scholarly journals Future palliative competence needs – a qualitative study of physicians’ and registered nurses’ views

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arja Suikkala ◽  
Anniina Tohmola ◽  
Eeva K. Rahko ◽  
Minna Hökkä
Keyword(s):  
Palliative Care ◽  
Registered Nurses ◽  
Postgraduate Education ◽  
Communicable Diseases ◽  
Continuous Assessment ◽  
Cross Sectional ◽  
Care Services ◽  
Social Welfare Services ◽  
Palliative Care Services ◽  
Assessment Of Competence

Abstract Background Globally, the need for palliative care will increase as a result of the ageing of populations and the rising burden of cancer, non-communicable diseases as well as some communicable diseases. Physicians and registered nurses working in palliative care should have a sufficient level of education and competence in managing the changing needs and requirements of palliative care. There is, however, need for evidence-based palliative care training and education of physicians and registered nurses. The purpose of this study was to describe the views of physicians and registered nurses regarding future competence needs within palliative care. Methods The study was conducted through use of a cross-sectional qualitative design. A total of 54 physicians and 110 registered nurses completed an open-ended questionnaire about the future competence needs of palliative care. The data were analyzed using inductive content analysis. Results The results revealed four main competence needs within palliative care for the coming decade: palliative care competence at all levels within healthcare and social welfare services; individualized palliative care competence; person-centered encounters competence; and systematic competence development within palliative care. Conclusions The results offer cues for education and professional development, which can be used to support physicians and registered nurses when future palliative care competences are included in educational programs. Seamless cooperation between palliative care services and educational institutions is recommended to ensure that undergraduate and postgraduate education is based on a continuous assessment of competence requirements within the field of palliative care. Therefore, online multi-professional simulations, for example, could be used to enhance future competencies within palliative care; undergraduate medical, nursing and allied healthcare students as well as postgraduate palliative care professionals and experts of experience could work together during simulations.

scholarly journals Family carer support in home and hospital: a cross-sectional survey of specialised palliative care

2019 ◽  
Vol 10 (4) ◽  
pp. e33-e33
Author(s):  
Maarten Vermorgen ◽  
Aline De Vleminck ◽  
Kathleen Leemans ◽  
Lieve Van den Block ◽  
Chantal Van Audenhove ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Information Support ◽  
Family Carers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services

ObjectivesTo evaluate: (1) to what extent family carers of people supported by specialised palliative care services felt they had been provided with information, support and aftercare and (2) how this varied by type of palliative care service, length of enrolment and characteristics of deceased.MethodsA cross-sectional postal survey was conducted using a structured questionnaire with nine items on information, support and aftercare provided by specialised palliative care services to family carers. Flemish family carers of people who had made use of specialised palliative care services at home or in hospital were contacted.ResultsOf all primary family carers (response rate of 53.5% resulting in n=1504), 77.7% indicated they were asked frequently by professionals how they were feeling. Around 75% indicated they had been informed about specific end-of-life topics and around 90% felt sufficiently supported before and immediately after the death. Family carers of people who had died in a palliative care unit, compared with other types of specialised palliative care services, indicated having received more information, support and aftercare.ConclusionsFamily carers evaluate the professional assistance provided more positively when death occurred in a palliative care unit. Policy changes might be needed to reach the same level of care across all specialised palliative care services.

scholarly journals Specialist palliative care services response to ethnic minority groups with COVID-19: equal but inequitable—an observational study

2021 ◽  
pp. bmjspcare-2021-003083
Author(s):  
Sabrina Bajwah ◽  
Jonathan Koffman ◽  
Jamilla Hussain ◽  
Andy Bradshaw ◽  
Mevhibe B Hocaoglu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Ethnic Minority ◽  
Online Survey ◽  
Minority Groups ◽  
Categorical Variables ◽  
Free Text ◽  
Ethnic Minority Groups ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services

