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Haeusermann T, Liu EY, Fong KC, Dohan D, Chiong W. Patient experiences of resection versus responsive neurostimulation for drug-resistant epilepsy. Epilepsy Behav 2024; 153:109707. [PMID: 38430673 PMCID: PMC11185832 DOI: 10.1016/j.yebeh.2024.109707] [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] [Received: 11/08/2023] [Revised: 01/17/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
This study explored illness experiences and decision-making among patients with epilepsy who underwent two different types of surgical interventions: resection versus implantation of the NeuroPace Responsive Neurostimulation System (RNS). We recruited 31 participants from a level four epilepsy center in an academic medical institution. We observed 22 patient clinic visits (resection: n = 10, RNS: n = 12) and conducted 18 in-depth patient interviews (resection: n = seven, RNS: n = 11); most visits and interviews included patient caregivers. Using an applied ethnographic approach, we identified three major themes in the experiences of resection versus RNS patients. First, for patients in both cohorts, the therapeutic journey was circuitous in ways that defied standardized first-, second-, and third- line of care models. Second, in conceptualizing risk, resection patients emphasized the permanent loss of "taking out" brain tissue whereas RNS patients highlighted the reversibility of "putting in" a device. Lastly, in considering benefit, resection patients perceived their surgery as potentially curative while RNS patients understood implantation as primarily palliative with possible additional diagnostic benefit from chronic electrocorticography. Insight into the perspectives of patients and caregivers may help identify key topics for counseling and exploration by clinicians.
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Affiliation(s)
| | - Emily Yang Liu
- UCSF Weill Institute for Neurosciences, United States; UCSF Bioethics, United States; UCSF Epilepsy Center, United States.
| | - Kristina Celeste Fong
- UCSF Weill Institute for Neurosciences, United States; UCSF Bioethics, United States
| | - Daniel Dohan
- UCSF Institute for Health Policy Studies, United States
| | - Winston Chiong
- UCSF Weill Institute for Neurosciences, United States; UCSF Bioethics, United States
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Rattner M, Cait CA. Nonphysical Suffering: An Under-Resourced and Key Role for Hospice and Palliative Care Social Workers. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2024; 20:8-25. [PMID: 37948164 DOI: 10.1080/15524256.2023.2272590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
This article highlights recent research findings that have significance for hospice and palliative care social work in Canada, and for the field of hospice and palliative care more broadly. A 2020 discourse analysis study examined the experiences of 24 interdisciplinary palliative care clinicians across Canada in their work with patients' nonphysical suffering. Nonphysical suffering is suffering that may be emotional, psychological, social, spiritual and/or existential in nature. The study found an absence of specialist social workers on hospice and palliative care teams or limited time for specialist social workers to address patients' nonphysical suffering due to high caseloads and complex practical needs. While the study recognizes social workers have expertise in supporting patients' nonphysical suffering, a competency and skill that has not been sufficiently captured in the existing literature, the systemic barriers they face in providing care may leave patients' needs unmet. The study also highlights the unique pressure social workers may feel to relieve patients' nonphysical suffering due to the psychosocial focus of their role. The need for specialist social workers to be included and adequately resourced on hospice and palliative care teams across diverse settings in Canada is evident.
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Affiliation(s)
- Maxxine Rattner
- Faculty of Social Work, Wilfrid Laurier University, Waterloo, Canada
| | - Cheryl-Anne Cait
- Faculty of Social Work, Wilfrid Laurier University, Waterloo, Canada
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Qureshi SP, Jones D, Dewar A. Physicians' Conceptions of the Dying Patient: Scoping Review and Qualitative Content Analysis of the United Kingdom Medical Literature. QUALITATIVE HEALTH RESEARCH 2022; 32:1881-1896. [PMID: 35981561 PMCID: PMC9511242 DOI: 10.1177/10497323221119939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Most people in high income countries experience dying while receiving healthcare, yet dying has no clear beginning, and contexts influence how dying is conceptualised. This study investigates how UK physicians conceptualise the dying patient. We employed Scoping Study Methodology to obtain medical literature from 2006-2021, and Qualitative Content Analysis to analyse stated and implied meanings of language used, informed by social-materialism. Our findings indicate physicians do not conceive a dichotomous distinction between dying and not dying, but construct conceptions of the dying patient in subjective ways linked to their practice. We argue that the focus of future research should be on exploring practice-based challenges in the workplace to understanding patient dying. Furthermore, pre-Covid-19 literature related dying to chronic illness, but analysis of literature published since the pandemic generated conceptions of dying from acute illness. Researchers should note the ongoing effects of Covid-19 on societal and medical awareness of dying.
