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Lee SC, Shih CY, Chen ST, Lee CY, Li SR, Tang CC, Tsai JS, Cheng SY, Huang HL. Factors Contributing to Non-Concordance Between End-of-Life Care and Advance Care Planning. J Pain Symptom Manage 2024; 67:544-553. [PMID: 38479538 DOI: 10.1016/j.jpainsymman.2024.03.004] [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: 01/14/2024] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 04/05/2024]
Abstract
CONTEXT Despite making do-not-resuscitate or comfort care decisions during advance care planning, terminally ill patients sometimes receive life-sustaining treatments as they approach end of life. OBJECTIVES To examine factors contributing to nonconcordance between end-of-life care and advance care planning. METHODS In this longitudinal retrospective cohort study, terminally ill patients with a life expectancy shorter than six months, who had previously expressed a preference for do-not-resuscitate or comfort care, were followed up after palliative shared care intervention. An instrument with eight items contributing to non-concordant care, developed through literature review and experts' consensus, was employed. An expert panel reviewed electronic medical records to determine factors associated with non-concordant care for each patient. Statistical analysis, including descriptive statistics and the chi-square test, examines demographic characteristics, and associations. RESULTS Among the enrolled 7871 patients, 97 (1.2%) received non-concordant care. The most prevalent factor was "families being too distressed about the patient's deteriorating condition and therefore being unable to let go" (84.5%) followed by "limited understanding of medical interventions among patients and surrogates" (38.1%), and "lack of patient participation in the decision-making process" (25.8%). CONCLUSIONS This study reveals that factors related to relational autonomy, emotional support, and health literacy may contribute to non-concordance between advance care planning and end-of-life care. In the future, developing an advance care planning model emphasizes respecting relational autonomy, providing emotional support, and enhancing health literacy could help patients receiving a goal concordant and holistic end-of-life care.
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Affiliation(s)
- Shih-Chieh Lee
- Department of Family Medicine (S.-C.L.), Fu Jen Catholic University Hospital, No. 69, Guizi Road, Taishan District, New Taipei City, Taiwan
| | - Chih-Yuan Shih
- Department of Family Medicine, College of Medicine and Hospital (C.-Y.S., J.-S.T.,S.-Y.C.,H.-L.H.), National Taiwan University, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan
| | - Shan-Ting Chen
- Department of Nursing (S.-T.C.,C.-Y.L.,S.-R.L.,C.-C.T.), National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan
| | - Ching-Yi Lee
- Department of Nursing (S.-T.C.,C.-Y.L.,S.-R.L.,C.-C.T.), National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan
| | - Shin-Rung Li
- Department of Nursing (S.-T.C.,C.-Y.L.,S.-R.L.,C.-C.T.), National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan
| | - Chia-Chun Tang
- Department of Nursing (S.-T.C.,C.-Y.L.,S.-R.L.,C.-C.T.), National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan; School of Nursing, College of Medicine (C.-C.T.), National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, Taiwan
| | - Jaw-Shiun Tsai
- Department of Family Medicine, College of Medicine and Hospital (C.-Y.S., J.-S.T.,S.-Y.C.,H.-L.H.), National Taiwan University, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan
| | - Shao-Yi Cheng
- Department of Family Medicine, College of Medicine and Hospital (C.-Y.S., J.-S.T.,S.-Y.C.,H.-L.H.), National Taiwan University, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, College of Medicine and Hospital (C.-Y.S., J.-S.T.,S.-Y.C.,H.-L.H.), National Taiwan University, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan.
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Atri V, Bhatt MT, Chaudhuri S, Mitra A, Maddani SS, Ravindranath S. Family's Perceived Needs and Satisfaction with Intensive Care Services: A Questionnaire-based Prospective Observational Study. Indian J Crit Care Med 2024; 28:483-494. [PMID: 38738197 PMCID: PMC11080099 DOI: 10.5005/jp-journals-10071-24621] [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: 09/28/2023] [Accepted: 12/01/2023] [Indexed: 05/14/2024] Open
Abstract
Background Holistic intensive care management involves the treatment of critically ill patients in the intensive care unit (ICU) as well as catering to family psychosocial needs helping in bettering satisfaction/perception of care. There is scarce data in the Indian intensive care setting regarding the same, especially in times of increasing end-of-life practices. Our study aimed to determine the factors impacting family perception/satisfaction with intensive care. Materials and methods A total of 336 family bystanders of patients in ICU with more than 72 hours of stay were surveyed using family satisfaction in the ICU 24 revised (FS-ICU 24R) questionnaire. Results Multivariable logistic regression analysis showed that the significant factors associated with the satisfaction among bystanders of ICU patients were the treatment of patient's physical symptoms like pain/breathlessness (Adjusted OR 3.73, p = 0.003), ICU staff's approach to family's need consideration (Adjusted OR 4.44, p < 0.001), concern and care towards patients' family (Adjusted OR 2.67, p = 0.023). Participation in patient care, ICU waiting room atmosphere, and emotional support are the other factors independently associated with satisfaction with ICU care. Family satisfaction was not associated with the patient's survival (p = 0.331, Chi-square test) or the length of ICU (p = 0.328, Chi-square test) and hospital stay (p = 0.865, Chi-square test). Conclusion Treatment of a patient's physical symptoms like pain, approach to family's needs consideration, and concern/care towards the patient's family are independent factors associated with optimal satisfaction among family members of ICU patients, which even takes precedence over the survival outcomes or length of ICU stay. How to cite this article Atri V, Bhatt MT, Chaudhuri S, Mitra A, Maddani SS, Ravindranath S. Family's Perceived Needs and Satisfaction with Intensive Care Services: A Questionnaire-based Prospective Observational Study. Indian J Crit Care Med 2024;28(5):483-494.
