu
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
| | - Tai-Chu Peng
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
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Ye Z, Jing L, Zhang H, Qin Y, Chen H, Yang J, Zhu R, Wang J, Zhang H, Xu Y, Chu T. Attitudes and influencing factors of nursing assistants towards hospice and palliative care nursing in chinese nursing homes: a cross-sectional study. BMC Palliat Care 2023; 22:49. [PMID: 37098562 PMCID: PMC10127064 DOI: 10.1186/s12904-023-01175-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Hospice and palliative care nursing (HPCN) in China is mainly available at public primary care institutions, where nursing homes (NHs) are rarely involved. Nursing assistants (NAs) play an essential role in HPCN multidisciplinary teams, but little is known about their attitudes towards HPCN and related factors. METHODS A cross-sectional study was designed to evaluate NAs' attitudes towards HPCN with an indigenised scale in Shanghai. A total of 165 formal NAs were recruited from 3 urban and 2 suburban NHs between October 2021 and January 2022. The questionnaire was composed of four parts: demographic characteristics, attitudes (20 items with four sub-concepts), knowledge (nine items), and training needs (nine items). Descriptive statistics, independent samples t-test, one-way ANOVA, Pearson's correlation, and multiple linear regression were performed to analyse NAs' attitudes, influencing factors, and their correlations. RESULTS A total of 156 questionnaires were valid. The mean score of attitudes was 72.44 ± 9.56 (range:55-99), with a mean item score of 3.6 ± 0.5 (range:1-5). The highest score rate was "perception of the benefits for the life quality promotion" (81.23%), and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (59.92%). NAs' attitudes towards HPCN were positively correlated with their knowledge score (r = 0.46, P < 0.01) and training needs (r = 0.33, P < 0.01). Marital status (β = 0.185), previous training experience (β = 0.201), location of NHs (β = 0.193), knowledge (β = 0.294), and training needs (β = 0.157) for HPCN constituted significant predictors of attitudes (P < 0.05), which explained 30.8% of the overall variance. CONCLUSION NAs' attitudes towards HPCN were moderate, but their knowledge should be improved. Targeted training is highly recommended to improve the participation of positive and enabled NAs and to promote high-quality universal coverage of HPCN in NHs.
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Affiliation(s)
- Zhuojun Ye
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Limei Jing
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China.
| | - Haoyu Zhang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Yongfa Qin
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Hangqi Chen
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Jiying Yang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Ruize Zhu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Jingrong Wang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Huiwen Zhang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Yifan Xu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Tianshu Chu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
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He FX, Geng X, Johnson A. The experience of palliative care among older Chinese people in nursing homes: A scoping review. Int J Nurs Stud 2021; 117:103878. [PMID: 33611016 DOI: 10.1016/j.ijnurstu.2021.103878] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To identify the gaps in understanding the experience of older Chinese people receiving palliative care in nursing homes. DESIGN A nine-step scoping review methodology was used to search for relevant literature. METHODS Sixteen databases were searched for relevant studies published in English from January 1990 to August 2019. The grey literature was searched for relevant theses pertaining to the topic. RESULTS A total of 18 studies from the United States (n = 2), mainland China (n = 1), Hong Kong (n = 13), Taiwan (n = 2) and one thesis from Hong Kong were included in the final analysis. The findings were categorised into four themes: (1) advance care planning preferences; (2) decision-making process related to palliative care; (3) palliative care experiences and barriers; and (4) practice to improve palliative care. CONCLUSIONS Given the distinctive experiences of older Chinese residents in nursing homes when faced with death and dying, cultural beliefs strongly influenced their attitudes and behaviours in receiving end-of-life care. As Chinese immigrants have become a major ethnic group in western countries, there is benefit in recognising that older Chinese people living in nursing homes and needing palliative care will face specific challenges. Culturally appropriate interventions to address older Chinese people's existential stress, grief related to loss, communication and dietary requirements, and other barriers should be developed and implemented.