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Affiliation(s)
- Shaun Peter Qureshi
- Edinburgh Medical School, The University of Edinburgh Edinburgh Medical School, Edinburgh, UK
| | - Derek Jones
- Edinburgh Medical School, The University of Edinburgh Edinburgh Medical School, Edinburgh, UK
| | - Avril Dewar
- Edinburgh Medical School, The University of Edinburgh Edinburgh Medical School, Edinburgh, UK
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Whitelaw S, Bell A, Clark D. The expression of 'policy' in palliative care: A critical review. Health Policy 2022; 126:889-898. [PMID: 35840439 DOI: 10.1016/j.healthpol.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
Abstract
The importance of 'policy' within palliative care has steadily increased over the past 25 years. Whilst this has been welcomed within the palliative care field and seen as a route to greater recognition, we focus here on a more critical perspective that challenge the effectiveness of a 'policy turn' in palliative care. Applying Bacchi's "What's the Problem Represented to Be?" (WPR) framework to data from a systematic search, we address the research question, "in what ways has 'policy' been articulated in palliative care literature?". The paper describes the construction of 'the problem' context and reflects critically on the robustness and pragmatic utility of such representations. In particular, we identify five elements as prominent and problematic: (1) a lack of empirical evidence that connects policy to practice; (2) the dominance of 'Global North' approaches; (3) the use of a policy narrative based on 'catastrophe' in justifying the need for palliative care; (4) the use of idealistic and aspirational 'calls to action'; and (5) a disengaged and antagonistic orientation to existing health systems. We conclude by suggesting that the efficacy of palliative care policy could be enhanced via greater emphases on 'Global South' perspectives, 'assets-based' approaches and attention to pragmatic implementation.
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Affiliation(s)
- Sandy Whitelaw
- School of Interdisciplinary Studies, University of Glasgow, Dumfries Campus, Dumfries, DG1 4ZL, United Kingdom.
| | - Anthony Bell
- School of Interdisciplinary Studies, University of Glasgow, Dumfries Campus, Dumfries, DG1 4ZL, United Kingdom
| | - David Clark
- School of Interdisciplinary Studies, University of Glasgow, Dumfries Campus, Dumfries, DG1 4ZL, United Kingdom
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Bennett HE, Duke S, Richardson A. Paediatric advance care planning in life-limiting conditions: scoping review of parent experiences. BMJ Support Palliat Care 2022; 13:161-173. [DOI: 10.1136/bmjspcare-2022-003544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/16/2022] [Indexed: 11/04/2022]
Abstract
BackgroundAdvance care planning is considered best practice for children and young people with life-limiting conditions but there is limited evidence how parents’ perceive, understand and engage with the process.AimTo understand parents’ experience of advance care planning for a child or young person with a life-limiting condition.DesignScoping review, theoretically informed by Family Sense of Coherence. Parents’ experience was conceptualised in terms of meaningfulness, comprehensibility and manageability.Data sourcesElectronic databases Medline, CINAHL and PyschINFO were searched for studies published between 1990 and 2021, using MeSH and broad-base terms.Results150 citations were identified and screened; 15 studies were included: qualitative (n=10), survey (n=3) and participatory research (n=2). Parents’ experience of advance care planning was contextualised by their family values and beliefs, needs and goals and the day-to-day impact of caring for their child and family. They valued conversations, which helped them to maximise their child’s quality of life and minimise their suffering. They preferred flexible, rather than definitive decisions about end-of-life care and treatment.ConclusionsAdvance care planning which solely focuses on treatment decisions is at odds with parents’ concerns about the current and future impact of illness on their child and family. Parents want advance care planning for their child to reflect what matters to them as a family. Future longitudinal and comparative studies are needed to understand the influence of advance care planning on parental decision-making over time and how social, cultural and contextual nuances influence parental experience.