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Affiliation(s)
- Viha Atri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Margiben Tusharbhai Bhatt
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Souvik Chaudhuri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Aarohi Mitra
- Department of Community Medicine, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Sagar Shanmukhappa Maddani
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Sunil Ravindranath
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
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Kelly EP, Klatt M, Caputo J, Pawlik TM. A single-arm pilot of MyInspiration: a novel digital resource to support spiritual needs of patients undergoing cancer-directed surgery. Support Care Cancer 2024; 32:289. [PMID: 38625539 PMCID: PMC11021224 DOI: 10.1007/s00520-024-08496-1] [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: 09/26/2023] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE This study aimed to assess the feasibility, acceptability, and satisfaction associated with the MyInspiration intervention, a digital spiritual support tool for patients undergoing cancer surgery. Additionally, we evaluated changes in spiritual well-being and the ability to find meaning in their experience with cancer before and after the intervention. METHODS This was a prospective, single-arm pilot study. Feasibility and acceptability were assessed by ratio of participants who completed all assessments among individuals who had signed consent forms. Satisfaction was assessed with 5 Likert-style questions around user experience. Patient spiritual well-being and finding meaning in their experience with cancer were measured at baseline and post-intervention. RESULTS Forty patients were enrolled, the majority of whom were female (80.0%) and diagnosed with breast cancer (52.5%), with an average age of 54.4 years (SD = 13.7, range 29.0-82.0). Regarding feasibility and acceptability, 76.9% of patients who consented to participate completed the full study protocol. In assessing satisfaction, 59% of patients were satisfied with the overall experience of MyInspiration. There was no difference in spiritual well-being pre-/post-intervention. There was a difference in pre (M = 1.95, SD = .95) and post (M = 2.23, SD = .86) scores relative to "finding meaning in the cancer experience" with a mean difference of 0.28 (p = 0.008). CONCLUSION MyInspiration was feasible and acceptable to patients, and the majority were satisfied with the tool. The intervention was associated with changes in patients' ability to find meaning within their cancer experience. A randomized control trial is needed to evaluate the efficacy of the tool in a broader population of patients with cancer.
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Affiliation(s)
- Elizabeth Palmer Kelly
- Department of Surgery, The Ohio State University Wexner Medical Center, James Comprehensive Cancer Center, 395 W 12th Ave. Suite 670, Columbus, OH, USA
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, The Ohio State College of Medicine, Columbus, OH, USA
| | - Jacqueline Caputo
- Department of Surgery, The Ohio State University Wexner Medical Center, James Comprehensive Cancer Center, 395 W 12th Ave. Suite 670, Columbus, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, James Comprehensive Cancer Center, 395 W 12th Ave. Suite 670, Columbus, OH, USA.
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Jacobs J, Walsh JL, Valencia J, DiFranceisco W, Hirschtick JL, Hunt BR, Quinn KG, Benjamins MR. Associations Between Religiosity and Medical Mistrust: An Age-Stratified Analysis of Survey Data from Black Adults in Chicago. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01979-1. [PMID: 38514511 DOI: 10.1007/s40615-024-01979-1] [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: 11/06/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024]
Abstract
Medical mistrust is associated with poor health outcomes, ineffective disease management, lower utilization of preventive care, and lack of engagement in research. Mistrust of healthcare systems, providers, and institutions may be driven by previous negative experiences and discrimination, especially among communities of color, but religiosity may also influence the degree to which individuals develop trust with the healthcare system. The Black community has a particularly deep history of strong religious communities, and has been shown to have a stronger relationship with religion than any other racial or ethnic group. In order to address poor health outcomes in communities of color, it is important to understand the drivers of medical mistrust, which may include one's sense of religiosity. The current study used data from a cross-sectional survey of 537 Black individuals living in Chicago to understand the relationship between religiosity and medical mistrust, and how this differs by age group. Descriptive statistics were used to summarize data for our sample. Adjusted stratified linear regressions, including an interaction variable for age group and religiosity, were used to model the association between religiosity and medical mistrust for younger and older people. The results show a statistically significant relationship for younger individuals. Our findings provide evidence for the central role the faith-based community may play in shaping young peoples' perceptions of medical institutions.
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Affiliation(s)
- Jacquelyn Jacobs
- Sinai Urban Health Institute, Sinai Health System, 1500 S. Fairfield Ave, Chicago, IL, 60608, USA.
| | - Jennifer L Walsh
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jesus Valencia
- Sinai Urban Health Institute, Sinai Health System, 1500 S. Fairfield Ave, Chicago, IL, 60608, USA
| | - Wayne DiFranceisco
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jana L Hirschtick
- Advocate Aurora Research Institute, Advocate Health Center, Chicago, IL, USA
| | - Bijou R Hunt
- Sinai Infectious Disease Center, Sinai Health System, Chicago, IL, USA
| | - Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Maureen R Benjamins
- Sinai Urban Health Institute, Sinai Health System, 1500 S. Fairfield Ave, Chicago, IL, 60608, USA
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Naidoo L, Pillay M, Naidoo U. Who really decides? Feeding decisions 'made' by caregivers of children with cerebral palsy. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2024; 71:e1-e14. [PMID: 38572900 PMCID: PMC11019338 DOI: 10.4102/sajcd.v71i1.1001] [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: 07/01/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND There are no definitive guidelines for clinical decisions for children with cerebral palsy (CP) requiring enteral feeds. Traditionally, medical doctors made enteral feeding decisions, while patients were essentially treated passively within a paternalistic 'doctor knows best' approach. Although a more collaborative approach to decision-making has been promoted globally as the favoured model among healthcare professionals, little is known about how these decisions are currently made practically. OBJECTIVES This study aimed to identify the significant individuals, factors and views involved in the enteral feeding decision-making process for caregivers of children with CP within the South African public healthcare sector. METHOD A single-case research design was used in this qualitative explorative study. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis. RESULTS Four primary individuals were identified by the caregivers in the decision-making process: doctors, speech therapists, caregivers' families and God. Four factors were identified as extrinsically motivating: (1) physiological factors, (2) nutritional factors, (3) financial factors and (4) environmental factors. Two views were identified as intrinsically motivating: personal beliefs regarding enteral feeding tubes, and feelings of fear and isolation. CONCLUSION Enteral feeding decision-making within the South African public healthcare sector is currently still dominated by a paternalistic approach, endorsed by a lack of caregiver knowledge, distinct patient-healthcare provider power imbalances and prescriptive multidisciplinary healthcare dialogues.Contribution: This study has implications for clinical practice, curriculum development at higher education training facilities, and institutional policy changes and development, thereby contributing to the current knowledge and clinical gap(s) in the area.
