Significant aspects of nursing within the process of end-of-life communication in an oncological context

2018 ◽  
Vol 39 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Annelie Rylander ◽  
Stina Fredriksson ◽  
Ewa Stenwall ◽  
Lena-Karin Gustafsson
Keyword(s):  
Palliative Care ◽  
Content Analysis ◽  
Patient Care ◽  
End Of Life ◽  
Qualitative Content Analysis ◽  
Before And After ◽  
New Situation ◽  
End Of Life Communication ◽  
Depth Interviews ◽  
Insight Into

The complexity of end-of-life communications has previously been described and found to be given late in the patient’s palliative care. There is a need for earlier and more continuous end-of-life-communications throughout the patient’s care to reduce anxiety, confusion, and promote participation. Registered nurses (RNs) have a unique closeness to the patient and the ability to identify early the need for end-of-life communication. The aim of this study was to describe crucial aspects of nursing in end-of-life communication in an oncology context. The study was designed as a qualitative content analysis of in-depth interviews with RNs working in oncology in-patient care units. Two domains were identified: before, and after end-of-life communications, with the categories importance of being well prepared to identify both the patient’s and their family’s needs. Cooperation and interaction between physicians and RNs were crucial to be able to support patients and their relatives around the clock. The presence of RNs encouraged further conversations about the patients’ conditions to gain insight into the new situation. End-of-life communication should not only be medicine oriented and performed by physicians. Involvement of RNs’ expertise enables increased patient/relative participation as well as reduced anxiety and suffering, creating clarity and safety for all involved in care.

Does Time for (in)Direct Nursing Care Activities at the End of Life for Patients With or Without Specialized Palliative Care in a University Hospital Differ? A Retrospective Analysis

2020 ◽  
Vol 37 (10) ◽  
pp. 844-852
Author(s):  
Monica C. Fliedner ◽  
Monika Hagemann ◽  
Steffen Eychmüller ◽  
Cynthia King ◽  
Christa Lohrmann ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Nursing Care ◽  
Direct Care ◽  
University Hospital ◽  
Before And After ◽  
Indirect Care ◽  
Specialized Palliative Care ◽  
Eol Care ◽  
Insight Into

Background: Nurses’ end of life (EoL) care focuses on direct (eg, physical) and indirect (e,g, coordination) care. Little is known about how much time nurses actually devote to these activities and if activities change due to support by specialized palliative care (SPC) in hospitalized patients. Aims: (1) Comparing care time for EoL patients receiving SPC to usual palliative care (UPC);(2) Comparing time spent for direct/indirect care in the SPC group before and after SPC. Methods: Retrospective observational study; nursing care time for EoL patients based on tacs® data using nonparametric and parametric tests. The Swiss data method tacs measures (in)direct nursing care time for monitoring and cost analyses. Results: Analysis of tacs® data (UPC, n = 642; SPC, n = 104) during hospitalization before death in 2015. Overall, SPC patients had higher tacs® than UPC patients by 40 direct (95% confidence interval [CI]: 5.7-75, P = .023) and 14 indirect tacs® (95% CI: 6.0-23, P < .001). No difference for tacs® by day, as SPC patients were treated for a longer time (mean number of days 7.2 vs 16, P < .001).Subanalysis for SPC patients showed increased direct care time on the day of and after SPC ( P < .001), whereas indirect care time increased only on the day of SPC. Conclusions: This study gives insight into nurses’ time for (in)direct care activities with/without SPC before death. The higher (in)direct nursing care time in SPC patients compared to UPC may reflect higher complexity. Consensus-based measurements to monitor nurses’ care activities may be helpful for benchmarking or reimbursement analysis.

scholarly journals ”Vi går inn i det private rommet til pasienten”. Sykepleieres erfaring med helsefremmende arbeid i somatiske polikliniske

2014 ◽  
Vol 10 (1) ◽  
pp. 70
Author(s):  
Anne Svelstad Evju ◽  
Gøril Salomonsen Klette ◽  
Anne Kasen ◽  
Terese Bondas
Keyword(s):  
Health Promotion ◽  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Outpatient Clinics ◽  
Nurses Role ◽  
Depth Interviews ◽  
Insight Into

<p><strong><em>Nurses experiences of health promotion with patients in somatic outpatient clinics</em></strong><em></em></p><p><em>The aim is to describe and understand nurses’ experiences of health promotion with patients, who have been recommended to change their lifestyles when cared for in outpatient clinics. Semi-structured in-depth interviews were carried out with a sample of 7 nurses, who cared for patients, suffering  from diabetes, obesity and COPD. A qualitative content analysis was used. The findings highlight the importance of creating trust to gain insight into the patient’s way of living, which is referred to as ‘the patient’s private health space’. The change interventional dialogue between the patient and the nurse was created by mapping out the patient’s potential for change, and by trying to make the patient responsible for their lifestyle by continuous follow up, long-term support and guidance. The nurses viewed individual adaptation of health promotion in relation to each patient as essential. The patients are challenged to use their own resources and are guided in regard to their own goals. The nurses role as the activator of change is important.</em></p>

