Providing Data-Driven Equitable Palliative and End-of-Life Care for Structurally Vulnerable Populations: A Pilot Survey of Information Management Strategies

2019 ◽  
Vol 37 (4) ◽  
pp. 244-249
Author(s):  
Akshay Rajaram ◽  
Trevor Morey ◽  
Sonam Shah ◽  
Naheed Dosani ◽  
Muhammad Mamdani
Keyword(s):  
Palliative Care ◽  
North America ◽  
Data Collection ◽  
Information Management ◽  
Vulnerable Populations ◽  
Management Strategies ◽  
Data Driven ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Data Infrastructure

Background: Considerable gains are being made in data-driven efforts to advance quality improvement in health care. However, organizations providing hospice-oriented palliative care for structurally vulnerable persons with terminal illnesses may not have the enabling data infrastructure or framework to derive such benefits. Methods: We conducted a pilot cross-sectional qualitative study involving a convenience sample of hospice organizations across North America providing palliative care services for structurally vulnerable patients. Through semistructured interviews, we surveyed organizations on the types of data collected, the information systems used, and the challenges they faced. Results: We contacted 13 organizations across North America and interviewed 9. All organizations served structurally vulnerable populations, including the homeless and vulnerably housed, socially isolated, and HIV-positive patients. Common examples of collected data included the number of referrals, the number of admissions, length of stay, and diagnosis. More than half of the organizations (n = 5) used an electronic medical record, although none of the record systems were specifically designed for palliative care. All (n = 9) the organizations used the built-in reporting capacity of their information management systems and more than half (n = 6) augmented this capacity with chart reviews. Discussion: A number of themes emerged from our discussions. Present data collection is heterogeneous, and storage of these data is highly fragmented within and across organizations. Funding appeared to be a key enabler of more robust data collection and use. Future work should address these gaps and examine opportunities for innovative ways of analysis and reporting to improve care for structurally vulnerable populations.

Tetrahydrocannabinol and Cannabidiol Use in an Outpatient Palliative Medicine Population

2020 ◽  
Vol 37 (8) ◽  
pp. 589-593 ◽  
Author(s):  
Bridget H. Highet ◽  
Elizabeth R. Lesser ◽  
Patrick W. Johnson ◽  
Judith S. Kaur
Keyword(s):  
Palliative Care ◽  
Chronic Illness ◽  
Side Effects ◽  
Patient Population ◽  
Palliative Medicine ◽  
Daily Basis ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample

Background: Palliative medicine physicians are challenged by lack of guidance regarding effectiveness and dosing of cannabis products in the setting of their emerging popularity. Objective: The aim of this study was to describe early patterns of tetrahydrocannabinol (THC) and cannabidiol (CBD) use in Florida following passage of the state’s first medical marijuana law. We describe here the perceived benefits, side effects, and beliefs expressed by patients in a single outpatient academic palliative medicine practice. Methods: A cross-sectional survey was performed of a sequential convenience sample of patients who presented to an outpatient academic palliative medicine clinic over a 3-month period. Results: In all, 24% (14/58) of respondents reported THC use, with half using THC on a daily basis. Patients reported improvements in pain, appetite, and nausea. In all, 71% (10/14) began using THC after the diagnosis of their chronic illness, and the most common form of usage was vaping. In all, 24% (14/58) of patients reported CBD use. Patients reported improvements in pain, and the most common form of usage was topical application. None of the patients had used CBD prior to the onset of their chronic illness. In all, 21% (3/14) of THC users and 21% (3/14) of CBD users thought that their substance was helping to cure their illness. Individual reported side effects in both groups were minimal. Conclusions: Approximately a quarter of outpatient palliative care patients use THC or CBD, often on a daily basis. Palliative care providers should be aware of the frequency, diverse usage, and beliefs behind cannabis product use in this patient population.

scholarly journals Knowledge, attitudes, beliefs and experience of palliative care amongst South African physiotherapists

