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Biesmans JMA, Bolt SR, Janssen DJA, Wintjens T, Khemai C, Schols JMGA, Van Der Steen JT, Zwakhalen SMG, Meijers JMM. Desired dementia care towards end of life: Development and experiences of implementing a new approach to improve person-centred dementia care. J Adv Nurs 2024. [PMID: 38923055 DOI: 10.1111/jan.16285] [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: 09/15/2023] [Revised: 04/08/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
AIMS To describe the co-creation of the 'Desired Dementia Care Towards End of Life' (DEDICATED) approach to improve person-centred palliative care for individuals with dementia and to describe the experiences of healthcare professionals during the approach's implementation. METHODS A needs assessment, comprising both qualitative and quantitative studies, informed palliative care needs of healthcare professionals, family caregivers and individuals with dementia. The approach was co-created with healthcare and education professionals, guided by the findings. Then, healthcare professionals were trained to implement the approach in their organizations. From April to June 2022, semi-structured interviews with actively engaged professionals were analysed using Conventional Content Analysis. RESULTS The needs assessment yielded six key themes: (1) raising palliative care awareness, (2) familiarization with a person with dementia, (3) communication about future care preferences, (4) managing pain and responsive behaviour, (5) enhancing interprofessional collaboration in advance care planning and (6) improving interprofessional collaboration during transitions to nursing homes. Interviews with 17 healthcare professionals revealed that active involvement in co-creating or providing feedback facilitated implementation. Overall, the DEDICATED approach was perceived as a valuable toolkit for optimizing palliative care for people with dementia and their loved ones. CONCLUSION Co-creating the DEDICATED approach with healthcare professionals facilitated implementation in daily practice. The approach was considered helpful in enhancing person-centred palliative dementia care. IMPACT STATEMENT This study underscores the importance of active involvement of healthcare professionals in the research and development of new interventions or tools for palliative care, which can influence the successful implementation, dissemination and sustained usage of the developed tools. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE The developed approach can improve person-centred palliative care for individuals with dementia, ultimately improving their quality of life and that of their loved ones. REPORTING METHOD This study used the Consolidated Criteria for Reporting Qualitative Research. PATIENT OF PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jesper M A Biesmans
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Sascha R Bolt
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Daisy J A Janssen
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Toon Wintjens
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Chandni Khemai
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Jenny T Van Der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Judith M M Meijers
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Zuyderland Medical Center, Sittard-Geleen, The Netherlands
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Harrison BH, DeGennaro R, Wiencek C. Innovative Strategies for Palliative Care in the Intensive Care Unit. AACN Adv Crit Care 2024; 35:157-167. [PMID: 38848573 DOI: 10.4037/aacnacc2024761] [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: 06/09/2024]
Abstract
Palliative care is interdisciplinary care that addresses suffering and improves the quality of care for patients and families when patients are facing a life-threatening illness. Palliative care needs in the intensive care unit include communication regarding diagnosis and prognosis, goals-of-care conversations, multidimensional pain and symptom management, and end-of-life care that may include withdrawal of mechanical ventilation and life support. Registered nurses spend the greatest amount of time with patients and families who are facing death and serious illness, so nurses must be armed with adequate training, knowledge, and necessary tools to address patient and caregiver needs and deliver high-quality, patient-centered palliative care. Innovative approaches to integrating palliative care are important components of care for intensive care nurses. This article reviews 2 evidence-based practice projects, a serious illness support tool and the 3 Wishes Project, to add to the palliative care toolkit for registered nurses and other team members.
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Affiliation(s)
- Brittany H Harrison
- Brittany H. Harrison is Nurse Practitioner, University of Virginia (UVA) Health, 1215 Lee St, Charlottesville, VA 22901
| | - Regina DeGennaro
- Regina DeGennaro is Professor of Nursing, UVA School of Nursing, Charlottesville, Virginia
| | - Clareen Wiencek
- Clareen Wiencek is Professor of Nursing, UVA School of Nursing, Charlottesville, Virginia
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Ibrahim AM, Elnaghy SF, Abo Elmatty GM, Mohamed Ghida NI, Mohamed MA. Effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy in Port Said City: A pre-post quasi-experimental study. Palliat Support Care 2024; 22:546-562. [PMID: 38287515 DOI: 10.1017/s1478951523002067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
BACKGROUND Emphasizing the pivotal role of caregivers in the cancer care continuum, a program designed to educate caregivers of cancer patients undergoing chemotherapy underscores their significance. The palliative care education initiative strives to cultivate a compassionate and effective care environment, benefiting both patients and caregivers. By imparting education, fostering positive attitudes, offering support, encouraging appropriate behaviors, and providing essential resources, the program aims to enhance the overall caregiving experience and contribute to the well-being of those navigating the challenges of cancer treatment. OBJECTIVES To evaluate the effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy. METHODS The research employed a purposive sample comprising 155 caregivers who were actively present with their cancer patients throughout the pre- and post-test phases within a quasi-experimental research design. The study took place at the outpatient oncology center of Al-Shifa Medical Complex in Port Said City, Egypt. To gather comprehensive data, 4 instruments were utilized: a demographic questionnaire, a nurse knowledge questionnaire, a scale measuring attitudes toward palliative care, and an assessment of reported practices in palliative care. This methodological approach allowed for a thorough exploration of caregiver perspectives, knowledge, attitudes, and practices within the context of a palliative care education program. RESULTS Before the palliative care education program, only 1.3% of caregivers had a good overall level of knowledge about cancer and palliative care; this increased to 40.6% after the program. Similarly, before the palliative care education program, 32.9% of caregivers had a positive overall attitude, which increased to 72.3% after the program. Similarly, 27.1% of caregivers had an overall appropriate palliative care practice during the pre-test phase, which increased to 93.5% after the palliative care education program. SIGNIFICANCE OF THE RESULTS The palliative care education program significantly improved caregivers' knowledge, attitudes, and practice scores. It is strongly recommended that caregivers of cancer patients receive continuing education in palliative care. In addition, it is crucial to conduct further research with a larger sample size in different situations in Egypt.
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Affiliation(s)
- Ateya Megahed Ibrahim
- College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Sara Fawzy Elnaghy
- Family and Community Health Nursing Department, Health Technical Institute in Port Said, Port Said, Egypt
| | - Gehad Mohamed Abo Elmatty
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| | | | - Magda Ali Mohamed
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
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Castro A, Lalonde-LeBlond G, Freitas Z, Arnaert A, Bitzas V, Kildea J, Moffatt K, Phillips D, Wiseblatt L, Hall AJ, Després V, Tsimicalis A. In-Home Respite Care Services Available to Families With Palliative Care Needs in Quebec: Novel Digital Environmental Scan. JMIR Nurs 2024; 7:e53078. [PMID: 38625735 PMCID: PMC11061788 DOI: 10.2196/53078] [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: 10/25/2023] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Caregiving dyads in palliative care are confronted with complex care needs. Respite care services can be highly beneficial in alleviating the caregiving burden, supporting survivorship and dying at home. Yet, respite care services are difficult to locate and access in the province of Quebec, Canada, particularly when navigating ubiquitous sources of online health information of varying quality. OBJECTIVE This project aimed to (1) compile a list of at-home palliative respite care services in Quebec, Canada; (2) describe key accessibility features for each respite care service; (3) identify accessibility gaps and opportunities; and (4) describe a novel method for conducting environmental scans using internet search engines, internet-based community health databases, and member checking. METHODS A novel environmental scan methodology using 2 internet-based targeted databases and 1 internet search engine was conducted. Results were screened and data were extracted, descriptively analyzed, and geographically schematized. RESULTS A total of 401 services were screened, and 52 at-home respite care services specific to palliative populations were identified, compiled, and analyzed. These respite care services were characterized by various types of assistance, providers, fees, and serviced geographical regions. Accessibility was explored through the lens of service amenability, availability, eligibility, and compatibility. The data revealed important barriers to accessing respite care services, such as a lack of readily available information on service characteristics, limited availability, and a time-consuming, technical search process for potential respite care users and clinicians to identify appropriate services. CONCLUSIONS Both methodological and contextual knowledge have been gained through this environmental scan. Few methodologies for conducting internet-based environmental scans have been clearly articulated, so we applied several learnings from other scans and devised a methodology for conducting an environmental scan using the mixed methods of internet search engines, internet-based community health databases, and member checking. We have carefully reported our methods, so that others conducting community health environmental scans may replicate our process. Furthermore, through this scan, we identified assorted respite care services and pinpointed needs in the provision of these services. The findings highlighted that more easily accessible and centralized information about respite care services is needed in Quebec. The data will enable the creation of a user-friendly tool to share with community support services across Quebec and ultimately help alleviate the added burden caregivers and clinicians face when looking for respite care services in fragmented and complex digital spaces.
