scholarly journals Smart, vulnerable, playful or just disturbing? A discourse analysis of child involvement in palliative care

Childhood ◽  
2020 ◽  
Vol 27 (4) ◽  
pp. 468-482 ◽  
Author(s):  
Ingrid Hogstad ◽  
Anne Jansen
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Discourse Analysis ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Interpretative Repertoires ◽  
Child Involvement ◽  
Minor Children

In Scandinavian countries, health professionals are legally obliged to involve patients’ minor children. A growing field of research focuses on the support to, and needs and experiences of, these children. We add to previous research by analysing discourse in qualitative interviews with nurses and doctors in Norwegian public palliative health care. The analysis identifies four interpretative repertoires picturing the child in different ways and defining possibilities for what health professionals can say and do regarding child involvement.

Palliative Care: Essential Concepts in the Education of Health Professionals

1987 ◽  
Vol 2 (2) ◽  
pp. 18-23 ◽  
Author(s):  
Dorothy Brockopp
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Patient Care ◽  
Health Care System ◽  
Health Professionals ◽  
Basic Concept ◽  
Professional Community ◽  
Multidisciplinary Nature ◽  
Clear Identification ◽  
Successful Integration

The successful integration of palliative care with the health care system may require a concentrated effort on the part of the professional community to clearly identify those concepts that form the basis for the model. The lack of a clear identification both of those concepts viewed by the various disciplines as forming the model, or basis of palliative care, and of the areas of conflict within the model, can lead to a variety of problems. Specific problems that can occur, as both formal and informal attempts are made to convey information about palliative care, include a) emphasizing one part of the model without providing an overview, b) presenting a portion of a given concept, and c) presenting one side of a conflict around a basic concept. The lack of a clearly delineated model of palliative care may be the result of the multidisciplinary nature of this particular approach to patient care. Each discipline has tended to emphasize those ideas that best represent that particular profession. This paper attempts to extract and describe from the literature those concepts that are emphasized, across disciplines, as essential to the provision of palliative care. Conflicts related to the essential concepts are also described.

scholarly journals Palliative care production for health professionals in the context of home care

2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Alexandre Ernesto Silva ◽  
Elysângela Dittz Duarte ◽  
Sérgio Joaquim Deodato Fernandes
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Home Care ◽  
Health Professionals ◽  
Exploratory Study ◽  
Qualitative Approach ◽  
Government Policies ◽  
Care Process ◽  
Health Care Network

ABSTRACT Objectives: to analyze palliative care production developed by health professionals to home care patients. Methods: this is an exploratory study, with a qualitative approach, using the transpersonal care theoretical framework. Thirteen interviews were conducted with health professionals and 18 observations were conducted on different cases. Content analysis was performed using MAXQDA©. Results: actions performed: maintenance and follow-up measures to people eligible for palliative care, in acts of dialogue and "listening" to caregivers and users, conducting guidelines for the care and self-care process, performing technical procedures, delivery of materials, referrals and medical prescriptions to users. Final Considerations: it is perceived the need for advances in the implementation of government policies in Brazil that insert palliative care into the Health Care Network through educational, managerial and care actions that ensure human dignity, thus allowing the development of these and other palliative care interventions.

Confronting Medicine’s Dichotomies: Older Adults’ Use of Interpretative Repertoires in Negotiating the Paradoxes of Polypharmacy and Deprescribing

2019 ◽  
Vol 30 (3) ◽  
pp. 448-457 ◽  
Author(s):  
Alison Ross ◽  
James Gillett
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
Qualitative Interviews ◽  
Care Providers ◽  
Routine Medical Care ◽  
Interpretative Repertoires

To address the risks associated with polypharmacy, health care providers are investigating the feasibility of deprescribing programs as part of routine medical care to reduce medication burden to older adults. As older adults are enrolled in these programs, they are confronted with two dominant and legitimate accounts of medications, labeled the medication paradox: medications keep you healthy but they might be making you sick. We investigated how the medication paradox operates in the lives of older adults. In-depth qualitative interviews were conducted and analyzed with older adults aged 70+ to identify the various paradoxes that seniors live through regarding their medications and the narratives that they engage to negotiate these contradictions. Older adults were found to have established interpretative repertoires to make sense of the incongruent narratives of the medication paradox. In this article, we demonstrate older adults’ efforts to carve out their unique place in the dichotomized institution of medicine.

scholarly journals National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
C. Bausewein ◽  
F. Hodiamont ◽  
N. Berges ◽  
A. Ullrich ◽  
C. Gerlach ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Mixed Methods ◽  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Symptom Control ◽  
Relevant Literature ◽  
Inpatient Setting ◽  
Specialist Palliative Care ◽  
Seriously Ill

