A scoping review of palliative care for persons with severe persistent mental illness

2019 ◽  
Vol 17 (04) ◽  
pp. 479-487 ◽  
Author(s):  
Erin E. Donald ◽  
Kelli I Stajduhar
Keyword(s):  
Mental Illness ◽  
Palliative Care ◽  
Scoping Review ◽  
Research Question ◽  
Healthcare Providers ◽  
Premature Death ◽  
Future Research ◽  
Research Activity ◽  
Complex Needs ◽  
Persistent Mental Illness

AbstractObjectivePeople with severe persistent mental illness (SPMI) experience a greater burden and severity of chronic disease, late diagnosis, and premature death compared with the general population. Those with SPMI also receive fewer medical treatments, poor quality of care, and are less likely to receive palliative care. A systematic scoping review was undertaken to determine the extent, range, and nature of research activity about people with SPMI requiring palliative care, and to identify gaps and opportunities for future research.MethodA systematic scoping review was undertaken in September 2017 and updated in May 2018 to map literature on this topic, determine the extent and range of what has been published, and report the findings. This five-stage framework was conducted by (1) identifying the research question; (2) identifying relevant studies; (3) determining study selection; (4) charting the data; and 5) collating, summarizing, and reporting the results. A narrative approach to analysis was used to synthesize and interpret findings. A search of multidisciplinary healthcare databases resulted in 46 included articles.ResultFour major themes were identified from the included studies: complexity of care; limited access to care (both through systems and healthcare providers); competence and autonomy; and the potential for relationships between mental health and palliative care.Significance of resultsThis review reveals a highly vulnerable population with complex needs that are not reliably being met by the healthcare system and providers. Research in this area must continue to develop using rigorous qualitative and quantitative study designs, and interventions should be developed and tested based on existing knowledge to inform care. The voices of people with SPMI in need of palliative care must be represented in future studies to address gaps. To expand a body of literature addressing mainly individuals, system perspectives and sociocultural analysis can bring much to contextualizing the experience of living with SPMI in the palliative phase of care. Adoption of a palliative approach, which promotes the principles of palliative care across nonspecialized care settings provided by nonspecialist palliative providers, has the potential to increase access to high-quality palliative treatment for people with SPMI.

scholarly journals Complexity In The Context of Palliative Care: A Scoping Review

2021 ◽  
Author(s):  
Hironori Ohinata ◽  
Maho Aoyama ◽  
Mitsunori Miyashita
Keyword(s):  
Palliative Care ◽  
Scoping Review ◽  
Healthcare Providers ◽  
The United States ◽  
Patient Specific ◽  
Future Research ◽  
Care Needs ◽  
Living Situation ◽  
Research Activities ◽  
Specific Factors

Abstract Background: Understanding the factors of complexity of patients in palliative care is very important for healthcare providers in addressing the care needs of their patients. However, the healthcare providers’ perception of the factors of complexity in palliative care lacks a common understanding. This study aimed to determine the scope of research activities and specific factors of complexity in the context of palliative care.Methods: A scoping literature review was performed, following the methods described by the Joanna Briggs Institute. We conducted an electronic literature search in MEDLINE (Ovid), PsycINFO, Web of Science Core Collection, and CINAHL, examining literature from May 1972 to 2020.Results: We identified 32 peer-reviewed articles published in English before 2020. The target literature mainly originated in Europe and the United States. The research methods included quantitative studies (n=13), qualitative studies (n=12), case studies (n=3), and reviews (n=4). We reviewed 32 studies and summarized the factors of complexity into three levels: the patient’s level, the healthcare setting level, and the socio-cultural landscape level. We identified factors affecting patient-specific complexity, including sex, race, age, living situation, family burden, resources, treatment, decision-making, communication, prognosis, disease, and comorbidity/complexity. Other factors identified as contributing to patient complexity were the interaction of physical, psychological, social, and spiritual categories, as well as the healthcare providers’ confidence and skills, and the socio-cultural components.Conclusions: This scoping review shows specific factors of complexity and future challenges in the context of palliative care. Future research should include the factors of complexity identified in this review and conduct longitudinal studies on the interactions among them. In addition, it is necessary to examine specific complexity factors in patients from various social and ethnic backgrounds.

