Physician Attire Influences Patient and Family Perceptions of Care in the Palliative Care Unit in Japan

2021 ◽  
pp. 104990912110516
Author(s):  
Atsushi Shimizu ◽  
Mitsue Takeuchi ◽  
Fumio Kurosaki ◽  
Kaichiro Tamba ◽  
Naohiro Sata ◽  
...  
Keyword(s):  
Palliative Care ◽  
Family Members ◽  
Palliative Care Unit ◽  
University Hospital ◽  
White Coat ◽  
Family Perceptions ◽  
Strongly Agree ◽  
Perception Of Care ◽  
The Impact ◽  
Perceptions Of Care

Background: Physician attire influences perceptions of care. This study was conducted to evaluate the impact of physician attire on perceptions of care by patients and families in a Japanese palliative care unit. Methods: From November 2018 to February 2020, patients and family members admitted to the Palliative Care Unit at Jichi Medical University Hospital were recruited and completed a survey consisting of 4 demographic questions and 15 questions regarding perceptions of care. A 7-point Likert scale (1 = strongly agree, 4 = neutral, 7 = strongly disagree) was used to judge attire (name tag, long sleeve white coat, short sleeve white coat, scrubs, scrub color, jeans, sneakers) addressing patient and overall impact on perception of care. Results: Of 203 patients admitted, 79 were enrolled. Surveys were received from 23 patients and 52 family members. Patients and families want physicians to wear name tags (median, interquartile range) (2, 1-2) and white coats (3, 2-4). Patients want to be addressed by surnames (2, 1.5-4). Patients and family members have neutral opinions about short sleeve white coats (4, 4-4) and scrubs (4, 4-4). Jeans were not liked (4, 4-6) while sneakers are acceptable (3, 2-4). The impact of attire on perceptions of care is significantly (p = .04) greater for patients (3, 2-4) than family members (4, 3-4). Conclusion: Patients and family members prefer their physicians to wear name tags and white coats and address patients by surnames. Physician attire has a significantly greater impact on perceptions of care for patients than family members in a palliative care unit.

Family members' experiences of the impact of the LCP in a palliative care unit and a geriatric ward in Sweden

2014 ◽  
Vol 20 (8) ◽  
pp. 381-386 ◽  
Author(s):  
Marie-Louise Ekeström ◽  
Mariann Olsson ◽  
Sara Runesdotter ◽  
Carl Johan Fürst
Keyword(s):  
Palliative Care ◽  
Family Members ◽  
Palliative Care Unit ◽  
Geriatric Ward ◽  
The Impact

The influence of care place and diagnosis on care communication at the end of life: bereaved family members’ perspective

2021 ◽  
pp. 1-8
Author(s):  
Anna O'Sullivan ◽  
Anette Alvariza ◽  
Joakim Öhlén ◽  
Cecilia Larsdotter ex. Håkanson
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Nursing Home ◽  
End Of Life ◽  
Family Members ◽  
Palliative Care Unit ◽  
Deceased Person ◽  
Specialized Palliative Care ◽  
Bereaved Family ◽  
At Home

Abstract Objective To investigate the influence of care place and diagnosis on care communication during the last 3 months of life for people with advanced illness, from the bereaved family members’ perspective. Method A retrospective survey design using the VOICES(SF) questionnaire with a sample of 485 bereaved family members (aged: 20−90 years old, 70% women) of people who died in hospital was employed to meet the study aim. Results Of the deceased people, 79.2% had at some point received care at home, provided by general practitioners (GPs) (52%), district nurses (36.7%), or specialized palliative home care (17.9%), 27.4% were cared for in a nursing home and 15.7% in a specialized palliative care unit. The likelihood of bereaved family members reporting that the deceased person was treated with dignity and respect by the staff was lowest in nursing homes (OR: 0.21) and for GPs (OR: 0.37). A cancer diagnosis (OR: 2.36) or if cared for at home (OR: 2.17) increased the likelihood of bereaved family members reporting that the deceased person had been involved in decision making regarding care and less likely if cared for in a specialized palliative care unit (OR: 0.41). The likelihood of reports of unwanted decisions about the care was higher if cared for in a nursing home (OR: 1.85) or if the deceased person had a higher education (OR: 2.40). Significance of results This study confirms previous research about potential inequalities in care at the end of life. The place of care and diagnosis influenced the bereaved family members’ reports on whether the deceased person was treated with respect and dignity and how involved the deceased person was in decision making regarding care.

scholarly journals Advancing Pediatric Palliative Care In a Low-Middle Income Country: An  Implementation Study, A challenging but not impossible task

2020 ◽  
Author(s):  
Ximena Garcia-Quintero ◽  
Luis Gabriel Parra-Lara ◽  
Angelica Claros-Hulbert ◽  
Maria Isabel Cuervo-Suarez ◽  
Wendy Gomez-Garcia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Pediatric Population ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Care Program ◽  
University Hospital ◽  
Pediatric Palliative Care ◽  
Middle Income ◽  
The Impact

Abstract Background: The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You ” (TCY) , in a tertiary care, university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017-2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.

