{"title":"The effectiveness of a pain management programme on pain control and quality of life in patients with metastatic cancer.","authors":"Apinya Prisutkul, Arunee Dechaphunkul, Tippawan Arundorn, Maliwan Songserm, Anongnart Ruangdam, Chirawadee Sathitruangsak","doi":"10.12968/ijpn.2022.28.9.436","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.9.436","url":null,"abstract":"<p><strong>Background: </strong>Pain is one of the most frequent symptoms in cancer patients and has a negative impact on their physical, emotional and functional status, as well as their quality of life (QOL). This study evaluated the effectiveness of a pain management programme on pain control and QOL among patients with metastatic cancer receiving systemic chemotherapy. The authors investigated whether a pain management programme contributes to a better pain control and improvement in QOL in the outpatient setting.</p><p><strong>Methods: </strong>The authors conducted a randomised, single-blinded, controlled, single-centre study of metastatic cancer patients experiencing cancer pain and requiring opioid therapy. Patients were enrolled from the Medical Oncology Outpatient Clinic, Songklanagarind Hospital, Prince of Songkla University, Thailand. Participants were randomly assigned to two strategies: pain assessment and management based on the programme developed by the researchers ('pain management programme' arm), and pain management by individual medical oncologists per the routine procedure ('standard of care' arm). Demographics questionnaires, a pain intensity assessment using the Numeric Rating Scale (NRS) and the Functional Assessment of Cancer Therapy-General (FACT-G, version 4) were used to assess the QOL and cancer pain severity at baseline and at two follow-up visits.</p><p><strong>Results: </strong>Between November 2016 and July 2017, 64 consecutive patients were randomly assigned to the two treatment groups. Most were male (79.7%), with a mean age of 55.1 (±13.8) years. The majority of patients (23; 35.9%) had squamous cell carcinoma of the head and neck, with other prevalent types being lung cancer (9.4%), esophageal cancer (9.4%) and colorectal cancer (9.4%). The most frequent metastatic sites were the lungs (28.1%), liver (26.6%), and bone (20.3%).</p><p><strong>Findings: </strong>Compared with standard care, pain intensity was significantly lower among the patients receiving the pain management programme: 4.0 ±2.2 versus 5.1 ±1.8 (P = 0.033) and 3.3 ±1.7 versus 4.7 ±2.1 (P = 0.025) at visit 1 and 2, respectively. Likewise, QOL measures scored higher in the pain management programme group: 71.2 ±15.4 versus 58.6 ±14.5 (P = 0.002) and 71.8 ±15.5 versus 55.4 ±16.3 (P = 0.002) at visit 1 and 2, respectively. Furthermore, there was a statistically significant positive correlation between pain control and QOL improvement (P = 0.011).</p><p><strong>Conclusion: </strong>The investigated pain management programme significantly improved both pain control and QOL in metastatic cancer patients receiving systemic chemotherapy in the outpatient setting.</p>","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 9","pages":"436-444"},"PeriodicalIF":1.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The opioid epidemic and the impact on opioid prescribing in hospice and palliative care: a qualitative study.","authors":"Joshua Borders, Susan Letvak","doi":"10.12968/ijpn.2022.28.9.426","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.9.426","url":null,"abstract":"<p><strong>Background: </strong>In the US, rising rates of opioid abuse has led to regulatory policies designed to curb opioid prescribing. While these policies generally exclude hospice and palliative care from prescribing restrictions, it is not known if these policies have had unintended consequences that affect opioid prescribing within hospice and palliative care.</p><p><strong>Methods: </strong>A qualitative, descriptive design, guided by the Theory of Planned Behaviour, was utilised to conduct a study to answer the following two research questions: 1) How has the opioid epidemic and related policies affected opioid prescribing practises among hospice and palliative care clinicians? and 2) How do hospice and palliative care clinicians perceive patients' end-of-life care has been impacted by the opioid epidemic and related policies?</p><p><strong>Findings: </strong>Ten clinicians, comprising physicians and nurse practitioners working in hospice and palliative care settings, were directly interviewed one-on-one. Data analysis revealed that the opioid epidemic and related policies have had an impact on the patient, clinician, nursing and hospice and palliative care speciality.</p><p><strong>Conclusions: </strong>As the broader medical community shifts away from opioid prescribing, care must be taken to ensure that hospice and palliative care patients still receive access to needed medications. Education is needed to assure that the relief of human suffering at end of life is prioritised.</p>","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 9","pages":"426-435"},"PeriodicalIF":1.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rudval Souza da Silva, Fernanda Carneiro Mussi, Maria Miriam Lima da Nóbrega, Ana Raquel Lima Peralva de Almeida, Laura Emmanuela Lima Costa, Álvaro Pereira
