What should be measured to assess the quality of community-based palliative care? Results from a collaborative expert workshop

2021 ◽  
pp. 1-7
Author(s):  
Nicole Williams ◽  
Nicole Boumans ◽  
Nicole Luymes ◽  
Nancy E. White ◽  
Manon Lemonde ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Population Aging ◽  
Well Being ◽  
Substantial Contribution ◽  
Special Importance ◽  
Community Based ◽  
Expert Opinions ◽  
The Individual

Abstract Objectives The need for palliative care (PC) will continue to increase in Canada with population aging. Many older adults prefer to “age in place” and receive care in their own homes. Currently, there is a lack of standardized quality indicators (QIs) for PC delivered in the community in Canada. Methods A one-day workshop collected expert opinions on what should be measured to capture quality PC. Three brainstorming sessions were focused on addressing the following questions: (1) what is important to measure to support quality PC, regardless of setting? (2) Of the identified measures, are any of special importance to care provided in the home? (3) What are the challenges, barriers, and opportunities for creating these measures? The National Consensus Project (NCP) for Quality Palliative Care framework was used as a guide to group together important comments into key themes. Results The experts identified four themes that are important for measuring quality, regardless of care setting, including access to care in the community by a multidisciplinary team, care for the individual with PC needs, support for the informal caregiver (e.g., family, friends), and symptom management for individuals with PC needs. Two additional themes were of special importance to measuring quality PC in the home, including spiritual care for individuals with PC needs and home as the preferred place of death. The challenges, barriers, and potential opportunities to these quality issues were also discussed. Significance of results PC experts, through this collaborative process, made a substantial contribution to the creation of a standardized set of QIs for community-based PC. Having a standardized set of QIs will enable health care professionals and decision makers to target areas for improvement, implement interventions to improve the quality of care, and ultimately, optimize the health and well-being of individuals with a serious illness.

The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia

2017 ◽  
Vol 23 (6) ◽  
pp. 404-413 ◽  
Author(s):  
Ahmad Rayan ◽  
Khaldoon Obiedate
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Health Care Professionals ◽  
Arab World ◽  
Well Being ◽  
Special Importance ◽  
Public Stigma ◽  
Culturally Competent ◽  
Severity Of Depression

BACKGROUND:Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. AIMS: The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. METHOD: In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. RESULTS: Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. CONCLUSIONS: Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.

scholarly journals Effects and Challenges Regarding Supervision in Palliative Care Teams: Results of a 5-Year Study in South Tyrol (Italy)

2020 ◽  
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Clinical Supervision ◽  
Controlled Trial ◽  
Well Being ◽  
Family Doctors ◽  
Palliative Care Teams ◽  
Positive Assessment ◽  
The Individual

Objective: Evaluating a solution-oriented clinical supervision to improve the quality of care. Design: We performed a randomized, longitudinal controlled trial. A total of 32 health districts were involved in the study. For the evaluation of the intervention, the following dimensions were collected as indicators of the quality of supervision: Quality of life (FACT-G, SF12, POS), psychological stress, depression, burn-out (HADS, BDI-II, VAS scales, HPS), sense of coherence (SOC-13), satisfaction with care, communication and support from the patients and relatives (VAS scales) and working conditions (COPSOQ) from the nursing staff and family doctors. Results: Of the 85 subscales, the SOC Nursing Sum Score (p=0.017), the SF-12 Nursing Sum Scale (p=0.036), and the COPSOQ Scales of General Practitioners showed significant differences in developmental opportunities (p=0.020), leadership (p=0.003), social support (p=0.001) and community spirit (p=0.024). At the second point time of the study, significant differences were found in the subscales of the Palliative Care Outcome Scale (POS) and the subscale of the test instrument Functional Assessment of Cancer Therapy - General (FACT-G) FUNCTIONAL WELL-BEING of the patients. The satisfaction values of nurses and general practitioners with the supervision showed an extremely positive assessment of both nurses and general practitioners regarding supervision. Conclusions: Supervision affects positively the process of palliative home care. It seems important to adjust the number of supervision meetings according to the needs of the individual team in order to achieve an optimized team performance.

La percezione degli operatori sanitari sulle cure palliative come mezzo per promuovere la qualità di vita dei pazienti e prevenire le richieste eutanasich / Healthcare workers’ perception of palliative care as a means to foster patients' quality of life and to prevent euthanasia requests*

2019 ◽  
Vol 68 (1) ◽  
pp. 25-39
Author(s):  
Konstantinos Mastorakis ◽  
Massimo Continisio ◽  
Maria Francesca Siotto ◽  
Luca Navarini ◽  
Franco Carnevale ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Well Being ◽  
Life Care ◽  
National Monitoring ◽  
Spiritual Well Being ◽  
Hospice Workers