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Affiliation(s)
- Aimee Castro
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | - Zelda Freitas
- Professional Practice Directorate of Rehabilitation and Multidisciplinary Services, CIUSSS West-Central Montreal, Montreal, QC, Canada
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Vasiliki Bitzas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Geriatrics and Palliative Care, CIUSSS West-Central Montreal, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Karyn Moffatt
- School of Information Studies, McGill University, Montreal, QC, Canada
| | - Devon Phillips
- Palliative Care McGill, McGill University, Montreal, QC, Canada
| | | | - Audrey-Jane Hall
- Palliative Home-Care Society of Greater Montreal, Montreal, QC, Canada
| | - Véronique Després
- St-Raphaël Palliative Care Home and Day Centre, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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Jounaidi K, Hamdoune M, Daoudi K, Barka N, Gantare A. Advancing Palliative Care through Advanced Nursing Practice: A Rapid Review. Indian J Palliat Care 2024; 30:155-162. [PMID: 38846131 PMCID: PMC11152512 DOI: 10.25259/ijpc_308_2023] [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: 11/08/2023] [Accepted: 02/09/2024] [Indexed: 06/09/2024] Open
Abstract
Objectives This study addresses the growing demand for palliative care (PC) by exploring the role of advanced nursing practice (ANP) within the multidisciplinary team. The purpose is to outline the background of ANP in PC, its interest, training needs, and some recommendations for its establishment in the Moroccan healthcare system. Materials and Methods A rapid review of relevant studies was carried out through databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards, edition (2020). The inclusion criteria focussed on studies published within the nursing domain between 2012 and 2022, with a preference for the English language. Results Study selection allowed to obtain eight relevant studies. The studies agreed that ANP improves the quality of care provided. It has a major role to play in the multidisciplinary team by mobilising all the knowledge required to offer a complete range of care for patients with needs. Nevertheless, its implementation is fraught with challenges. Conclusion ANP will be able to address the complexity of patient and family needs and serve as cost-effective medical care coordinators for patients and families with both chronic and life-limiting illnesses, to reduce suffering and improve the quality of living and dying across the lifespan. Advanced practice nurses execute assigned authorisations by mobilising the knowledge acquired through university training. The establishment of this cadre in the healthcare system is subject to many challenges that Morocco must anticipate.
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Affiliation(s)
- Khaoula Jounaidi
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Meryem Hamdoune
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Khadija Daoudi
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Najwa Barka
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Abdellah Gantare
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
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Alrimali AM, Alreshidi NM. Evaluating ICU nurses' education, practice, and competence in palliative and end-of-life care in Saudi Arabia: A cross-sectional study. BELITUNG NURSING JOURNAL 2024; 10:23-30. [PMID: 38425678 PMCID: PMC10900060 DOI: 10.33546/bnj.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/22/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
Background In palliative and end-of-life (PEOL) care, especially within intensive care units (ICUs), nurses' unique skills are critical, yet their expertise remains under-explored, particularly in Saudi Arabia. Objective This study aimed to evaluate the education, practice, and perceived competence of adult ICU nurses in Saudi Arabia regarding PEOL care and to pinpoint key factors that influence this aspect of healthcare delivery. Methods A cross-sectional design was utilized in this study. Participants were recruited from five public hospitals and one specialized center in Hail, Saudi Arabia. Data were gathered in September 2023 using the PEOL Care Index, which measures various care dimensions on a Likert scale in Arabic and English. IBM SPSS Statistics 29.0 was used for statistical analysis, particularly to conduct ANOVA, t-test, and multiple regression. Results 142 out of the targeted 171 ICU nurses completed the survey, yielding a response rate of 83.04%. Although 81% of the nurses had experience caring for dying patients, only 30.3% had received in-service PEOL care training. Those with this training demonstrated significantly higher scores in education, clinical practice, and perceived competence than their counterparts (p <0.05). Mean scores across these areas were 69.67, 71.01, and 71.61, respectively. In-service training positively correlated with these metrics (p <0.05). Multiple regressions also revealed that in-service training, job satisfaction, and communication authority are strong influencers, explaining 21.6% of the variation in clinical practice and 16.9% in perceived competence. Conclusion The study highlighted the proficiency of ICU nurses in PEOL care, emphasizing that in-service training, job satisfaction, and the authority to communicate effectively with patients and their families significantly improved clinical practice and nurses' competence in PEOL care. This underlines the critical need for healthcare institutions to acknowledge and address these key factors to optimize patient care outcomes.
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Guerreiro GM, Deodato S, Graça D, Fernandes C. Human responses in adolescents with oncological disease: a scoping review protocol. BMJ Open 2023; 13:e076393. [PMID: 37993162 PMCID: PMC10668176 DOI: 10.1136/bmjopen-2023-076393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION The classification of human responses to health conditions or life processes, assuming that human responses are the way that a person responds, referring to the individual's experiences, feelings, perceptions, behaviours and physical reactions, can be an exercise that, although challenging, is central to nursing diagnoses and, consequently, to nursing practice. It is necessary to gather and organise the existing knowledge about the human responses in adolescents with cancer, starting from the moment of diagnosis, due to the specificities inherent to this stage of human development. A scoping review is an appropriate method to use in order to map the existing knowledge on human responses in adolescents with oncological diseases experienced since the diagnosis. INCLUSION CRITERIA Will encompass all types of studies, including 'grey literature' that centres on human responses related to adolescents aged 10-19 years with oncological diseases. There will be no restrictions based on the type of cancer, disease stage or other contextual factors, whether in home or healthcare settings. METHODS AND ANALYSIS The review will be conducted following the guidelines outlined by the Joanna Briggs Institute for scoping reviews. The search will encompass the following databases: CINAHL Complete (EBSCOhost), Cochrane Database of Systematic Reviews (EBSCOhost), MEDLINE Complete (EBSCOhost), Nursing and Allied Health Collection: Comprehensive (EBSCOhost), Cochrane Clinical Answers (EBSCOhost Answers), Latin American and Caribbean Literature on Health Sciences (LILACS) and 'grey literature' sources accessible through the Scientific Open Access Repositories of Portugal (RCAAP). A three-step search strategy will be implemented. Titles and abstracts will undergo analysis by two independent reviewers. Articles selected for a full-text review will be organised. The results will be presented in tables and narratively summarised. ETHICS AND DISSEMINATION Ethics approval and patient consent for publication are not necessary. Findings will be disseminated through publication in scientific journals and through conference presentations. REVIEW REGISTRATION NUMBER EXUB4. Registration was made in the Open Science Framework (OSF).
