Does Family Disagreement Affect Donation Decisions by Next of Kin?

Researchers often have a need to conduct human tissue research using postmortem specimens. Medicolegal death investigation organizations are untapped areas for obtaining postmortem human tissues. Because death investigation organizations are not required by law to conduct or support research, an ethical dilemma exists in whether or not researchers should use cadaver tissues for research purposes. This paper analyzes the ethical issues of using human tissues through discussion of principles of biomedical ethics, respect for autonomy, nonmaleficence, beneficence, and justice. Policy makers, organ and tissue procurement organizations, medicolegal death investigation organizations, and scientists should be aware of these principles when considering researchers requests. The authors conclude that with Institutional Review Board approval and next of kin consent, there are prevailing reasons for using postmortem tissue for research.

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ReCOV: recovery and rehabilitation during and after COVID-19 – a study protocol of a longitudinal observational study on patients, next of kin and health care staff

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-021-00299-9 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

E. Rydwik ◽

L. Anmyr ◽

M. Regardt ◽

A. McAllister ◽

R. Zarenoe ◽

...

Keyword(s):

Health Care ◽

Psychosocial Support ◽

Care Staff ◽

Psychological Wellbeing ◽

Health Care Staff ◽

Post Traumatic Stress ◽

Next Of Kin ◽

Related Quality ◽

Long Term Consequences

Abstract Background The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients’ experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff. Methods This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts. Discussion This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients’, next of kins’ and staffs’ views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.

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49 A Quality Improvement Project to Assess and Refine the Handover Process at Morning Trauma Meetings

British Journal of Surgery ◽

10.1093/bjs/znab134.352 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S Sadiq ◽

M Tahir ◽

I Nur ◽

S Elerian ◽

A Malik

Keyword(s):

Categorical Variables ◽

Next Of Kin ◽

Chi Square ◽

Neck Of Femur ◽

Improvement Project ◽

Handover Process ◽

Neck Of Femur Fracture ◽

The Impact ◽

Standard Operating Protocol

Abstract Introduction Poor handover between shifts can result in patient harm. This study was designed to evaluate the impact of implementing a handover protocol on the quality of information exchanged in the trauma handover meetings in a UK hospital. Method A prospective single-centre observational study was performed at an NHS Trust. Ten consecutive weekday trauma meetings, involving 43 patients, were observed to identify poor practices in handover. This data was used in conjunction with the Royal College of Surgeons’ recommendations for effective handover (2007) to create and implement a standard operating protocol (SOP). Following its implementation, a further 8 consecutive meetings, involving a further 47 patients, were observed. The data was analysed using t-test for quantitative variables and chi-square or Fisher’s exact tests for categorical variables. Results An improvement was demonstrated in multiple aspects of trauma handover including past medical history, injury date, results, diagnosis, consent, mark, and starvation status (all p < 0.001). Subgroup analyses showed that handover of neck-of-femur fracture patients including information on baseline mobility (p = 0.04), Nottingham-Hip-Fracture Score (p = 0.01), next-of-kin discussion (p = 0.075) and resuscitation status (p = 0.001) all improved following the intervention. Conclusions These results demonstrate that the implementation of a well-structured handover protocol can improve the transmission of critical information in trauma meetings.

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Coassessment framework to identify person-centred unmet needs in stroke rehabilitation: a case report in Norway

BMJ Innovations ◽

10.1136/bmjinnov-2020-000432 ◽

2020 ◽

Vol 7 (1) ◽

pp. 148-156

Author(s):

Kari Jorunn Kværner ◽

Linn Nathalie Støme ◽

Jonathan Romm ◽

Karianne Rygh ◽

Frida Almquist ◽

...

