Journal of Palliative Care最新文献

EMPOWERING END-OF-LIFE CONVERSATIONS: The Role of Specialized Nursing Teams in Facilitating Code Status Changes at Discharge. 增强生命末期对话的能力：专业护理团队在促进出院时代码状态变化中的作用。

IF 1.7 4区医学

Journal of Palliative Care Pub Date : 2024-09-19 DOI: 10.1177/08258597241283303

Diane Wintz,Kathryn B Schaffer,Kelly Wright,Stacy L Nilsen

{"title":"EMPOWERING END-OF-LIFE CONVERSATIONS: The Role of Specialized Nursing Teams in Facilitating Code Status Changes at Discharge.","authors":"Diane Wintz,Kathryn B Schaffer,Kelly Wright,Stacy L Nilsen","doi":"10.1177/08258597241283303","DOIUrl":"https://doi.org/10.1177/08258597241283303","url":null,"abstract":"Objectives: Hospitalized patients may require goals of care (GOC) or Advance Health Care Planning (ACP), which can be time-consuming and emotionally tolling for providers. A nursing team specializing in code status (CODE), GOC, and ACP was developed to provide meaningful support for patients and families and decrease provider burden. Interest in CODE, GOC, ACP, and effectiveness of a nursing team to lead these conversations prompted this study. Methods: A collaborative nursing team was trained to address CODE, GOC, and ACP with patients demonstrating illness or geriatric syndrome. This team conducted 3 visits per patient on average during hospitalization using structured CODE templates to establish longer term goals and document what matters in the healthcare journey. Comprehensive narratives for ACP and GOC were included in charting, syncing the medical team, nursing, patient, and family. Consults were tracked over nine months with data reviewed retrospectively from medical charts. Descriptive analyses of cohort demographics, CODE and outcomes were completed. Results: The study group comprised 3342 patients between October 2022 and June 2023. Patients ranged in age from 18-106 years, with majority (88%) age 65 years and older. Mean length of stay (LOS) was 6.8 days with CODE documented for 91% upon admission. Of the 3166 older adults with known CODE on admission, 946 (30%) changed CODE by discharge, of which 95% were de-escalated. 83% of older patients arriving with limited CODE maintained limitations at discharge, with a small portion converting to comfort (16%). Conclusion: Employing a focused nursing team to conduct CODE, GOC, and ACP conversations may be an effective use of time and resources and result in de-escalation of resuscitation orders for patients demonstrating illness or geriatric syndrome.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electronic Patient Reported Outcomes Measures (e-PROMs) in Pediatric Palliative Oncology Care: A Scoping Review. 儿科姑息肿瘤治疗中的电子患者报告结果测量（e-PROMs）：范围综述》。

IF 1.7 4区医学

Journal of Palliative Care Pub Date : 2024-09-19 DOI: 10.1177/08258597241274027

Daniele Rusconi,Ilaria Basile,Flavia Rampichini,Stella Colombo,Laura Arba,Maria Luisa Pancheri,Letteria Consolo,Maura Lusignani

{"title":"Electronic Patient Reported Outcomes Measures (e-PROMs) in Pediatric Palliative Oncology Care: A Scoping Review.","authors":"Daniele Rusconi,Ilaria Basile,Flavia Rampichini,Stella Colombo,Laura Arba,Maria Luisa Pancheri,Letteria Consolo,Maura Lusignani","doi":"10.1177/08258597241274027","DOIUrl":"https://doi.org/10.1177/08258597241274027","url":null,"abstract":"Objective: Research findings regarding child-centered care and electronic patient reported outcome measures (e-PROMs) within pediatric palliative oncology care reveal an intricate field of study. This study aimed to map innovations in e-PROMs for the pediatric cancer population in palliative care and their impact on symptom management, and communication with healthcare professionals. Methods: A scoping review was designed following the Arksey and O'Malley framework. Literature searches were conducted in CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS, and Web of Science. Inclusion criteria targeted children aged 0-18 years with cancer, receiving palliative and/or end-of-life care, and using e-PROMs. Results: Twelve articles were included: 10 quantitative studies, one qualitative study, and one mixed-method study. A narrative synthesis approach was used to summarize the findings, categorized into three sections: (a) technological innovation of e-PROMs in pediatric palliative oncology care; (b) the impact of e-PROMs on symptom monitoring, management, and children's care; (c) the effects of e-PROMs on communication between children and healthcare professionals in pediatric palliative oncology care. Conclusion: e-PROMs have proven effective in empowering children to express their perspectives and actively engage in their end-of-life care. Due to flexible software and devices designed for various age groups, these tools fit seamlessly into children's daily routines and preferences, including the use of play-oriented applications. They facilitate a deeper understanding, and management of physical and emotional symptoms while ensuring care remains child-centered. This emphasizes the importance of preserving the essence of childhood and addressing the unique needs and experiences of young patients in pediatric palliative oncology care.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family Peace and Affecting Factors in Family Caregivers of Patients With Cancer: A Cross-Sectional Study. 癌症患者家庭照顾者的家庭和睦及其影响因素：一项横断面研究

