scholarly journals Health Professionals Palliative Care Education for Older Adults: Overcoming Ageism, Racism, and Gender Bias

2021 ◽  
Author(s):  
Shena B. Gazaway ◽  
Michael D. Barnett ◽  
Ella H. Bowman ◽  
Deborah Ejem ◽  
Erin R. Harrell ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Gender Bias ◽  
Health Professionals ◽  
Care Education ◽  
Palliative Care Education ◽  
And Gender

The need for palliative care education, support, and reflection among rural nurses and other staff: A quantitative study

2014 ◽  
Vol 13 (2) ◽  
pp. 265-274 ◽  
Author(s):  
Gerd Eriksson ◽  
Tina Wahlström Bergstedt ◽  
Christina Melin-Johansson
Keyword(s):  
Palliative Care ◽  
Rural Communities ◽  
Educational Interventions ◽  
Further Education ◽  
Healthcare Staff ◽  
Care Education ◽  
Staff Members ◽  
Palliative Care Education ◽  
And Gender ◽  
Education Support

AbstractObjective:Many people now die in community care, and, considering the aging population, all healthcare staff members must be prepared to provide palliative care. Our objectives were to describe the total staff working in different care organizations in a rural community in Sweden and to explore palliative care competence, to describe educational gaps and the need for support and reflection, and to determine whether there are differences in care organizations, professions, age, and gender.Method:A 4-section 20-item questionnaire was distributed to 1686 staff (65% response rate): in nursing homes (n = 395), home care (n = 240), and group residential settings (n = 365). Registered nurses (n = 70), assistant nurses (n = 916), managers (n = 43), and paramedics (n = 33) participated. Descriptive and correlational statistics were employed.Results:Significant differences were found, and 40% (53% among men) lacked palliative care education, Fewer than 50% lacked education in the spiritual/existential areas, and 75% of those aged 20–66 (75% women, 55% men) needed further education. More women than men and staff aged 50–59 had an increased need to reflect.Significance of Results:Our study may provide guidance for managers in rural communities when planning educational interventions in palliative care for healthcare staff and may support direct education with content for specific professions.

scholarly journals Can primary palliative care education change life-sustaining treatment intensity of older adults at the end of life? A retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Qian Liu ◽  
Mingzhao Qin ◽  
Jian Zhou ◽  
Hui Zheng ◽  
Weiping Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Retrospective Study ◽  
End Of Life ◽  
Categorical Variables ◽  
Treatment Intensity ◽  
Continuous Variables ◽  
Care Education ◽  
Palliative Care Education ◽  
Life Sustaining Treatment

Abstract Background Palliative care education has been carried out in some hospitals and palliative care has gradually developed in mainland China. However, the clinical research is sparse and whether primary palliative care education influence treatment intensity of dying older adults is still unknown. This study aims to explore the changes to the intensity of end-of-life care in hospitalized older adults before and after the implementation of primary palliative care education. Methods A retrospective study was conducted. Two hundred three decedents were included from Beijing Tongren Hospital’s department of geriatrics between January 1, 2014 to December 31, 2019. Patients were split into two cohorts with regards to the start of palliative care education. Patient demographics and clinical characteristics as well as analgesia use, medical resources use and provision of life-sustaining treatments were compared. We used a chi-square test to compare categorical variables, a t test to compare continuous variables with normal distributions and a Mann–Whitney U test for continuous variables with skewed distributions. Results Of the total participants in the study, 157(77.3%) patients were male. The median age was 88 (interquartile range; Q1-Q3 83–93) and the majority of patients (N = 172, 84.7%) aged 80 years or older. The top 3 causes of death were malignant solid tumor (N = 74, 36.5%), infectious disease (N = 74, 36.5%), and cardiovascular disease (N = 23, 11.3%). Approximately two thirds died of non-cancer diseases. There was no significant difference in age, gender, cause of death and functional status between the two groups (p > 0.05). After primary palliative care education, pain controlling drugs were used more (p < 0.05), fewer patients received electric defibrillation, bag mask ventilation and vasopressors (p < 0.05). There was no change in the length of hospitalization, intensive care admissions, polypharmacy, use of broad-spectrum antibiotics, blood infusions, albumin infusions, nasogastric/nasoenteric tubes, parenteral nutrition, renal replacement and mechanical ventilation (p > 0.05). Conclusions Primary palliative care education may promotes pain controlling drug use and DNR implementation. More efforts should be put on education about symptom assessment, prognostication, advance care planning, code status discussion in order to reduce acute medical care resource use and apply life-sustaining treatment appropriately.

scholarly journals A pilot study of interprofessional palliative care education of medical students in the UK and USA