Nel 2010 è stata emanata in Italia la Legge 38, che punta a migliorare formazione e tirocini nel campo delle cure palliative, sebbene al momento non esista un sistema nazionale di monitoraggio di tali pratiche su scala nazionale. A livello internazionale l’eutanasia si è andata sempre più configurando come trattamento possibile fra le cure di fine vita, mentre in Italia resta formalmente illegale. Esistono alcuni studi italiani sulle prospettive dei pazienti rispetto alle cure palliative e all’eutanasia, ma la letteratura relativa alla percezione degli operatori sanitari palliativisti è esigua. Scopo del presente studio è l’indagine di tali percezioni, sia rispetto alla qualità delle cure palliative sia al potenziale ruolo dell’eutanasia nelle cure di fine vita in Italia. La ricerca è stata condotta in tre hospice romani. È stato sviluppato e somministrato un questionario con 75 item graduati secondo la scala Likert a 5 punti, utilizzando come metodi di analisi l’analisi fattoriale e, per la parte statistica, SPSS. Il questionario è stato completato da 56 soggetti. Nella percezione dei partecipanti, i fattori rilevanti per la qualità delle cure palliative sono risultati sette: sofferenza fisica e sociale, benessere psicologico e spirituale, benessere emozionale, partecipazione alle decisioni, compassione, speranza ed empatia. Inoltre, le cure palliative ridurrebbero il desiderio di morte e di eutanasia. I fattori più importanti che emergono dal lavoro sono la sofferenza o il benessere sociali, fisici e psicologici. Gli operatori sanitari coinvolti nello studio non sostengono l’ipotesi dell’eutanasia e anzi ritengono che le cure palliative riducano il desiderio di ottenerla. ---------- In 2010, the State Law no 38 was enacted in Italy, seeking to improve palliative care education and training. There is currently no national monitoring system for palliative care practices in Italy. Euthanasia has become increasingly available internationally as an alternative amidst end-of-life care options, although in Italy this is not the case, and it is formally illegal. Although there are a few studies regarding patients’ perspectives regarding the issue of palliative care and euthanasia in Italy, there is limited literature focused on the perspectives of palliative care health care professionals. The purpose of this study is to explore the perspectives of hospice workers regarding both the quality of palliative care and the potential role of euthanasia in end-of-life care in Italy. This research was conducted with hospice clinicians in three hospices in Rome. A 75 item 5-point Likert scale questionnaire was developed and administered. Factor analysis was used, and descriptive statistics were performed using SPSS. Fifty-six respondents completed the questionnaire. From participants’ perspectives, there are seven significant factors explaining the quality of palliative care in Italy: social and physical suffering, psychological and spiritual well-being, emotional well-being, participation in decision making, compassion, hope, and empathy in care, while reducing patients’ desire for death and euthanasia. The most important of these factors regard social, physical and psychological suffering and well-being. Hospice workers in this study did not support euthanasia and felt that palliative care decreases the patient’s desire for euthanasia. * The manuscript was presented as an abstract in an International Congress on Palliative Care.

Reflections On… Occupational Therapy and Assertive Community Treatment

2002 ◽  
Vol 69 (3) ◽  
pp. 153-157 ◽  
Author(s):  
Terry Krupa ◽  
Debbie Radloff-Gabriel ◽  
Elizabeth Whippey ◽  
Bonnie Kirsh
Keyword(s):  
Occupational Therapy ◽  
Assertive Community Treatment ◽  
Occupational Therapists ◽  
Well Being ◽  
Community Treatment ◽  
Psychiatric Disabilities ◽  
Community Based ◽  
The Individual ◽  
Health And Well Being

Occupational therapists can play a valuable role on Assertive Community Treatment Teams (ACT). ACT is a widely disseminated, community based model of service delivery for individuals with severe psychiatric disabilities and high support needs. This paper discusses the generalist and specialist functions of occupational therapists within ACT. It is argued that occupational therapy addresses the occupational health and well being of ACT clients by intervening at three levels: the individual, the program and the community. This occupational focus is consistent with the ACT goal of enhancing community adjustment and quality of life. The paper concludes with a discussion of the opportunities and the constraints that face occupational therapists working within ACT.

The Chemical Effect in Medicine Interaction Determining the Form and Speed of Psychical Involution in the Prosthetic Restauration in the Edentulous

2018 ◽  
Vol 69 (8) ◽  
pp. 2306-2310
Author(s):  
Aureliana Caraiane ◽  
Razvan Leata ◽  
Veronica Toba ◽  
Doina Vesa ◽  
Luana Andreea Macovei ◽  
...  
Keyword(s):  
Practical Importance ◽  
Psychosocial Problems ◽  
Well Being ◽  
The Elderly ◽  
Chemical Effect ◽  
Special Importance ◽  
Dramatic Form ◽  
Specific Disorders ◽  
The Individual ◽  
Made In

