scholarly journals Perceived barriers and facilitators in providing palliative care for people with severe dementia: the healthcare professionals’ experiences

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
May Helen Midtbust ◽  
Rigmor Einang Alnes ◽  
Eva Gjengedal ◽  
Else Lykkeslet
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Severe Dementia

scholarly journals Barriers and facilitators to e-learning in palliative care

2020 ◽  
Vol 26 (8) ◽  
pp. 394-402
Author(s):  
Joanne Callinan
Keyword(s):  
Palliative Care ◽  
Administrative Support ◽  
Healthcare Professionals ◽  
Computer Training ◽  
Barriers And Facilitators ◽  
Cross Sectional ◽  
Face To Face ◽  
Course Work ◽  
E Learning ◽  
Prior Experiences

Background: E-learning provides opportunities for flexible learning to those who cannot access palliative education in the traditional classroom setting, but it also presents learners with challenges. The study aims to identify the barriers and facilitators to accessing e-learning courses in palliative care. Methods: Cross-sectional surveys were developed, piloted and disseminated to healthcare professionals (HCPs) working in palliative care on the island of Ireland (Republic of Ireland and Northern Ireland). Results: Important factors that motivated HCPs to participate in e-learning are: dedicated time; quick technical and administrative support; computer training before completing an e-learning course; and regular contact with the tutor in online course work. Some 50% indicated face-to-face assistance and hands-on training sessions as the type of support that they would like to receive. Conclusions: Healthcare professionals' prior experiences and attitudes towards e-learning will guide educators developing programmes. This study indicates the prerequisite for organisational supports and practical considerations to facilitate the uptake of e-learning.

scholarly journals The perception of barriers concerning opioid medicines: A survey examining differences between policy makers, healthcare professionals and other stakeholders

2019 ◽  
Vol 34 (4) ◽  
pp. 493-503
Author(s):  
Marjolein JM Vranken ◽  
Lisa Linge-Dahl ◽  
Aukje K Mantel-Teeuwisse ◽  
Lukas Radbruch ◽  
Marie-Hélène DB Schutjens ◽  
...  
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Perceived Barriers ◽  
Financial Resources ◽  
Policy Makers ◽  
Opioid Medication ◽  
Stakeholder Groups ◽  
Inadequate Knowledge ◽  
Relevant Stakeholder ◽  
And Training

Background: In many countries, the consumption of opioid medicines is too low to meet population needs. Discussions within the Access To Opioid Medication in Europe project indicated that there may be significant differences in the perception of barriers for their adequate use, depending on the stakeholders. Aim: The aim of this study was to examine the perception of barriers and their impact concerning opioid medicines, comparing policy makers, healthcare professionals working in the field of pain management, palliative care or harm reduction and other stakeholders. Design: Data were collected using a questionnaire partially constructed from existing surveys, reviewed for content validity by four experts and pilot-tested in Latvia. Setting/participants: Participants of the Access to Opioid Medication in Europe national conferences were invited to complete the questionnaire. Stakeholder groups were compared using non-parametric rank-sum tests. Results: In total, 199 participants (54%) in seven countries completed the questionnaire. Most frequently rated major barriers included lack of financial resources and inadequate knowledge, skills and training among policy makers (55%–66%). Overall, policy makers perceived issues less often as major barriers or having major impact (29% barrier, 32% impact) compared to other stakeholders (36%–42% barrier, 39%–51% impact). Significant differences were seen on several aspects. For example, excessive regulation or bureaucracy for prescribing was rated as having major impact by 55%–57% of healthcare professionals in contrast to only 20% of the policy makers ( p = 0.002). Conclusion: Multiple barriers may play an important role, partly depending on the perspective of the stakeholder involved. Hence, when addressing perceived barriers, it is important to include all relevant stakeholder groups. Only then, effective and widely supported solutions can be implemented.

scholarly journals Perceived barriers and facilitators to goals of care discussions in the emergency department: A descriptive analysis of the views of emergency medicine physicians and residents

CJEM ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 211-218 ◽  
Author(s):  
Niran Argintaru ◽  
Kieran L. Quinn ◽  
Lucas B. Chartier ◽  
Jacques Lee ◽  
Paul Hannam ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Palliative Care ◽  
Descriptive Analysis ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Environmental Interventions ◽  
Goals Of Care ◽  
Care Services ◽  
Palliative Care Services