2017 ◽  
Vol 73 (1) ◽  
Author(s):  
Brenda M. Morrow ◽  
Charlotte Barnard ◽  
Zimkhitha Luhlaza ◽  
Kelisha Naidoo ◽  
Sarah Pitt
Keyword(s):  
Palliative Care ◽  
South African ◽  
Survey Study ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Holistic Management ◽  
Scale Scores ◽  
Life Threatening ◽  
Care Training ◽  
Descriptive Survey

Background: Palliative care encompasses holistic management of patients and families facing life-threatening and life-limiting conditions. There is currently little known about South African physiotherapists’ palliative care knowledge, attitudes, beliefs, experience and training needs.Objectives: To describe the amount and adequacy of palliative care training received by South African physiotherapists, and their interest, knowledge, attitudes, beliefs and experiences of palliative care.Methods: This was a cross-sectional descriptive survey study of a convenience sample of physiotherapists, using an adapted Physical Therapy in Palliative Care-Knowledge, Attitudes, Beliefs and Experiences Scale (PTiPC-KABE Scale). Likert scale scores were converted to continuous data for analysis, presented as median (IQR). Seven universities were contacted to determine undergraduate palliative care curriculum content.Results: A total of 303 participants (8.4% response rate) completed the questionnaire, and 289 responses were included (5.35% margin of error with 95% CI). Participants had 16 (6–27) years of experience, with 85.5% in private practice. About 66.7% and 79% of participants reported not receiving any training at undergraduate and postgraduate levels, respectively, with more than 80% expressing that training was inadequate at both levels. Universities (n = 4/7; 57.1%) reported a maximum 3 hours undergraduate palliative care training. Seventy-nine percent of respondents had clinical experience in providing palliative care; however ‘knowledge’ was the lowest scoring domain (56.3% (43.8%–62.5%). The ‘beliefs’ domain scored highest at 82.6% (69.6%–91.3%).Conclusion: Many South African physiotherapists manage patients requiring palliative care, despite inadequate training and limited knowledge in this field. More under- and postgraduate learning opportunities should be made available for physiotherapists in the area of palliative care.

scholarly journals Factors Influencing a Student's Choice of a Graduate Professional Athletic Training Program

2020 ◽  
Vol 15 (3) ◽  
pp. 177-185
Author(s):  
Alyson Dearie ◽  
Deborah Van Langen ◽  
Julie M. Cavallario ◽  
Sonya A. Comins
Keyword(s):  
Data Collection ◽  
Training Program ◽  
Athletic Training ◽  
Online Survey ◽  
Graduate Program ◽  
Doctoral Degree ◽  
Pass Rate ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Convenience Sample

Context As the professional degree in athletic training transitions to the master's level, a growing concern for programs is enrollment. Understanding the factors that influence a student's choice of a graduate program in athletic training will provide institutions with vital information for marketing and enrollment management. Objective To explore factors that influence a student's choice of a professional graduate athletic training program. Design Cross-sectional. Setting Online survey. Patients or Other Participants A total of 52 participants from a convenience sample of 140 graduate students enrolled in a graduate professional athletic training program completed the survey: 43 females (82.7%) and 9 males (17.3%). Data Collection and Analysis Data collection took place over 4 weeks between April and May 2019. Participants completed an online questionnaire that consisted of 11 demographic items, 6 Likert-scale items about factors that may have influenced school choice, and 2 open-ended questions about career goals and pursuing a doctoral degree. We calculated descriptive statistics, frequency distributions, and percentages. Results Factors ranked as very important in influencing a student's choice fell within the categories of athletic training program and athletic training program faculty. Those ranked as not important were related to ethnicity and gender. Additionally, over half of the participants indicated an intended career path within the college or professional setting. Conclusions Although a variety of factors can influence a student's choice of graduate school, today's consumer seems mostly interested in program factors such as Board of Certification pass rate, accreditation status, and clinical sites. As programs transition to the graduate level, marketing and recruitment strategies should be designed around these factors to ensure enrollment.