IF 1.7 4区医学

Journal of Palliative Care Pub Date : 2024-09-19 DOI: 10.1177/08258597241282999

Furkan Şahin,Fatma Sinem Şahin,Ayse Özkaraman

{"title":"Family Peace and Affecting Factors in Family Caregivers of Patients With Cancer: A Cross-Sectional Study.","authors":"Furkan Şahin,Fatma Sinem Şahin,Ayse Özkaraman","doi":"10.1177/08258597241282999","DOIUrl":"https://doi.org/10.1177/08258597241282999","url":null,"abstract":"Objective: During the care process, family members who provide care for a patient with cancer are confronted with changes in their family dynamics. The purpose of this study was to evaluate the family peace of caregivers of patient with cancer and the associated factors. Methods: A cross-sectional study was conducted in a single center. The sample of the study included caregivers who were family members of patients with cancer. Data were collected with Caregiver and Patient Information Forms, General Self-Efficacy Scale, Family Peace Scale, Self-Care Behaviors Scale, and MD Anderson Symptom Inventory. Results: It was found that the mean age of the caregivers was 50.20 ± 0.71 years, 64.1% were female, 78.7% were married. The mean score of the caregivers on the total family peace scale was above the average value with 46 ± 0.75 out of 75 points. The caregivers' level of family peace increases as their scores on the scale increase. The family peace of caregivers who were widowed or divorced, were self-employed, had less income than their expenses, had a chronic disease, reported that their health was affected, had low self-efficacy was worse than that of others. The family peace of caregivers of patients who had gynecological cancer and had a good income was better (P < 0.05). The self-efficacy level of the caregivers and the symptoms of the patient with cancer were significant predictors of family peace (P < 0.001). Conclusions: Family peace of caregivers was affected by the type of cancer, symptom burden, self-care behaviors of the patient, and caregivers' income status, chronic disease, marital status, and self-efficacy. Physicians and nurses, who are in close contact with caregivers of cancer patients, should be aware of the issue, professionals should assess the family environment of the caregivers of patient with cancer and counseling should be provided if deemed necessary.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A General Overview of Palliative Care in Morocco: Needs Far Beyond Means 摩洛哥姑息关怀概况：需求远超财力

IF 1.7 4区医学

Journal of Palliative Care Pub Date : 2024-09-12 DOI: 10.1177/08258597241278399

Meryem Hamdoune, Khaoula Jounaidi, Asmaa Ghafili, Abdellah Gantare

引用次数: 0

The Lived Experiences of Hospice Healthcare Workers Caring for Adolescents and Young Adults With Advanced Cancer: An Interpretative Phenomenological Analysis. 临终关怀医护人员照顾晚期癌症青少年的生活经历：诠释现象学分析》。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2024-08-30 DOI: 10.1177/08258597241277725

Nadine Persaud, Sarah Brearley, Catherine Walshe

{"title":"The Lived Experiences of Hospice Healthcare Workers Caring for Adolescents and Young Adults With Advanced Cancer: An Interpretative Phenomenological Analysis.","authors":"Nadine Persaud, Sarah Brearley, Catherine Walshe","doi":"10.1177/08258597241277725","DOIUrl":"https://doi.org/10.1177/08258597241277725","url":null,"abstract":"Objective: To understand the lived experience of healthcare workers who provide palliative care to adolescents and young adults living with advanced cancer. Methods: Interpretative phenomenological analysis was the design of this study. Hospice healthcare workers from four pediatric hospices across Canada were recruited through purposive sampling. Semistructured in-person interviews were conducted. Results: Eighteen hospice healthcare workers participated. Two superordinate themes were identified. First, balancing on the tightrope of uncertainty wherein hospice healthcare workers strive to do their best while aiming to take the path of least regret. This theme was underscored by a notion of doing for the adolescents and young adults. Second, acting as a proxy revolves around the importance of fostering relationships with adolescents and young adults through honesty and transparency. The cycle of protection between adolescents and young adults, families, and healthcare providers was emphasized. Conclusions: An action-focused orientation when supporting adolescents and young adults was shared by the healthcare workers. The need to do for adolescents and young adults and the need to protect not only the people they care for but also themselves. More exploration is needed on how healthcare workers who care for adolescents and young adults can be supported while better understanding coping mechanisms.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Intersectionality of Race and Gender in Palliative Care Services Utilization Among Critically-Ill Necrotizing Pancreatitis Patients: Analysis of a Large Nationwide Database in the United States. 种族和性别在重症坏死性胰腺炎患者使用姑息治疗服务中的交叉性：美国大型全国性数据库分析》。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2024-08-28 DOI: 10.1177/08258597241276318

