scholarly journals A Qualitative Study of the Impact of COVID-19 on Hospice and Home-Based Palliative Care in Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1029-1030
Author(s):  
YuHsuan (Olivia) Wang ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Medical Team ◽  
Structured Interviews ◽  
Team Members ◽  
Time Points ◽  
Home Based ◽  
Alpha Variant ◽  
The Impact ◽  
Tremendous Impact

Abstract COVID-19 has had a tremendous impact on individuals and health care, particularly among those with serious illnesses. Although Taiwan initially reported low rates of COVID-19 (20.7 cases per million in 2020), by early 2021 the Alpha variant began spreading in Taiwan, which went into a soft lockdown from May to July. This study aimed to investigate the impact of COVID-19 on Hospice and Home-Based Palliative Care (HBPC) patients, family, and medical team member in Taiwan during different COVID-related time points. From November 2020 to May 2021, we conducted semi-structured interviews with 2 patient, 5 caregivers, and 8 medical team members in the hospice and HBPC setting to elicit their views about the impact of COVID-19 on care. Content analysis was used to guide the analysis of themes. Two researchers independently coded transcripts and met to reconcile codes. Results showed varying impact across the time points. In 2020, patients, caregivers, medical team members felt little impact of COVID-19. However, in 2021, HBPC caregivers reduced the frequency of HBPC visits to lower the household COVID-19 infection risk. Hospice and HBPC team members reported that more caregivers selected HBPC over hospice. They also observed an increase in complicated grief among family survivors following the soft lockdown. The impact of the pandemic on homecare provision increased as prevalence of COVID-19 increased, impacting care and quality of hospice and HBPC. Further research is needed to better understand the impact of the pandemic on the quality of hospice /HBPC and grief experiences.

scholarly journals CUIDADOS PALIATIVOS: VISÃO DE ENFERMEIROS DE UM HOSPITAL DE ENSINO

2016 ◽  
Vol 7 (1) ◽  
pp. 28-32
Author(s):  
Mariana Carneiro De Oliveira ◽  
Francine Lima Gelbcke ◽  
Luciana Martins Da Rosa ◽  
Mara Ambrosina De Oliveira Vargas ◽  
Juliana Balbinot Girondi Reis
Keyword(s):  
Palliative Care ◽  
Chronic Disease ◽  
World Health ◽  
Structured Interviews ◽  
Team Members ◽  
Clinical Unit ◽  
Calidad De Vida ◽  
Philosophy Of Palliative Care ◽  
Health Organization

Objetivo: identificar se há a inserção do conceito e dos princípios dos Cuidados Paliativos definidos pela Organização Mundial de Saúde na atuação de enfermeiros de Unidades de Clínicas Médicas e da Comissão de Cuidados Paliativos e Controle da Dor de um Hospital- Escola da Região Sul do Brasil. Metodologia: pesquisa qualitativa com coleta de dados mediante entrevista semiestruturada com 22 enfermeiros, submetidas à técnica de análise de conteúdo. Resultados: o enfermeiro vincula os Cuidados Paliativos com o processo de morte dos pacientes. A comunicação limitada oblitera as condutas tomadas pelos membros da equipe. As pessoas com doença crônica são encaminhadas tardiamente, submetendo-se a ações reducionistas que não proporcionam qualidade de vida. Conclusões: os princípios da filosofia dos Cuidados Paliativos estão inseridos parcialmente na prática dos profissionais. Há demanda de formação acadêmica e em serviço.Descritores: Cuidados Paliativos, Doença Crônica, Cuidados de Enfermagem, Serviço Hospitalar de Enfermagem.PALLIATIVE CARE: NURSES VISION OF A TEACHING HOSPITALObjective: identify if there is the inclusion of the concept and the principles of palliative care as defined by the World Health Organization in the performance of Medical Clinical Unit nurses and the Committee on Palliative Care and Pain Management of a teaching hospital in southern Brazil. Methodology: qualitative research with data collection through semi-structured interviews with 22 nurses, submitted to the technique of content analysis. Results: the nurse links Palliative Care of death of patients process. The limited communication obliterates the steps taken by team members. People with chronic disease are referred late, undergoing reductionist actions that do not provide quality of life. Conclusion: the principles of the philosophy of palliative care are partially inserted in professional practice. There is demand for academic training and service.Descriptors: Palliative Care, Chronic Disease, Nursing Care, Nursing Service Hospital.CUIDADOS PALIATIVOS: VISIÓN DE ENFERMEROS DE UN HOSPITAL UNIVERSITARIOObjetivo: identificar si existe la inclusión del concepto y los principios de los cuidados paliativos según lo definido por la Organización Mundial de la Salud en el desempeño de médicos enfermeras Clinical Unit y el Comité de Cuidados Paliativos y Tratamiento del Dolor de un hospital universitario en el sur de Brasil. Metodología: la investigación cualitativa con la recolección de datos a través de entrevistas semiestructuradas con 22 enfermeras, sometidos a la técnica de análisis de contenido. Resultados: la enfermera une cuidados paliativos de la muerte del proceso de los pacientes. La comunicación limitada borra las medidas adoptadas por los miembros del equipo. Las personas con enfermedades crónicas se refieren tarde, sometidos a acciones reduccionistas que no proporcionan la calidad de vida. Conclusións: los principios de la filosofía de los cuidados paliativos se insertan parcialmente en la práctica profesional. Hay demanda de formación académica y de servicio.Descriptores: Cuidados Paliativos, Enfermedad Crónica, Atención de Enfermería, Servicio de Enfermería en Hospital.