Case series of introducing palliative care consultation in psychiatry

2020 ◽  
Vol 34 (5) ◽  
pp. 680-683 ◽  
Author(s):  
Thorleif Etgen
Keyword(s):  
Mental Illness ◽  
Palliative Care ◽  
Case Series ◽  
Future Research ◽  
First Year ◽  
Problem Solution ◽  
Actual Case ◽  
Persistent Mental Illness ◽  
Palliative Care Consultation ◽  
Care Consultation

Background: The significance of palliative care consultation in psychiatry is unclear. Actual case series: Analysis of the introduction of palliative care consultation in a large psychiatric hospital. Possible courses of action: Continue without offering, survey the need for or offer palliative care consultation, and analyse its introduction. Formulation of a plan: Palliative care consultation was established and details including patient age, department, diagnosis, main problem, solution and discharge were analysed during the first 2 years. Outcome: Two consultations in the first year and 18 consultations in the second year were requested (18 geriatric, 2 addiction, 0 general, clinical social and forensic psychiatry) involving two domains: delirium associated with dementia or another condition (75%) and mental illness (e.g. alcoholic psycho-syndrome, psychosis, suicidal tendency, schizophrenia, depression) and cancer (25%). Recommendations of consultations were realized in 95%. Lessons from the case series: Implementation of palliative care consultation in psychiatry is one possible method of how to introduce palliative care in a field of medicine with lack of palliative care. View: Future research should focus on reasons for reservations about palliative care in psychiatry, include more patients with severe persistent mental illness and assess the value of palliative care consultation in resolving this problem.

Increasing our understanding of nonphysical suffering within palliative care: A scoping review

2021 ◽  
pp. 1-16 ◽  
Author(s):  
Maxxine Rattner
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Palliative Sedation ◽  
Primary Sources ◽  
Future Research ◽  
Social Emotional ◽  
Relief Of Suffering ◽  
Hastened Death

Abstract Objective Nonphysical suffering is emotional, psychological, existential, spiritual, and/or social in nature. While palliative care is a discipline dedicated to the prevention and relief of suffering — both physical and nonphysical — little is known about existing research specific to nonphysical suffering within the context of palliative care. This scoping review helps to fill this gap. Method Three hundred and twenty-eight unique records were identified through a systematic search of three databases (MEDLINE, CINAHL, and PsycINFO). The following keywords were used: (suffering) AND (palliative OR “end of life” OR “end-of-life” OR hospice OR dying OR terminal* ill*). Thirty studies published between 1998 and 2019 met the inclusion criteria. Results Losses, worries, and fears comprise patients’ primary sources of nonphysical suffering. Patients face numerous barriers in expressing their nonphysical suffering to healthcare providers. The idea that patients can choose how they perceive their circumstances, thereby minimizing their nonphysical suffering, is pervasive in the research. The nature of nonphysical suffering experienced by family caregivers and palliative care clinicians is revealed in the review. The unique and sensitive interplay between nonphysical suffering and both palliative sedation and requests for hastened death is also evident. Overall, seven themes can be identified: (i) patients’ experiences of nonphysical suffering; (ii) patient coping mechanisms; (iii) efforts to measure nonphysical suffering; (iv) palliative sedation; (v) requests for hastened death; (vi) family suffering; and (vii) clinician suffering. Significance of results This is the first scoping review to map palliative care's research specific to suffering that is social, emotional, spiritual, psychological, and/or existential in nature. Its findings expand our understanding of the nature of nonphysical suffering experienced by patients, families, and palliative care clinicians. The review's findings have significant implications for front-line practice and future research.

Palliative Care for Patients with Mental Illness

2019 ◽  
pp. 503-512
Author(s):  
John D. Chovan ◽  
Betty D. Morgan
Keyword(s):  
Mental Illness ◽  
Palliative Care ◽  
Special Needs ◽  
Ethical Decision Making ◽  
Healthcare Providers ◽  
Interdisciplinary Teams ◽  
Underserved Population ◽  
Persistent Mental Illness ◽  
Life Threatening ◽  
Persons With Schizophrenia

This chapter describes the challenges and special needs for persons living with severe and persistent mental illness as they face chronic and life-threatening illnesses. Healthcare providers, especially those working on palliative care interdisciplinary teams, will learn the magnitude of this underserved population; their circumstances; the special needs of the persons with schizophrenia, bipolar disorder, and personality disorders; and those aspects of their mental illness that limit access to and delivery of appropriate healthcare throughout the trajectory of their illnesses. Techniques for caring for and communicating with patients and their families are offered, as are ethical decision-making advice regarding refusal of treatment, capacity and competence, advance directives, and interpersonal issues.

Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

2021 ◽  
pp. 1-19
Author(s):  
Jonathan Plante ◽  
Karine Latulippe ◽  
Edeltraut Kröger ◽  
Dominique Giroux ◽  
Martine Marcotte ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Length Of Stay ◽  
Acute Care ◽  
Scoping Review ◽  
Research Question ◽  
Positive Association ◽  
Well Being ◽  
Future Research ◽  
Care Hospital ◽  
The Impact

Abstract Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

Nurse Burnout in Hospice and Palliative Care: A Scoping Review

2021 ◽  
pp. 105413732110398
Author(s):  
Erica Frechman ◽  
Patricia M. Wright
Keyword(s):  
Professional Development ◽  
Palliative Care ◽  
Scoping Review ◽  
Future Research ◽  
Self Awareness ◽  
Personal Factors ◽  
Workplace Issues ◽  
Mitigating Factors ◽  
Hospice And Palliative Care ◽  
Nursing Professional

Burnout in hospice and palliative care nurses is a growing issue, especially in light of the COVID-19 pandemic. However, few studies have focused specifically on burnout in this population. A scoping review was undertaken to identify what is known about burnout among hospice and palliative care nurses, and to unify disparate findings. Analysis of eight articles revealed three overarching categories: personal factors, organizational/workplace factors, and nursing professional development factors. Each category was then divided into three cross-cutting subcategories: contributory and noncontributory factors, mitigating factors, and workplace issues. Recommendations for individuals include self-care as well as self-awareness of intrinsic characteristics that can predispose one to burnout. Within the workplace, leaders are challenged to support evidence-based practice and ongoing education. Role modeling positive communication skills, effective conflict mitigation, responsiveness, promotion of equity, and workplace commitment also help to create a culture of wellness. Nursing professional development may aid in resilience-building, and promotion of self-efficacy, self-confidence, and assertiveness. Although all identified recommendations were derived from the literature, no interventional studies have been conducted to test the effects of suggested interventions. Future research should include interventional studies as well as qualitative research to capture nuanced experiences of burnout in hospice and palliative care nurses.

scholarly journals Electronic health records (EHR) simulation-based training: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036884
Author(s):  
Joseph K Nuamah ◽  
Karthik Adapa ◽  
Lukasz Mazur
Keyword(s):  
Scoping Review ◽  
Research Question ◽  
Healthcare Providers ◽  
Primary Data ◽  
Ethical Review ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Simulation Based ◽  
Electronic Health ◽  
Free Environment

IntroductionEffective electronic health record (EHR)-based training interventions facilitate improved EHR use for healthcare providers. One such training intervention is simulation-based training that emphasises learning actual tasks through experimentation in a risk-free environment without negative patient outcomes. EHR-specific simulation-based training can be employed to improve EHR use, thereby enhancing healthcare providers’ skills and behaviours. Despite the potential advantages of this type of training, no study has identified and mapped the available evidence. To fill that gap, this scoping review will synthesise the current state of literature on EHR simulation-based training.Methods and analysisThe Arksey and O’Malley methodological framework will be employed. Three databases (PubMed, Embase and Cumulative Index to Nursing and Allied Health Literature) will be searched for published articles. ProQuest and Google Scholar will be searched to identify unpublished articles. Databases will be searched from inception to 29 January 2020. Only articles written in English, randomised control trials, cohort studies, cross-sectional studies and case-control studies will be considered for inclusion. Two reviewers will independently screen titles and abstracts against inclusion and exclusion criteria. Then, they will review full texts to determine articles for final inclusion. Citation chaining will be conducted to manually screen references of all included studies to identify additional studies not found by the search. A data abstraction form with relevant characteristics will be developed to help address the research question. Descriptive numerical analysis will be used to describe characteristics of included studies. Based on the extracted data, research evidence of EHR simulation-based training will be synthesised.Ethics and disseminationSince no primary data will be collected, there will be no formal ethical review. Research findings will be disseminated through publications, presentations and meetings with relevant stakeholders.

scholarly journals Acceptability of palliative care approaches for patients with severe and persistent mental illness: a survey of psychiatrists in Switzerland

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Manuel Trachsel ◽  
Martina A. Hodel ◽  
Scott A. Irwin ◽  
Paul Hoff ◽  
Nikola Biller-Andorno ◽  
...  
Keyword(s):  
Mental Illness ◽  
Palliative Care ◽  
Persistent Mental Illness
Sign in / Sign up

Export Citation Format

Share Document