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Affiliation(s)
- Flora Xuhua He
- School of Nursing, Midwifery and Paramedicine (NSW/ACT), Australian Catholic University, 33 Berry Street, North Sydney, NSW 2060, Australia.
| | - Xiaowei Geng
- School of Nursing, Midwifery and Paramedicine (NSW/ACT), Australian Catholic University, 33 Berry Street, North Sydney, NSW 2060, Australia.
| | - Amanda Johnson
- School of Nursing, Midwifery and Paramedicine (NSW/ACT), Australian Catholic University, 33 Berry Street, North Sydney, NSW 2060, Australia.
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Baetz-Dougan M, Reiter L, Quigley L, Grossman D. Enhancing Care for Long-Term Care Residents Approaching End-of-Life: A Mixed-Methods Study Assessing a Palliative Care Transfer Form. Am J Hosp Palliat Care 2020; 38:1195-1201. [PMID: 33280402 DOI: 10.1177/1049909120976646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Many barriers exist in providing quality end-of-life care in long-term care (LTC), including transitions of care between acute care and LTC. Transfer forms can be beneficial in ensuring resident's end-of-life care needs are coordinated between different settings. The NYGH-LTC Transfer Form is a newly developed tool created to enhance care for residents transferred from acute care back to their LTC home for end-of-life. STUDY AIM Assess the perceived ease of use, usefulness, and care-enhancing potential of the NYGH-LTC Transfer Form by interprofessional LTC staff. METHODS The study population included interprofessional staff members at 2 LTC homes in Toronto, Canada. Quantitative data was obtained through surveys and qualitative data was obtained through focus groups. RESULTS There were a total of 34 participants. 79.4% of participants agreed the form was easy to use and 82.4% agreed it would improve care. Subgroup analysis demonstrated that participants with greater than 20 years experience were less likely to agree that it would improve care (p = 0.01). Qualitative analysis generated 4 themes: 1) Strengths, 2) Areas of Improvement, 3) Information Sharing, and 4) Communication. CONCLUSIONS The NYGH-LTC Transfer Form was overall well-evaluated. The form was seen as most useful for those with less experience or less confidence in palliative care. Communication was identified as a major barrier to successful transitions of care and increased bidirectional verbal communication is needed in addition to the form.
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Affiliation(s)
- Madelaine Baetz-Dougan
- Department of Family and Community Medicine, 8613North York General Hospital, University of Toronto, Toronto, Canada
| | - Leora Reiter
- Department of Family and Community Medicine, 8613North York General Hospital, University of Toronto, Toronto, Canada
| | - Laura Quigley
- Department of Family and Community Medicine, St. Joseph's Health Centre, Toronto, Canada
| | - Daphna Grossman
- Division of Palliative Care, Department of Family and Community Medicine, 8613North York General Hospital, University of Toronto, Toronto, Canada
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Quality of Palliative and End-Of-Life Care in Hong Kong: Perspectives of Healthcare Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145130. [PMID: 32708596 PMCID: PMC7400302 DOI: 10.3390/ijerph17145130] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022]
Abstract
Background: In response to population aging, there is a need for health systems to focus on care for chronic disease, specifically palliative care, while focusing on people-centered care. The objective of this study is to explore the healthcare system enablers and barriers to the provision of quality palliative and end-of-life care from the perspective of healthcare professionals. Materials and Methods: Using purposive sampling, fifteen focus group interviews and nine individual interviews involving 72 healthcare providers were conducted. Primary qualitative data were collected between May 2016 and July 2017. All recorded discussions were transcribed verbatim and analyzed. A thematic framework was developed. Results: The provision of quality palliative and end-of-life care is influenced by the interaction and integration of nine sub-themes under four identified themes: (1) political context; (2) organization setting; (3) support to patients, caregivers, and family members, and (4) healthcare workers and the public. Conclusions: Integration of palliative and end-of-life care is an important pillar of healthcare service to improve quality of life by addressing patients’ values, wishes and preference, and assist their family to handle challenges at the end stage of life. Further improvements to the service framework would be required, specifically in the political framework, multidisciplinary approach, and readiness and competence in healthcare workers and community. These were highlighted in our study as key components in service provision to ensure that patients can receive continuous and integrated care between hospitals and the community as well as dignified care at the end stage of life.
