Journal of Hospice & Palliative Nursing最新文献

Implementation of a Standardized Screening Process to Increase Palliative Care Referrals in Primary Care: An Evidence-Based Quality Approach. 实施标准化筛查流程，增加基层医疗机构的姑息关怀转诊：基于证据的质量方法。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1097/NJH.0000000000001064

Amy M Smith

{"title":"Implementation of a Standardized Screening Process to Increase Palliative Care Referrals in Primary Care: An Evidence-Based Quality Approach.","authors":"Amy M Smith","doi":"10.1097/NJH.0000000000001064","DOIUrl":"10.1097/NJH.0000000000001064","url":null,"abstract":"Despite initiatives to increase palliative care awareness, referrals in primary care settings are still primarily based on provider judgment, causing a lack of appropriate referrals and disparities in access to palliative care resources. The purpose of this quality improvement project was to develop and implement an evidence-based, standardized palliative care referral protocol to increase the palliative care referral rate for eligible patients at a primary care clinic. The project used a preimplementation and postimplementation design with the use of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to successfully implement and evaluate the standardized referral process. Over the 10-month project period, the palliative care referral rate increased from 2% (4/193) preimplementation to 11% (16/147) postimplementation of the standardized referral process, which is an increase of 9%. Taking into consideration the potential impact of multiple extraneous variables, there was an overall decrease of 69% in emergency room visits and 73% in hospitalizations for patients who received a palliative care referral. These outcomes support expansion of the standardized referral process throughout other primary care clinics to increase palliative care referrals and sustain a high level of quality patient care.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114894","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

"More Areas of Grey": Ambiguities in Neuropalliative Care. "更多灰色地带"：神经姑息治疗中的模糊地带。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-09-04 DOI: 10.1097/NJH.0000000000001054

Marianne Sofronas, David Kenneth Wright, Mary Ellen Macdonald, Vasiliki Bitzas, Franco A Carnevale

{"title":"\"More Areas of Grey\": Ambiguities in Neuropalliative Care.","authors":"Marianne Sofronas, David Kenneth Wright, Mary Ellen Macdonald, Vasiliki Bitzas, Franco A Carnevale","doi":"10.1097/NJH.0000000000001054","DOIUrl":"10.1097/NJH.0000000000001054","url":null,"abstract":"Neuropalliative care as a clinical speciality aims to address the unique end-of-life needs and concerns of patients with neurologic disease. Although literature has outlined clinical hurdles, a more nuanced understanding of how neuropalliative care was experienced, conceptualized, and enacted could provide context and depth to better outline practice and research priorities. This article presents findings from an ethnographic study of neuropalliative care conducted in a university-affiliated, tertiary care neurological hospital in Canada with a dedicated neuropalliative consultation service. Specifically, this article examines how clinical hurdles outlined in the neuropalliative literature were experienced and addressed by multiple stakeholders, including patients, families, and clinicians. These clinical hurdles include locating the scope of neuropalliative care, ascertaining the impact of prognostic uncertainty and poor recognition of the dying patient, and navigating the tensions between curative and palliative philosophies. In the discussion, the implications of these clinical hurdles are addressed, concluding with reflections on the role of ethnography, palliative care in the context of functional changes, and broadening approaches to uncertainty.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134509","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

Describing Medical Aid-in-Dying and Nursing "Leave-the-Room" Policies in California: A Mixed Methods Study. 描述加利福尼亚州的临终医疗援助和护理 "离开房间 "政策：混合方法研究》。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-08-23 DOI: 10.1097/NJH.0000000000001056

Karin Sobeck, Gianna R Strand, David N Hoffman

引用次数: 0

Perceived Dying Experience and Compassion in Oncology Patients and Nurses Following Implementation of the Forever Heart Program: A Pilot Study. 实施 "永恒之心 "计划后肿瘤患者和护士感知到的临终体验和同情心：试点研究。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-10-18 DOI: 10.1097/NJH.0000000000001063

Valerie T Terzano, Jessica Kirk, Jenna Blind, Benjamin Bass, Woodlyne Pierre-Lallemand, Kathleen Evanovich Zavotsky

{"title":"Perceived Dying Experience and Compassion in Oncology Patients and Nurses Following Implementation of the Forever Heart Program: A Pilot Study.","authors":"Valerie T Terzano, Jessica Kirk, Jenna Blind, Benjamin Bass, Woodlyne Pierre-Lallemand, Kathleen Evanovich Zavotsky","doi":"10.1097/NJH.0000000000001063","DOIUrl":"10.1097/NJH.0000000000001063","url":null,"abstract":"This pilot study explored the feasibility of a Forever Heart Program and the impact it has on oncology nurses' perception of the dying experience and their own compassion competence. Guided by Kubler-Ross's framework, the Forever Heart Program consists of a gemstone keepsake offered to patients and families during end-of-life care to support the grieving process. A mixed-methods approach utilized pretest/posttest design in a convenience sample of oncology nurses in an academic medical center over a 3-month period. The study collected demographics, Compassion Competence Scale scores, and qualitative responses via survey and an optional focus group. Twenty-five nurses participated in the presurvey, and 14 participated in the postsurvey. Seven nurses attended the focus groups. Overall, compassion competence scores were high, both pre and post. Qualitative themes included appreciation, connection, positive nursing, patient and family experience/relationships, grieving guidance, program benefits, and process opportunities. Although the study did not show statistically significant differences in compassion, it did show program feasibility and the potential positive impact that keepsakes like the Forever Heart Program can have on nurses and their role in the dying experience.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481269","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

