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Holdsworth LM, Siden R, Lessios AS, Verano M, Rickerson E, Fahy B, Johnston FM, Waterman B, Aslakson R. Patient Experiences of Specialty Palliative Care in the Perioperative Period for Cancer Surgery. J Pain Symptom Manage 2024; 68:292-298.e1. [PMID: 38906425 DOI: 10.1016/j.jpainsymman.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
CONTEXT Though patients undergoing treatment for upper gastrointestinal (GI) cancers frequently experience a range of sequelae and disease recurrence, patients often do not receive specialty palliative care soon after diagnosis and it is unknown in what ways they may benefit. OBJECTIVES To understand patient experiences of specialty palliative care in the perioperative period for patients seeking curative intent upper GI oncologic surgery. METHODS As part of a randomized controlled trial, we conducted in-depth interviews between November 2019 and July 2021 with 23 patients in the intervention arm who were undergoing curative intent treatment for upper GI cancers and who were also followed by the specialty palliative care team. RESULTS We found five themes that characterized patient experiences and perceptions of specialty palliative care. Patients typically had limited prior awareness of palliative care (theme 1), but during the study, came to understand it as a "talking" intervention (theme 2). Patients whose concerns aligned with palliative care described it as being impactful on their care (theme 3). However, most patients expressed a focus on cure from their cancer and less perceived relevance for integration of palliative care (theme 4). Integrating specialist palliative care practitioners with surgical teams made it difficult for some patients to identify how palliative care practitioners differed from other members of their care team (theme 5). CONCLUSION While receipt of specialty palliative care in the perioperative period was generally perceived positively and patients appreciated palliative care visits, they did not describe many needs typically met by palliative care practitioners. TRIAL REGISTRATION clinicaltrials.gov registration: NCT03611309.
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Affiliation(s)
- Laura M Holdsworth
- Division of Primary Care and Population Health (L.M.H., R.S., A.S.L., M.V.), Stanford University School of Medicine, Palo Alto, California, USA.
| | - Rachel Siden
- Division of Primary Care and Population Health (L.M.H., R.S., A.S.L., M.V.), Stanford University School of Medicine, Palo Alto, California, USA
| | - Anna Sophia Lessios
- Division of Primary Care and Population Health (L.M.H., R.S., A.S.L., M.V.), Stanford University School of Medicine, Palo Alto, California, USA
| | - Mae Verano
- Division of Primary Care and Population Health (L.M.H., R.S., A.S.L., M.V.), Stanford University School of Medicine, Palo Alto, California, USA
| | - Elizabeth Rickerson
- Department of Psychosocial Oncology and Palliative Care (E.R.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Anesthesiology (E.R.), Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bridget Fahy
- Department of Surgery (B.F.), Division of Surgical Oncology and Department of Internal Medicine, Division of Palliative Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Fabian M Johnston
- Department of Surgery (F.M.J.), Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Brittany Waterman
- Department of Internal Medicine (B.W.), Division of Palliative Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Rebecca Aslakson
- Department of Anesthesiology (R.A.), Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
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Haroen H, Maulana S, Harlasgunawan AR, Rahmawati S, Riansyah A, Musthofa F, Pardosi JF. Barriers and Facilitators of Early Palliative Care in the Trajectory of People Living with Chronic Condition: A Mini Review Using Socio-ecological Framework to Inform Public Health Strategy. J Multidiscip Healthc 2024; 17:4189-4197. [PMID: 39224483 PMCID: PMC11368106 DOI: 10.2147/jmdh.s473457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
The increasing incidence of chronic conditions on a global scale requires a comprehensive approach to palliative care, which is recognized as an essential element of the continuum of care for people with life-threatening conditions. It has been argued that the integration of early palliative care for people with chronic conditions is beneficial. Nevertheless, barriers to integrating early palliative care have been extensively not reviewed. This review aimed to explore the barriers and facilitators of integrating early palliative care for people living with chronic conditions, employing a socio-ecological framework to provide a critical understanding of the influencing factors at multiple levels. The method was a mini review. This review emphasizes the complex and diverse factors that either hinder or facilitate progress in four areas: individual (such as gaps in knowledge and emotional reactions), interpersonal (such as support from family caregiver), healthcare professionals and policy (such as barriers in education, guidelines, and collaboration among professionals), and community (such as societal knowledge and attitudes). Each level presents unique challenges and opportunities for enhancing early palliative care integration, from addressing misconceptions and fears at the individual level, to fostering supportive policies and community awareness. In conclusion, the effective management of early palliative care requires a comprehensive strategy that spans various dimensions, including educational initiatives, policy adjustments, and active involvements of the community. Healthcare systems are supposed to enhance the integration of early palliative care into the trajectory of chronic conditions and enhance the quality of life of affected persons and their families by recognizing and addressing the socio-ecological elements involved.
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Affiliation(s)
- Hartiah Haroen
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Sidik Maulana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Alia Rahmi Harlasgunawan
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
- Nursing Department, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Sri Rahmawati
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Alvi Riansyah
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Faizal Musthofa
- Nursing Department, Universitas Padjadjaran Hospital, Sumedang, Indonesia
| | - Jerico Franciscus Pardosi
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Matthys M, Chambaere K, Beernaert K, Cohen J, Van Brussel L, Deforche B, Quintiens B, Deliens L, Dhollander N. What does the general public know about palliative care? A population-based survey. BMJ Support Palliat Care 2024; 14:335-344. [PMID: 37699664 DOI: 10.1136/spcare-2023-004384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES The need for public education on palliative care has been widely argued for. To develop effective educational strategies, a stronger evidence base is needed on what exactly is known and unknown about palliative care as well as what the differences are between subgroups. METHODS We conducted a cross-sectional population-based survey. Mail questionnaires were sent to a random sample of 4400 citizens (aged ≥16 years) within 4 municipalities in Flanders, Belgium. The Palliative Care Knowledge Scale (PaCKS) was used to measure knowledge. Associations between knowledge and sociodemographics and various experiential factors were tested, as well as the congruence between actual and self-perceived knowledge scores. RESULTS Response was obtained from 2008 (45.6%) citizens. The mean PaCKS score was 7.87 (SD 3.41; range 0-13) with the highest proportion (84.7%) correctly answering that palliative care is not specifically for older adults and the lowest (32.1%) correctly answering that improving the ability to participate in daily life is a palliative care goal. Being aged between 30 and 59, non-religious, more highly educated, having professional healthcare experience and knowing palliative care through personal experience were significantly associated with higher knowledge, while sex and informal caregiving experience were not. 52.4% self-perceived their knowledge as lower than it actually was. CONCLUSIONS While the general public seems to be familiar with some basic concepts of palliative care, several key aspects remain unknown. Educational strategies, with suggested potential for community-based and experience-based approaches, may need to focus specifically on these aspects and not just on the broader palliative care concept.
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Affiliation(s)
- Marjolein Matthys
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kim Beernaert
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Medicine & Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Benedicte Deforche
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Movement and Nutrition for Health and Performance Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Bert Quintiens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Medicine & Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Naomi Dhollander
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
- Department of Medicine & Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Heckel M, Peters J, Schweighart S, Habermann M, Ostgathe C. Knowledge and Public Perception of Palliative Care in Germany. J Palliat Med 2024; 27:986-992. [PMID: 38625024 DOI: 10.1089/jpm.2023.0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Background: Literature reviews reveal poor knowledge and awareness of palliative care in the public. Health literacy deficits impact access to palliative care. Objectives: The aim of this manuscript is to explore the public perception of palliative care in Germany. Design: Triangulated qualitative research design: a snowball-spread online survey and a random pedestrian survey. Setting/Subjects: Citizens in Germany. Results: The pedestrian survey (n = 100) revealed 34% of the participants being not familiar with palliative care. The online survey (n = 994) 5.7% of participants reported to not know what palliative care was. The public's perception of palliative care is mainly medicine oriented, referring to inpatient care for the immediately dying; however, further significant misperceptions were scarce. Conclusions: The public perception shows an indistinct picture of palliative care, and some misconceptions about the objectives and areas of responsibility of the subject, meanwhile, palliative care is known to a majority of people. Understanding partly incomplete pictures of patients and relatives may help to react appropriately in staff-patient interactions and improve public relations.
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Affiliation(s)
- Maria Heckel
- Department of Palliative Medicine, CCC Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Joachim Peters
- Department of German Linguistics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Susanna Schweighart
- Department of Palliative Medicine, CCC Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Mechthild Habermann
- Department of German Linguistics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Ostgathe
- Department of Palliative Medicine, CCC Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Al-Atiyyat N, Ibraheemi AA, Rababa M, Othman WM, Khait AA, Jaradat DAS. Public Awareness of Palliative Care: A Nationally Representative Sample of Jordanian Adults. J Pain Symptom Manage 2024; 68:123-131. [PMID: 38679305 DOI: 10.1016/j.jpainsymman.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024]
Abstract
CONTEXT Internationally, studies suggest that inadequate comprehension of the concept of palliative care and misconceptions about it hinder the effective use of palliative care, especially in developing nations. OBJECTIVE To assess the awareness of the adult population in Jordan regarding palliative care. METHODS The study used a cross-sectional design and an online self-administered questionnaire survey. The recruitment method was convenience snowball sampling of three thousand nine hundred forty-two Jordanian adults covering 12 governorates. Participants were recruited through social media platforms like Facebook and WhatsApp. The process of gathering data commenced in October -December 2023. Descriptive statistics were computed. RESULTS A study of 3942 respondents in Jordan found that 45% have some knowledge of palliative care, with 31% being pretty knowledgeable. Most respondents (89%) strongly agree that patients with incurable illnesses should receive palliative care, with cancer patients showing the highest level of agreement (96%). The most agreed-upon aspect of palliative care is controlling pain and symptoms at home, while the least agreed-upon aspect is providing information on benefits and financial matters. The study also highlighted the link between palliative care and mortality, suggesting the need for increased awareness and education. CONCLUSION The demand for palliative care in Jordan is increasing, requiring increased access, a holistic approach, open discussions, and easily accessible information. Challenges include integrating palliative care into non-malignant progressive diseases, ensuring comprehensive end-of-life care, promoting societal receptiveness towards mortality, enhancing information accessibility, and health promotion efforts. The study's results indicate the importance of implementing educational strategies and engaging families and communities in policymaking to change public knowledge and attitudes toward palliative care.