{"title":"Nursing interventions for people in palliative care, based on the Dignity Model.","authors":"Rudval Souza da Silva, Fernanda Carneiro Mussi, Maria Miriam Lima da Nóbrega, Ana Raquel Lima Peralva de Almeida, Laura Emmanuela Lima Costa, Álvaro Pereira","doi":"10.12968/ijpn.2022.28.9.419","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.9.419","url":null,"abstract":"<p><strong>Background: </strong>The use of the standardised nursing language aims to accurately represent clinical practice, contributing to proper documentation and the creation of evidence-based practice.</p><p><strong>Aims: </strong>To validate nursing interventions (NI) for patients in palliative care, structuring these using the Dignity-Conserving Care Model.</p><p><strong>Methods: </strong>A methodological study was conducted, developed according to the recommendations of the International Council of Nurses (ICN) and anchored in the Dignity-Conserving Care Model. The NI were developed in four stages: 1) construction of NI, based in the International Standards Organisation's standard (18.104:2014); 2) content validation by 26 expert nurses; 3) cross-mapping with the NIs contained in the International Classification for Nursing Practice (ICNP<sup>®</sup>) catalogue, Palliative Care for Dignified Dying, to identify those already existing in the catalogue; and 4) structuring the NI based on the concepts of the Dignity-Conserving Care Model.</p><p><strong>Findings: </strong>209 NI were validated and grouped into categories, namely: illness-related concerns; dignity-conservation repertoire; social dignity inventory. Of these, 183 were new and 26 already existed in the ICNP<sup>®</sup> Catalogue.</p><p><strong>Conclusion: </strong>The study presents new insights into palliative care in Brazil and presents 183 new NI in addition to those already published by the ICN.</p>","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 9","pages":"419-425"},"PeriodicalIF":1.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The ending of a life.","authors":"Sean Boyle","doi":"10.12968/ijpn.2022.28.8.347","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.8.347","url":null,"abstract":"","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 8","pages":"347"},"PeriodicalIF":1.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40639186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Colleen Ryan, Margaret McAllister, Jennifer Mulvogue
{"title":"Choirs in end-of-life care: a thematic literature review.","authors":"Colleen Ryan, Margaret McAllister, Jennifer Mulvogue","doi":"10.12968/ijpn.2022.28.8.348","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.8.348","url":null,"abstract":"<p><strong>Background: </strong>Choirs are an important source of wellbeing for people experiencing palliative and end-of-life care. Threshold choirs are an innovation that could be more widely introduced, as hospital and palliative care settings have become more open to community input.</p><p><strong>Aims: </strong>Before such choirs are recommended and encouraged, evidence for their effectiveness and implementation barriers need to be known.</p><p><strong>Methods: </strong>A literature review was undertaken in 2019 and 2020 using CINAHL, PUBMED, Medline, ProQuest, Google Scholar and an internet manual search.</p><p><strong>Findings: </strong>The review identified a total of 26 research and discussion papers relevant to the topic of choir in palliative care settings.</p><p><strong>Conclusion: </strong>Following the review, guidelines were developed that may be useful to assist choirs and service providers to effectively introduce this valuable initiative. Choirs may be a creative, and uplifting arts-based activity to augment and enrich the culture of person-centred care during palliative care processes.</p>","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 8","pages":"348-356"},"PeriodicalIF":1.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40639187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early integration of palliative care into oncological care: a focus on patient-important outcomes.","authors":"Tolganay Ansatbayeva, Dilyara Kaidarova, Gulnara Kunirova, Ilmira Khussainova, Venera Rakhmetova, Dariga Smailova, Yuliya Semenova, Natalya Glushkova, Marina Izmailovich","doi":"10.12968/ijpn.2022.28.8.366","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.8.366","url":null,"abstract":"<p><strong>Background: </strong>Globally, cancer remains one of the leading causes of mortality. Palliative care is designed to meet a range of cancer patients' priority issues, including the management of pain and other cancer-associated symptoms. Routine palliative care envisages the provision of not just medical therapy, but also psychological support, social support and spiritual assistance. What constitutes the best model for palliative care remains a matter of debate.</p><p><strong>Aim: </strong>This review was undertaken with the aim to discuss different aspects of early integration of palliative care into oncological care, with a focus on patient-important outcomes.</p><p><strong>Methods: </strong>A comprehensive search of publications was conducted with a focus on integrative palliative care for incurable cancer patients. For this purpose, the following databases and search engines were used: Scopus, PubMed, Cochrane Library, Research Gate, Google Scholar, eLIBRARY and Cyberleninka.