Hospital end-of-life care: families’ free-text notes

2020 ◽  
pp. bmjspcare-2020-00239
Author(s):  
Sandra Kurkowski ◽  
Johannes Radon ◽  
Annika R Vogt ◽  
Martin Weber ◽  
Stephanie Stiel ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Qualitative Content Analysis ◽  
Free Text ◽  
Life Care ◽  
Quality Aspects ◽  
Care Of The Dying

BackgroundPalliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients’ loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones’ perspectives on need for improvements.AimTo identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire.DesignWithin the validation study of the questionnaire ‘Care of the Dying Evaluation’ (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring.Setting/participantsLoved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017.Results993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient’s and/or loved one’s will, involvement in decision-making at the end of life (patient’s volition) and having the possibility to say goodbye.ConclusionsIt is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients’ will and to be emotionally supported.Trial registration numberThis study was registered at the German Clinical Trials Register (DRKS00013916).

A Case–Control Study Evaluating the Impact of Dedicated Palliative Care Training on Critical Care Interventions at the end of Life

2021 ◽  
pp. 082585972110374
Author(s):  
Jee Y. You ◽  
Lie D. Ligasaputri ◽  
Adarsh Katamreddy ◽  
Kiran Para ◽  
Elizabeth Kavanagh ◽  
...  
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
High Risk ◽  
End Of Life ◽  
Poor Prognosis ◽  
Medical Interventions ◽  
Risk Of Death ◽  
Before And After ◽  
The Difference ◽  
The Impact

Many patients admitted to intensive care units (ICUs) are at high risk of dying. We hypothesize that focused training sessions for ICU providers by palliative care (PC) certified experts will decrease aggressive medical interventions at the end of life. We designed and implemented a 6-session PC training program in communication skills and goals of care (GOC) meetings for ICU teams, including house staff, critical care fellows, and attendings. We then reviewed charts of ICU patients treated before and after the intervention. Forty-nine of 177 (28%) and 63 of 173 (38%) patients were identified to be at high risk of death in the pre- and postintervention periods, respectively, and were included based on the study criteria. Inpatient mortality (45% vs 33%; P = .24) and need for mechanical ventilation (59% vs 44%, P = .13) were slightly higher in the preintervention population, but the difference was not statistically significant. The proportion of patients in whom the decision not to initiate renal replacement therapy was made because of poor prognosis was significantly higher in the postintervention population (14% vs 67%, P = .05). There was a nonstatistically significant trend toward earlier GOC discussions (median time from ICU admission to GOC 4 vs 3 days) and fewer critical care interventions such as tracheostomies (17% vs 4%, P = .19). Our study demonstrates that directed PC training of ICU teams has a potential to reduce end of life critical care interventions in patients with a poor prognosis.

scholarly journals Media, Culture and Indigenous Languages in Pakistan: A Critical Review

2020 ◽  
Vol V (IV) ◽  
pp. 27-33
Author(s):  
Irem Sultana ◽  
Malik Adnan ◽  
Muhammad Imran Mehsud
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Indigenous Languages ◽  
Media Culture ◽  
Native Languages ◽  
Mainstream Media ◽  
Study Results ◽  
The Media ◽  
Depth Interviews

This research paper inspected the role of Pakistani media to protect indigenous languages and culture in Pakistan. The study examined the situation; if Pakistani media outpours concern with the native languages or not. The article also checked the media landscape, its language-wise segregation and scenario of literacy in different areas of the country. The outcomes of the study showed that Pakistani media is neglecting the indigenous languages. The study results exhibited clearly that media houses’ focus on protecting native languages, is not profound. The findings also showed that foreign ownership of Media houses plays a role in neglecting indigenous language promotions. The current study presented that Pakistani mainstream media is damaging the local and native languages. The study was the outcome of qualitative content analysis and in-depth interviews of senior communication experts.

scholarly journals A Content Analysis of Blog Posts on Angry Library Patrons

2021 ◽  
Author(s):  
◽  
Iris Marigold Operario
Keyword(s):  
Content Analysis ◽  
Exploratory Study ◽  
Qualitative Content Analysis ◽  
Research Problem ◽  
Staff Members ◽  
Wide Range ◽  
Problem Library ◽  
Library Staff ◽  
Insight Into ◽  
Blog Posts

<p>Research Problem: This exploratory study looks into what is written in blogs regarding angry library patrons. It aims to provide insight on angry library patrons by identifying the themes/issues in the blog posts, the reasons for anger of the library patrons, and to describe the characteristics of the blog post authors. Methodology: A qualitative content analysis was used to analyse the blog posts. The blog search engine Google Blogs was used to search for the relevant blog posts. A sample of 92 individual and organisational blog posts were read and analysed. Results: Three main themes emerged in the analysis of the blog posts: 1) the causes of anger which can either be library-related or due to other patrons; 2) how anger was displayed; and 3) the sentiments of the library staff members towards angry patrons. The blog authors mostly come from North America and have a library background. Implications: Analysing these blog posts provides further insight into angry library patrons which might not otherwise be found in existing anger studies in a library setting and problem library patron research. Uncovering what is said in the blogosphere about angry library patrons will give a picture of a wide range of anger issues which may be relevant for library staff members as they try to better understand angry library patrons. While this study was not able to retrieve as much blog posts from an angry library patron’s perspective as originally planned, a study noting the key difference of opinions between angry library patrons and library staff members could be investigated in the future</p>

scholarly journals General practitioners’ perceptions of best practice care at the end of life: a qualitative study

