Impact of a contemplative end-of-life training program: Being with dying

2009 ◽  
Vol 7 (4) ◽  
pp. 405-414 ◽  
Author(s):  
Cynda Hylton Rushton ◽  
Deborah E. Sellers ◽  
Karen S. Heller ◽  
Beverly Spring ◽  
Barbara M. Dossey ◽  
...  

AbstractObjective:Health care professionals report a lack of skills in the psychosocial and spiritual aspects of caring for dying people and high levels of moral distress, grief, and burnout. To address these concerns, the “Being with Dying: Professional Training Program in Contemplative End-of-Life Care” (BWD) was created. The premise of BWD, which is based on the development of mindfulness and receptive attention through contemplative practice, is that cultivating stability of mind and emotions enables clinicians to respond to others and themselves with compassion. This article describes the impact of BWD on the participants.Methods:Ninety-five BWD participants completed an anonymous online survey; 40 completed a confidential open-ended telephone interview.Results:Four main themes—the power of presence, cultivating balanced compassion, recognizing grief, and the importance of self-care—emerged in the interviews and were supported in the survey data. The interviewees considered BWD's contemplative and reflective practices meaningful, useful, and valuable and reported that BWD provided skills, attitudes, behaviors, and tools to change how they worked with the dying and bereaved.Significance of results:The quality of presence has the potential to transform the care of dying people and the caregivers themselves. Cultivating this quality within themselves and others allows clinicians to explore alternatives to exclusively intellectual, procedural, and task-oriented approaches when caring for dying people. BWD provides a rare opportunity to engage in practices and methods that cultivate the stability of mind and emotions that may facilitate compassionate care of dying patients, families, and caregivers.

2021 ◽  
pp. 026921632110198
Author(s):  
Catriona R Mayland ◽  
Rosemary Hughes ◽  
Steven Lane ◽  
Tamsin McGlinchey ◽  
Warren Donnellan ◽  
...  

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.


2021 ◽  
pp. 107780122110089
Author(s):  
Chunrye Kim ◽  
Joel A. Capellan ◽  
Hung-En Sung ◽  
Eduardo Rafael Orellana

Intimate partner violence (IPV) among women in Latin America, including Honduras, is serious. To help IPV victims, a community-based educational program has been implemented. This study aims to examine the impact of IPV training among teachers and health care professionals ( n = 160) on increases in IPV knowledge, attitudes, and self-efficacy when dealing with IPV victims using a pretest and posttest design. We found that the treatment group who received IPV training showed significantly lower justification for IPV, higher gender equality attitudes, and higher IPV knowledge as well as higher confidence levels in identifying IPV victims and safety planning for victims. We concluded that the IPV training program using the community-based approaches has the potential to help IPV victims in Honduras. More efforts should be made to increase the educational opportunities the community members can receive.


2019 ◽  
Vol 5 ◽  
pp. 233372141989269 ◽  
Author(s):  
Megumi Inoue ◽  
Kyoko Hanari ◽  
Jun Hamano ◽  
Joshua Gallagher ◽  
Nanako Tamiya

Using the Ministry of Health, Labour and Welfare national data on perspectives toward medical care at the end of life, this study examined the current status of engagement in advance care planning (ACP) activities among physicians and nurses in Japan and associated factors. Only 28.7% of physicians and 27.6% of nurses answered that they were engaging their patients/clients in ACP. Multinomial regression analysis revealed that more frequent involvement in caring for dying patients was associated with ACP engagement for both physicians and nurses. Increased years of clinical practice experience and working in a hospital were associated with decreased likelihood of nurses’ ACP engagement. Completion of training designed to promote patient self-determination at the end of life was associated with both physicians’ and nurses’ ACP engagement. It is recommended that health care professionals be encouraged to complete such training to promote patients’ autonomy through ACP.


