Education of residents in palliative and hospice care.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 118-118
Author(s):  
Ela Eris ◽  
Shyam Ravisankar ◽  
Jennifer A Larosa
Keyword(s):  
Palliative Care ◽  
Palliative Medicine ◽  
Hospice Care ◽  
Daily Practice ◽  
Comfort Level ◽  
Emotional Symptoms ◽  
Advanced Illness ◽  
Online Questionnaire ◽  
Post Test ◽  
Interactive Lecture

118 Background: Patients with chronic advanced illness have a heavy burden of physical and emotional symptoms. In addition to these symptoms, social and spiritual supports are fundamental tenets of palliative care (PC). PC is most effective when delivered early and when routine reassessments are undertaken. Ideally, it is woven into the daily practice of all practitioners. However, current medical education has far too little education around this vital discipline in their curricula. We hypothesized that a single palliative medicine didactic experience would increase practitioners’ familiarity with core concepts of PC. Methods: Palliative care education was delivered as a single interactive lecture for 27 Internal Medicine residents. Information was primarily derived from resources from the Center to Advance Palliative Care (CAPC). The lecture focused on the definition of PC, optimal symptom management and support structures in palliative medicine, and how palliative medicine differs from hospice care (HC). An online questionnaire with ten questions was used to assess pre- and post-lecture knowledge of fundamentals of this discipline. Results: 27 residents participated in the pre-test and 23 participated in post-test. The overall pre-test score was 70% and the post-lecture score was 77%. The biggest difference was seen in the comfort level of first year residents in referring patients to PC and the purpose of PC. Residents had good baseline knowledge of when to refer to HC and the purpose of HC. Conclusions: A single, interactive lecture based on the fundamental tenets of hospice and palliative medicine can improve residents’ knowledge of this discipline. [Table: see text]

scholarly journals A Qualitative Study About How Nurses in Belgium Offer Relationship Support to Couples in Palliative Care

2019 ◽  
Vol 26 (1) ◽  
pp. 38-51
Author(s):  
Charlotte Benoot ◽  
Paul Enzlin ◽  
Lieve Peremans ◽  
Johan Bilsen
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Daily Practice ◽  
Observational Research ◽  
Relationship Functioning ◽  
Advanced Illness ◽  
Care Environment ◽  
Family Nursing ◽  
Depth Interviews ◽  
Do So

Although palliative care nurses are identified as key players in supporting couples during advanced illness, there is a lack of evidence about their knowledge and experiences with this particular role. The aim of the study was to explore palliative care nurses’ attitudes, roles, and experiences in addressing relationship functioning of couples in daily practice. A qualitative study was conducted using in-depth interviews, observational research, and peer debriefing groups with palliative care nurses in Flanders, Belgium. Nurses support relationship functioning by creating a couple-positive care environment, by being present/acknowledging feelings, and by rectifying imbalances between couples. They do so in a proactive way, backed up by team support. Nurses hesitate toward explicitly unraveling and intervening in relationship problems, in favor of providing comfort or offering a strengths-based approach. The findings offer an urgent call to enhance the educational programs for palliative care nurses by integrating the theories and practice frameworks that guide relational assessment and intervention, which are being used in family nursing.

Educating Internal Medicine Residents on Palliative Medicine and Hospice Care at a Community Teaching Hospital

2020 ◽  
pp. 104990912097917
Author(s):  
Cassandra Nicotra ◽  
Martin Barnes ◽  
Phyllis Macchio ◽  
Greg Haggerty ◽  
Carolina De Elia ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Palliative Medicine ◽  
Hospice Care ◽  
Medical Knowledge ◽  
Educational Opportunities ◽  
Short Term ◽  
Internal Medicine Residents ◽  
Post Test ◽  
Community Teaching ◽  
Question Survey