Tomas Gil Escobar, Mohammed A Quazi, Amir Humza Sohail, Muhammad Ali Butt, Aman Goyal, Sulaiman Sultan, Farooq Ali Sheikh, Muhammad Salman Khan, Abu Baker Sheikh

{"title":"The Intersectionality of Race and Gender in Palliative Care Services Utilization Among Critically-Ill Necrotizing Pancreatitis Patients: Analysis of a Large Nationwide Database in the United States.","authors":"Tomas Gil Escobar, Mohammed A Quazi, Amir Humza Sohail, Muhammad Ali Butt, Aman Goyal, Sulaiman Sultan, Farooq Ali Sheikh, Muhammad Salman Khan, Abu Baker Sheikh","doi":"10.1177/08258597241276318","DOIUrl":"https://doi.org/10.1177/08258597241276318","url":null,"abstract":"Objective: Necrotizing pancreatitis (NP) is a severe form of pancreatitis that often necessitates intensive care and can result in significant morbidity and mortality. This study aimed to investigate racial and gender disparities in palliative care (PC) utilization among mechanically-ventilated patients with NP.Methods: In this retrospective analysis using the National Inpatient Sample from 2016 to 2020, we investigated 84 335 patients with NP requiring invasive mechanical ventilation, and the utilization of PC services and their disparities based on gender and race. To adjust for potential confounding factors, we employed multivariable logistic regression, ensuring that our findings account for various influencing variables and provide a robust analysis of the data.Results: Among the patients studied, 15.4% utilized PC consultations. Notably, female patients were 12% more likely to utilize PC than their male counterparts (OR 1.1, 95% CI: 1.003-1.2; P = .008). Racial disparities were pronounced: African Americans (OR 0.8, 95% CI 0.7-0.9, P < .001), Hispanic (OR 0.8, 95% CI 0.7-0.9, P = .001), and Asian or Pacific Islander patients (OR 0.74, 95% CI 0.57-0.97; P = .03) had significantly lower odds of utilizing PC compared to White patients. The cohort utilizing PC had a higher in-hospital mortality rate (74.7% vs 24.8%; OR 8.2, 95% CI 7.7-9.2) but a shorter mean hospital stays and lower associated costs.Conclusions: Our findings indicate significant racial and gender disparities in the utilization of PC for intubated patients with NP, with lower utilization among males and minority populations. These findings emphasize the urgent requirement for comprehensive changes in healthcare protocols.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of Structured Goals of Care Discussions in Critically Ill Thoracic Surgery Patients. 结构化护理目标讨论在胸外科重症患者中的作用。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2024-08-23 DOI: 10.1177/08258597241274163

Christine E Alvarado, Stephanie G Worrell, Aaron E Tipton, Max Coffey, Boxiang Jiang, Philip A Linden, Christopher W Towe

{"title":"The Role of Structured Goals of Care Discussions in Critically Ill Thoracic Surgery Patients.","authors":"Christine E Alvarado, Stephanie G Worrell, Aaron E Tipton, Max Coffey, Boxiang Jiang, Philip A Linden, Christopher W Towe","doi":"10.1177/08258597241274163","DOIUrl":"https://doi.org/10.1177/08258597241274163","url":null,"abstract":"Objective: The American College of Surgeons recommends structured family meetings (FM) for high-risk surgical patients. We hypothesized that goals of care discussions (GOCD) in the form of an FM, multidisciplinary family meeting (MDFM), or palliative care consult (PCC) would be underutilized in imminently dying thoracic surgery patients. Methods: A retrospective chart review at a tertiary academic medical center was performed on all inpatient mortalities and discharges to hospice after any thoracic surgery operation. The utilization of GOCDs was compared between the 2 groups. Secondary outcomes were length-of-stay, comatose status and ventilator dependence during initial GOCD, and timing of code status change. Results: In total, 56 patients met inclusion criteria: 44 of 56 (78.6%) died and 12 of 56 (21.4%) were discharged to hospice. Most patients had a FM (79.5% mortality vs 100% hospice, P = .29) and few had an MDFM (25.0% mortality vs 25.0% hospice, P = 1.00). Patients discharged to hospice were more likely to have a PCC (66.7% vs 31.2%, P = .03) and less likely to be comatose (16.7% vs 59.1%, P = .009) or ventilator dependent during initial GOCD (16.7% vs 70.5%, P = .001). Among patients who died and were DNR-CC (do not resuscitate-comfort care; 37 of 44), 75.7% died the same day of code status change and 67.6% died within 48 h of initial GOCD. Discussion: Although FMs were common, MDFMs were infrequent. Patients discharged to hospice were more likely to have a PCC. Most deaths occurred shortly after initial GOCD and most code status changes occurred on day-of-death. This data suggest an opportunity to improve GOCDs in critically ill thoracic surgery patients.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emergency Preparedness in Philippine Hospices: Insights From a Global Literature Review. 菲律宾临终关怀机构的应急准备：全球文献综述的启示。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2024-08-22 DOI: 10.1177/08258597241276321