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Affiliation(s)
- Lavanya Naidoo
- Discipline of Speech-Language Therapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and Department of Speech Language Pathology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Selvakumaran K, Sleeman KE, Davies JM. How good are we at reporting the socioeconomic position, ethnicity, race, religion and main language of research participants? A review of the quality of reporting in palliative care intervention studies. Palliat Med 2024; 38:396-399. [PMID: 38331779 PMCID: PMC10955797 DOI: 10.1177/02692163231224154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
| | - Katherine E Sleeman
- Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, UK
| | - Joanna M Davies
- Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, UK
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Vasilaki M, Vlachou E, Kavga A, Govina O, Dokoutsidou E, Evangelou E, Ntikoudi A, Mantoudi A, Alikari V. Fatigue among Patients with Type 2 Diabetes Mellitus: The Impact of Spirituality and Illness Perceptions. Healthcare (Basel) 2023; 11:3154. [PMID: 38132044 PMCID: PMC10742637 DOI: 10.3390/healthcare11243154] [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: 10/22/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Type 2 Diabetes Mellitus (T2DM) can cause fatigue, negatively affecting the daily functioning and health of individuals. The purpose of this study was to investigate the impact of spirituality and illness perceptions on fatigue among patients with Type 2 Diabetes Mellitus. In this cross-sectional, descriptive study, 100 patients with Type 2 Diabetes Mellitus completed the Fatigue Assessment Scale, the FACIT Sp-12 scale, and the Illness Perception Questionnaire-Revised assessing fatigue, spirituality, and illness perceptions, respectively. The mean age of the sample was 52.18 ± 15.53 years and 65% were insulin-treated patients. The mean score for the FACIT Sp-12 scale was 31.86 ± 7.7, for the FAS 27.0 ± 7.63, and for the Consequences and Emotional Representations of IPQ-R 25.5 ± 5.3. Statistically negative significant correlations were observed between the FACIT Sp-12 total score and the FAS subscales (r = -0.44 to -0.48, p < 0.01) and positive correlations between the "IP-Consequences and Emotional Representations" subscales and FAS scores. The total score of the FACIT Sp-12 (β = -0.35) was a negative predictor while Consequences and Emotional Representations (β = 0.28) were positive predictors of the total FAS Score. Participants scored moderate levels of total fatigue. Spirituality and positive illness perceptions may have a protective effect on the fatigue of patients with Type 2 Diabetes Mellitus.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Victoria Alikari
- Post Graduate Program “Management of Chronic Diseases–Diabetes Nursing Care”, Department of Nursing, University of West Attica, 12243 Egaleo, Greece; (M.V.); (E.V.); (A.K.); (O.G.); (E.D.); (E.E.); (A.N.); (A.M.)
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Kurtgöz A, Koç Z. Effects of Nursing Care Provided to the Relatives of Palliative Care Patients on Caregivers' Spiritual Well-Being and Hope: A Randomized Controlled Trial. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:318-332. [PMID: 36036673 DOI: 10.1177/00302228221124643] [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: 11/17/2022]
Abstract
The aim of this study is to determine the effects of nursing care, based on Watson's Theory of Human Caring, given to the relatives of palliative care patients on caregivers' spiritual well-being and hope. This research was planned as a randomized controlled trial and conducted among 60 patient relatives (intervention group: 30, control group: 30) taking care of their patients in five palliative care units in Turkey. Data were collected via the Introductory Information Form on Patient Relatives, the Beck Hopelessness Scale, and the Spiritual Well-Being Scale. Although administered nursing care caused a significant difference in the Beck Hopelessness Scale scores of the intervention group (U= 235.5, p = 0.001); no change was measured in scores from the Spiritual Well-Being Scale (U=385.0, p = 0.336). The findings of the study evidenced that nursing care based on Theory of Human Caring diminished the hopelessness levels of patient relatives while causing no effect on their spiritual well-being.
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Affiliation(s)
- Aslı Kurtgöz
- Department of Therapy and Rehabilitation, Amasya University, Amasya, Turkey
| | - Zeliha Koç
- Health Science Faculty, Ondokuz Mayıs University, Samsun, Turkey
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Wedgeworth M, Cody SL. Spirituality and health outcomes within the context of social determinants of health. Nursing 2023; 53:41-45. [PMID: 37856300 DOI: 10.1097/01.nurse.0000978888.90787.38] [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: 10/21/2023]
Abstract
ABSTRACT Spirituality has a significant impact on patients' overall quality of life, however, it is often overlooked in the context of social determinants of health (SDOH). Nurses are well positioned to lead the expansion of SDOH models to include spirituality; however, routine nursing care does not emphasize spiritual assessment knowledge and skills. This article discusses spirituality and how it fits into the SDOH model, nursing education, and interdisciplinary healthcare. Spiritual care training may improve the confidence of nurses to integrate routine mental and spiritual assessments in clinical practice and serve as leaders in promoting spiritual care within interdisciplinary healthcare teams.
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Affiliation(s)
- Monika Wedgeworth
- Monika Wedgeworth and Shameka Cody are associate professors at the University of Alabama's Capstone College of Nursing
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García-Navarro EB, Navarro SG, Sousa L, José H, Caceres-Titos MJ, Ortega-Galán Á. Nursing students' perceptions of spiritual needs at the end of life. A qualitative study. Front Psychiatry 2023; 14:1132581. [PMID: 37520236 PMCID: PMC10375720 DOI: 10.3389/fpsyt.2023.1132581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Spirituality is defined as the meaning of life, being the very essence of life made up of all of the aspects inherent to it. During end-of-life processes, this need is shown to be particularly altered in patients and yet it is an aspect that the health professionals accompanying patients in this situation report being least equipped to address, alongside therapies that could help to meet these needs, such as art therapy. An exploratory qualitative study was conducted, adheres to the guidelines of COREQ (41). The study population were final year students undertaking a nursing degree at the University of Huelva, Spain. The sample was selected via intentional sampling using snowball recruitment from the study population. Stratification according to gender was performed due to the feminised nature of the population. Sample size was determined progressively during the research, with recruitment ceasing at 13 informants once information saturation was achieved. Inclusion criteria required that participants were to be final year students enrolled on a nursing degree who had provided consent to participate voluntarily in the research. The analysis Realized was interpretive phenomenological (IPA) as described by Smith (43-45). The present study revealed that students perceive their training on spiritual care to be deficient. Despite them reporting that they possess the skills and tools to provide end-of-life care, this is not enough to provide effective accompaniment, given that this moment brings them into touch with their own insecurities. Students verbalized the need to learn strategies to address this shortcoming regarding final accompaniment, for instance, through art, with creativity being one of the skills with the potential to uncover the meaning of life.