2017 ◽  
Vol 8 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Amy Gadoud ◽  
Wei-Hsin Lu ◽  
Lisa Strano-Paul ◽  
Susan Lane ◽  
Jason W Boland
Keyword(s):  
Palliative Care ◽  
Medical Student ◽  
Medical Students ◽  
Health Professionals ◽  
Teaching Experience ◽  
Interprofessional Team ◽  
Care Education ◽  
Palliative Care Education ◽  
Care Health ◽  
The Uk

BackgroundEducating medical students to care for patients at the end-of-life is increasingly recognised as an essential component of training. Traditionally, medical student programmes are run by doctors, but patient care is delivered by an interprofessional team. Our programmes in the UK and USA independently developed a teaching experience led by an interprofessional team of palliative care health professionals.ObjectivesThis study explores the palliative care health professionals’ perceptions, regarding their unique role in medical student palliative care education.MethodsThis is the first study to ascertain views of an interprofessional team delivering palliative care education to medical students. Focus groups enable interaction between members of the group as well as the generation of consensus of comments among group members.ResultsTwo major themes were identified: perceived benefits and value of the experience, and the challenges and lessons learnt from the experiences.ConclusionsDespite different structures and settings, this experiential learning in palliative care provided a rewarding interprofessional experience that has historically been difficult to achieve.

scholarly journals Can Primary palliative care education change life-sustaining treatment intensity of older adults at the end of life? A retrospective study

2020 ◽  
Author(s):  
Qian Liu ◽  
Mingzhao Qin ◽  
Jian Zhou ◽  
Hui Zheng ◽  
Weiping Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Retrospective Study ◽  
End Of Life ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Care Education ◽  
Palliative Care Education ◽  
Significant Difference ◽  
Cancer Diseases

Abstract Background In recent years, palliative care has gradually developed in mainland China. Since 2018, primary palliative care education has been carried out in the department of geriatrics at Beijing Tongren Hospital. This study aimed to explore the changes to the intensity of end-of-life care in hospitalized older adults before and after the implementation of primary palliative care education. Methods A retrospective study was conducted. 203 decedents were included from Beijing Tongren Hospital’s department of geriatrics between January 1, 2014 to December 31, 2019. Patients were split into two cohorts with regards to the start of palliative care education. Patient demographics and clinical characteristics as well as analgesia use, other medical resources use and provision of life-sustaining treatments were compared between the two groups. We used a chi-square test to compare categorical variables, a t test to compare continuous variables with normal distributions and a Mann–Whitney U test for continuous variables with skewed distributions. Results Of the total participants in the study, 157(77.3%) patients were male. The median age was 88 (interquartile range; Q1-Q3 83–93) and the majority of patients (N = 172, 84.7%) aged 80 years or older. The top 3 causes of death were malignant solid tumor (N = 74, 36.5%), infectious disease (N = 74, 36.5%), and cardiovascular disease (N = 23, 11.3%). Approximately two thirds died of non-cancer diseases. There was no significant difference in age, gender, cause of death and functional status between the two groups (p > 0.05). After primary palliative care education, pain controlling drugs were used more (p < 0.05), fewer patients received electric defibrillation, bag mask ventilation and vasopressors ( p༜0.05). There was no change in the length of hospitalization, intensive care admissions, polypharmacy, use of broad-spectrum antibiotics, blood infusions, albumin infusions, nasogastric/nasoenteric tubes, parenteral nutrition, renal replacement and mechanical ventilation (p > 0.05). Conclusions Primary palliative care education promotes symptom control and DNR implementation. In the future, more efforts should be put on education about symptom assessment, prognostication, advance care planning, code status discussion with particular focus on patients with end stage non-cancer diseases.

scholarly journals Palliative care medical student education: a cross-sectional medical school survey in mainland China

2019 ◽  
pp. bmjspcare-2019-002044
Author(s):  
Guanchen Ye ◽  
Jiahui Mao ◽  
Jingjing Hu ◽  
Jie Chen ◽  
Therese Hesketh
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Health Professionals ◽  
Mainland China ◽  
Medical Schools ◽  
Ministry Of Education ◽  
Care Education ◽  
Associate Deans ◽  
Palliative Care Education

ObjectiveAccording to the 2015 Quality of Death Index, China ranks 71st in terms of quality of palliative care out of 80 countries. Lack of palliative care education for health professionals is regarded as largely responsible. The study aims to evaluate the status of palliative care education for medical students in mainland China.MethodsA list of all medical schools was obtained from the Ministry of Education. A telephone survey of associate deans responsible for medical education at all 282 medical schools in mainland China was conducted in May 2019, following a standardised protocol. Telephone interviews focused on attitudes to palliative care teaching and the extent and manner in which palliative care is incorporated into the curriculum.ResultsAssociate deans from 173 (61.2%) of the 282 medical schools responded. A total of 120 schools (42.5%) completed the interview, while 53 (18.7%) evaded direct questions related to palliative care. Of the responding deans, 92 (76.7%) regarded palliative care education as very important. However, only 11 (9.2%) provided specific teaching on palliative care. A few schools (n=18) integrated palliative care education within required curricula, such as medical ethics and nursing science. The main reason reported for not providing palliative care education was that the medical curriculum dictated by the Ministry of Education does not require it.ConclusionA very small minority of medical schools in mainland China have any formal teaching about palliative care. Clearly, national standards for didactic and clinical teaching in palliative care for medical students and other health professionals are needed.