scholarly journals Patient and family perceptions of hospice services: ‘I knew they weren’t like hospitals’

2013 ◽  
Vol 5 (3) ◽  
pp. 206 ◽  
Author(s):  
Yvonne Bray ◽  
Felicity Goodyear-Smith
Keyword(s):  
Palliative Care ◽  
Ethnic Diversity ◽  
Care Service ◽  
Family Members ◽  
Ethnic Disparities ◽  
Palliative Care Service ◽  
Cultural Groups ◽  
Structured Interviews ◽  
Information Giving ◽  
Family Perceptions

INTRODUCTION: The vision for palliative care service provision in New Zealand is for all people who are dying and their families to have timely access to culturally appropriate, quality palliative care services. An Auckland hospice’s records show that the ethnically diverse population statistics were not reflected in the referrals for hospice services. The aim of this research was to gain a patient-and-their-family perspective on the hospice, including exploration of components of service care that could be improved for various cultural groups. METHODS: Patients currently under the care of the hospice and family members were recruited from hospice records. Semi-structured interviews were conducted to explore the emerging issues. The study collected data from a purposive sample of 18 palliative care patients or carer family members, ranging in age from 39 to 81 years, who reflected the ethnic diversity of the population of the region. Interviewing was carried out by an experienced research assistant and continued until data saturation was reached. FINDINGS: Four key themes emerged – hospice personnel’s approach to patients, quality of service, cultural barriers, and strategies for future improvement. It was determined that the latter two were the most significant to address in this article. CONCLUSION: The study revealed the need for information-giving and education, including public profiling of the hospice to strengthen community involvement. Strategies to reduce ethnic disparities include strengthening the awareness of, and access to, services by connecting with cultural groups through churches, community and specific cultural media. KEYWORDS: Cultural competency; hospice care; palliative care; patient education; terminal care

The Existential Dimension of Palliative Care: The Mirror Effect of Death on Life

2020 ◽  
pp. 003022282095218
Author(s):  
Frédérique Drillaud ◽  
Camille Saussac ◽  
Florence Keusch ◽  
Danièle Lafaye ◽  
Hélène Bely ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mirror Effect ◽  
Palliative Care Unit ◽  
University Hospital ◽  
Spiritual Dimension ◽  
Existential Suffering ◽  
Definition Of ◽  
Existential Dimension ◽  
Spiritual Suffering ◽  
Insight Into

The WHO has included the spiritual dimension in its definition of palliative care since 1990, but this dimension is frequently confused with notions of religion. Yet, the spiritual suffering experienced by palliative care patients is primarily a matter of existential suffering. The objective of this study was to examine the ways in which the existential dimension was manifested in the experiences of those present in a palliative care unit. This anthropological monograph was conducted in a palliative care unit in a French University Hospital. The existential dimension appears to reside in the connections between individuals and the proximity of death appears to shed new light on the meaning of life. The mirror effect of death on life, could serve to encourage greater appreciation of the value of our connections with others, and the desire to take care of others, which offers new insight into forms of solidarity and social organisation.

Overcoming recruitment challenges in a randomized clinical trial of early palliative care.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 140-140
Author(s):  
Susanne Zwahlen ◽  
Monica Fliedner ◽  
Steffen Eychmüller
Keyword(s):  
Palliative Care ◽  
University Hospital ◽  
Patient Recruitment ◽  
Consent Rate ◽  
Eligibility Criteria ◽  
Efficient Manner ◽  
Early Palliative Care ◽  
Study Staff ◽  
The Impact ◽  
Recruitment Barriers

140 Background: Reasons why clinical trials of early palliative care (ePC) interventions have prolonged patient recruitment time frames have been researched mainly qualitatively. Our objective was to identify major recruitment barriers encountered in our ePC trial, as well as to implement actions to overcome them. The impact of these changes on recruitment was measured. Methods: Data from all patients screened at the main study site (Inselspital, University Hospital Bern) between October 2013 and April 2016 were prospectively analyzed for: date of contact, reporting department, eligibility status, as well as consent status. Data until march 2014 was used to identify the main recruitment barriers. Starting in march 2014 changes to the recruitment process were implemented and all data from then onwards was used to estimate the impact of these adaptations. Results: The three main barriers identified were: Logistic, motivational, or related to eligibility criteria. Logistic barriers were overcome by changing from voluntary referral by the treating physician to systematically screening outpatient clinics of medical oncology, radio-oncology, gyneco-oncology and the internal medicine ward. Motivational barriers were addressed through education and dedicated study staff. Eligibility criteria were widened to include pancreatic and urothelial cancer. The actions implemented increased the accrual rate from one patient during a five month period to 2,8 patients per month. The widening of the eligibility criteria contributed to this result by recruiting 0,5 patients per month. The implementation of a systematic screening procedure increased the number of eligible patients invited to participate from one per month to 4,8 per month. An increase in the study consent rate from 20 % to 58 % can be translated into an increased acceptance of early palliative care. Conclusions: Education and dedicated study staff in order to increase the acceptance of ePC as well as a tool to identify eligible patients in a time-efficient manner improved patient recruitment in our ePC trial. We suggest that these factors can be relevant for the successful integration of ePC in standard oncology care.