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Affiliation(s)
- Nijmeh Al-Atiyyat
- Department of Adult Health Nursing (N.A.-A.), Faculty of Nursing, The Hashemite University, Zarqa, Jordan.
| | | | - Majdi Rababa
- Department of Adult Health Nursing (M.R., W.M.O.), Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Wafa'a Mousa Othman
- Department of Adult Health Nursing (M.R., W.M.O.), Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Abdallah Abu Khait
- Department of Community and Mental Health Nursing (A.A.K.), Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Dima Ali Salem Jaradat
- Department of Adult Health Nursing (D.A.S.J.), Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Masters JL, Josh PW, Kirkpatrick AJ, Kovaleva MA, Sayles HR. Providing clarity: communicating the benefits of palliative care beyond end-of-life support. Palliat Care Soc Pract 2024; 18:26323524241263109. [PMID: 39045294 PMCID: PMC11265247 DOI: 10.1177/26323524241263109] [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: 02/01/2024] [Accepted: 06/03/2024] [Indexed: 07/25/2024] Open
Abstract
Background Palliative care affords numerous benefits, including improvements in symptom management, mental health, and quality of life, financial savings, and decreased mortality. Yet palliative care is poorly understood and often erroneously viewed as end-of-life care and hospice. Barriers for better education of the public about palliative care and its benefits include shortage of healthcare providers specializing in palliative care and generalist clinicians' lack of knowledge and confidence to discuss this topic and time constraints in busy clinical settings. Objectives Explore and compare the knowledge, values, and practices of community-dwelling adults 19 years and older from Nebraska about serious illness and end-of-life healthcare options. Design Secondary analysis of cross-sectional data collected in 2022 of 635 adults. We examined the fifth wave (2022) of a multiyear survey focusing on exploring Nebraskans' understanding of and preferences related to end-of-life care planning. Methods Descriptive statistics and chi-square tests to compare results between groups. Univariable and multivariable logistic regression analyses examine associations of variables as to knowledge of hospice and palliative care. Results While 50% of respondents had heard a little or a lot about palliative care, 64% either did not know or were not sure of the difference between palliative care and hospice. Those who reported being in poor health were not more likely to know the difference between palliative care and hospice compared to those reporting being in fair, good, or excellent health. Conclusion This study offers insight into the knowledge and attitudes about palliative care among community-dwelling adults, 19 years and older living in Nebraska. More effort is needed to communicate what palliative care is, who can receive help from it, and why it is not only for people at end of life. Advance care planning discussions can be useful in offering clarity.
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Affiliation(s)
- Julie L. Masters
- Department of Gerontology, University of Nebraska Omaha, 312 Nebraska Hall, 901 North 17 Street, Lincoln, NE 68588-0562, USA
| | - Patrick W. Josh
- Department of Gerontology, University of Nebraska Omaha, Omaha, NE, USA
| | | | - Mariya A. Kovaleva
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Harlan R. Sayles
- University of Nebraska Medical Center College of Public Health, Omaha, NE, USA
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Presley CJ, Dalal N, Davenport AP, Gounden A, Ramchandran K, Tonorezos E. Survivorship in Advanced Lung Cancer: Understanding a New Landscape and Opportunities. Am Soc Clin Oncol Educ Book 2024; 44:e433298. [PMID: 38768420 DOI: 10.1200/edbk_433298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
People with advanced lung cancer represent a distinct group whose needs remain understudied, especially compared with people diagnosed with limited-stage disease. Fortunately, novel treatments such as tyrosine kinase inhibitors and immune checkpoint inhibitors are leading to significant advances in prognosis and survival, even among those with advanced disease at the time of diagnosis. However, there are known gaps in symptom management, psychosocial and nutritional support, complex care coordination, health behavior coaching, and health care delivery efforts among patients living with advanced lung cancer. Many of these patients would benefit from survivorship and palliative care approaches. In particular, survivorship care may include health care maintenance, treatment of immune-related adverse events and late- or long-term effects, frailty assessment and rehabilitation, and care coordination. Palliative care may be best suited to discuss ongoing symptom management, advanced care planning, and end-of-life considerations, as well as psychosocial well-being. To this end, we share a review of the current status of the palliative and survivorship care infrastructure for patients with advanced lung cancer and provide suggestions across the care continuum for this diverse group of patients and families.
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Affiliation(s)
- Carolyn J Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Ashley P Davenport
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
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Ibrahim AM, Elnaghy SF, Abo Elmatty GM, Mohamed Ghida NI, Mohamed MA. Effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy in Port Said City: A pre-post quasi-experimental study. Palliat Support Care 2024; 22:546-562. [PMID: 38287515 DOI: 10.1017/s1478951523002067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
BACKGROUND Emphasizing the pivotal role of caregivers in the cancer care continuum, a program designed to educate caregivers of cancer patients undergoing chemotherapy underscores their significance. The palliative care education initiative strives to cultivate a compassionate and effective care environment, benefiting both patients and caregivers. By imparting education, fostering positive attitudes, offering support, encouraging appropriate behaviors, and providing essential resources, the program aims to enhance the overall caregiving experience and contribute to the well-being of those navigating the challenges of cancer treatment. OBJECTIVES To evaluate the effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy. METHODS The research employed a purposive sample comprising 155 caregivers who were actively present with their cancer patients throughout the pre- and post-test phases within a quasi-experimental research design. The study took place at the outpatient oncology center of Al-Shifa Medical Complex in Port Said City, Egypt. To gather comprehensive data, 4 instruments were utilized: a demographic questionnaire, a nurse knowledge questionnaire, a scale measuring attitudes toward palliative care, and an assessment of reported practices in palliative care. This methodological approach allowed for a thorough exploration of caregiver perspectives, knowledge, attitudes, and practices within the context of a palliative care education program. RESULTS Before the palliative care education program, only 1.3% of caregivers had a good overall level of knowledge about cancer and palliative care; this increased to 40.6% after the program. Similarly, before the palliative care education program, 32.9% of caregivers had a positive overall attitude, which increased to 72.3% after the program. Similarly, 27.1% of caregivers had an overall appropriate palliative care practice during the pre-test phase, which increased to 93.5% after the palliative care education program. SIGNIFICANCE OF THE RESULTS The palliative care education program significantly improved caregivers' knowledge, attitudes, and practice scores. It is strongly recommended that caregivers of cancer patients receive continuing education in palliative care. In addition, it is crucial to conduct further research with a larger sample size in different situations in Egypt.
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Affiliation(s)
- Ateya Megahed Ibrahim
- College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Sara Fawzy Elnaghy
- Family and Community Health Nursing Department, Health Technical Institute in Port Said, Port Said, Egypt
| | - Gehad Mohamed Abo Elmatty
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| | | | - Magda Ali Mohamed
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
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Batzler YN, Schallenburger M, Schwartz J, Marazia C, Neukirchen M. The General Public and Young Adults' Knowledge and Perception of Palliative Care: A Systematic Review. Healthcare (Basel) 2024; 12:957. [PMID: 38786369 PMCID: PMC11121430 DOI: 10.3390/healthcare12100957] [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: 04/16/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Background: As a result of demographic change, chronic and oncological diseases are gaining importance in the context of public health. Palliative care plays a crucial role in maintaining the quality of life of those affected. International guidelines demand access to palliative care not only for the elderly but also for younger people who face severe illnesses. It can be assumed that palliative care will become increasingly important for them. In order to develop public health strategies which are able to promote palliative care, it is important to assess the knowledge of, and attitude towards, palliative care as found among members of the general public and its specific target groups. In particular, little is known about young adults' knowledge and perceptions of palliative care. Objectives and design: This work aimed to assess the understanding and viewpoints regarding palliative care among the general population and among young adults aged 18 to 24. We therefore conducted a systematic review, which, for this target population, could be seen as a novel approach. Methods: Exclusion and inclusion criteria were developed using the PICOS process. Literature was researched within MEDLINE (via PubMed), Google Scholar and Web of Science. A search string was developed and refined for all three databases. Grey literature was included. Duplicates were excluded using Mendeley. The literature was independently screened by two researchers. Narrative synthesis was used to answer the main research question. Results: For the general public, palliative care is still associated with death and dying and comforting sick people towards the end of their lives. Multiple social determinants are linked to better knowledge of palliative care: higher education, higher income, female gender, having relatives that received palliative care, and permanent employment. The population's knowledge of palliative care structures increases, the longer such structures have been established within a country. Young adults are familiar with the term palliative care, yet their understanding lacks nuance. They associate palliative care with death and dying and perceive palliative care to be a medical discipline primarily for the elderly. Nevertheless, young adults demand participation within the planning of interventions to destigmatize palliative care. Conclusions: The general public still lacks a detailed understanding of palliative care. Palliative care faces stigma at multiple levels, which creates barriers for those who set out to implement it. However, addressing young adults as a crucial peer group can help break down barriers and promote access to palliative care.
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Affiliation(s)
- Yann-Nicolas Batzler
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (Y.-N.B.); (J.S.); (M.N.)
| | - Manuela Schallenburger
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (Y.-N.B.); (J.S.); (M.N.)
| | - Jacqueline Schwartz
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (Y.-N.B.); (J.S.); (M.N.)
| | - Chantal Marazia
- Department of the History, Philosophy and Ethics of Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany;
| | - Martin Neukirchen
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (Y.-N.B.); (J.S.); (M.N.)
- Department of Anesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
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Pask S, Omoruyi A, Mohamed A, Chambers RL, McFarlane PG, Johansson T, Kumar R, Woodhead A, Okamoto I, Barclay S, Higginson IJ, Sleeman KE, Murtagh FEM. Telephone advice lines for adults with advanced illness and their family carers: a qualitative analysis and novel practical framework. Palliat Med 2024; 38:555-571. [PMID: 38600058 PMCID: PMC11107135 DOI: 10.1177/02692163241242329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Telephone advice lines have been recommended internationally to support around-the-clock care for people living at home with advanced illness. While they undoubtedly support care, there is little evidence about what elements are needed for success. A national picture is needed to understand, improve and standardise service delivery/care. AIM To explore telephone advice lines for people living at home with advanced illness across the four UK nations, and to construct a practical framework to improve services. DESIGN A cross-national evaluation of telephone advice lines using structured qualitative interviews. A patient and public involvement workshop was conducted to refine the framework. SETTING/PARTICIPANTS Professionals with responsibilities for how palliative care services are delivered and/or funded at a local or regional level, were purposively sampled. RESULTS Seventy-one interviews were conducted, covering 60 geographical areas. Five themes were identified. Availability: Ten advice line models were described. Variation led to confusion about who to call and when. Accessibility, awareness and promotion: It was assumed that patients/carers know who to call out-of-hours, but often they did not. Practicalities: Call handlers skills/expertise varied, which influenced how calls were managed. Possible responses ranged from signposting to organising home visits. Integration/continuity of care: Integration between care providers was limited by electronic medical records access/information sharing. Service structure/commissioning: Sustained funding was often an issue for charitably funded organisations. CONCLUSIONS Our novel evidence-based practical framework could be transformative for service design/delivery, as it presents key considerations relating to the various elements of advice lines that may impact on the patient/carer experience.
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Affiliation(s)
- Sophie Pask
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Allen Omoruyi
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Ahmed Mohamed
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Rachel L Chambers
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Phillippa G McFarlane
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Therese Johansson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Rashmi Kumar
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Andy Woodhead
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Ikumi Okamoto
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
- King’s College Hospital NHS Foundation Trust, London, UK
| | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
- King’s College Hospital NHS Foundation Trust, London, UK
| | - Fliss EM Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
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11
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Trevizan FB, Paiva CE, de Almeida LF, de Oliveira MA, Bruera E, Paiva BSR. When and how to discuss about palliative care and advance care planning with cancer patients: A mixed-methods study. Palliat Support Care 2024; 22:387-395. [PMID: 37885316 DOI: 10.1017/s1478951523001517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVES To identify the patients who are most likely to participate in discussions about palliative care (PC) and advance care planning (ACP), and to determine their preferred timing and approach of discussion. METHODS The study included women aged 18-75 years diagnosed with breast cancer. In the quantitative phase, sociodemographic and clinical characteristics, knowledge, decision-making, and stigmas were evaluated. The qualitative phase included questions about patients' understanding, timing, and method of discussing PC and ACP, which were analyzed by Bardin's content analysis. RESULTS In Phase 1, a total of 115 participants were included, with 53.04% completing both phases and 46.96% declining further participation. Those who completed both phases exhibited higher rates of marriage and educational attainment, while those who declined Phase 2 had a higher prevalence of advanced-stage cancer and palliative treatment. Completion of both phases was associated with a greater knowledge of reality and increased awareness of PC and ACP. Furthermore, the qualitative analysis revealed 5 convergent themes: timing, demystification, patient empowerment, misconception elimination, and open communication. These themes informed the development of a conceptual model that provides a framework for discussing PC and ACP with patients at different stages of cancer diagnosis and treatment, highlighting appropriate and inappropriate approaches and timing. SIGNIFICANCE OF RESULTS Early discussion is beneficial, but withholding information or infringing on autonomy should be avoided. The study reveals that married and highly educated individuals tend to be more receptive to these discussions. However, patients with late-stage cancer tend to decline participation. Patients value open communication, demystification of PC, and empowering discussions that eliminate misunderstandings. Efforts should be made to reach patients with limited familiarity, particularly those with late-stage cancer, to increase their receptiveness to enable well-informed decision-making.