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Affiliation(s)
- E. Begoña García-Navarro
- Social Studies and Social Intervention Research Center & COIDESO, University of Huelva, Huelva, Spain
- Department of Nursing, University of Huelva, Huelva, Spain
| | | | - Luis Sousa
- Escola Superior de Saúde Atlântica, Barcarena, Portugal
| | - Helena José
- Escola Superior de Saúde Atlântica, Barcarena, Portugal
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da Silva MDAP, Corradi-Perini C. The Mapping of Influencing Factors in the Decision-Making of End-of-Life Care Patients: A Systematic Scoping Review. Indian J Palliat Care 2023; 29:234-242. [PMID: 37700891 PMCID: PMC10493695 DOI: 10.25259/ijpc_292_2022] [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: 12/08/2022] [Accepted: 01/27/2023] [Indexed: 09/14/2023] Open
Abstract
Decisions in end-of-life care are influenced by several factors, many of which are not identified by the decision maker. These influencing factors modify important decisions in this scenario, such as in decisions to adapt to therapeutic support. This presented scoping review aims to map the factors that influence end-of-life care decisions for adult and older adult patients, by a scoping review. The review was carried out in 19 databases, with the keyword 'clinical decision-making' AND 'terminal care' OR 'end-of-life care' and its analogues, including publications from 2017 to 2022. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. The search resulted in 3474 publications, where the presence of influencing factors in end-of-life decision-making for adults and the elderly was applied as a selection criterion. Fifty-four (54) of them were selected, which means 1.5% of all the results. Among the selected publications, 89 influencing factors were found, distributed in 54 (60.6%) factors related to the health team, 18 (20.2%) to patients, 10 (11.2%) related to family or surrogates and 7 (7.8%) factors related to the decision environment. In conclusion, we note that the decision-making in end-of-life care is complex, mainly because there is an interaction of different characters (health team, patient, family, or surrogates) with a plurality of influencing factors, associated with an environment of uncertainty and that result in a critical outcome, with a great repercussion for the end of life, making it imperative the recognition of these factors for more competent and safe decision-making.
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Affiliation(s)
| | - Carla Corradi-Perini
- Bioethics Graduate Program, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Laranjeira C, Dixe MA, Querido A. Perceived Barriers to Providing Spiritual Care in Palliative Care among Professionals: A Portuguese Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6121. [PMID: 37372708 DOI: 10.3390/ijerph20126121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants' perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Maria Anjos Dixe
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
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13
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Pook CJ, Haas-Heger T, Adam S, Haile-Redai A, Harrow S. Student perspectives of spirituality teaching initiatives in healthcare education. J Clin Nurs 2023; 32:1514-1515. [PMID: 34687100 DOI: 10.1111/jocn.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Celina J Pook
- Medical student at GKT School of Medical Education, King's College London, London, UK
| | - Tabea Haas-Heger
- Medical student at GKT School of Medical Education, King's College London, London, UK
| | - Suhaylah Adam
- Medical student at GKT School of Medical Education, King's College London, London, UK
| | - Ayda Haile-Redai
- Medical student at GKT School of Medical Education, King's College London, London, UK
| | - Simeon Harrow
- Medical student at GKT School of Medical Education, King's College London, London, UK
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14
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Guo P, Alajarmeh S, Alarjeh G, Alrjoub W, Al-Essa A, Abusalem L, Giusti A, Mansour AH, Sullivan R, Shamieh O, Harding R. Providing person-centered palliative care in conflict-affected populations in the Middle East: What matters to patients with advanced cancer and families including refugees? Front Oncol 2023; 13:1097471. [PMID: 37051537 PMCID: PMC10083486 DOI: 10.3389/fonc.2023.1097471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionUniversal health coverage highlights palliative care as an essential component of health services. However, it is unclear what constitutes person-centered care in populations affected by conflict, as they may have specific concerns in the dimensions of physical, emotional, social, and spiritual wellbeing. This study aimed to identify what matters to patients with advanced cancer and family caregivers in Jordan including refugees, to inform appropriate person-centered assessment and palliative care in conflict-affected populations.MethodsCross-sectional face-to-face, semi-structured interviews were conducted at two sites in Amman. Adult patients with advanced cancer and family caregivers were purposively sampled to maximize diversity and representation. Interviews were digitally audio recorded, anonymized, and transcribed verbatim for thematic analysis.FindingsFour themes were generated from 50 patients (22 refugees; 28 Jordanians) and 20 caregivers (7 refugees; 13 Jordanians) (1). Information, communication, and decision-making. Truth-telling and full disclosure from clinicians was valued, and participants expressed concerns that information was not shared in case patients would disengage with treatment. (2) Priorities and concerns for care and support. Participants’ top priority remained cure and recovery (which was viewed as possible). Other priorities included returning to their “normal” life and their “own” country, and to continue contributing to their family. (3) Role of spirituality and Islam. Most participants had strong faith in God and felt that having faith could comfort them. For refugees whose social network was fractured due to being away from home country, prayer and Quran reading became particularly important. (4) Unmet support needs of family caregivers. Family caregivers were affected physically and emotionally by worrying about and caring for the patients. They needed support and training, but often could not access this.DiscussionTruth-telling is highly valued and essential to achieving person-centered care and informed decision-making. This study also reveals specific concerns in conflict-affected populations, reflecting the experience of prior losses and fracturing of existing social networks and support. The role of religion is crucial in supporting refugee communities, and consideration should be paid to the needs of patients and caregivers when caring for a patient at home without access to their communities of origin and the support they accessed.
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Affiliation(s)
- Ping Guo
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, United Kingdom
- *Correspondence: Ping Guo, ; Omar Shamieh,
| | - Sawsan Alajarmeh
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Ghadeer Alarjeh
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Waleed Alrjoub
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Ayman Al-Essa
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Lana Abusalem
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Alessandra Giusti
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, United Kingdom
| | - Asem H. Mansour
- Chief Executive Office, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Richard Sullivan
- Institute of Cancer Policy, King’s College London, London, United Kingdom
| | - Omar Shamieh
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
- Department of Palliative Care, King Hussein Cancer Center (KHCC), Amman, Jordan
- Faculty of Medicine, the University of Jordan, Amman, Jordan
- *Correspondence: Ping Guo, ; Omar Shamieh,
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, United Kingdom
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15
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Hentsch L, Pereira C, Pinon N, Tahar A, Pautex S. Identifying the palliative care needs of frail, older, housebound patients in the community: A cross-sectional study. Palliat Support Care 2023:1-8. [PMID: 36803464 DOI: 10.1017/s1478951523000056] [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: 02/22/2023]
Abstract
BACKGROUND The early introduction of palliative care can have a positive impact on the quality of life of patients suffering from life-limiting diseases. However, the palliative care needs of older, frail, housebound patients are still mostly unknown, as is the impact of frailty on the importance of these needs. OBJECTIVES To identify the palliative care needs of frail, older, housebound patients in the community. METHODS We conducted a cross-sectional observational study. This study took place in a single primary care center and included patients who were ≥65 years old, housebound, followed by the Geriatric Community Unit of the Geneva University Hospitals. RESULTS Seventy-one patients completed the study. Most patients were female (56.9%), and mean age (SD) was 81.1 (±7.9). The Edmonton Symptom Assessment Scale mean (SD) score was higher in frail patients as opposed to vulnerable patients for tiredness (p = 0.016), drowsiness (p = 0.0196), loss of appetite (p = 0.0124), and impaired feeling of well-being (p = 0.0132). There was no difference in spiritual well-being, measured by the spiritual scale subgroup of the Functional Assessment of the Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-sp) between frail and vulnerable participants, although scores in both groups were low. Caregivers were mainly spouses (45%) and daughters (27.5%) with a mean (SD) age of 70.7 (±13.6). The overall carer-burden measured by the Mini-Zarit was low. SIGNIFICANCE OF RESULTS Older, frail, housebound patients have specific needs that differ from non-frail patients and should guide future palliative care provision. How and when palliative care should be provided to this population remains to be determined.
