scholarly journals Caring for depression in the dying is complex and challenging – survey of palliative physicians

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Lee ◽  
Sungwon Chang ◽  
Michelle DiGiacomo ◽  
Brian Draper ◽  
Meera R. Agar ◽  
...  
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Online Survey ◽  
Symptom Assessment ◽  
Depression Care ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Training And Research ◽  
Screening Assessment ◽  
Patient Burden

Abstract Background Depression is prevalent in people with very poor prognoses (days to weeks). Clinical practices and perceptions of palliative physicians towards depression care have not been characterised in this setting. The objective of this study was to characterise current palliative clinicians’ reported practices and perceptions in depression screening, assessment and management in the very poor prognosis setting. Methods In this cross-sectional cohort study, 72 palliative physicians and 32 psychiatrists were recruited from Australian and New Zealand Society of Palliative Medicine and Royal Australian and New Zealand College of Psychiatrists between February and July 2020 using a 23-item anonymous online survey. Results Only palliative physicians results were reported due to poor psychiatry representation. Palliative physicians perceived depression care in this setting to be complex and challenging. 40.0% reported screening for depression. All experienced uncertainty when assessing depression aetiology. Approaches to somatic symptom assessment varied. Physicians were generally less likely to intervene for depression than in the better prognosis setting. Most reported barriers to care included the perceived lack of rapidly effective therapeutic options (77.3%), concerns of patient burden and intolerance (71.2%), and the complexity in diagnostic differentiation (53.0%). 66.7% desired better collaboration between palliative care and psychiatry. Conclusions Palliative physicians perceived depression care in patients with very poor prognoses to be complex and challenging. The lack of screening, variations in assessment approaches, and the reduced likelihood of intervening in comparison to the better prognosis setting necessitate better collaboration between palliative care and psychiatry in service delivery, training and research.

scholarly journals Burnout Determinants among Nurses Working in Palliative Care during the Coronavirus Disease 2019 Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3358
Author(s):  
José Vítor Gonçalves ◽  
Luísa Castro ◽  
Guilhermina Rêgo ◽  
Rui Nunes
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Online Survey ◽  
Three Dimensions ◽  
Linear Regression Models ◽  
Perceived Health Status ◽  
Cross Sectional ◽  
National Network ◽  
Work Related ◽  
High Level

Nurses working in palliative care are at risk of burnout. The Copenhagen Burnout Inventory was used to determine burnout levels of nurses working in the Portuguese national network of palliative care. We evaluated the contribution of personal, work, and COVID-19 variables in three burnout subclasses: personal, work, and patient-related. A cross-sectional, exploratory, and quantitative design was employed and participants were sampled using convenience and snowball technique. An online survey was conducted and 153 nurses participated in our study. Socio-demographic characterization was conducted, levels of burnout and determinants were explored through multiple linear regression models for its three dimensions. High levels of personal, working, and patient burnout were present in 71 (46%), 68 (44%), and 33 nurses (22%), respectively. Most of them agreed that COVID-19 had an impact on their activities. Significant personal and work related burnout factors found were specialization in palliative care, self-perceived health status, unit type, weekly hours of work, and allocation to COVID-19 units. Gender was found to be a significant factor in patient-related burnout. There is a high level of burnout among nurses working in the Portuguese national network of palliative care. Measures for identification and mitigation of burnout are necessary to protect health care professionals.

scholarly journals Return to Learn After Sport-Related Concussion: A Survey of Secondary School and Collegiate Athletic Trainers

2018 ◽  
Vol 53 (10) ◽  
pp. 990-1003 ◽  
Author(s):  
Chelsea L. Williamson ◽  
Grant E. Norte ◽  
Donna K. Broshek ◽  
Joseph M. Hart ◽  
Jacob E. Resch
Keyword(s):  
Secondary School ◽  
Online Survey ◽  
Current Knowledge ◽  
Athletic Trainers ◽  
Management Policy ◽  
Annual Number ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Return To Learn ◽  
National Athletic Trainers Association

