Palliative care and palliative radiotherapy education in radiation oncology: A survey of US radiation oncology program directors.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 178-178
Author(s):  
Randy Wei ◽  
Lauren Colbert ◽  
Joshua Adam Jones ◽  
Gabrielle Kane ◽  
Margarita Racsa-Alamgir ◽  
...  
Keyword(s):  
Palliative Care ◽  
Radiation Oncology ◽  
Care Service ◽  
Palliative Care Service ◽  
Program Directors ◽  
The United States ◽  
Residency Programs ◽  
Care Education ◽  
Palliative Care Education ◽  
Residency Program Directors

178 Background: To assess the state of palliative care education curricula in radiation oncology residency programs in the United States. Methods: We surveyed 90 program directors of radiation oncology residency programs in the United States from September 2015 to November 2015. An electronic survey on palliative care education during residency was sent to all program directors. The survey consisted of questions on perceived relevance of palliative care in radiation oncology residency, formal didactics on domains of palliative care, effective teaching formats for palliative care education, and perceived barriers for integrating palliative care into the residency curriculum. Results: Sixty-three percent (57/90) residency program directors completed the survey. Most (93%) program directors agree or strongly agree that palliative care is an important competency for radiation oncologists. A vast majority (90%) of programs have dedicated palliative care services; however, only 57% of programs offer residents an opportunity to spend elective time on a palliative care service. Of these programs, only 30% reported residents rotating on a palliative care service in the past two years. Furthermore, 67% of residency programs have formal educational activities in principles and practice of palliative care. The palliative care curriculum included faculty-led lectures (73%), resident-led lectures (42%), and seminars (22%). Most programs have one or more hours of formal didactics on management of pain (66%), management of neuropathic pain (64%), and management of nausea and vomiting (64%). 35%, 46%, and 48% programs had one or more hours of management of non-physical symptoms including fatigue, anorexia, and anxiety, respectively. Conclusions: Residency program directors believe that palliative care is an important competency for their trainees. The survey revealed that many programs have structured curricula on PSC and palliative radiation education, but that there are still areas for improvement.

A Needs Assessment of Palliative Care Education among the United States Adult Neurology Residency Programs

2018 ◽  
Vol 21 (10) ◽  
pp. 1448-1457 ◽  
Author(s):  
Ambereen K. Mehta ◽  
Salim Najjar ◽  
Natalie May ◽  
Binit Shah ◽  
Leslie Blackhall
Keyword(s):  
United States ◽  
Palliative Care ◽  
Needs Assessment ◽  
The United States ◽  
Residency Programs ◽  
Care Education ◽  
Palliative Care Education

Long-term collaboration for building sustainable palliative care in Belarus.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 142-142
Author(s):  
Sarah Slater ◽  
Kathleen Doyle
Keyword(s):  
Palliative Care ◽  
Needs Assessment ◽  
Legal Status ◽  
The United States ◽  
Difficulty Level ◽  
Major Barrier ◽  
Care Education ◽  
Palliative Care Education ◽  
The Government ◽  
Healthcare Administrators

142 Background: The WHO and the Worldwide Palliative Care Alliance have published findings that only 10% of the 20.4 million people who need palliative care currently receive it. A major barrier to meeting that need is insufficient education of healthcare workers in palliative care. Over the last decade, palliative care has attracted significant interest from the government of Belarus, with the first adult hospice founded in 2005 and introduced palliative care into the National Healthcare Law in 2013. However, the country faces a shortage of healthcare providers trained in palliative care. We report on the experience of developing and implementing a palliative care curriculum in Belarus. Methods: We first conducted a needs assessment that examined physician knowledge of and attitudes toward palliative care, the legal status of palliative care, drug availability, and other topics. We utilized past in-country experience, a literature review, a questionnaire, and interviews with Belarusian colleagues. Based on the needs assessment, we developed, modified, and translated a 25-lecture curriculum that was comprehensive, at an adequate difficulty level, and culturally appropriate. A team of four clinicians taught the curriculum in Belarus over to an audience of physicians, and healthcare administrators. Results: The course was well-received—participants were satisfied, reported a better understanding of palliative care, and improved their skills and confidence in managing symptoms and discussing prognosis. Conclusions: We have continued our collaboration with our Belarusian colleagues. New government policies and have passed which promote palliative care. We subsequently held a web-based teleconference with members of the Ministry of Health as well has medical education administrators in Belarus to discuss the structure of palliative care programs in the United States and our model of palliative care education. A second in-person palliative care education workshop for both physicians and nurses is being planned for the fall of 2015. We hope that our experience provides encouragement and resources for the continued promotion of palliative care education and development worldwide.