scholarly journals A longitudinal evaluation of the impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders

2021 ◽  
pp. 1-21
Author(s):  
K Hennigan ◽  
M McGovern ◽  
R Plunkett ◽  
S Costello ◽  
C McDonald ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anxiety Disorders ◽  
Social Isolation ◽  
Social Impact ◽  
Rating Scales ◽  
Structured Interviews ◽  
Time Points ◽  
The Impact ◽  
Over Time

Abstract Objectives: To examine if the Covid-19 pandemic is associated with a differential effect over time in relation to its’ psychological and social impact on patients with established anxiety disorders. Methods: Semi-structured interviews were conducted with 24 individuals attending the Galway-Roscommon Mental Health Services with an ICD-10 diagnosis of an anxiety disorder at two-time points (six-months apart) to determine the impact of the Covid-19 restrictions on anxiety and depressive symptoms, social and occupational functioning and quality of life. Results: No statistical difference in symptomatology was noted between the two time points in relation to anxiety symptoms as measured utilising psychometric rating scales (BAI, HARS) or utilising a Likert Scale. The greatest impact of COVID-19 at both time points related to social functioning and quality of life. Significant variability was noted for individual participants. Qualitative analysis noted social isolation, concern for the participants’ future and increased difficulty managing anxiety with ongoing restrictions. Conclusions: No significant overall change in symptomatology or functioning over time was noted for individuals with pre-existing anxiety disorders. Variability was however demonstrated between individuals, with some individuals describing ongoing anxiety, social isolation and concern for their future. Identifying those with ongoing symptoms or distress and providing multidisciplinary support to this cohort is suggested.

Refractory suffering: The impact of team dynamics on the interdisciplinary palliative care team

2011 ◽  
Vol 9 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Kate Swetenham ◽  
Meg Hegarty ◽  
Katrina Breaden ◽  
Carol Grbich
Keyword(s):  
Palliative Care ◽  
Interdisciplinary Team ◽  
Team Cohesion ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Skill Sets ◽  
Team Members ◽  
Care Experience ◽  
The Individual ◽  
The Impact

AbstractObjective:This qualitative study aimed to describe the skill sets that experienced palliative care clinicians possess when managing refractory suffering.Method:Thirteen tape recorded semi-structured interviews and four online questionnaires were completed by participants with at least two years clinical palliative care experience. The research team undertook cross sectional thematic analysis of the transcribed interviews.Results:In the face of refractory suffering, team cohesion was identified as a key requirement to support the interdisciplinary team. However, team cohesion was found to be undermined by philosophical differences between team members, a paradigm shift concerning cure versus care and individual opinions regarding the chosen approach and levels of respect between the individual disciplines involved in the care of a person with a life limiting illness.Significance of results:The findings of this study highlight the precarious nature of the interdisciplinary team when significant challenges are faced. As a result of witnessing refractory suffering the division and fracturing of teams can easily occur; often team members are completely unaware of its cause. The findings of this study contribute to the limited literature on the nature of refractory suffering from the perspective of the interdisciplinary team.

scholarly journals Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers

2021 ◽  
pp. 104990912110126
Author(s):  
Valeria Cardenas ◽  
Anna Rahman ◽  
Yujun Zhu ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Condition ◽  
Insurance Companies ◽  
Structured Interviews ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.