Context Recent recommendations have emphasized return-to-learn (RTL) protocols to aid athletes in recovery from sport-related concussion (SRC) but have been based primarily on anecdotal evidence. Objective To investigate the RTL practices of certified athletic trainers (ATs) after an SRC. Design Cross-sectional study. Setting Online survey. Patients or Other Participants A total of 1083 individuals (27%) from a random sample of 4000 ATs in the National Athletic Trainers' Association membership database completed an electronic survey. Participants consisted of 729 self-identified secondary school ATs (SSATs; 67.3%; experience = 14.0 ± 9.7 years) and 354 self-identified collegiate ATs (CATs; 32.7%; experience = 13.4 ± 9.7 years). Main Outcome Measure(s) We used χ2 analyses to assess respondent differences related to current knowledge, current practices, and available resources. Independent t tests were used to compare SSATs and CATs on years of certification and annual number of SRCs evaluated. Results Of our total respondents, 41.2% (n = 446) correctly indicated the absence of evidence-based RTL guidelines. Whereas most (73.9%, n = 800) respondents had an established RTL policy, only 38.1% (n = 413) used such guidelines in their clinical practice. Most (97.1%, n = 708) SSATs and 82.2% (n = 291) of CATs had access to (a) mental health professional(s); however, minorities of SSATs (21.4%, n = 156) and CATs (37.0%, n = 131) never accessed these resources to care for concussed student-athletes. Conclusions Our results suggested that, despite the absence of empirical evidence, most surveyed ATs incorporated some form of RTL protocol in their SRC management policy. The varying AT knowledge, clinical practices, and resources highlighted by our results should be considered when creating or refining an RTL protocol.

Assessing Patient Participation Burden Based on Protocol Design Characteristics

2019 ◽  
pp. 216847901986728
Author(s):  
Kenneth Getz ◽  
Venkat Sethuraman ◽  
Jessica Rine ◽  
Yaritza Peña ◽  
Sharma Ramanathan ◽  
...  
Keyword(s):  
Online Survey ◽  
Protocol Design ◽  
Retention Rates ◽  
Cross Sectional ◽  
Perceived Burden ◽  
Study Results ◽  
Design Characteristics ◽  
And Performance ◽  
Viable Approach ◽  
Patient Burden

Background: Although a number of studies have quantitatively measured investigative site burden to administer increasingly complex protocol designs, robust scholarly research has not been performed to quantify the burden that patients face as participants in clinical trials. Methods: This paper presents the results of a cross-sectional pilot study conducted by the Tufts Center for the Study of Drug Development and ZS Associates among nearly 600 patients via an online survey conducted between February and March 2019. Respondents rated the perceived burden of 60 commonly administered protocol procedures. The association and relationship between overall patient burden—derived from aggregating mean perceived burden ratings for individual procedures—and performance (eg, screen failure and retention rates, clinical trial cycle times) for a cross-sectional sample of 137 individual protocols was assessed. Descriptive statistics, significance tests, and univariate analyses were performed. Results: Strong positive, statistically significant associations were observed between a composite measure of patient burden and protocol-specific design and performance measures, most notably study visits above the tolerable mean and the study conduct duration from first patient first visit to last patient last visit. Conclusions: The study results suggest a new and viable approach to optimize protocol design and improve patient engagement.

scholarly journals EXPERIENCE OF LGBT PATIENTS AND FAMILY WITH HOSPICE AND PALLIATIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Palliative Care ◽  
Staff Training ◽  
Online Survey ◽  
Research Policy ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Future Research ◽  
Policy And Practice ◽  
Cross Sectional ◽  
Hospice And Palliative Care

Abstract This study examines the degree to which hospice and palliative care staff observe or perceive inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely to experience discrimination at their institution than non-LGB patients; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Findings reported also include: institutional non-discrimination policy, staff training, intake procedures, and comfort in assessing LGBT status. Implications for future research, policy, and practice will be presented.

scholarly journals The Changing Clinical Landscape in Acupuncture for Women’s Health: A Cross-Sectional Online Survey in New Zealand and Australia

2021 ◽  
Author(s):  
Sandro Graca ◽  
Debra Betts ◽  
Caroline A. Smith ◽  
Mike Armour ◽  
Kate Roberts
Keyword(s):  
New Zealand ◽  
Chinese Medicine ◽  
Women’S Health ◽  
Women's Health ◽  
Online Survey ◽  
Health Conditions ◽  
Health Practice ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Referral Networks

Abstract Background Acupuncture is growing in popularity as a treatment option for women’s health worldwide with reported increasing usage in the last ten years. A significant number of clinical trials and meta-analysis are now published on aspects of women’s health treatment with acupuncture. The aim of this survey was to explore if, how and why, aspects of acupuncture practice has changed since our last survey in 2013. Method An online cross-sectional survey of registered acupuncturists and Chinese Medicine practitioners in Australia and New Zealand. Questions covered the practitioner demographics and training, women’s health conditions commonly treated, modalities used, sources of information and continuing education (CE) (e.g. webinars), changes in clinical practice, and referral networks. Results One hundred and seventy registered practitioners responded to this survey, with 93% reporting treating women’s health in the last 12 months. The majority of respondents were from Australia (60%), held a bachelors level qualification (60%), and used a traditional Chinese medicine framework (86%). Most practitioners incorporated other modalities in addition to acupuncture. Most practitioners’ referral networks were predominantly based on word of mouth for menstrual, fertility and pregnancy related conditions, with referrals from medical practitioners being much less common. More than half (57%) reported having changed their women’s health practice in the past 12 months; just over a quarter of those who changed treatment (27%) reported it was due to research findings. The most commonly used sources of information/CE used to inform treatment were webinars and conferences, while peer-reviewed journal articles were the least commonly used source. Conclusion Acupuncture practitioners in Australia and New Zealand commonly treat women’s health conditions, but this is usually the result of women seeking them out, rather than being referred from a medical practitioner. The majority of practitioners did report changing their women’s health practice, but peer reviewed academic articles alone are not an ideal medium to convey this information since practitioners favour knowledge obtained from webinars and conferences. Academics and other clinician researchers should consider alternative means of disseminating knowledge beyond traditional academic publications and conferences, special interest groups may assist in this and also help improve research literacy.