ObjectivesTo develop insights into response of palliative care services caring for people from ethnic minority groups during COVID-19.MethodsCross-sectional online survey of UK palliative care services response to COVID-19. Quantitative data were summarised descriptively and χ2 tests used to explore relationships between categorical variables. Free text comments were analysed using reflexive thematic analysis.Results277 UK services responded. 168 included hospice teams (76% of all UK hospice teams). Services supporting those from ethnic minority groups were more likely to include hospital (p<0.001) and less likely to include hospice (p<0.001) or home care teams (p=0.008). 34% (93/277) of services had cared for patients with COVID-19 or families from ethnic minority groups. 66% (61/93) of these services stated no difference in how they supported or reached these groups during the pandemic.Three themes demonstrated impact of policy introduced during the pandemic, including: disproportionate adverse impact of restricted visiting, compounded communication challenges and unmet religious and faith needs. One theme demonstrated mistrust of services by ethnic minority groups, and the final theme demonstrated a focus on equal and individualised care.ConclusionsPolicies introduced during the COVID-19 pandemic may have adversely impacted those from ethnic minority groups making these at-risk populations even more vulnerable. The palliative care response may have been equal but inequitable. During the para-COVID-19 period, systemic steps, including equality impact assessments, are urgently needed.

scholarly journals Understanding the impact of the Covid-19 pandemic on delivery of rehabilitation in specialist palliative care services: An analysis of the CovPall-Rehab survey data

2021 ◽  
pp. 026921632110633
Author(s):  
Joanne Bayly ◽  
Andy Bradshaw ◽  
Lucy Fettes ◽  
Muhammed Omarjee ◽  
Helena Talbot-Rice ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Survey ◽  
Rehabilitation Services ◽  
Free Text ◽  
Specialist Palliative Care ◽  
Advanced Illness ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
The Impact

Background: Palliative rehabilitation involves multi-professional processes and interventions aimed at optimising patients’ symptom self-management, independence and social participation throughout advanced illness. Rehabilitation services were highly disrupted during the Covid-19 pandemic. Aim: To understand rehabilitation provision in palliative care services during the Covid-19 pandemic, identifying and reflecting on adaptative and innovative practice to inform ongoing provision. Design: Cross-sectional national online survey. Setting/participants: Rehabilitation leads for specialist palliative care services across hospice, hospital, or community settings, conducted from 30/07/20 to 21/09/2020. Findings: 61 completed responses (England, n = 55; Scotland, n = 4; Wales, n = 1; and Northern Ireland, n = 1) most frequently from services based in hospices (56/61, 92%) providing adult rehabilitation. Most services (55/61, 90%) reported rehabilitation provision becoming remote during Covid-19 and half reported reduced caseloads. Rehabilitation teams frequently had staff members on sick-leave with suspected/confirmed Covid-19 (27/61, 44%), redeployed to other services/organisations (25/61, 41%) or furloughed (15/61, 26%). Free text responses were constructed into four themes: (i) fluctuating shared spaces; (ii) remote and digitised rehabilitation offer; (iii) capacity to provide and participate in rehabilitation; (iv) Covid-19 as a springboard for positive change. These represent how rehabilitation services contracted, reconfigured, and were redirected to more remote modes of delivery, and how this affected the capacity of clinicians and patients to participate in rehabilitation. Conclusion: This study demonstrates how changes in provision of rehabilitation during the pandemic could act as a springboard for positive changes. Hybrid models of rehabilitation have the potential to expand the equity of access and reach of rehabilitation within specialist palliative care.

Palliative care need among inpatients in acute general hospitals in Nepal: a point prevalence survey

2017 ◽  
Vol 4 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Paras Acharya ◽  
Bimal Pandey ◽  
Yagya Pokhrel ◽  
Kedar Baral ◽  
Dan Munday ◽  
...  
Keyword(s):  
Palliative Care ◽  
Planning Process ◽  
Symptom Burden ◽  
Abdominal Distension ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Care Services ◽  
Point Prevalence Survey ◽  
Palliative Care Services

Introductions: Developing palliative care services in acute hospitals is important to address the need of patients dying from malignant and non-malignant diseases. This study is carried out to assess the need of palliative care in Patan Hospital to inform the planning process for starting palliative care services. Methods: A cross-sectional, point prevalence survey of in-patient beds occupied in Patan Hospital was carried out using Supportive and Palliative Care Indicators Tool. For patients who met the criteria, symptom burden was noted. Results: Of the 116 patients admitted on the day of surveillance, 30% met the criteria for palliative care need; 60% were aged 60 or above. The most common conditions requiring palliative care need was lung disease (46%) followed by cardio vascular (23%) and neurological diseases (23%). The most common symptoms patients were suffering from were fatigue (60%) followed by shortness of breath (51%), inability to move (35%), abdominal distension (31%), anorexia (31%) and pain (25%). Conclusions: Almost one third of patients admitted to Patan Hospital need palliative care with majority of them being above sixty years. This highlights the need to develop palliative care services in the hospital to address the need of such patients and families to improve the quality of life in the last years of life.

