Observational Pain Assessment Instruments for Use With Nonverbal Patients at the End-of-life: A Systematic Review

2019 ◽  
Vol 34 (4) ◽  
pp. 255-266 ◽  
Author(s):  
Diane Tapp ◽  
Sara Chenacher ◽  
Ngangue Patrice Alain Gérard ◽  
Philippe Bérubé-Mercier ◽  
Celine Gelinas ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Pain Assessment ◽  
Reliability And Validity ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Severe Illness ◽  
Assessment Instruments ◽  
Measurement Instruments ◽  
Health Measurement

Purpose: To review studies pertaining to the reliability and validity of observational pain assessment tools for use with nonverbal patients at the end-of-life, a field of research not documented by previous systematic reviews. Methods: Databases (PubMed, Embase, Epistemonikos, the Cochrane Library, and CINAHL) were systematically searched for studies from study inception to February 21, 2016 (update in May 9, 2018). Two independent reviewers screened study titles, abstracts, and full texts according to inclusion and exclusion criteria. Disagreements were resolved through consensus. Reviewers also extracted the psychometrics properties of studies of observational pain assessment instruments dedicated to a noncommunicative population in palliative care or at the end-of-life. A comprehensive quality assessment was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) to derive poor, fair, good or excellent ratings for the psychometric tests reported in each study. Results: Four studies linked to 4 different tools met the inclusion criteria. Study populations included dementia, palliative care and severe illness in the context of intensive care. All the studies included in this review obtained poor COSMIN ratings overall. Conclusions: At this point, it is impossible to recommend any of the tools evaluated given the low number and quality of the studies. Other analyses and studies need to be conducted to develop, adapt, or further validate observational pain instruments for the end-of-life population, regardless of the disease.

scholarly journals Informant-based assessment instruments for dementia and their measurement properties in persons with intellectual disability: systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040920
Author(s):  
Elisabeth L Zeilinger ◽  
Sophie Komenda ◽  
Irina Zrnic ◽  
Fabian Franken ◽  
Katharina Woditschka
Keyword(s):  
Intellectual Disability ◽  
Developmental Disorders ◽  
Measurement Properties ◽  
Cochrane Library ◽  
Assessment Instruments ◽  
Functional Impairments ◽  
Global Risk ◽  
Measurement Instruments ◽  
Health Measurement

IntroductionPersons with intellectual disability (ID) are at a higher risk of developing dementia than persons without ID, with an expected earlier onset. Assessment methods for the general population cannot be applied for persons with ID due to their pre-existing intellectual and functional impairments. As there is no agreed-upon measure to assess dementia in persons with ID, multiple instruments for this purpose have been developed and adapted in the past decades. This review aimed to identify all available informant-based instruments for the assessment of dementia in persons with ID, to evaluate and compare them according to their measurement properties, and to provide a recommendation for the most suitable instruments. Additionally, an overview of the amount and quality of research on these instruments will be provided.Methods and analysisThis review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We will adhere to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines and use a set of characteristics developed for assessment instruments for persons with ID, the Characteristics of Assessment Instruments for Psychiatric Disorders in Persons with Intellectual Developmental Disorders. Two comprehensive, systematic literature searches will be applied in 10 international databases, including ASSIA, CINAHL, Cochrane Library, ERIC, MEDLINE, PsycINFO, Scopus, Web of Science, OpenGrey and ProQuest Dissertations and Theses Global. Risk of bias and quality assessment will be done according to COSMIN guidelines. We will apply the modified Grading of Recommendations, Assessment, Development and Evaluation approach to rate the overall quality of the available evidence.Ethics and disseminationNo ethics statement is needed for this study. The results will be submitted to a peer-reviewed journal and will be presented at international conferences.

Reliability and Validity of Physical Tools and Measurement Methods to Quantify Hand Swelling: A Systematic Review

2020 ◽  
Author(s):  
Catalina Llanos ◽  
Ellen Yanxiang Gan ◽  
Jophie Chen ◽  
Mi-Joung Lee ◽  
Sharon L Kilbreath ◽  
...  
Keyword(s):  
Measurement Method ◽  
Assessment Tool ◽  
Reliability And Validity ◽  
Region Of Interest ◽  
Measurement Methods ◽  
Assessment Tools ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Cross Sectional ◽  
Physical Assessment