scholarly journals Why do pharmacists leave the profession? A mixed-method exploratory study

2021 ◽  
Vol 19 (2) ◽  
pp. 2332
Author(s):  
Trudi J. Aspden ◽  
Pushkar R. Silwal ◽  
Munyaradzi Marowa ◽  
Rhys Ponton
Keyword(s):  
New Zealand ◽  
Mixed Method ◽  
Online Survey ◽  
Career Pathways ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Policy Documents ◽  
Pharmacy Profession ◽  
Wide Range ◽  
Professional Environment

Background: Recent New Zealand policy documents aim for pharmacists to be retained, and promote the provision of extended clinical pharmacy services. However, younger pharmacists have expressed dissatisfaction with the profession on informal social for a. Objectives: To explore the characteristics, and perspectives of pharmacy as a career, of recent Bachelor of Pharmacy (BPharm, four-year degree) graduates who have left, or are seriously considering leaving the New Zealand pharmacy profession in the near future and where they have gone, or plan to go. Methods: We conducted a cross-sectional study with a mixed-method explanatory sequential design. An anonymous online survey among those who completed their pharmacy undergraduate degree (BPharm or equivalent) in 2003 or later and who had left or who were seriously considering leaving the New Zealand pharmacy profession in the next five years, was open from 1st December 2018 to 1st February 2019. Recruitment occurred via University alumni databases, pharmacy professional organisations, pharmaceutical print media, social media and word-of-mouth. Ten semi-structured interviews were then conducted with a purposive sample of survey respondents. Descriptive statistics were generated from the quantitative data and qualitative data were analysed using manifest content analysis. Results: We received 327 analysable surveys of which 40.4% (n=132) were from those who had already left the New Zealand pharmacy sector at the time of the data collection and the rest (59.6% n=195) were those working within the sector, but seriously considering leaving the profession. Reasons most commonly reported for studying pharmacy were having an interest in health and wanting to work with people. The most common reasons for leaving, or wanting to leave, were dissatisfaction with the professional environment, including inadequate remuneration, and a perceived lack of career pathways or promotion opportunities. A wide range of career destinations were declared, with medicine being most frequently reported. Conclusions: Most of the reasons for leaving/considering leaving the profession reported relate to the values and features of the pharmacy profession such as the professional environment, remuneration and career pathways. These findings are consistent with other studies and may represent a barrier to achieving the aims of recent health policy documents.

scholarly journals A Cross-Sectional Description of Parental Perceptions and Practices Related to Risky Play and Independent Mobility in Children: The New Zealand State of Play Survey

2019 ◽  
Vol 16 (2) ◽  
pp. 262 ◽  
Author(s):  
Charlotte Jelleyman ◽  
Julia McPhee ◽  
Mariana Brussoni ◽  
Anita Bundy ◽  
Scott Duncan
Keyword(s):  
New Zealand ◽  
Online Survey ◽  
Health And Safety ◽  
Future Research ◽  
Emotional Wellbeing ◽  
Independent Mobility ◽  
Cross Sectional ◽  
Risky Play ◽  
Nationally Representative ◽  
Stranger Danger

The potential for risky play and independent mobility to increase children’s physical activity, and enhance cognitive development and emotional wellbeing has been recognised for some time. The aim of this study was to describe the attitudes of New Zealand parents towards such risky play practices and independent mobility, the barriers preventing them from allowing their children to participate, and how often their children engaged in risky play activities. An online survey comprised mostly of validated scales and standardised questions was completed by a nationally representative sample of 2003 parents. We found that parents had neutral feelings about the risk of injury to their child through play, rather they were concerned about road safety and “stranger danger”. There was strong agreement that there are multiple benefits to be gained from exposure to risk and challenge, and that health and safety rules are too strict. However, 73% of respondents stated that their 5–12 year old child seldom or never engaged in four or more risky activities, and only 14.3% engaged in four or more often or always. While parents agree that their child is likely to benefit from risky play, they do not have the confidence to allow their children to engage in such activities. Future research should address barriers and fears when implementing strategies to facilitate risky play.

