District nurses' experiences of providing palliative care in the home: An interview study

2019 ◽  
Vol 40 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Elina Mikaelsson Midlöv ◽  
Terese Lindberg
Keyword(s):  
Palliative Care ◽  
Content Analysis ◽  
Home Care ◽  
Qualitative Content Analysis ◽  
Care Team ◽  
Organizational Changes ◽  
Structured Interviews ◽  
Palliative Home Care ◽  
District Nurses ◽  
At Home

The trend shows that more people are choosing to die at home. Since at home palliative care is often provided by district nurses, their work will be affected, and the burden will increase. The aim of this study was to illuminate district nurses' experiences of providing palliative care in the home. Qualitative semi-structured interviews were conducted with 12 district nurses. The interviews were analyzed according to the qualitative content analysis methods that Graneheim and Lundman describe. Findings consist of three main categories with nine subcategories. The conclusion is that collaboration with others is essential. Providing palliative care in the home is both emotionally rewarding and demanding, and the work is additionally time and expertise consuming. District nurses want more resources and organizational changes, such as access to doctors and a palliative home care team who only work with these patients. This would be an advantage both for district nurses and the patients.

Scarborough's Palliative ‘At-Home’ Care Team (PACT): A Model for a Suburban Physician Palliative Care Team

1995 ◽  
Vol 11 (3) ◽  
pp. 43-49 ◽  
Author(s):  
J.S. Gardner-Nix ◽  
R. Brodie ◽  
E. Tjan ◽  
M. Wilton ◽  
L. Zoberman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Palliative Care Team ◽  
Care Team ◽  
At Home

Cooperating with a palliative home-care team: expectations and evaluations of GPs and district nurses

2005 ◽  
Vol 19 (3) ◽  
pp. 241-250 ◽  
Author(s):  
Dorthe Goldschmidt ◽  
Mogens Groenvold ◽  
Anna Thit Johnsen ◽  
Annette S Strömgren ◽  
Allan Krasnik ◽  
...  
Keyword(s):  
Home Care ◽  
Care Team ◽  
Palliative Home Care ◽  
District Nurses

scholarly journals Gastrointestinal Symptoms in Children With Life-Limiting Conditions Receiving Palliative Home Care

2021 ◽  
Vol 9 ◽  
Author(s):  
Holger Hauch ◽  
Peter Kriwy ◽  
Andreas Hahn ◽  
Reinhard Dettmeyer ◽  
Klaus-Peter Zimmer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Phase 1 ◽  
Gastrointestinal Symptoms ◽  
Phase 2 ◽  
Palliative Home Care ◽  
Asymptomatic Children ◽  
Number Of Patients ◽  
Gi Symptoms ◽  
At Home

Context: Children with life-limiting diseases suffer from gastrointestinal (GI) symptoms. Since the introduction of specialized palliative home care (SPHC) in Germany, it is possible to care for these children at home. In phase 1 of care the aim is to stabilize the patient. In phase 2, terminal support is provided.Objectives: Analysis were performed of the differences between these phases. The causes and modalities/outcome of treatment were evaluated.Methods: A retrospective study was performed from 2014 to 2020. All home visits were analyzed with regard to the abovementioned symptoms, their causes, treatment and results.Results: In total, 149 children were included (45.9% female, mean age 8.17 ± 7.67 years), and 126 patients were evaluated. GI symptoms were common in both phases. Vomiting was more common in phase 2 (59.3 vs. 27.1%; p < 0.001). After therapy, the proportion of asymptomatic children in phase 1 increased from 40.1 to 75.7%; (p < 0.001). Constipation was present in 52.3% (phase 1) and 54.1% (phase 2). After treatment, the proportion of asymptomatic patients increased from 47.3 to 75.7% in phase 1 (p < 0.001), and grade 3 constipation was reduced from 33.9 to 15% in phase 2 (p < 0.05).Conclusion: Painful GI symptoms occur in both palliative care phases but are more common in phase 2. The severity and frequency can usually be controlled at home. The study limitations were the retrospective design and small number of patients, but the study had a representative population, good data quality and a unique perspective on the reality of outpatient pediatric palliative care in Germany.