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Affiliation(s)
- Fulvio Bergamo Trevizan
- GPQual - Research Group on Palliative Care and Quality of Life - Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Carlos Eduardo Paiva
- GPQual - Research Group on Palliative Care and Quality of Life - Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Laura Fiacadori de Almeida
- GPQual - Research Group on Palliative Care and Quality of Life - Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Marco Antonio de Oliveira
- GPQual - Research Group on Palliative Care and Quality of Life - Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bianca Sakamoto Ribeiro Paiva
- GPQual - Research Group on Palliative Care and Quality of Life - Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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12
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Altarifi AA, Baker M, Abedal-Kareem K, Abu-Ishqair A, AbuMelhim Z, Abu Shetayyah S, Almhdawi KA. Knowledge and Attitude of the General Public Toward Palliative Care in Jordan: A Cross-Sectional Study. Am J Hosp Palliat Care 2024:10499091241231781. [PMID: 38321762 DOI: 10.1177/10499091241231781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Palliative care is directed to relieve the symptoms of serious and life-threatening illnesses. Unfortunately, it's usually provided lately in the disease course in developing countries due to a lack of awareness about its concept, which deprives many patients of its benefits. This study aims to investigate the knowledge and attitude of the Jordanian general public toward palliative care. A cross-sectional study was conducted using an electronic questionnaire via social media platforms. Knowledge about palliative care was measured using the "Palliative Care Knowledge Scale" (PaCKS), whereas the attitude was measured using an edited version of the "Frommelt Attitudes Toward Care of the Dying -B(FATCOD-B)" tool. The inclusion criteria were adults older than 18 years old who live in Jordan. Any subject who was younger than 18 years old, refused to give informed consent, and working or studying in a healthcare-related profession was excluded. 329 respondents filled out the survey (females = 214 (65%), mean age = 32.7 ± (13.63) years). Only 67 respondents (20.4%) heard about palliative care previously. The average knowledge score (out of 13) was 6.8 (±4.2). The average attitude score (out of 5) was 3.0 (±.4). Higher knowledge self-evaluation, older age, and higher income were factors associated with a higher level of knowledge and favorable attitude toward palliative care. Our study showed a moderate knowledge and neutral attitude toward palliative care. Further awareness campaigns should be conducted to raise the awareness of the Jordanian society regarding the objectives of palliative care.
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Affiliation(s)
- Ahmad A Altarifi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed Baker
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Kenda Abedal-Kareem
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Zaina AbuMelhim
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Khader A Almhdawi
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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13
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Sansone H, Ekberg S, Lord S, Stevenson J, Martinez K, Yates P. Managing understandings of palliative care as more than care immediately before death: Evidence from observational analysis of consultations. Health Expect 2024; 27:e13903. [PMID: 37926927 PMCID: PMC10726268 DOI: 10.1111/hex.13903] [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: 04/07/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Evidence suggests that public, and some professional, understandings of palliative care are limited to care provided immediately before death, which contrasts palliative care's scope as care provided across a range of illness stages. OBJECTIVE To examine how clinicians manage patients' understandings of palliative care during initial consultations. DESIGN Initial palliative care consultations were video-recorded and analysed using conversation analytic methods. SETTING/PARTICIPANTS Consultations were recorded in a specialist palliative care outpatient unit within an Australian public hospital. Participants included 20 newly referred patients and their families, and three palliative care clinicians. RESULTS During initial consultations, it was observed that specialist palliative care clinicians frequently managed the possibility that patients may understand palliative care as limited to care provided immediately before death. Clinicians used recurrent practices that seemed designed to pre-empt and contradict patients' possible narrow understandings. When discussing the palliative care inpatient unit, clinicians recurrently explained inpatient care could include active treatment and referred to the possibility of being discharged. These practices contradict possible understandings that future admission to the inpatient unit would be solely for care immediately before death. DISCUSSION The findings demonstrate that palliative care clinicians are aware of possible narrow understandings of their discipline among members of the public. The practices identified show how clinicians pre-emptively manage these understandings to patients newly referred to palliative care. CONCLUSIONS These findings highlight scope for greater partnership with teams referring patients to palliative care, to assist patients in understanding the range of reasons for their referral. PATIENT OR PUBLIC CONTRIBUTION The observational method of conversation analysis provides direct insight into matters that are relevant for patients, as raised in their consultations with clinicians. This direct evidence enables analysis of their lived experience, as it occurs, and grounds analysis in observable details of participants' conduct, rather than interpretations of subjective experiences. The patients' contributions, therefore, were to allow observation into their initial palliative care consultations.
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Affiliation(s)
- Holly Sansone
- School of Psychology and CounsellingQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Stuart Ekberg
- School of Psychology and CounsellingQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Sarah Lord
- The Prince Charles HospitalChermsideQueenslandAustralia
| | - James Stevenson
- Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Katherine Martinez
- Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Patsy Yates
- Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
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14
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Balasubramanian I, Malhotra C. Why is end-of-life inpatient cost high among cancer patients? A prospective cohort study. Cancer Med 2024; 13:e7057. [PMID: 38457240 PMCID: PMC10923043 DOI: 10.1002/cam4.7057] [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: 10/30/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Inpatient cost for cancer patients is high during the last year of life, but reasons for this are not understood. We aim to understand the type of hospital admissions and inpatient services associated with an increase in inpatient cost in last year of life. METHODS We used survey and billing records of 439 deceased patients with a solid metastatic cancer, enrolled in a prospective cohort study. Based on cost per day of inpatient admissions, we classified admissions as low- or high-intensity. We decomposed the inpatient cost into cost for different inpatient services. We examined the inpatient cost in the last year of life. We also assessed patient characteristics associated with higher inpatient cost in the next 3 months. RESULTS Towards death, proportion of inpatient cost for "maintenance care" increased while that for intensive care unit (ICU) and surgeries decreased. Low-intensity, compared to high-intensity admissions had a higher proportion of cost for "maintenance care" and a lower proportion for surgeries and ICU. Number of low-intensity admissions increased more steeply towards death than high-intensity admissions. Both admission types contributed equally to the share of inpatient cost. Older patients were less likely to have a high-intensity admission (β:-0.01, CI: -0.02, 0.00). Greater preference for life extension (β: 0.06, CI: 0.01, 0.11) and inaccurate prognostic belief were associated with higher cost of high-intensity admissions (β: 0.32, CI: 0.03, 0.62). CONCLUSIONS Findings suggest that inpatient costs in last year of life may be reduced if maintenance care is availed in low-cost settings such as hospice/palliative care alongside steps to reduce non-beneficial surgeries and ICU admissions.
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Affiliation(s)
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke‐NUS Medical SchoolSingaporeSingapore
- Program in Health Services and Systems Research, Duke‐NUS Medical SchoolSingaporeSingapore
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15
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Smith GM, Singh N, Hui F, Sossenheimer PH, Hannah JM, Romano P, Wong HN, Heidari SN, Harman SM. Education About Specialty Palliative Care Among Nonhealthcare Workers: A Systematic Review. J Pain Symptom Manage 2024; 67:e70-e89. [PMID: 37797678 DOI: 10.1016/j.jpainsymman.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/15/2023] [Accepted: 09/16/2023] [Indexed: 10/07/2023]
Abstract
CONTEXT Despite the expansion of palliative care (PC) services, the public has little knowledge and holds misperceptions about PC, creating barriers to accessing timely specialty PC. OBJECTIVES To systematically review the evidence regarding the efficacy of educational interventions to improve knowledge and attitudes about PC among nonhealthcare workers. METHODS We searched five databases (PubMed/MEDLINE, Embase, CIANHL, Web of Science, and Scopus) for studies investigating educational interventions about specialty PC in adults who identified as patients, caregivers, or members of the public. We included studies that were available in English and had a comparator group. We excluded studies that only sampled health professionals or children. We used the Mixed Methods Appraisal Tool to assess quality and risk of bias. RESULTS Of 12,420 records identified, we screened 5948 abstracts and assessed 526 full texts for eligibility. Twenty-one articles were extracted for analysis, representing 20 unique educational interventions. Common methodologies included quasi-experimental (9, 45%), randomized controlled trial (4, 20%), and nonrandomized trial (2, 10%). Common components of the educational interventions included video presentations (9, 45%), written materials (8, 40%), and lectures (4, 20%). Content included definition (14, 70%) and philosophy (14, 70%) of PC, distinctions between PC and hospice (11, 55%), and eligibility for PC (11, 55%). Fourteen (70%) interventions showed statistically significant positive differences in either knowledge or attitudes about PC. CONCLUSIONS While educational interventions can positively impact knowledge and attitudes about PC among nonhealthcare workers, more research is needed to inform the design, delivery, and evaluation of interventions to increase knowledge and attitudes about PC.
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Affiliation(s)
- Grant M Smith
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA.
| | - Nainwant Singh
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Felicia Hui
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Philip H Sossenheimer
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Josef M Hannah
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Pablo Romano
- Columbia University Vagelos College of Physicians and Surgeons (P.R.), New York, NY
| | - Hong-Nei Wong
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Shireen N Heidari
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
| | - Stephanie M Harman
- Stanford University School of Medicine (G.M.S., N.S., F.H., P.H.S., H.W., S.N.H., S.M.H.), Stanford, CA
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16
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Doubova SV, Bhadelia A, Pérez-Moran D, Martinez-Vega IP, García-Cervantes N, Knaul F. Dimensions of suffering and the need for palliative care: experiences and expectations of patients living with cancer and diabetes and their caregivers in Mexico - a qualitative study. BMJ Open 2023; 13:e075691. [PMID: 38101838 PMCID: PMC10729252 DOI: 10.1136/bmjopen-2023-075691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/16/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVES Over 40 million people in low-income and middle-income countries (LMICs) experience serious health-related suffering (SHS) annually and require palliative care. Patient and caregiver experiences of SHS in LMICs are understudied despite their importance in guiding palliative care provision. Diabetes and cancer are the second-leading and third-leading causes of death in Mexico, causing a significant SHS burden on patients, families and health systems. This study examines SHS and palliative care from the point of view of patients with cancer and diabetes and their caregivers. DESIGN A qualitative descriptive study based on in-depth telephone interviews was conducted between August 2021 and February 2022. Data were analysed through inductive thematic analysis. PARTICIPANTS Overall, 20 patients with end-stage cancer, 13 patients with diabetes and 35 family caregivers were interviewed individually. SETTING Participants were recruited from two family medicine clinics and a pain clinic in Mexico City. RESULTS Seven themes emerged: (1) suffering as a multifaceted phenomenon, (2) diversity in perceptions of suffering, (3) different coping strategies, (4) need and perceived importance of relief from suffering, (5) barriers to accessing services to relieve suffering, (6) demand for the health sector's active and humane role in addressing suffering and (7) preferences and need for comprehensive care for relief from suffering. The primary coping strategies included family companionship, protective buffering and faith-based support. Participants lacked knowledge of palliative care. They expressed the importance of relief from suffering, viewing it as the health sector's responsibility and requesting more humane, personalised care and access to medicines and pain clinics. CONCLUSIONS The multifaceted nature of SHS highlights the health system's responsibility to provide high-quality palliative care. Policies to enhance access to palliative care should integrate it into primary care, redesigning services towards patient and caregiver biopsychosocial and spiritual needs and ensuring access to medicines and competent health personnel.
