scholarly journals Ethical issues in nursing home palliative care: a cross-national survey

2018 ◽  
Vol 10 (3) ◽  
pp. e29-e29 ◽  
Author(s):  
Deborah H. L. Muldrew ◽  
Sharon Kaasalainen ◽  
Dorry McLaughlin ◽  
Kevin Brazil
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Ethical Issues ◽  
Survey Design ◽  
Family Values ◽  
Ageing Population ◽  
Policy Recommendations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Uk

ObjectivesWith an increased dependency on nursing homes to provide care to the ageing population, it is likely that ethical issues will also increase. This study aimed to identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada, and pilot the Ethical issues in Palliative Care for Nursing Homes (EPiCNH) instrument in Canada.MethodsA cross-sectional survey design was used. One hundred and twenty-three nurses located in 21 nursing homes across the UK and Canada completed the EPiCNH instrument.ResultsFrequent ethical issues include upholding resident autonomy, managing family distress, lack of staff communication and lack of time in both countries. Higher levels of distress resulted from poor communication, insufficient training, lack of time and family disagreements. Nurses in Canada experienced a greater frequency of ethical issues (p=0.022); however, there was no statistical difference in reported distress levels (p=0.53). The survey was positively rated for ease of completion, relevance and comprehensiveness.ConclusionsNurses’ reported comparable experiences of providing palliative care in UK and Canadian nursing homes. These findings have implications on the practice of care in nursing homes, including how care is organised as well as capacity of staff to care for residents at the end of life. Training staff to take account of patient and family values during decision-making may address many ethical issues, in line with global policy recommendations. The EPiCNH instrument has demonstrated international relevance and applicability.

scholarly journals The palliative care knowledge of nursing home staff: The EU FP7 PACE cross-sectional survey in 322 nursing homes in six European countries

2018 ◽  
Vol 32 (9) ◽  
pp. 1487-1497 ◽  
Author(s):  
Tinne Smets ◽  
Lara Pivodic ◽  
Ruth Piers ◽  
H Roeline W Pasman ◽  
Yvonne Engels ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
The Netherlands ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Specific Knowledge ◽  
Cross Sectional ◽  
Care Survey ◽  
Substantial Heterogeneity ◽  
Representative Samples

Background: The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. Aim: This study assesses the palliative care knowledge of staff in NHs in Europe. Design: Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy. Palliative care knowledge is measured with the Palliative Care Survey. Scores on the scales range between 0 and 1; higher scores indicate more knowledge. Results: A total of 3392 NH-staff were given a questionnaire, and 2275 responded (67%). Knowledge of basic palliative care issues ranged between 0.20 in Poland (95% confidence interval (CI) 0.19; 0.24) and 0.61 in Belgium (95% CI 0.59; 0.63), knowledge of physical aspects that can contribute to pain ranged between 0.81 in Poland (95% CI 0.79; 0.84) and 0.91 in the Netherlands (95% CI 0.89; 0.93), and knowledge of psychological reasons that can contribute to pain ranged between 0.56 in England (95% CI 0.50; 0.62) and 0.87 in Finland (95% CI 0.83; 0.90). Factors associated with knowledge were country, professional role and having undertaken formal training in palliative care. Conclusions: Knowledge of nurses and care assistants concerning basic palliative care issues appears to be suboptimal in all participating countries, although there is substantial heterogeneity. Education of nursing staff needs to be improved across, but each country may require its own strategy to address the unique and specific knowledge gaps.

scholarly journals The factors of adaptation to nursing homes in mainland China: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Changxian Sun ◽  
Yiting Yu ◽  
Xuxu Li ◽  
Yan Cui ◽  
Yaping Ding ◽  
...  
Keyword(s):  
Social Support ◽  
Nursing Home ◽  
Nursing Homes ◽  
Filial Piety ◽  
Mainland China ◽  
Stressful Events ◽  
Ageing Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care