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Affiliation(s)
- Gonçalo Miguel Guerreiro
- Pediatrics, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
- Faculdade de Ciências da Saúde e Enfermagem, Centre for Interdisciplinary Research in Health, Nursing Research Platform, Universidade Católica Portuguesa, Lisboa, Portugal
| | - Sérgio Deodato
- Faculdade de Ciências da Saúde e Enfermagem, Centre for Interdisciplinary Research in Health, Nursing Research Platform, Universidade Católica Portuguesa, Lisboa, Portugal
- School of Nursing, Faculdade de Ciências da Saúde e Enfermagem, Universidade Catolica Portuguesa, Lisboa, Portugal
| | - Daniela Graça
- Pediatrics, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
| | - Catarina Fernandes
- Pediatrics, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
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Bassah N, Vaughn L, Santos Salas A. Nurse-led adult palliative care models in low- and middle-income countries: A scoping review. J Adv Nurs 2023; 79:4112-4126. [PMID: 36965072 DOI: 10.1111/jan.15646] [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: 12/15/2022] [Revised: 02/21/2023] [Accepted: 03/08/2023] [Indexed: 03/27/2023]
Abstract
AIMS To map evidence on the nature and extent of use of nurse-led palliative care models in low- and middle-income countries serving adults with life-limiting conditions. DESIGN A scoping review of the literature was undertaken. DATA SOURCES A systematic search was performed from database inception to March 2022 in: Medline, EMBASE, CINAHL, Wiley Cochrane Library, SCOPUS, Web of Science, SciELO and Global Health. Main search terms included: Nurse-led AND Palliative care AND Low-and middle-income countries. Grey literature was searched from Proquest Dissertations and Theses Global, the World Health Organization and selected palliative care websites. We searched the reference list of included articles for additional studies. REVIEW METHODS We used the framework by Arksey and O'Malley and the PRISMA-ScR guidelines. Titles and abstracts were screened by one reviewer and full text by two reviewers. Thematic analysis was used to synthesize data and results are presented descriptively using themes and categories. RESULTS Eighteen studies were included, with majority from Sub-Saharan Africa (10/20). Three nurse-led palliative care models emerged: nurse-led empowering care, nurse-led symptom control and nurse-led multicomponent palliative care. They served particularly cancer and HIV patients and were delivered in person or by telehealth care. Reported outcomes were adherence to therapy, improved self-care ability, improved quality of life and increased access to palliative. CONCLUSIONS The use of nurse-led palliative care in low- and middle-income countries is in its developing stages and seems feasible. Nursing roles in in low- and middle-income countries need to be expanded by developing advanced practice nurses and nurse practitioner programmes, with palliative care content. More impact evaluation studies on the use of nurse-led palliative care models in these countries are needed. IMPACT This review highlights nurse-led care models that can enhance access and quality of life of patients with life-limiting conditions in low- and middle-income countries.
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Affiliation(s)
- Nahyeni Bassah
- Faculty of Nursing, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Department of Nursing, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Lisa Vaughn
- Faculty of Nursing, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
| | - Anna Santos Salas
- Faculty of Nursing, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
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Hamdan KM, Al-Bashaireh AM, Al-Dalahmeh M, Saifan AR, Albqoor MA, Shaheen AM. Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan. Acute Crit Care 2023; 38:469-478. [PMID: 38052512 DOI: 10.4266/acc.2023.00430] [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: 02/15/2023] [Accepted: 08/03/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study's purpose was to examine nurses' knowledge and attitudes toward palliative care. METHODS A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data. RESULTS We measured nurses' knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type. CONCLUSIONS ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.
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Affiliation(s)
| | - Ahmad M Al-Bashaireh
- Faculty of Health Science, Higher Colleges of Technologies, Fujairah, United Arab Emirates
| | | | | | | | - Abeer M Shaheen
- Community Health Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
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Alshammari F, Sim J, Lapkin S, McErlean G. Registered Nurses' attitudes towards end-of-life care: A sequential explanatory mixed method study. J Clin Nurs 2023; 32:7162-7174. [PMID: 37300363 DOI: 10.1111/jocn.16787] [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: 02/01/2023] [Revised: 04/12/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
AIMS To examine registered nurses' attitudes about end-of-life care and explore the barriers and facilitators that influence the provision of high-quality end-of-life care. DESIGN A sequential explanatory mixed methods research design was used. METHODS An online cross-sectional survey was distributed to 1293 registered nurses working in five different hospitals in the Kingdom of Saudi Arabia. The Frommelt Attitudes Towards Care of the Dying Scale was used to assess nurses' attitudes towards end-of-life care. Following the survey, a subset of registered nurses were interviewed using individual semi-structured interviews. RESULTS Four hundred and thirty-one registered nurses completed the online survey, and 16 of them participated in individual interviews. Although nurses reported positive attitudes towards caring for dying patients and their families in most items, they identified negative attitudes towards talking with patients about death, their relationship with patients' families and controlling their emotions. The individual interview data identified the barriers and facilitators that registered nurses experience when providing end-of-life care. Barriers included a lack of communication skills and family and cultural and religious resistance to end-of-life care. The facilitators included gaining support from colleagues and patients' families. CONCLUSION This study has identified that while registered nurses hold generally favourable attitudes towards end-of-life care, they have negative attitudes towards talking with patients and families about death and managing their emotional feelings. RELEVANCE TO CLINICAL PRACTICE Education providers and leaders in healthcare settings should consider developing programmes for undergraduate nurses and nurses in clinical practice to raise awareness about the concept of death in a cross-section of cultures. Nurses' attitudes towards dying patients will be enhanced with culture-specific knowledge which will also enhance communication and coping methods. REPORTING METHOD This study used the Mixed Methods Article Reporting Standards (MMARS).
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Affiliation(s)
- Fares Alshammari
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- College of Applied Medical Sciences, University of Hafr Al-Batin, Hafr Al-Batin, Saudi Arabia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- School of Nursing & Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
- WHO Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Samuel Lapkin
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Gemma McErlean
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Battista V, Sciacca K. Professional Standards and the Role of the Advanced Practice Registered Nurse in Hospice and Palliative Care. J Hosp Palliat Nurs 2023; 25:249-254. [PMID: 37550855 DOI: 10.1097/njh.0000000000000968] [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: 08/09/2023]
Abstract
Palliative care aims to optimize quality of life and reduce physical, psychological, social, and spiritual suffering for people living with serious and life-threatening illness throughout the life span. There are different educational pathways to becoming an advanced practice registered nurse (APRN) and a range of areas in which APRNs may specialize, including hospice and palliative care. National guidelines and professional standards have been developed to guide the delivery of high-quality palliative care and to demonstrate the need for all nurses to be competent in providing primary palliative care. Advanced practice registered nurses are well poised to integrate palliative care standards into their practice in a variety of settings and in myriad ways including clinical care, program development, leadership, education, and advocacy. This article is the first in a series that will highlight the different roles of the hospice and palliative care APRN, including the doctor of nursing practice, clinical nurse specialist, pediatric APRN, adult/gerontology APRN, and community-based APRN in a variety of settings throughout the country.
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Miller EM, Porter JE, Barbagallo MS. The Effects of the Ward Environment and Language in Palliative Care: A Qualitative Exploratory Study of Victorian Nurses' Perspectives. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:146-158. [PMID: 37265375 PMCID: PMC10621022 DOI: 10.1177/19375867231177299] [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: 06/03/2023]
Abstract
OBJECTIVES The current study aimed to explore regional nurses' perspectives of how bad news is delivered and the physical, natural, social, and symbolic environments where these conversations occur. BACKGROUND In regional hospitals within Victoria, Australia, palliative and end-of-life patients are cared for in acute wards that are often busy, noisy, and do not have a palliative psychosocial focus. On the other hand, Palliative Care Units (PCUs) have more home-like dedicated spaces, yet nearly all these facilities are in metropolitan areas. Diagnostic/prognostic (bad news) conversations about life-limiting illnesses often occur at the bedside in both environments. METHOD Nurses providing palliative or end-of-life care in regional or metropolitan Victorian hospital inpatient wards were invited to interview and recruited through social media and snowballing. Six semi-structured, audio-recorded online interviews were conducted between March and May 2022, and themes were developed using reflexive thematic analysis. RESULTS Semi-structured online interviews were conducted with six female, registered nurses, four of whom worked in regional Victorian hospitals and two in metropolitan PCUs as Nurse Unit Managers. Three central themes were developed: "conducting family meetings," "palliative care practice," and "the environment matters." CONCLUSIONS A therapeutic environment for palliative patients and their families consists of home-like ambience and aesthetics and a psychosocial environment created by staff who can provide holistic palliative care. Holistic palliative care requires mentoring and mirroring of expert practice to increase the expertise and capacity of the palliative care workforce in acute general hospital wards.
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Affiliation(s)
- Elizabeth M. Miller
- Collaborative Evaluation and Research Group (CERG), Federation University Australia, Churchill, Victoria, Australia
| | - Joanne E. Porter
- Collaborative Evaluation and Research Group (CERG), Federation University Australia, Churchill, Victoria, Australia
| | - Michael S. Barbagallo
- Institute of Health and Wellbeing, Federation University Australia, Churchill, Victoria, Australia
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Aydin R, Kabukcuoğlu K, Haugan G. The Nurse-Patient Interaction Scale: Translation and Psychometric Properties Among Hospitalized Cancer Patients in Turkey. J Nurs Meas 2023; 31:378-388. [PMID: 37788857 DOI: 10.1891/jnm-2021-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background and Purpose: Cancer patients experience physical and psychological ailments resulting from cancer illness, a difficult and long treatment process and fear of death. Nurse-patient interaction seems to play an important role when responding to the psychological needs of patients with cancer. The aim of this study is to adapt and examine the psychometric properties of the Nurse-Patient Interaction Scale (NPIS) among Turkish cancer patients. Design and Method: In a cross-sectional design, patients receiving cancer treatment at Farabi hospital in Turkey responded to the Personal Information Form and the NPIS. Descriptive statistics, principal component analysis (PCA), and confirmatory factor analysis (CFA) were applied. Findings: The NPIS was found to be suitable for a single factor structure, including 11 out of the original 14 items. The 11-items uni-dimensional model showed an acceptable/good fit with the data: χ2 = 154.369, (df = 44), χ2/df = 3.51, p = .0001, RMSEA = 0.100, p-value for test of close fit = 0.0001, CFI = 0.98, TLI = 0.97 and SRMR = 0.012.