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Affiliation(s)
- Svetlana V Doubova
- Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Social Security Institute, Mexico City, Mexico
| | - Afsan Bhadelia
- Department of Public Health. College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Diana Pérez-Moran
- Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Social Security Institute, Mexico City, Mexico
| | - Ingrid Patricia Martinez-Vega
- Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Social Security Institute, Mexico City, Mexico
| | | | - Felicia Knaul
- Sylvester Comprehensive Cancer Centre, University of Miami, Miami, Florida, USA
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
- Tómatelo a Pecho, Mexico City, CDMX, Mexico
- Fundación Mexicana para la Salud, Mexico City, CDMX, Mexico
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17
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Diviani N, Bennardi M, Gamondi C, Saletti P, Stüssi G, Delbue-Luisoni M, Rubinelli S. Awareness, attitudes, and beliefs about palliative care: Results from a representative survey of the Italian-speaking Swiss population. PLoS One 2023; 18:e0294807. [PMID: 38015954 PMCID: PMC10684106 DOI: 10.1371/journal.pone.0294807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE To understand the knowledge and awareness of palliative care in the Italian-speaking Swiss general population, describing main misconceptions or false beliefs and their relationship with attitudes towards palliative care. METHODS Cross-sectional representative population survey (N = 313). RESULTS We observed a high awareness of «palliative care,» although it is mainly associated with pain management and the very last days of life. While false beliefs are relatively rare, there is low awareness of goals, targets, and services offered by palliative care. Overall the Italian-speaking Swiss population has a good predisposition towards palliative care, but negative attitudes are more common among those who lack knowledge. More than one-third of respondents are interested in receiving more information about palliative care, especially from their healthcare providers or through dedicated information points. CONCLUSION AND PRACTICE IMPLICATIONS Health communication interventions to promote palliative care are needed because there is still significant unclarity about the goals of palliative care, which negatively affects its acceptance. This study instructs on how to intervene specifically in the Italian-speaking part of Switzerland, including what to communicate and how. Further, our findings can inspire similar studies in other Swiss regions or countries that can optimize recognition, knowledge, and understanding and contribute to filling gaps in populations' health service demand and utilization.
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Affiliation(s)
- Nicola Diviani
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marco Bennardi
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Claudia Gamondi
- Palliative and Supportive Care Clinic, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | | | - Georg Stüssi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | | | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Meier C, Vilpert S, Wieczorek M, Borrat-Besson C, Jox RJ, Maurer J. Development and validation of a subjective end-of-life health literacy scale. PLoS One 2023; 18:e0292367. [PMID: 37831689 PMCID: PMC10575492 DOI: 10.1371/journal.pone.0292367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Personal health literacy is the ability of an individual to find, understand, and use information and services to inform health-related decisions and actions for oneself and others. The end of life is commonly characterized by the occurrence of one or several diseases, the use of many different types of healthcare services, and a need to make complex medical decisions that may involve challenging tradeoffs, such as choices between quality and length of life. Although end-of-life care issues concern most people at some point in life, individuals' competencies to deal with those questions have rarely been explored. This study aims to introduce, develop, and validate an instrument to measure individuals' self-assessed competencies to deal with end-of-life medical situations, the Subjective End-Of-Life Health Literacy Scale (S-EOL-HLS), in a sample of older adults aged 50+ living in Switzerland who participated in wave 8 (2019/2020) of the Survey of Health, Ageing, and Retirement in Europe. The S-EOL-HLS uses a series of questions on self-rated difficulties in understanding end-of-life medical jargon, defining in advance which end-of-life medical treatments to receive or refuse, and communicating related choices. Aside from conducting exploratory and confirmatory factor analysis to evaluate the construct validity, we compared measurements from the S-EOL-HLS to respondents' general health literacy measured with the European Health Literacy Survey questionnaire. We obtained a three-factor model with acceptable fit properties (CFI = 0.993, TLI = 0.992, RMSEA = 0.083, SRMR = 0.061) and high reliability (α = 0.93). The partial associations between the health literacy scores from the two scales and respondents' sociodemographic characteristics were similar; however, individuals with higher end-of-life health literacy scores appeared to have more positive attitudes towards end-of-life care planning outcomes. The S-EOL-HLS demonstrates reliable and consistent results, making the instrument suitable for older adults in population surveys.
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Affiliation(s)
- Clément Meier
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
- Swiss Centre of Expertise in the Social Sciences (FORS), Lausanne, Switzerland
| | - Sarah Vilpert
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Swiss Centre of Expertise in the Social Sciences (FORS), Lausanne, Switzerland
| | - Maud Wieczorek
- Swiss Centre of Expertise in Life Course Research LIVES, Lausanne and Geneva, Geneva, Switzerland
| | | | - Ralf J. Jox
- Palliative and Supportive Care Service, Chair in Geriatric Palliative Care, and Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jürgen Maurer
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
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19
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Bergman TD, van der Plas AGM, Pasman HRW, Onwuteaka-Philipsen BD. Awareness and Actual Knowledge of Palliative Care Among Older People: A Dutch National Survey. J Pain Symptom Manage 2023; 66:193-202.e2. [PMID: 37207787 DOI: 10.1016/j.jpainsymman.2023.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
CONTEXT Lack of public knowledge of palliative care may be a barrier to timely use of palliative care and hinder engagement in advance care planning (ACP). Little research has been conducted on (the relationship between) awareness and actual knowledge of palliative care. OBJECTIVES To determine awareness and actual knowledge of palliative care and explore factors that contribute to knowledge of palliative care among older people. METHODS A cross-sectional study in a representative sample of 1242 Dutch people (≥ 65 years; response 93.2%) on whether they had heard of palliative care and knowledge statements about palliative care. RESULTS The majority had heard of the term palliative care (90.1%), and 47.1% reported to know (quite) exactly what it means. Most knew palliative care is not only for people with cancer (73.9%) and is not only provided in hospice facilities (60.6%). A minority knew palliative care can be provided alongside life-prolonging treatment (29.8%) and is not only for people who have a few weeks left to live (23.5%). Experience with palliative care through family, friends and/or acquaintances (range ORs: 1.35-3.39 for the four statements), higher education (ORs: 2.09-4.81), being female (ORs: 1.56-1.91), and higher income (OR: 1.93) were positively associated with one or more statements, while increasing age (ORs: 0.52-0.66) was negatively associated. CONCLUSION Knowledge of palliative care is limited, stressing the need for population-wide interventions, including information meetings. Attention should be paid to timely attention for palliative care needs. This might stimulate ACP and raise public knowledge of (im) possibilities of palliative care.
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Affiliation(s)
- Tessa D Bergman
- Department of Public and Occupational Health (T.D.B., A.G.M.V.D.P, H.R.W.P, B.D.O.P), Amsterdam Public Health Research Institute, Expertise Centre for Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007MB Amsterdam, The Netherlands.
| | - Annicka G M van der Plas
- Department of Public and Occupational Health (T.D.B., A.G.M.V.D.P, H.R.W.P, B.D.O.P), Amsterdam Public Health Research Institute, Expertise Centre for Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007MB Amsterdam, The Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health (T.D.B., A.G.M.V.D.P, H.R.W.P, B.D.O.P), Amsterdam Public Health Research Institute, Expertise Centre for Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007MB Amsterdam, The Netherlands
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health (T.D.B., A.G.M.V.D.P, H.R.W.P, B.D.O.P), Amsterdam Public Health Research Institute, Expertise Centre for Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007MB Amsterdam, The Netherlands
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20
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Gebel C, Basten J, Kruschel I, Ernst T, Wedding U. Knowledge, feelings, and willingness to use palliative care in cancer patients with hematologic malignancies and solid tumors: a prospective, cross-sectional study in a comprehensive cancer center in Germany. Support Care Cancer 2023; 31:445. [PMID: 37410174 DOI: 10.1007/s00520-023-07914-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Patients with hematologic malignancies (HM) receive palliative care (PC) less often and later than patients with solid tumors (ST). Patients' lack of knowledge about PC and negative feelings about PC are barriers to their willingness to use PC. Is there a difference between patients with HM and ST in their knowledge and willingness to use PC? METHODS Two hundred ten patients (85 HM, 125 ST) from an oncology day clinic at a university hospital participated in this cross-sectional, questionnaire-based survey. RESULTS Patients with HM and ST had high knowledge and mainly positive feelings about PC. More than half of the patients answered that they would feel reassured by the use of PC, and one-third would feel anxious or hopeless. The majority of patients (58.3%) were willing to use PC. There are no significant differences between patients with HM and ST. In multiple regression analysis, perceived chance of cure and feelings of reassurance and anxiety are associated with willingness to use PC, but not with the HM/ST disease group. More than half (53.9%) of the participants would like the treating physician to choose the timing of a discussion about PC. CONCLUSION Our study shows a high level of knowledge and relatively positive feelings of patients about PC, with no differences between patients with HM or ST. They expect their treating physician to initiate communication about PC. Communication should include the patient's feelings about PC and their chances of a cure.
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Affiliation(s)
- Cordula Gebel
- Department of Palliative Care, Jena University Hospital, Jena, Germany.
| | - Judith Basten
- Department of Palliative Care, Jena University Hospital, Jena, Germany
| | - Isabel Kruschel
- Department of Palliative Care, Jena University Hospital, Jena, Germany
| | - Thomas Ernst
- University Tumor Center, Jena University Hospital, Jena, Germany
| | - Ulrich Wedding
- Department of Palliative Care, Jena University Hospital, Jena, Germany
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Alnajar MK, Abdalrahim MS, Mosleh SM, Farhan M, Amro K, Darawad MW. The need of patients living with cancer for palliative care. Int J Palliat Nurs 2023; 29:236-245. [PMID: 37224093 DOI: 10.12968/ijpn.2023.29.5.236] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND A comprehensive assessment of patients' problems and needs is essential for all patients with chronic diseases, including cancer. AIM This study assesses the problems, unmet needs and requirement for palliative care (PC) among patients with cancer. METHOD A descriptive cross-sectional design was employed using a valid self-reported questionnaire. RESULTS On average, 62% of patients had problems that were unresolved. The need for patients to have more information about their health was identified (75.1%), followed by financial problems because of the illness and ability to afford healthcare (72.9%), and psychological issues, such as depression, anxiety and stress (67.1%). Patients stated that their spiritual needs were not being met (78.8%), and that they were experiencing psychological distress and problems with daily living that needed to be addressed through PC (78%, 75.1%, respectively). A chi-square test revealed that all problems are significantly associated with the need for PC (P<.001). CONCLUSION Patients needed more assistance in psychological, spiritual, financial and physical domains, and this can be provided by palliative care. Palliative care in low-income countries is a human right for patients with cancer.