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Thoresen L, Røberg ASB. The construction of the responsible patient in complex palliative care: interpreting palliative care policies. Palliat Care Soc Pract 2022; 16:26323524221118586. [PMID: 36059854 PMCID: PMC9434665 DOI: 10.1177/26323524221118586] [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] [Received: 03/31/2022] [Revised: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background: To contribute with knowledge to health policy development, this article
presents a critical discourse analysis of two Norwegian official reports on
palliative care published in 1999 and 2017. Methods: We identify, describe and discuss how linguistic features in policy documents
contribute to and engender a distinct change from 1999 to 2017 in how
patients are framed, documenting the development of palliative care. Results: The analysis identifies and considers two interwoven discourses: the
discourse of accountability and the discourse of complexity. The patient
moves from being described as in need of care, in the 1999 report, to being
described as an active and responsible patient making proper choices, in the
2017 report. Conclusion: Result of this policy development might be less involvement of professionals
and focus on existential questions, and more responsibility on patients for
their prospective wellbeing and health: a change that we argue should be
considered and counteracted in upcoming policy processes considering
palliative care.
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Affiliation(s)
- Lisbeth Thoresen
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Pb. 1089 Blindern, N-0318 Oslo, Norway
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Abstract
The concept of modern palliative care has been disseminating slowly in Turkey and has recently been included in the National Cancer Control Program. The aim of this study was to explore healthcare professionals’ knowledge and views of palliative care. It was conducted at three hospitals with a sample of 369 healthcare professionals working in adult clinics. Data were collected via open-ended questions and 16 statements from healthcare professionals on their views of palliative care. Most respondents stated that there was a lack of in-service/continuing education in palliative care, and more than half said they had not received any education in palliative care. A majority stated that the meaning and goal of palliative care is “improving the quality of life of a patient who is in the terminal stage.” Lack of awareness of palliative care and a lack of educational resources in that field are the most frequently reported barriers to the development of palliative care in Turkey. Palliative care should be included in curricula for healthcare professionals and in-service education programs should be established.
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Affiliation(s)
- Gulay Turgay
- S Kav (corresponding author): Baskent University Faculty of Health Sciences, Department of Nursing, Baglica Kampusu Eskisehir Yolu 20. Km, Baglica 06810, Ankara, Turkey
| | - Sultan Kav
- G Turgay: Baskent University Vocational School of Health Services, Ankara, Turkey
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Nurses Providing End-of-Life Care for Infants and Their Families in the NICU: A Review of the Literature. Adv Neonatal Care 2018; 18:471-479. [PMID: 30507828 DOI: 10.1097/anc.0000000000000533] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurses working in the neonatal intensive care unit (NICU) who care for dying infants and their families say they do not necessarily have the expertise or the specific training to provide quality end-of-life-care (EOLC). PURPOSE The purpose of this review was to critically appraise the existing qualitative literature regarding nurses' experiences when caring for infants during end of life in the NICU and to identify barriers and enablers to provide quality EOLC. SEARCH STRATEGY A literature search was conducted using CINAHL and OVID databases. Studies that explored nurses' experiences when caring for infants who were dying or when lifesaving care was withdrawn were retrieved and 15 studies were thematically analyzed. RESULTS Five major themes emerged: advocating for the dying infant, building close relationships with the family, providing an appropriate care environment, nurses' emotional responses to dying or death, and professional inadequacy in EOLC. IMPLICATIONS FOR PRACTICE Nurses face multiple challenges when providing EOLC including moral dilemmas and feelings of professional inadequacy. Avoidance was a common strategy used by nurses to cope with the stress associated with EOLC. Managers can foster quality EOLC by implementing education sessions about infant mortality, EOLC, advocacy, team communication, and self-care practices. IMPLICATIONS FOR RESEARCH Research could evaluate the effectiveness of EOLC education sessions to build nurses' competence and confidence in advocacy and EOLC clinical skills.
