The Case for Dual Training in Geriatric Medicine and Palliative Care: The Time is Now

2017 ◽  
Vol 35 (2) ◽  
pp. 364-370
Author(s):  
Jennifer Gabbard ◽  
Matthew McNabney
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Quality Care ◽  
Geriatric Medicine ◽  
Symptom Burden ◽  
Aging Population ◽  
Chronic Illnesses ◽  
Care Providers ◽  
Care Needs

The majority of older adults die from chronic illnesses which are preceded by years of progressive decline and increasing symptom burden. Delivery of high-quality care cannot take place without sufficient numbers of health professionals with appropriate training and skills in both geriatric and palliative care medicine. Despite the surge in aging population and the majority of deaths being attributed to patients with multiple comorbidities, very few health-care providers undergo dual training in these areas. Thus, the nation is facing a health-care crisis as the number of geriatric patients with chronic disease increasingly outpaces the number of physicians with adequate skills to manage them. Joint training in palliative care and geriatric medicine could prepare physicians to better manage our aging population by addressing all their health-care needs irrespective of their stage of disease emphasizing patient-directed care.

Spiritual issues in palliative medicine

2015 ◽  
Author(s):  
Susan E. McClement
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Spiritual Care ◽  
Future Research ◽  
Care Providers ◽  
Care Needs ◽  
Spiritual Assessment ◽  
Future Research Directions

The focus of palliative care is the whole person, including biopsychosocial, cultural, and spiritual dimensions of patient needs. The burgeoning literature examining the topic of spirituality within health care in general, and within palliative care in particular, underscores the notion that attending to patients’ spiritual care needs is a vital part of providing optimal palliative care. Yet health-care providers frequently report that they feel ill equipped to provide spiritual care at the end of life and wrestle with many questions and uncertainties: What is spiritual care? What is spiritual suffering? Who should provide spiritual care? How is a spiritual assessment conducted? What are some spiritual interventions for end of life care? What are some future research directions in the area of spiritual care? Answers to these questions form the basis of this chapter.

scholarly journals Improving Respect and Dignity of Older Lesbian Adults: Interprofessional Approaches for Specialized Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 611-611
Author(s):  
Noell Rowan ◽  
Stephanie Smith ◽  
Tamatha Arms ◽  
Kris Hohn
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cultural Sensitivity ◽  
Health Knowledge ◽  
Quality Care ◽  
Empirical Literature ◽  
Care Providers ◽  
Care Needs ◽  
Specialized Care ◽  
Cultural Sensitivity Training

Abstract Interprofessional research pertaining to LGBTQ older adult cultural sensitivity training for social workers and nurses is often missing in the empirical literature. Members of the LGBTQ communities become increasingly vulnerable to health disparities as they age and treating clients with respect and dignity is at the forefront of this study. Students and faculty engaged in an interprofessional simulation project with older members of the LGBTQ community to learn health knowledge and applied assessment and brief intervention skills. Quantitative findings (N=58; 23 social work; 35 nursing) indicated increased student health knowledge. Reflection and qualitative findings are included with four primary themes: (a) bias of health care providers, (b) access to quality care, (c) specific health care needs, and (d) health risks of LGBTQ older adults. Specific emphasis is given to reflection and insight of the older lesbian participants about access to care, recognition of significant relationships, and marriage equality.

scholarly journals Barriers and facilitators to palliative care of patients with chronic heart failure in Germany: a study protocol

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Stefan Köberich ◽  
Jeantte Ziehm ◽  
Erik Farin ◽  
Gerhild Becker
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Health Care Providers ◽  
Symptom Burden ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
Heart Failure Patients ◽  
Patients With Heart Failure

<em>Background</em>. Despite its high prevalence, similar symptoms and symptom burden, people suffering from chronic heart failure receive less palliative care than patients with malignant diseases. Internationally, numerous barriers to palliative care of patients with chronic heart failure are known, however, there are no credible data regarding barriers and facilitators to palliative care of people suffering from chronic heart failure available for Germany. <br /><em>Design and Methods</em>. Tripartite study. First part of this study evaluates health care providers’ (physicians and nurses) perceived barriers and facilitators to palliative care of patients with chronic heart failure using a qualitative approach. At least 18 persons will be interviewed. In the second part, based on the results of part one, a questionnaire about barriers and facilitators to palliative care of patients with chronic heart failure will be designed and applied to at least 150 physicians and nurses. In the last part a classic Delphi method will be used to develop specific measures to improve the palliative care for chronic heart failure patients. <br /><em>Expected Impact for Public Health.</em> The results of this study will help to understand why patients with heart failure are seldom referred to palliative care and will provide solutions to overcome these barriers. Developed solutions will be the first step to improve palliative care in patients with heart failure in Germany. In addition, the results will help health care providers in other countries to take action to improve palliative care situations for heart failure patients.

