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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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Ibrahim AM, Abdelmeged RM, El-Sakhawy MA, Zaghamir DEF, Elsehrawey MG, Elalem OM, Ahmed MAA, Magdi HM, Hafez SH, Mohamed MA. Palliative and Supportive Care for Patients with End-Stage Hepatocellular Carcinoma: Perspectives of Egyptian Domestic Caregivers. Asian Pac J Cancer Prev 2023; 24:4179-4186. [PMID: 38156853 PMCID: PMC10909099 DOI: 10.31557/apjcp.2023.24.12.4179] [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: 07/02/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Palliative care is a holistic, patient-centered approach to improving the quality of life for those with terminal diseases and their families. The main objective of the current study was to evaluate the Egyptian domestic caregivers' knowledge, attitudes, and competencies related to palliative and supportive care. METHODS Three hundred and thirty-five family caregivers in total were recruited. A descriptive research design was used. Four tools were used to collect data; structured interview questionnaire to collect demographic questions, palliative care knowledge questionnaire, Palliative Attitude Scale, and Competence Scale. The study was conducted in oncology outpatient and pain clinics located at the Damietta Cancer Institute in Damietta Governorate, Egypt. RESULTS Nearly two-thirds of the informal family caregivers are aged between 30-40 years old; 54% are female, and 83% are married. Also, sixty-seven point eight of the informal family caregivers were working (part-time). Furthermore, 65 % of them had insufficient knowledge, 68 % had a positive attitude, and 58% of the informal family caregivers had non-competency skills regarding palliative and supportive care. CONCLUSION Approximately two-thirds of informal care providers had insufficient total knowledge scores, more than half possessed a positive attitude, and more than half reported non-competency skills regarding palliative care of hepatocellular patients. RECOMMENDATION It is highly advisable to launch extensive health education programs and campaigns aimed at all of the unpaid informal family careers of patients with serious terminal illnesses, including hepatocellular carcinoma, at various governments with greater sample sizes.
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Affiliation(s)
- Ateya Megahed Ibrahim
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt.
| | - Reda M. Abdelmeged
- Assistant Professor, EMS Department, AL-Ghad College for Applied Medical Sciences, Riyadh, KSA.
- Lecturer of Anaesthesia and Surgical ICU, Department of Anesthesia and Critical Care, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Mohamed A. El-Sakhawy
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj11942, Saudi Arabia.
- Department of Medicinal and Aromatic Plants, Desert Research Center, Cairo, Egypt.
| | - Donia Elsaid Fathi Zaghamir
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
- Lecturer of Pediatric Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt.
| | - Mohamed Gamal Elsehrawey
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
- Lecturer of Nursing Administration, Faculty of Nursing, Port Said University, Port Said, Egypt.
| | - Omima Mohamed Elalem
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt.
- Community Health Nursing, College of Nursing, University of Hail, Saudi Arabia.
| | | | - Hussein M. Magdi
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
- Lecturer of Psychiatric and Mental Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
| | - Sameer Hamdy Hafez
- Department of Community and Mental Health, College of Nursing, Najran University, Najran, Saudi Arabia.
- Assistant Professor, Community Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
| | - Magda Ali Mohamed
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt.
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Ul Hassan SS, Ali W, Khan H, Raja AR, Hassan M, Haque G, Ayub F, Waqar MA, Latif A. Confronted With Death: Factors Affecting End of Life Decisions in the Intensive Care Unit. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231198360. [PMID: 37632273 DOI: 10.1177/00302228231198360] [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: 08/27/2023]
Abstract
To determine how often care is limited at the end of life and the factors that are associated with this decision, we reviewed the medical records of all patients that passed away in the intensive care units (ICU) of Aga Khan University. We found that a majority of patients had Do-Not-Resuscitate orders in place at the time of death. Our analysis yielded 6 variables that were associated with the decision to limit care. These are patient age, sex, duration of mechanical ventilation, Glasgow Coma Scale (GCS) ≤8 at any point during ICU stay, GCS ≤8 in the first 24 hours following ICU admission, and mean arterial pressure <65 mm of Hg while on vasopressors in the first 24 hours following ICU admission. These variables require further study and should be carefully considered during end of life discussions to allow for optimal management at the end of life.