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Affiliation(s)
- Ruveyde Aydin
- Department of Gynecology and Obstetrics Nursing, Health Sciences Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Kamile Kabukcuoğlu
- Department of Gynecology and Obstetrics Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Gørill Haugan
- Norwegian University of Science and Technology, NTNU Center for Health Promotion Research, Faculty of Nursing and Health Sciences, Trondheim Norway
- Nord University, Faculty of Nursing and Health Science, Levanger, Norway
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Basirika D, Merriman A, Gumoyesige N, Namisango E, Matthews E, Guma S. Insights into Advance Care Planning in Africa. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 180:16-20. [PMID: 37353429 DOI: 10.1016/j.zefq.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 06/25/2023]
Abstract
Advance Care Planning is an important element of palliative care whose relevance has over the years shifted from focusing on patients at end of life to being applicable at any stage of an individual's health. It is said to be beneficial not only to the patient but also to the general health care system. It may facilitate a peaceful death in addition to minimizing unnecessary costs and the use of resources yet its use among health care workers in Africa is not well researched. This study therefore aimed to explore the use of Advance Care Planning among health care providers in sub-Saharan Africa. It was a survey that targeted health care professionals across Sub-Saharan Africa who were either current staff or alumni of Hospice Africa Uganda (HAU) between 2012 and 2023. These were conveniently sampled from HAU data base. An electronic survey was sent out, data was collected into an excel sheet and it was analysed descriptively. Responses to the survey came from nine out of 37 countries with PC services across Africa and there was a 14% response rate. 83% of the respondents had insight into Advance Care Planning and a surprise finding was that 40% had cared for patients with ACP. The majority (96%) would respect Advance Care Plans of their patients. These findings gave some insights into the use of ACP although the results cannot be generalised to a wider demography of healthcare providers.
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Affiliation(s)
| | | | | | - Eve Namisango
- African Palliative Care Association, Kampala, Uganda
| | - Emma Matthews
- St. Luke's Hospice Sheffield, Sheffield, United Kingdom
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Toqan D, Malak MZ, Ayed A, Hamaideh SH, Al-Amer R. Perception of Nurses' Knowledge about Palliative Care in West Bank/ Palestine: Levels and Influencing Factors. J Palliat Care 2023; 38:336-344. [PMID: 36278305 DOI: 10.1177/08258597221133958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Objective: Healthcare professionals particularly nurses should be professionally prepared with knowledge about the standards of palliative care and their roles in providing palliative care. Nurses' knowledge about palliative care and influencing factors has not been examined adequately in Arab countries including Palestine. Thus, this study aimed to assess the adequacy of knowledge level and influencing factors (socio-demographic) about palliative care among nurses in West Bank/ Palestine. Methods: A descriptive-correlational design was utilized. A cluster random sampling method was applied to select 12 hospitals from the three regions in West Bank. Then, four hospitals were selected from each region using a simple random method. All registered nurses working in critical care units and medical and surgical wards in the selected hospitals were recruited. The sample consists of 424 registered nurses and data were collected using Palliative Care Quiz for Nursing (PCQN). Results: The Findings revealed that nurses' level of knowledge about palliative care was low/inadequate (M = 7.75, SD = 2.96). Knowledge about palliative care was influenced by age (B = -.106; p < 0.05), gender (B = -.223; p < 0.001), and hospital ward (B = -.597; p < 0.001), in which younger nurses, females, and those who work in critical care units reported higher levels of knowledge about palliative care. Conclusions: Findings of this study emphasized the need for developing educational and training courses, seminars, and workshops on palliative care to increase nurses' knowledge in order to enhance the quality of patient care. Also, policymakers should develop national strategic plans and policies regarding palliative care and apply these plans in all hospitals in West Bank/ Palestine.
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Affiliation(s)
- Dalia Toqan
- Nursing Education, Faculty of Nursing, Arab American University of Palestine (AAUP), Jenin, Palestine
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ahmad Ayed
- Pediatric Health Nursing, Faculty of Nursing, Arab American University of Palestine (AAUP), Jenin, Palestine
| | - Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Rasmieh Al-Amer
- Psychiatric Health Nursing, Faculty of Nursing, Isra University, Amman, Jordan
- School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia
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Abu-Aziz B, Alkasseh ASM, Bayuo J, Abu-Odah H. Towards the Provision of Palliative Care Services in the Intensive Coronary Care Units: Nurses' Knowledge, Training Needs, and Related-Barriers. Healthcare (Basel) 2023; 11:1781. [PMID: 37372899 DOI: 10.3390/healthcare11121781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its delivery to people with cardiac problems, particularly in the Middle East region (EMR), remains a critical issue. There is a scarcity of research assessing nursing staff's needs and knowledge in providing PC to cardiac patients in the EMR. This study aimed to assess the level of knowledge and needs of PC among nurses towards the provision of PC in intensive coronary care units (ICCUs) in the Gaza Strip, Palestine. It also identified the barriers to the provision of PC services in ICCUs in the Gaza Strip. A hospital-based descriptive quantitative cross-sectional design was adopted to collect data from 85 nurses working in ICCUs at four main hospitals in the Gaza Strip. Knowledge about PC was collected using a developed questionnaire based on the Palliative Care Quiz Nursing Scale (PCQN) and Palliative Care Knowledge Test (PCKT). PC training needs and barriers were assessed using the PC Needs Assessment instrument. Approximately two-thirds of nurses did not receive any PC educational or training programs, which contributed to their lack of PC knowledge. Most nurses would like to enroll in PC training programs, such as family support and communications skills courses. Nurses reported that there was a high demand for PC guidelines and discharge planning for patients with chronic illnesses. Insufficient healthcare professionals' knowledge about PC and a staff shortage were the main barriers to integrating PC into the Gaza healthcare system. This study suggests incorporating PC into nursing curricula and in-service training, and it covers both basic and advanced PC principles. Intensive coronary care unit nurses need knowledge and training about PC, guidance, and support to provide appropriate care to patients with cardiovascular issues.
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Affiliation(s)
- Baraa Abu-Aziz
- Nasser Medical Complex Hospital, Ministry of Health, Gaza P.O. Box P860, Palestine
| | - Areefa S M Alkasseh
- Department of Midwifery, Nursing College, Islamic University of Gaza, Gaza P.O. Box P108, Palestine
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- WHO Collaborating Centre for Community Health Services (WHOCC), School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza P.O. Box P860, Palestine
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Ding W, Jian M, Xu RJ. The impact of standardized perioperative care management on improving outcomes in patients with peptic ulcer disease. Medicine (Baltimore) 2023; 102:e33769. [PMID: 37233432 PMCID: PMC10219734 DOI: 10.1097/md.0000000000033769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
The present study investigated the impact of standardized perioperative nursing management on improving outcomes in patients with peptic ulcer disease. A total of 90 patients with peptic ulcers were admitted to the Wuhan Wuchang Hospital between July 2020 to July 2022. These patients were included in the present study. They were divided into 2 groups based on the nursing management that they received, with 45 patients classified into each group. The control group received routine nursing care, while the observation group received standardized perioperative nursing management. The improvement in clinical symptoms, recurrence rate, negative emotions and disease management capacity were compared between the 2 groups. The results demonstrated that the improvement rate of clinical symptom in the observation group was significantly higher as compared with the control group (P < .05). The recurrence rate in the observation group was significantly lower than in the control group (P = .026). Patients in the observation group had better psychological status, and better disease management capacity as compared with those in the control group (P < .05). The application of standardized perioperative nursing management for patients with peptic ulcer can help improve the patients' clinical symptoms, enhance their disease management capacity, reduce anxiety, and ensure the quality of nursing care.