Abstract Background China is one of the most rapidly ageing countries and has the largest ageing population in the world. The demand for long-term care is increasing. Nursing home placement is one of the most stressful events in a person’s life. Although research on relocation adjustment has been conducted in many countries, few studies have been related to the predictors of nursing home adjustment in mainland China. This study aimed to identify the predictors of nursing home adjustment in the context of filial piety in mainland China. Methods This was a descriptive study that employed a cross-sectional survey. A total of 303 residents from 22 nursing homes in Nanjing, China, were recruited. A structured questionnaire about residents’ characteristics, activities of daily living, social support, resilience, and nursing home adjustment was administered. Multiple linear regression was used to identify the predictors of adaptation to nursing homes. Results The predictors of nursing home adjustment were the satisfaction with services(β = .158, P < .01), number of diseases(β = −.091, P < .05), length of stay(β = .088, P < .05), knowledge of the purpose of admission (β = .092, P < .05), resilience(β = .483, P < .001) and social support(β = .186, P < .001). The total explained variance for this model was 61.6%. Conclusion Nursing staff members should assess the characteristics of residents to promote their better adjustment. Resilience had the most significant influence on the level of adaptation, which has been the primary focus of interventions to improve adjustment. The management of disease comorbidities in nursing homes should be standardized and supervised by the government. More volunteers from universities and communities should be encouraged to provide social support to residents. Moreover, a caring culture needs to be emphasized, and the value of filial piety should be advocated in nursing homes of East Asian countries.

scholarly journals 2084

2017 ◽  
Vol 1 (S1) ◽  
pp. 53-53
Author(s):  
Jane Otado ◽  
Veronica Thomas ◽  
Shawneequa Callier ◽  
Faun Rockcliffe ◽  
Dietrich Johnson ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Survey Design ◽  
African Descent ◽  
Genetic Research ◽  
Population Data ◽  
The United States ◽  
Genetic Profile ◽  
Willingness To Participate ◽  
Cross Sectional Survey ◽  
Cross Sectional

OBJECTIVES/SPECIFIC AIMS: The purpose of this descriptive study is to explore knowledge, attitudes, and behaviors related to genetics and genetic research in a sample of persons of African descent. METHODS/STUDY POPULATION: Data were generated using a cross-sectional survey design. A nonprobability sample of 272 persons of African descent, ages 18 and older, were recruited from the Washington, DC metropolitan area through public advertisement and word-of-mouth. Participants had diverse backgrounds with most born in the United States (93%), female (71%), some college or above education (57%), household income under $40,000 (54%), and some with a reported disability (38%). Before survey recruitment and administration, this study was reviewed and approved by the Howard University Institutional Review Board. RESULTS/ANTICIPATED RESULTS: The majority (79.8%) of the participants considered themselves as having a “fair” to “good” knowledge of genetics. The sample had a 2.24 (SD=77) mean score on the 5-item genetics knowledge questionnaire with total possible mean scores ranging from 0 (no correct responses) to 5 (all correct responses). Most (53.3%) participants believe it is important for persons of African descent to participate in genetic research. However, almost one-half (46.7%) felt that information from genetic research can be used to discriminate against minorities. In terms of behaviors, 83.4% of the participants never had genetic testing conducted. However, an overwhelming majority reported that they would be willing to participate in a genetic research project specifically for detection of risk factors such as cancer (87%), diabetes (89.3%), Alzheimer disease (88.6%), and alcohol use disorder (75%). DISCUSSION/SIGNIFICANCE OF IMPACT: This investigation suggests that persons of African descent generally view participation in genetic research as important and are willing to have their genetic profile analyzed to detect susceptibility to certain diseases. However, ethical issues, such as misuse of genetic research to discriminate against minorities, remain a prominent concern. Further studies are needed to illuminate KABEs and to help identify the role these factors may play in this population’s willingness to participate in testing and research. Such information could provide invaluable insight to the development and implementation of more ethical and culturally competence strategies for recruiting minority participants into genetic research.

