scholarly journals An examination of home-based end-of-life care for cancer patients: a qualitative study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Xiao Bin Lai ◽  
Li Qun Chen ◽  
Shu Hui Chen ◽  
Hai Ou Xia
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Community Health ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Community Health Service ◽  
Life Care ◽  
Care Providers ◽  
Home Based

Abstract Background Only a small number of patients have utilized the home-based end-of-life care service in Shanghai that has been offered since 2012. This study explores how home-based end-of-life care is delivered in community health service centers in Shanghai and examines the difficulties in the delivery of the care. Methods This was a qualitative study in which data were collected from interviews and analyzed using qualitative content analysis. Nineteen health care providers with experience in delivering home-based end-of-life care in 12 community health service centers were recruited. The interviews were conducted between August 2018 and February 2019. Results Four themes emerged from the interviews: (i) Patients under home-based end-of-life care: Patients receiving the care were cancer patients with less than 1 year of life expectancy. The criteria for patients were broad. (ii) Service structure: The service was delivered regularly by the physicians and nurses using the approaches of home visits and/or telephone follow-ups. (iii) Service process: The service consisted of multiple components, including monitoring the patient’s condition, managing the patient’s symptoms, giving daily care instructions, performing nursing procedures, and giving psychological support. However, most of the care focused on monitoring the patients and managing their physical discomfort. (iv) Difficulties in delivering care: Being unable to provide the service and feeling powerless when facing psycho-spiritual problems were the two major difficulties. Three factors contributed to the suspension of the service: The gap between the service and the needs of the patients, a lack of patients, and low work motivation. The demand that the truth be concealed from the families and their attitude of avoiding talking about death were the key factors of the failure of psycho-spiritual care. Conclusions Several issues should be addressed before the service can be further developed, including fully understanding the needs and preferences of local patients and their families, securing more financial support and a better supply of drugs, delivering better training for staff, and ensuring greater rewards for individuals and institutions providing the service.

scholarly journals Home-Based End-of-Life Care Program for Oncology Patients in Rwanda

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 176s-176s
Author(s):  
O. Mukeshimana ◽  
B. Uhagaze ◽  
C. Ntizimira
Keyword(s):  
Pain Management ◽  
Health Service ◽  
Service Delivery ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Health Service Delivery ◽  
Community Level ◽  
Life Care ◽  
Home Based

Background and context: Almost two-thirds of the 7.6 million deaths every year from cancer worldwide occur in low-income and middle income countries, making cancer a leading cause of mortality in these settings. In Rwanda, we are focused on the development of the tools needed to perform social and health service delivery in addition to policy research in resource-limited settings. There is a real need for qualified staff members who are able to ask appropriate questions, to make relevant hypotheses, develop research protocols, and conduct effective studies to identify innovative approaches in social and health service delivery. Cancer patients undergoing end-of-life care suffer from physical pain, mental illness and psychological trauma. Aim: The aims of this project are to identify cancer patients at end-of-life care at the community level without appropriate support through a mobile clinic, to mobilize existing resources to introduce home based care at the community level with participation of community health workers and to sensitize the population in cancer prevention and supportive care of patient using African socio-cultural perspectives. Strategy/Tactics: This project, the first kind in Rwanda, bring at home the same services cancer patients receive at the hospital level except for access to chemotherapy or radiotherapy. And it's where all those services provided and patients' family are counseled and reduce the burden and challenges they used to have going to hospital. Program/Policy process: During this project patients are visited in their homes and are treated mostly with pain management and their complaints are listened to together with other issues related to cancer, then their families are also approached to clearly explain to them the case of the patient and how to well console him/her and support in their sickness, all these are done periodically with assessment of past visits. Outcomes: Before this project, many people used to die early due to lack of pain management, counseling and follow-up, and also patient families used to abandon them at home or at health facilities. With this current project people have already started to understand that cancer can be treated like other diseases and this awareness helps in the advocacy for pain treatment and availability of pain killers for cancer patients. What was learned: The lessons learned from this project is that home based end of life care for oncology is an important tool to care for oncology patients and to reduce the burdens they have such as pain and depression and also the burdens for their families such as loss of money in the cost of treatment. This program can be expanded to reach as many as possible patients and their families.

scholarly journals What does effective end-of-life care at home for children look like? A qualitative interview study exploring the perspectives of bereaved parents

