Journal of Hospice & Palliative Nursing最新文献_第3页

A Goal-Concordant Prescribing Conceptual Framework: Implications for Practice and Measurement.

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-27 DOI: 10.1097/NJH.0000000000001112

Susan DeSanto-Madeya, Margaret F Clayton, Erik Fromme, Francesca Troiani, Jennifer Tjia

{"title":"A Goal-Concordant Prescribing Conceptual Framework: Implications for Practice and Measurement.","authors":"Susan DeSanto-Madeya, Margaret F Clayton, Erik Fromme, Francesca Troiani, Jennifer Tjia","doi":"10.1097/NJH.0000000000001112","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001112","url":null,"abstract":"Optimizing medication benefit and minimizing harm through effective and appropriate medication management is emerging as an important strategy in hospice and palliative care. This approach, however, often fails to align patient and family goals for remaining life with clinician priorities. Ascertaining patient and caregiver values and goals and aligning these goals with clinicians' priorities for care is a complex and iterative process. This process requires effective communication between all participants as a patient's illness trajectory moves toward death. The purpose of this article was to present a beginning conceptual framework for clinical consideration and use, as well as an example of a potential measurement framework envisioned from the conceptual framework for future research application. Both frameworks focus on goal-concordant prescribing among seriously ill older adults in home hospice. An environmental scan of existing deprescribing frameworks and approaches to goal ascertainment that inform hospice deprescribing was conducted. Feedback from practicing hospice clinicians engaged in a pilot project implementing a novel goal-concordant prescribing approach, as well as interprofessional clinicians and family caregivers from previous projects, were also used to identify theoretical and clinically relevant gaps in care as well as future research opportunities. The environmental scan and multiproject feedback served as the foundation for the development of the conceptual framework. The suggested communication frameworks for goal-concordant prescribing seek to bridge the gap between the preferences and priorities of the patient and family caregiver, and the risk-benefit considerations brought forth by clinicians.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525310","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

Assessing Advance Care Planning Readiness in Older Adults: A Pilot Study.

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-26 DOI: 10.1097/NJH.0000000000001115

Sarah Oliveira, Karen A Karlowicz

引用次数: 0

Caring Beyond Cure: Perspectives of Pediatric Oncology Nurses on End-of-Life Care.

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-26 DOI: 10.1097/NJH.0000000000001107

Peter Scarperi, Meredith MacKenzie Greenle

{"title":"Caring Beyond Cure: Perspectives of Pediatric Oncology Nurses on End-of-Life Care.","authors":"Peter Scarperi, Meredith MacKenzie Greenle","doi":"10.1097/NJH.0000000000001107","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001107","url":null,"abstract":"Pediatric oncology patients should receive high-quality end-of-life care when needed. Little is known about nurses' attitudes toward providing end-of-life care in pediatric oncology and the role of work experience in developing comfort with providing this care. In a sample of nursing students and nurses working in pediatric oncology, this mixed-methods study aimed to describe attitudes toward and experiences of providing end-of-life care and examine the relationship between education, work experience, and attitudes. Participants completed a demographic survey and the Frommelt Attitude Toward Care of the Dying, modified for pediatrics. Qualitative interviews were then completed with 10 participants. Participants (N = 38) were primarily female (87%) and White (89%). Overall, participants held positive attitudes toward end-of-life care, with staff nurses more positive than student nurses. All participants had provided end-of-life care, yet only 2 (5.41%) thought their education thus far prepared them. Age, education, experience, and burnout were associated with attitudes toward providing end-of-life care. Qualitative themes included challenges of preparedness and training, the nurse's role, and parent team barriers. Training in pediatric end-of-life care is crucial to improve nurses' comfort with providing this care. Further research should explore the impact of burnout, compassion fatigue, and interdisciplinary conflict on end-of-life care.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525312","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

Online Education to Improve Palliative Care Professionals' Knowledge of Sleep Management. 提高姑息关怀专业人员睡眠管理知识的在线教育。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-01 Epub Date: 2024-12-16 DOI: 10.1097/NJH.0000000000001067