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Affiliation(s)
- Lisa Hentsch
- Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Cristiana Pereira
- Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Nathalie Pinon
- Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Aurélie Tahar
- Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Sophie Pautex
- Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
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16
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Bashir S, Mir A, Altwaijri N, Uzair M, Khalil A, Albesher R, Khallaf R, Alshahrani S, Abualait T. Neuroeconomics of decision-making during COVID-19 pandemic. Heliyon 2023; 9:e13252. [PMID: 36744067 PMCID: PMC9882954 DOI: 10.1016/j.heliyon.2023.e13252] [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: 08/25/2022] [Revised: 12/27/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic reveals the decision-making challenges faced by communities, governments, and international organizations, globally. Policymakers are much concerned about protecting the population from the deadly virus while lacking reliable information on the virus and its spread mechanisms and the effectiveness of possible measures and their (direct and indirect) health and socioeconomic costs. This review aims to highlight the various balanced policy decision that would combine the best obtainable scientific evidence characteristically provided by expert opinions and modeling studies. This article's main goal is to summarize the main significant progress in the understanding of neuroeconomics of decision-making and discuss the anatomy of decision making in the light of COVID-19 pandemic.
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Affiliation(s)
- Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia,Corresponding author
| | - Ali Mir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Nouf Altwaijri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Uzair
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Amani Khalil
- Department of Mental Health, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Rania Albesher
- Department of Mental Health, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Roaa Khallaf
- Department of Neurology, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Saad Alshahrani
- Department of Research Operation and Administration, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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17
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Ozdemir S, Chaudhry I, Tan SNG, Teo I, Malhotra C, Malhotra R, Finkelstein EA. Variation in Patient-Reported Decision-Making Roles in the Last Year of Life among Patients with Metastatic Cancer: A Longitudinal Study. Med Decis Making 2023; 43:203-213. [PMID: 36214321 DOI: 10.1177/0272989x221131305] [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: 01/11/2023]
Abstract
OBJECTIVE We investigated the variation in patient-reported decision-making roles in the past year of life among patients with metastatic solid cancer and the associations of these roles with patient quality of life and perceived quality of care. METHODS We used the last year of life data of 393 deceased patients from a prospective cohort study. Patients reported their decision-making roles, quality of life (emotional well-being, spiritual well-being, and psychological distress) and perceived quality of care (care coordination and physician communication) every 3 months until death. We used mixed effects linear regressions to investigate the associations of decision-making roles with patients' quality of life and perceived quality of care. RESULTS The most reported roles, on average, were patient-led (37.9%) and joint (23.4%; with physicians and/or family caregivers) decision making, followed by no patient involvement (14.8%), physician/family-led (12.9%), and patient alone (11.0%) decision making. Patient level of involvement in decision making decreased slightly as death approached (P < 0.05). Compared with no patient involvement, joint decision making was associated with better emotional well-being (β [95% confidence interval] = 1.02 [0.24, 1.81]), better spiritual well-being (1.48 [0.01, 2.95]), lower psychological distress (-1.99 (-3.21, -0.77]), higher perceived quality of care coordination (5.04 [1.24, 8.85]), and physician communication (5.43 [1.27, 9.59]). Patient-led decision making was associated with better spiritual well-being (1.69 [0.24, 3.14]) and higher perceived quality of care coordination (6.87 [3.17, 10.58]) and physician communication (6.21 [2.15, 10.27]). CONCLUSION Joint and patient-led decision-making styles were reported by 61% of the patients and were associated with better quality of life and quality of care. A decrease in the level of patient involvement over time indicates reliance on family and physicians as death approached. HIGHLIGHTS Among patients with metastatic cancer, the level of patient involvement in decision making decreased slightly as death approached.Joint decision making of patients with their physicians and/or family caregivers and patient-led decision making were associated with better quality of life and perceived quality of care.Patients with metastatic cancer should be encouraged to be involved in decision making together with their physicians and/or family caregivers to potentially improve their end-of-life experience.
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Affiliation(s)
- Semra Ozdemir
- Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Isha Chaudhry
- Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Si Ning Germaine Tan
- Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Irene Teo
- Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,National Cancer Centre Singapore, Singapore
| | - Chetna Malhotra
- Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Rahul Malhotra
- Signature Program in Health Services and Systems Research; Centre for Aging Research and Education, Duke-NUS Medical School, Singapore
| | - Eric Andrew Finkelstein
- Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Duke Global Health Institute, Duke University, USA
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18
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Mendes BV, Donato SCT, Silva TLD, Penha RM, Jaman-Mewes P, Salvetti MDG. Spiritual well-being, symptoms and performance of patients under palliative care. Rev Bras Enferm 2023; 76:e20220007. [PMID: 37042924 PMCID: PMC10084779 DOI: 10.1590/0034-7167-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/15/2022] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES to assess the relationship between spiritual well-being, symptoms and performance of patients under palliative care. METHODS this is a descriptive correlational study, conducted with 135 patients seen in palliative care outpatient clinics. Karnofsky Performance Status Scale, Edmonton Symptom Assessment Scale, Spirituality Scale and Hospital Anxiety and Depression Scale were used. Data were submitted to descriptive statistical analysis and Spearman's correlation. RESULTS among participants, 68.2% were cancer patients. The most prevalent symptoms were changes in well-being (65.2%), anxiety (63.7%), sadness (63%) and fatigue (63%). Sadness, dyspnea, sleepiness, anxiety and depression presented weak to moderate correlation with spiritual well-being. Symptom overload showed weak negative correlation with performance. CONCLUSIONS symptom intensification was correlated with worsening in spiritual well-being perception. The reduction in performance was related to increased number of symptoms, especially depression and anxiety.