2021 ◽  
pp. 026921632110233
Author(s):  
Cari Malcolm ◽  
Katherine Knighting
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Life Care ◽  
Care Providers ◽  
Specialist Care ◽  
Bereaved Parents ◽  
Home Based ◽  
Qualitative Interview Study ◽  
At Home

Background: End-of-life care for children with life-shortening conditions is provided in a range of settings including hospital, hospice and home. What home-based, end-of-life care should entail or what best practice might look like is not widely reported, particularly from the perspective of parents who experienced the death of a child at home. Aim: To explore the value and assess the effectiveness of an innovative model of care providing home-based, end-of-life care as perceived by families who accessed the service. Design: A qualitative descriptive study design was employed with in-depth semi-structured interviews conducted with bereaved parents. Setting/participants: Thirteen bereaved parents of 10 children supported by the home-based end-of-life care service. Results: Parents reported effective aspects of end-of-life care provided at home to include: (1) ability to facilitate changes in preferred place of death; (2) trusted relationships with care providers who really know the child and family; (3) provision of child and family-centred care; (4) specialist care and support provided by the service as and when needed; and (5) quality and compassionate death and bereavement care. Parents proposed recommendations for future home-based end-of-life care including shared learning, improving access to home-based care for other families and dispelling hospice myths. Conclusion: Parents with experience of caring for a dying child at home offer valuable input to future the policy and practice surrounding effective home-based, end-of-life care for children. New models of care or service developments should consider the key components and attributes for effective home-based end-of-life identified by bereaved parents in this study.

scholarly journals Challenges Faced by Chinese Community Nurses When Providing Home-based Hospice and Palliative Care: a Descriptive Qualitative Study

2021 ◽  
Author(s):  
Jinxin Zhang ◽  
Yingjuan Cao ◽  
Mingzhu Su ◽  
Joyce Cheng ◽  
Nengliang Yao
Keyword(s):  
Palliative Care ◽  
Health Service ◽  
Qualitative Study ◽  
Community Health ◽  
Medical Personnel ◽  
Community Health Service ◽  
Future Research ◽  
Home Based ◽  
Hospice And Palliative Care ◽  
Descriptive Qualitative

Abstract Background: Hospital facilities in China are experiencing increased strain on existing systems and medical resources, which necessitates the use of home-based hospice and palliative care (HBHPC). HBHPC primarily relies on community nurses and related medical personnel. Understanding the challenges that community nurses face when providing this form of care is urgently needed to optimize the design and delivery of HBHPC. Our study aimed to gain insight into community nurses’ challenges when providing HBHPC for patients.Methods: We performed a descriptive qualitative study with a phenomenology approach. Purposive sampling was used to recruit 13 nurses from two community health service centers in Jinan, Shandong Province, China. A thematic analysis was applied to identify themes from the transcribed data.Results: Three major themes emerged: 1) Community nurses’ inadequate self-preparation for providing HBHPC; 2) Patients and their families’ non-collaboration in HBHPC; 3) Community health service career disadvantages. Conclusion: Community nurses faced multifaceted challenges in home care settings. This study could provide a framework for guiding the improvement of interventional variables in the provision of HBHPC. Future research should involve developing effective methods of improving community nurses’ job motivation and community health service institutions’ incentive systems, as well as increasing advocacy around HBHPC.

scholarly journals Emotional labour in palliative and end-of-life care communication: A qualitative study with generalist palliative care providers

2019 ◽  
Vol 102 (3) ◽  
pp. 494-502 ◽  
Author(s):  
Lisa Jane Brighton ◽  
Lucy Ellen Selman ◽  
Katherine Bristowe ◽  
Beth Edwards ◽  
Jonathan Koffman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Providers ◽  
Emotional Labour ◽  
Generalist Palliative Care

scholarly journals Interprofessional case conferences to bridge perception gaps regarding ethical dilemmas in home-based end-of-life care: a qualitative study

2020 ◽  
Vol 15 (3) ◽  
pp. 104-115
Author(s):  
Yoshihisa Hirakawa ◽  
Chifa Chiang ◽  
Tsukasa Muraya ◽  
Hideaki Andoh ◽  
Atsuko Aoyama
Keyword(s):  
Qualitative Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Ethical Dilemmas ◽  
Life Care ◽  
Home Based ◽  
Case Conferences
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