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Affiliation(s)
- Malek Kh Alnajar
- Graduate Research and Teaching Assistant, University of Utah, United States
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22
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Reigada C, Sandgren A, Rivas S, Carvajal A, Hermida-Romero S, Benítez E, Ripoll G, Olza I, Centeno C, Gómez B. Palliative care stay room - designing, testing and evaluating a gamified social intervention to enhance palliative care awareness. BMC Palliat Care 2023; 22:46. [PMID: 37081434 PMCID: PMC10116670 DOI: 10.1186/s12904-023-01166-9] [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: 09/22/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION The message of palliative care can be promoted using creative thinking and gamification. It can be an innovative strategy to promote changes in behaviour, promote thinking, and work on skills such as empathy. AIM Design, test and evaluate a gamified social intervention to enhance palliative care awareness among young university students from non-health background. METHODS Participatory action research study with mixed methods, Design Thinking and using the Public Engagement strategy. Forty-three undergraduate students participated in a Palliative Care Stay Room and completed the Test of Cognitive and Affective Empathy (TECA) before and after the game. At the end of the game, a ten-minute debriefing was held with the participants, which was concluded with an open conversation. The content analysis was done independently and the sum of the scores of each dimension was compared before and after the activity. FINDINGS The Stay Room improved the participants' knowledge and new perspectives about palliative care. Before the game, their views focused on the end of life and after the game on their values, highlighting the dedication of the healthcare professionals who do not treat death but the life until death. After de game, participants (N = 43: female = 23; male = 20; x̄ 19.6 years old) presented higher values in perspective adoption (intellectual ability to put oneself in the other's place) p = 0.046 and in emotional understanding (ability to recognize emotional states) p = 0.018, and had high scores on empathic joy (p = 0.08). CONCLUSION Gamification can be used in teaching and transmitting positive attitudes. Palliative Care and can help young university students to think positively about care issues.
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Affiliation(s)
- Carla Reigada
- ATLANTES Global Observatory of Palliative Care, Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Sonia Rivas
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Ana Carvajal
- ATLANTES Global Observatory of Palliative Care, Institute for Culture and Society, University of Navarra, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
- School of Nursing, University of Navarra, Pamplona, Spain.
| | - Santiago Hermida-Romero
- ATLANTES Global Observatory of Palliative Care, Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Edgar Benítez
- ATLANTES Global Observatory of Palliative Care, Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Guillem Ripoll
- School of Economics and Business, University of Navarra, Pamplona, Spain
| | - Inés Olza
- Emotional Culture and Identity Project, Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Carlos Centeno
- ATLANTES Global Observatory of Palliative Care, Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Beatriz Gómez
- School of Communication, University of Navarra, Pamplona, Spain
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Shim HY, Park JH, Kang GH, Kim MJ. Adults above 65 years of intention to use homecare hospice and a study on the factors influencing the perception of hospice·palliative care service. Appl Nurs Res 2023; 71:151684. [PMID: 37179070 DOI: 10.1016/j.apnr.2023.151684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND This study is a descriptive correlation survey conducted to understand the effect of attitudes toward death, hospice palliative care perception, and knowledge on homecare hospice use intention for adult men and women aged 65 or older ones. AIM This study identified factors affecting the intention to use homecare hospice and the perception of hospice·palliative care for adults aged 65 or older. METHODS Researchers used tools which were intention to use homecare hospice, the hospice palliative care knowledge, death orientation, hospice palliative perception. RESULTS The higher the perception of hospice·palliative care, for men than women, then they are the higher the willingness to use homecare hospice. In addition, the factors influencing the perception of hospice·palliative care of subjects who are willing to use homecare hospice were education and hospice·palliative care knowledge. CONCLUSION By improving hospice·palliative care perception by acquiring hospice·palliative care knowledge, people will choose the place where they want to die. In addition, once there is an increasing demand for it, nations and Institutions can help to set up support homecare hospice. For this, campaigns, and education to provide knowledge and improve perception of hospice·palliative care must be continued at the socio-cultural level.
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Filippou P, Hugar LA, Louwers R, Pomper A, Chisolm S, Smith AB, Gore JL, Gilbert SM. Palliative care knowledge, attitudes, and experiences amongst patients with bladder cancer and their caregivers. Urol Oncol 2023; 41:108.e1-108.e9. [PMID: 36529652 DOI: 10.1016/j.urolonc.2022.10.013] [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: 06/14/2022] [Revised: 10/02/2022] [Accepted: 10/13/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Palliative care is underutilized amongst patients with bladder cancer despite guideline recommendations and known benefits. In order to uncover potential access barriers, we sought to describe patient and caregiver knowledge, attitudes and experiences surrounding palliative care. METHODS We surveyed 272 patients with bladder cancer and their caregivers through the Bladder Cancer Advocacy Network Patient Survey Network. In addition to collecting demographic, socioeconomic, and clinical characteristics, previously studied and validated questionnaires on palliative care knowledge and beliefs were administered. Patients and caregivers were also queried regarding their experiences with palliative care consultation. RESULTS Survey respondents demonstrated highly accurate knowledge of palliative care services. Attitudes and beliefs surrounding palliative care were overall positive. Caregivers demonstrated better knowledge and more positive beliefs of palliative care compared to patients. Despite an overall positive sentiment toward palliative care, only 9% of the cohort had palliative care consultation as part of their cancer treatment plan. Most patients with muscle-invasive or metastatic bladder cancer wished that palliative care had been discussed by their providers. CONCLUSIONS A subset of bladder cancer patients possess accurate knowledge and positive beliefs of palliative care. Palliative care is infrequently discussed during the treatment of bladder cancer, with patients and their caregivers expressing desire for palliative care to be discussed more often. Provider education surrounding palliative care services is imperative to improving access for bladder cancer patients and caregivers.
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Affiliation(s)
| | - Lee A Hugar
- Division of Genitourinary Oncology, H.Lee Moffitt Cancer Center and Research Institute, Tampa FL
| | - Renata Louwers
- Bladder Cancer Advocacy Network, Bethesda, Maryland, USA
| | - Ann Pomper
- Bladder Cancer Advocacy Network, Bethesda, Maryland, USA
| | | | - Angela B Smith
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill NC
| | - John L Gore
- Department of Urology, University of Washington, Seattle WA
| | - Scott M Gilbert
- Division of Genitourinary Oncology, H.Lee Moffitt Cancer Center and Research Institute, Tampa FL
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25
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Hoe DF, Wang YH, Rahman A, Enguidanos S. Identifying Paths Forward: Expanding Palliative Care to Low-Income Patients in California. Am J Hosp Palliat Care 2022:10499091221131973. [PMID: 36218324 DOI: 10.1177/10499091221131973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Multiple studies demonstrate most consumers do not know about palliative care. And, since January 2018, California's Medi-Cal Managed Care patients have been eligible for palliative care services under Senate Bill 1004 (SB 1004). Yet, the uptake of palliative care services was underwhelming. The purpose of this study was to explore patient-centered barriers to palliative care. We recruited 27 adult Medicaid managed care patients from community-based sites in Los Angeles and conducted semi-structured qualitative interviews. Each participant was asked questions to elicit their knowledge about, and perspectives on, palliative care as well as their preferred communication approaches for receiving a referral to palliative care. The interviews were audio-recorded and transcribed verbatim. We used a grounded theory approach to guide our analysis of primary themes. Our findings indicated that the barriers to palliative care referrals among this population included lack of knowledge about palliative care and available services; the reliance on, and trust in, primary care physicians for information; language and cultural barriers; housing instability; and patient believing they are neither old enough nor sick enough to need palliative care. These findings emphasize the critical role primary care physicians play in advocating for low-income patients and the necessity for culturally sensitive education about palliative care. Promoting knowledge and understanding of palliative care among both primary care physicians and consumers is critical to ensuring access to care.
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Affiliation(s)
- Deborah F Hoe
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
| | - Yu-Hsuan Wang
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
| | - Anna Rahman
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
| | - Susan Enguidanos
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
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Ramos-Vera C, Krikorian A, Vallejos Saldarriaga J. Factors related to positive attitudes toward palliative care: Direct and indirect effects of self-care self-efficacy, knowledge, and beliefs. Palliat Support Care 2022; 21:1-7. [PMID: 35894093 DOI: 10.1017/s1478951522000864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Knowledge, beliefs, and attitudes toward palliative care (PC) constitute barriers to its access. Few studies have focused on the intrinsic relationship between these variables, and none has examined the relationship between them and self-care self-efficacy. OBJECTIVE To examine the direct and indirect effects of self-care self-efficacy, knowledge, and beliefs on attitudes toward PC. METHODS A cross-sectional predictive study was conducted. Self-care self-efficacy, knowledge, attitudes, and beliefs about PC were analyzed using information from the Health Information National Trends Survey (HINTS 5, cycle 2, 2018). Data from 1,162 participants were considered. Structural equation modeling (SEM) was used to represent the statistical mediation model with latent and observable variables. RESULTS The structural model presents positive coefficients indicating that self-care self-efficacy significantly predicts knowledge (β = 0.127, p < 0.001) and beliefs (β = 0.078, p = 0.023). Similarly, knowledge is associated with attitudes (β = 0.179, p < 0.001) and beliefs (β = 0.213, p < 0.001). The beliefs measure is also significantly related to attitudes (β = 0.474, p < 0.001). In addition, this structural multiple mediation model shows optimal goodness-of-fit indices: χ2/df = 3.49, CFI = 0.983, TLI = 0.976, RMSEA = 0.046 [90% CI: 0.037-0.056], SRMR = 0.038. CONCLUSION Self-care self-efficacy is significantly associated with knowledge and beliefs about PC, which in turn are related to each other. Altogether, these variables predict positive attitudes toward PC. Understanding the relationship between these variables is relevant for targeting-specific populations and designing timely strategies to improve access to PC.
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Affiliation(s)
- Cristian Ramos-Vera
- Research Area, School of Health Sciences, Universidad César Vallejo, Lima, Peru
- Sociedad Peruana de Psicometría, Lima, Peru
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
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Zelko E, Vrbek L, Koletnik M. Last Aid Course—The Slovenian Experience. Healthcare (Basel) 2022; 10:healthcare10071154. [PMID: 35885681 PMCID: PMC9315648 DOI: 10.3390/healthcare10071154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Educating and raising awareness among lay members of the public about palliative care can significantly improve the care for terminally ill patients and their quality of life. This paper reports on the survey aimed at assessing the experience and expectations of participants in the Last Aid course launched in Slovenia in 2019 to train hospice volunteers and promote dialogue on death and dying. The course implementation was supported by materials prepared, translated, and/or adapted from German under the PO-LAST project, which linked Slovenian medical and healthcare professionals, hospice representatives, and university students. The Last Aid course follows an international four-module curriculum that has been successfully applied in 18 countries so far. In Slovenia, the course was delivered 30 times with 21 in-person deliveries and 9 online events attended by 450 participants of different sexes, ages, and professions. The surveyed population included 250 people who returned the evaluation questionnaires by October 2020. The aim of the analysis was to gain insight that can be applied broadly in future work and research on adult education on palliative care and the erasure of death-related taboos.