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Affiliation(s)
| | | | | | - Ramon Moraes Penha
- Universidade Federal do Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul,, Brazil
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19
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Onyishi CN, Eseadi C, Ilechukwu LC, Okoro KN, Okolie CN, Egbule E, Asogwa E. Potential influences of religiosity and religious coping strategies on people with diabetes. World J Clin Cases 2022; 10:8816-8826. [PMID: 36157650 PMCID: PMC9477035 DOI: 10.12998/wjcc.v10.i25.8816] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes is a significant health issue that threatens patients’ overall wellbeing and quality of life. Critical public health concerns center on creating the best approach for diabetes management. Patients and caregivers have different approaches to diabetes management; however, this and the associated physiological, physical and mental health issues remain challenging. This review explores the potential influences of religiosity and religious coping strategies on people with diabetes. This study used a literature review approach to investigate how religiosity and religious coping strategies can influence the effective management of diabetes among patients. Based on the literature search, the researchers were able to identify and cite published papers that were analyzed using the descriptive-narrative analysis. An important goal of the descriptive-narrative analysis was to provide descriptions of the selected literature and take implications from the literature. The results of studies reviewed show some religious coping strategies for managing chronic diseases such as diabetes. The studies did establish a relationship between religiosity and diabetes management and suggest that religious coping strategies could positively impact the management of diabetes; however, they reported some adverse effects. Hence, we propose a pathway for the development of religion-oriented interventions and support framework for the management of diabetes.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | | | - Kingsley Nwannennaya Okoro
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Charles Nkem Okolie
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Emmanuel Egbule
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Emmanuel Asogwa
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
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20
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Rego F, Sommovigo V, Setti I, Giardini A, Alves E, Morgado J, Maffoni M. How Supportive Ethical Relationships Are Negatively Related to Palliative Care Professionals' Negative Affectivity and Moral Distress: A Portuguese Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3863. [PMID: 35409546 PMCID: PMC8997490 DOI: 10.3390/ijerph19073863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 01/27/2023]
Abstract
In the modern healthcare landscape, moral distress has become an increasingly common phenomenon among healthcare professionals. This condition is particularly prevalent among palliative care professionals who are confronted with bioethical issues in their daily practice. Although some studies described the effects of poor ethical climate and negative affectivity on moral distress, how these variables could be incorporated into a single model is still unclear. Thus, this study aims to investigate whether ethical relationships with the hospital could be related to the intensity and frequency of moral distress, both directly and as mediated by professionals' negative affectivity. Sixty-one Portuguese palliative care professionals completed web-based self-report questionnaires. After exploring descriptive statistics, mediation analyses were performed using the partial least squares method. The results indicated that the presence of positive relationships with the hospital reduced the professionals' negative affectivity levels. This, in turn, led palliative care professionals to experience a lower frequency and intensity of moral distress. Being a physician was positively associated with negative affectivity but not with the frequency of moral distress. Considering the protective role of ethical relationships with hospitals, health organizations could consider implementing interventions to improve hospitals' ethical climate and provide staff with ethics training programs.
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Affiliation(s)
- Francisca Rego
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (F.R.); (E.A.)
| | - Valentina Sommovigo
- Department of Brain and Behavioural Sciences, Unit of Applied Psychology, University of Pavia, 27100 Pavia, Italy; (V.S.); (I.S.)
- Department of Management, University of Bologna-Rimini Campus, 47900 Rimini, Italy
| | - Ilaria Setti
- Department of Brain and Behavioural Sciences, Unit of Applied Psychology, University of Pavia, 27100 Pavia, Italy; (V.S.); (I.S.)
| | - Anna Giardini
- IT Department, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy;
| | - Elsa Alves
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (F.R.); (E.A.)
| | - Julliana Morgado
- Institute of Philosophy and Human Sciences, Federal University of Pará, Belém 66075-110, Brazil;
| | - Marina Maffoni
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
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21
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Antunes ML, Reis-Pina P. The Physician and End-of-Life Spiritual Care: The PALliatiVE Approach. Am J Hosp Palliat Care 2022; 39:1215-1226. [PMID: 35044883 DOI: 10.1177/10499091211068819] [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
Spiritual care is universally acknowledged as a cornerstone of palliative care, yet most healthcare professionals find it difficult to address. The present work aims to provide a simple educational tool that may help physicians address spirituality in their clinical practice. We found articles written in both Portuguese and English through PubMed, using the combination of MeSH terms: "Spirituality" and "Palliative Care." The research was complemented by relevant monographs previously known to the authors, consultation of selected references of the main bibliography, and interviews to an experienced spiritual care provider. In order to help physicians to incorporate spiritual care in their clinical practice, a flexible yet standardized approach is long overdue. This is the aim of the PALliatiVE approach, which compiles the literature in a set of 5 attitudes that may aid the clinician in the delivery of spiritual care: Prepare (P), Ask (A), Listen (L), Validate (V), and consult an Expert (E). This approach is based on a synthesis of a broad literature review, which motivated the five-layered approach. There is a significant literature coverage supporting each attitude of this five-layered approach, including at least one randomized control trial or systematic review per attitude. Though still requiring external validation, the PALliatiVE approach can be a guide to the physician on how to provide spiritual care, a practice rooted in compassion and in simply being-with the one who suffers.
