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Bruch JD, Khazen M, Mahmic-Kaknjo M, Légaré F, Ellen ME. The effects of shared decision making on health outcomes, health care quality, cost, and consultation time: An umbrella review. PATIENT EDUCATION AND COUNSELING 2024; 129:108408. [PMID: 39214045 DOI: 10.1016/j.pec.2024.108408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 08/18/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To review the effects of shared decision making (SDM) on health outcomes, health care quality, cost, and consultation time METHODS: We conducted an umbrella review and searched systematic reviews on SDM from PubMed, CINHAL, and Web of Science. We included reviews on SDM interventions used in a health care setting with patients. We assessed the eligibility of retrieved articles and evaluated whether the review addressed Consolidated Framework for Implementation Research (CFIR) characteristics. RESULTS Out of 3678 records, 48 reviews were included. Half of the reviews focused exclusively on RCT studies (n = 21). A little less than half were focused specifically on decision aids (n = 23). Thirty-two reviews discussed CFIR characteristics explicitly or implicitly; the majority of which were specific to intervention characteristics. Reviews tended to cluster around patient populations and tended to be low or critically low to moderate in their quality. Reviews of SDM on health outcomes, health care quality, cost, and consultation time were highly uncertain but often ranged from neutral to positive. CONCLUSIONS We observed that SDM implementation did not typically increase costs or increase consultation time while having some neutral to positive benefits on outcomes and quality for certain populations. Gaps in knowledge remain including better research on the climate where SDM is most effective.
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Affiliation(s)
- Joseph Dov Bruch
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Maram Khazen
- The Max Stern Yezreel Valley College, Emek Jezreel, Israel
| | - Mersiha Mahmic-Kaknjo
- Department of Clinical Pharmacology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina; Faculty of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
| | - Moriah E Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada.
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Pillen H, Attrill S, Fisher A, Forte S, Brebner C, Robinson S. Educating for supported decision making and shared decision making: a scoping review of educational design and outcomes for education and training interventions. Disabil Rehabil 2024:1-12. [PMID: 38591714 DOI: 10.1080/09638288.2024.2337099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE To characterise existing knowledge about the design and learning outcomes of education and training programs for supported or shared decision making. MATERIALS AND METHODS A scoping review was performed to identify academic and grey literature, published between January 2006 and February 2022, that reported on the design and/or learning outcomes of supported or shared decision making education or training programs. Eligible literature was mapped across domains of educational design and Kirkpatrick's hierarchy of learning effectiveness, and then qualitatively synthesised using cross-case analysis. RESULTS A total of 33 articles were identified (n = 7 for supported decision making and n = 26 for shared decision making) that provided education or training to supporters of persons with mental illness or substance use disorders (n = 14), dementia or neurocognitive disorders (n = 6), cognitive disability (n = 5), mixed populations (n = 1), and those receiving end-of-life care (n = 7). In their design, most programs sought specific changes in practice (behaviour) via experiential learning. Reported educational outcomes also focused on supporter behaviour, with limited evidence for how changes in learner attitudes, skills, or knowledge might be contributing to changes in supporter behaviour. CONCLUSIONS Future education and training would benefit from a closer engagement with theories of teaching and learning, particularly those oriented towards co-design.
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Affiliation(s)
- Heath Pillen
- School of Allied Health Science and Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Stacie Attrill
- School of Allied Health Science and Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Alinka Fisher
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sabrina Forte
- Council for Intellectual Disability, Surry Hills, Australia
| | - Chris Brebner
- Office of the Deputy Vice-Chancellor, Flinders University, Adelaide, Australia
| | - Sally Robinson
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Björk J. "It is very hard to just accept this" - a qualitative study of palliative care teams' ethical reasoning when patients do not want information. BMC Palliat Care 2024; 23:91. [PMID: 38575905 PMCID: PMC10996159 DOI: 10.1186/s12904-024-01412-8] [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: 11/05/2023] [Accepted: 03/15/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The aim of this study was to explore how palliative care staff reason about the autonomy challenge that arises when a patient who has first said he wants full information appears to change his mind and rejects being informed. METHODS The study had a qualitative and exploratory design. Participants (physicians, registred nurses, social workers, physiotherapists and occupational therapists) were recruited from palliative care teams in southern Sweden. Six separate focus group interviews with a total number of 33 participants were conducted. The teams were asked to discuss a fictional case of a man who first wants, then rejects, information about his situation. The interviews were audiotaped and transcribed verbatim. Reflexive thematic analysis following Braun and Clarke was undertaken to analyse data. RESULTS The analysis resulted in three themes: Patients have a right to reject information, Questioning whether this patient WANTS to reject information and There are other values at stake, too. Although participants endorsed a right to reject information, they were unsure whether this right was relevant in this situation, and furthermore felt that it should be balanced against counteracting factors. The effect of such balancing was that participants would aim to find a way to present relevant information to the patient, but in a probing and flexible way. CONCLUSIONS In their work with dying patients, palliative care staff meet many autonomy challenges. When faced with a choice to withhold information as per a patient's wishes, or to provide information with the patient's best interest in mind, staff find it hard to balance competing values. Staff also find it hard to balance their own interests against a purely professional stance. The overall strategy seems to be to look for caring ways to impart the information.
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Affiliation(s)
- Joar Björk
- Centre for Research Ethics and Bioethics (CRB), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
- Department of Research and Development, Region Kronoberg, Växjö, Sweden.
- Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Stockholm, Sweden.