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Bloomer MJ, Endacott R, Copnell B, O'Connor M. 'Something normal in a very, very abnormal environment'--Nursing work to honour the life of dying infants and children in neonatal and paediatric intensive care in Australia. Intensive Crit Care Nurs 2015; 33:5-11. [PMID: 26687773 DOI: 10.1016/j.iccn.2015.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 09/15/2015] [Accepted: 09/17/2015] [Indexed: 11/24/2022]
Abstract
The majority of deaths of children and infants occur in paediatric and neonatal intensive care settings. For nurses, managing an infant/child's deterioration and death can be very challenging. Nurses play a vital role in how the death occurs, how families are supported leading up to and after the infant/child's death. This paper describes the nurses' endeavours to create normality amidst the sadness and grief of the death of a child in paediatric and neonatal ICU. Focus groups and individual interviews with registered nurses from NICU and PICU settings gathered data on how neonatal and paediatric intensive care nurses care for families when a child dies and how they perceived their ability and preparedness to provide family care. Four themes emerged from thematic analysis: (1) respecting the child as a person; (2) creating opportunities for family involvement/connection; (3) collecting mementos; and (4) planning for death. Many of the activities described in this study empowered parents to participate in the care of their child as death approached. Further work is required to ensure these principles are translated into practice.
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Affiliation(s)
- Melissa J Bloomer
- Monash University, School of Nursing and Midwifery, Building E, PO Box 527, Frankston, VIC 3199, Australia.
| | - Ruth Endacott
- Monash University, School of Nursing and Midwifery, 10 Chancellors Walk, Clayton Campus, Clayton, VIC 3800, Australia.
| | - Beverley Copnell
- Monash University, School of Nursing and Midwifery, 10 Chancellors Walk, Clayton Campus, Clayton, VIC 3800, Australia.
| | - Margaret O'Connor
- Monash University, School of Nursing and Midwifery, Building E, PO Box 527, Frankston, VIC 3199, Australia.
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Lamers CPT, Williams RR. Older People’s Discourses About Euthanasia and Assisted Suicide: A Foucauldian Exploration. THE GERONTOLOGIST 2015. [DOI: 10.1093/geront/gnv102] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Affiliation(s)
- Sarah Russell
- Professional Doctorate Student, Centre for Research in Primary and Community Care, University of Hertfordshire, UK
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15
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Bloomer MJ, O'Connor M, Copnell B, Endacott R. Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: nurses' emotional talk and sources of discomfort. A mixed methods study. Aust Crit Care 2015; 28:87-92. [PMID: 25659197 DOI: 10.1016/j.aucc.2015.01.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/28/2014] [Accepted: 01/08/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The majority of in-hospital deaths of children occur in paediatric and neonatal intensive care units. For nurses working in these settings, this can be a source of significant anxiety, discomfort and sense of failure. OBJECTIVES The objectives of this study were to explore how NICU/PICU nurses care for families before and after death; to explore the nurses' perspectives on their preparedness/ability to provide family care; and to determine the emotional content of language used by nurse participants. METHODS Focus group and individual interviews were conducted with 22 registered nurses from neonatal and paediatric intensive care units of two major metropolitan hospitals in Australia. All data were audio recorded and transcribed verbatim. Transcripts were then analysed thematically and using Linguistic Inquiry to examine emotional content. RESULTS Four core themes were identified: preparing for death; communication challenges; the nurse-family relationship and resilience of nurses. Findings suggested that continuing to provide aggressive treatment to a dying child/infant whilst simultaneously caring for the family caused discomfort and frustration for nurses. Nurses sometimes delayed death to allow families to prepare, as evidenced in the Linguistic Inquiry analysis, which enabled differentiation between types of emotional talk such as anger talk, anxiety talk and sadness talk. PICU nurses had significantly more anxiety talk (p=0.018) than NICU nurses. CONCLUSION This study provided rich insights into the experiences of nurses who are caring for dying children including the nurses' need to balance the often aggressive treatments with preparation of the family for the possibility of their child's death. There is some room for improvement in nurses' provision of anticipatory guidance, which encompasses effective and open communication, focussed on preparing families for the child's death.
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Affiliation(s)
- Melissa J Bloomer
- Monash University, School of Nursing and Midwifery, Building E, PO Box 527, Frankston, VIC 3199, Australia.
