scholarly journals Training hospital staff on spiritual care in palliative care influences patient-reported outcomes: Results of a quasi-experimental study

2016 ◽  
Vol 31 (8) ◽  
pp. 743-753 ◽  
Author(s):  
Joep van de Geer ◽  
Marieke Groot ◽  
Richtsje Andela ◽  
Carlo Leget ◽  
Jelle Prins ◽  
...  
Keyword(s):  
Palliative Care ◽  
Spiritual Care ◽  
Patient Reported Outcomes ◽  
Healthcare Professionals ◽  
Physical Symptoms ◽  
Spiritual Needs ◽  
Multidisciplinary Teams ◽  
Spiritual Distress ◽  
Patient Reported ◽  
Care Training

Background: Spiritual care is reported to be important to palliative patients. There is an increasing need for education in spiritual care. Aim: To measure the effects of a specific spiritual care training on patients’ reports of their perceived care and treatment. Design: A pragmatic controlled trial conducted between February 2014 and March 2015. Setting/participants: The intervention was a specific spiritual care training implemented by healthcare chaplains to eight multidisciplinary teams in six hospitals on regular wards in which patients resided in both curative and palliative trajectories. In total, 85 patients were included based on the Dutch translation of the Supportive and Palliative Care Indicators Tool. Data were collected in the intervention and control wards pre- and post-training using questionnaires on physical symptoms, spiritual distress, involvement and attitudes (Spiritual Attitude and Involvement List) and on the perceived focus of healthcare professionals on patients’ spiritual needs. Results: All 85 patients had high scores on spiritual themes and involvement. Patients reported that attention to their spiritual needs was very important. We found a significant ( p = 0.008) effect on healthcare professionals’ attention to patients’ spiritual and existential needs and a significant ( p = 0.020) effect in favour of patients’ sleep. No effect on the spiritual distress of patients or their proxies was found. Conclusion: The effects of spiritual care training can be measured using patient-reported outcomes and seemed to indicate a positive effect on the quality of care. Future research should focus on optimizing the spiritual care training to identify the most effective elements and developing strategies to ensure long-term positive effects. This study was registered at the Dutch Trial Register: NTR4559.

scholarly journals Multidisciplinary Training on Spiritual Care for Patients in Palliative Care Trajectories Improves the Attitudes and Competencies of Hospital Medical Staff: Results of a Quasi-Experimental Study

2017 ◽  
Vol 35 (2) ◽  
pp. 218-228 ◽  
Author(s):  
Joep van de Geer ◽  
Nic Veeger ◽  
Marieke Groot ◽  
Hetty Zock ◽  
Carlo Leget ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Spiritual Care ◽  
Health Care Professionals ◽  
Hospital Staff ◽  
Multicenter Trial ◽  
Teaching Hospitals ◽  
Spiritual Needs ◽  
Multidisciplinary Teams ◽  
Quasi Experimental

Objectives: Patients value health-care professionals’ attention to their spiritual needs. However, this is undervalued in health-care professionals’ education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. Methods: A pragmatic multicenter trial using a quasi-experimental pretest–posttest design as part of an action research study. Eight multidisciplinary teams in regular wards and 1 team of PC consultants, in 8 Dutch teaching hospitals, received questionnaires before training about perceived barriers for SC, spiritual attitudes and involvement, and SC competencies. The effect on the barriers on SC and SC competencies were measured both 1 and 6 months after the training. Results: For nurses (n = 214), 7 of 8 barriers to SC were decreased after 1 month, but only 2 were still after 6 months. For physicians (n = 41), the training had no effect on the barriers to SC. Nurses improved in 4 of 6 competencies after both 1 and 6 months. Physicians improved in 3 of 6 competencies after 1 month but in only 1 competency after 6 months. Significance of Results: Concise SC training programs for clinical teams can effect quality of care, by improving hospital staff competencies and decreasing the barriers they perceive. Differences in the effects of the SC training on nurses and physicians show the need for further research on physicians’ educational needs on SC.

scholarly journals Training Spiritual Care in Palliative Care in Teaching Hospitals in the Netherlands (SPIRIT-NL): A Multicentre Trial.