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Park M, Yeom HA, Yong SJ. Hospice care education needs of nursing home staff in South Korea: a cross-sectional study. BMC Palliat Care 2019; 18:20. [PMID: 30755208 PMCID: PMC6373091 DOI: 10.1186/s12904-019-0405-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 02/04/2019] [Indexed: 12/02/2022] Open
Abstract
Background While the importance of hospice care education in nursing homes is recognized, the volume of research on the specific educational needs of caregivers in hospice care in nursing homes is still lacking. This study aimed to assess educational needs in hospice care among the nursing home staff in South Korea, and to examine factors related to their education needs. Methods This is a cross-sectional descriptive study. A total of 324 nursing staff members recruited from 15 nursing homes in South Korea participated in this cross-sectional study. Measurements included demographic information, organizational characteristics, education experiences in hospice care, and educational needs in hospice care based on questionnaires developed by Whittaker and colleagues. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression techniques. Results In the present study, 70.6% (n = 218) of respondents reported that they had previous experience with education in hospice care and expressed their continued need for further education. The provision of care in the last days of a patient’s life was the most frequent issue identified by nursing home staff for further education. Factors predicting educational needs in hospice care included provision of hospice care services in nursing homes and the existence of hospice care team meetings in the institution. Multiple regression analysis resulted in 14.3% of explained variance in the educational needs of nursing home staff in hospice care. Conclusions Nursing home staff members showed high levels of need for training in hospice care. Therefore, it is imperative for nursing home administrators to initiate and support well-suited hospice care education for multi-level care workers on an ongoing basis.
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Affiliation(s)
- Mihyun Park
- The Catholic University of Korea College of Nursing, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, South Korea
| | - Hye-Ah Yeom
- The Catholic University of Korea College of Nursing, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, South Korea.
| | - Sr Jinsun Yong
- The Catholic University of Korea College of Nursing, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, South Korea.,WHO Collaborating Centre for Training in Hospice and Palliative Care, The Research Institute for Hospice and Palliative Care, The Catholic University of Korea, Seoul, South Korea
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Luo H, Lou VWQ, Li Y, Chi I. Development and Validation of a Prognostic Tool for Identifying Residents at Increased Risk of Death in Long-Term Care Facilities. J Palliat Med 2018; 22:258-266. [PMID: 30383467 DOI: 10.1089/jpm.2018.0219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To promote better care at the end stage of life in long-term care facilities, a culturally appropriate tool for identifying residents at the end of life is crucial. OBJECTIVE This study aimed to develop and validate a prognostic tool, the increased risk of death (IRD) scale, based on the minimum data set (MDS). DESIGN A retrospective study using data between 2005 and 2013 from six nursing homes in Hong Kong. SETTING/SUBJECTS A total of 2380 individuals were randomly divided into two equal-sized subsamples: Sample 1 was used for the development of the IRD scale and Sample 2 for validation. MEASUREMENTS The measures were MDS 2.0 items and mortality data from the discharge tracking forms. The nine items in the IRD scale (decline in cognitive status, decline in activities of daily living, cancer, renal failure, congestive heart failure, emphysema/chronic obstructive pulmonary disease, edema, shortness of breath, and loss of weight), were selected based on bivariate Cox proportional hazards regression. RESULTS The IRD scale was a strong predictor of mortality in both Sample 1 (HRsample1 = 1.50, 95% confidence interval [CI]: 1.37-1.65) and Sample 2 (HRsample2 = 1.31, 1.19-1.43), after adjusting for covariates. Hazard ratios (HRs) for residents who had an IRD score of 3 or above for Sample 1 and Sample 2 were 3.32 (2.12-5.21) and 2.00 (1.30-3.09), respectively. CONCLUSIONS The IRD scale is a promising tool for identifying nursing home residents at increased risk of death. We recommend the tool to be incorporated into the care protocol of long-term care facilities in Hong Kong.