| | - Margaret O'Connor
- Emeritus Professor of Nursing, Monash University, School of Nursing and Midwifery, Building E, PO Box 527, Frankston, VIC, 3199, Australia
| | - Beverley Copnell
- Monash University, School of Nursing and Midwifery, Wellington Road, Clayton, VIC 3800, Australia
| | - Ruth Endacott
- Monash University, School of Nursing and Midwifery, Wellington Road, Clayton, VIC 3800, Australia; Plymouth University, Faculty of Health and Human Sciences, 8 Portland Villas, Drake Circus, Plymouth PL4 8AA, UK
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Watts T. Final-year nursing undergraduates' understandings of palliative care: a qualitative study in Wales, UK. Int J Palliat Nurs 2014; 20:285-93. [PMID: 25040864 DOI: 10.12968/ijpn.2014.20.6.285] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND With worldwide population ageing and the increasing prevalence of chronic conditions, government policies promoting palliative care, and evidence of disparate or even blurred conceptions of palliative care, it is important for educators and practitioners who support undergraduate nurses to establish how these students conceptualise palliative care. Today's students are tomorrow's nurses, and their understanding will shape the ways in which palliative care is integrated into their professional practice. AIM The aim of this work was to explore nursing undergraduates' understandings of palliative care. METHODS As part of a larger qualitative study of palliative care for people with advanced dementia, 11 final-year adult-field nursing undergraduates' understandings of palliative care were explored through in-depth individual interviews. The data was subject to thematic content analysis. FINDINGS The analysis revealed that the participants were cognisant of the broad scope of palliative care. Moreover, they valued and appreciated compassionate comfort care and emotional support. However, their understanding was rather superficial and focused on the imminently dying phase. CONCLUSION The findings are positive as they indicate that the participants appreciated and valued compassionate person- and family-centred care. However, they also illuminate where undergraduate nurse education could be further enhanced.
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Affiliation(s)
- Tessa Watts
- Associate Professor in Nursing, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales
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Dieltjens SM, Heynderickx PC, Dees MK, Vissers KC. Linguistic Analysis of Face-to-Face Interviews with Patients with An Explicit Request for Euthanasia, their Closest Relatives, and their Attending Physicians: the Use of Modal Verbs in Dutch. Pain Pract 2013; 14:324-31. [DOI: 10.1111/papr.12076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Marianne K. Dees
- Section of Ethics, Philosophy and History of Medicine, Scientific Institute for Quality of Healthcare; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Kris C. Vissers
- Department of Anesthesiology; Pain and Palliative Medicine; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
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Biasco G, Tanzi S, Bruera E. “Early Palliative Care: How?” From a Conference Report to a Consensus Document, Bentivoglio, May 14, 2012. J Palliat Med 2013; 16:466-70. [DOI: 10.1089/jpm.2012.0603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Guido Biasco
- Department of Oncology, University of Bologna, Academy of Sciences of Palliative Medicine, Bentivoglio, Bologna, Italy
| | - Silvia Tanzi
- Department of Oncology, University of Bologna, Academy of Sciences of Palliative Medicine, Bentivoglio, Bologna, Italy
- Palliative Care Unit, IRCCS, Reggio Emilia, Italy
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Giesbrecht MD, Crooks VA, Stajduhar KI. Examining the language-place-healthcare intersection in the context of Canadian homecare nursing. Nurs Inq 2012. [PMID: 23190192 DOI: 10.1111/nin.12010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Currently, much of the western world is experiencing a shift in the places where care is provided, namely from institutional settings like hospitals to diverse community settings such as the home. However, little is known about how language and the physical and social aspects of place interact to influence how health-care is delivered and experienced in the home environment. Drawing on ethnographic participant observations of homecare nursing visits and semi-structured interviews with Canadian family caregivers, care recipients and nurses, the intersection of language, place and health-care was explored in this secondary analysis. Our findings reveal four themes: homecare nurses view themselves as 'guests'; home environments facilitate the development of nurse-client relationships; nurses adapt healthcare language to each home environment; and storytelling and illness narratives largely prevail during medical interactions in the home. These findings demonstrate the spatiality of language and how the home environment informs decisions regarding language use. Furthermore, these findings exemplify how language and place mutually influence the experiences and delivery of home health-care. We conclude by discussing the importance of considering the language-place-healthcare intersection in order to gain a better understanding of medical exchanges in places and the associated implications for optimizing best nursing practice.
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Affiliation(s)
- Melissa D Giesbrecht
- Department of Geography, Simon Fraser University, Burnaby, BC, CanadaSchool of Nursing and Centre on Aging, University of Victoria, Victoria, BC, Canada
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Lau R, O'Connor M. Behind the rhetoric - is palliative care equitably available for all? Contemp Nurse 2012. [DOI: 10.5172/conu.2012.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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