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Joep Van De Geer ◽  
Hetty Zock ◽  
Carlo Leget ◽  
Nic Veeger ◽  
Jelle Prins ◽  
...  
Keyword(s):  
Palliative Care ◽  
The Netherlands ◽  
Spiritual Care ◽  
Healthcare Professionals ◽  
Multicentre Trial ◽  
Physical Symptoms ◽  
Teaching Hospitals ◽  
Medical Specialization ◽  
Palliative Care Consultation ◽  
Palliative Care Teams

Background: In the Netherlands, the spiritual dimension in healthcare became marginal in the second part of the twentieth century. In the Dutch healthcare system, palliative care is not a medical specialization and teaching hospitals do not have specialist palliative care units with specialized palliative care teams. Palliative care in these hospitals is delivered by healthcare professionals in general departments (mainly curative focused ones), and is based on multidisciplinary guidelines supported by palliative care consultation teams. A national multidisciplinary guideline on spiritual care is included, but standardized training based on this guideline still lacks. Implementation of this guideline is expected to have a positive effect on quality of care but is in an early state, the role of the specialists in this field—the healthcare chaplains—is developing. The objective of this article is to present the protocol of this study and stimulate discussion about methods of research on spirituality and spiritual care.Methods and Findings: This action research study is planned as an explorative multicentre trial. Healthcare chaplains of ten teaching hospitals will offer training onspiritual care in palliative care for healthcare professionals. What is the effect of this intervention on the competences of clinical teams? What is the effect on the perceived care and treatment as experienced by patients? The effects of the intervention on the competences of the clinicians will be measured once pre-study and twice post-study. Effects on patients’ physical symptoms and spiritual distress, and the perceived focus of caregivers on their spiritual needs or existential questions will also be measured pre- and post-study.

scholarly journals Dignity Therapy Led by Nurses or Chaplains for Elderly Cancer Palliative Care Outpatients: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Sheri Kittelson ◽  
Lisa Scarton ◽  
Paige Barker ◽  
Joshua Hauser ◽  
Sean O'Mahony ◽  
...  
Keyword(s):  
Palliative Care ◽  
Elderly Patients ◽  
Usual Care ◽  
Patient Outcomes ◽  
Spiritual Care ◽  
Physical Symptoms ◽  
Cancer Prognosis ◽  
Care Group ◽  
Spiritual Distress ◽  
Patients With Cancer

BACKGROUND Our goal is to improve psychosocial and spiritual care outcomes for elderly patients with cancer by optimizing an intervention focused on dignity conservation tasks such as settling relationships, sharing words of love, and preparing a legacy document. These tasks are central needs for elderly patients with cancer. Dignity therapy (DT) has clear feasibility but inconsistent efficacy. DT could be led by nurses or chaplains, the 2 disciplines within palliative care that may be most available to provide this intervention; however, it remains unclear how best it can work in real-life settings. OBJECTIVE We propose a randomized clinical trial whose aims are to (1) compare groups receiving usual palliative care for elderly patients with cancer or usual palliative care with DT for effects on (a) patient outcomes (dignity impact, existential tasks, and cancer prognosis awareness); and (b) processes of delivering palliative spiritual care services (satisfaction and unmet spiritual needs); and (2) explore the influence of physical symptoms and spiritual distress on the outcome effects (dignity impact and existential tasks) of usual palliative care and nurse- or chaplain-led DT. We hypothesize that, controlling for pretest scores, each of the DT groups will have higher scores on the dignity impact and existential task measures than the usual care group; each of the DT groups will have better peaceful awareness and treatment preference more consistent with their cancer prognosis than the usual care group. We also hypothesize that physical symptoms and spiritual distress will significantly affect intervention effects. METHODS We are conducting a 3-arm, pre- and posttest, randomized, controlled 4-step, stepped-wedge design to compare the effects of usual outpatient palliative care and usual outpatient palliative care along with either nurse- or chaplain-led DT on patient outcomes (dignity impact, existential tasks, and cancer prognosis awareness). We will include 560 elderly patients with cancer from 6 outpatient palliative care services across the United States. Using multilevel analysis with site, provider (nurse, chaplain), and time (step) included in the model, we will compare usual care and DT groups for effects on patient outcomes and spiritual care processes and determine the moderating effects of physical symptoms and spiritual distress. RESULTS The funding was obtained in 2016, with participant enrollment starting in 2017. Results are expected in 2021. CONCLUSIONS This rigorous trial of DT will constitute a landmark step in palliative care and spiritual health services research for elderly cancer patients. CLINICALTRIAL ClinicalTrials.gov NCT03209440; https://clinicaltrials.gov/ct2/show/NCT03209440 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12213

