Barriers to and Facilitators of Neonatal Palliative Care Among Neonatal Professionals in China

2021 ◽  
pp. 104990912110462
Author(s):  
Lin Gu ◽  
Zhen-Zhen Li ◽  
Niang-Huei Peng ◽  
Jian-Fu Zhou ◽  
Bi-Rong Wei ◽  
...  
Keyword(s):  
Palliative Care ◽  
Clinical Education ◽  
Neonatal Intensive Care ◽  
Moral Distress ◽  
Attitude Scale ◽  
Neonatal Intensive Care Units ◽  
Cultural Issues ◽  
Cross Sectional ◽  
Medical Centers ◽  
Care Training

Objectives: This study investigated institutional and personal barriers to and facilitators of neonatal palliative care facing neonatal professionals in China. Methods: A cross-sectional questionnaire surveyed 231 neonatal clinicians employed in 5 neonatal intensive care units from 2 children’s hospitals and 3 medical centers in China. Measurements: The translated modified version of the Neonatal Palliative Care Attitude Scale was used to survey neonatal clinicians’ attitudes and beliefs regarding neonatal palliative care. Results: Findings highlight 4 facilitators and 5 barriers among participating clinicians. Participants gave contradictory responses regarding the relative importance of curative treatment versus palliative care in the NICU. Negatively traumatic feelings, cultural issues and moral distress may impact this contradictory response and discourage clinicians from providing neonatal palliative care. Additionally, neonatologists and nurses held differing attitudes on several topics (p < 0.05). Conclusion: Further research should address strategies to improve knowledge and attitudes and relieve moral distress in NICU clinicians. Neonatal clinicians providing neonatal palliative care should receive regular palliative care training addressing culture-specific issues and communication skills. Practice Implications: Study findings will be beneficial to inform clinical education and practice. Regular interdisciplinary team training is needed to enhance support for palliative care and decrease clinicians’ moral distress during end-of-life care.

Barriers of Palliative Care in Neonatal Intensive Care Units

2016 ◽  
Vol 34 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Mansooreh Azzizadeh Forouzi ◽  
Marjan Banazadeh ◽  
Jila Soltan Ahmadi ◽  
Farideh Razban
Keyword(s):  
Palliative Care ◽  
Organizational Culture ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Attitude Scale ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Eol Care

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.

scholarly journals Identifying medication errors in neonatal intensive care units: a two-center study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kaveh Eslami ◽  
Fateme Aletayeb ◽  
Seyyed Mohammad Hassan Aletayeb ◽  
Leila Kouti ◽  
Amir Kamal Hardani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Cross Sectional ◽  
Quality Of Prescribing

Abstract Background This study aimed to assess the types and frequency of medication errors in our NICUs (neonatal intensive care units). Methods This descriptive cross-sectional study was conducted on two neonatal intensive care units of two hospitals over 3 months. Demographic information, drug information and total number of prescriptions for each neonate were extracted from medical records and assessed. Results A total of 688 prescriptions for 44 types of drugs were checked for the assessment of medical records of 155 neonates. There were 509 medication errors, averaging (SD) 3.38 (+/− 5.49) errors per patient. Collectively, 116 neonates (74.8%) experienced at least one medication error. Term neonates and preterm neonates experienced 125 and 384 medication errors, respectively. The most frequent medication errors were wrong dosage by physicians in prescription phase [WU1] (142 errors; 28%) and not administering medication by nurse in administration phase (146 errors; 29%). Of total 688 prescriptions, 127 errors were recorded. In this regard, lack of time and/or date of order were the most common errors. Conclusions The most frequent medication errors were wrong dosage and not administering the medication to patient, and on the quality of prescribing, lack of time and/or date of order was the most frequent one. Medication errors happened more frequently in preterm neonates (P < 0.001). We think that using computerized physician order entry (CPOE) system and increasing the nurse-to-patient ratio can reduce the possibility of medication errors.

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 Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N

2021 ◽  
Vol 9 ◽  
Author(s):  
Berhanu Gulo ◽  
Laura Miglierina ◽  
Francesca Tognon ◽  
Silvia Panunzi ◽  
Ademe Tsegaye ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Parent Satisfaction ◽  
Cross Sectional Study ◽  
Hospital Environment ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Item Scores ◽  
Almost All

Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains.Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided.Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67–5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33–5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience.Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.

scholarly journals Formal education about hygienic aural care and the relationship between aural hygiene awareness and practices: a cross-sectional study from a super-speciality hospital in West Bengal, India

2019 ◽  
Vol 6 (8) ◽  
pp. 3298
Author(s):  
Saikat Samaddar ◽  
Arup Chakraborty ◽  
Sangita Bhattacharya Samaddar ◽  
Arista Lahiri ◽  
Saumendra Nath Bandyopadhyay
Keyword(s):  
Formal Education ◽  
West Bengal ◽  
Nuclear Family ◽  
Cross Sectional Study ◽  
P Value ◽  
Cultural Issues ◽  
Cross Sectional ◽  
Aware Group ◽  
Care Training ◽  
Training Resources

Background: The result of poor ear care and hygiene behaviours are often encountered in otology practice. There is also lack of any proper guideline of hygienic ear care behaviours. The present study aims to assess the awareness and practice of hygienic ear care behaviours of the community, in the light of the guidelines as per WHO Primary Ear and Hearing Care Training Resources-Basic level.Methods: A cross-sectional descriptive study was conducted at Baruipur Sub-Divisional Hospital serving semi urban population of South 24 Parganas, West Bengal, India. Patients and parents (in case of children below the age of six years) were interviewed. Maintaining the inclusion and exclusion criteria after obtaining informed consent 480 participants were included in the study who responded to a validated self-reported semi structured questionnaire.Results: The mean age was 32.44 (±18.95) years. Around 51.3% were male, 81.25% were professionals. Majority belonged to nuclear family (52.083%) and Islam (53.333%). Around 88.958% of the population had practice of ear care behaviour which was poor. Joint family had an odds of 2.86 (p value=0.002) and Islam by religion had an odds of 1.99 (p value=0.044) for a higher level of awareness. Educated group had an odds of 4.07 (p<0.001) for higher awareness. Aware group had an odds of 19.95 (p<0.001) in favour of having hygienic ear care practices.Conclusions: The study demonstrated lack of formal education regarding ear hygiene at the community level. Dearth in formal knowledge leading to poor practices is compounded with several socio-cultural issues. 

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