Attitudes and Perceptions of End-of-Life Dreams and Visions and Their Implication to the Bereaved Family Caregiver Experience

Background: While the majority of research assesses the impact of end-of-life dreams and visions (ELDVs) on patients, more recent research has begun to explore their impact on family caregivers (FCG). Objective: This study evaluates the relationship between general attitudes about dreams, perspectives of ELDV and their role the bereaved FCG experience. Design: Mixed-methods using a cross-sectional survey and five focus groups. Settings/Subjects: A total of 500 FCGs of patients who died under hospice care were recruited for the survey. Focus group members were self-selected through identified interest from the survey. Measurements: In addition to demographics and ELDV prevalence, general attitude toward dreams, ELDV perspectives, and impact on grief were assessed using ad hoc surveys. Results: Participants reporting ELDVs were significantly more validating of everyday dreams ( p < .001). Positive attitudes toward dreams strongly correlated with comfort from ELDVs for both patients and FCGs. Openness correlated positively with comfort from the ELDV for both the patient ( r = .149, p = .038) and FCG ( r = .217, p = 0.002) and negatively with fear/anxiety ( r = −.141, p = 0.050). Negative ELDV perceptions (ex. ELDVs were caused by medications) affected grief in areas such as accepting the loss ( r = −.235, p = .010) or maintaining connection ( r = −.255, p = .010) with the deceased. Focus group discussions were thematically analyzed resulting in 4 themes: ELDV narrative, Connection, Reflection, and Other Experiences. Conclusions: Positive general attitudes toward dreams and positive ELDV perceptions are correlated with better bereavement outcomes. Therefore, patient and family education on ELDVs that focuses on awareness and understanding of ELDVs may enhance clinical outcomes for both family and patients.

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Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211018655 ◽

2021 ◽

pp. 104990912110186

Author(s):

James Alton Croker ◽

Julie Bobitt ◽

Sara Sanders ◽

Kanika Arora ◽

Keith Mueller ◽

...

Keyword(s):

Palliative Care ◽

End Of Life ◽

Fast Track ◽

Hospice Care ◽

Cannabis Use ◽

Care Plan ◽

Medical Cannabis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

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Intention to Communicate End-of-Life Wishes among Rural African Americans: Is Awareness of Hospice Care Important?

Innovation in Aging ◽

10.1093/geroni/igab046.2852 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 777-778

Author(s):

Yan Luo ◽

Lewis Lee ◽

Hyunjin Noh ◽

Hee Lee

Keyword(s):

End Of Life ◽

Hospice Care ◽

Black Belt ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Black Belt Region ◽

The Us ◽

The Relationship ◽

Univariate Analyses

Abstract The intention to communicate end-of-life wishes and its related factors among adults in the southern rural region of the US has not been studied. This study aims to: (1) assess the intention to communicate end-of-life wishes among rural residents living in the Black Belt Region; (2) controlling for demographics and social determinants of health (SDH), examine the relationship between awareness of hospice care and the intention to communicate end-of-life wishes. A convenient sample living in rural Alabama was collected to complete a cross-sectional survey (N=182, age=18-91). Univariate analyses were conducted to assess participants’ intention to communicate end-of-life wishes, demographic characteristics, and SDH. Binary logistic regressions were used to examine the relationship between awareness of hospice care and the intention to communicate end-of-life wishes while controlling for demographics and SDH. The majority of participants were willing to communicate end-of-life wishes to their family (77.5%) or doctors (72.5%). Participants who were aware of hospice care were more likely to be willing to communicate end-of-life wishes to both their families (OR=10.08, p<0.01) and doctors (OR=7.20, p<0.05). Moreover, participants who were older were less likely to communicate end-of-life wishes to their doctors while participants with higher social isolation scores had lower intention to communicate end-of-life wishes to their families (OR=0.53, p<0.05). This is the first study assessing the intention of communicating end-of-life wishes among residents living in the Black Belt Region. This study demonstrated that awareness of hospice care is positively associated with the intention to communicate end-of-life wishes to both families and doctors.