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Viana JN, Pilbeam C, Howard M, Scholz B, Ge Z, Fisser C, Mitchell I, Raman S, Leach J. Maintaining High-Touch in High-Tech Digital Health Monitoring and Multi-Omics Prognostication: Ethical, Equity, and Societal Considerations in Precision Health for Palliative Care. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2023; 27:461-473. [PMID: 37861713 DOI: 10.1089/omi.2023.0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Advances in digital health, systems biology, environmental monitoring, and artificial intelligence (AI) continue to revolutionize health care, ushering a precision health future. More than disease treatment and prevention, precision health aims at maintaining good health throughout the lifespan. However, how can precision health impact care for people with a terminal or life-limiting condition? We examine here the ethical, equity, and societal/relational implications of two precision health modalities, (1) integrated systems biology/multi-omics analysis for disease prognostication and (2) digital health technologies for health status monitoring and communication. We focus on three main ethical and societal considerations: benefits and risks associated with integration of these modalities into the palliative care system; inclusion of underrepresented and marginalized groups in technology development and deployment; and the impact of high-tech modalities on palliative care's highly personalized and "high-touch" practice. We conclude with 10 recommendations for ensuring that precision health technologies, such as multi-omics prognostication and digital health monitoring, for palliative care are developed, tested, and implemented ethically, inclusively, and equitably.
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Affiliation(s)
- John Noel Viana
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
- Responsible Innovation Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - Caitlin Pilbeam
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Mark Howard
- Monash Data Futures Institute, Monash University, Clayton, Australia
- Department of Philosophy, School of Philosophical, Historical and International Studies, Monash University, Clayton, Australia
| | - Brett Scholz
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Zongyuan Ge
- Monash Data Futures Institute, Monash University, Clayton, Australia
- Department of Data Science & AI, Monash University, Clayton, Australia
| | - Carys Fisser
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Imogen Mitchell
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
- Intensive Care Unit, Canberra Hospital, Canberra, Australia
| | - Sujatha Raman
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
| | - Joan Leach
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
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Tseng Y, Lin Y, Hsu W, Kang Y, Su H, Cheng S, Tsai J, Chiu T, Huang H. Shared decision making with Oncologists and Palliative care specialists (SOP) model help advanced pancreatic cancer patients reaching goal concordant care: A prospective cohort study. Cancer Med 2023; 12:20119-20128. [PMID: 37740620 PMCID: PMC10587919 DOI: 10.1002/cam4.6590] [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: 12/31/2022] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Pancreatic cancer is often diagnosed at a late stage with a poor prognosis due to insidious symptoms and lack of evidence-based screening in general population. Palliative care's acceptance in Asian cultures is hindered by misconceptions and ineffective communication about management that improve quality of life other than cancer directed treatment. Our study aimed to determine the effect of the Shared decision-making with Oncologists and Palliative care specialists (SOP) model developed from the traditional shared decision-making (SDM) model on the palliative care acceptance rate and medical resource utilization. METHODS This is a prospective cohort study implementing the SOP model at the National Taiwan University Hospital from January 2018 to December 2019 for patients with advanced pancreatic cancer. Medical resource utilization was defined and recorded as the rate of hospitalization, emergency room (ER), and intensive care unit admissions. We compared the results between two groups: patients who received the SOP model in 2019 and patients who did not receive it in 2018. RESULTS 137 patients with advanced pancreatic cancer were included in our study. The result showed that the acceptance rate of palliative care significantly increased from 50% to 78.69% after the SOP model (p = 0.01). The hospitalization rate did not show a significant difference between 2018 (93.42%, 95% CI: 0.88-0.99) and 2019 (93.44%, 95% CI: 0.87-1.00). 83.61% (95% CI: 0.74-0.93) of our patients in 2019 had at least one ER visit; the rate was 81.5% (95% CI: 0.73-0.91) in 2018 (p = 0.28). The percentage of patients admitted to the ICU increased from 3.95% in 2018 to 8.2% (95% CI: -0.05-0.08) in 2019 (95% CI: 0.11-0.15) (p = 0.00). The hospitalization and ER visit showed no statistically difference between 2 years. CONCLUSIONS The modified SOP model markedly augmented palliative care's acceptance of patients with advanced pancreatic cancer. Adoption of the SOP model would provide these patients a more proactive and systematic approach to deliver needed healthcare.
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Affiliation(s)
- Yung‐Ling Tseng
- Department of EducationKuang Tien General HospitalTaichungTaiwan
| | - Yun‐Ching Lin
- Cancer Administration and Coordination centerNational Taiwan University HospitalTaipei cityTaiwan
| | - Wan‐Ju Hsu
- Cancer Administration and Coordination centerNational Taiwan University HospitalTaipei cityTaiwan
- Department of NursingNational Taiwan University HospitalTaipei cityTaiwan
| | - Ya‐Chun Kang
- Cancer Administration and Coordination centerNational Taiwan University HospitalTaipei cityTaiwan
| | - Hsin‐Yin Su
- Cancer Administration and Coordination centerNational Taiwan University HospitalTaipei cityTaiwan
| | - Shao‐Yi Cheng
- Department of Family MedicineNational Taiwan University HospitalTaipei cityTaiwan
| | - Jaw‐Shiun Tsai
- Department of Family MedicineNational Taiwan University HospitalTaipei cityTaiwan
| | - Tai‐Yuan Chiu
- Department of Family MedicineNational Taiwan University HospitalTaipei cityTaiwan
| | - Hsien‐Liang Huang
- Department of Family MedicineNational Taiwan University HospitalTaipei cityTaiwan
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Dennison Himmelfarb CR, Beckie TM, Allen LA, Commodore-Mensah Y, Davidson PM, Lin G, Lutz B, Spatz ES. Shared Decision-Making and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation 2023; 148:912-931. [PMID: 37577791 DOI: 10.1161/cir.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Shared decision-making is increasingly embraced in health care and recommended in cardiovascular guidelines. Patient involvement in health care decisions, patient-clinician communication, and models of patient-centered care are critical to improve health outcomes and to promote equity, but formal models and evaluation in cardiovascular care are nascent. Shared decision-making promotes equity by involving clinicians and patients, sharing the best available evidence, and recognizing the needs, values, and experiences of individuals and their families when faced with the task of making decisions. Broad endorsement of shared decision-making as a critical component of high-quality, value-based care has raised our awareness, although uptake in clinical practice remains suboptimal for a range of patient, clinician, and system issues. Strategies effective in promoting shared decision-making include educating clinicians on communication techniques, engaging multidisciplinary medical teams, incorporating trained decision coaches, and using tools (ie, patient decision aids) at appropriate literacy and numeracy levels to support patients in their cardiovascular decisions. This scientific statement shines a light on the limited but growing body of evidence of the impact of shared decision-making on cardiovascular outcomes and the potential of shared decision-making as a driver of health equity so that everyone has just opportunities. Multilevel solutions must align to address challenges in policies and reimbursement, system-level leadership and infrastructure, clinician training, access to decision aids, and patient engagement to fully support patients and clinicians to engage in the shared decision-making process and to drive equity and improvement in cardiovascular outcomes.