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Affiliation(s)
- Hao Luo
- 1 Department of Social Work and Social Administration, The University of Hong Kong , Hong Kong, China
| | - Vivian W Q Lou
- 2 Department of Social Work and Social Administration and Sau Po Centre on Ageing, The University of Hong Kong , Hong Kong, China
| | - Yuekang Li
- 1 Department of Social Work and Social Administration, The University of Hong Kong , Hong Kong, China
| | - Iris Chi
- 3 Suzanne Dworak-Peck School of Social Work, University of Southern California , Los Angeles, California
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Smets T, Pivodic L, Piers R, Pasman HRW, Engels Y, Szczerbińska K, Kylänen M, Gambassi G, Payne S, Deliens L, Van den Block L. The palliative care knowledge of nursing home staff: The EU FP7 PACE cross-sectional survey in 322 nursing homes in six European countries. Palliat Med 2018; 32:1487-1497. [PMID: 29972343 PMCID: PMC6158686 DOI: 10.1177/0269216318785295] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. AIM This study assesses the palliative care knowledge of staff in NHs in Europe. DESIGN Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy. Palliative care knowledge is measured with the Palliative Care Survey. Scores on the scales range between 0 and 1; higher scores indicate more knowledge. RESULTS A total of 3392 NH-staff were given a questionnaire, and 2275 responded (67%). Knowledge of basic palliative care issues ranged between 0.20 in Poland (95% confidence interval (CI) 0.19; 0.24) and 0.61 in Belgium (95% CI 0.59; 0.63), knowledge of physical aspects that can contribute to pain ranged between 0.81 in Poland (95% CI 0.79; 0.84) and 0.91 in the Netherlands (95% CI 0.89; 0.93), and knowledge of psychological reasons that can contribute to pain ranged between 0.56 in England (95% CI 0.50; 0.62) and 0.87 in Finland (95% CI 0.83; 0.90). Factors associated with knowledge were country, professional role and having undertaken formal training in palliative care. CONCLUSIONS Knowledge of nurses and care assistants concerning basic palliative care issues appears to be suboptimal in all participating countries, although there is substantial heterogeneity. Education of nursing staff needs to be improved across, but each country may require its own strategy to address the unique and specific knowledge gaps.
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Affiliation(s)
- Tinne Smets
- 1 Department of Family Medicine and Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,2 Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Lara Pivodic
- 1 Department of Family Medicine and Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Ruth Piers
- 3 Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium
| | - H Roeline W Pasman
- 4 EMGO Institute for Health and Care Research, Expertise Center for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands
| | - Yvonne Engels
- 5 Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Katarzyna Szczerbińska
- 6 Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Marika Kylänen
- 7 National Institute for Health and Welfare, Helsinki, Finland
| | | | - Sheila Payne
- 9 International Observatory on End-of-Life Care, Lancaster University, Lancaster, UK
| | - Luc Deliens
- 1 Department of Family Medicine and Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,9 International Observatory on End-of-Life Care, Lancaster University, Lancaster, UK
| | - Lieve Van den Block
- 1 Department of Family Medicine and Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
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Palliative care during the final week of life of older people in nursing homes: A register-based study. Palliat Support Care 2017; 15:417-424. [DOI: 10.1017/s1478951516000948] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTObjective:Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes.Method:Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics.Results:The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place.Significance of results:There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.