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Impact of School Feeding Programme on Learners’ Academic Performance in Mlunduzi Ward, Tanzania

International Journal of Educational Studies ◽

10.33687/educ.005.03.2667 ◽

2018 ◽

Vol 5 (3) ◽

pp. 125-130

Author(s):

Shabani N. Maijo

Keyword(s):

Academic Performance ◽

Focus Group ◽

Focus Group Discussion ◽

Primary Schools ◽

Group Discussion ◽

Careful Examination ◽

Cross Sectional Survey ◽

Cross Sectional ◽

School Feeding ◽

The Impact

This study conducted to assess the impact of school feeding programme on pupil’s academic performance in Mlunduzi ward, Tanzania. The cross-sectional survey design was used for this study. This study was equally qualitative and quantitative in nature. A questionnaire was administered to capture the impact from 96 respondents in four randomly selected primary schools in Mlunduzi ward. Focus Group Discussion (FGD) was employed to complement the questionnaires. A checklist was used to validate data from learners and teachers through the focus group discussion. The data were analyzed using descriptive statistics. The results expose that school feeding programme had shown significant impact on learner’s academic performance. The analysis has indicated that the school feeding programme had increased examination performance, helped to get learners into school, enhancing enrolment and reducing absenteeism. The assessment of examination scores in the period before and during school feeding programme had shown that learners got better in an examination during the school feeding programme than before. The study recommends that in practice school feeding programme is difficult interventions; it can be with advantages if the policy makers and implementers can benefit from a careful examination of the programme by involving local communities than depending on donors so as to ensure sustainability of the programme.

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Bereaved Family Members’ Satisfaction with Care during the Last Three Months of Life for People with Advanced Illness

Healthcare ◽

10.3390/healthcare6040130 ◽

2018 ◽

Vol 6 (4) ◽

pp. 130 ◽

Cited By ~ 1

Author(s):

Anna O’Sullivan ◽

Anette Alvariza ◽

Joakim Öhlen ◽

Cecilia Håkanson

Keyword(s):

Educational Attainment ◽

Hospice Care ◽

Survey Design ◽

Family Members ◽

Satisfaction With Care ◽

Advanced Illness ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Deceased Person ◽

Bereaved Family

Background: Studies evaluating the end-of-life care for longer periods of illness trajectories and in several care places are currently lacking. This study explored bereaved family members’ satisfaction with care during the last three months of life for people with advanced illness, and associations between satisfaction with care and characteristics of the deceased individuals and their family members. Methods: A cross-sectional survey design was used. The sample was 485 family members of individuals who died at four different hospitals in Sweden. Results: Of the participants, 78.7% rated the overall care as high. For hospice care, 87.1% reported being satisfied, 87% with the hospital care, 72.3% with district/county nurses, 65.4% with nursing homes, 62.1% with specialized home care, and 59.6% with general practitioners (GPs). Family members of deceased persons with cancer were more likely to have a higher satisfaction with the care. A lower satisfaction was more likely if the deceased person had a higher educational attainment and a length of illness before death of one year or longer. Conclusion: The type of care, diagnoses, length of illness, educational attainment, and the relationship between the deceased person and the family member influences the satisfaction with care.

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Malaria Prevention and Mothers: Sudan

Basic and Applied Sciences - Scientific Journal of King Faisal University ◽

10.37575/b/med/2384 ◽

2021 ◽

Author(s):

Yousif Elmosaad ◽

Ahmed Al Rajeh ◽

Asif khan ◽

Elfatih Malik ◽

Ilias Mahmud

Keyword(s):

Formal Education ◽

Effective Means ◽

Malaria Prevention ◽

Good Knowledge ◽

Bed Nets ◽

Cluster Sampling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Attitudes And Practices ◽

Positive Attitudes

This study assessed the knowledge, attitudes, and practices (KAP) in malaria prevention using insecticide-treated bed nets (ITNs) among mothers of children under five years of age in White Nile State, Sudan. Multistage cluster sampling was used to select 761 mothers for this cross-sectional survey. There were gaps in the KAP in malaria prevention. Only 46.3% of the mothers stated personal protective measures (PPMs) as the best malaria prevention strategy; 54.9% considered ITNs as an effective means; and only 18.7% reported sleeping under an ITN every day. Older mothers were less likely to have good knowledge (OR=0.96), attitudes (OR=0.98) and practices (OR=0.98). Having a Government employee as the head of the household was positively associated with knowledge (OR=2.16) and attitudes (OR=1.96). The mother having a formal education was also positively associated with good knowledge (OR=1.55) and positive attitudes (OR=1.69). Mothers with a monthly household income of <491 Sudanese Pound were more likely to have good knowledge (OR=1.43). Mothers who had good knowledge (OR=4.99) and positive attitudes towards PPMs (OR=2.60) in malaria prevention were found to be more likely to practice preventive measures. Therefore, we recommend focusing on raising mothers’ awareness of the different preventive activities to protect them and their family from malaria.