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Hatzikiriakidis K, Ayton D, Skouteris H, Patitsas L, Smith K, Dhulia A, Poon P. A rapid umbrella review of the literature surrounding the provision of patient-centred end-of-life care. Palliat Med 2023; 37:1079-1099. [PMID: 37448148 DOI: 10.1177/02692163231183007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
BACKGROUND Patients have reported a broad range of unmet needs in their receipt of clinical care at the end of life. Therefore, enhancing the quality of end-of-life care through patient-centred healthcare interactions is warranted. AIM The aim of this rapid umbrella review was to synthesise previous literature reviews that have examined: (1) patient preferences for patient-centred end-of-life care; (2) barriers and enablers to patient-centred end-of-life care; (3) interventions designed to enhance patient-centred end-of-life care; and (4) patient-centred models of end-of-life care. DESIGN A rapid umbrella review was conducted and informed by the Joanna Briggs Institute's methodological guidance for conducting umbrella reviews. DATA SOURCES Three academic databases were searched for relevant literature in May 2022: MEDLINE, PsycINFO and CINAHL Plus. Inclusion criteria encompassed literature reviews that examined the topic of patient-centred care for any adult patients in end-of-life care. RESULTS A total of 92 literature reviews were identified. Findings suggest that there is often a discrepancy between patient preferences and the provision of care. These discrepancies have been associated with a range of barriers at the patient, staff and system levels. Common interventions included education and training for staff which were often met with improved patient outcomes. Patient-centred models of care were underrepresented across the literature. CONCLUSIONS This review highlighted a need for healthcare systems to support staff in providing a patient-centred end of life experience through the development of a co-designed patient-centred model of care, supplemented by professional development and a systematic approach to identifying and documenting patient preferences.
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Affiliation(s)
- Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton VIC, Australia
| | - Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton VIC, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton VIC, Australia
- Warwick Business School, University of Warwick, Coventry, West Midlands, United Kingdom
| | - Luke Patitsas
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton VIC, Australia
| | | | | | - Peter Poon
- Monash Health, Clayton, VIC, Australia
- School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
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Davis A, Dukart-Harrington K. Enhancing Care of Older Adults Through Standardizing Palliative Care Education. J Gerontol Nurs 2023; 49:6-12. [PMID: 37256761 DOI: 10.3928/00989134-20230512-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Nursing skill in caring for persons with serious chronic illness is increasingly in demand as the proportion of older adults in the United States increases. There is robust evidence that palliative care education among health care providers influences the reduction of death anxiety and avoidance behavior, while positively impacting self-efficacy and comfort, when caring for persons with serious illness or those nearing death. The international recognition of access to palliative care as a universal human right drives the need for education to adequately prepare nurses who have not been properly prepared for this work. The development of national competencies in palliative care education for nurses is an important step in synthesizing and disseminating available evidence in support of palliative care nursing education. These recently published competencies can lead to policy innovations at local, state, and national levels. Identifying competencies that lead to more clearly defined curricula will ultimately improve standardizing education and improve nursing practice in caring for older adults with serious chronic illness and their families. [Journal of Gerontological Nursing, 49(6), 6-12.].
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Coats H, Doyon K, Isaacson MJ, Tay D, Rosa WE, Mayahara M, Kates J, Frechman E, Wright PM, Boyden JY, Broden EG, Hinds PS, James R, Keller S, Thrane SE, Mooney-Doyle K, Sullivan SS, Xu J, Tanner J, Natal M. The 2023-2026 Hospice and Palliative Nurses Association Research Agenda. J Hosp Palliat Nurs 2023; 25:55-74. [PMID: 36843048 DOI: 10.1097/njh.0000000000000935] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The Hospice and Palliative Nursing Association established the triannual research agenda to ( a ) provide focus for researchers to conduct meaningful scientific and quality improvement initiatives and inform evidence-based practice, ( b ) guide organizational funding, and ( c ) illustrate to other stakeholders the importance of nursing research foci. HPNA Research Agendas are developed to give direction for future research to continue advancing expert care in serious illness and ensure equitable delivery of hospice and palliative care.