Jeff Clyde G Corpuz, Aurora M Peñaflor

引用次数: 0

"How Do I Practise Palliative Care When I Don't Know How?" Exploring the Impact of EPAN, An Online Educational Intervention on General Nurses in Singapore: An Evaluation Study. "当我不知道如何开展姑息关怀时，我该如何实践？探索 EPAN（一种在线教育干预措施）对新加坡普通护士的影响：一项评估研究。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2024-07-26 DOI: 10.1177/08258597241264454

Yi Ling Neo, Norasyikin Hassan, Jemima Koh, Rasidah Alias, Liyun Wang, Yazid Hussein, Yoke Ping Wong

{"title":"\"How Do I Practise Palliative Care When I Don't Know How?\" Exploring the Impact of EPAN, An Online Educational Intervention on General Nurses in Singapore: An Evaluation Study.","authors":"Yi Ling Neo, Norasyikin Hassan, Jemima Koh, Rasidah Alias, Liyun Wang, Yazid Hussein, Yoke Ping Wong","doi":"10.1177/08258597241264454","DOIUrl":"https://doi.org/10.1177/08258597241264454","url":null,"abstract":"Objective(s): The majority of deaths in Singapore (62.1%) occur in the hospital, but most nurses do not have palliative care (PC) education. An online e-learning course, \"Essential Palliative Care Approach for Nurses\" (EPAN), was developed to close the learning gap. The study aimed to evaluate the impact of EPAN on general nurses' knowledge, confidence, and attitude in delivering end-of-life care. Methods: Convergent parallel mixed methods design. Results: 1708 nurses (67%), mostly from inpatient and ambulatory settings, completed EPAN. Statistically significant increases in mean scores across knowledge, confidence, and attitude (p < 0.05) remained consistent immediately post-course and 3 months post-course. Respondents shared their intentions to change practice in the immediate post-course survey (n = 1155) and how they have practiced end-of-life care in the 3-month post-course survey (n = 777). Major categories from the content analysis included: (i) actualise confidence to deliver effective communication, (ii) making time and showing empathy in end-of-life care, (iii) advocating for end-of-life care, (iv) proactive collaboration with other healthcare professionals, (v) navigated and accepted end-of-life boundaries, and (vi) able to self-manage emotions. Conclusions: EPAN, developed within an Asian context, has demonstrated a significant impact on nurses' knowledge, confidence, and attitude in delivering end-of-life care. This has broader implications for general palliative care education in countries of similar cultural concerns.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Setting Regional Priorities for Palliative and End-of-Life Care Research Using a Delphi Technique Approach. 使用德尔菲技术方法确定姑息治疗和临终关怀研究的地区优先事项。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2024-07-26 DOI: 10.1177/08258597241264455

Nikolaos Efstathiou, Ping Guo, Wendy Walker, John I MacArtney, Cara Bailey

{"title":"Setting Regional Priorities for Palliative and End-of-Life Care Research Using a Delphi Technique Approach.","authors":"Nikolaos Efstathiou, Ping Guo, Wendy Walker, John I MacArtney, Cara Bailey","doi":"10.1177/08258597241264455","DOIUrl":"https://doi.org/10.1177/08258597241264455","url":null,"abstract":"Objective: Identifying research priorities is very important for palliative and end-of-life care to ensure research is focused on evidence gaps. This project aimed to identify and prioritise palliative and end-of-life care research areas within the West Midlands region in United Kingdom (UK).Methods: A modified Delphi technique approach was used with palliative care stakeholders. The first round was item generation via rapid interviews. Data were analysed using content analysis and all the items were grouped into main categories. For round two, an online survey was conducted to present all the items from round one, and stakeholders were asked to rate the priority of items on a Likert-type scale (1 = not a priority to 7 = essential priority). Items that achieved consensus in round two were presented to the third round, where stakeholders ranked them in descending order.Results: We completed and analysed 56 rapid interviews which resulted in 158 research items under 15 categories. The research items were rated by 30 stakeholders and seven items which reached consensus were subsequently ranked in order by 45 stakeholders. The highest ranked item was 'Integrated care systems to prevent crisis', followed by three research items related to 'equity' in palliative care.Conclusions: Our research priorities, although unique for our region, mirror previously research priorities from other regions and countries. This suggests issues of integration and equity in palliative and end-of-life care remain unresolved, despite ongoing initiatives and research to address these issues.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0