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Affiliation(s)
| | - Paulo Reis-Pina
- Palliative Care Unit, Casa de Saúde da Idanha, Sintra, Portugal.,Faculty of Medicine, Ringgold:37809University of Lisbon, Lisboa, Portugal
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22
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Hosseini SM, Naseri-Salahshour V, Farsi Z, Esmaeili M, Sajadi M, Maddah Z, Fournier A. The effect of spirituality-oriented psychological counseling on the fear of death among patients undergoing chronic hemodialysis: A randomized controlled trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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King N, Nelson S, Joseph S, Chowdhury M, Whitfield B, Hanjra P, Lin LO. The Sacred Sites of Houston: A Novel Experiential Course for Undergraduate Medical Education on Religion and Spirituality. JOURNAL OF RELIGION AND HEALTH 2021; 60:4500-4520. [PMID: 34245437 DOI: 10.1007/s10943-021-01325-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Medical schools are charged to deliver a curriculum on religion and spirituality (R/S), so a novel experiential course, the Sacred Sites of Houston, was developed. Sixty students completed the course consisting of 6 site visits. Post-course, participants described more general knowledge and knowledge of how each faith tradition describes medicine and health (p < 0.05 for all) except for Catholicism (p = 0.564 and p = 0.058). Ten course participants and 6 control non-course participants were interviewed following clinical rotations to assess the impact of the experiential course on R/S in the clinical setting. Themes from qualitative interviews such as R/S, barriers, interactions, and the course impact emerged. The importance of R/S in the patient-provider relationship and end-of-life care was prominent in course participant interviews compared to non-course participant control subjects. Participation in the course resulted in increased chaplain engagement and significant personal impact. These qualitative and quantitative findings indicate that an experiential course may be effective at addressing the deficit in R/S undergraduate medical education and help enhance the spiritually and religiously competent care of patients.
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Affiliation(s)
- Nicholas King
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA.
- Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Stuart Nelson
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA
- Institute for Spirituality and Health, Houston, TX, USA
| | - Samuel Joseph
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mahveesh Chowdhury
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA
- Columbia University Irving Medical Center, New York, NY, USA
| | - Benjamin Whitfield
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA
| | - Pahul Hanjra
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA
| | - Lawrence O Lin
- McGovern Center for Humanities and Ethics, 6431 Fannin Street, JJL 351, Houston, TX, 77030, USA
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
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24
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Ullrich A, Schulz H, Goldbach S, Hollburg W, Rommel A, Müller M, Kirsch D, Kopplin-Förtsch K, Messerer J, König L, Schulz-Kindermann F, Bokemeyer C, Oechsle K. Need for additional professional psychosocial and spiritual support in patients with advanced diseases in the course of specialist palliative care - a longitudinal observational study. BMC Palliat Care 2021; 20:182. [PMID: 34823535 PMCID: PMC8613968 DOI: 10.1186/s12904-021-00880-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We investigated the need for additional professional support and associated factors in patients (pts) at initiation and in the course of in- and outpatient specialist palliative care (I-SPC/O-SPC). METHODS Pts entering an urban SPC network consecutively completed questionnaires on psychosocial/spiritual problems and support needs within 72 h (T0) as well as within the first 6 weeks (T1) of SPC. Hierarchical linear regression analysis was used to investigate the impact of sociodemographic / disease-related variables, psychological / physical burden, social support, and SPC setting on the extent of support needs. RESULTS Four hundred twenty-five pts (70 years, 48% female, 91% cancer, 67% O-SPC) answered at T0, and 167 at T1. At T0, main problems related to transportation, usual activities, and dependency (83-89%). At T1, most prevalent problems also related to transportation and usual activities and additionally to light housework (82-86%). At T0, support needs were highest for transportation, light housework, and usual activities (35-41%). Cross-sectional comparisons of SPC settings revealed higher problem scores in O-SPC compared to I-SPC at T0 (p = .039), but not at T1. Support need scores were higher in O-SPC at T0 (p < .001), but lower at T1 (p = .039). Longitudinal analyses showed a decrease of support need scores over time, independent from the SPC setting. At T0, higher distress (p = .047), anxiety/depression (p < .001), physical symptom burden (p < .001) and I-SPC (p < .001) were associated with higher support need scores (at T1: only higher distress, p = .037). CONCLUSION Need for additional professional psychosocial/spiritual support was identified in up to 40% of pts. with higher need at the beginning of O-SPC than of I-SPC. During SPC, this need decreased in both settings, but got lower in O-SPC than in I-SPC over time. Support need scores were not only associated with psychological, but also physical burden.
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Affiliation(s)
- Anneke Ullrich
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany
| | - Sven Goldbach
- Specialist Outpatient Palliative Care Team "PalliativPartner Hamburg GbR", Hamburg, Germany
| | - Wiebke Hollburg
- Specialist Outpatient Palliative Care Team "PalliativPartner Hamburg GbR", Hamburg, Germany
| | - Annette Rommel
- Specialist Outpatient Palliative Care Team "Das Palliativteam", Hamburg, Germany
| | - Marten Müller
- Palliative Care Ward, Asklepios Hospital Rissen, Hamburg, Germany
| | - Denise Kirsch
- Specialist Outpatient Palliative Care Team "PCT Hamburg-West", Hamburg, Germany
| | | | - Julia Messerer
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Louise König
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | | | - Carsten Bokemeyer
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Karin Oechsle
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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Satija A, Bhatnagar S, Ozdemir S, Finkelstein E, Maholtra C, Teo I, Yang GM. Patients' Awareness of Advanced Disease Status, Psychological Distress and Quality of Life Among Patients With Advanced Cancer: Results From the APPROACH Study, India. Am J Hosp Palliat Care 2021; 39:772-778. [PMID: 34477010 DOI: 10.1177/10499091211042837] [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] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Prognostic disclosure to patients with advanced cancer facilitates treatment decisions and goals of care discussions. However, the perspectives of patients, families and physicians differ in this regard across different cultures. Non-disclosure of cancer diagnosis or prognosis is commonly observed in family-centric cultures such as India. AIM To assess the prevalence of and factors associated with cancer patients' awareness of advanced disease status; and its with quality of life and psychological distress. METHODS Patients for this cross-sectional questionnaire-based survey were recruited from oncology and palliative medicine clinics at a tertiary cancer hospital in India from January 2017 to June 2018. Patients aged ≥ 21 years, aware of cancer diagnosis and receiving oncology treatment for Stage IV solid cancer were included in the study after obtaining written informed consent. RESULTS Two hundred patients were enrolled, of which 146 (73%) were not aware of the stage of their malignancy and 9 (4.5%) believed that their disease was at stage I, II or III. Those who were aware of their advanced cancer stage had more years of education (9.9 years vs 8.1 years, p = .05) and had poorer spiritual wellbeing in the faith domain (adjusted difference -1.6, 95% confidence interval -3.1 to -0.1, p = .03) compared to those who were unaware. CONCLUSION It is recommended that future studies may explore prognostic understanding in Indian patients according to their socio-cultural, spiritual and educational background.