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Boufkhed S, Yurduşen S, Alarjeh G, Ahmed F, Alrjoub W, Guo P, Alajarmeh S, Şengelen M, Cemaloğlu M, Aydın B, Alnassan A, Al-Awady S, Kutluk T, Shamieh O, Harding R. Concerns and priority outcomes for children with advanced cancer and their families in the Middle East: A cross-national qualitative study. Front Oncol 2023; 13:1120990. [PMID: 36998436 PMCID: PMC10043430 DOI: 10.3389/fonc.2023.1120990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/13/2023] [Indexed: 03/15/2023] Open
Abstract
IntroductionPalliative care access is limited in the Middle-East, with few specialist centers and forcibly displaced migrants facing additional struggles to access care. Little is known about the specificities of providing palliative care to children and young people (CYP) with cancer. They are rarely asked directly their concerns and needs, which limits the provision of quality patient-centered care. Our study aims to identify the concerns and needs of CYP with advanced cancer and their families, in Jordan and Turkey.MethodA qualitative cross-national study in Jordan and Turkey with framework analysis was conducted two pediatric cancer centers in Jordan and Turkey. In each country, 25 CYP, 15 caregivers and 12 healthcare professionals participated (N=104). Most caregivers (70%) and healthcare professionals (75%) were women.ResultsWe identified five areas of concern: (1) Physical pain and other symptoms (e.g. mobility, fatigue); (2) Psychological concerns and needs (e.g. anger, psychological changes); (3) Spirituality, uncertainty over the future and use of “Tawakkul” (e.g. use of religion as a coping mechanism); (4) Negative impact on social life (e.g. social isolation, loss of support); (5) Burden on caregiver and their families (e.g. financial issues, siblings left behind). Psychological concerns were a priority for both CYPs and caregivers (particularly for refugee and displaced families) but often overlooked during routine care. CYP were able to share their own concerns and care priorities.ConclusionsAdvanced cancer care must ensure assessment and management of concerns across the concerns identified. Developing child- and family-centered outcomes would ensure monitoring the quality of care. Spirituality had a more important role compared to similar investigation in other regions.
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Affiliation(s)
- Sabah Boufkhed
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, United Kingdom
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, United Kingdom
- *Correspondence: Sabah Boufkhed,
| | - Sema Yurduşen
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
- Ankara Bilim Üniversitesi, Department of Psychology, Ankara, Türkiye
| | - Ghadeer Alarjeh
- Center for Palliative and Cancer Care in Conflict, King Hussein Cancer Center, Amman, Jordan
| | - Fahad Ahmed
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
| | - Waleed Alrjoub
- Center for Palliative and Cancer Care in Conflict, King Hussein Cancer Center, Amman, Jordan
| | - Ping Guo
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, United Kingdom
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Sawsan Alajarmeh
- Center for Palliative and Cancer Care in Conflict, King Hussein Cancer Center, Amman, Jordan
| | - Meltem Şengelen
- Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Cemaloğlu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
| | - Anwar Alnassan
- Paediatric Palliative Care, King Hussein Cancer Center, Amman, Jordan
| | - Shireen Al-Awady
- Paediatric Palliative Care, King Hussein Cancer Center, Amman, Jordan
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
| | - Omar Shamieh
- Center for Palliative and Cancer Care in Conflict, King Hussein Cancer Center, Amman, Jordan
- Department of Palliative Care, King Hussein Cancer Center, Amman, Jordan
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, United Kingdom
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Perry LM, Mossman B, Lewson AB, Gerhart JI, Freestone L, Hoerger M. Application of Terror Management Theory to End-Of-Life Care Decision-Making: A Narrative Literature Review. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221107723. [PMID: 35687031 PMCID: PMC9734278 DOI: 10.1177/00302228221107723] [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] [Indexed: 12/13/2022]
Abstract
Patients with serious illnesses often do not engage in discussions about end-of-life care decision-making, or do so reluctantly. These discussions can be useful in facilitating advance care planning and connecting patients to services such as palliative care that improve quality of life. Terror Management Theory, a social psychology theory stating that humans are motivated to resolve the discomfort surrounding their inevitable death, has been discussed in the psychology literature as an underlying basis of human decision-making and behavior. This paper explores how Terror Management Theory could be extended to seriously ill populations and applied to their healthcare decision-making processes and quality of care received.
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Affiliation(s)
- Laura M. Perry
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Psychology, Tulane University, New Orleans,
Louisiana, USA
| | - Brenna Mossman
- Department of Psychology, Tulane University, New Orleans,
Louisiana, USA
| | - Ashley B. Lewson
- Department of Psychology, Indiana University–Purdue
University Indianapolis, Indianapolis, Indiana, USA
| | - James I. Gerhart
- Department of Psychology, Central Michigan University,
Mount Pleasant, Michigan, USA
| | - Lily Freestone
- Department of Psychology, Tulane University, New Orleans,
Louisiana, USA
| | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans,
Louisiana, USA
- Departments of Psychiatry and Medicine, Tulane University
School of Medicine, New Orleans, Louisiana, USA
- Tulane Cancer Center, Tulane University School of
Medicine, New Orleans, Louisiana, USA
- Freeman School of Business, Tulane University, New
Orleans, Louisiana, USA
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LoBrutto LR, Fix G, Wiener RS, Linsky AM. Leveraging the timing and frequency of patient decision aids in longitudinal shared decision-making: A narrative review and applied model. Health Expect 2022; 25:1246-1253. [PMID: 35652372 PMCID: PMC9327840 DOI: 10.1111/hex.13531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Shared decision‐making (SDM) is intended to increase patient‐centredness of medical decision‐making for patients with acute and chronic conditions. Concurrently, patient decision aids (PtDAs) can supplement SDM by providing information to guide communication between patients and healthcare providers. Because of the prevalence of chronic conditions, where decisions may be extended or recurring, we sought to explore how effectively these tools have been leveraged in this context. Methods We conducted a narrative review of the literature on both SDM and PtDAs, searching PubMed and Boston University's library database search tool for English‐language articles published from January 2005 until March 2021. Additional search terms focused on temporality. Drawing from our findings, we developed a combined framework to highlight areas for future research using the discussion of end‐of‐life decisions as an exemplar to illustrate its relevance to chronic care contexts. Results After screening 57 articles, we identified 25 articles that fulfilled the inclusion criteria on SDM, PtDA use and temporality for chronic care. The literature on SDM highlighted time outside of the medical visit and opportunity to include outside decision partners as important elements of the process. PtDAs were commonly evaluated for process‐related and proximal outcomes, but less often for distal outcomes. Early evidence points to the value of comparative outcome evaluation based on the timing of PtDA distribution. Conclusion Our review of the literature on SDM and PtDAs reveals less attention to the timing of PtDAs relative to that of SDM. We highlight the need for further study of timing in PtDA use to improve longitudinal SDM for chronic care. The model that we propose in our discussion provides a starting point for future research on PtDA efficacy. Patient or Public Contribution Five patient consultants provided input and feedback on the development and utility of our model.