Knowledge and perceptions of palliative care among oncology outpatients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 118-118
Author(s):  
Gillian McKie
Keyword(s):  
Palliative Care ◽  
Clinical Information ◽  
Multivariate Regression Analysis ◽  
Educational Strategies ◽  
Oncology Patients ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Perceived Needs ◽  
Palliative Care Services ◽  
Oncology Care

118 Background: Palliative care is emerging as an integral component of oncology care. There is growing evidence of its benefits but providers struggle with how to integrate specialist palliative services for the oncology population. The purpose of this study was to measure patients’ knowledge and perceptions, and their intention to seek palliative services. This study helps inform and guide oncology and palliative providers in their efforts to bridge the gap for oncology patients. Methods: The study used a cross-sectional design. A convenience sample of adult oncology patients using ambulatory cancer services at a community hospital was surveyed using the Knowledge of Care Options (KOCO) and Perceptions of Palliative Care Instrument (PPCI). Clinical information was abstracted from their health records retrospectively. Descriptive statistics were used to describe all variables. The association between knowledge, perceptions, and intention was analyzed using Pearson’s r correlation and multivariate regression analysis. Results: The majority of the 139 participants enrolled were female (61.9%), white (76.7%), and had good functional status with ECOG of 0 or 1 (87.1%). Mean age was 63.4 years. The mean KOCO score was 84.4% although several items scored less than 70%. Overall intention to seek palliative care was low at 2.53 on a seven point scale; a majority of patients indicated that they were unlikely to seek palliative care. There was a positive correlation between overall perception and intention to seek palliative care in the next three months (r = 0.212, p = 0.02).In addition, patients with higher scores on perceived needs for palliative care were more likely to report an intention to seek palliative care (r = 0.308, p = 0.001). Conclusions: There remains a knowledge deficit about palliative care in the oncology population. Participants did not experience negative emotional or cognitive reactions in response to information about palliative care. Perceived needs were associated with intention to seek palliative care services. Routine screening for needs and effective educational strategies are needed to better integrate palliative and oncology care.

Rapid Changes in Telehealth Access among Vulnerable Populations Amid Covid-19 Policy Expansions: Cross-sectional Study (Preprint)

2020 ◽  
Author(s):  
Saif Khairat ◽  
Yuxiao Yao ◽  
Cameron Coleman ◽  
Christopher Shea ◽  
Barbara Edson ◽  
...  
Keyword(s):  
Data Collection ◽  
Vulnerable Populations ◽  
Cross Sectional Study ◽  
Study Data ◽  
Unintended Consequences ◽  
Primary Data ◽  
Emergency Rooms ◽  
Cross Sectional ◽  
Virtual Visits ◽  
Rural Patients

UNSTRUCTURED Objective To examine the effect of the Covid-19 policy expansions on telehealth access among vulnerable populations including uninsured, seniors, and rural patients. Data Sources Primary data collection of telehealth visits between January 21- April 19, 2020. Data Collection Study data was collected through the online platform and extracted from the institutional data warehouse for processing and analysis. Study Design We conducted a cross-sectional analysis of virtual visits through a state-wide telehealth center embedded in a large academic healthcare system. Primary outcomes of this study were changes in health access among vulnerable populations and changes in provider staffing to stabilize the telehealth practice. Principal Findings A total of 2132 telehealth visits were conducted, 1530(71.8%) patients were female, 1561(73.2%) were between the ages 18-50, 1576(74%) were uninsured, and 1225(57.5%) were from rural regions. A significant increase in access among senior (p<0.05), uninsured (p<0.001), and rural (p=0.001) patients, and video visits (p<0.001) occurred in response to the telehealth expansion. Post-expansion, the daily average number of telehealth visits and wait times increased by 229% and 436% respectively, which required an increase in telehealth providers by 228% to meet patient demands. The predictive model expected 394% increase in virtual visits through June, 2020 (95% CI: 2892-8579). Conclusions Recent telehealth policy expansions appear to expand access to vulnerable populations such as senior, uninsured, and rural patients while decompressing hospitals and emergency rooms and maintaining positive patient experiences. While the policy expansion displayed effectiveness, additional measures are needed. These include the need for regulations around virtual visits unintended consequences, certification of telehealth software, and guidelines for workforce training.

