scholarly journals Structures in Specialised Out-patient Palliative Care in Germany - Results of an Online Survey

2016 ◽  
Vol 4 (3) ◽  
pp. 29-31
Author(s):  
Papke J ◽  
Lux E A
Author(s):  
José Vítor Gonçalves ◽  
Luísa Castro ◽  
Guilhermina Rêgo ◽  
Rui Nunes

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.


2021 ◽  
Vol 22 (02) ◽  
pp. 102-110
Author(s):  
Cornelia Brandstötter ◽  
Simon Krutter ◽  
Piret Paal ◽  
Angelika Schirnhofer ◽  
Manela Glarcher

Zusammenfassung Ziel der Studie Trotz gesetzlicher Regelung zu Palliative Care in der Gesundheits- und Krankenpflege in Österreich, fehlen Vorgaben zu Ausbildungsstunden, zum Praktikum und zur Qualifikation von Lehrenden. Ziel der Studie ist es, ein umfassendes Bild zu Palliative Care in der Pflegegrundausbildung zu erhalten. Methode 2019 wurde eine deskriptive Querschnittsstudie mittels Online-Survey in 29 Institutionen durchgeführt. Ergebnisse Die theoretische Ausbildung weist eine hohe Spannbreite pro Ausbildungsform auf und bewegt sich im Durchschnitt von 21,2 Unterrichtstunden in den Schulen für Gesundheits- und Krankenpflege bis 2,5 ECTS im Bachelorstudium. Ebenso wird die praktische Ausbildung sowie didaktische Vermittlung von Inhalten einrichtungsspezifisch gehandhabt. Schlussfolgerung Die gesetzliche Verankerung von Palliative Care in der Grundausbildung ist ein erster Ansatz. Die Ergebnisse dieser Studie können als Ausgangspunkt zur Entwicklung eines einheitlichen Curriculums dienen.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24099-e24099
Author(s):  
Júlia Maria Mathias Pedreira de Freitas ◽  
Daniela Oliveira de Almeida ◽  
Luciana Castro G. Landeiro ◽  
Tércia Vilasboas Reis ◽  
Thomas Azevedo de Carmo ◽  
...  

e24099 Background: Medical cannabis (MC) emerged as an important complementary therapy in the context of oncological diseases. In 2019, the Brazilian Health Regulatory Agency (Anvisa) approved use of MC, which can be produced in the country and sold in pharmacies under medical prescription. Previous investigations have extensively correlated MC effectiveness, over management and support of symptoms caused by the disease and/ or its treatment. However, studies evaluating knowledge and patterns of MC use in oncology patients MC are lacking. In the present study, we assessed the perception of oncologists and palliative care physicians on MC as a complementary therapy for cancer patients, and their personal experiences in clinical practice in Brazil. Methods: In October 2020 an online survey was sent via e-mail by the Brazilian Society of Clinical Oncology and the National Academy of Palliative Care for physicians with expertise in oncology and/or palliative care. Outcomes measured included knowledge and opinions about MC, prescription experience and impressions about the Brazilian legislation. Data analysis was performed with descriptive statistics, comparison tests and the Poisson regression model with robust variance, using the IBM Statistical Package for the Social Sciences software, version 25. Results: A total of 124 physician participated in the study and, of those, 58.1% were oncologists, and 82.3% believed that MC has application as a complementary therapy in cancer. In contrast, only 52.4% of the participants felt comfortable recommending its use and only 15.3% have ever prescribed MC for their patients with cancer. Further, among those who have never prescribed, 71% have already referred patients to other professionals to prescribe, and 61% indicated lack of knowledge as the main factor for not prescribing. In addition, more than half of participants claimed not knowing Brazilian legislation regarding MC use. Nausea and vomiting were mentioned by 73.4% of physicians as the major indication for MC. Conclusions: Oncologists and palliative care physicians agree with the applicability of MC use for the management of symptoms related with or caused by cancer. However, our findings infer that factors such as lack of knowledge, legislation barriers and lack of robust scientific evidence, lead to its limited use among Brazilian oncologists and palliative care physicians.


Author(s):  
Rebecca McLaughlan ◽  
Kieran Richards ◽  
Ruby Lipson-Smith ◽  
Anna Collins ◽  
Jennifer Philip

Objective: To contribute staff perspectives on the design of palliative care facilities to better align with the philosophy of palliative care, in support of patient, family, and staff well-being. Background: The receipt of palliative care differs from other inpatient experiences owing to its distinct philosophy of care, longer lengths of stay, a greater presence of family members, and more frequent end-of-life events. While research regarding the optimal design of palliative care environments recognizes these differences, this knowledge has been slow to exert change on the guidelines and procurement processes that determine the design solutions possible within these settings. Sustained research attention is required. Methods: An online survey, comprising a series of open-ended questions, elicited the perceptions of palliative care staff regarding the relationship between the physical environment and the distinct philosophy of palliative care. Results: Responses from 89 Australian-based palliative care professionals confirmed the high value that staff place on environments that offer privacy, homeliness, safety, and access to gardens to assist the delivery of optimum care. Conclusions: Our findings illustrate that the implications of privacy and homeliness extend far beyond the patient room and that homeliness is about more than an aesthetic of comfort. This highlights a broader capacity for design to better support the philosophy of palliative care. Importantly, the data reveal a key relationship between staff well-being and the environments in which they work; environments that are unable to match the quality of care that staff aspire to deliver can engender frustration and distress.