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Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

10.2196/preprints.24776 ◽

2020 ◽

Author(s):

Khanh Ngoc Cong Duong ◽

Tien Nguyen Le Bao ◽

Phuong Thi Lan Nguyen ◽

Thanh Vo Van ◽

Toi Phung Lam ◽

...

Keyword(s):

Psychological Distress ◽

General Population ◽

Psychological Health ◽

Online Survey ◽

Survey Study ◽

Limited Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Event Scale ◽

The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

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Perspectives of future pharmacists on the potential for development and implementation of pharmacist prescribing in Qatar

International Journal of Clinical Pharmacy ◽

10.1007/s11096-019-00946-9 ◽

2020 ◽

Vol 42 (1) ◽

pp. 110-123

Author(s):

Mohammad Issam Diab ◽

Angham Ibrahim ◽

Oraib Abdallah ◽

Alla El-Awaisi ◽

Monica Zolezzi ◽

...

Keyword(s):

Focus Group ◽

Treatment Options ◽

Developed Countries ◽

Focus Group Discussions ◽

Cross Sectional Survey ◽

Group Discussions ◽

Cross Sectional ◽

Pharmacist Prescribing ◽

Barriers To Implementation ◽

Special Training Program

AbstractBackground Pharmacists in many developed countries have been granted prescribing authorities under what is known as “non-medical prescribing” or “pharmacist prescribing”. However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists’ perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.

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COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116076 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6076

Author(s):

Hasan S. Alamri ◽

Wesam F. Mousa ◽

Abdullah Algarni ◽

Shehata F. Megahid ◽

Ali Al Bshabshe ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Health Care Workers ◽

Psychological Impact ◽

Psychological Outcomes ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Care Workers ◽

The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

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Are e-learning Webinars the future of medical education? An exploratory study of a disruptive innovation in the COVID-19 era

Cardiology in the Young ◽

10.1017/s1047951120004503 ◽

2020 ◽

pp. 1-10

Author(s):

Colin J. McMahon ◽

Justin T. Tretter ◽

Theresa Faulkner ◽

R. Krishna Kumar ◽

Andrew N. Redington ◽

...

Keyword(s):

Deep Learning ◽

Carbon Footprint ◽

Quantitative Research ◽

Survey Design ◽

Hybrid Approach ◽

Disruptive Innovation ◽

Cross Sectional Survey ◽

Cross Sectional ◽

E Learning ◽

The Impact

Abstract Objective: This study investigated the impact of the Webinar on deep human learning of CHD. Materials and methods: This cross-sectional survey design study used an open and closed-ended questionnaire to assess the impact of the Webinar on deep learning of topical areas within the management of the post-operative tetralogy of Fallot patients. This was a quantitative research methodology using descriptive statistical analyses with a sequential explanatory design. Results: One thousand-three-hundred and seventy-four participants from 100 countries on 6 continents joined the Webinar, 557 (40%) of whom completed the questionnaire. Over 70% of participants reported that they “agreed” or “strongly agreed” that the Webinar format promoted deep learning for each of the topics compared to other standard learning methods (textbook and journal learning). Two-thirds expressed a preference for attending a Webinar rather than an international conference. Over 80% of participants highlighted significant barriers to attending conferences including cost (79%), distance to travel (49%), time commitment (51%), and family commitments (35%). Strengths of the Webinar included expertise, concise high-quality presentations often discussing contentious issues, and the platform quality. The main weakness was a limited time for questions. Just over 53% expressed a concern for the carbon footprint involved in attending conferences and preferred to attend a Webinar. Conclusion: E-learning Webinars represent a disruptive innovation, which promotes deep learning, greater multidisciplinary participation, and greater attendee satisfaction with fewer barriers to participation. Although Webinars will never fully replace conferences, a hybrid approach may reduce the need for conferencing, reduce carbon footprint. and promote a “sustainable academia”.

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