scholarly journals Impact of Critical Care Medicine Training Programs' Palliative Care Education and Bedside Tools on ICU Use at the End of Life

2014 ◽  
Vol 6 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Howard L. Saft ◽  
Paul S. Richman ◽  
Andrew R. Berman ◽  
Richard A. Mularski ◽  
Paul A. Kvale ◽  
...  
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
End Of Life ◽  
Training Programs ◽  
Care Program ◽  
Program Directors ◽  
Critical Care Medicine ◽  
Care Education ◽  
Palliative Care Education

Abstract Background Intensive care unit (ICU) use at the end of life is rising. Little research has focused on associations among critical care fellows' training, institutional support, and bedside tools with ICU use at the end of life. Objective We evaluated whether hospital and critical care medicine program interventions were associated with ICU use in the last 6 months of life for patients with chronic illness. Methods Our observational, retrospective study explored associations between results from a survey of critical care program directors and hospital-level Medicare data on ICU use in the last 6 months of life. Program directors evaluated quality of palliative care education in their critical care fellowships and reported on the number of bedside tools and the presence or absence of an inpatient palliative care consultation service. Results For the 89 hospitals and 71 affiliated training programs analyzed, there were statistically significant relationships between 2 of the explanatory variables—the quality of palliative care education and the number of bedside tools—in ICU use. Each level of increased educational quality (1–5 Likert scale) was associated with a 0.57-day decrease in ICU days, whereas, for each additional, evidence-based bedside tool, there was a 0.31-day decrease. The presence of an inpatient palliative care program was not a significant predictor of ICU use. Conclusions We found that the quality of palliative care training in critical care medicine programs and the use of bedside tools were independently associated with reduced ICU use at the end of life.

scholarly journals Evidence-Based Practice: Community-Based Palliative Cancer Care

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Jajang Ganjar Waluya ◽  
Nur Maziyya ◽  
Eva Nurlaela ◽  
Ita Vusfita ◽  
Ihda Al Adawiyah Mz ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Evidence Based Practice ◽  
Care Service ◽  
Palliative Care Service ◽  
The United States ◽  
Evidence Based ◽  
Community Based ◽  
Middle East Countries

Prevalence of  cancer is estimated will increase in the next two decades. Therefore, there is a challenge for health provider to encounter treatment and caring for the patients. Especially, the cancer patients face several problems not only physical but also psychological, emotional, spiritual and social cultural aspects.This study explored the evidence-based practice on community-based palliative cancer care. Literature study is done by making a summary of published articles related to the question. The searching method used several electronic databases such as Google Scholar, Proquest, and PubMed. Articles under the keywords of “Palliative Cancer Care”, “Community”, and “Nursing” reach as much as 1.804. The inclusion criteria for this literature review were articles that have been peer-reviewed, are in full-text, in either English or Indonesian, and publication year from 2008 to 2018. Meanwhile, the exclusion criteria include those that do not follow a standardized structure of an article (consisting of Abstract, Introduction, Method, Result, Discussion, Implication, and Reference), are in the form of a review, and whose content does not answer research questions.Results: The United States of America is on the highest place regarding palliative care service, following by community-based palliative cancer implementation in Europe. Asian countries had been applying palliative care service, integrated with national health care system. In the Middle East countries, palliative care program ranks the lowest, but in implementation, they have discreetly performed community-based palliative care. In Africa, it is not the main focus in the field of health. Palliative care for cancer patients that is potential for development in Indonesia is that of family-based.Conclusion: Community-based palliative care is a variant of palliative treatment long applied and being developed in many countries in the world. In continents such as America and Europe, the implementation of palliative care ranks the highest place. In Indonesia, it is done partially and only available in hospitals or non-governmental organization. In the level of community, family-based palliative care can be developed by involving trained family members.

scholarly journals Integrative Hematology Oncology Fellowship Program: A National Survey Based Analysis of Need

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1887-1887
Author(s):  
Krisstina L. Gowin ◽  
Betsy Wertheim ◽  
Ashley Larsen ◽  
John Camoriano
Keyword(s):  
Palliative Care ◽  
National Survey ◽  
Radiation Oncology ◽  
Formal Education ◽  
Training Programs ◽  
Care Program ◽  
Program Directors ◽  
The United States ◽  
Education Programs ◽  
Fellowship Programs