Symptom burden and distress in patients with cancer in Africa.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 255-255
Author(s):  
John K. Weru
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Symptom Burden ◽  
Public Health Problem ◽  
Symptom Assessment ◽  
University Hospital ◽  
Care Providers ◽  
Patients With Cancer ◽  
Edmonton Symptom Assessment Scale

255 Background: Cancer has become a significant public health problem in Africa but still most diagnoses are made late, Sitas et al (2006). The need for palliative care is significant due to the late contact with health care providers and the many symptoms they present with. No study has been undertaken to assess symptomatology for these patients in Africa. Objective: To study the prevalence of symptoms in patients with cancer in an African setting. Methods: Symptom studies from records of patients with cancer referred to the Palliative Care Services at the Aga Khan University Hospital, Nairobi in 6 months. Symptoms charted on Edmonton Symptom Assessment Scale. Results: 42 patients were referred to the service in this period. All the patients reported > 3 symptoms which cut across the physical, social, psychological and spiritual concerns. The most common symptoms were pain in the physical dimension (90%) as reported by the patient. Fatigue was reported by (93%).Family wellbeing was the main worry in psychological dimension (95%). 94 % reported social disconnect due to the diagnosis, job losses and huge cost of health care. 96% suffered from the existential question of why me and worry about the future. Conclusions: Cancer has become a major burden to patients, families, societies and nations in Africa. Patients suffering from this illness experience a myriad of symptoms which require holistic approach to care. Social wellbeing remains a major concern for patients with cancer in Africa.

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

scholarly journals Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

2019 ◽  
Vol 15 (10) ◽  
pp. 531-538 ◽  
Author(s):  
Vinita Singh ◽  
Ali J. Zarrabi ◽  
Kimberly A. Curseen ◽  
Roman Sniecinski ◽  
Justine W. Welsh ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Medical Marijuana ◽  
Survey Study ◽  
Care Practice ◽  
Care Providers ◽  
Patients With Cancer ◽  
Medical Marijuana Laws ◽  
Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

2018 ◽  
Vol 34 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Erin Relyea ◽  
Brooke MacDonald ◽  
Christina Cattaruzza ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Access To Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Scoping Review ◽  
End Of Life Care ◽  
Psychosocial Interventions ◽  
Life Care ◽  
Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

scholarly journals Adults on the Autism Spectrum Face Significant Challenges Accessing Health Care Services

2021 ◽  
Vol 14 (1) ◽  
pp. 53
Author(s):  
Setareh Ghahari ◽  
Megan Widmer ◽  
Tom Heneghan ◽  
Methuna Naganathan ◽  
Thanusha Kathiravel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Quality Care ◽  
Autism Spectrum ◽  
Service Access ◽  
Care Providers ◽  
Spectrum Access ◽  
Health Service Access ◽  
Care Services

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties with social skills, verbal and non-verbal communication, repetitive behaviours and atypical sensory processing. Individuals on the autism spectrum face a higher prevalence of health conditions and have a higher mortality rate than the general population. There is a critical need to understand adults&rsquo; experiences on the autism spectrum when accessing health care services to understand how to improve accessibility to health care for these individuals. The purpose of this scoping review was to investigate how adults on the autism spectrum access and experience health care services. Four databases, including Embase, MEDLINE, CINAHL, and PsycInfo, were systematically searched for literature exploring how individuals on the autism spectrum access and experience health care. Results were extracted and categorized into five determinants based on the accessibility framework described by Levesque et al. (2013). Results indicated adults on the autism spectrum experience numerous barriers when accessing health care services. The dimension of access most frequently cited was the appropriateness of care, followed by the acceptability of care. It is essential to explore access as it is often conceptualized as the availability and affordability of services; however, results of this study indicate the broader experience of quality care provision and acceptance of the individual are important in understanding the complex experience individuals on the autism spectrum face. Based on these findings, there is a need to provide comprehensive education and clinical practice guidelines for health care providers to help reduce barriers to providing appropriate care for adults on the autism spectrum. Efforts to destigmatize intrapersonal and extra-personal perceptions of individuals on the autism spectrum will help overcome the barriers that affect care acceptability. Further research must understand how to design and implement strategies to maximize health service access for adults on the autism spectrum.

“Recognize Our Humanity”: Immigrant Youth Voices on Health Care in Arizona’s Restrictive Political Environment

2018 ◽  
Vol 29 (4) ◽  
pp. 498-509 ◽  
Author(s):  
Sofía Gómez ◽  
Heide Castañeda
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Immigrant Youth ◽  
Lessons Learned ◽  
Research Approach ◽  
Policy Recommendations ◽  
Care Providers ◽  
Care Needs ◽  
Action Research Approach ◽  
Important Position

The “DACAmented Voices in Healthcare” project examined the intersection of restrictive immigration policies and health care via photovoice, a participatory action research approach, with immigrant youth living in Arizona, who were recipients of the Deferred Action for Childhood Arrivals (DACA) program. These “DACAmented” youth took part in nine photovoice sessions exploring their health care experiences and accessibility to care using documentary photography and narratives. They poignantly illustrated their experiences through images identifying their main health concerns and strengths, facilitating the development of health policy recommendations. This article illustrates the thematic findings and discusses policy recommendations and lessons learned from presentations to policy makers and health care providers. Findings suggest that immigrant youth are knowledgeable of their family’s health care needs and hold a unique and important position within mixed-status households. Health care providers can benefit from the proposed recommendations by building bridges to care to address health equity in immigrant communities.

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