Facilitating the Provision of Quality Spiritual Care in Palliative Care

2013 ◽  
Vol 67 (1-2) ◽  
pp. 37-41 ◽  
Author(s):  
Hillel Bodek
Keyword(s):  
Palliative Care ◽  
Spiritual Care ◽  
Healthcare Professionals ◽  
Social Suffering ◽  
Critical Component ◽  
Consensus Panel ◽  
Hospice Movement ◽  
Total Pain ◽  
Care Training ◽  
Core Principle

In 1948, Dame Cicely Saunders, the founder of the modern hospice movement, established a core principle of palliative care, Total Pain, which is defined as physical, spiritual, psychological, and social suffering. In 2009, a consensus panel (Puchalski, Ferrell, Virani, Otis-Green, Baird, Bull, et al., 2009) was convened to address the important issue of integrating spirituality in palliative care, which led to renewed efforts to focus on spiritual care as a critical component of quality palliative care. This project is a combination of advocacy for the importance of spiritual care, training chaplains, seminarians, community clergy, and healthcare professionals in palliative care, and creating a spiritual care curriculum which can be self-taught or taught to members of transdisciplinary teams.

The Support, Education, and Advocacy (SEA) Program of Care for Women With Metastatic Breast Cancer: A Nurse-Led Palliative Care Demonstration Program

2019 ◽  
Vol 36 (10) ◽  
pp. 864-870 ◽  
Author(s):  
Victoria Reiser ◽  
Margaret Rosenzweig ◽  
Ann Welsh ◽  
Dianxu Ren ◽  
Barbara Usher
Keyword(s):  
Breast Cancer ◽  
Palliative Care ◽  
Social Service ◽  
Patient Reported Outcomes ◽  
Metastatic Breast ◽  
Well Being ◽  
Mean Difference ◽  
Generalized Anxiety ◽  
Supportive Services ◽  
Patient Reported

Background: Women with metastatic breast cancer (MBC) experience unique symptom management and psychosocial needs due to aggressive, yet palliative treatment with a progressive, chronic illness. Objective: This article describes the effect of a quality improvement project for coordination of supportive care in MBC. Program evaluations included referral rates for supportive services, patient-reported outcomes of symptom distress, generalized anxiety, and overall well-being. Design: An interdisciplinary Support, Education and Advocacy Program (MBC-SEA) was developed. The 1-hour, weekly, patient review included collaborative assessments to determine needs for social service, psychological counseling, and palliative care. A prospective pre- and postexperimental cohort design with convenience sampling was used. Analysis was conducted with paired t test analysis of pre- and postimplementation outcomes. Setting/Participants: Program outcomes of 118 women with MBC visiting an urban outpatient breast cancer clinic during September 2016 to November 2016 (pre) and January 2017 to March 2017 (post) were evaluated. Measurements: Referral rates to social work and palliative care, symptom, anxiety, and overall well-being scores. Results: Following program implementation, referrals to palliative care and social work supportive services increased significantly including patient-reported outcomes symptom distress scores mean difference 1.4 (95% confidence interval [CI]: 0.4306-2.6428), P = .004; generalized anxiety scores mean difference 1.5 (95% CI: 0.5406-2.5781), P = .003; and overall well-being mean difference of −0.7 (95% CI: −1.3498 to −0.0570), P = .03. Conclusions: Purposeful nurse-led assessment for social service and palliative care needs increases referrals with improvement in patient-reported outcomes.

Provisional Educational Needs of Health Care Providers in Palliative Care in Three Nursing Homes in Ontario

1997 ◽  
Vol 13 (3) ◽  
pp. 13-17 ◽  
Author(s):  
Chris Patterson ◽  
William Molloy ◽  
Rosalie Jubelius ◽  
G.H. Guyatt ◽  
M. Bédard
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Nursing Homes ◽  
Health Care Providers ◽  
Educational Needs ◽  
Physical Symptoms ◽  
Spiritual Needs ◽  
Care Providers ◽  
Pharmacological Management ◽  
Traditional Lectures

Health care providers in three nursing homes in Ontario were surveyed to determine educational needs, barriers to meeting these needs, and the preferred format for education. Of the 415 health care providers asked to participate, 225 completed the questionnaire. Need was expressed for the majority of the 35 educational topics identified, including the role of the palliative care team, management of physical symptoms, pharmacological and non-pharmacological management of pain, stress management, spiritual needs, culture and death, and counseling. Group discussions and seminars were favored over traditional lectures. The primary factors influencing attendance at a palliative care workshop were loss of pay and time and location of the workshop.

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