Abstract Objective Hand swelling may result from injury or trauma. Various physical assessment tools and measurement methods can be used to quantify the volume or size of the hand or fingers; however, the reliability and validity of each tool and measurement method have not been evaluated. The purpose of this study was to evaluate the reliability and validity of physical assessment tools and methods used to quantify hand and finger volume or size. Methods MEDLINE, CINAHL, EMBASE, Web of Science, and Scopus were searched using key terms related to swelling, edema, volume, size, hand, measures, reliability and validity. Cross-sectional or longitudinal studies that assessed reliability and/or validity of physical assessment tools or measurement methods to quantify hand swelling. Two examiners independently extracted data from the included articles and appraised the articles’ quality using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. Data extracted from studies analysing reliability and validity were grouped by type of assessment tool and measurement method. Conclusions Five physical assessment tools used for quantification of hand swelling were evaluated. All measurement methods with these tools had good to excellent reliability and moderate to high validity. The evidence underpinning the figure-of-eight technique, which uses a tape measure, was the highest. Because these physical assessment tools and measurement methods assess different aspects and regions of the hand, which one is selected would depend on the region of interest for assessment and the availability of tools. Impact Reliable tools and measurement methods are available to measure the size or volume of the hand and fingers, either together or separately. The best tool will depend on the aim of assessment and tool availability.

scholarly journals Effects of dignity therapy on palliative patients’ family members: A systematic review

2021 ◽  
pp. 1-10
Author(s):  
Leonor Grijó ◽  
Carolina Tojal ◽  
Francisca Rego
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
End Of Life ◽  
Meaning In Life ◽  
Family Members ◽  
Cochrane Library ◽  
Publication Date ◽  
Dignity Therapy ◽  
Bibliographic Search ◽  
Palliative Patients

Abstract Objective Dignity therapy (DT) is a kind of psychotherapy that identifies the main concerns of end-of-life patients that affect their perception of dignity and helps them to find a new meaning in life. Most prior studies on DT analyze outcomes for palliative care patients. The aim of this systematic review is to explore the outcomes of DT in palliative care patients’ family members. Method In June 2020, a bibliographic search was performed using the terms “Dignity Therapy” and “Palliative Care” in the following databases: Cochrane library, TRIP database, PUBMED, Scopus, and Web of Knowledge. Of the 294 articles found, 8 met the selection criteria and were considered in the present study. No articles were excluded based on their publication date. Results Family members generally believe that DT helps them to better prepare the patient's end-of-life and overcome the bereavement phase. The legacy document was considered a source of comfort, and most would recommend DT to other people in their situation. DT is generally considered as important as any other aspect of the patient's treatment. Significance of results There is evidence of the benefits of DT for palliative patients’ family members. However, there are still few studies that evaluate these outcomes. The existing evidence is poorly generalized, and thus, further studies are needed to deeply explore the benefits of this therapy both for patients and their families.

Rural community-based nurses’ self-reported knowledge and skills in the provision of psychosocial care to palliative and end-of-life clients and carers

2021 ◽  
pp. 1-9
Author(s):  
Eli Ristevski ◽  
Michael Leach ◽  
Ellen Bolton ◽  
Melissa Spargo ◽  
Anny Byrne ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Rural Community ◽  
Psychosocial Care ◽  
Assessment Tools ◽  
Formal Training ◽  
Educational Strategies ◽  
Community Based ◽  
Knowledge And Skills ◽  
Practice Gaps

Abstract Objective This study examined rural community-based nurses' self-reported knowledge and skills in the provision of psychosocial care to rural residing palliative and end-of-life clients and carers. We further sought to determine correlates of knowledge gaps to inform workforce education and planning. Method Nurses from a rural area of Victoria, Australia, were invited to complete an electronic questionnaire rating their knowledge against 6 national palliative care standards and 10 screening and assessment tools. A 5-point scale of (1) No experience to (5) Can teach others was used to rate knowledge. Results were classified into three categories: practice gaps, areas of consolidation, and strengths. Descriptive and logistical regression was used to analyze data. Results A total of 122 of 165 nurses (response rate = 74%) completed the survey. Of these nurses, 87% were Registered Nurses, 43% had ≥10 years' experience in palliative care, and 40% had palliative care training. The majority of practices across the standards and screening and assessment tools were rated as knowledge strengths (N = 55/67, 82%). Gaps and areas of consolidation were in the use of client and carer assessment tools, the care of specific populations such as children, supporting carers with appropriate referrals, resources, and grief, and facilitating the processes of reporting a death to the coroner. Lack of formal training and lower years of experience were found to be associated with practice gaps. Significance of results Our study found rural nurses were confident in their knowledge and skills in the majority of psychosocial care. As generalist nurses make up the majority of the rural nursing workforce, further research should be undertaken on what educational strategies are needed to support and upskill rural community-based nurses to undertake formal training in palliative care.

scholarly journals Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians’ experiences, perceptions and perspectives