AbstractObjectiveFew studies have examined the challenges faced by emergency medicine (EM) physicians in conducting goals of care discussions. This study is the first to describe the perceived barriers and facilitators to these discussions as reported by Canadian EM physicians and residents.MethodsA team of EM, palliative care, and internal medicine physicians developed a survey comprising multiple choice, Likert-scale and open-ended questions to explore four domains of goals-of-care discussions: training; communication; environment; and patient beliefs.ResultsSurveys were sent to 273 EM staff and residents in six sites, and 130 (48%) responded. Staff physicians conducted goals-of-care discussions several times per month or more, 74.1% (80/108) of the time versus 35% (8/23) of residents. Most agreed that goals-of-care discussions are within their scope of practice (92%), they felt comfortable having these discussions (96%), and they are adequately trained (73%). However, 66% reported difficulty initiating goals-of-care discussions, and 54% believed that admitting services should conduct them. Main barriers were time (46%), lack of a relationship with the patient (25%), patient expectations (23%), no prior discussions (21%), and the inability to reach substitute decision-makers (17%). Fifty-four percent of respondents indicated that the availability of 24-hour palliative care consults would facilitate discussions in the emergency department (ED).ConclusionsImportant barriers to discussing goals of care in the ED were identified by respondents, including acuity and lack of prior relationship, highlighting the need for system and environmental interventions, including improved availability of palliative care services in the ED.

Perceived barriers and facilitators for general practitioner–patient communication in palliative care: A systematic review

2011 ◽  
Vol 25 (6) ◽  
pp. 613-629 ◽  
Author(s):  
W Slort ◽  
BPM Schweitzer ◽  
AH Blankenstein ◽  
EA Abarshi ◽  
Il Riphagen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
General Practitioner ◽  
Patient Communication ◽  
Perceived Barriers ◽  
Barriers And Facilitators

scholarly journals P011: Discerning perceived barriers and facilitators to goals of care discussion in the emergency department: A survey of emergency physicians and residents

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S81
Author(s):  
N. Argintaru ◽  
S. Vaillancourt ◽  
L.B. Chartier ◽  
J.S. Lee ◽  
E. O’Connor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Online Survey ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Emergency Physicians ◽  
Urban Centre ◽  
Advanced Directives ◽  
Goals Of Care ◽  
Competing Priorities

Introduction: Patients presenting to the Emergency Department (ED) may require clarification of their goals of care (GOC) to ensure they receive treatments aligned with their values. However, these discussions can be difficult to conduct for multiple reasons, including lack of time in a busy ED, competing priorities and a limited relationship with the patient. Few studies have examined the perceived challenges faced by Emergency Physicians in conducting GOC discussions. This study sought to contextualize and discern the barriers and facilitators to having these conversations as reported by Emergency physicians. Methods: An interdisciplinary team of Emergency Medicine, Palliative Care and Internal Medicine providers developed an online survey comprised of multiple choice, Likert-scale and open-ended questions to explore four domains of GOC discussions: training; communication; environment; and personal beliefs. Invitations and scheduled reminders were sent to 275 ED physicians at six academic sites in a Canadian urban centre, including 49 EM residents. Results: 105 (46%) staff physicians and 23 (47%) residents responded with similar representation from all sites. Differences were reported in the frequency of GOC discussions: 59% of staff physicians conduct several per month whereas 65% of residents conduct less than one per month. Most agreed that GOC discussions are within their scope of practice (92%), they feel comfortable (96%), and are adequately trained (73%) to have them; however, 66% reported difficulty initiating GOC discussions. 73% believed that admitting services should conduct GOC discussions, yet acuity was noted in the comments as a major determinant with initiating GOC discussions by ED physicians. Main barriers identified were lack of time, chaotic environment, lack of advanced directives and the inability to reach substitute decision makers. 54% of respondents indicated that the availability of 24-hour Palliative Care consults would facilitate GOC discussions in the ED. Conclusion: Emergency physicians are prepared to conduct goals of care discussions, but often believe they should instead be conducted by the patient’s admitting service. Multiple perceived barriers to goals of care discussion in the ED were identified, and a majority of respondents felt that the availability of Palliative Care in the ED may facilitate these discussions.

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