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Affiliation(s)
- Wei Ding
- Department of Nursing, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Man Jian
- Department of Gastroenterology, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Rui-jie Xu
- Department of Gastroenterology, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
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18
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Huijten DCM, Bolt SR, Meesterberends E, Meijers JMM. Nurses' support needs in providing high-quality palliative care to persons with dementia in the hospital setting: A cross-sectional survey study. J Nurs Scholarsh 2023; 55:405-412. [PMID: 36218182 DOI: 10.1111/jnu.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 07/18/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Since dementia is an irreversible progressive disease characterized by a decline in mental functions and overall health, a palliative care approach is recommended. Nevertheless, many persons with dementia experience burdensome hospitalizations in end-of-life care. Their quality of life during hospitalization can be improved by palliative nursing care that suits their fragile health. AIM To explore hospital nurses' perceived support needs while providing high-quality palliative care for persons with dementia and to identify differences between nurses in different ward types and at different educational levels. DESIGN Cross-sectional, multicenter survey study. METHOD Between January 2021 and April 2021, a convenience sample of Dutch hospital nurses received a web-based questionnaire on the topics of palliative caregiving, communication, collaboration, and hospital admissions. The data were analyzed using descriptive statistics. RESULTS The survey was completed by 235 nurses. The most frequently endorsed support needs were "communicating with persons with severe dementia" (58.3%), "appointing a permanent contact person in the care for persons with dementia" (53.6%), and "dealing with family disagreement in end-of-life care" (53.2%). If nurses had more time to provide care, 66.4% of them would prioritize providing personal attention. Most support needs identified by nurses were similar. CONCLUSION A heterogeneous group of nurses demonstrates overall similar support needs in providing palliative care for persons with dementia and their families in the hospital setting. CLINICAL RELEVANCE Nursing practices should implement dementia-friendly interventions to improve the quality of dementia care in the hospital.
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Affiliation(s)
| | - Sascha R Bolt
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, the Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | | | - Judith M M Meijers
- Zuyderland, Zuyderland Medical Center, Sittard-Geleen, the Netherlands.,Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, the Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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19
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Conley CE. Student nurses' end-of-life and post mortem care self-efficacy: A descriptive study. NURSE EDUCATION TODAY 2023; 121:105698. [PMID: 36549255 DOI: 10.1016/j.nedt.2022.105698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/02/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Student nurses providing end-of-life care reported that caring for a person dying created anxiety, fear, and increased stress and reflected low self-efficacy. New nurses felt unprepared academically and emotionally. High self-efficacy is necessary to handle adverse emotional reactions. However, the literature lacks an instrument to evaluate nursing students' self-efficacy in caring for someone who is dying. OBJECTIVE The study aims to investigate the reliability and validity of the "End-of-Life and Postmortem Self-Efficacy Scale" and explore nursing students' self-efficacy associated with the nursing duties and responsibilities of caring for individuals during the active phase of dying and immediately after death. DESIGN The study was a quantitative descriptive, cross-sectional design. PARTICIPANTS National Student Nurses' Association members enrolled in undergraduate registered nurse associate's, bachelor's degree programs, or a nursing diploma program. METHOD National Student Nurses' Association members responded to an electronic survey containing 18 items related to end-of-life and post mortem nursing responsibilities. RESULTS A total of 498 responses were analyzed. Cronbach's alpha (α = 0.938) showed high reliability of the 18 items on the instrument. The Kaiser-Meyer-Olkin was 0.925 and indicated sampling adequacy. Bartlett's test of sphericity was highly significant (p = .001). The nursing students' mean end-of-life and post mortem self-efficacy score was 62 (scale of 0-100). CONCLUSION The "End-of-Life and Postmortem Self-Efficacy Scale" showed high reliability in evaluating the latent concept of end-of-life and post mortem self-efficacy. The low mean self-efficacy score indicated that nursing students might be underprepared to provide EOL and post mortem care as new graduates. Faculty can use the "End-of-Life and Postmortem Self-Efficacy Scale" to assess student readiness and identify gaps in knowledge in the care of someone who is dying. Future research is needed to determine how increasing nursing students' end-of-life and post mortem self-efficacy influences the perception of end-of-life preparedness.
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Affiliation(s)
- Carol E Conley
- Department of Nursing, Cox College, United States of America.
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20
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Khatib SE, Khoder A, Moghrabi D, Rabah M, Tabbah SA. Nurses' knowledge about palliative care services in North Lebanon. Int J Palliat Nurs 2022; 28:474-481. [DOI: 10.12968/ijpn.2022.28.10.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: The surge in number of people needing palliative care services along with the deficit in nursing knowledge in in this field are challenges to be addressed in order to ensure higher quality end of life life care. Aim: The aim of this cross-sectional, exploratory pilot study was to assess nurses' knowledge in palliative care using the palliative care knowledge test (PCKT). Method: Descriptive analysis and correlations were carried out. Findings: Nurses showed insufficient knowledge in palliative care; 52% had a poor level (≤18 points) and 48% a fair level (19–28) of knowledge. No participants scored more than 73% in the total PCKT score. Nurses scored poorest in the management of dyspnoea and psychiatric problems. Conclusion: This pilot study demonstrated that promoting continuous education in palliative care is needed to provide quality care to terminally ill patients.
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Affiliation(s)
- Sarah El Khatib
- Assistant Professor, Faculty of Public Health, Lebanese University, Lebanon; Center for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, France
| | - Ansar Khoder
- Registered Nurse, Faculty of Public Health, Lebanese University; Al Youssef Hospital Center, Lebanon
| | - Dalal Moghrabi
- Registered Nurse, Faculty of Public Health, Lebanese University; Al Youssef Hospital Center, Lebanon
| | - Mohamad Rabah
- Registered Nurse, Faculty of Public Health, Lebanese University; Nini Hospital, Lebanon
| | - Samaa Al Tabbah
- Clinical Pharmacist, Faculty of Health Sciences, American University of Beirut; School of Pharmacy, Lebanese American University, Lebanon
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Hebdon MCT, Phan CT, Phillips C, Wan S, Doyon K, Gray T, Johnson L, Fischer SM. Ethical and Policy Implications of Financial Burden in Family Caregivers. J Hosp Palliat Nurs 2022; 24:E226-E232. [PMID: 35666768 PMCID: PMC10365074 DOI: 10.1097/njh.0000000000000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Palliative care nurses are key members of the health care team and provide support to patients and their families navigating chronic and life-limiting illness. Financial burden is an issue inherent to chronic illness, yet has not been fully addressed in family caregivers. The purpose of this article is to (1) provide a case study of a family caregiver navigating chronic illness with her daughter and the associated financial and employment consequences and (2) review the nursing ethical, policy, and practice implications of financial burden for family caregivers. The ethical implications of financial burden in family caregivers relate to health equity and health outcomes for both the patient and family caregiver in treatment access and quality. The policy implications include state and federal policies related to caregiver compensation and support and family medical leave. Palliative care nurses play an integral role in addressing caregiver financial burden through assessment, education, referral, and policy support. Family caregivers are essential to the palliative care team, and palliative care nurses have the opportunity to lead initiatives to support the financial well-being of family caregivers in practice, research, and policy settings.
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Affiliation(s)
| | | | | | - Shaowei Wan
- University of Colorado Denver Anschutz Medical Center
| | | | - Tamryn Gray
- Harvard Medical School, Dana-Farber Cancer Institute
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Santos S, Martins H, Capelas ML, Domingues TD, Caldeira S, Taylor EJ. Validation of the Nurse Spiritual Care Therapeutics Scale in Portuguese palliative care settings: a methodological study. Int J Palliat Nurs 2022; 28:157-163. [PMID: 35465699 DOI: 10.12968/ijpn.2022.28.4.157] [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: 11/11/2022]
Abstract
BACKGROUND Spirituality is a critical dimension in palliative care, but difficulties have been described in literature concerning the effective implementation and measuring of spiritual care. AIM To translate, adapt and validate the Nurse Spiritual Care Therapeutics Scale (NSCTS) in Portuguese palliative care settings. METHODS A methodological study was conducted. A final version of the questionnaire included the scale and was submitted to full psychometric testing using nurses working in Portuguese palliative care settings. FINDINGS A total of 88 nurses participated. The average age of the sample was 36.1 ± 8.93 years (range 23-60 years), and 92.0% were women. A Cronbach alpha value of 0.88; Kaiser-Meyer-Olkin measure of sampling adequacy 0.80; and Bartlett's Test of Sphericity were adequate. An exploratory factor analysis was conducted using principal axis factoring with an oblimin rotation that resulted in a three-factors solution. CONCLUSION The European Portuguese NSCTS questionnaire is a valid and reliable tool to assess the frequency of nurses' activities concerning spirituality in palliative care.