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037466
Author(s):  
Patricia Harasym ◽  
Sarah Brisbin ◽  
Misha Afzaal ◽  
Aynharan Sinnarajah ◽  
Lorraine Venturato ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Symptom Assessment ◽  
Assessment Tools ◽  
Life Care ◽  
Community Based ◽  
Term Care

ObjectiveThe COVID-19 pandemic has highlighted ongoing challenges to optimal supportive end-of-life care for adults living in long-term care (LTC) facilities. A supportive end-of-life care approach emphasises family involvement, optimal symptom control, multidisciplinary team collaboration and death and bereavement support services for residents and families. Community-based and palliative care specialist physicians who visit residents in LTC facilities play an important role in supportive end-of-life care. Yet, perspectives, experiences and perceptions of these physicians remain unknown. The objective of this study was to explore barriers and facilitators to optimal supportive end-of-life palliative care in LTC through the experiences and perceptions of community-based and palliative specialist physicians who visit LTC facilities.DesignQualitative study using semi-structured interviews, basic qualitative description and directed content analysis using the COM-B (capability, opportunity, motivation - behaviour) theoretical framework.SettingResidential long-term care.Participants23 physicians who visit LTC facilities from across Alberta, Canada, including both in urban and rural settings of whom 18 were community-based physicians and 5 were specialist palliative care physicians.ResultsMotivation barriers include families’ lack of frailty knowledge, unrealistic expectations and emotional reactions to grief and uncertainty. Capability barriers include lack of symptom assessment tools, as well as palliative care knowledge, training and mentorship. Physical and social design barriers include lack of dedicated spaces for death and bereavement, inadequate staff, and mental health and spiritual services of insufficient scope for the population.ConclusionFindings reveal that validating families’ concerns, having appropriate symptom assessment tools, providing mentorship in palliative care and adapting the physical and social environment to support dying and grieving with dignity facilitates supportive, end-of-life care within LTC.

Instruments for Measuring Satisfaction With Physical Therapy Care: A Systematic Review

2020 ◽  
Vol 100 (9) ◽  
pp. 1690-1700
Author(s):  
Daniel Gutiérrez-Sánchez ◽  
David Pérez-Cruzado ◽  
Antonio I Cuesta-Vargas
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Physical Therapy ◽  
Psychometric Properties ◽  
Methodological Quality ◽  
Cochrane Library ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Selection Of

Abstract Objective Several instruments to measure patient satisfaction have been developed to assess satisfaction with physical therapy care. The selection of the most appropriate instrument is very important. The purpose of this study was to identify instruments for assessing satisfaction with physical therapy care and their psychometric properties and to evaluate the methodological quality of studies on psychometric properties. Methods A systematic search was conducted in ProQuest Medline, SciELO, ProQuest PsycINFO, Theseus, Cochrane Library, and Google Scholar. Articles published from 1990 to 2019, in English and Spanish, were used as limits. This systematic review followed the Consensus-based Standards for the Selection of Health Measurement Instruments and Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The articles were evaluated by 2 independent reviewers using the Consensus-based Standards for the Selection of Health Measurement Instruments 4-point checklist. Eighteen studies were included. Results Nine instruments were found to be specifically designed to assess satisfaction with physical therapy care. The methodological quality of the studies was “fair” for most of the psychometric characteristics analyzed (43 items), with 24 properties scored as “poor,” 5 as “good,” and 3 as “excellent.” Conclusions Different instrument characteristics—such as the scope and population with which the instrument will be used, its dimensions, the number of items, and the evidence shown in the evaluation of each psychometric property—should be considered by clinicians and researchers to decide which instrument is the best to measure the construct of patient satisfaction with physical therapy. Impact Evaluating patient satisfaction is very useful in clinical practice at the hospital, community, and primary care levels. Physical therapist clinicians and researchers can use this systematic review to select instruments whose characteristics will best measure their patients’ satisfaction with physical therapy care.

Building a Transdisciplinary Approach to Palliative Care in an Acute Care Setting

2013 ◽  
Vol 67 (1-2) ◽  
pp. 43-51 ◽  
Author(s):  
Donnelle Daly ◽  
Stephen Chavez Matzel
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Acute Care ◽  
Care Setting ◽  
Care Service ◽  
Palliative Care Service ◽  
Assessment Tools ◽  
Community Resources ◽  
Acute Care Setting ◽  
Transdisciplinary Approach

A transdisciplinary team is an essential component of palliative and end-of-life care. This article will demonstrate how to develop a transdisciplinary approach to palliative care, incorporating nursing, social work, spiritual care, and pharmacy in an acute care setting. Objectives included: identifying transdisciplinary roles contributing to care in the acute care setting; defining the palliative care model and mission; identifying patient/ family and institutional needs; and developing palliative care tools. Methods included a needs assessment and the development of assessment tools, an education program, community resources, and a patient satisfaction survey. After 1 year of implementation, the transdisciplinary palliative care team consisted of seven palliative care physicians, two social workers, two chaplains, a pharmacist, and End-of-Life Nursing Consortium (ELNEC) trained nurses. Palomar Health now has a palliative care service with a consistent process for transdisciplinary communication and intervention for adult critical care patients with advanced, chronic illness.