Abstract Background In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impacts on palliative care for non-COVID-19 patients. Strategies on the care for seriously ill and dying people in pandemic times are lacking. Therefore, the program ‘Palliative care in Pandemics’ (PallPan) aims to develop and consent a national pandemic plan for the care of seriously ill and dying adults and their informal carers in pandemics including (a) guidance for generalist and specialist palliative care of patients with and without SARS-CoV-2 infections on the micro, meso and macro level, (b) collection and development of information material for an online platform, and (c) identification of variables and research questions on palliative care in pandemics for the national pandemic cohort network (NAPKON). Methods Mixed-methods project including ten work packages conducting (online) surveys and qualitative interviews to explore and describe i) experiences and burden of patients (with/without SARS-CoV-2 infection) and their relatives, ii) experiences, challenges and potential solutions of health care professionals, stakeholders and decision makers during the SARS-CoV-2 pandemic. The work package results inform the development of a consensus-based guidance. In addition, best practice examples and relevant literature will be collected and variables for data collection identified. Discussion For a future “pandemic preparedness” national and international recommendations and concepts for the care of severely ill and dying people are necessary considering both generalist and specialist palliative care in the home care and inpatient setting.

Māori Research(er) in Three Poems

2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd
Keyword(s):  
Palliative Care ◽  
Health Literacy ◽  
Cultural Identity ◽  
Focus Groups ◽  
Health Professionals ◽  
Bell Hooks ◽  
Face To Face ◽  
The Third ◽  
Ruth Behar ◽  
Seeking Help

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.

Oral health diseases among the older people: a general health perspective

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Health Professionals ◽  
General Health ◽  
Oral Health Care ◽  
Oral Diseases ◽  
Public Health Professionals ◽  
The Relationship

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.

Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study (Preprint)

2019 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Professional ◽  
Clinical Setting ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Smartphone App ◽  
Implementation Study ◽  
Pilot Testing ◽  
Effective Implementation

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

A Scoping Review of Interventions Aimed at Improving Knowledge, Detection Practices and Management of Dementia among Health Professionals (Preprint)

2020 ◽  
Author(s):  
Krishna Krishna Prasad Pathak
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Health Professionals ◽  
Educational Program ◽  
Best Practice ◽  
Intervention Studies ◽  
Educational Interventions ◽  
Learning Activities ◽  
Inclusion Criteria ◽  
Improving Health Care

BACKGROUND Health professionals (HPs) play a key role in dementia management and detection. However, there is a gap in the literature as to what represents best practice with regard to educating HPs to improve their dementia detection practices and management. OBJECTIVE The objective of this scoping review is to synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among HPs. METHODS We searched electronically published relevant articles with inclusion criteria; (1) intervention studies aimed at improving HPs practices concerning dementia care and (2) educational interventions focused on nurses and doctors’ knowledge, detection practice and management of dementia. Twenty-five articles fit the inclusion criteria. RESULTS Collaborative programs of practice based workshops, interactive learning activities with community and multi-faced educational program were the most effective. CONCLUSIONS HPs should be supported to improve their knowledge, tackle behavioural problems associated with dementia, be made aware of services and be enabled to engage in more early diagnosis. CLINICALTRIAL no applicable

scholarly journals Caring for One’s Wife With Dementia—at Home: Older Husbands’ Experiences With Managing Challenges of Everyday Life

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983445
Author(s):  
Linda Rykkje ◽  
Oscar Tranvåg
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Memory Clinics ◽  
Male Caregivers ◽  
Caregiving Roles ◽  
Caregiver Role ◽  
At Home

More than 80,000 Norwegians live with dementia. Most caregivers for people with dementia are spouses, and women outnumber men. Due to an aging population, and women’s higher risk of dementia as well as men’s increased life expectancy, the number of male caregivers will rise. There are some differences in the caregiving roles of men and women. Research suggest that males report lower burden and depression than female caregivers, but some men struggle to adjust to the caregiver role, and men are less likely to access health care services. The aim of this study is to explore the experiences of husbands engaged in caregiving for their home-dwelling spouse with dementia. This knowledge will add to the growing body of research about men in the context of dementia care and may raise gender awareness. The method is qualitative interviews with hermeneutical interpretation. The participants are five husbands recruited from two Hospital Memory Clinics in Norway. The results portray how the husbands managed their everyday challenges, and how they adapted to changes, experiences of loss and bereavement, and how they redefined personal freedom and expanded their responsibilities. Acknowledging the rewards of caregiving, the husbands found their life meaningful and they were thriving in their caregiving role. Health care personnel should recognize and respect the challenging life situation caregiving husbands may experience, calling for personnel to learn from, care for, and collaborate with them, enabling the couple to live a meaningful life together at home as long as possible.

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