Journal of Hospice & Palliative Nursing最新文献

{"title":"Parents' Experiences of Palliative Care Decision Making for Children With Terminal Cancer: A Qualitative Study.","authors":"Lichan Liang, Hongyu Ye, Weifei Liu, Fangling Yi, Rong Jiang, Yanqun Hu, Lei Shi","doi":"10.1097/NJH.0000000000001088","DOIUrl":"10.1097/NJH.0000000000001088","url":null,"abstract":"<p><p>The objective of this study was to describe the experiences and perceptions of parents making palliative care decisions for children with end-stage malignancies. This qualitative study was conducted with 13 parents from 9 families of children with end-stage malignant tumors. Data were analyzed using thematic content analysis. Three interrelated themes were identified: (1) parental knowledge of the child's condition influences palliative care decision making, (2) the establishment of a mutually trusting relationship between parents and health care professionals is key to implementing palliative care decision making, and (3) the influence of family background and traditional culture on parental palliative care decision making. This study adds to the evidence related to parents' experiences of end-of-life care decision making and provides findings of international significance, particularly concerning the place of care and the introduction of end-of-life care discussions. Parents' expert knowledge of their child's condition is important and should be recognized. End-of-life care decision making is a complex and delicate process; each family's information needs and preferences are individualized and need to be understood by the professionals involved in care.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E75-E80"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Primary Palliative Care Needs of People With Parkinson Disease, Their Care Partners, and Health Care Professionals.","authors":"Nancy Dudley, Alice L Butzlaff, Toby Adelman","doi":"10.1097/NJH.0000000000001128","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001128","url":null,"abstract":"<p><p>The National Consensus Project Domain Structure and Process of Care focuses on a comprehensive assessment, patient and family engagement, communication, care coordination, and continuity of care across care settings. For people with Parkinson disease and their family care partners (n = 20), a qualitative descriptive study was conducted to examine elements of the Structures and Process of Care and the primary palliative care needs of people with Parkinson disease, their family care partners, clinicians, and community services and programs (n = 48). The data yielded 4 themes that highlight the needs of this population: (1) uncertainty about the progressive speed of the disease and its symptoms, (2) the need for advocacy to access needed care, (3) poorly coordinated care and limited access to palliative care, and (4) awareness that nurses are untapped resources within the health care system.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702347","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}

{"title":"Factors Associated With the Management of Pressure Injuries at the End of Life: A Scoping Review.","authors":"Pauline Catherine Gillan, Christina Parker","doi":"10.1097/NJH.0000000000001119","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001119","url":null,"abstract":"<p><p>Pressure injuries are a major problem in all health care settings. The incidence of pressure injuries at the end of life is as high as 58% in some facilities, and there is little consensus on how pressure injuries are managed at the end of life. A scoping review was conducted, to investigate what is known of the factors associated with the management of pressure injuries at the end of life. Literature was sourced from several databases. A total of 1760 potential sources were identified; after applying the Population Concept Context inclusion and exclusion criteria, 16 empirical research articles were sourced: 10 were quantitative, 5 were qualitative, and 1 was mixed methods. Studies were published between 2003 and 2021 and originated from Italy, the United States, Australia, Sweden, Brazil, Taiwan, Turkey, and Canada. Key interventions included regular second hourly turning, wound debridement, wound assessment, and application of various wound coverings. The most widely discussed management strategy, regular second hourly turning, proved controversial and inconsistent in practice. There were also inconsistencies with wound assessment, with practice not always following best evidence-based assessment guidelines. Research findings also highlighted issues with prognostication and identification of the end-of-life phase with no consistent tool applied to assist end-of-life pressure injury management decision-making.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694690","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}

{"title":"Spiritual Needs of Turkish Palliative Care Patients.","authors":"Betulay Kılıc, Ece Kafadar, Tuğba Yardımcı Gürel, Fatma Ilknur Cınar, Serap Korkmaz","doi":"10.1097/NJH.0000000000001124","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001124","url":null,"abstract":"<p><p>Spiritual care is an integral component of palliative care and addresses the physical, psychosocial, and spiritual needs of patients and their families. This study aimed to determine the spiritual needs of hospitalized palliative care patients in Turkey and to provide insights into culturally sensitive spiritual care practices. This descriptive, cross-sectional study was conducted with 108 palliative care patients hospitalized in a public hospital between July 2022 and December 2023. Data were collected using a sociodemographic questionnaire and the Turkish version of the Spiritual Needs Assessment Scale. The average age of the participants was 72.43 ± 15.53, and 50% were women. The most frequently reported spiritual needs in palliative care patients were \"compassion and kindness\" (59.3%), \"feeling hopeful\" (55.5%), \"gratitude\" (54.6%), \"inner peace\" (52.8%), and \"companionship\" (51.9%). Existential and relational dimensions, such as feeling connected to the world and receiving love, were identified in the data. The findings underscored the need for holistic approaches that integrate spiritual, cultural, and psychosocial dimensions into palliative care. Standardizing spiritual care practices and incorporating them into health care professionals' training could enhance the quality of care in Turkish palliative care settings.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659661","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}