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Affiliation(s)
- Lara R LoBrutto
- Center for Healthcare Organization and Implementation Research, VA Boston & VA Bedford Healthcare Systems, Boston, Massachusetts, USA
| | - Gemmae Fix
- Center for Healthcare Organization and Implementation Research, VA Boston & VA Bedford Healthcare Systems, Boston, Massachusetts, USA.,Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Renda S Wiener
- Center for Healthcare Organization and Implementation Research, VA Boston & VA Bedford Healthcare Systems, Boston, Massachusetts, USA.,Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amy M Linsky
- Center for Healthcare Organization and Implementation Research, VA Boston & VA Bedford Healthcare Systems, Boston, Massachusetts, USA.,Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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13
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Washington KT, Demiris G, White P, Mathis HC, Forsythe JE, Parker Oliver D. A Goal-Directed Model of Collaborative Decision Making in Hospice and Palliative Care. J Palliat Care 2022; 37:120-124. [PMID: 34787009 PMCID: PMC9106802 DOI: 10.1177/08258597211049138] [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] [Indexed: 11/16/2022]
Abstract
Hospice and palliative care teams face numerous barriers to the meaningful involvement of patients and families in medical decision making, which limits opportunities for exploration of the very values, preferences, and goals that ideally inform serious illness care. Researchers who develop and test interventions to address these barriers have noted the complementary utility of two existing models in supporting collaborative relationships between hospice and palliative care teams and the patients and families they serve: (1) the social problem-solving model, and (2) the integrative model of shared decision making in medical encounters. This paper describes the integration and extension of these two highly synergistic models, resulting in a goal-directed model of collaborative decision making in hospice and palliative care. Directions for practice innovation and research informed by the model are discussed at length.
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Affiliation(s)
| | - George Demiris
- Penn Integrates Knowledge (PIK) University Professor, University of Pennsylvania, USA
| | | | | | | | - Debra Parker Oliver
- Washington University in St. Louis, USA
- Barnes-Jewish College, Goldfarb School of Nursing, USA
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14
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Aboumatar H, Pitts S, Sharma R, Das A, Smith BM, Day J, Holzhauer K, Yang S, Bass EB, Bennett WL. Patient engagement strategies for adults with chronic conditions: an evidence map. Syst Rev 2022; 11:39. [PMID: 35248149 PMCID: PMC8898416 DOI: 10.1186/s13643-021-01873-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patient and family engagement (PFE) has been defined as a partnership between patients, families, and health care providers to achieve positive health care outcomes. There is evidence that PFE is critical to improving outcomes. We sought to systematically identify and map the evidence on PFE strategies for adults with chronic conditions and identify areas needing more research. METHODS We searched PubMed, CINAHL, EMBASE, and Cochrane, January 2015 to September 2021 for systematic reviews on strategies for engaging patients with chronic conditions and their caregivers. From each review, we abstracted search dates, number and type of studies, populations, interventions, and outcomes. PFE strategies were categorized into direct patient care, health system, and community-policy level strategies. We found few systematic reviews on strategies at the health system, and none at the community-policy level. In view of this, we also searched for original studies that focused on PFE strategies at those two levels and reviewed the PFE strategies used and study findings. RESULTS We found 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. Four original studies addressed PFE at the health system or community-policy levels. Most direct patient care reviews focused on self-management support (SMS) (n = 85) and shared decision-making (SDM) (n = 43). Forty-nine reviews reported positive effects, 35 reported potential benefits, 37 reported unclear benefits, and 4 reported no benefits. Health system level strategies mainly involved patients and caregivers serving on advisory councils. PFE strategies with the strongest evidence focused on SMS particularly for patients with diabetes. Many SDM reviews reported potential benefits especially for patients with cancer. DISCUSSION Much more evidence exists on the effects of direct patient care strategies on PFE than on the effects of health system or community-policy strategies. Most reviews indicated that direct patient care strategies had positive effects or potential benefits. A limitation of this evidence map is that due to its focus on reviews, which were plentiful, it did not capture details of individual interventions. Nevertheless, this evidence map should help to focus attention on gaps that require more research in efforts to improve PFE.