The progress made in dentistry during the latest decades is due, conceptually, to the new, systemic vision of man, which has also taken place in this field of medicine. In this context, the link between organic and psychic is indestructible. Thus illness is understood as a drama in which the somatic process has a psychic value, and the mental one has a body value. It is known that the morphological and functional integrity of the dental system, health and vigorousness, gives the individual a state of well-being that affects his somatic and psychic health, as any disturbance at this level entails repercussions in psychological and social behavior. Such a disruption is the total edification that seriously alters not only the dental system but the whole organism, putting various biological and psychosocial problems to the practitioner. The total expression represents not only a physical disability but also a psychological one. A special importance in studying psychological changes at total edentulous presents the psychological aspects of senile involution. This is not only a theoretical but also a practical importance due to the increase in the number of elderly people. Through the researches of the present paper we intend to present the reality of the psychological manifestations in the total edentation, which is objectified on different methods of psychodiagnosis in the first part, in order for the second part to be addressed to problems of prosthetic psychotherapy.The study comprises a group of 43 patients, of whom 24 were men and 19 women with total uni or bimaxilar edentation. Total edentation can be and is responsible for somatopsychic alterations, along with other pathogens, general, local, social, which sometimes can take a dramatic form, converting, where the area is also favorable, a pure somatic disease, for those who are not in psychopathy or even psychosis, although these latter cases are extremely rare and especially in youngsters, which would disrupt not only the person�s behavior as an individual, but also their status, function and social integrity. The treatment of dental and psychological complex is mandatory for any patient, but especially for the elderly, where recovery is more difficult, with disease-specific disorders adding to those of senescence.

Social Capital and Sustainable Health Care: An Analysis of Community Based Palliative Care Model of Kerala

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdul Azeez. E.P
Keyword(s):  
Social Capital ◽  
Palliative Care ◽  
Social Services ◽  
Social Inclusion ◽  
Well Being ◽  
Vital Role ◽  
Voluntary Organizations ◽  
Community Based ◽  
The Social ◽  
Palliative Care Units

Social Capital is the most crucial asset which significantly influence the efficacy and resilience of any community. Social capital is a dependent variable that depends upon the competence and coherence of the individuals in the community and mode of social relationships, trust and networks they maintain. It is one of the most sustainable social resources that originate from human relations and results on the mutual support of people. Utilization of Social capital has a wide applicability in the process of social inclusion, especially in dealing with the vulnerable and disadvantaged sections in the community itself. Voluntary organizations are very keen to utilize the social capital for community/social services and community development in a sustainable manner. Community based de-institutionalized Palliative Care is one of the foremost among such organizations that made social capital in a strategic way for social inclusion and community well being. This paper analyses the extent to which different elements of social capital helps in initiating the sustainable community based palliative care movement by assessing the unique intervention strategies carried out by the palliative care. This paper explores conceptual questions of how social capital and voluntary community based services are correlated. A case study method was adopted for the study in which ten palliative care units were analyzed. The results show that a number of social capital elements are playing a vital role in the sustainability of community palliative care movement in Kerala.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Bossi ◽  
M Tringali ◽  
P Colombo ◽  
C Mazzali ◽  
G Puleo ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Critical Appraisal ◽  
Population Aging ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Lombardy Region ◽  
Double Blinded ◽  
Sustainable Health ◽  
Local Healthcare

Abstract Issue With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports. Description of the Problem To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports. Results In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference. Lessons We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement. Key messages The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.

Does a Patient-Held Quality-of-Life Diary Benefit Patients With Inoperable Lung Cancer?

2009 ◽  
Vol 27 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Moyra E. Mills ◽  
Liam J. Murray ◽  
Brian T. Johnston ◽  
Chris Cardwell ◽  
Michael Donnelly
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Standard Care ◽  
Care Quality ◽  
Care Group ◽  
Consistent Difference ◽  
Life Questionnaire

Purpose To examine the effect of weekly completion of a patient-held quality-of-life (QOL) diary in routine oncology practice for palliative care patients. Patients and Methods In a pragmatic randomized controlled trial, 115 patients with inoperable lung cancer were randomly assigned to receive either standard care or a structured QOL diary (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and the related lung cancer module LC13) that they completed at home each week for 16 weeks. Patients were encouraged to share the QOL information with health professionals involved in their care. Changes in QOL over time (measured by the Functional Assessment of Cancer Therapy–Lung questionnaire and the Palliative Care Quality of Life Index), discussion of patient problems, and satisfaction with communication and general care were assessed at baseline and at 2 and 4 months after baseline. Results Analysis of QOL indicated a small but consistent difference between patients in the diary group and the standard care group. The diary group had a poorer QOL in many domains. Two different QOL summary scores (total and overall QOL) indicated a statistically significant between-group difference. No effects were found in relation to satisfaction with care, communication, or the discussion of patient problems. Conclusion The regular completion of a QOL questionnaire without appropriate feedback to health care professionals and without the provision of appropriate support may have a negative impact on inoperable lung cancer patients. Further research should focus on identifying features such as feedback loops that are required for the successful and meaningful use of QOL questionnaires in routine patient care.

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