{"title":"Highlighting the Importance of Nurse Practitioner Fellowships in Palliative Care: A Model at the Columbia University School of Nursing.","authors":"Pierce DiMauro, Nicolas Burry, Penelope Buschman, Mary Tresgallo, Marlene McHugh","doi":"10.1097/NJH.0000000000001122","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001122","url":null,"abstract":"<p><p>The field of palliative care faces an impending clinician shortage, and nurse practitioners (NPs) are well-positioned to fill this critical need. However, there are currently not enough advanced practice educational opportunities for NPs in the form of fellowships/residencies to prepare them to fill this gap, despite the demonstrated benefit of such programs on self-reported preparedness for entry to practice and corresponding patient outcomes. Palliative care fellowship opportunities are limited by a lack of funding and developmental opportunities, with many experienced NPs in the field foregoing such an experience before entering practice. The purpose of this article is to overview the yearlong palliative care fellowship at Columbia University School of Nursing, wherein the part-time structure offers fellows the opportunity to build an exceptional foundation in palliative care while balancing other professional responsibilities. Palliative care will require NP leaders who are prepared to advance the field in practice, advocacy, education, and research; NP fellowships offer a remarkable foundation to prepare NPs to lead in this regard.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659660","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}

{"title":"Integrating Palliative Care Consultation Into Inpatient Liver Transplant Evaluations: A Quality Improvement Study.","authors":"Alissa A Ulanday, Lindsay B Waters, Melanie Donovan, Jennifer Do, Fady M Kaldas","doi":"10.1097/NJH.0000000000001118","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001118","url":null,"abstract":"<p><p>Palliative care (PC) consultation in high-risk patients with liver disease who are undergoing liver transplant (LT) evaluation is underused due to common beliefs that PC would negatively impact a patient's desire for transplant. This population is at risk due to high morbidity, mortality, and negative impact to overall quality of life. A 4-week pilot study was conducted in a transplant surgical intensive care unit at a single academic center to increase PC consultation during inpatient LT evaluation and improve transitions in care. Two Plan, Do, Study, Act quality improvement cycles were subsequently led by the PC nurse practitioner and social worker to increase the effectiveness of this intervention. The first cycle (November 29, 2018, to September 30, 2019) identified the need to increase PC education of intensive care unit nurses and promote interdisciplinary collaboration. The second cycle (October 1, 2019, to June 13, 2022) modified the study protocol to prioritize high-risk patients undergoing inpatient LT evaluation. Palliative care consultation increased by 262.5% from 2018 to 2019, with consults completed on 19% of all patients admitted for inpatient LT evaluations throughout the duration of the quality improvement study. Palliative care consultation on high-risk patients undergoing inpatient LT evaluation is a promising targeted strategy to increase utilization of PC in this population.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652019","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}

{"title":"Primary Palliative Care in Assisted Living and Residential Care: A Metasynthesis.","authors":"Daniel David, Vanessa Jimenez, Abraham A Brody","doi":"10.1097/NJH.0000000000001121","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001121","url":null,"abstract":"<p><p>Assisted living (AL) and residential care (RC) settings are experiencing substantial growth as older adults with lower care needs seek alternatives to nursing homes. Despite this trend, there is a lack of skilled nursing care to support palliative care (PC) in these environments. Primary PC delivered by AL staff has emerged as a potential model to bridge this gap, focusing on symptom management and holistic support for individuals with serious illness. A metasynthesis of 88 qualitative studies was conducted to explore the provision of primary PC in AL/RC settings. The National Consensus Project Clinical Practice Guidelines for Quality Palliative Care was used to provide a holistic framework to identify unmet PC need and gaps in PC delivery. Studies published between 2012 and 2024 were analyzed to identify themes and categories related to PC domains, including physical, psychological, social, spiritual, cultural, end-of-life care, and ethical and legal considerations. Thematic synthesis revealed key findings across the identified PC domains within AL/RC settings. Studies highlighted challenges and opportunities for delivering primary PC in these environments, emphasizing the importance of addressing physical symptoms, psychological distress, social isolation, and spiritual needs among residents with serious illnesses. The metasynthesis underscores the critical role of primary PC in enhancing quality of life and care continuity for older adults residing in AL/RC settings. It also identifies gaps in current practices and emphasizes the need for tailored interventions and training to support care providers in delivering comprehensive PC to this population. By integrating qualitative research findings with the National Consensus Project guidelines, this metasynthesis provides a comprehensive overview of primary PC in AL/RC settings. The study underscores the necessity of enhancing PC delivery in these environments to meet the evolving needs of older adults with serious illnesses, thereby improving overall quality of care for residents with unmet palliative needs.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617351","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}

