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Ben-Arye E, Samuels N, Keshet Y, Golan M, Baruch E, Dagash J. Exploring unmet concerns in home hospice cancer care: Perspectives of patients, informal caregivers, palliative care providers, and family physicians. Palliat Support Care 2024:1-9. [PMID: 38587040 DOI: 10.1017/s1478951524000567] [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: 04/09/2024]
Abstract
OBJECTIVES The study examines perspectives of patients in home hospice care; their informal caregivers; palliative health-care providers (HCPs); and family physicians, all regarding patients' unmet needs and quality of life (QoL)-related concerns. METHODS Participants from all 4 groups were approached within 2 months after the patient's admission to the home hospice care unit. Participants completed Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCAW) questionnaires, for patient's QoL-related concerns. Qualitative analysis of short narratives was conducted using ATLAS.ti software for systematic coding. RESULTS In total, 78 participants completed the study questionnaires: 24 patients, 22 informal caregivers, 22 palliative HCPs, and 11 family physicians. Informal caregivers gave higher scores (i.e., greater severity) than patients for fatigue on ESAS (p = 0.009); and family physicians lower scores than patients for ESAS drowsiness (p = 0.046). Compared with patients, palliative HCPs gave higher scores for patient emotional-spiritual concerns (77.2% vs. 41.7%, p = 0.02); lower scores for gastrointestinal concerns (p = 0.048); and higher scores for overall function (p = 0.049). Qualitative assessment identified a gap between how patients/informal caregivers vs. palliative HCPs/family physicians regard emotional-spiritual themes, including discussing issues related to death and dying. SIGNIFICANCE OF RESULTS The findings of the present study suggest that exploring a multifaceted cohort of home hospice patients, informal caregivers, palliative HCPs, and family physicians may provide insight on how to reduce communication gaps and address unmet needs of patients, particularly regarding emotional and spiritual concerns. CONCLUSIONS While the 4 groups were similar in their scoring of patient QoL-related concerns, there were discrepancies for some concerns (e.g., patient fatigue) and expectations regarding the need to discuss emotional and spiritual concerns, including on death and dying. Educational initiatives with programs providing training to all 4 groups may help bridge this gap, creating a more open and collaborative hospice care environment.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yael Keshet
- Department of Sociology, Western Galilee College, Akko, Israel
| | - Miri Golan
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel
| | - Erez Baruch
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel
| | - Jamal Dagash
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel
- Palliative Care - Home Care Hospice, Clalit Health Services, Haifa, Israel
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Testoni I, Ronconi L, Orkibi H, Biancalani G, Raccichini M, Franchini L, Keisari S, Bucuta M, Cieplinski K, Wieser M, Varani S. Death education for Palliative care: a european project for University students. BMC Palliat Care 2023; 22:47. [PMID: 37085886 PMCID: PMC10120108 DOI: 10.1186/s12904-023-01169-6] [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: 11/30/2022] [Accepted: 04/12/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The need to spread the culture of palliative care and to train health care professionals from undergraduate courses is recognised internationally. The article presents the outcomes of a project devoted to palliative care training in university courses in four countries. AIMS This article considered the outcomes of a course designed for university students who had the potential to work in a palliative care team. The main aim was to check the efficacy of the course and the motivation to work in palliative care settings, considering the impact of fear and representations of death. METHODS The project presented the essential contents related to palliative care, using psychodramatic and photo-voice techniques. Longitudinal measurements were taken using a quantitative method design to detect changes among the students involved. The project involved 341 students at the first administration of the survey consisted of a protocol composed of standardized questionnaires in five countries (Austria, Israel, Italy, Poland and Romania), of whom 276 completed the pre- and post-surveys-165 of them in the experimental group and 111, in the control group. RESULTS The experience showed that it is possible to address death-related issues seriously and competently without necessarily causing discomfort and despondency in students. The results of the changes over time in the experimental and control groups highlight how the view of death as annihilation is correlated with the fear of death and the need for avoidance of thoughts concerning dying. The main result is that competence in palliative care facilitates familiarisation with issues of death and dying, as well as the ability to work in this area, thereby enhancing interpersonal skills. CONCLUSION The project showed that it is possible to implement death education on palliative care topics in undergraduate courses to increase motivation to work in this field.
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Grants
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
- 2019-1-IT02-KA203-063243 This research was funded by the Erasmus+Program of the European Union. Specifically, the funding for this study comes from the Erasmus plus project: "Death Education for Palliative Psychology" (DE4PP), project code: 2019-1-IT02-KA203-063243.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, Padua, 35131, Italy.