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Affiliation(s)
| | - Helga Martins
- PhD student, Cathoclic University of Portugal, Institute of Health Sciences, Centre for Interdisciplinary Research in Health, Portugal
| | - Manuel Luís Capelas
- Associate Professor, Cathoclic University of Portugal, Institute of Health Sciences, Centre for Interdisciplinary Research in Health Portugal
| | - Tiago Dias Domingues
- Assistant Professor, Centre of Statistics and its Applications, University of Lisbon, Portugal
| | - Sílvia Caldeira
- Assistant Professor, Cathoclic University of Portugal, Institute of Health Sciences, Centre for Interdisciplinary Research in Health, Portugal
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Kean T. Palliative care nurses' experiences caring for patients with eating deficiencies. Evid Based Nurs 2022; 25:ebnurs-2022-103519. [PMID: 35277456 DOI: 10.1136/ebnurs-2022-103519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Terri Kean
- Faculty of Nursing (retired), University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Chalmers T, Eaves S, Lees T, Lin CT, Newton PJ, Clifton-Bligh R, McLachlan CS, Gustin SM, Lal S. The relationship between neurocognitive performance and HRV parameters in nurses and non-healthcare participants. Brain Behav 2022; 12:e2481. [PMID: 35191214 PMCID: PMC8933753 DOI: 10.1002/brb3.2481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/04/2021] [Accepted: 12/19/2021] [Indexed: 11/05/2022] Open
Abstract
Nurses represent the largest sector of the healthcare workforce, and it is established that they are faced with ongoing physical and mental demands that leave many continuously stressed. In turn, this chronic stress may affect cardiac autonomic activity, which can be non-invasively evaluated using heart rate variability (HRV). The association between neurocognitive parameters during acute stress situations and HRV has not been previously explored in nurses compared to non-nurses and such, our study aimed to assess these differences. Neurocognitive data were obtained using the Mini-Mental State Examination and Cognistat psychometric questionnaires. ECG-derived HRV parameters were acquired during the Trier Social Stress Test. Between-group differences were found in domain-specific cognitive performance for the similarities (p = .03), and judgment (p = .002) domains and in the following HRV parameters: SDNNbaseline, (p = .004), LFpreparation (p = .002), SDNNpreparation (p = .002), HFpreparation (p = .02), and TPpreparation (p = .003). Negative correlations were found between HF power and domain-specific cognitive performance in nurses. In contrast, both negative and positive correlations were found between HRV and domain-specific cognitive performance in the non-nurse group. The current findings highlight the prospective use of autonomic HRV markers in relation to cognitive performance while building a relationship between autonomic dysfunction and cognition.
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Affiliation(s)
- Taryn Chalmers
- Neuroscience Research Unit, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Shamona Eaves
- Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ty Lees
- The Pennsylvania State University Department of Human Development and Family Studies, University Park, Pennsylvania, USA
| | - Chin-Teng Lin
- Computational Intelligence and Brain Computer Interface Centre (CIBCI), FEIT, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Phillip J Newton
- School of Nursing & Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Roderick Clifton-Bligh
- Medicine, Northern Clinical School, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia
| | - Craig S McLachlan
- Centre for Healthy Futures, Torrens University Australia - Sydney Campus Pyrmont, Pyrmont, New South Wales, Australia
| | - Sylvia M Gustin
- University of New South Wales School of Psychology, Sydney, New South Wales, Australia
| | - Sara Lal
- Faculty of Science, University of Technology Sydney, Sydney, New South Wales, Australia
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Wantonoro W, Suryaningsih EK, Anita DC, Nguyen TV. Palliative Care: A Concept Analysis Review. SAGE Open Nurs 2022; 8:23779608221117379. [PMID: 35966230 PMCID: PMC9364202 DOI: 10.1177/23779608221117379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/17/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Palliative care is critically important for the world’s aging population and can change illness trajectories and promote advances in health care technologies. As health care team members, nurses have the most contact with palliative care patients. However, misconceptions about which patients need to receive palliative care may be an obstacle to meeting patients’ needs for palliative care. Objectives This study aimed to describe preceding events, characteristics and outcomes of patients in palliative care according to current concept analysis studies. Methods A literature review was conducted. Inclusion criteria were: (1) concept analysis studies, (2) use of the term palliative care or palliative nursing care, (3) palliative care explanation including antecedents, attributes, and consequences, and (4) articles written in English published between 2004 and 2021. Results Four concept analysis studies on palliative care were included in this review. Palliative care was described as an approach to alleviating physical and psychological suffering and improving patients’ and families’ quality of life in the early stages of diagnosed illness. Terminal illnesses, acute or chronic diseases, and actual or potentially life-threatening illnesses were confirmed as the events preceding palliative care. Characteristics of palliative care include holistic care, interdisciplinary teamwork, and compassionate, patient- and family-centered care. Improved patient and family quality of life, enhanced human dignity, improved self-care, and strengthened coping abilities are outcomes of palliative care. Conclusions/Implications for Practice Palliative care is a concept that is related to the early stage of an illness, the timing of illness diagnosis, and the onset of symptoms. Including palliative care terms in nursing education and training and developing palliative care models in clinical practice are recommended to ensure nurses understand the services of the palliative care needs of patients and their families. Future reviews, including grounded qualitative studies on the concept of palliative care, are recommended.
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Affiliation(s)
- Wantonoro Wantonoro
- Department of Nursing, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | | | - Diyah Chandra Anita
- Department of Nursing, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Tuan Van Nguyen
- Department of Nursing, Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
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Rohilla K, Ranga K, Ranga U, Kalyani CV. Descriptive cross-sectional study to assess the knowledge of undergraduate nurses of predictors of palliative care. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_261_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Li L, Lv J, Zhang L, Song Y, Zhou Y, Liu J. Association between attitude towards death and spiritual care competence of Chinese oncology nurses: a cross-sectional study. BMC Palliat Care 2021; 20:150. [PMID: 34587921 PMCID: PMC8480268 DOI: 10.1186/s12904-021-00846-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS An understanding of the oncology nurse spiritual care competence would help nurse managers recognize weakness in spiritual practice and improve the quality of spiritual care. But the relationship between attitude towards death and spiritual care competence is unknown. METHODS We recruited 326 nurses from hospitals in Guangzhou, China. The nurses completed the Chinese Spiritual Care Competence Scale and the Chinese Death Attitude Profile-Revised questionnaires. RESULTS The total score of spiritual care competence was 61.62 ± 16.10. And the lowest score of attitude towards death was for escape acceptance, 2.64 ± 0.82. Factors associated with nurse spiritual care competence were work department, whether trained in spiritual care, approaching acceptance, and escaping acceptance of attitude towards death. CONCLUSION Nurses need to perfect their spiritual care competence and establish positive attitudes towards death.
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Affiliation(s)
- Liujin Li
- School of Nursing, Guangzhou Medical University, 195 Dongfeng West Road, Yuexiu District, Guangzhou, P.R. China
| | - Jingmin Lv
- School of Nursing, Guangzhou Medical University, 195 Dongfeng West Road, Yuexiu District, Guangzhou, P.R. China
| | - Lingling Zhang
- Nursing Department, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Yalan Song
- Nursing Department, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, 195 Dongfeng West Road, Yuexiu District, Guangzhou, P.R. China
| | - Jiaxian Liu
- School of Nursing, Guangzhou Medical University, 195 Dongfeng West Road, Yuexiu District, Guangzhou, P.R. China.