BJGP Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. bjgpopen19X101660 ◽  
Author(s):  
Anne Herrmann ◽  
Mariko Carey ◽  
Alison Zucca ◽  
Lucy Boyd ◽  
Bernadette Roberts
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Best Practice ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Natural Extension ◽  
Family Needs ◽  
Qualitative Interview Study ◽  
Wide Range ◽  
Practice Care

BackgroundGPs can play a central role in palliative care delivery. However, little is known about their views on what constitutes best practice care at the end of life.AimTo explore, in a sample of Australian GPs, their perceptions of best practice palliative care and their ideal role in its delivery.Design & settingA qualitative interview study of 25 GPs practising in metropolitan and non-metropolitan locations in New South Wales, Australia.MethodSemi-structured telephone interviews were conducted. Data were analysed using qualitative content analysis.ResultsParticipants had a mean age of 51 years, and had practised between 3 and 38 years (mean 19 years). Best practice palliative care was perceived to be proactive and responsive to a wide range of patient and family needs. Many participants indicated a need for relational continuity, which involves GPs establishing a care pathway from diagnosis to palliation, coordinating care across the pathway, and collaborating with other healthcare providers. A number of participants perceived palliative care as a natural extension of primary care and indicated that best practice palliative care mainly requires experiential knowledge and good communication skills, rather than specialised medical knowledge. Participants listed a number of communication strategies to offer patients and their families choice and ongoing negotiation about the recommended treatments.ConclusionThis study provides novel in-depth insights into GPs’ perceptions of best practice palliative care. Future research should further investigate the identified features of care, and whether they can maximise the outcomes of patients and their families.

scholarly journals “There’s a Lot of Support”: Junior Doctors’ Experiences of the Medical Internship

2020 ◽  
Author(s):  
Yvonne Carlsson ◽  
Anna Nilsdotter ◽  
Stefan Bergman ◽  
Matilda Liljedahl
Keyword(s):  
Content Analysis ◽  
Medical Student ◽  
Medical School ◽  
Scientific Knowledge ◽  
Qualitative Content Analysis ◽  
Clinical Work ◽  
Qualitative Description ◽  
Healthcare Organisation ◽  
Junior Doctors ◽  
Depth Interviews

Abstract Background: It is known that the transition from medical school to clinical work can be stressful. In some countries, an introductory service bridges the gap, introducing the doctor-to-be to clinical work. However, there is a lack of scientific knowledge about whether these introductory services serve their purpose as justifiable introductions. To address the gap, this paper aimed to explore experiences that junior doctors hold of the medical internship.Methods: Using a qualitative description approach, data was collected through twelve individual in-depth interviews with volunteering medical interns from three different hospital sites in Sweden. Data were verbatim transcribed and analysed by qualitative content analysis, generating categories and themes. Results: Four main themes were identified in our data. The interns felt increasingly comfortable as doctors (‘finding one’s feet’) through taking responsibility for patients while receiving necessary help and assistance (‘a doctor with support’). Although appreciative of getting an overview of the healthcare organisation (‘healthcare sightseeing’), interns were exhausted by repeatedly changing workplaces and felt stuck in a rigid framework (‘stuck at the zoo’).Conclusions: This study showed that the transition from medical student to clinical doctor does not necessarily have to be characterised by stress and mental exhaustion but can, with extensive support, provide a fruitful opportunity for interns to grow into their roles as doctors.

Factors Influencing the Adoption of ISO/IEC 29110 in Thai Government Projects

2021 ◽  
pp. 1340-1366
Author(s):  
Veeraporn Siddoo ◽  
Noppachai Wongsai
Keyword(s):  
Content Analysis ◽  
Financial Support ◽  
Success Factors ◽  
Qualitative Content Analysis ◽  
Software Process ◽  
Time Constraints ◽  
Government Organizations ◽  
Factors Influencing ◽  
Thai Government ◽  
Depth Interviews

This paper presents the views of four Thai government organizations who had been awarded ISO/IEC 29110 Basic Profile Certification. Team ideas as to the success factors and barriers involved in implementations are explored. In-depth interviews with closed- and open-ended questions were conducted. The data collected was analyzed using qualitative content analysis. The results show two reasons for choosing standard, first, to enhance software development process, and second, because the financial support from the SIPA. The success factors were supportive organizational policy, staff participation, availability of time and resources for the improvement of the software process, consultations with the SIPA and team commitment and recognition. The barrier factors were time constraints, lack of experience, documentation load, unsynchronized means of communication and improper project selection. The findings were based on four diverse organizations. Other countries may take into account the variations e.g. working culture or organizational structure when seeking to apply these results.

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