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Affiliation(s)
| | - Wajid Ali
- Dean's Clinical Research Fellow, Aga Khan University, Karachi, Pakistan
| | - Hamza Khan
- Dean's Clinical Research Fellow, Aga Khan University, Karachi, Pakistan
| | | | | | - Ghazal Haque
- Centre for Patient Safety, Aga Khan University, Karachi, Pakistan
| | - Farwa Ayub
- Centre for Patient Safety, Aga Khan University, Karachi, Pakistan
| | | | - Asad Latif
- Centre for Patient Safety, Aga Khan University, Karachi, Pakistan
- Department of Anesthesiology, Aga Khan University Hospital, Karachi, Pakistan
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, USA
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Zhu L, Zhang N, Hu Y, Xu Y, Luo T, Xiang Y, Jiang S, Zhang Z, Chen M, Xiong Y. Influencing factors of knowledge, attitude and behavior in children's palliative care among pediatric healthcare workers: a cross-sectional survey in China. BMC Palliat Care 2023; 22:67. [PMID: 37280672 DOI: 10.1186/s12904-023-01187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Palliative care has become a key medical field worldwide. Although research relating to adult palliative care is well-established, less is known about children's palliative care (CPC). Therefore, this study investigated the knowledge, attitude and behavior of pediatric healthcare workers (PHWs) regarding CPC and analyzed the influencing factors for the implementation and development of CPC. METHODS A cross-sectional survey of 407 PHWs was carried out in a Chinese province from November 2021 to April 2022. The questionnaire consisted of two parts: a general information form and questions on the knowledge, attitude and behavior of PHWs about CPC. Data were analyzed using t-test, ANOVA and multiple regression analysis. RESULTS The total score of the PHWs' knowledge, attitude and behavior about CPC was 69.98, which was at a moderate level. PHWs' CPC knowledge, attitude, and behavior are positively correlated.The most important influencing factors were working years, highest education, professional title, job position, marital status, religion, grade of hospital (I, II or III), type of medical institution, experience of caring for a terminally ill child/kinsfolk and total hours of CPC education and training received. CONCLUSIONS In this study, PHWs in a Chinese province had the lowest scores on the knowledge dimension of CPC, with moderate attitude and behavior and various influencing factors. In addition to professional title, highest education and working years, it is also worth noting that the type of medical institution and marital status also affected the score. Continuing education and training of PHWs in CPC should be emphasized by the administrators of relevant colleges and medical institutions. Future research should start with the above-mentioned influencing factors and focus on setting up targeted training courses and evaluating the post-training effects.
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Affiliation(s)
- Lihui Zhu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
| | - Na Zhang
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Department of Nursing, Hunan Children's Hospital, Changsha, China
| | - Yaojia Hu
- Department of Ophthalmology, Hunan Children's Hospital, Changsha, China
| | - Yi Xu
- Department of Nursing, Hunan Children's Hospital, Changsha, China
| | - Tingwei Luo
- Department of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yuqiong Xiang
- Department of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Sishan Jiang
- Department of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Zhiqiang Zhang
- Department of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Muhua Chen
- Department of Neonatology, Hunan Children's Hospital, Changsha, China
| | - Yuee Xiong
- Department of Neonatology, Hunan Children's Hospital, Changsha, China
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Ye Z, Jing L, Zhang H, Qin Y, Chen H, Yang J, Zhu R, Wang J, Zhang H, Xu Y, Chu T. Attitudes and influencing factors of nursing assistants towards hospice and palliative care nursing in chinese nursing homes: a cross-sectional study. BMC Palliat Care 2023; 22:49. [PMID: 37098562 PMCID: PMC10127064 DOI: 10.1186/s12904-023-01175-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Hospice and palliative care nursing (HPCN) in China is mainly available at public primary care institutions, where nursing homes (NHs) are rarely involved. Nursing assistants (NAs) play an essential role in HPCN multidisciplinary teams, but little is known about their attitudes towards HPCN and related factors. METHODS A cross-sectional study was designed to evaluate NAs' attitudes towards HPCN with an indigenised scale in Shanghai. A total of 165 formal NAs were recruited from 3 urban and 2 suburban NHs between October 2021 and January 2022. The questionnaire was composed of four parts: demographic characteristics, attitudes (20 items with four sub-concepts), knowledge (nine items), and training needs (nine items). Descriptive statistics, independent samples t-test, one-way ANOVA, Pearson's correlation, and multiple linear regression were performed to analyse NAs' attitudes, influencing factors, and their correlations. RESULTS A total of 156 questionnaires were valid. The mean score of attitudes was 72.44 ± 9.56 (range:55-99), with a mean item score of 3.6 ± 0.5 (range:1-5). The highest score rate was "perception of the benefits for the life quality promotion" (81.23%), and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (59.92%). NAs' attitudes towards HPCN were positively correlated with their knowledge score (r = 0.46, P < 0.01) and training needs (r = 0.33, P < 0.01). Marital status (β = 0.185), previous training experience (β = 0.201), location of NHs (β = 0.193), knowledge (β = 0.294), and training needs (β = 0.157) for HPCN constituted significant predictors of attitudes (P < 0.05), which explained 30.8% of the overall variance. CONCLUSION NAs' attitudes towards HPCN were moderate, but their knowledge should be improved. Targeted training is highly recommended to improve the participation of positive and enabled NAs and to promote high-quality universal coverage of HPCN in NHs.