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Bükki J, Neuhaus PM, Paal P. End of life care in nursing homes: Translating focus group findings into action. Geriatr Nurs 2016; 37:440-445. [DOI: 10.1016/j.gerinurse.2016.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/06/2016] [Accepted: 06/13/2016] [Indexed: 11/30/2022]
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Cable-Williams B, Wilson DM. Dying and death within the culture of long-term care facilities in Canada. Int J Older People Nurs 2016; 12. [DOI: 10.1111/opn.12125] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Beryl Cable-Williams
- Trent/Fleming School of Nursing; Fleming College; Trent University; Peterborough ON Canada
| | - Donna M. Wilson
- Faculty of Nursing; University of Alberta; Edmonton AB Canada
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International publication trends and collaboration performance of China in healthcare science and services research. Isr J Health Policy Res 2016; 5:1. [PMID: 26834970 PMCID: PMC4733273 DOI: 10.1186/s13584-016-0061-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 01/19/2016] [Indexed: 01/27/2023] Open
Abstract
Background In recent years, China’s healthcare reforms and related studies have drawn particular global attention. The main objective of this study is to evaluate quantitatively the publication trends and collaboration performance of China in healthcare science and services (HSS) research. Methods Scientometric methods and visualization technology were used to survey the growth and development trends of HSS research based on the Web of Science publications during the past 15 years. Results China’s international publications on HSS research increased rapidly compared to those of the global HSS and Chinese scientific studies. Growth trends indicate that collaboration among countries, institutions and authors has also increased. China’s leading partners were all developed countries, such as the US, the UK, Australia and Canada, which have contributed to the majority of the joint publications. The academic impact of publications involving partners from European and American countries was relatively higher than those involving partners from Asian countries. Prominent institutions were universities that could be primarily classified into two groups, namely, Mainland China on the one hand and Hong Kong universities and foreign universities on the other. The most prominent actors were elite institutions, such as Peking University, Fudan University, Chinese University of Hong Kong, University of Hong Kong. The papers published by the Chinese Ministry of Health had relatively high academic impact, whereas those published by Mainland China universities alone had a lower academic impact compared to foreign cooperation papers. Issues related to the Chinese healthcare reform, priority diseases (e.g., breast cancer, HIV/AIDS, tuberculosis, etc.), health systems performance, quality of life and measurement tools, aging problems and research methods have been the most popular HSS topics in China in recent years. Conclusions Despite the extensive achievement of the Chinese HSS reforms and research, gaps and challenges remain to be addressed, including those related to health insurance and the effects of the evaluation of essential medicine systems, human resources training and allocation in the health sector, government hospitals reforms and health services systems remodeling. These findings could help scholars and decision-makers understand the current status and likely future trends of the Chinese HSS research, and help them select the most appropriate collaboration partners and policies.
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End-of-life care research in Hong Kong: A systematic review of peer-reviewed publications. Palliat Support Care 2015; 13:1711-20. [DOI: 10.1017/s1478951515000802] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:This systematic review aimed to examine end-of-life (EoL) care research undertaken in an Eastern cultural context—Hong Kong—with the hope of better informing EoL care professionals and policy makers and providing lessons for other countries or areas that share similar EoL care challenges.Method:Eight databases were searched from their respective inception through to August of 2014. All of the resulting studies conducted in Hong Kong and relevant to EoL care or palliative care were examined. The included studies were assessed with respect to study design, care settings, participants, research themes, and major findings.Results:Some 107 publications published between 1991 and 2014 were identified. These studies were undertaken at a range of places by different professionals. Of the total, 44 were led by physicians, 36 by nurses, 17 by social workers, and 10 by other professionals. Participants included both inpatients and outpatients with different illnesses, nursing home residents, older community-dwelling adults, deceased individuals, care staff, and informal caregivers. A total of 13 research themes were identified: (1) attitudes to or perceptions of death and dying; (2) utilization of healthcare services, (3) physical symptoms or medical problems; (4) death anxiety or mental health issues; (5) quality of life; (6) advance directives or advance care planning; (7) supportive care needs, (8) decision making; (9) spirituality; (10) cost-effectiveness or utility studies; (11) care professionals' education and training; (12) informal caregivers' perceptions and experience; and (13) scale development or validation.Significance of results:While there has been a wide and diverse range of research activities in Hong Kong, EoL care services at primary care settings should be strengthened. Some priority areas for further research are recommended.