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Affiliation(s)
- Hanan Aboumatar
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.
| | - Samantha Pitts
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Ritu Sharma
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Asar Das
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brandon M Smith
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeff Day
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine Holzhauer
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Sejean Yang
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Eric B Bass
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wendy L Bennett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
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15
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Mixed methods analysis of hospice staff perceptions and shared decision making practices in hospice. Support Care Cancer 2022; 30:2679-2691. [PMID: 34825279 PMCID: PMC9067598 DOI: 10.1007/s00520-021-06631-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Shared decision making has been a long-standing practice in oncology and, despite a lack of research on the subject, is a central part of the philosophical foundation of hospice. This mixed methods study examined the perceptions of staff regarding shared decision making and their use of shared decision elements in hospice interdisciplinary team meetings. METHODS The revised Leeds Attitude to Concordance scale (LatConII) was used to measure the attitudes of hospice staff toward shared decision making. Field notes and transcripts of hospice interdisciplinary team meetings that included family caregivers as participants were coded to identify 9 theory-driven shared decision making elements. The results were mixed in a matrix analysis comparing attitudes with practice. Three transcripts demonstrate the variance in the shared decision making process between hospice teams. RESULTS Hospice staff reported overall positive views on shared decision making; however, these views differed depending on participants' age and position. The extent to which staff views were aligned with the observed use of shared decision making elements in hospice interdisciplinary team meetings varied. CONCLUSION Policy and practice conditions can make shared decision making challenging during hospice interdisciplinary team meetings despite support for the process by staff. TRIAL REGISTRATION This study is a sub-study of a parent study registered with clinicaltrials.gov (NCT02929108).
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16
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García-Sanjuán S, Fernández-Alcántara M, Clement-Carbonell V, Campos-Calderón CP, Orts-Beneito N, Cabañero-Martínez MJ. Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review. Front Psychol 2022; 12:807869. [PMID: 35095694 PMCID: PMC8792401 DOI: 10.3389/fpsyg.2021.807869] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Congruence, understood as the agreement between the patient's preferred place of death and their actual place of death, is emerging as one of the main variables indicating the quality of end-of-life care. The aim of this research was to conduct a systematic literature review on levels and determinants of congruence in palliative patients over the period 2010-2021. Method: A systematic review of the literature in the databases of PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cuiden, the Cochrane Library, CSIC Indexes, and IBECS. Information was extracted on research characteristics, congruence, and associated factors. Results: A total of 30 studies were identified, mainly of retrospective observational design. The congruence values varied substantially between the various studies, ranging from 21 to 100%. The main predictors of congruence include illness-related factors (functional status, treatments and diagnosis), individual factors (age, gender, marital status, and end of life preferences), and environmental factors (place of residence, availability of health, and palliative care services). Conclusion: This review, in comparison with previous studies, shows that treatment-related factors such as physical pain control, marital status, having a non-working relative, age, discussing preferred place of death with a healthcare professional, and caregiver's preference have been associated with higher levels of congruence. Depending on the study, other factors have been associated with either higher or lower congruence, such as the patient's diagnosis, gender, or place of residence. This information is useful for designing interventions aimed towards greater congruence at the end of life.
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Affiliation(s)
- Sofía García-Sanjuán
- Department of Nursing, Alicante Institute for Health and Biomedical Research (ISABIAL), University of Alicante, Alicante, Spain
| | | | | | | | - Núria Orts-Beneito
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - María José Cabañero-Martínez
- Department of Nursing, Alicante Institute for Health and Biomedical Research (ISABIAL), University of Alicante, Alicante, Spain
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17
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Rosa WE, Buck HG, Squires AP, Kozachik SL, Huijer HAS, Bakitas M, Boit JM, Bradley PK, Cacchione PZ, Chan GK, Crisp N, Dahlin C, Daoust P, Davidson PM, Davis S, Doumit MAA, Fink RM, Herr KA, Hinds PS, Hughes TL, Karanja V, Kenny DJ, King CR, Klopper HC, Knebel AR, Kurth AE, Madigan EA, Malloy P, Matzo M, Mazanec P, Meghani SH, Monroe TB, Moreland PJ, Paice JA, Phillips JC, Rushton CH, Shamian J, Shattell M, Snethen JA, Ulrich CM, Wholihan D, Wocial LD, Ferrell BR. International consensus-based policy recommendations to advance universal palliative care access from the American Academy of Nursing Expert Panels. Nurs Outlook 2021; 70:36-46. [PMID: 34627615 DOI: 10.1016/j.outlook.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/26/2021] [Accepted: 06/17/2021] [Indexed: 12/24/2022]
Abstract
The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.
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Affiliation(s)
- William E Rosa
- Palliative Care & End-of-Life Expert Panel; Global Nursing & Health Expert Panel; Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) Health Expert Panel.
| | - Harleah G Buck
- Palliative Care & End-of-Life Expert Panel; Expert Panel on Aging
| | | | | | - Huda Abu-Saad Huijer
- Palliative Care & End-of-Life Expert Panel; Global Nursing & Health Expert Panel
| | | | | | | | | | | | | | | | | | - Patricia M Davidson
- Palliative Care & End-of-Life Expert Panel; Global Nursing & Health Expert Panel
| | | | | | | | - Keela A Herr
- Palliative Care & End-of-Life Expert Panel; Expert Panel on Aging
| | | | - Tonda L Hughes
- Global Nursing & Health Expert Panel; Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) Health Expert Panel
| | | | | | | | | | | | | | | | | | | | | | | | - Todd B Monroe
- Palliative Care & End-of-Life Expert Panel; Expert Panel on Aging
| | - Patricia J Moreland
- Palliative Care & End-of-Life Expert Panel; Global Nursing & Health Expert Panel
| | | | - J Craig Phillips
- Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) Health Expert Panel
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18
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Rosa WE, Pettus KI, De Lima L, Silvers A, Sinclair S, Radbruch L. Top Ten Tips Palliative Clinicians Should Know About Evidence-Based Advocacy. J Palliat Med 2021; 24:1240-1245. [PMID: 33944616 PMCID: PMC8418524 DOI: 10.1089/jpm.2021.0182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 02/06/2023] Open
Abstract
The escalating global burden of serious health-related suffering makes the need for funded policies that integrate palliative care (PC) into the continuum of services more urgent than ever. Palliative specialists are uniquely positioned to merge their clinical expertise with empirical evidence to advocate for improved PC delivery. There is a vital feedback loop between advocacy and clinical practice that palliative specialists can leverage to influence key stakeholders and decision makers and bridge PC policy deficits. Sustained interdisciplinary partnerships are critical to evidence-based PC advocacy that addresses resource gaps, social injustice, and unmet and disparate needs. Although PC advocacy may appear optional or even frivolous at times, it is an essential skill for any practitioner working to improve care for seriously ill individuals and their families. This article highlights 10 pragmatic tips that palliative specialists can use to advocate for policy changes that enhance PC access and equity at institutional, local, national, and global levels.