{"title":"Simulation, Flipped Classroom, and Reflective Dialogue in Socioemotional Training in End-of-Life Care: Perspectives of Nursing Students.","authors":"María Lanza, Rebeca Abajas, Mar Aparicio, Ángeles Melero, Carmen Ortego","doi":"10.1097/NJH.0000000000001123","DOIUrl":"10.1097/NJH.0000000000001123","url":null,"abstract":"<p><p>The implementation of active methodologies in end-of-life education can play a crucial role in stimulating participatory learning and facilitating the acquisition of socioemotional competencies. An exploratory descriptive qualitative study was conducted to describe the students' perspective on the use of simulation, reflective dialogue, and the flipped classroom in an end-of-life education program. Undergraduate nursing students who had not yet begun their practicums were included. At the end of the training program, 4 focus groups were used. After the analysis, 3 themes and 32 categories emerged from the study. The themes included the contribution of the methodologies to learning, the characteristics that the methodology had to meet to be more effective, and motivational and emotional aspects triggered by the educational resources used. From the students' perspective, simulation, reflective dialogue, and flipped classroom enhance the conceptual learning process and facilitate students' socioemotional preparation to face this complex and challenging professional situation.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617354","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}

{"title":"The Role of Palliative Nursing in the Context of Immunotherapies: A Scoping Review of Patient- and Family-Centered Care Considerations.","authors":"Djin L Tay, Rebekah Perkins, Jordan R Muehlberger, Tallie Casucci, Toby Campbell, Mary M McFarland, Lee Ellington","doi":"10.1097/NJH.0000000000001111","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001111","url":null,"abstract":"<p><p>Immunotherapies are increasingly used to treat advanced cancers and can extend survival in some patients. The potential for longer survival may inflate prognosis expectations among patients and caregivers and delay palliative care. This review sought to identify issues impacting patients and caregivers that influence specialized palliative care use in the context of immunotherapies. A scoping review was conducted with guidance from the JBI Manual for Evidence Synthesis. Studies were identified using MEDLINE, EMBASE, CINAHL Complete, AgeLine, Cochrane Library, and APA PsycINFO, without any database filters or limiters. Inclusion criteria included palliative care utilization among adult cancer patients receiving immunotherapy and their family caregivers in any geographical or specialty setting. The protocol was registered in the Open Science Framework. Using Covidence, 11 898 studies were screened by reviewers, with 10 studies meeting inclusion criteria. Themes of patient and family considerations that affect the use of specialized palliative care included (1) understanding of disease/treatment, (2) hope/optimism, (3) communication barriers, and (4) emotional distress and uncertainty. This review is one of the first to identify issues impacting patients receiving immunotherapies and their families. Findings have implications for nurse communication, education, and psychosocial support with advanced cancer patients and families receiving immunotherapies.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598429","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}

{"title":"Palliative Care Nurse Specialists' Perspectives on Spiritual Care at End of Life-A Scoping Review.","authors":"Bronagh Dunning, Michael Connolly, Fiona Timmins","doi":"10.1097/NJH.0000000000001114","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001114","url":null,"abstract":"<p><p>The purpose of this scoping review was to explore and to summarize the published literature on palliative care nurse specialist's perspectives of spiritual care at end of life. The Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews Checklist was followed. Searches were conducted in 6 online databases (PubMed, MEDLINE, CINAHL, PsycINFO, Cochrane, HSELibrary). Following a rigorous review process, 15 studies met the inclusion criteria. Data were extracted using a template analyzing aims, population, mean age, setting, year of study, methodology, and key findings. The findings were organized into 4 categories: communication, education and experience, religion, and nurse-patient relationship. The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses' own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568843","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}