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Affiliation(s)
- Zhuojun Ye
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Limei Jing
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China.
| | - Haoyu Zhang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Yongfa Qin
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Hangqi Chen
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Jiying Yang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Ruize Zhu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Jingrong Wang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Huiwen Zhang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Yifan Xu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
| | - Tianshu Chu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China
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Murali KP, Kang JA, Bronstein D, McDonald MV, King L, Chastain AM, Shang J. Measuring Palliative Care-Related Knowledge, Attitudes, and Confidence in Home Health Care Clinicians, Patients, and Caregivers: A Systematic Review. J Palliat Med 2022; 25:1579-1598. [PMID: 35704053 PMCID: PMC9639230 DOI: 10.1089/jpm.2021.0580] [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] [Accepted: 05/13/2022] [Indexed: 11/12/2022] Open
Abstract
Background: Integrating palliative care services in the home health care (HHC) setting is an important strategy to provide care for seriously ill adults and improve symptom burden, quality of life, and caregiver burden. Routine palliative care in HHC is only possible if clinicians who provide this care are prepared and patients and caregivers are well equipped with the knowledge to receive this care. A key first step in integrating palliative care services within HHC is to measure preparedness of clinicians and readiness of patients and caregivers to receive it. Objective: The objective of this systematic review was to review existing literature related to the measurement of palliative care-related knowledge, attitudes, and confidence among HHC clinicians, patients, and caregivers. Methods: We searched PubMed, CINAHL, Web of Science, and Cochrane for relevant articles between 2000 and 2021. Articles were included in the final analysis if they (1) reported specifically on palliative care knowledge, attitudes, or confidence, (2) presented measurement tools, instruments, scales, or questionnaires, (3) were conducted in the HHC setting, (4) and included HHC clinicians, patients, or caregivers. Results: Seventeen articles were included. While knowledge, attitudes, and confidence have been studied in HHC clinicians, patients, and caregivers, results varied significantly across countries and health care systems. No study captured knowledge, attitudes, and confidence of the full HHC workforce; notably, home health aides were not included in the studies. Conclusion: Existing instruments did not comprehensively contain elements of the eight domains of palliative care outlined by the National Consensus Project (NCP) for Quality Palliative Care. A comprehensive psychometrically tested instrument to measure palliative care-related knowledge, attitudes, and confidence in the HHC setting is needed.
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Affiliation(s)
- Komal Patel Murali
- Center for Health Policy, Columbia University School of Nursing, New York, New York, USA
| | - Jung A. Kang
- Center for Health Policy, Columbia University School of Nursing, New York, New York, USA
| | - David Bronstein
- Columbia University Mailman School of Public Health, New York, New York, USA
- George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Margaret V. McDonald
- Center for Home Care Research and Policy, Visiting Nurse Service of New York, New York, New York, USA
| | - Lori King
- Center for Home Care Research and Policy, Visiting Nurse Service of New York, New York, New York, USA
| | - Ashley M. Chastain
- Center for Health Policy, Columbia University School of Nursing, New York, New York, USA
| | - Jingjing Shang
- Center for Health Policy, Columbia University School of Nursing, New York, New York, 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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Kluger BM, Miyasaki JM. Key concepts and opportunities. HANDBOOK OF CLINICAL NEUROLOGY 2022; 190:3-15. [PMID: 36055718 DOI: 10.1016/b978-0-323-85029-2.00014-2] [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: 06/15/2023]
Abstract
Neuropalliative care is an emerging field dedicated to applying palliative care approaches to meet the needs of persons living with neurologic illness and their families. The development of this field acknowledges the unique needs of this population, including in terms of neuropsychiatric symptoms, the impact of neurologic illness on personhood, and the logistics of managing neurologic disability. In defining the goals of this field, it is important to distinguish between neuropalliative care as an approach to care, as a skillset, as a medical subspecialty, and as a public health goal as each of these constructs offers their own contributions and opportunities. As a newly emerging field, there are nearly unlimited opportunities to improve care through research, clinical care, education, and advocacy.