Rana Sagha Zadeh, Elizabeth Capezuti, Michael Ames Brigham, Brooke Ana Dias, Benjamin Chanhee Kim, Evie Lengetti, Ana C Krieger

{"title":"Online Education to Improve Palliative Care Professionals' Knowledge of Sleep Management.","authors":"Rana Sagha Zadeh, Elizabeth Capezuti, Michael Ames Brigham, Brooke Ana Dias, Benjamin Chanhee Kim, Evie Lengetti, Ana C Krieger","doi":"10.1097/NJH.0000000000001067","DOIUrl":"10.1097/NJH.0000000000001067","url":null,"abstract":"Inadequate sleep is a common problem among those receiving palliative care services, yet there is limited knowledge regarding nonpharmacological sleep interventions among staff. An educational online program was developed to address this deficit. This study assessed the extent of knowledge acquired following the online educational sleep program and determined the feasibility of using this intervention with palliative care professionals. Thirty-one participants (54.8% licensed nurses) completed the educational program. Most worked in either inpatient residential (38.7%) or home-based (35.5%) settings and had considerable experience working in palliative care. The total average pretest score was 67.5% (SD, 6.5%; range, 56.3%-79.2%) compared with the total average posttest score of 93.1% (SD, 6.0; range, 78.7%-100%). There was a significant mean difference in the scores as documented by a paired-sample t test ( t30 = -21.9, P < .0001). The results did not differ between the disciplines and those working in each setting or by years of experience. The study had a 51.6% recruitment rate and an 88.6% retention rate. The significant increase in the palliative care professionals' knowledge following the educational program suggests it is a useful tool for nurses, aides, social workers, and managers to improve direct care.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"27-34"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840308","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

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 : 2025-02-01 Epub 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":"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":" ","pages":"20-26"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","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

A Rapid Review on Shared Decision Making in Pediatric Palliative Care and End-of-Life Care: Implications for Clinical Practice, Research, and Policy. 儿科姑息治疗和临终关怀共同决策的快速回顾：对临床实践、研究和政策的影响。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-01 Epub Date: 2024-12-03 DOI: 10.1097/NJH.0000000000001089

Beth Fisher, Carrie L Cormack, Amy Corey Haskamp, Kerry A Hagen, Ayaba Logan

引用次数: 0

Impact of an Inpatient Telepalliative Care Consult Service in Rural Hospitals: One State Story. 农村医院住院病人远疗会诊服务的影响：一个州的故事。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-01 Epub Date: 2024-12-04 DOI: 10.1097/NJH.0000000000001083

Anup Bhushan, Scott D Hurley, Patrick J Coyne

引用次数: 0

Standardizing Initial Inpatient Palliative Care Consultations for Patients Receiving Left Ventricular Assist Devices at a Large Urban Hospital. 在一家大型城市医院为接受左心室辅助装置治疗的患者提供标准化的姑息治疗初始住院咨询。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-01 Epub Date: 2024-11-28 DOI: 10.1097/NJH.0000000000001082

Deborah A Szeto, Robin L Whitney, Dulce E Alcantara

{"title":"Standardizing Initial Inpatient Palliative Care Consultations for Patients Receiving Left Ventricular Assist Devices at a Large Urban Hospital.","authors":"Deborah A Szeto, Robin L Whitney, Dulce E Alcantara","doi":"10.1097/NJH.0000000000001082","DOIUrl":"10.1097/NJH.0000000000001082","url":null,"abstract":"Left ventricular assist devices can improve survival rates and quality of life for individuals with advanced heart failure. However, complications and repeated hospitalizations are common. Palliative care involvement is required before and after left ventricular assist device placement. However, limited guidance on the objectives and structure of palliative care consultation in the left ventricular assist device context has led to variation in how these consultations are conducted and confusion around the consultations' objectives and structure. We piloted and modified an evidence-based, semistructured script to guide pre-left ventricular assist device palliative care consultations. Palliative care clinicians were trained on use of the script. Presurvey and postsurvey were used to examine changes in clinician confidence and assess script acceptability. Script use did not result in changes to clinicians' confidence. Clinicians felt the script provided valuable structure and guidance but suggested improvements to script structure and flow, emphasizing the need for a standardized workflow and closer collaboration between palliative care and heart failure teams.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E43-E50"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741062","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