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Affiliation(s)
- Erika Zelko
- Institute for General practice, Johannes Keppler University, 4020 Linz, Austria
- Department for Family Medicine, Faculty of Medicine University Maribor, Taborska cesta 8, 2000 Maribor, Slovenia
- Correspondence:
| | - Larisa Vrbek
- Cerebral Paralysis Association of Slovenia, Rožanska ulica 2, 1000 Ljubljana, Slovenia;
| | - Melita Koletnik
- Faculty of Arts, University of Maribor, 2000 Maribor, Slovenia;
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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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Kangtanyagan C, Vatcharavongvan P. No Terminally Ill Patients with Non-cancer Received Palliative Care Services During Hospital Admission: A Cross-Sectional Study. Am J Hosp Palliat Care 2022; 40:492-499. [PMID: 35614032 DOI: 10.1177/10499091221105466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Terminally ill patients admitted to a hospital with noncancer conditions may miss palliative care (PC) service opportunities. This study aimed to examine the utilization of PC services among these hospitalized patients. METHODS We conducted a cross-sectional study using the electronic medical records of noncancer patients admitted to internal medicine wards, intensive care units (ICUs), and cardiac intensive care units (CICUs). The patients meeting the Supportive and Palliative Care Indicators Tool (SPICT) criteria needed PC, and the patients who had advanced care plans or received PC consultations received PC services. We reported the proportions of patients with PC needs and PC services and their associated factors with the crude and adjusted odds ratios. RESULTS Of 459 patients, 49.9% were female, and 92.6% were discharged alive. The mean age was 63 years old, and the average length of stay was 10 days. Additionally, 61.7% needed PC according to the SPICT criteria, but none of these patients received PC services. Patients with dementia/frailty, kidney disease, and heart disease had the highest rate of PC underutilization (100%, 96.8%, and 91.3%, respectively). Age, number of discharge medications, and length of stay were associated with needing PC, but some associations disappeared after the subgroup analysis. CONCLUSION None of the terminally ill noncancer patients in our study received PC services. The patients with dementia/frailty, kidney disease, and heart disease underutilized the services. A long length of stay and many discharge medications were associated with the PC needs and can be used to assess the PC needs.
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Affiliation(s)
| | - Pasitpon Vatcharavongvan
- Research Unit in Physical Anthropology and Health Sciences, 37699Thammasat University, Pathum-Thani, Thailand.,Department of Community Medicine and Family Medicine, Thammasat University, Pathum-Thani, Thailand
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Lei L, Lu Y, Gan Q, Hu Z, Luo Y. Awareness and Perceptions of Palliative Care Among the Elderly: A Qualitative Study. J Palliat Care 2022; 37:204-212. [PMID: 35195464 DOI: 10.1177/08258597221082393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives: With the rapidly aging population worldwide, the demand for palliative care is increasing. Palliative care publicity and education must be further developed globally, especially for the elderly. It is essential to perform targeted promotion by understanding the awareness and needs of palliative care of the elderly. This study aimed to investigate elderly people's awareness of palliative care and their own views on and needs for palliative care, which could provide a basis for the popularization of palliative care among them. Methods: A total of 20 elderly people were recruited to participate in the semi-structured, and in-depth interviews. Participants were from communities and nursing homes in Chongqing, China. The interview transcripts were coded using the method of thematic analysis. Results: Finally, 4 themes and 10 subthemes were identified, that is: unawareness of the concept of palliative care (never heard of palliative care, confusion between euthanasia and palliative care), motivations for accepting palliative care (personal perspective: less suffering; family perspective: relieving the burden), factors influencing palliative care decision (cost of palliative care, knowledge of palliative care, opinion of decision-making agents), and necessity and preferences for publicizing palliative care (eagerness to know more about palliative care, focusing on policy and charges, preference for Electronic Media Advertising). Conclusions: Palliative care publicity among the elderly is important and necessary. Findings in this study could provide some insights into how to popularize palliative care among the elderly. Considering the preference of the elderly for access to palliative care information, simultaneous publicity through TV and online channels is suggested. Since the elderly would like to choose their doctors and adult children as decision-making agents, more communication between community, health professionals and family is advocated.
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Affiliation(s)
- Lei Lei
- School of Nursing, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Ya Lu
- School of Nursing, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Quanxi Gan
- Southwest University Hospital, Chongqing, P.R. China
| | - Zongping Hu
- The Thirteenth Hospital of Chongqing, Chongqing, P.R. China
| | - Yu Luo
- School of Nursing, Army Medical University (Third Military Medical University), Chongqing, P.R. China
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Atena D, Imane B, Maryam R, Naiire S, Fatemeh T. The level of knowledge about palliative care in Iranian patients with cancer. BMC Palliat Care 2022; 21:33. [PMID: 35264125 PMCID: PMC8907034 DOI: 10.1186/s12904-022-00920-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patient awareness plays an important role in integrating palliative care into the patient care process. Lack of awareness can create a negative attitude towards palliative care and affect patients' decisions during the treatment process. The present study was conducted to determine the level of knowledge about palliative care in Iranian patients with cancer. Methods The descriptive study was conducted with a convenience sample of 103 cancer patients admitted to an oncology center in Yazd, Iran, A three-part questionnaire including demographic information, sources of palliative care information and the Palliative Care Knowledge Scale (PaCKS) was used to collect data. All statistical analyses were performed using software SPSS 21. Results The mean age of patients was 36.2 ± 13.5 years. Of the total, 38.8% of patients received information about palliative care through the media and 36.9% from the treatment team. On a scale of 0 to 13, the mean PaCKS score was 6.7 ± 3.7. A ‘good’ level of knowledge was reported by 29.1% of participants; however 84.5% stated that they should leave other doctors at the time of receiving palliative care, 71.8% considered palliative care for patients in the last six months of life, 84.5% considered palliative care for patients with cancer, and 70.9% stated that palliative care encourages people to discontinue treatments aimed at treating their disease. Conclusion Our study found most cancer patients have a moderate to weak level of knowledge and considerable misinformation about palliative care, which highlights the importance of providing palliative care education. The development of training programs in this area could play an effective role in improving patients' knowledge of palliative care.
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Affiliation(s)
- Dadgari Atena
- Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Bagheri Imane
- Ph.D Nursing Student, College of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rassouli Maryam
- PhD. RN Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Salmani Naiire
- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. .,, Yazd, Iran.
| | - Tahani Fatemeh
- Oncology Nurse, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Wang Z, Selvaggi K, Stein D. Survey Study of Awareness and Perception of Palliative and Hospice Care in a Cancer Center in Rural Pennsylvania. Palliat Med Rep 2022; 3:17-20. [PMID: 36262549 PMCID: PMC8900202 DOI: 10.1089/pmr.2020.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: Hospice and palliative medicine (HPM) have been gaining ground especially in large urban settings. However, less is known about their perception in small rural areas. This study assessed the awareness and perception of a rural oncology population of this field and the effects of prognosis on their awareness. Methods: Subjects were patients of the community cancer center in rural Clarion County, Pennsylvania, who volunteered to complete a short nine-question survey (supplemental figure). Results were analyzed based on completed surveys. Results: A total of 65 surveys were collected from the Cancer Center at the Clarion Hospital. Among these patients, 54% stated that they have heard of palliative and hospice medicine. When correlating patient-reported prognosis with their awareness of palliative and hospice care, 100% of the patients with poor prognosis were aware of palliative or hospice care, respectively. In contrast, only <20% of patients with reported good prognosis were aware of HPM. Conclusions: Our study has shown that the awareness of HPM in rural areas is improving. It was observed that more patients are aware of HPM is when their prognosis was poor as compared with those who reported good prognosis.
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Affiliation(s)
- Zhu Wang
- Department of Family Medicine, Clarion Hospital, Butler Health System, Clarion, Pennsylvania, USA
| | - Kathy Selvaggi
- Department of Palliative Care, Butler Memorial Hospital, Butler, Pennsylvania, USA
| | - Dillon Stein
- Department of Palliative Care, Butler Memorial Hospital, Butler, Pennsylvania, USA
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Hudson P, Collins A, Boughey M, Philip J. Reframing palliative care to improve the quality of life of people diagnosed with a serious illness. Med J Aust 2021; 215:443-446. [PMID: 34676567 PMCID: PMC9298245 DOI: 10.5694/mja2.51307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Peter Hudson
- St Vincent's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC.,Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Jennifer Philip
- St Vincent's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
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Masoud B, Imane B, Naiire S. Patient awareness of palliative care: systematic review. BMJ Support Palliat Care 2021; 13:136-142. [PMID: 34635546 DOI: 10.1136/bmjspcare-2021-003072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/18/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND One of the barriers to the integration of palliative care within the process of patient care and treatment is the lack of awareness of patients about palliative care. In order to develop efficient resources to improve patient awareness, comprehensive information is required to determine the specific aspects of palliative care where a paucity of evidence on patient awareness exists. This review aims to synthesise evidence from previous studies in order to provide a comprehensive information set about the current state of patient awareness of palliative care. METHODS In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Magiran, Scientific Information Database(SID) and Islamic Science Citation (ISC) were searched to identify articles published between 2000 and 2021 that considered patients' awareness of palliative care. RESULTS Of the 5347 articles found, 22 studies were retained after quality evaluation; three full-text articles were excluded. Nineteen articles are included in this review. More than half of the patients did not have any information about palliative care or hospice care. Some patients accurately defined hospice care and palliative care; other patients had misunderstandings about palliative care. Patients had limited information about pastoral care, social care and bereavement care. Patients' awareness about individuals or centres providing palliative care or hospice care was limited. Video presentation and distribution of information at the community level indicated that this method would be beneficial in increasing the awareness. CONCLUSION The review points to the need for patient education programmes and interventional studies to increase patients' awareness.
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Affiliation(s)
- Bahrami Masoud
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bagheri Imane
- College of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Salmani Naiire
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Zimmermann C, Wong JL, Swami N, Pope A, Cheng Y, Mathews J, Howell D, Sullivan R, Rodin G, Hannon B, Moineddin R, Le LW. Public knowledge and attitudes concerning palliative care. BMJ Support Palliat Care 2021:bmjspcare-2021-003340. [PMID: 34620693 DOI: 10.1136/bmjspcare-2021-003340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE WHO recommends early integration of palliative care alongside usual care to improve quality of life, although misunderstanding of palliative care may impede this. We compared the public's perceived and actual knowledge of palliative care, and examined the relationship of this knowledge to attitudes concerning palliative care. METHODS We analysed data from a survey of a representative sample of the Canadian public, accessed through a survey panel in May-June 2019. We compared high perceived knowledge ('know what palliative care is and could explain it') with actual knowledge of the WHO definition (knew ≥5/8 components, including that palliative care can be provided early in the illness and together with life-prolonging treatments), and examined their associations with attitudes to palliative care. RESULTS Of 1518 adult participants residing in Canada, 45% had high perceived knowledge, of whom 46% had high actual knowledge. Participants with high (vs low) perceived knowledge were more likely to associate palliative care with end-of-life care (adjusted OR 2.15 (95% CI 1.66 to 2.79), p<0.0001) and less likely to believe it offered hope (0.62 (95% CI 0.47 to 0.81), p=0.0004). Conversely, participants with high (vs low) actual knowledge were less likely to find palliative care fearful (0.67 (95% CI 0.52 to 0.86), p=0.002) or depressing (0.72 (95% CI 0.56 to 0.93), p=0.01) and more likely to believe it offered hope (1.88 (95% CI 1.46 to 2.43), p<0.0001). CONCLUSIONS Stigma regarding palliative care may be perpetuated by those who falsely believe they understand its meaning. Public health education is needed to increase knowledge about palliative care, promote its early integration and counter false assumptions.