2019 ◽  
Author(s):  
Miguel Angel Mayer ◽  
Octavi Rodríguez Blanco ◽  
Antonio Torrejon

BACKGROUND In the last few years, the number of mobile apps for health professionals has increased exponentially. Nevertheless, there is a lack of knowledge about the professional use, training requirements, and quality perception of these apps among health care professionals such as nurses. Considering that the nursing profession is the largest segment of health care workforce in many countries such as Spain, the impact of the use of health apps by these professionals can be critical to the future of modern health care. OBJECTIVE The main objective of this study was to determine if nurses were using health apps professionally and what types of apps they were using. The secondary objectives were (1) to find out if, among nurses, there is a need for training in the use of health apps and (2) to explore nurses’ perceptions of health professional apps, determining whether there is a need for a certification process for health apps and the type of institution or organization that should review and validate these apps for professional use. METHODS After an initial piloting survey, all registered nurses at the Nursing Association of Barcelona were invited to participate in a 34-item online survey. Eventually, 1293 nurses participated in the survey; however, 52 did not complete the survey properly, omitting both age or gender information, and they were excluded from the analysis. RESULTS About half of the respondents (600/1241, 48.35%) had health professional apps installed on their devices and were included for analysis. Most participants in the survey were women (474/600, 79.0%) and the remaining were men (126/600, 21.0%). The most popular types of apps used and installed among nurses were related to drug information, health calculators, and health guidelines. Overall, 97.0% (582/600) of nurses thought that the health apps should be certified, and 80.0% (480/600) agreed that the certification process should be carried out by professional or health institutions. Furthermore, 14.5% (87/600) of participants mentioned that they were asked by their patients to prescribe a health app and only 6.5% (28/430) recommended them often. Most nurses (354/433, 81.8%) who answered the question about the importance of receiving specific training on using and prescribing health apps considered this point a very relevant issue. CONCLUSIONS About half of the nurses in Catalonia use health apps for professional purposes, and they believe that these types of tools should be validated and certified by health or professional institutions before using them in clinical environments. Although the prescription of health apps in clinical environments is infrequent among nurses, they would be willing to prescribe apps if they were certified by a health organization. Finally, among nurses, there is a need for training in using and prescribing health apps for health care purposes.


Author(s):  
Liz Carlin ◽  
Maxine E. Whelan ◽  
Hayley Musson ◽  
Emma J. Adams

Background: The benefits of physical activity for preventing and managing long-term health conditions are well established and health care professionals could promote physical activity to patients. The current study aims to evaluate the impact of the Clinical Champions Physical Activity Training Program. Methods: Health care professionals attend a one-off in-person training session delivered by a trained Clinical Champion. Attendees at the Clinical Champions Physical Activity Training Program were asked to complete a baseline survey prior to the training session and follow-up surveys 4 and 12 weeks posttraining. Results: A total of 5945 training attendees completed the baseline survey. A total of 1859 and 754 participants completed 4- and 12-week follow-up (31.3% and 12.7% response rate, respectively). Significant increases in confidence to deliver brief physical activity advice and knowledge of physical activity guidelines were reported at 12 weeks (P < .001). The perceived frequency of physical activity discussions with patients significantly increased (P < .001). Twelve weeks after training, fewer barriers in promoting physical activity were reported. Conclusions: The evaluation of the Clinical Champions Physical Activity Training Program demonstrated an increase in knowledge of physical activity guidelines, levels of confidence, and frequency of delivery of brief physical activity advice to patients. Further research is required to determine if this impact translates into changes to patients’ physical activity behavior.


2021 ◽  
Author(s):  
Iffat Elbarazi ◽  
Basema Saddik ◽  
Michal Grivna ◽  
Faisal Aziz ◽  
Deena Al Souri ◽  
...  