scholarly journals Primary Palliative Care for Emergency Medicine (PRIM-ER): Protocol for a Pragmatic, Cluster-Randomised, Stepped Wedge Design to Test the Effectiveness of Primary Palliative Care Education, Training and Technical Support for Emergency Medicine

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030099 ◽  
Author(s):  
Corita R Grudzen ◽  
Abraham A Brody ◽  
Frank R Chung ◽  
Allison M Cuthel ◽  
Devin Mann ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Medicine ◽  
Palliative Care ◽  
Healthcare Utilisation ◽  
Audit And Feedback ◽  
Stepped Wedge ◽  
Care Education ◽  
Palliative Care Education ◽  
Cluster Randomised ◽  
Evaluation Phase

IntroductionEmergency departments (ED) care for society’s most vulnerable older adults who present with exacerbations of chronic disease at the end of life, yet the clinical paradigm focuses on treatment of acute pathologies. Palliative care interventions in the ED capture high-risk patients at a time of crisis and can dramatically improve patient-centred outcomes. This study aims to implement and evaluate Primary Palliative Care for Emergency Medicine (PRIM-ER) on ED disposition, healthcare utilisation and survival in older adults with serious illness.Methods and analysisThis is the protocol for a pragmatic, cluster-randomised stepped wedge trial to test the effectiveness of PRIM-ER in 35 EDs across the USA. The intervention includes four core components: (1) evidence-based, multidisciplinary primary palliative care education; (2) simulation-based workshops; (3) clinical decision support; and (4) audit and feedback. The study is divided into two phases: a pilot phase, to ensure feasibility in two sites, and an implementation and evaluation phase, where we implement the intervention and test the effectiveness in 33 EDs over 2 years. Using Centers for Medicare and Medicaid Services (CMS) data, we will assess the primary outcomes in approximately 300 000 patients: ED disposition to an acute care setting, healthcare utilisation in the 6 months following the ED visit and survival following the index ED visit. Analysis will also determine the site, provider and patient-level characteristics that are associated with variation in impact of PRIM-ER.Ethics and disseminationInstitutional Review Board approval was obtained at New York University School of Medicine to evaluate the CMS data. Oversight will also be provided by the National Institutes of Health, an Independent Monitoring Committee and a Clinical Informatics Advisory Board. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03424109; Pre-results

HOPE. Home Care Outreach for Palliative Care Education.

1998 ◽  
Vol 6 (2) ◽  
pp. 79-85 ◽  
Author(s):  
BR Ferrell ◽  
R Virani ◽  
M Grant
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Care Education ◽  
Palliative Care Education

scholarly journals Chinese medical teachers’ cultural attitudes influence palliative care education: a qualitative study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Antonia M. Willemsen ◽  
Piret Paal ◽  
Silja Zhang ◽  
Stephen Mason ◽  
Frank Elsner
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Death And Dying ◽  
Developed Countries ◽  
Special Importance ◽  
Cultural Attitudes ◽  
Care Education ◽  
Palliative Care Education ◽  
Education In China ◽  
Medical Teachers

Abstract Background China holds one fifth of the world’s population and faces a rapidly aging society. In its ambition to reach a health care standard comparable to developed countries by 2030, the implementation of palliative care gains special importance. Until now, palliative care education in China is limited and disparate. This study aims to explore and determine factors that have impeded the development and implementation of palliative care education in China. Methods We conducted semi-structured interviews with n=28 medical teachers from seven Chinese universities. Interviews were transcribed, and thematic analysis applied. Results Three themes with two subthemes were constructed from data analysis. Theme 1 covers the still ambivalent perception of palliative care and palliative care education among participants. The second theme is about cultural attitudes around death and communication. The third theme reflects participants’ pragmatic general understanding of teaching. All themes incorporate obstacles to further implementation of palliative care and palliative care education in China. Conclusions According to the study participants, palliative care implementation through palliative care education in China is hindered by cultural views of medical teachers, their perception of palliative care and palliative care education, and their understanding of teaching. The study demonstrates that current attitudes may work as an obstacle to the implementation of palliative care within the health care system. Approaches to changing medical teachers’ views on palliative care and palliative care education and their cultural attitudes towards death and dying are crucial to further promote the implementation of palliative care in China.

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