Differences between incarcerated and non-incarcerated patients who die in community hospitals highlight the need for palliative care services for seriously ill prisoners in correctional facilities and in community hospitals: A cross-sectional study

2017 ◽  
Vol 32 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Alex Rothman ◽  
Shannon McConville ◽  
Renee Hsia ◽  
Lia Metzger ◽  
Cyrus Ahalt ◽  
...  
Keyword(s):  
Palliative Care ◽  
The United States ◽  
Cross Sectional Study ◽  
Correctional Facilities ◽  
Sectional Study ◽  
Community Hospitals ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Seriously Ill

Background: Incarcerated populations worldwide are aging dramatically; in the United States, prisoner mortality rates have reached an all-time high. Little is known about the incarcerated patients who die in community hospitals. Aim: Compare incarcerated and non-incarcerated hospital decedents in California. Design: Cross-sectional study. Setting/participants: All state hospital decedents ( N = 370,831) from 2009 to 2013, decedent age over time examined with additional data (2001–2013). Results: Overall, 745 incarcerated and 370,086 non-incarcerated individuals died in California hospitals. Incarcerated decedents were more often male (93% vs 51%), Black (19% vs 8%) Latino (27% vs 19%), younger (55 vs 73 years), had shorter hospitalizations (13 vs 16 days), and fewer had an advance care plan (23% vs 36%, p < 0.05). Incarcerated decedents had higher rates of cancer, liver disease, HIV/AIDs, and mental health disorders. Cause of death was disproportionately missing for incarcerated decedents. The average age of incarcerated decedents rose between 2001 and 2013, while it remained stable for others. Conclusion: Palliative care services in correctional facilities should accommodate the needs of relatively young patients and those with mental illness. Given the simultaneous growth in the older prisoner population with the rising age of incarcerated hospital decedents, community hospital clinicians should be prepared to care for seriously ill, incarcerated patients. Significant epidemiologic differences between incarcerated and non-incarcerated decedents in this study suggest the importance of examining the differential palliative care needs of incarcerated patients in all communities.

Preferred Place of Death—A Study of 2 Specialist Community Palliative Care Services in Australia

2021 ◽  
pp. 082585972110180
Author(s):  
Emily Saurman ◽  
Sam Allingham ◽  
Kylie Draper ◽  
Julie Edwards ◽  
Jeanette Moody ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Facility ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Place Of Death ◽  
Residential Aged Care ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Individual Variables

Choice and preference are fundamental to person-centered care and supporting personal choice at the end of life should be a priority. This study analyzed the relationship between a person’s preferred place of death and other individual variables that might influence their actual place of death by examining the activity of 2 specialist community palliative care services in Australia. This was a cross-sectional study of 2353 people who died between 01 August 2016-31 August 2018; 81% died in their preferred place. Sex, type of life-limiting illness, and length of time in care were the only variables significantly related to dying in one’s preferred place. Women were more likely to die in their preferred place than men (84% v 78%) and people with a non-cancer diagnosis were 7% more likely to die in their preferred place than those with cancer, particularly when that place was their private residence (74% v 60%) or Residential Aged Care Facility (98% v 89%). Someone in care for 0-7 days had 4.2 times greater odds of dying in their preferred place (OR = 4.18, 2.20-7.94), and after 21 days in care, people had 4.6 greater odds of having a preference to die in a hospital (OR = 4.63, 3.58-5.99). Both community palliative care services have capacity and a model of care that is responsive to choice. These findings align with known referral patterns and disease trajectories and demonstrate that it is possible to support the majority of people in the care of community palliative care services to die in their preferred place.

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