</p><p><strong>Results: </strong>A comprehensive approach with early integration of different medical services appears to be the most promising. Integrative palliative care is best provided via specialised interdisciplinary teams, given that all members maintain systemic communications and regularly exchange information. This model ensures that timely and adequate interventions are provided to address the needs of patients.</p><p><strong>Conclusion: </strong>Further research is needed to pinpoint the most optimal strategies to deliver palliative care and make it as tailored to the patient's demands as possible.</p>","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 8","pages":"366-375"},"PeriodicalIF":1.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40639188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"End-of-life simulation: a cross-field evaluation in an undergraduate nursing programme.","authors":"Maria Parry, Bridie Jones, Clare Churcher","doi":"10.12968/ijpn.2022.28.8.388","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.8.388","url":null,"abstract":"<p><strong>Background: </strong>Death can cause a great deal of anxiety in nursing students for a variety of reasons. They are expected to provide a high level of care for patients, give the family the respect and patience they deserve and contend with the associated emotional attachments. This raised the question in today's educational world-can the use of technology and simulation aid students in preparing for an end-of-life scenario as part of an undergraduate nursing programme?</p><p><strong>Aim: </strong>To explore the efficacy of the use of simulations in end-of-life care.</p><p><strong>Method: </strong>A small study focusing upon the evaluation of an end-of-life simulated scenario for undergraduate second year cross-field Bachelor of Nursing students in a university setting. The simulated scenario consisted of a young patient who was dying and her mother. This project used a mixed approach to address varied students' learning styles and combined the need for visualisation and more structured base-sessions on the topic of death and end-of-life care. One student from the cohort group was randomly assigned as the nurse in charge, while other students were allocated to a scenario (out of a potential four) and provided care in real time. Subsequently, the impact of the scenario was assessed and students were immediately debriefed. Students' response to the scenario was important and needed to be considered, as it directly influenced the debriefing. There were some significant differences between how the students approached the scenario and their reaction to it.</p><p><strong>Results: </strong>Of the students who took part in the end-of-life simulated scenario, the majority strongly agreed that the simulation increased their clinical reasoning and learning.</p><p><strong>Conclusion: </strong>The end-of-life scenario was deemed beneficial, despite the emotional impact on the learners involved.</p>","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 8","pages":"388-395"},"PeriodicalIF":1.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40655222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nurses' perceptions of supporting a 'good death' in intensive care units.","authors":"Nicola Stanzl, Janet Scammell","doi":"10.12968/ijpn.2022.28.8.357","DOIUrl":"https://doi.org/10.12968/ijpn.2022.28.8.357","url":null,"abstract":"BACKGROUND\u0000Death in the intensive care unit (ICU) is an unavoidable aspect of nursing practice. Nurses are the primary front-line healthcare professionals (HCPs) which care for dying patients in this setting. Facilitating 'good deaths' in the ICU has become increasingly debated due to the challenges involved, especially during the COVID-19 pandemic. Aim: To explore how nurses perceive a 'good death' for patients in the ICU.\u0000\u0000\u0000METHOD\u0000Literature published in English between 2005 and 2020 was rigorously searched and recorded using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data sources were: CINAHL Complete, MEDLINE complete, APA PsycInfo, ScienceDirect, SocINDEX, SwePub, SciELO, Complementary Index, Academic Search Ultimate, Supplemental Index, Education Source and Directory of Open Access Journals. Search terms included: nurses' perceptions, ICUs, 'good deaths', quality of death and dignified deaths.\u0000\u0000\u0000FINDINGS\u0000Seven articles met the search criteria, five used qualitative methods, one used a quantitative method and one used a mixed method design. Each of these were critically analysed. A process of thematic analysis identified three prevalent themes: ensuring physical comfort, providing an appropriate physical environment and the importance of relatives.\u0000\u0000\u0000CONCLUSION\u0000The review revealed that creating a less technical environment within the ICU can influence a 'good death', but further research is needed to establish how this can be enacted. More effective management of physical symptoms such as pain and dyspnoea are also recommended. Including care of relatives in care plans was also found to contribute toward a 'good death' and that this could be facilitated through improved staff education. Providing a private area for grieving relatives within the ICU has also had an impact in enabling a 'good death'.","PeriodicalId":47415,"journal":{"name":"International Journal of Palliative Nursing","volume":"28 8","pages":"357-364"},"PeriodicalIF":1.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40639185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}