scholarly journals Palliative care provider attitudes toward existential distress and treatment with psychedelic-assisted therapies

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Halsey Niles ◽  
Colleen Fogg ◽  
Ben Kelmendi ◽  
Mark Lazenby
Keyword(s):  
Palliative Care ◽  
Advanced Practice Nurses ◽  
Educational Outreach ◽  
Advanced Practice ◽  
Health Providers ◽  
Care Providers ◽  
Snowball Sampling ◽  
Provider Attitudes ◽  
Practice Nurses ◽  
Existential Distress

Abstract Background Existential distress is a significant source of suffering for patients facing life-threatening illness. Psychedelic-Assisted Therapies (PAT) are novel treatments that have shown promise in treating existential distress, but openness to providing PAT may be limited by stigma surrounding psychedelics and the paucity of education regarding their medical use. How PAT might be integrated into existing treatments for existential distress within palliative care remains underexplored. Methods The present study aimed to elucidate the attitudes of palliative care clinicians regarding treatments for existential distress, including PAT. We recruited palliative care physicians, advanced practice nurses, and spiritual and psychological care providers from multiple US sites using purposive and snowball sampling methods. Attitudes toward PAT were unknown prior to study involvement. Semi-structured interviews targeted at current approaches to existential distress and attitudes toward PAT were analyzed for thematic content. Results Nineteen respondents (seven physicians, four advanced practice nurses, four chaplains, three social workers, and one psychologist) were interviewed. Identified themes were 1) Existential distress is a common experience that is frequently insufficiently treated within the current treatment framework; 2) Palliative care providers ultimately see existential distress as a psychosocial-spiritual problem that evades medicalized approaches; 3) Palliative care providers believe PAT hold promise for treating existential distress but that a stronger evidence base is needed; 4) Because PAT do not currently fit existing models of existential distress treatment, barriers remain. Conclusions PAT is seen as a potentially powerful tool to treat refractory existential distress. Larger clinical trials and educational outreach are needed to clarify treatment targets and address safety concerns. Further work to adapt PAT to palliative care settings should emphasize collaboration with spiritual care as well as mental health providers and seek to address unresolved concerns about equitable access.

scholarly journals Integration of Palliative Care in the Role of the Oncology Advanced Practice Nurse

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Betty R. Ferrell, RN, PhD, MA, FAAN, FPCN, CHPN ◽  
Rose Virani, RNC, MHA, FPCN ◽  
Elinor Han, BA ◽  
Polly Mazanec, PhD, ACNP-BC, AOCN, FPCN, FAAN
Keyword(s):  
Palliative Care ◽  
Training Program ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses ◽  
Disease Trajectory ◽  
Barriers To Implementation ◽  
Increasing Demand ◽  
One Year ◽  
Oncology Practice

Numerous organizations have cited the increasing demand for palliative care in oncology and the challenge of a limited workforce to deliver specialty palliative care. Advanced practitioners in oncology can provide generalist or primary palliative care to complement the care provided by specialists and enhance the overall provision of care. This article reports on a National Cancer Institute–funded training program to prepare advanced practice nurses to incorporate palliative care within their practice. One-year follow-up of the first three national cohorts (N = 276) included evaluation of goal achievement as these nurses integrated palliative care within their oncology practice. Goal analysis reported here demonstrates the success of the training program in impacting practice as well as the barriers to implementation efforts. The advanced practice registered nurses’ implemented goals included extensive training of clinicians across disciplines and numerous systems changes to improve delivery of palliative care. Advanced practice nurses will continue to be a valuable source of extending palliative care into oncology care to support patients and families across the disease trajectory.

scholarly journals Clarification and Mitigation of Ethical Problems Surrounding Withdrawal of Extracorporeal Membrane Oxygenation

2016 ◽  
Vol 36 (5) ◽  
pp. 56-65 ◽  
Author(s):  
Susan B. Williams ◽  
Michael D. Dahnke
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Moral Distress ◽  
Life Support ◽  
Ethical Issues ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Care Providers ◽  
Ethical Problems ◽  
Practice Nurses ◽  
Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice. In particular, these issues are considered in relation to how they affect and can be addressed by staff nurses and advanced practice nurses in the intensive care unit. Advanced practice nurses in particular can represent the voice of nurses to promote a healthier workplace in situations of moral distress related to stopping ECMO life-support technology and in developing clear and consistent guidelines for ceasing ECMO treatment, all leading toward clarification and mitigation of the ethical problems surrounding the withdrawal of this critical technology.