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Ebadinejad Z, Rassouli M, Fakhr-Movahedi A. Assessing the compliance of educational curricula of selected disciplines with the content standards of cancer-related palliative care. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:247. [PMID: 34485544 PMCID: PMC8395876 DOI: 10.4103/jehp.jehp_1415_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/15/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Management of cancer complications requires the provision of palliative care as a comprehensive care by the main and trained members of this method of care. The aim of the present study was to assess the compliance of educational curricula of selected disciplines with the content standards of cancer-related palliative care. MATERIALS AND METHODS In this descriptive-comparative study, the content standards of palliative care for nurses, physicians, and social workers were identified based on the World Health Organization guideline and Oxford Textbook of Palliative Nursing. For this purpose, a separate checklist was prepared for the disciplines with different dimensions. Then the face and content validity of the checklists were checked. Finally, we examined the coordination between selected curricula available on the website of Education Deputy of the Ministry of Health, Treatment and Medical Education with the dimensions of the checklists. RESULTS All three curricula in most domains were relevant with the content standards, but there was the biggest education need in the areas related to the dimensions of "planning and educational," "educating physician in palliative care," and "considering patient preferences" in these disciplines. CONCLUSIONS To meet the educational needs, it is suggested to change some course topics, hold training courses, or joint workshops.
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Affiliation(s)
- Zahra Ebadinejad
- Student Research Committee, Pediatric and Neonatal Nursing Department, School of Nursing, Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Rassouli
- Cancer Research Centre, Pediatric Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Fakhr-Movahedi
- Nursing Care Research Center, Pediatric and Neonatal Nursing Department, School of Nursing, Semnan University of Medical Sciences, Semnan, Iran
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Big Five Personality Model-based study of death coping self-efficacy in clinical nurses: A cross-sectional survey. PLoS One 2021; 16:e0252430. [PMID: 34043723 PMCID: PMC8158956 DOI: 10.1371/journal.pone.0252430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Specific personality traits may affect the ability of nurses to deal with patient death. The relationship between personality and death coping self-efficacy (DCS) has rarely been investigated in the palliative care setting. In this study, we explored the associations between different personality profiles and DCS in clinical nurses from general wards and ICU. Methods A cross-sectional survey of 572 Chinese nurses was conducted between August and September 2020, by way of a self-administered questionnaire. Results Among the Big Five Personality Traits, in nurses the score was highest for conscientiousness and lowest for neuroticism. With regard to DCS, nurses scored highly on the intention of hospice care. The Big Five Personality Traits were found to explain 20.2% of the overall variation in DCS. Openness, agreeableness and conscientiousness were significantly associated with DCS in nurses. Conclusions Nursing managers should pay attention to differences in personality characteristics and provide personalized and targeted nursing education. This should improve nurses’ DCS, enrich their professional development and promote high quality palliative care for patients and their families.
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Chen H, So TH, Cho WCS, Qin Z, Ma CH, Li SG, Yang Z, Jiang F, Wu J, Zhang ZJ, Kong FM, Lao L. The Adjunctive Effect of Acupuncture for Advanced Cancer Patients in a Collaborative Model of Palliative Care: Study Protocol for a 3-Arm Randomized Trial. Integr Cancer Ther 2021; 20:15347354211012749. [PMID: 33957783 PMCID: PMC8113363 DOI: 10.1177/15347354211012749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Cancer is the second leading cause of death before the age of 70. Improved cancer survival has put increasing demands on cancer care. Palliative care is the specialized multi-disciplinary care providing relief from the pain, symptoms, and stress of serious illness. The study aims to evaluate the adjunctive effect of acupuncture for advanced cancer patients in a collaborative model of palliative care. Methods/Design: This is a single-blinded, randomized, sham-controlled trial. One hundred twenty advanced cancer patients undergoing palliative care will be randomized in a ratio of 2:1:1 to manual acupuncture plus standard care group (ASC), sham acupuncture plus standard care group (SSC), and standard care group (SC). Patients in ASC and SSC will receive 9 sessions of acupuncture or sham acupuncture for 3 weeks, and will be followed up for 2 months. The primary measure is the change from baseline score of the Edmonton Symptom Assessment System at 3 weeks. The secondary measures include the Brief Fatigue Inventory, Hospital Anxiety and Depression Scale, Insomnia Severity Index, Numeric Rating Scale, and European Organization for Research and Treatment of Cancer Quality of Life 15 items Questionnaire for Palliative Care. Discussion: The finding of this trial will provide high-quality evidence on the adjunctive effect of acupuncture to standard care on advanced cancer patients undergoing palliative care. Trial Registration: Clinicaltrials.gov, NCT04398875 (https://www.clinicaltrials.gov/ct2/show/NCT04398875), Registered on 21 May 2020.
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Affiliation(s)
| | - Tsz Him So
- The University of Hong Kong, Hong Kong, China
| | | | - Zongshi Qin
- The University of Hong Kong, Hong Kong, China
| | - Chun Ho Ma
- The University of Hong Kong Clinical Centre for Teaching and Research in Chinese Medicine (Aberdeen), Hong Kong, China
| | - Shi Guang Li
- Shen Zhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Zhenjiang Yang
- Shen Zhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Fei Jiang
- University of California, San Francisco, CA, USA
| | - Junmei Wu
- The University of Hong Kong, Hong Kong, China
| | | | | | - Lixing Lao
- The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Fairfax, VA, USA
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Lundin E, Godskesen TE. End-of-life care for people with advanced dementia and pain: a qualitative study in Swedish nursing homes. BMC Nurs 2021; 20:48. [PMID: 33743691 PMCID: PMC7981921 DOI: 10.1186/s12912-021-00566-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Of the Swedish people with advanced dementia, the majority die in nursing homes. Unresolved pain can occur in people with a terminal illness such as dementia. However, pain management in people with advanced dementia is often suboptimal and inadequate, with fewer palliative care interventions than offered to cancer patients. Although they are largely responsible for the care of these people, few studies have addressed the experiences of registered nurses in this respect. Therefore, the aim of this study was to describe the experiences of nurses in caring for people with advanced dementia and pain at the end of life. Methods The study had a descriptive explorative design. Individual qualitative, semi-structured interviews were carried out with 13 nurses from 12 nursing homes in Sweden. The results were analysed using thematic content analysis. Results The nurses described communicative, relational and organisational challenges. One major issue involved difficulties communicating with the person with advanced dementia, resulting in uncertain pain assessment. Other difficulties involved the differentiation of pain from anxiety, the balance of benefits and risks with morphine administration, and the creation of good relationships with healthcare personnel and the persons’ relatives. Relatives can greatly affect the assessment and management of pain, both because of their ability to interpret pain behaviour and by questioning the care given. Good pain management was facilitated by good communication and relationships with healthcare staff and relatives, extensive professional nursing experience, and already knowing the person with advanced dementia. Conclusions This study highlights the need for nursing homes to employ specialist nurses who have been trained in the appropriate knowledge and skills to deal with the challenges of end-of-life care for people with advanced dementia and pain. Additionally, there should be resources and strategies available for providing information to family members and for involving them in the decision-making process, as they are often unfamiliar with the multitude of considerations involved in decisions such as whether to administer morphine or not. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00566-7.
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Affiliation(s)
- Emma Lundin
- Nacka Senior Centre Talliden, Helgesons väg 5, SE-131 37, Nacka, Sweden
| | - Tove E Godskesen
- Centre for Research Ethics & Bioethics, Uppsala University, BMC, Box 564, SE-751 22, Uppsala, Sweden. .,Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Box 11189, SE-100 61, Stockholm, Sweden.
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Ferrell BR, Virani R, Han E, Mazanec P. Integration of Palliative Care in the Role of the Oncology Advanced Practice Nurse. J Adv Pract Oncol 2021; 12:165-172. [PMID: 34109048 PMCID: PMC8017798 DOI: 10.6004/jadpro.2021.12.2.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Numerous organizations have cited the increasing demand for palliative care in oncology and the challenge of a limited workforce to deliver specialty palliative care. Advanced practitioners in oncology can provide generalist or primary palliative care to complement the care provided by specialists and enhance the overall provision of care. This article reports on a National Cancer Institute-funded training program to prepare advanced practice nurses to incorporate palliative care within their practice. One-year follow-up of the first three national cohorts (N = 276) included evaluation of goal achievement as these nurses integrated palliative care within their oncology practice. Goal analysis reported here demonstrates the success of the training program in impacting practice as well as the barriers to implementation efforts. The advanced practice registered nurses' implemented goals included extensive training of clinicians across disciplines and numerous systems changes to improve delivery of palliative care. Advanced practice nurses will continue to be a valuable source of extending palliative care into oncology care to support patients and families across the disease trajectory.