Abstract Introduction: Integrative hematology oncology (IHO), the combination of complementary medicine in conjunction with conventional cancer treatments, is emerging as an important supportive care modality. Formal education programs, such as IHO fellowship programs, are not currently available. We conducted a national survey to gauge interest and investigate barriers to the development of IHO training programs in the US. Methods: An 18-question survey was sent to hematology/oncology, radiation oncology, and palliative care program directors, physicians, and fellows, and internal medicine residents planning to enter into any of the above fellowship programs. Recruitment was national with use of public email list servs and social media. Program directors and fellowship programs were identified through the Accreditation Council for Graduate Medical Education (ACGME). Participant informed consent was completed online and, Qualtrics survey links were shared weekly via email in two 4-week sessions. Results: Participants (n=208) included physicians from: Hematology/Oncology 65.9% (n=137), Radiation Oncology 8.6%(n=18) and Palliative Care 25.4% (n=53). Hematology oncology respondents included physicians 47.4% (n=65), fellows 33.6% (n=46), and residents planning to enter into a hematology oncology fellowship 3.6% (n=5). Program directors (n=69) from each specialty included: 15.3% (n=21) from hematology/oncology, 61.1% (n=11) from radiation oncology, and 69.8% (n=37) from palliative care. Interestingly, palliative care had the highest response rate in this category. Survey respondents were mostly aged 31-40 y (38.4%), 41-50 y (23.8%), or 51-60 y (21.5%). Participant genders were male (45.7%), female (50.9%), or prefer not to identify (3.5%). There was diverse regional participation across the United States. Overall participant responses revealed significant interest for an IHO training program, despite little (36.0%) to no (49.4%) previous training in integrative medicine (Table 1). Curriculum topics of primary interest were physician/provider wellness, stress reduction techniques, off-label use of medication, exercise/physical activity, nutrition, and lifestyle counseling. The preferred education delivery was didactic lectures and clinical practice exposure. Barriers to implementation included lack of good curriculum and inadequate budget/time/faculty experience to implement the program. Need for IHO training was based on perceived benefit to patients in 39 participants (73.6%), and patient request for services in 37 participants (68.8%). Conclusion: In this national survey of 208 physicians, the majority (64%) expressed interest in IHO education programs. Barriers included lack of curriculum, expertise, budget, and time. Education preference for fellowship track and certificate programs were similar, suggesting interest of both available options. Most participants (87%) felt fellows should participate in IHO research. In conclusion, IHO training is perceived as valuable and desirable. Thus, the development and dissemination of IHO training programs is needed. Figure 1 Figure 1. Disclosures Gowin: Incyte: Speakers Bureau.

Effects of VA Facility Dog on Hospitalized Veterans Seen by a Palliative Care Psychologist: An Innovative Approach to Impacting Stress Indicators

2016 ◽  
Vol 35 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Cheryl A. Krause-Parello ◽  
Cari Levy ◽  
Elizabeth Holman ◽  
John E. Kolassa
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
The United States ◽  
Clinical Psychologist ◽  
Stress Indicators ◽  
Therapy Dog ◽  
Time Period ◽  
And Control ◽  
Animal Assisted Intervention

The United States is home to 23 million veterans. In many instances, veterans with serious illness who seek healthcare at the VA receive care from a palliative care service. Animal-assisted intervention (AAI) is gaining attention as a therapeutic stress reducing modality; however, its effects have not been well studied in veterans receiving palliative care in an acute care setting. A crossover repeated-measures study was conducted to examine the effects of an animal-assisted intervention (AAI) in the form of a therapy dog on stress indicators in 25 veterans on the palliative care service at the VA Eastern Colorado Healthcare System in Denver, CO. Veterans had a visit from a therapy dog and the dog’s handler, a clinical psychologist (experimental condition) and an unstructured visit with the clinical psychologist alone (control condition). Blood pressure, heart rate, and the salivary biomarkers cortisol, alpha-amylase, and immunoglobulin A were collected before, after, and 30-minutes after both the experimental and control conditions. Significant decreases in cortisol were found when the before time period was compared to the 30-minutes after time period for both the experimental ( p = 0.007) and control condition ( p = 0.036). A significant decrease in HR was also found when the before time period was compared to the 30-minutes after time period for both the experimental ( p = 0.0046) and control ( p = 0.0119) condition. Results of this study supported that a VA facility dog paired with a palliative care psychologist had a measurable impact on salivary cortisol levels and HR in veterans.

Impact of a Hospital Palliative Care Service: Perspective of the Hospital Staff

2002 ◽  
Vol 18 (3) ◽  
pp. 160-167 ◽  
Author(s):  
Helen Carter ◽  
Eileen Mckinlay ◽  
Ian Scott ◽  
Deborah Wise ◽  
Rod Macleod
Keyword(s):  
Palliative Care ◽  
Discharge Planning ◽  
Care Service ◽  
Palliative Care Service ◽  
Hospital Staff ◽  
Support Service ◽  
Spiritual Needs ◽  
Staff Support ◽  
Palliative Care Education ◽  
Future Hospital

The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients’ care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service.

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