Advance Directives for Adolescents and Young Adults Living With Neuromuscular Disease: A Nurse Practitioner-Driven Intervention. 预先指示青少年和年轻人生活与神经肌肉疾病：护士执业驱动的干预。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-01 Epub Date: 2024-12-03 DOI: 10.1097/NJH.0000000000001086

Vanessa Battista, Deborah J Baker, Tara Trimarchi, Sarah Stoney, Rita D'Aoust

{"title":"Advance Directives for Adolescents and Young Adults Living With Neuromuscular Disease: A Nurse Practitioner-Driven Intervention.","authors":"Vanessa Battista, Deborah J Baker, Tara Trimarchi, Sarah Stoney, Rita D'Aoust","doi":"10.1097/NJH.0000000000001086","DOIUrl":"10.1097/NJH.0000000000001086","url":null,"abstract":"The literature shows that adolescents and young adults (AYAs) living with neuromuscular disease want to have discussions about goals of care and want them sooner. Conversations about goals of care and advance directives are not common practice in the neuromuscular clinic setting. This nurse practitioner-led project used a conversation tool as a 1-time intervention to guide conversations about participants' goals and wishes, comparing the number of participants with advance directives before and after the use of the intervention, and their satisfaction with having had a conversation about goals of care using this tool was measured. A total of 14 AYAs with genetically confirmed neuromuscular disease were enrolled in this project. There was a 92.9% increase in the number of AYAs with an advance directive demonstrating clinical meaningfulness. Most project participants were either quite a bit satisfied (21.4%) or very much satisfied (57.1%) with having used the intervention to discuss goals of care. This quality improvement project demonstrated that, if asked, AYAs with neuromuscular disease willingly agreed to discuss their goals of care and found satisfaction in using the intervention to complete an advance directive. Advanced Practice Registered Nurses should consider systematic processes to include these discussions as a part of routine practice.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"5-11"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774875","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

Voices of Care: Nurses' Perspectives on End-of-Life Care for Black/African American Patients. 护理之声：护士对黑人/非裔美国病人临终关怀的看法。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-02-01 Epub Date: 2024-12-05 DOI: 10.1097/NJH.0000000000001081

Siobhan P Aaron, Katherine Supiano, Samantha DeSimio

{"title":"Voices of Care: Nurses' Perspectives on End-of-Life Care for Black/African American Patients.","authors":"Siobhan P Aaron, Katherine Supiano, Samantha DeSimio","doi":"10.1097/NJH.0000000000001081","DOIUrl":"10.1097/NJH.0000000000001081","url":null,"abstract":"This qualitative study examines the distinct experiences of Black/African American nurses in providing end-of-life care to patients of the same racial background and their families. It fills a significant gap in existing research by focusing on the lived experiences and perceptions of Black/African American nurses, gathered through semistructured interviews. Using phenomenological analysis with Colaizzi's method, the study identified principal themes such as racial and ethnic disparities in treatment, challenges in pain management, the need for cultural sensitivity, and the significant influence of historical Black/African American patients' mistrust in health care interactions. The findings illustrate pervasive health care disparities, which are intensified by socioeconomic variables, cultural incompetence, and systemic bias. The nurses highlighted the urgent need for enhanced cultural competence in health care practices to ensure equitable treatment and patient-centric care. This research underscores the necessity for systemic reforms to improve cultural sensitivity and trust within health care services, advocating for comprehensive cultural competency training, greater diversity in health care representation, and effective mechanisms for reporting and addressing disparities. These measures are critical for improving health care outcomes and trust among Black/African American communities at the end of life.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E33-E42"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787756","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}

引用次数: 0