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Ho AHY, Dai AAN, Lam SH, Wong SWP, Tsui ALM, Tang JCS, Lou VWQ. Development and Pilot Evaluation of a Novel Dignity-Conserving End-of-Life (EoL) Care Model for Nursing Homes in Chinese Societies. THE GERONTOLOGIST 2015; 56:578-89. [DOI: 10.1093/geront/gnv037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/07/2015] [Indexed: 11/12/2022] Open
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Håkanson C, Cronfalk BS, Henriksen E, Norberg A, Ternestedt BM, Sandberg J. First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care. Open Nurs J 2015; 8:71-8. [PMID: 25628769 PMCID: PMC4303953 DOI: 10.2174/1874434601408010071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/23/2014] [Accepted: 08/09/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.
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Affiliation(s)
- Cecilia Håkanson
- Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden ; Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Berit Seiger Cronfalk
- Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden ; Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden ; Stord Haugesund University College, Norway
| | - Eva Henriksen
- Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden ; FOU-nu, Stockholm County Council, Stockholm, Sweden
| | - Astrid Norberg
- Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden ; Department of Nursing, Umeå University, Umeå, Sweden
| | - Britt-Marie Ternestedt
- Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden ; Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden ; Stockholms Sjukhem foundation, Research, Development and Education Unit, Stockholm, Sweden
| | - Jonas Sandberg
- Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden ; Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden
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Ho AHY, Luk JKH, Chan FHW, Chun Ng W, Kwok CKK, Yuen JHL, Tam MYJ, Kan WWS, Chan CLW. Dignified Palliative Long-Term Care: An Interpretive Systemic Framework of End-of-Life Integrated Care Pathway for Terminally Ill Chinese Older Adults. Am J Hosp Palliat Care 2015; 33:439-47. [PMID: 25588584 DOI: 10.1177/1049909114565789] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To critically examine the system dynamics necessary for successfully implementing a novel end-of-life integrated care pathway (EoL-ICP) program in promoting dignity and quality of life among terminally-ill Chinese nursing home residents. METHODS Thirty stakeholders were recruited to participate in 4 interpretive-systemic focus groups. RESULTS Framework analysis revealed 10 themes, organized into 3 categories, namely, (1) Regulatory Empowerment (interdisciplinary teamwork, resource allocation, culture building, collaborative policy making), (2) Family-Centered Care (continuity of care, family care conference, partnership in care), and (3) Collective Compassion (devotion in care, empathic understanding, compassionate actions). CONCLUSIONS These findings highlight the importance of organizational structure, social discourse, and shared meaning in the provision of EoL-ICP in Chinese societies, underscoring the significant triangulation between political, cultural, and spiritual contexts embodied in the experience of dignity.