Circumstances of hospital admissions in palliative care: A cross-sectional survey of patients admitted to hospital with palliative care needs

2018 ◽  
Vol 32 (5) ◽  
pp. 1030-1036 ◽  
Author(s):  
Jackie Robinson ◽  
Merryn Gott ◽  
Rosemary Frey ◽  
Christine Ingleton
Keyword(s):  
Palliative Care ◽  
Hospital Admissions ◽  
Community Services ◽  
Ageing Population ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care At Home ◽  
Palliative Care Needs ◽  
At Home

Background: On average, people will experience 2.28 hospital admissions in the last year of life with the likelihood of a hospital admission increasing in the last 2 weeks of life. Reducing hospital admissions has become a focus for high-income countries as they work to manage the financial implications of an ageing population. However, the circumstances by which patients with palliative care needs are admitted to hospital remain poorly understood. Aim: To explore the circumstances of hospital admissions for patients with palliative care needs. Design: Cross-sectional survey design using face-to-face questionnaires. Setting/participants: In total, 116 patients aged >18 years admitted to a tertiary hospital with palliative care needs. Results: Those with a non-cancer diagnosis and those aged over 75 years were less likely to have hospice involved prior to the admission ( x2 (1, n = 116) = 10.19, p = 0.00). Few patients recognised community services as having a role in enabling them to remain at home. Those with cancer placed a significantly higher priority on receiving information about their illness ( t(114) = 2.03, p = 0.04) and receiving tests and investigations ( t(114) = 2.37, p = 0.02) in hospital. Conclusion: This study has demonstrated the complexity of hospital admissions in palliative care. Further research is needed to explore patient perceptions of care at home and the role of community services to enable them to remain at home. Understanding the motivation to come to hospital in the context of an incurable illness and limited treatment options may help to inform the development of services that can enable better care at home.

scholarly journals Ethical issues experienced during palliative care provision in nursing homes

2018 ◽  
Vol 26 (6) ◽  
pp. 1848-1860 ◽  
Author(s):  
Deborah HL Muldrew (née Preshaw) ◽  
Dorry McLaughlin ◽  
Kevin Brazil
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Nursing Homes ◽  
Registered Nurses ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Shared Environment ◽  
Care Provision ◽  
Cross Sectional Survey ◽  
The United Kingdom

Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context. Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom. Design: Exploratory, sequential, mixed-methods design. Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015. Ethical considerations: Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager. Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress. Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change.

Graduating nurses' knowledge of palliative and end-of-life care

2020 ◽  
Vol 26 (1) ◽  
pp. 5-12
Author(s):  
Ann Selena Cleary
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Baccalaureate Nursing ◽  
Survey Design ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Eol Care ◽  
Care Course ◽  
Nurses Knowledge

Background: Generalist nurses frequently care for people who have advanced chronic diseases in decline, or who are dying. Few studies have measured graduating nurses' knowledge about end-of-life (EoL) care. Aims: To measure and compare knowledge about EoL care using the palliative care quiz for nurses among two cohorts of graduating nurses in a baccalaureate nursing programme. Methods: A quantitative cross-sectional survey design using a convenience sample of two cohorts of students. Findings: Total mean scores were low at 44.5% and 46.5% for the cohorts, respectively; this was not statistically significant. Misconceptions related to presentation and symptom management of the dying patient and integration of palliative with acute care. Palliative care knowledge was higher among the cohort who completed the dedicated EoL care course. Conclusion: Significant misconceptions about EoL care exist among these graduating nurses; this information provides direction for curriculum revision.

scholarly journals The Prevalence of Cognitive Impairment on Admission to Nursing Home among Residents with and without Stroke: A Cross–Sectional Survey of Nursing Homes in Ireland

2020 ◽  
Vol 17 (19) ◽  
pp. 7203
Author(s):  
Nora-Ann Donnelly ◽  
Eithne Sexton ◽  
Niamh A. Merriman ◽  
Kathleen E. Bennett ◽  
David J Williams ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Cognitive Status ◽  
Service Planning ◽  
Nursing Home Admission ◽  
Ageing Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prevalence Estimates

Post–stroke cognitive impairment (PSCI) is a common consequence of stroke. Epidemiological evidence indicates that, with an ageing population, stroke and PSCI are likely to increase in the coming decades. This may have considerable implications for the demand for nursing home placement. As prevalence estimates of both cognitive impairment and dementia on admission to nursing home among residents with and without stroke have not yet been compared, they were estimated and compared in this study. We performed a cross–sectional survey to establish the admission characteristics of 643 residents in 13 randomly selected nursing homes in Ireland. The survey collected data on resident’s stroke and cognitive status at the time of nursing home admission. The survey found, among nursing home residents that experienced stroke prior to admission, prevalence estimates for cognitive impairment (83.8%; 95% CI = 76.9–90.6%) and dementia (66.7%; 95% CI = 57.9–75.4%) were significantly higher compared to residents that had not experienced stroke prior to admission (cognitive impairment: 56.6%; 95% CI = 52.4–60.8%; X2 (1) = 28.64; p < 0.001; dementia: 49.8%; 95% CI = 45.6–54.1%; X2 (1) = 10.47; p < 0.01). Since the prevalence of PSCI is likely to increase in the coming decades, the findings highlight an urgent need for health service planning for this increased demand for nursing home care to meet the care needs of these stroke survivors.