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Affiliation(s)
- William E. Rosa
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- International Association for Hospice and Palliative Care, Houston, Texas, USA
| | - Katherine I. Pettus
- International Association for Hospice and Palliative Care, Houston, Texas, USA
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston, Texas, USA
| | | | | | - Lukas Radbruch
- International Association for Hospice and Palliative Care, Houston, Texas, USA
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
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19
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Thodé M, Pasman HRW, van Vliet LM, Damman OC, Ket JCF, Francke AL, Jongerden IP. Feasibility and effectiveness of tools that support communication and decision making in life-prolonging treatments for patients in hospital: a systematic review. BMJ Support Palliat Care 2020; 12:262-269. [PMID: 33020150 PMCID: PMC9411882 DOI: 10.1136/bmjspcare-2020-002284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/12/2020] [Accepted: 09/04/2020] [Indexed: 11/19/2022]
Abstract
Objective Patients with advanced diseases and frail older adults often face decisions regarding life-prolonging treatment. Our aim was to provide an overview of the feasibility and effectiveness of tools that support communication between healthcare professionals and patients regarding decisions on life-prolonging treatments in hospital settings. Design Systematic review: We searched PubMed, CINAHL, PsycINFO, Embase, Cochrane Library and Google Scholar (2009–2019) to identify studies that reported feasibility or effectiveness of tools that support communication about life-prolonging treatments in adult patients with advanced diseases or frail older adults in hospital settings. The Mixed Methods Appraisal Tool was used for quality appraisal of the included studies. Results Seven studies were included, all involving patients with advanced cancer. The overall methodological quality of the included studies was moderate to high. Five studies described question prompt lists (QPLs), either as a stand-alone tool or as part of a multifaceted programme; two studies described decision aids (DAs). All QPLs and one DA were considered feasible by both patients with advanced cancer and healthcare professionals. Two studies reported on the effectiveness of QPL use, revealing a decrease in patient anxiety and an increase in cues for discussing end-of-life care with physicians. The effectiveness of one DA was reported; it led to more understanding of the treatment in patients. Conclusions Use of QPLs or DAs, as a single intervention or part of a programme, may help in communicating about treatment options with patients, which is an important precondition for making informed decisions.
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Affiliation(s)
- Maureen Thodé
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Center of Expertise in Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Liesbeth M van Vliet
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Olga C Damman
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Johannes C F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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20
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Cruz-Oliver DM, Pacheco Rueda A, Viera-Ortiz L, Washington KT, Oliver DP. The evidence supporting educational videos for patients and caregivers receiving hospice and palliative care: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:1677-1691. [PMID: 32241583 PMCID: PMC7495206 DOI: 10.1016/j.pec.2020.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study is to explore the evidence surrounding educational videos for patients and family caregivers in hospice and palliative care. We ask three research questions: 1. What is the evidence for video interventions? 2. What is the quality of the evidence behind video interventions? 3. What are the outcomes of video interventions? METHODS The study is a systematic review, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Researchers systematically searched five databases for experimental and observational studies on the evidence supporting video education for hospice and palliative care patients and caregivers, published in 1969-2019. RESULTS The review identified 31 relevant articles with moderate-high quality of evidence. Most studies were experimental (74 %), came from the United States (84 %) and had a mean sample size of 139 participants. Studies showed that video interventions positively affect preferences of care and advance care planning, provide emotional support, and serve as decision and information aids. CONCLUSION A strong body of evidence has emerged for video education interventions in hospice and palliative care. Additional research assessing video interventions' impact on clinical outcomes is needed. PRACTICE IMPLICATIONS Videos are a promising tool for patient and family education in hospice and palliative care.
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Affiliation(s)
- Dulce M Cruz-Oliver
- Palliative Medicine Program, Johns Hopkins Hospital, 600 N. Wolfe Street, Suite 342B, Baltimore, MD, 21287, USA.
| | - Angel Pacheco Rueda
- University of Puerto Rico, Medical Sciences Campus, School of Medicine, Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Liliana Viera-Ortiz
- University of Puerto Rico, Medical Sciences Campus, Department of Surgery, Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Karla T Washington
- Department of Family and Community Medicine, University of Missouri Medical Sciences Building, DC032.00, Columbia, MO, 65212, USA.
| | - Debra Parker Oliver
- Department of Family and Community Medicine, University of Missouri Medical Sciences Building, DC032.00, Columbia, MO, 65212, USA.