MAiD in America: A Rapid Review of Medical Assistance in Dying in the United States and Its Implications for Practice for Health Care Professionals. 美国的临终关怀：美国的临终医疗协助：美国临终医疗协助快速回顾及其对医疗保健专业人员实践的影响》（A Rapid Review of Medical Assistance in Dying in the United States and Its Implications for Practice for Health Care Professionals）。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-10-18 DOI: 10.1097/NJH.0000000000001070

Kathy Howard Grubbs, Christiana M Keinath, Sharon E Bigger

{"title":"MAiD in America: A Rapid Review of Medical Assistance in Dying in the United States and Its Implications for Practice for Health Care Professionals.","authors":"Kathy Howard Grubbs, Christiana M Keinath, Sharon E Bigger","doi":"10.1097/NJH.0000000000001070","DOIUrl":"10.1097/NJH.0000000000001070","url":null,"abstract":"The evolving legal landscape associated with medical assistance in dying (MAiD) may pose significant challenges for hospice and palliative care professionals. In the United States, 10 states and 1 jurisdiction have passed legislation allowing MAiD. National organizations, such as the Hospice and Palliative Nurses Association, have created position statements to serve as guides to care. Given the clinical and ethical challenges associated with MAiD, a rapid review was conducted to provide current evidence for policymakers, health care professionals, and researchers to use when considering care management and policy initiatives. Using a systematic approach, publications related to MAiD between 2019 and 2024 were extracted and synthesized. The review provides definitions of terms that differentiate between MAiD, euthanasia, physician-assisted suicide, medically assisted death of the nonterminal patient, and death with dignity. A total of 23 articles were included in the review and categorized into 4 themes: (1) legal, regulatory, and policy concerns; (2) health care professional experience of MAiD; (3) patient and caregiver experience of and communication about MAiD; and (4) disparate access to MAiD.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481268","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

Improving Patient-Centered Care for End-Stage Renal Disease Patients at a Community Palliative Setting. 在社区姑息治疗机构改善以患者为中心的终末期肾病患者护理。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1097/NJH.0000000000001059

Behdokht Rouhi, Catherine Collins-Fulea

{"title":"Improving Patient-Centered Care for End-Stage Renal Disease Patients at a Community Palliative Setting.","authors":"Behdokht Rouhi, Catherine Collins-Fulea","doi":"10.1097/NJH.0000000000001059","DOIUrl":"10.1097/NJH.0000000000001059","url":null,"abstract":"End-stage renal disease (ESRD) is a complex medical condition growing fastest in Americans 65 years and older. Despite its chronic nature, fewer than 10% of these patients have had advanced care planning. A chart audit (n = 20) of the palliative patients at a community palliative program revealed that no patient had a conversation about prognostication, 10% (n = 2) about the burden of kidney disease, 30% (n = 6) had coordination of care with the nephrologist, and 35% (n = 7) had engaged in end-of-life planning. This project aimed to increase patient-centered care for ESRD patients to 80% in 90 days. The project utilized the Plan-Do-Study-Act quality improvement model in four 2-week rapid cycles with 2 focus improvement areas. The 2 core interventions were patient screening for preferences and values and providing the right care for palliative management utilizing a checklist. At the end of the project, patient-centered right care for ESRD increased from a baseline of 24% to 94%. Patient engagement scores increased from a baseline of 3.2 to 4.9 on a 5-point Likert scale, with 5 being the highest supporting a shared decision model of care in improving patient-centered right care.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082651","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

Perspectives on Death and Dying by the Bereaved Designated Personal Representatives of Women Diagnosed With Metastatic Breast Cancer. 被诊断患有转移性乳腺癌妇女的指定个人代表对死亡和临终的看法。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-09-27 DOI: 10.1097/NJH.0000000000001066

Rachel L Brazee, Karen E Alsbrook, Kathleen O Lindell, Jennifer B Seaman, Margaret Q Rosenzweig