scholarly journals Multisite Recruitment and Data Collection Among Older Adults: Exploring Methods to Conserve Human and Financial Resources

2012 ◽  
Vol 20 (2) ◽  
pp. 142-152 ◽  
Author(s):  
Valerie Lander McCarthy ◽  
Karen Cassidy
Keyword(s):  
Older Adults ◽  
Data Collection ◽  
Assisted Living ◽  
Senior Citizen ◽  
Community Dwelling ◽  
Retirement Communities ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Community Based Research ◽  
Dementia Screening

The purpose of this article is to describe strategies that were effective in recruitment and data collection among older adults in 3 quantitative studies while decreasing costs in terms of time and money. Factors effective in reducing use of investigators’ time and expenses included limiting exclusion of data because of abnormal Mini-Cog scores by careful initial screening and avoiding repeated reminders or follow-up, collecting data in small groups, collapsing consent, dementia screening, and data collection into single sessions, as well as accommodating for sensory and literacy deficits.The cross-sectional, descriptive studies were conducted among community-dwelling older adults attending senior citizen centers and among older adults in independent or assisted living apartments within continuing care retirement communities (CCRCs).1 In the latest study, a convenience sample (N = 152) was recruited and data collection was completed in 4 weeks at a total cost of less than $5,000. Methods common to qualitative research and those commonly used in community-based research were adapted to reduce time and costs for recruitment, screening, and data collection. Given limited availability of research funding, other nursing researchers may find one or more of these methods useful.

scholarly journals Pain Evaluation and Treatment Techniques Designed Specially for Hospital Nurses in Order to Provide High-Quality Health Care Services

2021 ◽  
Vol 2 (2) ◽  
pp. 1-7
Author(s):  
Wielfrid Chokwueze ◽  
Kulechy Ịhenache
Keyword(s):  
Pain Assessment ◽  
Management Strategies ◽  
Opioid Analgesics ◽  
P Value ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Breathing Exercises ◽  
Pain Evaluation ◽  
Chi Square Analysis

The purpose of this research was to examine the pain evaluation and treatment procedures used by practicing nurses. The research is a descriptive cross-sectional research that was conducted on 146 nurses who were directly engaged in patient care, were not on leave throughout the data collecting period, and volunteered to participate in the research using the convenience sample methodology. The data collection instrument was a pretested self-structured questionnaire with a 0.9 reliability value. Sorting, coding, entering, and analyzing data were performed using the SPSS version 23.0 software program at a 5% level of significance. The majority of respondents, 136 (93.1 percent), were female, while just 10 (6.9 percent) were male. 48 (23.9 percent) of respondents were SNOs, 86 (58.9 percent) of respondents had 6–10 years of experience, 120 (82.2 percent) were married, and 140 (95.9 percent ) were Christians. Concerning respondents' degree of knowledge regarding pain assessment techniques, 28 (19.2 percent) had inadequate knowledge, 44 (30.1 percent) had acceptable knowledge, and 74 (50.7 percent) had enough information. Self-reported pain management strategies included patient positioning and movement, massage, breathing exercises, diversional therapy, the use of warm or hot compresses, encouraging rest and relaxation, the use of both weak and strong opioid analgesics, and the administration of non-opioid analgesics. Using chi-square analysis, it was shown that there is no statistically significant relationship between nurses' knowledge and use of pain assessment instruments (p-value =0.15).