Evolution of the Palliative Team

2021 ◽  
pp. 23-30
Author(s):  
Britni Lookabaugh ◽  
Charles von Gunten
Keyword(s):  
Palliative Care ◽  
Physician Assistants ◽  
Advanced Practice Nurses ◽  
Interdisciplinary Teams ◽  
Direct Care ◽  
Advanced Practice ◽  
Practice Nurses ◽  
Care Services ◽  
Palliative Care Services ◽  
Hospice And Palliative Care

Hospice and palliative care teams are inherently interdisciplinary to be able to assess and address all the domains of palliative care for patients with chronic, complex, and life-limiting illness. These domains include the physical, psychosocial, spiritual, and practical needs of patients and families, among others. The disciplines include, but are not limited to, physician, advanced practice provider, pharmacist, nurse, social worker, and chaplain, among others. Advanced practice providers are defined in the National Consensus Project Guidelines for Quality Palliative Care as physician assistants and advanced practice nurses utilized to expand the capacity of palliative care interdisciplinary teams to deliver complex care and provide direct care. The term advanced practice provider means either physician assistants or advanced practice nurses. The development of an interdisciplinary team in the midst of team and consult growth is essential to be able to provide high-quality palliative care. Team resilience should be supported and maintained as it is necessary to meet the high demand for specialty palliative care services throughout the care continuum.

scholarly journals Palliative Care for Advanced Practice Nurses

2015 ◽  
Vol 26 (2) ◽  
pp. 108-109
Author(s):  
Denise Buonocore ◽  
Debra L. Wiegand
Keyword(s):  
Palliative Care ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses

Knowledge, Attitudes, and Perceptions of Advanced Practice Nurses Regarding Urinary Incontinence in Older Adult Women

2010 ◽  
Vol 24 (4) ◽  
pp. 260-279 ◽  
Author(s):  
Linda J. Keilman ◽  
Karen S. Dunn
Keyword(s):  
Urinary Incontinence ◽  
Older Adult ◽  
Health Care Providers ◽  
Advanced Practice Nurses ◽  
Adult Women ◽  
Advanced Practice ◽  
Care Providers ◽  
Cross Sectional ◽  
Practice Nurses ◽  
Attitudes And Perceptions

This study examined the level of knowledge and the attitudes and perceptions of advanced practice nurses (APNs) regarding urinary incontinence (UI) in older adult women. UI is a common health issue for older adult women, and APNs are in a unique position as health care providers to prevent, diagnose, treat, and manage the condition successfully. Little is known about how well APNs were educated regarding UI, especially in older adult women. Purposive sampling was utilized to conduct a cross-sectional, descriptive, and correlational design study. Fifty-four APNs completed a questionnaire developed by the author based on the aging literature, advanced practice nursing competencies, and UI guidelines. Findings suggest that APNs generally have positive attitudes, perceptions, and knowledge of UI in women. However, participants had difficulty in applying this knowledge to the clinical setting: assessing, diagnosing, treating, and managing UI. More emphasis is needed in graduate nursing curriculums and in precepted clinical experiences regarding UI in women.

Palliative Care for Advanced Practice Nurses

2015 ◽  
Vol 26 (2) ◽  
pp. 108-109
Author(s):  
Denise Buonocore ◽  
Debra L. Wiegand
Keyword(s):  
Palliative Care ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses

Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams

2016 ◽  
Vol 34 (4) ◽  
pp. 330-334 ◽  
Author(s):  
Sean O’Mahony ◽  
Tricia J. Johnson ◽  
Shawn Amer ◽  
Marlene E. McHugh ◽  
Janet McHenry ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses

Beratungsqualität von Pflegeexpertinnen-APN im spitalexternen Bereich (APN-BQ) – Psychometrische Testung des Instruments

Pflege ◽  
2014 ◽  
Vol 27 (6) ◽  
pp. 393-403
Author(s):  
Heidi Petry ◽  
Susanne Suter-Riederer ◽  
Carmen Kerker-Specker ◽  
Lorenz Imhof
Keyword(s):  
Advanced Practice Nurses ◽  
Alte Menschen ◽  
Advanced Practice ◽  
Varimax Rotation ◽  
Practice Nurses ◽  
Chronisch Kranke

Hintergrund: Patientenzentrierte und individuell ausgerichtete Angebote, wie die häusliche Beratung durch Pflegeexpertinnen-APN (Advanced Practice Nurses), eignen sich besonders, chronisch kranke alte Menschen in einer möglichst selbstständigen Lebensführung zu unterstützen. Methode: Um die Qualität einer patientenzentrierten Beratung zu evaluieren, wurde ein 23-Item Instrument entwickelt und seine psychometrischen Eigenschaften mit einer Stichprobe von 206 Personen, die 80 Jahre und älter waren getestet. Ziel: Ziel dieses Artikels ist es, die Entwicklung und Evaluation des APN-BQ zu beschreiben. Die psychometrische Testung des Instruments erfolgte anhand einer Hauptkomponentenanalyse mit Varimax-Rotation. Ergebnisse: Die Analyse ergab eine stabile vier Faktorenstruktur (FS = 0,91) mit 19 Items. Alle Faktoren hatten eine Faktorladung > 0,45. Die interne Konsistenz der Gesamtskala ergab einen Wert von Cronbachs alpha 0,86. Die hohe Rücklaufquote der Fragebogen und die Tatsache, dass 98,8 % der Fragen beantwortet wurden, bestätigten die Anwendungsfreundlichkeit und Akzeptanz des Instruments. Schlussfolgerungen: Das APN-BQ erwies sich als zuverlässiges und in Bezug auf Inhalt und Konstrukt valides Instrument, die Struktur-, Prozess- und Ergebnisqualität einer patientenzentrierten Beratungsintervention in der gemeindenahen Versorgung sowie das Ausmaß der Partizipation und Selbstbefähigung (Empowerment) der zu Beratenden zu messen.

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