Background: The Accreditation Council of Graduate Medical Education (ACGME) currently requires Internal Medicine (IM) GME programs to incorporate educational opportunities for training and structured experiences in Palliative and Hospice Medicine. Miscomprehension of the differences between palliative medicine and hospice care is a barrier for IM residents ordering palliative consults as many residents may underutilize palliative medicine if a patient is not appropriate for hospice. Objective: This educational performance improvement (PI) project assessed 3 domains, including Medical Knowledge (MK) of palliative versus hospice medicine at baseline and following a single didactic session. Additionally, the number of palliative consults ordered was used as a surrogate for interpersonal and communication skills (ICS) and patient care (PC) domains. Methods: An 8-question survey and 30-minute didactic session were created based upon experientially-determined issues most confusing to IM residents. Participants included 33 IM residents (PGY-1s-3 s) from July 2018 (first cohort) and 32 (PGY-1 s and any PGY-2s-3 s who did not participate in the first cohort) from July 2019 (second cohort). Results: 65 of a possible 73 residents participated (89% response rate) Pre-test Questions 5, 6, and 8 correct responses were <50% in both cohorts with average scores, respectively, of 43.1%, 35.4%, and 40%. Residents improved on the post-test for Q5, 6, 8 to, respectively, 80%, 86.7%, and 48.3% (t = 7.68, df = 59, p < 001). Correct Q1 responses declined in the first cohort, but clarification for the second cohort improved from pre-test (36.4%) to post-test (65.5%). The total number of palliative consults placed by IM residents increased as well. Conclusions: Baseline MK of palliative versus hospice medicine was <50% on 4/8 questions. A brief educational session significantly improved residents’ short-term comprehension and increased the number of palliative consults.

scholarly journals Global Scientific Outputs of Palliative Care Publications: A Holistic Approach with Bibliometric Analysis

Acta Medica ◽  
2021 ◽  
pp. 1-10
Author(s):  
Arzu Akdağlı Ekici ◽  
Özgür Yağan
Keyword(s):  
Palliative Care ◽  
Bibliometric Analysis ◽  
Palliative Medicine ◽  
Hospice Care ◽  
Holistic Approach ◽  
Medicine Journal ◽  
Scientific Outputs ◽  
The Usa ◽  
Number Of Publications ◽  
New Research

Objective: This study aims to summarize the scientific outputs of the palliative care studies conducted between 1975 and 2019 through bibliometric analyses, identify the top effective journals, top-cited studies, the collaboration between countries, and trend topics. Materials and Methods: We performed a bibliometric analysis on palliative care. “Palliative care”, “terminal care”, “end-of-life care” and “hospice care” terms were used as the keywords in the title section of articles in Web of Science database. Spearman correlation coefficient was performed for the correlation analysis between the number of publications produced by the countries and economic indicators. Results: There were 22361 publications about palliative care. Of these publications, 10309 were articles. The top three countries that produced more than 100 articles were the USA, the United Kingdom, and Canada. The top three journals that had the highest number of publications were Journal of Palliative Medicine, Journal of Pain and Symptom Management, and Palliative Medicine. There was a positive, highly significant relationship between the number of publications and Gross domestic product (r = 0.709, p <0.001). Conclusion: This study is believed to be a beneficial guide about the global outputs of palliative care for the clinicians and scientists and present new research ideas to the researchers.

Patient perceptions of palliative care in the process of allogeneic hematopoietic cell transplantation.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24082-e24082
Author(s):  
Megan Elizabeth Melody ◽  
Chimere Bruning ◽  
Rachel Mack ◽  
Kimberley Parrott ◽  
Richard Taylor ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Palliative Medicine ◽  
Hematopoietic Cell Transplantation ◽  
Patient Perceptions ◽  
Comfort Level ◽  
Care Planning ◽  
Palliative Care Consultation ◽  
Advance Care ◽  
Care Consultation