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Affiliation(s)
- Benzi M Kluger
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Janis M Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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Di Nitto M, Artico M, Piredda M, De Maria M, Magnani C, Marchetti A, Mastroianni C, Latina R, De Marinis MG, D’Angelo D. Factors influencing place of death and disenrollment among patients receiving specialist palliative care. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022189. [PMID: 35545986 PMCID: PMC9534221 DOI: 10.23750/abm.v93is2.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Place of death and disenrollment from specialized palliative care services (SPCSs) are two aspects that determine service utilization. These aspects should be determined by patient needs and preferences, but they are often associated to patient sociodemographic or contextual characteristics. The aim of this study was to describe which factors are associated with utilizing SPCSs in terms of place of death and disenrollment. METHODS Retrospective cohort study. Patients (>18 years) who died or were disenrolled during SPCSs utilization. Two hierarchical regression models were performed, and variables were categorized in predisposing, enabling, and need factors according to the Andersen behavioral model of health services use. RESULTS We included 35,869 patients (52,5% male, mean age 74,6 ± 12,3 SD), where 17,225 patients died in hospice and 16,953 at home, while 1,691 patients were disenrolled. Dying at home was associated with older age, oncological diagnosis, painful symptoms and longer survival time. Instead, service disenrollment was associated with less education, longer wait time and longer length of stay. CONCLUSIONS SPCS utilization was not influenced only by patient need, but also by other factors, such as social and contextual factors. These factors need to be considered by health care providers and efforts are needed for 1) identifying barriers and implementing effective interventions to support patients and caregivers in their preferred place of care and death and 2) for avoiding SPCS disenrollment with an increased probability of aggressive treatments and worse quality of life for patients.
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Affiliation(s)
- Marco Di Nitto
- Department of biomedicine and prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Marco Artico
- Department of Palliative Care and Pain Therapy Unit, Azienda ULSS n.4 Veneto Orientale, San Donà di Piave, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Maddalena De Maria
- Department of biomedicine and prevention, University of Rome “Tor Vergata”, Rome, Italy
| | | | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | | | - Roberto Latina
- Deptment of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Excellence Specialists University of Palermo, Palermo, Italy
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Biswas J, Banik PC, Ahmad N. Physicians' knowledge about palliative care in Bangladesh: A cross-sectional study using digital social media platforms. PLoS One 2021; 16:e0256927. [PMID: 34469497 PMCID: PMC8409647 DOI: 10.1371/journal.pone.0256927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/18/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Palliative care is still a new concept in many developing countries like Bangladesh. Basic knowledge about palliative care is needed for all physicians to identify and provide this care. This study aims to assess the preliminary knowledge level and the misconceptions about this field among physicians. Methods This cross-sectional study was conducted among 479 physicians using a self-administered structured questionnaire adapted from Palliative Care Knowledge Scale (PaCKs) on various digital social media platforms from December 2019 to February 2020. Chi-square, Fisher’s extract test, and the Monte Carlo extract test was done to compare the knowledge level with the study subjects’ demographic variables. Results An almost equal number of physicians of both genders from four major specialties and their allied branches took part in the study (response rate 23.9%). The majority (71%) of the respondents had an average to an excellent level of knowledge about palliative care, with a median score of 11.0. Although most physicians had average knowledge about the primary goals and general concepts of palliative care, misconceptions are highly prevalent. The commonly present misconceptions were that palliative care discourages patients from consulting other specialties (88.9%), refrains them from taking curative treatments (83.1%), and this care is only for older adults (74.5%), cancer patients (63%), and the last six months of life (56.4%). Age, educational qualifications, and specialties had significant relationships (P<0.05) with the level of knowledge. Conclusion Despite having average or above knowledge about palliative care, the physicians’ prevailing misconceptions act as a barrier to recognizing the need among the target populations. So, proper education and awareness among the physicians are necessary to cross this field’s barrier and development.
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Affiliation(s)
- Jheelam Biswas
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
- * E-mail:
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Nezamuddin Ahmad
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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