{"title":"Perspectives on Death and Dying by the Bereaved Designated Personal Representatives of Women Diagnosed With Metastatic Breast Cancer.","authors":"Rachel L Brazee, Karen E Alsbrook, Kathleen O Lindell, Jennifer B Seaman, Margaret Q Rosenzweig","doi":"10.1097/NJH.0000000000001066","DOIUrl":"10.1097/NJH.0000000000001066","url":null,"abstract":"Metastatic breast cancer (MBC) is a complex disease with variability in disease subtype, length of survival, treatment selection, symptom burden, and, ultimately, end-of-life (EOL) care. Influencing factors that contribute to the complexity of this disease are socioeconomic factors, provider differences, and patient and family preferences. Because of this variability, it is challenging for health care providers to know when treatments are no longer helpful but contribute to a poor quality of end-of-life care and a poor death experience for both patients and their families. Determining the unique point, based on their own values and goals, at which patients and their family members feel that MBC treatment becomes unhelpful and unwanted, is difficult to ascertain. Of the 25 individuals who participated in the Quality of Death and Dying survey, 16 individuals participated in an interview to provide a reflection of the patient's EOL experience and its congruence with their wishes. Four major categories emerged as primary priorities essential to high quality end-of-life care, that is, resilience, communication, support, and knowledge. Without tailored and precise care, patients with MBC will continue to receive prolonged, inappropriate, and costly treatment, resulting in a potentially unacceptable poor-quality EOL and death experience.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362469","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

End-of-Life Education in a Prelicensure Nursing Program. 执业前护理课程中的临终教育。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI: 10.1097/NJH.0000000000001057

Elizabeth Byrd, Ashley McMath, Jennifer Ware, Rebecca Jacobs, Kendra Weaver

引用次数: 0

Impact of an Educational Deprescribing Intervention on Provider Confidence, Knowledge and Polypharmacy in the Nursing Home Setting. 教育性取消处方干预措施对养老院护理人员信心、知识和多重用药的影响。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-10-14 DOI: 10.1097/NJH.0000000000001068

Julianne Murthi, Molly Langford, Lisa Abdallah

{"title":"Impact of an Educational Deprescribing Intervention on Provider Confidence, Knowledge and Polypharmacy in the Nursing Home Setting.","authors":"Julianne Murthi, Molly Langford, Lisa Abdallah","doi":"10.1097/NJH.0000000000001068","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001068","url":null,"abstract":"Polypharmacy is commonly encountered by providers caring for patients with medically complex and palliative care needs in many settings. The purpose of this quality improvement project was to measure the impact of an evidence-based educational deprescribing intervention on polypharmacy rate and provider confidence and knowledge in the nursing home. We invited providers working in 52 nursing homes to attend a 1-hour-long educational deprescribing session. Twenty-one nurse practitioners and 1 physician assistant across 11 states participated in the intervention. Provider confidence level related to deprescribing improved in all categories, with statistical significance demonstrated with both paired t test and Wilcoxon signed rank test (P < .001). The polypharmacy rate 3 months after the intervention decreased more in centers where a provider had attended the training. Additional open-ended data about experiences with and barriers to deprescribing were collected and analyzed. The findings from this quality improvement project demonstrate that an educational intervention focused on providers practicing in the nursing home setting can improve deprescribing confidence and reduce polypharmacy rates. These findings may be used to implement similar deprescribing education programs for palliative care nurses and providers that prioritize goals of care for patients living with serious illness.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481267","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

Predictors of Supportive Care Needs During Serious Illness: Cross-sectional Analysis of Reservation-Based Informal Caregivers. 重病期间支持性护理需求的预测因素：对保留地非正规护理人员的横断面分析。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2024-10-01 Epub Date: 2024-08-05 DOI: 10.1097/NJH.0000000000001050

Katie E Nelson, Kassie Runsabove, Martha Abshire Saylor, Kathleen Adams, Patricia M Davidson, Nancy Perrin, Alicia Werk, Rebecca Wright, Teresa N Brockie

{"title":"Predictors of Supportive Care Needs During Serious Illness: Cross-sectional Analysis of Reservation-Based Informal Caregivers.","authors":"Katie E Nelson, Kassie Runsabove, Martha Abshire Saylor, Kathleen Adams, Patricia M Davidson, Nancy Perrin, Alicia Werk, Rebecca Wright, Teresa N Brockie","doi":"10.1097/NJH.0000000000001050","DOIUrl":"10.1097/NJH.0000000000001050","url":null,"abstract":"Native Americans (Indigenous Americans) have high rates of serious illness in the United States. Informal caregivers are heavily relied on in caring for patients in low-resource settings. The needs of caregivers residing on reservations are sorely underreported. Therefore, our objective was to examine relationships between facilitators (communal mastery, cultural identity, and spirituality) and barriers (depression, anxiety, stress, and burden) with supportive care needs among adult informal caregivers in 1 reservation-based community. A cross-sectional survey was distributed in July and August 2022 as part of a larger multimethod, community-based participatory research study. We used descriptive statistics and linear regression models to examine relationships against the primary outcome, the Supportive Care Needs Assessment Tool for Indigenous People. Overall, 127 participants were included; most were female (n = 92, 72.4%), were between 30 and 49 years (n = 57, 44.9%), and had 6 months or less of caregiving experience (n = 41, 32.5%). Higher depression, anxiety, stress, and burden were significantly associated with higher Supportive Care Needs Assessment Tool for Indigenous People scores. Overall, mental health is a significant barrier that may indicate greater supportive care needs among informal caregivers, although further work is needed to differentiate symptoms and their impact on caregiving from a cultural perspective.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898960","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