e24082 Background: Allogeneic hematopoietic cell transplantation (allo-HCT) is associated with significant short- and long-term sequelae that affect patients’ overall quality of life (QoL) and their physical and psychological well-being. Studies have shown improvement in patient QoL and physician satisfaction with palliative care involvement in the allo-HCT process. However, patient and physician perceptions regarding palliative care often impact timely referral. We conducted a prospective study to examine patient perceptions of palliative care both before and after palliative care consultation during evaluation for allo-HCT. Methods: This is a prospective, single-center study, of patients > 18 years of age, who were referred for a palliative care consultation as part of standard evaluation for allo-HCT. Patients were administered a pre- and post-visit internally derived questionnaire to assess their understanding and comfort level with palliative care. The primary objective of this study was to examine patient perceptions of palliative care consultation during evaluation for allo-HCT. Primary end point was the change in patient pre- and post- questionnaire responses. Secondary endpoint was the completion of advance care planning documentation pre- and post- consultation. Results: We enrolled 32 patients (male = 14) undergoing evaluation for allo-HCT with a primary diagnosis of AML (n = 8), NHL (n = 8), MDS (n = 7), ALL (n = 2), and other (n = 7). Following consultation with palliative care there was a statistically significant increase in patient understanding of the reason for the appointment, p = 0.0006. There was also a significant increase in patient’s knowledge of palliative care, with only 28% describing their knowledge as “good” or “excellent” prior to consultation and 79.3% after consultation, p < 0.0001. There was an observed positive, non-statistically significant, trend in patient comfort level with palliative medicine with only 20.7% (n = 6) describing their comfort as “high” or “very high” prior to consultation and 51.7% (n = 15) after consultation, p = 0.60. There was a higher rate of completion of advance care planning documentation following consultation with palliative medicine 56.3% vs 71.4%, p = 0.042. Conclusions: Palliative care consultation prior to allo-HCT increases a patient’s understanding of the role of palliative medicine as part of their allo-HCT and improves advance care planning. These findings need to be validated in a larger, multicenter, patient cohort.

scholarly journals Palliative care in pediatric patients with hematologic malignancies

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 490-495 ◽  
Author(s):  
Lisa Humphrey ◽  
Tammy I. Kang
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Hospice Care ◽  
Hematologic Malignancies ◽  
Transitions Of Care ◽  
Institute Of Medicine ◽  
Healthcare Organizations ◽  
Advanced Illness ◽  
Advanced Malignancy

Abstract Children with advanced cancer, including those with hematologic malignancies, can benefit from interdisciplinary palliative care services. Palliative care includes management of distressing symptoms, attention to psychosocial and spiritual needs, and assistance with navigating complex medical decisions with the ultimate goal of maximizing the quality-of-life of the child and family. Palliative care is distinct from hospice care and can assist with the care of patients throughout the cancer continuum, irrespective of prognosis. While key healthcare organizations, including the Institute of Medicine, the American Academy of Pediatrics and the American Society of Clinical Oncology among many others endorse palliative care for children with advanced illness, barriers to integration of palliative care into cancer care still exist. Providing assistance with advance care planning, guiding patients and families through prognostic uncertainty, and managing transitions of care are also included in goals of palliative care involvement. For patients with advanced malignancy, legislation, included in the Patient Protection and Affordable Health Care Act allows patients and families more options as they make the difficult transition from disease directed therapy to care focused on comfort and quality-of-life.

Tinjauan sistematis: Efektifitas Palliative Home Care untuk Pasien dengan HIV/AIDS

1970 ◽  
Vol 5 (1) ◽  
Author(s):  
Linlin Lindayani ◽  
Nenden Nur Asriyani Maryam
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Palliative Medicine ◽  
Cochrane Library ◽  
Palliative Home Care ◽  
Hiv Aids

Asuhan palitif untuk pasien dengan HIV/AIDS merupakan elemen inti dari asuhan pasien dengan HIV/AIDS. Asuhan paliatif yang berbasis home care saat ini menjadi elemen penting yang digunakan di berbagainegara. Akan tetapi, tidak ada studi atau tinjauan sebelumnya yang menganalisis efektifitas dari asuhanpaliatif yang berbasis home care pada pasien dengan HIV/AIDS. Tujuan dari tinjauan sistematik ini adalahuntuk mengevaluasi efektivitas Palliative Home Care untuk pasien dengan HIV/AIDS terhadap nyeri,pengendalian gejala, meningkatkan kualitas hidup, meningkatkan kepuasan asuhan, dan efektivitas biaya.Pencarian awal terbatas dilakukan di MEDLINE dan CINAHL. Kedua database tersebut dipilih denganpertimbangan bahwa keduanya merupakan database terbesar di bidang kesehatan dan kedokteran. Kemudiastrategi pencarian lainnya dilakukan pada database lain meliputi: Cochrane Library, UpToDate, Ovid, AIDSCare, Journal of Palliative Care, dan Journal of Palliative Medicine. Studi yang diterbitkan dalam Bahasa Inggrisdan tahun 2000-2016 dipertimbangkan untuk dimasukkan dalam tinjauan ini. Data diekstrak oleh penulis dandiringkas menggunakan alat ekstraksi data dari JBI (Joanna Briggs Institute). Kami menemukan 4 studi yangmasuk kedalam kriteria tinjauan kami, satu studi randomizes control trial dan tiga studi prospectively control.Hasil dari tinjauan ini menunjukkan bahwa Palliative Home Care terbukti efektif dalam mengontol nyeridan gejala-gelaja lain, mempertahankan dan meningkatkan kualitas hidup pasien, tingginya kepuasan daripasien dan kelurga terhadap asuhan Palliative Home Care berkisar 93% - 96% dan lebih cost-effectivenessdibandingkan dengan Hospital-Based Palliative Care. Dengan demikian, penting untuk mengembangkanPalliative Home Care untuk pasien dengan HIV/AIDS terutama untuk negara dengan sumber daya yang terbatas.