Keyword(s):

Cognitive Impairment ◽

Stroke Rehabilitation ◽

Unmet Needs ◽

Health Workers ◽

University Hospital ◽

Health Staff ◽

Hospital Workers ◽

Next Of Kin ◽

Patient Journey ◽

Health Value

ObjectiveTo describe unmet needs and values in stroke rehabilitation using the Health Value Framework and the associated coassessment tool Health Value Spider, a framework designed to identify and prioritise unmet needs based on health technology assessment (HTA).SettingThe study took place at Oslo University Hospital, Norway, from February to April 2019. Participants in three consecutive workshops were recruited from Sunnaas Rehabilitation Hospital, Oslo Municipality, Hospital Procurement Trust and Oslo University Hospital. Twenty-four hospital workers (medical and allied health staff and administrative staff) participated in workshop 1 and 29 patients, user representatives and hospital workers in workshop 2. Twenty-one patients and hospital workers participated in workshop 3.InterventionsStakeholder analysis and scenario building was performed in a coassessment setting where unmet needs were identified applying the Health Value Framework. Two of the authors are also the developers of the Health Value Framework (KJK and LNS).ResultsIn the two first workshops where health workers, patients and next of kin perspectives were elicited, three needs were identified: patient insecurity in patient journey transitions, lack of stroke rehabilitation expertise in primary care and invisible patient problems, such as fatigue and cognitive impairment. In workshop 3, 12 opportunity areas were identified. Four opportunity areas were selected by the stakeholders based on a prioritisation process: early discovery of cognitive impairment, rehabilitation continuity, empowered patients and next of kin and remote monitoring and digital touchpoints.ConclusionHealth Value Spider successfully identified and prioritised unmet needs and described associated values.

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How next of kin experience palliative care of relatives at home

European Journal of Cancer Care ◽

10.1046/j.1365-2354.2003.00436.x ◽

2003 ◽

Vol 12 (4) ◽

pp. 339-346 ◽

Cited By ~ 57

Author(s):

G. BROBÄCK ◽

C. BERTERÖ

Keyword(s):

Palliative Care ◽

Next Of Kin ◽

At Home

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Technologies in older people’s care

Nursing Ethics ◽

10.1177/0969733015594665 ◽

2015 ◽

Vol 24 (2) ◽

pp. 125-137 ◽

Cited By ~ 8

Author(s):

Maria Andersson Marchesoni ◽

Karin Axelsson ◽

Ylva Fältholm ◽

Inger Lindberg

Keyword(s):

New Technology ◽

Quality Care ◽

Care Facility ◽

Development Project ◽

Working Environment ◽

Drop Out ◽

Problem Solver ◽

Good Care ◽

Next Of Kin ◽

Caring Relationship

Background: The tension between care-based and technology-based rationalities motivates studies concerning how technology can be used in the care sector to support the relational foundation of care. Objectives: This study interprets values related to care and technologies connected to the practice of good care. Research design: This research study was part of a development project aimed at developing innovative work practices through information and communication technology. Participants and research context: All staff (n = 18) working at two wards in a care facility for older people were asked to participate in interviews, and 12 accepted. We analysed the data using latent content analysis in combination with normative analysis. Ethical considerations: The caregivers were informed that participation was voluntary and that they could drop out at any time without providing any explanation. Findings: Four values were identified: ‘presence’, ‘appreciation’, ‘competence’ and ‘trust’. Caregivers wanted to focus on care receivers as unique persons, a view that they thought was compromised by time-consuming and beeping electronic devices. Appraising from next-of-kin and been seen as someone who can contribute together with knowledge to handle different situations were other desires. The caregivers also desired positive feedback from next-of-kin, as they wanted to be seen as professionals who have the knowledge and skills to handle difficult situations. In addition, the caregivers wanted their employer to trust them, and they wanted to work in a calm environment. Discussion: Caregivers’ desire for disturbance-free interactions, being valued for their skills and working in a trustful working environment were interpreted as their base for providing good care. The caregivers’ arguments are based on caring rationality, and sometimes they felt the technological rationality interfered with their main mission, providing quality care. Conclusion: Introducing new technology in caring should support the caring relationship. Although society’s overall technology-based approach may have gained popularity as a problem solver, technology-based rationality may compromise a care-based rationality. A shift in attitudes towards care as a concept on all societal levels is needed.

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