680 OPIOIDS CONSUMPTION: THE IMPACT OF A PALLIATIVE CARE UNIT

2009 ◽  
Vol 13 (S1) ◽  
Author(s):  
A. Salve ◽  
A. Modè ◽  
A. Saccardi ◽  
P. Daldosso ◽  
M. Germiniasi
Keyword(s):  
Palliative Care ◽  
Palliative Care Unit ◽  
The Impact

scholarly journals Intrathecal Infusions for Intractable Cancer Pain: A Qualitative Study of the Impact on a Case Series of Patients and Caregivers

2009 ◽  
Vol 14 (5) ◽  
pp. 371-379 ◽  
Author(s):  
Philippa Hawley ◽  
Elizabeth Beddard-Huber ◽  
Cameron Grose ◽  
William McDonald ◽  
Daphne Lobb ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Case Series ◽  
Palliative Care Unit ◽  
Intractable Pain ◽  
Management Service ◽  
Palliative Care Setting ◽  
Intractable Cancer Pain ◽  
The Impact ◽  
Intrathecal Infusion

BACKGROUND: The need for intrathecal infusion in a palliative care setting is infrequent. Despite established efficacy, safety and cost effectiveness, this is considered an ‘extraordinary measure’ in Canada. Patients requiring this approach are not typical palliative care patients, having shorter and more uncertain life expectancies.OBJECTIVES: The present study is a qualitative exploration of the impact of intrathecal pump implantation on cancer patients, and also the impact of the intervention on the staff caring for those patients.METHODS: Palliative care unit patients who received an implanted intrathecal pump or dome catheter for intractable cancer pain participated in multiple semistructured interviews. Doctors and nurses caring for each patient were also interviewed. Interviews were recorded and analyzed for themes. The study terminated when saturation was reached.RESULTS: Six patients participated, with up to three interviews each. Twenty-four staff interviews took place. Patients’ hopes and expectations were not always fully met, but the infusions had a profound positive effect on quality of life. Patients expressed anxiety about dependence on the device, and also on a few highly skilled individuals. Staff interviews revealed a significant impact on the ‘culture’ of the palliative care unit. Clear communication of the rationale for infusion was very important, as was regular education about infusion management.CONCLUSIONS: Implanted intrathecal infusion devices are a necessary part of a tertiary level cancer pain management service for the unfortunate minority with intractable pain. Practical recommendations for care are made for palliative care programs contemplating offering intrathecal infusions.

A Survey of Bereaved Family Members To Assess Quality of Care on a Palliative Care Unit

2015 ◽  
Vol 18 (4) ◽  
pp. 358-365 ◽  
Author(s):  
Katherine A. Roza ◽  
Eric J. Lee ◽  
Diane E. Meier ◽  
Nathan E. Goldstein
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Family Members ◽  
Palliative Care Unit ◽  
Assess Quality ◽  
Bereaved Family

scholarly journals Increased number of deaths within 24 h of admission during a period of social restriction related to the COVID-19 pandemic: A retrospective service evaluation in a metropolitan palliative care unit

2021 ◽  
pp. 026921632110265
Author(s):  
Rachel Everitt ◽  
Neil Robinson ◽  
David Marco ◽  
Jennifer Weil ◽  
Tamsin Bryan
Keyword(s):  
Palliative Care ◽  
Tertiary Hospital ◽  
Service Evaluation ◽  
Health Care Utilisation ◽  
Palliative Care Unit ◽  
Published Data ◽  
Hospital Inpatient ◽  
Number Of Patients ◽  
Social Restriction ◽  
The Impact

Background: COVID-19 has led to implementation of wide-ranging social restriction measures with consequent impact on health care utilisation in many domains. There is little published data on the experience of palliative care services catering to a population with low case numbers of COVID-19. Aim: This study aimed to consider the impact of COVID-19 on utilisation of inpatient palliative care in the context of low community transmission, and low numbers of cases in hospital. Design: A retrospective service evaluation examining differences in number of admissions, diagnoses, number of deaths and time from admission to death, across three discrete 8-week time periods spanning the early COVID-19 pandemic. Setting/participants: All admissions ( n = 194) to a metropolitan tertiary hospital inpatient palliative care unit in Melbourne during the study period. Results: An initial 16.9% fall in admissions was followed by a return to baseline admission numbers, with a 46.7% increase in number of deaths compared to baseline. The number of deaths within 24 h rose from 10.8% to 37.3% ( p < 0.01). The number of patients with non-malignant diagnoses increased from 32.4% to 52%, and those with non-malignant diagnoses were more likely to die rapidly ( p < 0.01). There were no patients with COVID-19 infection. Conclusion: Increased numbers of deaths within 24 h of admission occurred on the palliative care unit despite low COVID-19 case numbers in the wider community, and in the setting of widespread social restriction measures. More research is needed examining the health-related consequences of such restrictions for individuals not infected with COVID-19.

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