60. Using a pocket card to improve end-of-life care on clinical teaching units: A controlled trials

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
J. Downar ◽  
J. Mikhael
Keyword(s):  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Palliative Medicine ◽  
Clinical Teaching ◽  
Intervention Group ◽  
Comfort Level ◽  
Control Group ◽  
Life Care ◽  
Comfort Levels

Although palliative and end-of-life is a critical part of in-hospital medical care, residents often have very little formal education in this field. To determine the efficacy of a symptom management pocket card in improving the comfort level and knowledge of residents in delivering end-of-life care on medical clinical teaching units, we performed a controlled trial involving residents on three clinical teaching units. Residents at each site were given a 5-minute questionnaire at the start and at the end of their medicine ward rotation. Measures of self-reported comfort levels were assessed, as were 5 multiple-choice questions reflecting key knowledge areas in end-of-life care. Residents at all three sites were given didactic teaching sessions covering key concepts in palliative and end-of-life care over the course of their medicine ward rotation. Residents at the intervention site were also given a pocket card with information regarding symptom management in end-of-life care. Over 10 months, 137 residents participated on the three clinical teaching units. Comfort levels improved in both control (p < 0.01) and intervention groups (p < 0.01), but the intervention group was significantly more comfortable than the control group at the end of their rotations (z=2.77, p < 0.01). Knowledge was not significantly improved in the control group (p=0.07), but was significantly improved in the intervention group (p < 0.01). The knowledge difference between the two groups approached but did not reach statistical significance at the end of their rotation. In conclusion, our pocket card is a feasible, economical educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on clinical teaching units. Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The Status of Undergraduate Palliative Medicine Education in Canada: a 2001 Survey. Journal Palliative Care 2004; 20:32. Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-610. Okon TR, Evans JM, Gomez CF, Blackhall LJ. Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway. Journal of Palliative Medicine 2004; 7:279-295.

Images of the Hospice

2017 ◽  
Author(s):  
Alan Baron ◽  
John Hassard ◽  
Fiona Cheetham ◽  
Sudi Sharifi
Keyword(s):  
General Public ◽  
Palliative Medicine ◽  
Healthcare Professionals ◽  
Hospice Care ◽  
Care Work ◽  
Dirty Work ◽  
Key Stakeholders ◽  
Host Organization ◽  
Local Healthcare

This chapter looks ‘outside’ the Hospice at issues of the organization’s image. The authors talked to staff, volunteers, and members of the general public, as well as to a number of key stakeholders in the local healthcare community, in order to gauge their views on the host organization. The analysis examines the problems associated with the image of hospices and discusses attempts of staff and volunteers to ‘dispel the myths’ about the nature of hospice care work—a form of labour which potentially runs the risk of being characterized as ‘dirty work’. The chapter then examines how the Hospice is seen in the eyes of other healthcare professionals and discusses the choice of palliative medicine as a career for junior medics. Finally it discusses a degree of ‘confusion’ that staff and volunteers claim exists in the minds of GPs and consultants in specialist cancer hospitals about the role of hospices.

Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

2020 ◽  
pp. 1-9
Author(s):  
Hyunjin Noh ◽  
Lewis H. Lee ◽  
Chorong Won
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Cognitive Impairment ◽  
Educational Intervention ◽  
Test Scores ◽  
Informal Caregivers ◽  
Cognitively Impaired ◽  
Significant Difference ◽  
Post Test ◽  
Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

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