scholarly journals Professionals’ views on working in the field of domestic violence and abuse during the first wave of COVID-19: a qualitative study in the Netherlands

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicole E. van Gelder ◽  
Ditte L. van Haalen ◽  
Kyra Ekker ◽  
Suzanne A. Ligthart ◽  
Sabine Oertelt-Prigione
Keyword(s):  
Domestic Violence ◽  
The Netherlands ◽  
Working Conditions ◽  
Critical Evaluation ◽  
Physical Contact ◽  
Structured Interviews ◽  
Online Tools ◽  
The Impact ◽  
Domestic Violence And Abuse

Abstract Background The COVID-19 pandemic and lockdown evoked great worries among professionals in the field of domestic violence and abuse (DVA) as they expected a rise of the phenomenon. While many countries reported increased DVA, the Netherlands did not. To understand this discrepancy and the overall impact of the lockdown on DVA support services, we interviewed DVA professionals about their experiences with DVA during the rise of COVID-19, the impact of the lockdown on clients and working conditions, and views on eHealth and online tools. Methods Semi-structured interviews were conducted among 16 DVA professionals with various specializations. This data was analyzed using open thematic coding and content analysis. Results Most professionals did not see an increase in DVA reports but they did notice more severe violence. They experienced less opportunities to detect DVA and worried about their clients’ wellbeing and the quality of (online) care. Furthermore, their working conditions rapidly changed, with working from home and online, and they expressed frustration, insecurity and loneliness. Professionals feel eHealth and online tools are not always suitable but they do see them as an opportunity to increase reach and maintain services when physical contact is not possible. Conclusion This study suggests DVA was probably under-detected during the lockdown rather than not having increased. The Dutch system heavily relies on professionals to detect and report DVA, suggesting a need for critical evaluation of the accessibility of professional help. Professionals experienced significant challenges and should themselves be supported psychologically and in their changed work practices to maintain their ability to aid survivors.

Sexuality and Intimacy Needs Within a Hospitalized Palliative Care Population: Results From a Qualitative Study

2021 ◽  
pp. 104990912110369
Author(s):  
Anne Kelemen ◽  
Clara Van Gerven ◽  
Katherine Mullins ◽  
Hunter Groninger
Keyword(s):  
Palliative Care ◽  
Family Relationships ◽  
Comparative Method ◽  
Future Research ◽  
Spiritual Needs ◽  
Structured Interviews ◽  
Course Of Illness ◽  
Serious Illness ◽  
Medical Teams ◽  
The Impact

Background: Palliative care (PC) clinicians are well trained to address physical, psychosocial and spiritual needs of patients who have a serious illness. However, one area that is often overlooked is intimacy and sexuality. Objective: To explore patient concerns regarding intimacy as it relates to illness, family reactions, physician conversations, and coping strategies and challenges. Methods: Eligible subjects (at least 18 years old, capacitated, receiving PC consultation at the lead author’s institution) participated in semi-structured interviews between November and December 2017. Transcripts were open-coded and analyzed using Dedoose 3.5.35 software. A constant comparative method was used to identify patterns in the data. Results: 21 interviews were analyzed and several themes emerged. Participants described the effect of physical and mental/emotional changes on their relationships. Family relationships, romantic relationships, and sexuality were prominent in patients’ experiences of intimacy and how it changed as the illness progressed. Relationships were often noted to strengthen during the course of illness, while sexual activity was frequently reported to be negatively impacted. Patients consistently reported little provider communication on the impact of illness on intimacy beyond instructions about what sexual activities they could or could not engage in. Conclusion: This study underlines the significant impact of serious, progressive illness on relationships, sexuality, and physical and emotional intimacy. It highlights that these topics continue to be priorities for patients with serious illness, and that medical teams frequently fail to address them at all. Future research should further explore these issues across diverse patient populations.

The Impact of Privatization on Minority Faith Prison Chaplains in Canada

2021 ◽  
Vol 75 (3) ◽  
pp. 199-206
Author(s):  
Adar Abdulkadir ◽  
Ibrahim J. Long
Keyword(s):  
Spiritual Care ◽  
Correctional Facilities ◽  
Correctional Institutions ◽  
Structured Interviews ◽  
Federal Prison ◽  
For Profit ◽  
Major Shift ◽  
Prison Chaplains ◽  
The Impact