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21
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Death and Dying in the Emergency Department. Adv Emerg Nurs J 2020; 42:81-89. [PMID: 32358420 DOI: 10.1097/tme.0000000000000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) and to assist with the translation of research into practice. For each column, a topic and a particular research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. Our current column discusses factors associated with the quality of the death and dying experience in the emergency department (ED) from the perspective of health care providers with implications for APRN practice and strategies using the following study: . "Exploring the quality of the dying and death experience in the emergency department: An integrative literature review," International Journal of Nursing Studies, 85, 106-117. Our case involves a man with metastatic colon cancer where his oncology nurse practitioner recommends no further treatment and tells him he has approximately 6 months to live.
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22
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van der Smissen D, Overbeek A, van Dulmen S, van Gemert-Pijnen L, van der Heide A, Rietjens JA, Korfage IJ. The Feasibility and Effectiveness of Web-Based Advance Care Planning Programs: Scoping Review. J Med Internet Res 2020; 22:e15578. [PMID: 32181750 PMCID: PMC7109619 DOI: 10.2196/15578] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/04/2019] [Accepted: 12/16/2019] [Indexed: 01/20/2023] Open
Abstract
Background Advance care planning (ACP) is a process with the overall aim to enhance care in concordance with patients’ preferences. Key elements of ACP are to enable persons to define goals and preferences for future medical treatment and care, to discuss these with family and health care professionals, and to document and review these if appropriate. ACP is usually conducted through personal conversations between a health care professional, a patient, and—if appropriate—family members. Although Web-based ACP programs have the potential to support patients in ACP, their effectiveness is unknown. Objective This study aimed to assess the feasibility and effectiveness of Web-based, interactive, and person-centered ACP programs. Methods We systematically searched for quantitative and qualitative studies evaluating Web-based, interactive, and person-centered ACP programs in seven databases including EMBASE, Web of Science, Cochrane Central and Google Scholar. Data on the characteristics of the ACP programs’ content (using a predefined list of 10 key elements of ACP), feasibility, and effectiveness were extracted using a predesigned form. Results Of 3434 titles and abstracts, 27 studies met the inclusion criteria, evaluating 11 Web-based ACP programs—10 were developed in the United States and one in Ireland. Studied populations ranged from healthy adults to patients with serious conditions. Programs typically contained the exploration of goals and values (8 programs), exploration of preferences for treatment and care (11 programs), guidance for communication about these preferences with health care professionals or relatives (10 programs), and the possibility to generate a document in which preferences can be recorded (8 programs). Reportedly, participants were satisfied with the ACP programs (11/11 studies), considering them as easy to use (8/8 studies) and not burdensome (7/8 studies). Designs of 13 studies allowed evaluating the effectiveness of five programs. They showed that ACP programs significantly increased ACP knowledge (8/8 studies), improved communication between patients and their relatives or health care professionals (6/6 studies), increased ACP documentation (6/6 studies), and improved concordance between care as preferred by the patients and the decisions of clinicians and health care representatives (2/3 studies). Conclusions Web-based, interactive, and person-centered ACP programs were mainly developed and evaluated in the United States. They contained the key elements of ACP, such as discussing and documenting goals and preferences for future care. As participants considered programs as easy to use and not burdensome, they appeared to be feasible. Among the 13 studies that measured the effectiveness of programs, improvement in ACP knowledge, communication, and documentation was reported. The concordance between preferred and received care is yet understudied. Studies with high-quality study designs in different health care settings are warranted to further establish the feasibility and effectiveness of Web-based ACP programs.
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Affiliation(s)
- Doris van der Smissen
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anouk Overbeek
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Criminal Law, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Sandra van Dulmen
- Nivel (Netherlands institute for health services research), Utrecht, Netherlands.,Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, Netherlands.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Agnes van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Judith Ac Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Ida J Korfage
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
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23
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Alsirafy SA, Hammad AM, Ibrahim NY, Farag DE, Zaki O. Preferred Place of Death for Patients With Incurable Cancer and Their Family Caregivers in Egypt. Am J Hosp Palliat Care 2018; 36:423-428. [PMID: 30477314 DOI: 10.1177/1049909118813990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Little is known about the place of death of patients with cancer in Eastern Mediterranean countries including Egypt, where palliative care is underdeveloped. Identifying the preferred place of death (PPoD) is important for the development of appropriate palliative care models in these countries. OBJECTIVES: To know the PPoD of Egyptian patients with incurable cancer and their family caregivers (FCGs) and to determine the factors that may impact their preferences. METHODS: An observational cross-sectional study that included 301 dyads of patients with incurable cancer and one of their FCGs. A questionnaire was designed to collect data about the characteristics of patients and FCGs as well as their preferences. RESULTS: The majority of dyads (272/301, 90.4%) answered the PPoD question. Home was the PPoD in 93% of patients and 90.1% of FCGs ( P = .218). The congruence between patients' and FCGs' PPoD was 92.7% (κ = 0.526). In multivariate analysis, poorer performance status (Eastern Cooperative Oncology Group 3 or 4) and full employment of FCGs associated significantly with patients' preference to die in hospital (odds ratio [OR] = 3.015 [95% confidence interval [CI]: 1.004-9.054], P = .049 and OR = 4.402 [95% CI: 1.561-12.417], P = .005, respectively), while poorer performance status and nonreferral to the palliative medicine unit were associated with FCGs' preference of hospital death (OR = 2.705 [95% CI: 1.105-6.626], P = .029 and OR = 2.537 [95% CI: 1.082-5.948], P = .032, respectively). CONCLUSIONS: The results of the current study suggest that home is the PPoD for the vast majority of Egyptian patients with incurable cancer and their FCGs. Palliative care interventions that promote home death of patients with incurable cancer are needed in Egypt.
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Affiliation(s)
- Samy A Alsirafy
- 1 Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Ahmad M Hammad
- 1 Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Noha Y Ibrahim
- 2 Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Dina E Farag
- 1 Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Omar Zaki
- 2 Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
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