Graduating nurses' knowledge of palliative and end-of-life care

2020 ◽  
Vol 26 (1) ◽  
pp. 5-12
Author(s):  
Ann Selena Cleary
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Baccalaureate Nursing ◽  
Survey Design ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Eol Care ◽  
Care Course ◽  
Nurses Knowledge

Background: Generalist nurses frequently care for people who have advanced chronic diseases in decline, or who are dying. Few studies have measured graduating nurses' knowledge about end-of-life (EoL) care. Aims: To measure and compare knowledge about EoL care using the palliative care quiz for nurses among two cohorts of graduating nurses in a baccalaureate nursing programme. Methods: A quantitative cross-sectional survey design using a convenience sample of two cohorts of students. Findings: Total mean scores were low at 44.5% and 46.5% for the cohorts, respectively; this was not statistically significant. Misconceptions related to presentation and symptom management of the dying patient and integration of palliative with acute care. Palliative care knowledge was higher among the cohort who completed the dedicated EoL care course. Conclusion: Significant misconceptions about EoL care exist among these graduating nurses; this information provides direction for curriculum revision.

scholarly journals Estado nutricional e sua associação com o perfil sintomatológico de pacientes em cuidados paliativos internados em um hospital de urgências do nordeste brasileiro

2020 ◽  
Vol 2 (35) ◽  
pp. 139-143
Author(s):  
Rebeca Rocha Almeida ◽  
Larissa Monteiro Costa ◽  
Fabiana Ferreira da Paixão Santos ◽  
Jicelia Santos de Oliveira de Oliveira ◽  
Joana Cardoso dos Santos ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nutritional Status ◽  
Terminal Illness ◽  
Symptom Assessment ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Northeastern Brazil ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Emergency Hospital

Introduction: Palliative care are provided to patients with irreversible diseases, due to the therapeutic impossibility of cure. Palliative treatment is intended to alleviate the symptoms that affect these individuals, portraying death as something natural and acceptable. Therefore, since there are few studies addressing this theme, the present article aimed to assess the symptoms of patients in palliative care in an emergency hospital in northeastern Brazil and its association with nutritional status. Methods: An analytical cross-sectional study was carried out with a convenience sample of 52 individuals diagnosed with palliative care admitted to the Sergipe Emergency Hospital, from August to September 2018, the Memorial Symptom Assessment Scale questionnaires were applied for evaluation of symptoms, and the Subjective Global Assessment Produced by the Patient, for the nutritional diagnosis. Results: The sample consisted of 52 individuals with an average age of 59.62 ± 15.51 years, most of the individuals were male (53.85%), had neoplasms and about 41.86% were moderately malnourished. Among the symptoms evaluated, the most frequent were: I don’t look like myself anymore (78.85%), weight loss (73.07%), pain (69.23%), sadness (65.38%), mouth drought (57.69%), lack of energy (55.76%). A statistically significant association was observed between physical symptoms and the general scale with the patients’ nutritional status (p <0.05). Conclusion: Given the above, it was possible to conclude that the progression of terminal illness involves physical, psychological, spiritual and social symptoms, which result from the progression of the primary disease, as well as its treatment and comorbidities, with a direct association with nutritional status.

Pediatrics Palliative Care and Ethical Consideration From Nursing and PharmD Perspectives: A Study in Jordan

2020 ◽  
Author(s):  
Sawsan Abuhammad ◽  
Suhiab Mufleh ◽  
Karem H Alzoubi ◽  
Roaa Almasri ◽  
Omar Khraisat
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
Science And Technology ◽  
Terminally Ill ◽  
Pediatric Palliative Care ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Correlational Design ◽  
Significant Difference ◽  
The Subject

Abstract Aim: This research aimed to survey a sample of nursing students and PharmD students in Jordan about their knowledge of pediatric palliative care (PPC) in the context of treating terminally ill children.Method: A descriptive, cross-sectional, correlational design was used to fulfill the goal of this research. A convenience sample of nursing and PharmD students currently studying in Jordan University of Science and Technology in Jordan was recruited to complete a survey that contained 20 statements about issues on and around the subject of PPC Results: The results showed that there a significant difference in PPC between nurses and PharmD students. Mother’s education (t= 2.158, p= .032) and being a nursing or PharmD student ( t=1.969, p=.050) were associated with knowledge toward PPC. Other listed factors such as gender, working ward, and age were not associated with knowledge toward PPC.Conclusion: this was the first study in Jordan to survey a sample of nursing students and PharmD students in Jordan about their knowledge of PPC. The current study found that knowledge of nursing and PharmD students regarding PPC was satisfactory according to the scale used.

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