Supportive care day hospital: A new tool for palliative care in cancer centers.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 170-170
Author(s):  
Carole Bouleuc
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Supportive Care ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Plan ◽  
Day Hospital ◽  
Cancer Centers ◽  
Advance Care ◽  
At Home

170 Background: In May 2005, the Curie Institute in Paris opened the first supportive care day hospital in France. This type of new ward is now very frequent in the French comprehensive cancer centers. Methods: Patients are managed by the palliative care team with a two-part team of a physician and a nurse in order to address their supportive care needs: advanced-care symptoms, psychosocial distress, medical questions and concerns, support need in decision making, end of life care preference and advance care plan when patients or caregivers when needed. Depending of the needs identified by the palliative care team assess, at least 2 of the following healthcare professionals will intervene: oncologist, pain physician, psycho-oncologist, dietitician, social worker, physiotherapist. Coordination with the home care team takes systematically place (with general practitioner, nurse and home palliative care team). New symptoms occurrence are explored with biological test or radiographic examination when necessary. Medical procedures are sometimes performed like venous perfusion therapy, blood transfusions, or draining effusion after ultrasonic tracking. It is possible to offer the patient hypnosis, relaxation or sophrology consultation. Eventually at the end of the in-patient stay, the patient is given a medical synthesis with therapeutic recommendations and personalized care plan. 1 Physician and two nurses are needed to manage 4 patients every day. Results: In 2016 we have admitted 350 patients and performed 948 stays in our supportive rand 55% of them have breast cancer. Median survival since the first day at supportive care day hospital is 65 days. Death at home occurred in 15% of patients and in hospice for 62%. Home death is more often when patients don’t have any dyspnea are included in a home palliative care network and when they receive the last chemotherapy more than 30 days before death. More date will be shown. Conclusions: Supportive care day hospital is really a good tool for integrated palliative care, promoting collaboration with oncologists, coordination with home care teams, and advance care planning, so that patients can longer stay at home as they often hope so.

A Study of the Association Between Multidisciplinary Home Care and Home Death Among Thai Palliative Care Patients

2016 ◽  
Vol 34 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Kittiphon Nagaviroj ◽  
Thunyarat Anothaisintawee
Keyword(s):  
Palliative Care ◽  
Logistic Regression ◽  
Home Care ◽  
Home Visits ◽  
Place Of Death ◽  
Home Death ◽  
Data Set ◽  
Palliative Home Care ◽  
Palliative Care Teams ◽  
At Home

Purpose: Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death. Methods: A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient’s profile, disease status, functional status, patient’s symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient’s actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home. Results: A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38). Conclusion: Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand.

scholarly journals Patients’ Experiences of Telehealth in Palliative Home Care: Scoping Review

10.2196/16218 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e16218 ◽  
Author(s):  
Simen A Steindal ◽  
Andréa Aparecida Goncalves Nes ◽  
Tove E Godskesen ◽  
Alfhild Dihle ◽  
Susanne Lind ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Palliative Care ◽  
Home Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Visual Features ◽  
Palliative Home Care ◽  
At Home

Background Telehealth is increasingly being used in home care and could be one measure to support the needs of home-based patients receiving palliative care. However, no previous scoping review has mapped existing studies on the use of telehealth for patients in palliative home care. Objective The aim of this study was to map and assess published studies on the use of telehealth for patients in palliative home care. Methods A scoping review was conducted using the methodological framework of Arksey and O’Malley. Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic and comprehensive search of Medical Literature Analysis and Retrieval System Online, EMBASE, PsycINFO, and Cumulative Index to Nursing and Allied Health was performed for studies published between January 2000 and October 2018. Two authors independently assessed eligibility and extracted data. Results The review included 22 papers from 19 studies. Four thematic groupings were identified among the included papers: easy and effortless use of telehealth regardless of the current health condition, visual features that enhance communication and care via telehealth, symptom management and self-management promotion by telehealth, and perceptions of improved palliative care at home. Conclusions The use of telehealth in palliative home care seems to be feasible, improving access to health care professionals at home and enhancing feelings of security and safety. The visual features of telehealth seem to allow a genuine relationship with health care professionals. However, there are contradicting results on whether the use of telehealth improves burdensome symptoms and quality of life. Future research should investigate the experiences of using telehealth among patients with life-limiting illness other than cancer and patients aged 85 years or older. More research is needed to increase the body of knowledge regarding the effectiveness of telehealth on symptoms and quality of life.

scholarly journals How to support patients who are crying in palliative home care: an interview study from the nurses’ perspective

