scholarly journals Palliative care needs and experiences of people in prison: A systematic review and meta-synthesis

2021 ◽  
pp. 026921632110682
Author(s):  
Isabelle Schaefer ◽  
Michelle DiGiacomo ◽  
Nicole Heneka ◽  
Stacey Panozzo ◽  
Tim Luckett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Qualitative Data ◽  
Prison Population ◽  
Perceived Barriers ◽  
Care Provision ◽  
Care Needs ◽  
Prison Environment ◽  
To Receive ◽  
Palliative Care Needs

Background: Globally, the prison population is growing and ageing, as is the need for palliative care. Yet, little is known about how people in prison perceive palliative care provision in this setting. Aims: To identify the: (i) perceptions of palliative care provision and dying in custody by people in prison; and (ii) perceived barriers and facilitators of person-centred palliative care provision in prison. Design: A systematic review and meta-synthesis was registered and undertaken in accordance with the reporting guidelines. Data Sources: Keywords and MeSH headings encompassing (i) palliative care, end-of-life care, death; and (ii) prison; were used to search Pubmed, Medline, CINAHL, PsycINFO, Web of Science, CINCH and ProQuest Central. Articles published in English, from high income countries, and containing qualitative data exploring perceptions of people in prison of palliative care in custody were included. Findings were reporting using the ENTREQ guidelines. Findings: Of the 2193 articles identified, 12 were included. Experiences of people in prison regarding palliative care related to two themes: (1) expectations versus experiences of palliative care; and (2) prison context complicates access to and provision of palliative care. People in prison with palliative care needs want to feel safe, cared for, and acknowledged as they face an expected death. The prison environment can severely restrict access to palliative care, leaving people in prison feeling isolated and powerless. Conclusions: People in prison expect to receive high-quality palliative care, but their experiences often do not match their expectations. Numerous structural and organisational challenges complicate the provision of palliative care in prisons, limiting accessibility of care.

scholarly journals 188 Identification of patients with potential palliative care needs: a systematic review of screening tools in primary care

2020 ◽  
Author(s):  
Yousuf ElMokhallalati ◽  
Stephen H Bradley ◽  
Emma Chapman ◽  
Lucy Ziegler ◽  
Fliss EM Murtagh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Palliative Care ◽  
Screening Tools ◽  
Care Needs ◽  
Palliative Care Needs

scholarly journals Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review

2020 ◽  
pp. 026921632096394 ◽  
Author(s):  
Stephanie MC Ament ◽  
Inge ME Couwenberg ◽  
Josiane JJ Boyne ◽  
Jos Kleijnen ◽  
Henri EJH Stoffers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Care Process ◽  
Care Needs ◽  
Process Guidance ◽  
Palliative Care Needs

Background: The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. Aim: To identify tools to help healthcare professionals recognize palliative care needs in patients with advanced chronic heart failure. Design: This systematic review was registered in the PROSPERO database (CRD42019131896). Evidence of tools’ development, evaluation, feasibility, and implementation was sought and described. Data sources: Electronic searches to identify references of tools published until June 2019 were conducted in MEDLINE, CINAHL, and EMBASE. Hand-searching of references and citations was undertaken. Based on the identified tools, a second electronic search until September 2019 was performed to check whether all evidence about these tools in the context of chronic heart failure was included. Results: Nineteen studies described a total of seven tools. The tools varied in purpose, intended user and properties. The tools have been validated to a limited extent in the context of chronic heart failure and palliative care. Different health care professionals applied the tools in various settings at different moments of the care process. Guidance and instruction about how to apply the tool revealed to be relevant but may be not enough for uptake. Spiritual care needs were perceived as difficult to assess. Conclusion: Seven tools were identified which showed different and limited levels of validity in the context of palliative care and chronic heart failure.

scholarly journals A systematic review of classifications systems to determine complexity of patient care needs in palliative care

2021 ◽  
pp. 026921632199698
Author(s):  
Matthew Grant ◽  
Everlien de Graaf ◽  
Saskia Teunissen
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Patient Care ◽  
Clinical Care ◽  
Health Care Team ◽  
Service Planning ◽  
Classification Systems ◽  
Care Needs ◽  
The Right ◽  
Palliative Care Needs

Background: Providing the right care for each individual patient is a key element of quality palliative care. Complexity is a relatively new concept, defined as the nature of patients’ situations and the extent of resulting needs. Classifying patients according to the complexity of their care needs can guide integration of services, anticipatory discussions, health service planning, resource management and determination of needs for specialist or general palliative care. However, there is no consistent approach to interpreting and classifying complexity of patient needs. Aim: The aim of this article is to identify and describe classification systems for complexity of patient care needs in palliative care. Design: Narrative systematic review (PROSPERO registration number CRD42020182102). Data sources: MEDLINE, Embase, CINAHL and PsychINFO databases were searched without time limitations. Articles were included that described classification systems for complexity of care requirements in populations with palliative care needs. Results: In total, 4301 records were screened, with nine articles identified reporting the use of patient classification systems in populations with palliative care needs. These articles included the use of six classification systems: HexCom, Perroca Scale, AN-SNAP, Hui Major Criteria, IDC-Pal and PALCOM. These systems were heterogenous in the manner they determined complexity of care needs. The HexCom and IDC-Pal systems contained items that covered all domains of complexity as described by Hodiamont; personal, social support, health care team and environment. Conclusion: Although six classification systems have been developed, they access differing aspects of care needs and their application has been limited. The HexCOM and IDC-Pal systems offer the broadest determinations of complexity from an individual perspective. Further research is needed to apply these systems to populations external to those in which they were developed, and to appreciate how they may integrate with, and impact, clinical care.