scholarly journals A quantitative assessment of the parameters of the role of receptionists in modern primary care using the work design framework

2019 ◽  
Author(s):  
Michael Burrows ◽  
Nicola Gale ◽  
Sheila Greenfield ◽  
Ian Litchfield
Keyword(s):  
Primary Care ◽  
Cognitive Load ◽  
Survey Design ◽  
Work Design ◽  
Social Characteristics ◽  
Valuable Insight ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
The Uk

Abstract Background General practice faces unprecedented demands as the UK population ages and care complexity increases. Amidst these increased pressures, the receptionist continues to fulfil key administrative and clinically related tasks. The need for more robust support for these key personnel to ensure they stay focussed and motivated is apparent, but for this to be effective a more systematic understanding of the parameters of their work is required. Here we present a valuable insight into the tasks they fulfil their relationship with colleagues and their organisation, and their attitudes and behaviour at work collectively defined as their ‘work design’. Methods Our aim was to quantitatively assess the various characteristics of receptionists in UK primary care using the validated Work Design Questionnaire. A cross-sectional survey design was employed with receptionists randomly sampled from general practices across the UK. We used the Work Design Questionnaire (WDQ) a 21 point validated questionnaire, divided into four categories: task, knowledge and social characteristics and work context with a series of sub-categories within each. Results Seventy participants completed the WDQ. Receptionists reported high task variety, task significance and high level of information processing, confirming the high cognitive load placed on them by performing numerous yet significant tasks. This complex role required an array of skills and there was a reliance on colleagues for support and feedback. Conclusion Research with modern GP receptionists is sparse and little is known formally regarding the parameters of the role. This research explores the work design of GP receptionists and offers clinicians in practice a practical overview of this important and essential role and its implications for the modern GP practice. We suggest a number of ways in to better support the modern receptionist, including separating complex tasks to avoid the errors involved with high cognitive load, providing informal feedback and developing training programmes.

PERCEIVED EFFECTS OF STREET HAWKING ON THE WELL-BEING OF CHILDREN IN ANYIGBA, DEKINA LOCAL GOVERNMENT AREA OF KOGI STATE, NIGERIA

2018 ◽  
Vol 8 (1) ◽  
pp. 01-07
Author(s):  
Alfred Eboh
Keyword(s):  
Local Government ◽  
Survey Design ◽  
Sampling Technique ◽  
Well Being ◽  
Local Government Area ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Perceived Effects ◽  
The Government

Background: The hawking of wares by children has been a serious issue confronting the Nigerian society. Children hawk in some of the most horrible conditions conceivable, where they face a serious risk of injury, chronic illness, kidnapping, rape or death. Objective: The focus of this study was to assess the perceived effects of street hawking on the well-being of children in Anyigba, Dekina Local Government Area of Kogi State. Methods: The population of this study consists of parents of the street hawkers in Anyigba while cross-sectional survey design was used through the purposive sampling technique to choose the sample size of one hundred and sixty-two (162) respondents. The validated structured questionnaire and In-Depth Interviews (IDIs) served as the instruments for the data collection respectively. The hypotheses were tested using Chi-Square at a predetermined 0.05 level of significance. The quantitative data were analysed with the aid of the SPSS (version 20). Results: The results indicated among others that street hawking had significant social implications and physical consequences on children's moral behaviour as well as health status in the study area. Conclusion: The study, therefore, concluded that the government of Kogi State should carry out an enlightenment campaign through the media and religious institutions on the negative consequences of street hawking are recommended as panacea. Also, the child right act instrument and its implementation should be strengthened in order to curb street hawking in the study area.

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