BACKGROUND The COVID-19 pandemic created a crisis in the world of information and digital literacy. The amount of misinformation surrounding COVID-19 that has circulated through social media (SM) since January 2020 is notably significant and it has been linked to rising levels of anxiety and fear amongst SM users. The COVID-19 'infodemic' was singled out by the World Health Organization (WHO) and several newly published studies as one of the causes of anxiety, depression, and fear amongst the global population OBJECTIVE This study aimed to assess SM practices during COVID-19 and investigates their impact on well-being. METHODS An online infodemic cross-sectional survey was distributed via different SM platforms in the United Arab Emirates and other countries. Adults above 18 years of age were invited to complete an online survey that covered multiple domains, including the WHO-5 Well-being Index. RESULTS The study sheds light on the use of SM during the pandemic and its impact on well-being throughout the novel coronavirus pandemic. Out of 993 participants, 73% were females, 76% were non-Emirati, 91% university graduates, and 50% were employed in various occupations, of which 20% were health care professionals. Participants indicated that they acquired COVID-19 related information primarily from social media, of which WhatsApp was the most accessed. Most participants reported sharing the information after the verification. The mean well-being score was 12.6 ±5.6 with 49% of participants had poor well-being (WHO-5 score <12.5). The adjusted linear regression showed that Facebook usage was negatively associated with well-being score. Also, high time-usage was associated with poorer well-being. When adjusting for other factors, including low confidence in information around COVID-19 and poor knowledge overall, SM usage was significantly associated with poorer well-being CONCLUSIONS Social media practices during emergencies and disasters may impact public well-being. Authorities are advised to step in to minimize the spread of misinformation and more frequent use of social media, as it may influence well-being leading to increased levels of anxiety, stress, and depression. Public health specialists, information technology and communication experts should collaborate to limit the infodemic effect on communities.


2020 ◽  
Vol 34 (3) ◽  
pp. 269-285
Author(s):  
Kristina Ma ◽  
David Kenneth Wright ◽  
Brandi Vanderspank-Wright ◽  
Wendy E. Peterson ◽  
Franco A. Carnevale

BackgroundMoral distress, the phenomenon in which an agent is constrained in acting on their ethical choice, is a reoccurring theme in the literature on nurses' experiences of end-of-life care (EOLC). Understanding moral engagement solely through a lens of moral distress can be limiting—as such, we sought to explore the diverse experiences nurses consider ethically meaningful in their palliative and EOLC practice.Purpose and MethodsThis article presents an exploration and analysis of stories told to us, within an interpretive description study, by five nurses practicing in EOLC in diverse settings across Canada. Although these stories were told to us in a research context, the purpose of this theory article is to explore what these stories demonstrate about the moral engagement of nurses caring for dying patients.FindingsOur analysis suggests that while moral distress is a feature of nursing stories, so too are many other dimensions of moral experience, including resilience, responsibility, and care.Implications for PracticeExpanding how we understand nurses' moral engagement in the care of dying patients has implications for how we account for the many responsibilities that nurses shoulder in striving to provide “good” care to people at the end of life.


2020 ◽  
Vol 11 ◽  
pp. 215145932091693 ◽  
Author(s):  
Luke Harries ◽  
Andrew Moore ◽  
Clare Kendall ◽  
Sophie Stanger ◽  
Thomas D. Stringfellow ◽  
...  

Introduction: The mortality of patients with neck-of-femur (NOF) fractures remains high, with increasing recognition of a subgroup of patients with predictable mortality. The role of palliative care in this group is poorly understood and underdeveloped. This research aims to investigate current clinician attitudes toward palliative care for patients with NOF fracture, and explore processes in place for early identification for patients nearing the end of life. Materials and Methods: An online survey was constructed with reference to National Institute for Health and Clinical Excellence end-of-life guidelines (CG13) and distributed to multidisciplinary teams involved in the care of NOF fracture patients in 4 hospitals of contrasting size and location in the United Kingdom. Results: Forty health-care professionals with a broad range of seniority and roles responded. The palliative care team was felt to have several potential roles in the care of NOF fracture patients, but there was difference of opinion between specialties about what these were. A number of barriers to palliative referral were identified, including stigma and active surgical management. The majority (75%) felt that all NOF fracture patients should have a discussion about ceiling of care, with difference of opinion about who should do so, and when. Discussion: As the elderly population has grown, so too has the volume of NOF fracture patients. It is increasingly important to identify and escalate patients who have poor prognosis following hip fracture and ensure they benefit from palliative care where appropriate. This survey demonstrates a barrier to addressing the care of these patients and a lack of consensus on identification and referral to appropriate palliative care planning. Conclusions: There should be close communication between specialties with regard to requirements for palliative care in NOF fracture patients, with ongoing education and clear local and national guidance to ensure they receive the right care at the right time.


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