Role of flavours in vaping uptake and cessation among New Zealand smokers and non-smokers: a cross-sectional study

2020 ◽  
Vol 30 (1) ◽  
pp. 108-110 ◽  
Author(s):  
Philip Gendall ◽  
Janet Hoek
Keyword(s):  
New Zealand ◽  
Online Survey ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cigarette Smokers ◽  
Former Smokers ◽  
Never Smokers

BackgroundConcerns about the effects of vaping have prompted calls to restrict e-cigarette flavours. Vaping proponents have criticised these proposals, which they argue may discourage smokers from taking up vaping or trigger relapse to smoking. We explored the role flavours play in vaping uptake and cessation among New Zealand cigarette smokers and vaping-susceptible never smokers (VSNS), and examined current vapers’ preferred flavours.MethodsWe conducted an online survey of 1005 New Zealanders aged 18–70 years that included 324 current vapers (vaped in the last 30 days) and 302 ‘past’ vapers (reported past vaping, but not within the last month). We asked respondents their reasons for vaping and explored current vapers’ preferred e-cigarette flavours; we analysed the data using descriptive statistics and logistic regression.ResultsIrrespective of smoking status, flavour was one of the main reasons respondents gave for vaping (smokers 83%; former smokers 77%; VSNS 80%). Flavour was less important to former vapers; 47% of smokers, 57% of former smokers and 64% of VSNS cited flavour as a reason for originally taking up vaping. Fruit flavours were most popular among all three groups; smokers also favoured tobacco flavour, while former smokers also favoured mint or menthol, and never smokers also favoured confectionery/sweets/lolly flavours.ConclusionsFlavours play a major role in vaping initiation for current smokers, former smokers and vaping-susceptible non-smokers, and remain important to those who continue vaping. Our findings highlight the need for regulation that allows some flavour diversity without the extravagant marketing currently used to promote vaping and e-liquids.

scholarly journals Comfort level of caregivers of cancer patients receiving palliative care

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Maisa Vitória Gayoso ◽  
Marla Andréia Garcia de Avila ◽  
Thays Antunes da Silva ◽  
Rúbia Aguiar Alencar
Keyword(s):  
Palliative Care ◽  
Functional Status ◽  
Cancer Patients ◽  
Symptom Assessment ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Comfort Level ◽  
Cross Sectional ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale

ABSTRACT Objective: To verify the association between the level of comfort of the caregiver and socio-demographic variables related to caregiving, and the patient’s functional status and symptoms. Method: Cross-sectional study with non-probabilistic intentional sample. The instruments Palliative Performance Scale (score 0 to 100%), Edmonton Symptom Assessment Scale (symptom scores from zero to ten) and Holistic Comfort Questionnaire (total score ranging from 49 to 294 and mean score from 1 to 6) were used. The relationship between comfort scores and independent variables was calculated by multiple linear regression. Results: Fifty informal caregivers participated in the study - 80% were female, 32% were 60 years old or older, 36% were children of the patient, 58% had paid work and 60% did not have help in the care. The mean overall comfort was 4.52 points. A better functional status of the patients was associated with higher levels of comfort of the caregivers. Older caregivers who received helped in the care activities presented higher comfort scores. Conclusion: The level of comfort of caregivers of cancer patients receiving palliative care was associated with socio-demographic variables and patients’ functional status and symptoms.

scholarly journals Needs of Terminally ill Patients and their Families: An Experience with Fifty-three Patients Attending a Newly Organized Palliative Care Service in Bangladesh

2009 ◽  
pp. 38-43
Author(s):  
Nezamuddin Ahmad ◽  
Mustafa Kamal ◽  
AHM Mostak Anwar ◽  
AKM Shafiqur Rahman
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Symptom Relief ◽  
Terminally Ill ◽  
Palliative Care Service ◽  
Disease Status ◽  
Symptom Assessment ◽  
Cross Sectional ◽  
Terminally Ill Cancer Patients ◽  
Terminally Ill Patients

Objective: To identify the needed care of the terminally ill patients and their families in Bangladesh Design: Retrospective, descriptive cross-sectional study Setting: Out Patient Consultation, referred admitted patients and home care visits by the same palliative care team of Bangabandhu Sheikh Mujib Medical University (BSMMU) Participants: 53 terminally ill cancer patients registered with the palliative care service of BSMMU Results: Age range of 22 to 80 years, mostly from middle to poor class. Most of the patients needed relief from pain, anxiety, sleeplessness and constipation along with other symptom relief. Major concern of patients was financial whereas major concern of family members was not to inform the patient of the disease status.. Preferred site of care was at home when uncertainty about the disease status was reduced. Conclusion: even if a ‘good life' is not possible for all the people of Bangladesh, ‘a good death for most of the patients suffering from incurable diseases can be an affordable reality. Key words: need, symptom assessment, palliative care, Bangladesh   Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.38-43

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