2016 ◽  
Vol 17 (05) ◽  
pp. 479-488 ◽  
Author(s):  
Kerstin Rydé ◽  
Katarina Hjelm
Keyword(s):  
Home Care ◽  
Qualitative Content Analysis ◽  
Close Contact ◽  
Structured Interviews ◽  
Palliative Home Care ◽  
Pain Anxiety ◽  
Explorative Study ◽  
Sense Of Security ◽  
Practical Support ◽  
Different Types

AimThe aim of this study was to explore how nurses can support patients who are crying in a palliative home care context.BackgroundIn palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse’s responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons.MethodsA qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32–63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis.FindingsIt was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient’s wishes. A few examples of the patients’ need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.

scholarly journals Implementing welfare technology in palliative homecare for patients with cancer: a qualitative study of health-care professionals’ experiences

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Lina Oelschlägel ◽  
Alfhild Dihle ◽  
Vivi L. Christensen ◽  
Kristin Heggdal ◽  
Anne Moen ◽  
...  
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Palliative Home Care ◽  
Patients With Cancer ◽  
Welfare Technology ◽  
Professional Care ◽  
Municipal Health ◽  
At Home

Abstract Background Introducing welfare technology in home-based palliative care has been suggested to be beneficial for improving access to health care at home and enhancing patients’ feelings of security and safety. However, little is known about the experiences of municipal health-care professionals using welfare technology in palliative home care. The aim of this study was to explore municipal health-care professionals’ experiences regarding the significant challenges, facilitators, and assessments associated with implementing a technological solution named “remote home care” in palliative home care for patients with cancer. Methods A qualitative, descriptive, exploratory design was used. Data were collected through focus-group interviews and individual semi-structured interviews with interdisciplinary health-care professionals who had experience using remote home care in clinical encounters with cancer patients who were in the palliative phase and living at home. Data were analyzed using qualitative content analysis. Results Three themes were identified: 1) shifting from objective measures to assessing priorities for patients, 2) lack of experience and personal distress regarding cancer inhibits professional care, and 3) prominent organizational challenges undermine the premise of remote home care. Conclusion The results showed that shifting from a disease-focused to a person-centered approach enables health-care professionals to assess patients’ personal priorities. However, health-care professionals’ uncertainty and lack of knowledge and experience, along with organizational issues concerning information-sharing, represent great challenges that have the potential to inhibit professional care. The availability of networks through which difficult issues can be discussed was highlighted as being a fundamental resource for facilitating the provision of care.

scholarly journals Community Nurses’ Preparations for and Challenges in Providing Palliative Home Care: A Qualitative Study

2021 ◽  
Vol 18 (22) ◽  
pp. 11838
Author(s):  
Chien-Yi Wu ◽  
Yu-Hsuan Wu ◽  
Yi-Hui Chang ◽  
Min-Shiow Tsay ◽  
Hung-Cheng Chen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Critical Role ◽  
Home Care Services ◽  
Structured Interviews ◽  
Community Based ◽  
Palliative Home Care ◽  
Care Services ◽  
Leading Role ◽  
Study Results

Hospitals have played a leading role in providing palliative care in Taiwan as its care model has developed over the past few decades. However, earlier local studies in Taiwan showed that terminal patients prefer to die at home, highlighting the need to promote community-based palliative care instead of hospital-based care. Along with this shift, how community nurses provide palliative home care merits further exploration. This qualitative descriptive study aims to understand (1) how community nurses implement community-based palliative care, (2) what preparations are needed, and (3) what challenges they may face. Purposive sampling was used for recruiting nurses. We conducted one-on-one, in-depth, semi-structured interviews. Interview recordings were transcribed verbatim and analyzed using thematic analysis. Eight community nurses with a range of experience in palliative home care were interviewed. Four major themes emerged: (1) Opportunities, (2) Qualifications, (3) Support, and (4) Commitments. Psychological preparedness, well-developed professional capabilities, external assistance, and peer support motivate community nurses to offer community-based palliative care. As the requests for palliative home care services increase, community nurses play a critical role in palliative home care. Although the sample size is small and the findings retrieved from a small number of experiences might not be generalized to every region, the study results could inform future experience-sharing and workshop sessions to train more nurses for community-based care, expanding service coverage, and providing optimal palliative care.

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