scholarly journals What constitutes a palliative care need in people with serious illnesses across Africa? A mixed-methods systematic review of the concept and evidence

2021 ◽  
pp. 026921632110087
Author(s):  
Oladayo A Afolabi ◽  
Kennedy Nkhoma ◽  
Matthew Maddocks ◽  
Richard Harding
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Mixed Methods ◽  
Health Literacy ◽  
Health Coverage ◽  
Care Needs ◽  
Eligibility Criteria ◽  
Care Assessment ◽  
Context Specific ◽  
Palliative Care Needs

Background: Clarity on what constitutes a palliative care need is essential to ensure that health systems and clinical services deliver an appropriate response within Universal Health Coverage. Aim: To synthesise primary evidence from Africa for palliative care needs among patients and families with serious illness. Design: We conducted a mixed methods systematic review with sequential synthesis design. The protocol was registered with PROSPERO (CRD42019136606) and included studies were quality assessed using Mixed Method Appraisal Tool. Data sources: Six global literature databases and Three Africa-specific databases were searched up to October 2020 for terms related to palliative care, serious illnesses and Africa. Palliative care need was defined as multidimensional problems, symptoms, distress and concerns which can benefit from palliative care. Results: Of 7810 papers screened, 159 papers met eligibility criteria. Palliative care needs were mostly described amongst patients with HIV/AIDS ( n = 99 studies) or cancer ( n = 59), from East ( n = 72) and Southern ( n = 89) Africa. Context-specific palliative care needs included managing pregnancy and breastfeeding, preventing infection transmission (physical); health literacy needs, worry about medical bills (psychological); isolation and stigma, overwhelmed families needing a break, struggling to pay children’s school fees and selling assets (social and practical needs); and rites associated with cultural and religious beliefs (spiritual). Conclusions: Palliative care assessment and care must reflect the context-driven specific needs of patients and families in Africa, in line with the novel framework. Health literacy is a crucial need in this context that must be met to ensure that the benefits of palliative care can be achieved at the patient-level.

scholarly journals Improving palliative care provision in primary care: a pre- and post-survey evaluation among PaTz groups

2018 ◽  
Vol 68 (670) ◽  
pp. e351-e359 ◽  
Author(s):  
Annicka GM van der Plas ◽  
H Roeline W Pasman ◽  
Bart Schweitzer ◽  
Bregje D Onwuteaka-Philipsen
Keyword(s):  
Palliative Care ◽  
Added Value ◽  
Care Provision ◽  
Care Needs ◽  
Post Evaluation ◽  
Post Test ◽  
Systematic Identification ◽  
Survey Evaluation ◽  
Palliative Care Needs ◽  
Existential Issues

BackgroundIn PaTz (PAlliatieve Thuis Zorg, palliative care at home), modelled after the Gold Standards Framework, GPs and community nurses meet on a regular basis to identify patients with palliative care needs (the PaTz register), and to discuss care for these patients.AimTo study the effects of the implementation of PaTz, and provide additional analyses on two important elements: the PaTz register and patient discussions.Design and settingA pre- and post-evaluation among Dutch GPs (n = 195 before the start of PaTz; n = 166, 1 year after the start of PaTz). The GPs also provided data on recently deceased patients (n = 460 before the start of PaTz; n = 305 14 months after the start of PaTz).MethodGPs from all 37 PaTz groups filled in questionnaires. Pre- and post-test differences were analysed using multilevel analyses to adjust for PaTz group.ResultsIdentification of patients with palliative care needs was done systematically for more patients after implementation of PaTz compared with before (54.3% versus 17.6%). After implementation, 64.8% of deceased patients had been included on the PaTz register. For these patients, when compared with patients not included on the PaTz register, preferred place of death was more likely to be known (88.1% of patients not on the register and 97.3% of deceased patients included on the register), GPs were more likely to have considered a possible death sooner (>1 month before death: 53.0% and 80.2%), and conversations on life expectancy, physical complaints, existential issues, and possibilities of care occurred more often (60.8% and 81.3%; 68.6% and 86.1%; 22.5% and 34.2%; 60.8% and 84.0%, respectively).ConclusionsImplementation of PaTz improved systematic identification of palliative care patients within the GP practice. Use of the PaTz register has added value.

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