Canadian federal prison chaplaincy underwent a major shift in 2013 when the provision of its services was privatized and outsourced to a single for-profit company. This article presents a summary of the experiences and concerns expressed by minority faith chaplains serving in federal correctional institutions following privatization. It is based on ten in-depth, semi-structured interviews with minority faith prison chaplains. The results show that minority faith federal prison chaplains are concerned about increased levels of bureaucratization that have compromised the quality of spiritual care available to prisoners, reductions in resources for chaplains, and increased levels of emotional exhaustion and frustration among themselves and fellow minority faith chaplains serving in Canadian correctional facilities.

scholarly journals Understanding Low-value Care and Associated De-implementation Processes: A Qualitative Study of Choosing Wisely Interventions Across Canadian Hospitals

2021 ◽  
Author(s):  
Gillian Parker ◽  
Monika Kastner ◽  
Karen Born ◽  
Nida Shahid ◽  
Whitney Berta
Keyword(s):  
Process Model ◽  
Healthcare Providers ◽  
Implementation Process ◽  
Choosing Wisely ◽  
Structured Interviews ◽  
Team Members ◽  
Implementation Processes ◽  
Healthcare Settings ◽  
National Campaigns ◽  
The Impact

Abstract Background:Choosing Wisely (CW) is an international movement comprised of national campaigns in more than 20 countries to reduce low-value care (LVC). Hospitals and healthcare providers are examining existing practices and putting interventions in place to reduce practices that offer little to no benefit to patients or may cause them harm. De-implementation, the reduction or removal of a healthcare practice is an emerging field of research. Little is known about the factors which (i) sustain LVC; and (ii) the magnitude of the problem of LVC. In addition, little is known about the processes of de-implementation, and if and how these processes differ from implementation endeavours. The objective of this study was to explicate the myriad factors which impact the processes and outcomes of de-implementation initiatives that are designed to address national Choosing Wisely campaign recommendations.Methods:Semi-structured interviews were conducted with individuals implementing Choosing Wisely Canada recommendations in healthcare settings in four provinces. The interview guide was developed using concepts from the literature and the Implementation Process Model (IPM) as a framework. All interviews were conducted virtually, recorded, and transcribed verbatim. Data were analysed using thematic analysis.Results:Seventeen Choosing Wisely team members were interviewed. Participants identified numerous provider factors, most notably habit, which sustain LVC. Contrary to reporting in recent studies, the majority of LVC in the sample was not ‘patient facing’; therefore, patients were not a significant driver for the LVC, nor a barrier to reducing it. Participants detailed aspects of the magnitude of the problems of LVC, specifically the impact of harm and resources. Unique factors influencing the processes of de-implementation reported were: influence of Choosing Wisely campaigns, availability of data, lack of targets and hard-coded interventions.Conclusions: This study explicates factors ranging from those which impact the maintenance of LVC to factors that impact the success of de-implementation interventions intended to reduce them. The findings draw attention to the significance of unintentional factors, highlight the importance of understanding the impact of harm and resources to reduce LVC and illuminate the overstated impact of patients in de-implementation literature. These findings illustrate the complexities of de-implementation.

scholarly journals Healing at the End of Life: The Voice of the Patient

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Cory Ingram
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Lived Experience ◽  
End Of Life ◽  
Life Story ◽  
Patient Centered ◽  
Whole Person ◽  
Centered Care ◽  
The Impact

In palliative care we have the privilege to care for seriously ill people and their families. Some people value capturing their life story or illness journey on film. I have been fortunate to have been invited into the lives of many people close the end of life for a heartfelt conversation.On an interactive iPad incorporated in the poster, the recorded narrative of patients and one bereft spouse the poster audience will experience the lived experience of people close to the end of life as they reflect on their lives. The narratives will demonstrate how each lived with a new found improved quality of life in the face of increasing symptoms, declining functioning and the approaching end of life; otherwise known as healing. Topics of healing and quality of life, patient-centered care, dignity, human development, spirituality and love will be the focus of their stories. The stories lay bare the very practical, emotional, existential, and personal experience central to our provision of whole person care through palliative care. The poster audience will experience a renewed sense of the impact of a dedicated approach to whole person care as experienced through those on the receiving end.

scholarly journals Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study

2021 ◽  
pp. 238008442110419
Author(s):  
M. Hijryana ◽  
M. MacDougall ◽  
N. Ariani ◽  
L.S. Kusdhany ◽  
A.W.G. Walls
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Environmental Factors ◽  
Periodontal Disease ◽  
Older People ◽  
Structured Interviews ◽  
Research Perspective ◽  
The Impact ◽  
People’S Perceptions

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.

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