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Affiliation(s)
- Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanne L Wong
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Nadia Swami
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ashley Pope
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - YiQin Cheng
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jean Mathews
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Richard Sullivan
- Institute of Cancer Policy, Guy's Hospital, King's College London, London, UK
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Breffni Hannon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Lisa W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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Dittborn M, Turrillas P, Maddocks M, Leniz J. Attitudes and preferences towards palliative and end of life care in patients with advanced illness and their family caregivers in Latin America: A mixed studies systematic review. Palliat Med 2021; 35:1434-1451. [PMID: 34338052 DOI: 10.1177/02692163211029514] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Achieving universal access to palliative care is considered a global and equity priority. Understanding patients and caregivers' attitudes and preferences towards palliative and end-of-life care in Latin America is essential to develop person-centred services in the region. AIM To synthesize and appraise the evidence about patients with advanced illness and their caregivers' attitudes and preferences towards palliative and end-of-life care in Latin America. DESIGN Mixed studies systematic review with sequential exploratory synthesis (thematic and narrative synthesis). Quality was assessed using the Mixed-Methods Appraisal Tool. DATA SOURCES MEDLINE, Embase, PsychINFO, Lilacs, Web of Science, Scielo and Scopus to March 2021. Empirical studies examining patient or caregiver attitudes and/or preferences towards palliative and end-of-life care were included. RESULTS Of 3575 records screened, 45 articles were included, comprising 7 countries and a total of 1220 patients and 965 caregivers (26.8% non-cancer-related participants). Data were organized around seven themes: Symptom management and nutrition; End-of-life medical decisions; Communication patterns; Place of end-of-life care and death; God and religious community as source of hope and support; Caregiver's role; and Mixed understandings of palliative care. Main findings include; conflicted views around palliative care and pain relief; patients' preference to be informed about their condition contrasting with caregivers' reluctance to discuss this with patients; common preference for shared decision-making; and overburdened caregivers lacking professional home-care support. Methodological flaws were found in general. CONCLUSION Core themes provide context-specific evidence to inform the design of culturally sensitive palliative and end-of-life care services, models and public policies in Latin America.
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Affiliation(s)
- Mariana Dittborn
- Paediatric Bioethics Centre, Great Ormond Street Hospital for Children, London, UK.,Centro de Bioética, Facultad de Medicina CAS-UDD, Santiago, Chile.,Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Pamela Turrillas
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
| | - Javiera Leniz
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
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Mallon A, Hasson F, Casson K, Slater P, McIlfatrick S. Young adults understanding and readiness to engage with palliative care: extending the reach of palliative care through a public health approach: a qualitative study. BMC Palliat Care 2021; 20:120. [PMID: 34320961 PMCID: PMC8320215 DOI: 10.1186/s12904-021-00808-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/03/2021] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Moving palliative care from a solely clinical focus to a more population based and community orientated approach is the hallmark of a much advocated public health approach to palliative care. Young adults are a vital cohort of the public, yet their understanding of palliative care has not been investigated. This study aimed to explore young adults' understanding of palliative care and identify factors that influence their engagement. METHODS A purposive sample of young adults (n = 24) aged 18-29 years were recruited from one UK University. Semi-structured interviews were undertaken face to face or via telephone or Skype between November 2017 and February 2018. Thematic analysis using a framework approach and underpinned by a socioecological perspective was used to analyse the interviews. RESULTS Three thematic categories were identified relating to intrapersonal and interpersonal influences, cultural and social influences and organisational and public policy influences. Palliative care was understood as supportive comfort care, delivered in the absence of cure, associated with the end of life and specifically focused on death and dying. Negative attitudes related to the context of care, which represented a static and hopeless situation. Whilst some reported positive attitudes, potential engagement was seen to be governed by a lack of knowledge and protective cultural norms. In terms of demonstrating readiness to engage with palliative care, participants requested clear information and suggested a normalising of palliative care through the education system. CONCLUSION Young adults in this study were ready to find out more about palliative care and identified social media as a platform upon which to engage this population. However, their perception of a society that views palliative care as a subject for those directly affected, creates a barrier to engagement. This study identified the ingredients of a public health message and mediums for disseminating the message. However, findings also suggest that a cultural shift is required to recognise the potential of engaging young adults in health issues that cross the life span, empowering them not only as individuals but as vital members of community and society.
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Affiliation(s)
- Anita Mallon
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB Northern Ireland
| | - Felicity Hasson
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB Northern Ireland
| | - Karen Casson
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB Northern Ireland
| | - Paul Slater
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB Northern Ireland
| | - Sonja McIlfatrick
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB Northern Ireland
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Rutherford J, Willmott L, White BP. What the Doctor Would Prescribe: Physician Experiences of Providing Voluntary Assisted Dying in Australia. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211033109. [PMID: 34282961 DOI: 10.1177/00302228211033109] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Like many countries where voluntary assisted dying (VAD) is legal, eligible doctors in Victoria, Australia, have sole legal authority to provide it. Doctors' attitudes towards legalised VAD have direct bearing on their willingness to participate in VAD and consequently, on whether permissive laws can effectively facilitate access to VAD. The study aimed to explore how some Victorian doctors are perceiving and experiencing the provision of legalised VAD under a recently commenced law. METHODS Semi-structured interviews with 25 Victorian doctors with no in-principle objection to legalised VAD were conducted between July 2019-February 2020. Interviews were recorded, transcribed, and analysed using thematic analysis. Ethical approval from the relevant institution was obtained. RESULTS Doctors perceive or experience VAD to fundamentally challenge traditional medical practice. Barriers to access to VAD derive from applicant, communication, and doctor-related factors. Doctors' willingness to participate in VAD is situation specific.
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Affiliation(s)
- Jodhi Rutherford
- Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | - Lindy Willmott
- Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | - Ben P White
- Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia
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Lessons Learned from Introducing Last Aid Courses at a University Hospital in Germany. Healthcare (Basel) 2021; 9:healthcare9070906. [PMID: 34356284 PMCID: PMC8306471 DOI: 10.3390/healthcare9070906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/17/2022] Open
Abstract
In recent years, so called "Last Aid courses", concerning end-of-life care for people dying, have successfully been established in community settings in several European countries, Australia, and South-America. To date, they have not been evaluated in hospital settings, where educational needs (concerning care of the dying) are especially high, and may differ from the general population. To evaluate if Last Aid courses are feasible in hospital settings, and if informational needs of hospital staff are met by the curriculum, we introduced Last Aid courses at a university hospital. Five courses were offered; participants of courses 1 and 2 completed surveys with open-ended questions; the answers were used to develop the evaluation questionnaire employed in courses 3-5. In these three courses, 55 of the 56 participants completed an evaluation survey to explore their learning goals and obtain feedback. Courses were fully booked; participants were heterogeneous with regard to their professional background. The most prevalent learning goals were "preparation for emotional aspects in care of dying" (65.5% ratings "very important"), "preparation for medical/care aspects in care of dying" (60.0%), and "knowledge of supportive services and facilities" (54.5%). Overall, the evaluation showed that Last Aid courses were more suitable to educate non-medical hospital staff about care of the dying. Medical staff, in contrast to non-medical staff, more often requested courses with an extended curriculum in order to meet their learning goals. Last Aid courses were well accepted and helped to reduce information deficits on care of the dying in a heterogeneous population of hospital staff.
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Fliedner MC, Zambrano SC, Eychmueller S. Public perception of palliative care: a survey of the general population. Palliat Care Soc Pract 2021; 15:26323524211017546. [PMID: 34164622 PMCID: PMC8191057 DOI: 10.1177/26323524211017546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/22/2021] [Indexed: 12/13/2022] Open
Abstract
Background: The public’s view of palliative care often involves its potential to improve of quality-of-life as well as its use as a last resource prior to death. Objective: To obtain an idea of the image of palliative care held by the public in the German-speaking part of Switzerland, the authors sought to understand (1) the perceptions of palliative care and the (2) elements important when thinking about their own end of life. Methods and Sample: A qualitative design with an inductive reasoning approach based on Mayring (2014) was chosen. Visitors at an exhibition about palliative care in six locations provided hand-written answers on provided cards to two statements: (1) if I hear the term ‘Palliative Care’ I think of … and (2) when thinking about my own end of life, the following is important to me … Results: Answers of 199 visitors (mean age 52, mostly in a good/very good health status) were analysed. In response to hearing the term palliative care, six areas were categorized: (1) the main focus; (2) ways of providing palliative care; (3) the best timing; (4) places where palliative care is provided; (5) who is seen as provider and (6) outcomes of palliative care. Five categories to the statement about their own end-of-life were identified: (1) the ability to look back on a fulfilled life and being satisfied; (2) maintaining trusting relationships until the end; (3) organizing affairs and having everything settled; (4) having their family being cared for and (5) relief of suffering with the support of knowledgeable people. Conclusion: Palliative care was mostly associated with positive terms acknowledging an interprofessional approach. Maintaining one’s dignity as well as dying without suffering pointed at the persisting stigma that palliative care is mainly limited to end-of-life care. The results may help healthcare professionals to better understand how the public view palliative care.
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Affiliation(s)
- Monica C Fliedner
- University Center for Palliative Care, Department of Oncology, Inselspital, University Hospital Bern, SWAN C518, Freiburgstrasse, 3010 Bern, Switzerland
| | - Sofia C Zambrano
- University Center for Palliative Care, Department of Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Steffen Eychmueller
- University Center for Palliative Care, Department of Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
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McIlfatrick S, Slater P, Beck E, Bamidele O, McCloskey S, Carr K, Muldrew D, Hanna-Trainor L, Hasson F. Examining public knowledge, attitudes and perceptions towards palliative care: a mixed method sequential study. BMC Palliat Care 2021; 20:44. [PMID: 33731087 PMCID: PMC7971949 DOI: 10.1186/s12904-021-00730-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Palliative care is recognised as a public health issue with the need for earlier integration in the wider healthcare system. However, research indicates that it continues to be accessed late in the course of an illness, public understanding of palliative care is limited, and common misconceptions prevail. Strategies to address this are needed in order to reduce barriers to palliative care delivery and improve access. Methods An explanatory sequential mixed methods study, comprising a cross-sectional survey and interviews was undertaken. Sociodemographic characteristics, public awareness, knowledge and perceptions of palliative care were examined and strategies to raise awareness and overcome barriers within a public health framework were identified. Survey data were analysed using SPSS v25 with factor analysis and non-parametric statistics and qualitative data were analysed using thematic analysis. Results A total of 1201 participants completed the survey (58.3% female, mean age 61 years) and 25 took part in interviews. A fifth of participants (20.1%) had previously heard about palliative care and had an accurate understanding of the term. Being female, higher educated, married, and older, increased respondents’ levels of awareness. The three most commonly held misconceptions included: Palliative care is exclusively for people who are in the last 6 months of life (55.4% answered incorrectly); A goal of palliative care is to address any psychological issues brought up by serious illness (42.2% answered incorrectly); and a goal of palliative care is to improve a person’s ability to participate in daily activities (39.6% answered incorrectly). Talking about palliative and end of life care was advocated but societal taboos restricted this occurring with exposure limited to personal experience. Conclusions Current knowledge gaps and misconceptions derived from limited ad hoc personal experiences and fear of engaging in taboo conversations may deter people from accessing integrated palliative care services early in a disease trajectory. The results indicate the need for public education programmes that move beyond merely raising awareness but provide key messages within a public health approach, which may change attitudes to palliative care thus ultimately improving end of life outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00730-5.