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Affiliation(s)
| | - Rose Virani
- From City of Hope National Medical Center, Duarte, California
| | - Elinor Han
- From City of Hope National Medical Center, Duarte, California
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Stilos KK, Huynh L, Wynnychuk L. The Advance Practice Nurse: A valuable resource to increase timely access to palliative care for those in need. Can Oncol Nurs J 2021; 31:106-108. [PMID: 38919455 PMCID: PMC11195560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Affiliation(s)
- Kalliopi Kalli Stilos
- Advance Practice Nurse for the In-Patient Palliative Care Consult Team, Adjunct Clinical Faculty, University of Toronto's Lawrence Bloomberg Faculty of Nursing, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
| | - Lise Huynh
- Department of Family and Community Medicine, Division of Palliative Medicine, Faculty of Medicine, University of Toronto, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
| | - Lesia Wynnychuk
- Department of Family and Community Medicine, Division of Palliative Medicine, Faculty of Medicine, University of Toronto, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
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Senderovich H, McFadyen K. Palliative Care: Too Good to Be True? Rambam Maimonides Med J 2020; 11:RMMJ.10394. [PMID: 32213278 PMCID: PMC7571433 DOI: 10.5041/rmmj.10394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Many patients and their families are hesitant to consult a palliative care (PC) team. In 2014, approximately 6,000,000 people in the United States could benefit from PC, and this number is expected to increase over the next 25 years. OBJECTIVES The purpose of this review is to shed light on the significance of PC and provide a holistic view outlining both the benefits and existing barriers. METHODS A literature search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Web of Science to identify articles published in journals from 1948 to 2019. A narrative approach was used to search the grey literature. DISCUSSION Traditionally, the philosophy behind PC was based on alleviating suffering associated with terminal illnesses; PC was recommended only after other treatment options had been exhausted. However, the tenets of PC are applicable to anyone with a life-threatening illness as it is beneficial in conjunction with traditional treatments. It is now recognized that PC services are valuable when initiated alongside disease-modifying therapy early in the disease course. Studies have shown that PC decreased total symptom burden, reduced hospitalizations, and enabled patients to remain safely at home. CONCLUSION As the population ages and chronic illnesses become more widespread, there continues to be a growing need for PC programs. The importance of PC should not be overlooked despite existing barriers such as the lack of professional training and the cost of implementation. Education and open discussion play essential roles in the successful early integration of PC.
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Affiliation(s)
- Helen Senderovich
- Geriatrics & Palliative Care & Pain Medicine, Baycrest Health Sciences, Toronto, Ontario, Canada
- Assistant Professor of the University of Toronto, Department of Family and Community Medicine, Division of Palliative Care, Toronto, Ontario, Canada
- To whom correspondence should be addressed. E-mail:
| | - Kristen McFadyen
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Engberink AO, Mailly M, Marco V, Bourrie D, Benezech JP, Chevallier J, Vanderhoeven S, Crosnier R, Bourrel G, Lognos B. A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France. BMC Palliat Care 2020; 19:34. [PMID: 32197609 PMCID: PMC7085140 DOI: 10.1186/s12904-020-0536-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 03/02/2020] [Indexed: 11/28/2022] Open
Abstract
Background Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Methods Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Results Nurses recognize their role as being witnesses to the patient’s experience through their constant presence. This is in line with their professional values and gives them an “alert role” that can anticipate a patient-centered palliative approach. The physician’s positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, “rethinking care within a team environment” allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses “balance” while providing personal and professional support. Conclusions The Physician’s positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. “Recognition at work”, specifically “recognition of the individual role of nurse” is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a “facilitating intermediary” within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.
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Affiliation(s)
- Agnès Oude Engberink
- University of montpellier CEPS platform, site Saint Charles, 34000, Montpellier, France. .,Maison de Santé Pluriprofessionnelle Universitaire Avicenne, 2 rue IBN Sinai dit Avicenne, 66330, Cabestany, France. .,Department of Palliative Care, CHU Montpellier, Montpellier, France.
| | - Maryse Mailly
- Mobile Palliative Care Team, CHU Montpellier, Montpellier, France
| | - Valerie Marco
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | - Daniele Bourrie
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | - Jean-Pierre Benezech
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | | | - Sandrine Vanderhoeven
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | - Remy Crosnier
- Mobile Palliative Care Team, CHU Montpellier, Montpellier, France
| | - Gérard Bourrel
- Maison de Santé Pluriprofessionnelle Universitaire Avicenne, 2 rue IBN Sinai dit Avicenne, 66330, Cabestany, France.,Department of Palliative Care, CHU Montpellier, Montpellier, France
| | - Béatrice Lognos
- University of montpellier CEPS platform, site Saint Charles, 34000, Montpellier, France.,Department of Palliative Care, CHU Montpellier, Montpellier, France
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Webb JA, LeBlanc TW, El-Jawahri AR. Integration of Palliative Care into Acute Myeloid Leukemia Care. Semin Oncol Nurs 2019; 35:150959. [PMID: 31767262 DOI: 10.1016/j.soncn.2019.150959] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide an overview of the past, present, and future of the integration of palliative care services for patients with hematologic malignancies, such as acute myeloid leukemia (AML). DATA SOURCES Published literature as indexed in Medline, relevant guideline documents, textbooks, and clinical experience. CONCLUSION Patients with acute leukemias have substantial palliative care needs that often go unmet with standard oncology care. Evidence shows that the early integration of specialist palliative care into standard oncology care improves patient-centered outcomes among those with advanced solid tumors. Emerging evidence supports similar benefits among hospitalized patients with hematologic malignancies undergoing stem cell transplantation, and additional trials are underway to further test palliative care interventions in patients with AML. IMPLICATIONS FOR NURSING PRACTICE By better understanding the palliative care needs of patients with AML and the evidence of integration with standard oncologic care, patients with leukemias may be more likely to receive early integrated palliative care.
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Affiliation(s)
- Jason A Webb
- Duke Palliative Care, Duke University and Health System, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC.
| | - Thomas W LeBlanc
- Department of Medicine, Duke University School of Medicine, Durham, NC; Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, NC; Duke Cancer Institute, Durham, NC
| | - Areej R El-Jawahri
- Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
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Guo Q, Zheng R. Assessing oncology nurses’ attitudes towards death and the prevalence of burnout: A cross-sectional study. Eur J Oncol Nurs 2019; 42:69-75. [DOI: 10.1016/j.ejon.2019.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 10/26/2022]
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Bernardes JF, Nolasco FF, Jardim ASL, Cunha GR, Takeshita IM, Barroso RADA. O acompanhante do paciente oncológico em fase terminal: percepção do técnico de enfermagem. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n1.71351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: compreender a percepção dos técnicos de enfermagem em relação aos acompanhantes dos pacientes oncológicos em fase terminal.Metodologia: trata-se de uma pesquisa descritivo-exploratória de natureza qualitativa, desenvolvida em um hospital referência para o tratamento do câncer em Belo Horizonte, Minas Gerais. A coleta de dados ocorreu entre os meses de setembro e outubro de 2016. Utilizou-se a Análise de Conteúdo fundamentada em Bardin para a avaliação das entrevistas.Resultados: a partir da análise das entrevistas, emergiram duas categorias empíricas: O conviver cotidiano do técnico de enfermagem e o acompanhante do paciente oncológico em fase terminal e Fatores dificultadores da interação da enfermagem com os acompanhantes, focando-se na interação dos profissionais com o acompanhante e os fatores de conflito entre as partes.Conclusão: foi evidenciada a importância do acompanhante pelo técnico de enfermagem nesse processo de terminalidade, na medida em que podem proporcionar segurança e acolhimento ao paciente. No entanto, a ausência de uma comunicação adequada entre os acompanhantes e o profissional foi o fator preponderante na geração de conflitos. A enfermagem requer, por parte da instituição assim como do acompanhante, de espaços nos quais possam expressar suas angústias e anseios, fazendo que esse percurso seja um momento de acolhimento e de criação de vínculos entre os envolvidos.
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Chang WP. How social support affects the ability of clinical nursing personnel to cope with death. Appl Nurs Res 2018; 44:25-32. [DOI: 10.1016/j.apnr.2018.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/08/2018] [Accepted: 09/16/2018] [Indexed: 11/28/2022]
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