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Affiliation(s)
- Aanchal Satija
- Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Eric Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Chetna Maholtra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Grace Meijuan Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.,Department of General Medicine, Sengkang General Hospital, Singapore, Singapore
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Tay DL, Ellington L, Towsley GL, Supiano K, Berg CA. Emotional expression in conversations about advance care planning among older adult home health patients and their caregivers. PATIENT EDUCATION AND COUNSELING 2021; 104:2232-2239. [PMID: 33658140 DOI: 10.1016/j.pec.2021.02.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/24/2021] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To examine patient and caregivers' differences in emotional expression and explore topics associated with emotional expression during advance care planning (ACP) discussions. METHODS Older adult home health patient-caregiver dyads participated in video-recorded ACP conversations as part of a collaboration-focused intervention study. Recordings were coded in Noldus Observer XT, analyzed with descriptive statistics, Cochran-Mantel-Haenszel and Breslow-Day test, and integrated with qualitative content analysis. RESULTS Eighteen patient-caregiver dyads were purposively recruited. Participants were mostly female (11 patients; 13 caregivers). Mean ages were 68.22 (SD = 9.64) for patients and 61.28 (SD = 13.60) for caregivers. Emotional expression (depth of emotion, positive and negative valence) was similar across patients and caregivers. Conversations centered on positive and negative decisional, relational, and existential topics. CONCLUSIONS This study explored emotional expression and identified topics associated with emotion for patients and caregivers during collaborative ACP. Findings suggest that collaboration in ACP can have positive relational aspects for patient-caregiver dyads, while negative emotions can also be distressing. PRACTICE IMPLICATIONS This study describes the range of emotions that are common during patient and caregiver ACP discussions. Clinical implications for the assessment of caregiver support and awareness of the interdependent nature of decision making is discussed.
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Affiliation(s)
- Djin L Tay
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Gail L Towsley
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Katherine Supiano
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, 84112, USA.
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Kelly EP, Myers B, Henderson B, Sprik P, White KB, Pawlik TM. The Influence of Patient and Provider Religious and Spiritual Beliefs on Treatment Decision Making in the Cancer Care Context. Med Decis Making 2021; 42:125-134. [PMID: 34196249 DOI: 10.1177/0272989x211022246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Providers often underestimate the influence of patient religious and spiritual (R&S) needs. The current study sought to determine the influence of R&S beliefs on treatment decision making among patients and providers in the context of cancer care. METHODS We conducted a systematic review of the literature using web-based search engines and discipline-specific databases. Search terms included a combination of the following Medical Subject Headings and key terms: "cancer,""spirituality,""religion," and "decision making." We used Covidence to screen relevant studies and extracted data into Microsoft Excel. RESULTS Among 311 screened studies, 32 met inclusion/exclusion criteria. Most studies evaluated the patient perspective (n = 29), while 2 studies evaluated the provider perspective and 1 study examined both. In assessing patient R&S relative to treatment decision making, we thematically characterized articles according to decision-making contexts, including general (n = 11), end-of-life/advance care planning (n = 13), and other: specific (n = 8). Specific contexts included, but were not limited to, clinical trial participation (n = 2) and use of complementary and alternative medicine (n = 4). Within end-of-life/advance care planning, there was a discrepancy regarding how R&S influenced treatment decision making. The influence of R&S on general treatment decision making was both active and passive, with some patients wanting more direct integration of their R&S beliefs in treatment decision making. In contrast, other patients were less aware of indirect R&S influences. Patient perception of the impact of R&S on treatment decision making varied relative to race/ethnicity, being more pronounced among Black patients. CONCLUSION Most articles focused on R&S relative to treatment decision making at the end of life, even though R&S appeared important across the care continuum. To improve patient-centered cancer care, providers need to be more aware of the impact of R&S on treatment decision making.
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Affiliation(s)
| | - Brian Myers
- The Ohio State University, Columbus, OH, USA
| | | | - Petra Sprik
- Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA
| | - Kelsey B White
- Department of Health Management & System Sciences, University of Louisville, Louisville, KY, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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28
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Badanta B, Rivilla-García E, Lucchetti G, de Diego-Cordero R. The influence of spirituality and religion on critical care nursing: An integrative review. Nurs Crit Care 2021; 27:348-366. [PMID: 33966310 DOI: 10.1111/nicc.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/21/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. AIMS AND OBJECTIVES To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. METHODS An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. RESULTS Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. CONCLUSION AND IMPLICATIONS FOR PRACTICE Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinical practice. Nurses are encouraged to increase their knowledge and awareness towards spiritual issues.
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Affiliation(s)
- Bárbara Badanta
- Research Group under the Andalusian Research CTS 1050 "Complex Care, Chronic and Health Outcomes", Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, University of Seville, Seville, Spain
| | | | - Giancarlo Lucchetti
- Department of Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | - Rocío de Diego-Cordero
- Research Group CTS 969 "Innovation in HealthCare and Social Determinants of Health", School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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Gelegjamts D, Yong Yoo J, Kim J, Sun Kim J. Undergraduate nursing students' palliative care knowledge and attitudes towards end-of-life care: a cross-sectional descriptive study. Contemp Nurse 2021; 56:477-490. [PMID: 33573520 DOI: 10.1080/10376178.2021.1890165] [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] [Indexed: 10/22/2022]
Abstract
BACKGROUND It is crucial that future nurses be prepared with the knowledge and skills to provide palliative care (PC). AIMS This study aimed to investigate Mongolian nursing students' PC knowledge and attitudes towards end-of-life (EOL) care, as well as identify related predictors. METHODS Participants were 141 students who enrolled in nursing program in Mongolia. RESULTS Mean Palliative Care Quiz for Nursing (PCQN) score was 7.15 out of 20. The mean Frommelt Attitudes Toward Care of the Dying (FATCOD) score was 64.2 out of 100. Older age, male gender, and higher satisfaction with nursing school were significant predictors of higher levels of palliative care knowledge. Living in traditional Mongolian housing (Ger) and having clinical EOL experience were significant predictors of positive attitudes towards EOL care. CONCLUSIONS Mongolian senior nursing students were inadequately prepared to provide PC. PC nursing education in Mongolia needs to be improved to meet an appropriate global standard.
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Affiliation(s)
- Delgersuren Gelegjamts
- Chosun University, Gwangju, South Korea and Mongolian National University, Ulaanbaatar, Mongolia
| | - Jae Yong Yoo
- Department of Nursing, Chosun University, Gwangju, South Korea
| | - Jinhee Kim
- Department of Nursing, Chosun University, Gwangju, South Korea
| | - Jin Sun Kim
- Department of Nursing, Chosun University, Gwangju, South Korea
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