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Affiliation(s)
- Andy Hau Yan Ho
- Division of Psychology, School of Humanities and Social Sciences, Nangyang Technological University, Singapore Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - James K H Luk
- Tung Wah Group of Hospitals, Fung Yiu King Hospital, Hong Kong
| | - Felix H W Chan
- Tung Wah Group of Hospitals, Fung Yiu King Hospital, Hong Kong
| | - Wing Chun Ng
- Community Care Services, Hong Kong West Cluster, Hospital Authority, Hong Kong
| | - Catherine K K Kwok
- Tung Wah Group of Hospitals, Jockey Club Care and Attention Home, Hong Kong
| | - Joseph H L Yuen
- Tung Wah Group of Hospitals, Jockey Club Care and Attention Home, Hong Kong
| | - Michelle Y J Tam
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Wing W S Kan
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| | - Cecilia L W Chan
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong
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The need for palliative care education, support, and reflection among rural nurses and other staff: A quantitative study. Palliat Support Care 2014; 13:265-74. [DOI: 10.1017/s1478951513001272] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Many people now die in community care, and, considering the aging population, all healthcare staff members must be prepared to provide palliative care. Our objectives were to describe the total staff working in different care organizations in a rural community in Sweden and to explore palliative care competence, to describe educational gaps and the need for support and reflection, and to determine whether there are differences in care organizations, professions, age, and gender.Method:A 4-section 20-item questionnaire was distributed to 1686 staff (65% response rate): in nursing homes (n = 395), home care (n = 240), and group residential settings (n = 365). Registered nurses (n = 70), assistant nurses (n = 916), managers (n = 43), and paramedics (n = 33) participated. Descriptive and correlational statistics were employed.Results:Significant differences were found, and 40% (53% among men) lacked palliative care education, Fewer than 50% lacked education in the spiritual/existential areas, and 75% of those aged 20–66 (75% women, 55% men) needed further education. More women than men and staff aged 50–59 had an increased need to reflect.Significance of Results:Our study may provide guidance for managers in rural communities when planning educational interventions in palliative care for healthcare staff and may support direct education with content for specific professions.
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Lee J, Cheng J, Au KM, Yeung F, Leung MT, Ng J, Hui E, Lo R, Woo J. Improving the Quality of End-of-Life Care in Long-Term Care Institutions. J Palliat Med 2013; 16:1268-74. [DOI: 10.1089/jpm.2013.0190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jenny Lee
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong
| | - Joanna Cheng
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Kar-ming Au
- Community Outreach Service Team, Prince of Wales Hospital, Hong Kong
| | - Fannie Yeung
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Mei-tak Leung
- Community Outreach Service Team, Prince of Wales Hospital, Hong Kong
| | - Joey Ng
- Community Outreach Service Team, Prince of Wales Hospital, Hong Kong
| | - Elsie Hui
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong
| | - Raymond Lo
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Hsu CP, Chen HW, Lee SY, Tsou MT. Knowledge and Attitude toward Hospice Palliative Care among Community-Dwelling Aged Taiwanese—Analysis of Related Factors. INT J GERONTOL 2012. [DOI: 10.1016/j.ijge.2012.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Brazil K, Kaasalainen S, McAiney C, Brink P, Kelly ML. Knowledge and perceived competence among nurses caring for the dying in long-term care homes. Int J Palliat Nurs 2012; 18:77-83. [DOI: 10.12968/ijpn.2012.18.2.77] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kevin Brazil
- Department of Clinical Epidemiology and Biostatistics
| | | | - Carrie McAiney
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Mary Lou Kelly
- School of Social Work, Lakehead University, Thunder Bay, Ontario
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Kelly K, Thrane S, Virani R, Ferrell B, Malloy P. Expanding palliative care nursing education in California: the ELNEC Geriatric project. Int J Palliat Nurs 2011; 17:188-94. [DOI: 10.12968/ijpn.2011.17.4.188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kathe Kelly
- Division of Nursing Research & Education, City of Hope, 1500 East Duarte Road, Duarte, California 91010-3000, USA
| | - Susan Thrane
- Division of Nursing Research & Education, City of Hope, 1500 East Duarte Road, Duarte, California 91010-3000, USA
| | - Rose Virani
- Division of Nursing Research & Education, City of Hope, 1500 East Duarte Road, Duarte, California 91010-3000, USA
| | - Betty Ferrell
- Division of Nursing Research & Education, City of Hope, 1500 East Duarte Road, Duarte, California 91010-3000, USA
| | - Pam Malloy
- American Association of Colleges of Nursing (AACN), USA
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Bibliography. PROGRESS IN PALLIATIVE CARE 2010. [DOI: 10.1179/096992610x12775428636944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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