- Drama & Health Science Lab, and the Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
| | - Lucia Ronconi
- IT and Statistical Services, Multifunctional Pole of Psychology, University of Padova, Padova, Italy
| | - Hod Orkibi
- Drama & Health Science Lab, and the Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Gianmarco Biancalani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, Padua, 35131, Italy
| | | | | | - Shoshi Keisari
- Drama & Health Science Lab, and the Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Mihaela Bucuta
- Department of Journalism, Public Relations, Sociology and Psychology, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Krzysztof Cieplinski
- Department of Psychotherapy and Health Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Michael Wieser
- Department of Psychology, Alpen-Adria-Universität Klagenfurt, Klagenfurt, Austria
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Guidetti G, Grandi A, Converso D, Bosco N, Fantinelli S, Zito M, Colombo L. Funeral and Mortuary Operators: The Role of Stigma, Incivility, Work Meaningfulness and Work-Family Relation to Explain Occupational Burnout. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136691. [PMID: 34206238 PMCID: PMC8297114 DOI: 10.3390/ijerph18136691] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022]
Abstract
The funeral and mortuary sector, including funeral homes, cemeteries and crematoria, is a largely neglected sector in regard to the study of occupational factors that can affect the quality of working life. The present study aimed at overcoming this gap by investigating job demands and resources that may affect burnout levels. Data were collected through a self-report questionnaire involving funeral industry employees (N = 229) from cemetery, morgues, crematoria and funeral agencies in a Northern Italian region. The survey was cross-sectional and non-randomized. Results reveal that among job demands, stigma consciousness, supervisor incivility and work-to-family negative spillover significantly affect levels of burnout, whereas meaningfulness of work and family-to-work positive spillover may represent relevant resources to counter the onset of burnout. The results of this study contribute to new insights into the psychosocial working conditions that affect occupational wellbeing among the funeral industry sector by also giving insight into how to promote resources to prevent burnout.
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Affiliation(s)
- Gloria Guidetti
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.G.); (S.F.)
| | - Annalisa Grandi
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; (D.C.); (L.C.)
- Correspondence:
| | - Daniela Converso
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; (D.C.); (L.C.)
| | - Nicoletta Bosco
- Department of Cultures, Politics and Society, University of Turin, Lungo Dora Siena 100/A, 10124 Turin, Italy;
| | - Stefania Fantinelli
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.G.); (S.F.)
| | - Margherita Zito
- Department of Business, Law, Economics and Consumer Behaviour “Carlo A. Ricciardi”, Università IULM, Via Carlo Bo 1, 20143 Milan, Italy;
| | - Lara Colombo
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; (D.C.); (L.C.)
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Testoni I, Palazzo L, Ronconi L, Donna S, Cottone PF, Wieser MA. The hospice as a learning space: a death education intervention with a group of adolescents. BMC Palliat Care 2021; 20:54. [PMID: 33827535 PMCID: PMC8028247 DOI: 10.1186/s12904-021-00747-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. Literature shows that death education may allow them to become familiar with this topic without causing negative effects. This article describes the effects of a death education course with adolescents, wherein participants were given the opportunity to meet palliative doctors and palliative psychologists at school and in a hospice, where they were able to converse with the families of the dying. Methods This study used mixed methods and included an evaluation of a death education intervention with longitudinal follow-up of outcomes. The course involved 87 secondary school students (experimental group) aged between 16 and 20 years. We also recruited a control group of 76 similarly-aged students to observe differences. The variables we examined were: alexithymia, representation of death, value attributed to life and spirituality. These were measured with the following instruments: the Toronto Alexithymia Scale-20, the Testoni Death Representation Scale, the Personal Meaning Profile and the Spiritual Orientation Inventory, respectively. To better understand how the students perceived the experience, we asked the experimental group to answer some open-ended questions. Their answers were analysed through thematic analysis. Results The study showed that death education and the hospice experience did not produce negative effects, but rather allowed students to decrease alexithymia, improving their ability to recognise and express emotions. Thematic analysis revealed that all participants perceived the experience as very positive. Conclusions Our findings affirm that death education programs can be successfully implemented in high schools, and that they can usefully involve local hospices and palliative care professionals, especially physicians and psychologists. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00747-w.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, 35131, Padova (PD), Italy. .,Emili Sagol Creative Arts Therapies Research Center, University of Haifa, 3498838, Haifa, Israel.
| | - Lorenza Palazzo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, 35131, Padova (PD), Italy
| | - Lucia Ronconi
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, 35131, Padova (PD), Italy
| | - Stefania Donna
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, 35131, Padova (PD), Italy
| | - Paolo Francesco Cottone
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, Via Venezia 14, 35131, Padova (PD), Italy
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Testoni I, Palazzo L, Calamarà N, Rossi G, Wieser MA. "Imagine You Have ALS": Death Education to Prepare for Advance Treatment Directives. Behav Sci (Basel) 2021; 11:6. [PMID: 33419214 PMCID: PMC7825599 DOI: 10.3390/bs11010006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 12/11/2022] Open
Abstract
The study presents the results of qualitative research carried out within a death education project dedicated to advance treatment directives (ATDs) in which it was proposed to participants to empathize with people who had received a diagnosis of Amyotrophic Lateral Sclerosis (ALS). The study involved 104 people who discussed and reflected on issues related to the knowledge of having to die, palliative care and ATDs, investigating what choices they would have made if they had received such a diagnosis. Finally, they were asked to write a paper describing their impressions and hypothetical choices. Qualitative analysis has elucidated among fundamental themes. Four thematic areas emerged from the data analysis: (1) ATDs and the family; (2) the importance of reducing pain and suffering; (3) emotions and considerations regarding death, illness and spirituality; and (4) opinions on the DeEd course. It has emerged that some people are unfamiliar with palliative care or the right to self-determination and that addressing these issues helps manage the thought of the future with less terror. The experience of death education has therefore proven to be very positive in dealing with complex and often censored issues, allowing thinking about death in a less distressing way.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35131 Padova, Italy; (L.P.); (N.C.)
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, 3498838 Haifa, Israel
| | - Lorenza Palazzo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35131 Padova, Italy; (L.P.); (N.C.)
| | - Nicoletta Calamarà
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35131 Padova, Italy; (L.P.); (N.C.)
| | - Gabriella Rossi
- Unione Italiana Lotta alla Distrofia Muscolare (UILDM)—Milano Section, 20124 Milan, Italy;
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