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Affiliation(s)
- Sonja McIlfatrick
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland.
| | - Paul Slater
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland
| | - Esther Beck
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland
| | - Olufikayo Bamidele
- Institute of Clinical and Applied Health Research, Hull York Medical School, Allam Medical Building, University of Hull, Hull, HU6 7RX, UK
| | - Sharon McCloskey
- Southern Health and Social Care Trust, The Rowans, Craigavon Area Hospital, Lurgan Road, Portadown, BT36 5QQ, Northern Ireland
| | - Karen Carr
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland
| | - Deborah Muldrew
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland
| | - Lisa Hanna-Trainor
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland
| | - Felicity Hasson
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road Newtownabbey, Antrim, BT37 0QB, Northern Ireland
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Bollig G, Brandt Kristensen F, Wolff DL. Citizens appreciate talking about death and learning end-of-life care – a mixed-methods study on views and experiences of 5469 Last Aid Course participants. PROGRESS IN PALLIATIVE CARE 2021. [DOI: 10.1080/09699260.2021.1887590] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Georg Bollig
- Medical Research Unit, Institute of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
- Palliative Care Team, Medical Department Sønderborg/Tønder, South Jutland Hospital, Sønderborg, Denmark
- Last Aid International, Schleswig, Germany
- Medical Department Sønderborg/Tønder, South Jutland Hospital, Sønderborg, Denmark
| | - Frans Brandt Kristensen
- Medical Research Unit, Institute of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
- Medical Department Sønderborg/Tønder, South Jutland Hospital, Sønderborg, Denmark
| | - Donna Lykke Wolff
- Medical Research Unit, Institute of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
- Medical Department Sønderborg/Tønder, South Jutland Hospital, Sønderborg, Denmark
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Laranjeira C, Dixe MDA, Gueifão L, Caetano L, Passadouro R, Gabriel T, Querido A. Development and psychometric properties of the general public's attitudes toward advance care directives scale in Portugal. J Public Health Res 2021; 10:1881. [PMID: 33681087 PMCID: PMC7922370 DOI: 10.4081/jphr.2021.1881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022] Open
Abstract
Background: To date, no instrument in Portugal has evaluated the attitudes of the population about advance care directives. This paper describes the development and testing of the General Public's Attitudes Toward Advance Care Directives (GPATACD) Scale. Design and Methods: Methodological study. The development of the instrument was based on a literature review, updated in 2018. Face and content validity were verified by an expert panel and piloted among six participants. Data were collected in an online survey of 1024 Portuguese adults. The obtained data were analyzed using Varimax rotation, while the reliability was evaluated by calculating Cronbach's alpha. Results: The scale achieves good Item-Content Validity Index (I-CVI) values, between 0.89 and 1.00, and scale-CVI values of 0.91. A principal component analysis generated four dimensions with 26 items as a final scale, with overall Cronbach's alpha of 0.848. Conclusions: The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of the general public's attitudes toward advance care directives.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic Institute of Leiria; Research in Education and Community Intervention (RECI), Piaget Institute; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria
| | - Maria Dos Anjos Dixe
- School of Health Sciences of Polytechnic of Leiria; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria
| | - Luís Gueifão
- Intensive Care Unit, Leiria Hospital Center, Leiria
| | | | - Rui Passadouro
- ACES do Pinhal Litoral, Leiria; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria
| | | | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Center for Research in Health and Information Systems (CINTESIS), NursID, University of Porto, Portugal
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Mallon A, Slater P, Hasson F, Casson K, McIlfatrick S. What do young adults know about palliative care? A cross-sectional survey. Public Health 2021; 191:78-84. [PMID: 33545498 DOI: 10.1016/j.puhe.2020.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES A public health approach to palliative care that reorientates care towards the public is advocated in global policy. The public are drivers in identifying care priorities and partners in finding solutions to care issues; however, a necessary prerequisite is that the public knows what palliative care is and what it can achieve. The aim of this study was to investigate what young adults, an important cohort of the public, know about palliative care and identify key predictors of knowledge. STUDY DESIGN This is a cross-sectional online survey. METHODS A cross-sectional online survey measured knowledge of palliative care using the Palliative Care Knowledge Scale (PaCKS), with young adults (aged 18-29 years) recruited from a university in the UK. Data relating to demographic characteristics and familiarity and experience of palliative care were collected, with descriptive, bivariate and multivariate analyses undertaken to determine respondents' knowledge levels and key predictors. RESULTS In total, 83% (n = 710) of respondents (n = 859) had heard of the term palliative care. The mean score on the PaCKS was 8.87 (standard deviation = 3.4, range = 0-13); men had lower levels of knowledge (P = 0.016). Most respondents were aware that palliative care is not specifically for those with cancer or exclusively for older populations. They were unsure of timing and other key aspects reporting significant levels of 'I don't 'know' responses. Linear regression analysis demonstrated that familiarity and experience of palliative care moderated demographic influences (age, gender, education level) on knowledge (β = 0.45, P < 0.001). CONCLUSIONS The findings suggest that despite high levels of awareness and familiarity with the term, significant numbers of respondents indicated a lack of knowledge of palliative care rather than inaccurate knowledge. This suggests the need for public health organisations to partner with palliative care sectors to develop and disseminate clear unequivocal messaging relating to the breadth of palliative care that both informs and engages young adults.
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Affiliation(s)
- A Mallon
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Irsland, UK.
| | - P Slater
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Irsland, UK
| | - F Hasson
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Irsland, UK
| | - K Casson
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Irsland, UK
| | - S McIlfatrick
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Irsland, UK
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Mills J, Rosenberg JP, Bollig G, Haberecht J. Last Aid and Public Health Palliative Care: Towards the development of personal skills and strengthened community action. PROGRESS IN PALLIATIVE CARE 2020. [DOI: 10.1080/09699260.2020.1829798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jason Mills
- Torrens University Australia, Brisbane, Australia
- University of the Sunshine Coast, Queensland, Australia
| | - John P. Rosenberg
- University of the Sunshine Coast, Queensland, Australia
- Public Health Palliative Care International
| | - Georg Bollig
- Last Aid International
- Medical Research Unit, Institute of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
- Palliative Care Team, Medical Department Sønderborg/Tønder, South Jutland Hospital, Sønderborg, Denmark
| | - John Haberecht
- Palliative Care Queensland, Australia
- Centre for Palliative Care Research and Education, Queensland Health, Australia
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Xie Y, Xu Y, Yang S, Yan J, Jin XQ, Liu C. Investigation of the awareness of and demand for hospice care and attitudes towards life-sustaining treatment at the end of life among community residents in Hangzhou. BMC Palliat Care 2020; 19:128. [PMID: 32807160 PMCID: PMC7433355 DOI: 10.1186/s12904-020-00628-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To understand the status of residents' awareness of and demand for hospice care services in Hangzhou and to provide a reference for promoting the formulation of hospice care-related policies in China. METHODS A small cross-sectional survey of 519 adults aged over 40 years old living in the rural-urban fringe and urban area of Xihu District, Hangzhou City, was conducted using convenience sampling and a self-designed questionnaire. The measures assessed awareness of hospice care (13-item scale), attitudes towards life support therapy (3-item scale), and demand for hospice care services (9-item scale). RESULTS The rate of awareness of hospice care among community residents was 50.30%. A total of 51.0% of residents wanted only comfortable life-sustaining treatment at the end of their lives. The acceptance of hospice care was positively correlated with the degree of understanding (x2 = 18.382, P = 0.001), and residents in the urban area were more likely to prefer hospice care than residents in the urban-rural fringe (x2 = 7.186, P = 0.028). Elderly residents showed a stronger tendency to prefer comfortable life support therapy (x2 = 12.988, P < 0.001). A total of 83.04% of the residents accepted the current necessity for hospice care to be provided in medical institutions. The preferred locations were professional hospice care institutions or general hospitals. A total of 93.64% of the residents agreed that the number of beds in hospice care wards should not exceed 2. In addition, the residents could afford part of the out-of-pocket expenses for hospice care services, with the ability to pay under 200 yuan per day, and the improvement of facilities was expected. CONCLUSIONS To improve public awareness and acceptance of hospice care and promote healthy development in China, it is necessary to promote hospice care education for everyone.
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Affiliation(s)
- Yanhong Xie
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
| | - Ying Xu
- Department of Nursing, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China.
| | - Shulan Yang
- Department of Nursing, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
| | - Jing Yan
- Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
| | - Xiao Qing Jin
- Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
| | - Caixia Liu
- Department of Nursing, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
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Bollig G, Pothmann R, Mainzer K, Fiedler H. Kinder und Jugendliche möchten über Tod und Sterben reden – Erfahrungen aus Pilotkursen Letzte Hilfe Kids/Teens für 8- bis 16-Jährige. ZEITSCHRIFT FÜR PALLIATIVMEDIZIN 2020. [DOI: 10.1055/a-1222-8041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund und Ziel Letzte-Hilfe-Kurse können Bürger befähigen, mehr Menschen ein Sterben zu Hause zu ermöglichen. Ziel der Studie ist die Evaluation der neu etablierten Letzte-Hilfe-Kurse für Kinder und Jugendliche.
Materialien und Methoden Neun Letzte-Hilfe-Kurse für Kinder und Jugendliche mit insgesamt 128 Teilnehmern von 9–17 Jahren wurden durchgeführt. Die Evaluation basiert auf mixed-methods und erfolgte mittels eines Fragebogens.
Ergebnisse 120 von 128 Teilnehmern (94 %) nahmen an der Evaluation teil. Die Teilnehmer schätzten die Möglichkeit, über Tod und Sterben zu reden. 94 % fanden den Kurs hilfreich für alle und 92 % wollen ihn weiterempfehlen. 89 % fanden die Kursinhalte leicht zu verstehen.
Schlussfolgerungen und Ausblick Die Kurse für Kids/Teens werden von den Teilnehmern sehr gut angenommen. In Zukunft sollten die Kurse weiter verbreitet und in die Schulcurricula aufgenommen werden, um Informationen und Austausch zu Sterben und Begleitung am Lebensende zu ermöglichen.
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Affiliation(s)
- Georg Bollig
- Letzte Hilfe Deutschland gUG, AG Kids/Teens, Schleswig
- Medical Research Unit, Institute of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
- Palliative Care Team, Medical Department Sønderborg/Tønder, South Jutland Hospital, Sønderborg, Denmark
| | - Raymund Pothmann
- Letzte Hilfe Deutschland gUG, AG Kids/Teens, Schleswig
- Kinder PACCT, Hamburg
| | - Kirsten Mainzer
- Letzte Hilfe Deutschland gUG, AG Kids/Teens, Schleswig
- Kinder PACCT, Hamburg
| | - Holger Fiedler
- Letzte Hilfe Deutschland gUG, AG Kids/Teens, Schleswig
- Kinder Palliativteam Südhessen, Frankfurt
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48
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Rousseau PC. Recent Literature. J Palliat Med 2020. [DOI: 10.1089/jpm.2019.0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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