Pain assessment tools in palliative care: an urgent need for consensus

2008 ◽  
Vol 22 (8) ◽  
pp. 895-903 ◽  
Author(s):  
MJ Hjermstad ◽  
J Gibbins ◽  
DF Haugen ◽  
A Caraceni ◽  
JH Loge ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pain Assessment ◽  
Assessment Tools

scholarly journals Psychometric properties of self-reported financial toxicity measures in cancer survivors: a systematic review protocol using COSMIN methodology

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036365
Author(s):  
Zheng Zhu ◽  
Weijie Xing ◽  
Lucylynn Lizarondo ◽  
Jian Peng ◽  
Yan Hu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Survivors ◽  
Psychometric Properties ◽  
Measurement Properties ◽  
Cochrane Library ◽  
Public Healthcare ◽  
Financial Toxicity ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Patient Reported

IntroductionDue to the higher costs associated with advancements in cancer treatment and longer duration of cancer survivorship, increasing financial toxicity has become a great threat to survivors, caregivers and public healthcare systems. Since accurate and reproducible measures are prerequisites for robust results, choosing an acceptable measure with strong psychometric properties to assess financial toxicity is essential. However, a description of the psychometric properties of existing measures is still lacking. The aim of this study is to apply COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology to systematically review the content and structural validity of patient-reported outcome measures (PROMs) of financial toxicity for cancer survivors.Methods and analysisPubMed/Medline, Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), Web of Science, ProQuest Dissertations and Theses, and Cochrane Library (Wiley) will be comprehensively searched from database inception to 15 November 2019. Studies that report the measurement properties of PROMs assessing financial toxicity for cancer survivors will be included. The evaluation of measurement properties, data extraction and data synthesis will be conducted according to the COSMIN methodology.Ethics and disseminationNo individual data are involved in this systematic review. The results will be disseminated to a clinical audience and policy-makers though peer-reviewed journals and conferences and will support researchers in choosing the best measure to evaluate the financial toxicity of cancer survivors.

scholarly journals Risk of behaviour suggestive of opioid abuse: a protocol for a systematic review of validated assessment tools

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021948
Author(s):  
Sheila Raposo Galindo ◽  
Tatiana de Paula Santana da Silva ◽  
Manoel Henrique da Nóbrega Marinho ◽  
Carlos Eduardo de Souza Leão Ribeiro ◽  
Murilo Duarte da Costa Lima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Meta Analysis ◽  
Opioid Abuse ◽  
Assessment Tools ◽  
Measurement Instruments ◽  
Opioid Use ◽  
Health Measurement ◽  
Registration Number ◽  
The Individual

IntroductionOpioid use patterns of individuals with non-cancer pain are influenced by the behavioural dynamics of the individual in managing and properly following the prescription. The use of assessment tools for measuring the risk of behaviour suggestive of opioid abuse is important for health professionals who provide care to individuals with non-cancer pain. The aim of the proposed review is to analyse the psychometric properties of tools for measuring the risk of behaviour suggestive of opioid abuse in adults with non-cancer pain.Methods and analysisThe review process will be based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The Consensus-Based Standards for the Selection of Health Measurement Instruments will be used to analyse the assessment tools. Two independent reviewers will perform the literature search and analysis procedures. Searches will be performed on PubMed, Web of Science, Cochrane, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases, and the ‘snowball’ strategy will be employed. The inclusion criteria will be (1) validation studies, (2) assessment tools designed exclusively for measuring the risk of behaviour suggestive of opioid abuse and (3) assessment tools designed for evaluation of adults with chronic non-cancer pain. The titles and abstracts of the studies retrieved from the databases will be analysed for the preselection of articles, which will be submitted to a full-text analysis to define the final sample. Divergence of opinion between two reviewers will be resolved by consulting a third reviewer.Ethics and disseminationThe review will offer an overview of assessment tools available for measuring the risk of behaviour suggestive of opioid abuse, which is relevant to reducing the risk of deaths due to abusive consumption and for clinical management of adults with chronic non-cancer pain.PROSPERO registration numberCRD42018081577.

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