2018 ◽  
Vol 8 (3) ◽  
pp. 370.1-370 ◽  
Author(s):  
Ishrat Islam ◽  
Anthony Byrne ◽  
Annmarie Nelson

IntroductionA major challenge in developing new models of palliative care is to identify the current needs of the public patients and carer (Dixon 2015). There is a lack of evidence on people’s attitudes towards end of life care (EoLC) in Wales.AimTo increase understanding of people’s feelings views knowledge and preferences around EoLC.MethodAn online survey was conducted using an electronic survey tool. Descriptive statistics and thematic analysis were used to perform data analysis.Results2210 people (Age: Mean +SD; 55+14 years) participated in the survey 43% of those were members of the general public 29% were patients/carers and 23% were health professionals. 49% of respondents thought that available palliative care was inadequate and 92% believed that end of life care for dying people should have equal priority for the NHS. 95% of respondents thought that expressing preferences around EoLC in advance was important but only 13% had done this in practice and 60% did not know how to plan their EoLC. However the top three needs in EoLC were identified as having a trained carer (84%) access to other professionals (59%) and emergency care (44%). The top three preferences for EoLC were being surrounded by loved ones (62%) maintaining dignity (55%) and a feeling of peace (40%). Just 24% respondents would chose to be at home while receiving EoLC.ConclusionsUnderstanding public attitudes is essential to understanding changing contexts of care. Developing a need-based palliative care model enhances an effective service delivery.Reference. Dixon J, et al. Equity in the provision of palliative care in the UK: Review of evidence2015;pg. 1–145. London: Personal Social Services Research Unit. Available at: https://www.mariecurie.org.uk/globalassets/media/documents/policy/campaigns/equity-palliative-care-uk-report-full-lse.pdf


2019 ◽  
Vol 34 (s1) ◽  
pp. s151-s152
Author(s):  
Gerald Ripberger ◽  
Michael Oppert ◽  
Jens Werner Bickelmayer

Introduction:The treatment of patients in the triage category “expectant” is not in the focus of the prehospital disaster medicine. The aim is to save as many lives as possible in situations with very limited resources. It is necessary to allocate the life-saving interventions to those who have the chance to survive, but there is a human right of best assistance even for those who are expected to die.Aim:In Germany, it is possible to use the triage category “expectant” in overwhelming disasters, so there should be preparedness for those patients, who receive this categorization. A survey was conducted to find out what the needs are of those patients.Methods:An online-survey was submitted to German medical incident commanders and palliative care physician in function of expert groups via their national associations.Results:219 physicians participated. The majority confirmed a necessity to treat those patients and to be prepared. Currently, in most of the areas, there is no preparation. The main needs are the treatment of pain, dyspnoea, fear, and loneliness. Following the “Dying person’s bill of rights” (1), the most relevant rights are: To be treated as living human being until I dieTo be free from painTo express the feelings and emotionsTo die in peace and dignityDiscussion:Palliative care should be part of disaster medicine planning. It is not too difficult to prepare a special group of helper for the care of dying patients. Medical incident commanders and palliative care physicians agree in the majority about the necessity, so SOPs can be implemented to teach non-medics. The medics will be needed for the first aim of disaster medicine.


2020 ◽  
Vol 18 (6) ◽  
pp. 662-669
Author(s):  
Karl W. Bitschnau ◽  
Pam Firth ◽  
Maria Wasner

AbstractObjectivesSocial work is considered to be a key player in Hospice and Palliative Care. To prove this claim, the Social Worker Task Force within the European Association for Palliative Care (EAPC) decided to carry out a survey. The aim of this survey was to generate basic data and thus to create a basis for further development of Palliative Care Social Work (PCSW) in Europe.MethodThe online survey consisted of two parts: in Part 1, the 57 collective members of the EAPC were asked to fill in an online questionnaire containing questions about basic data. In Part 2, individual Palliative Care Social Workers (SWs) from all over Europe were asked to fill in another questionnaire with a focus on the basic conditions concerning their jobs as well, as on their tasks and roles.ResultsThirty-two collective members of the EAPC completed the online questionnaire. SWs can be found in all of the Palliative Care settings, but there are considerable differences between the countries concerning the prevalence of SWs. Only five countries (20%) reported specialized qualification training in PCSW and just around half of the responding SWs had such a specialized training. The responding SWs (n = 360) were quite content with their working conditions. Tasks concerning patient and family and tasks concerning the interprofessional team were most prominent. There is a significant role overlap with other professions.Significance of resultsThe study reveals a very mixed picture of PCSW in Europe. This could be due to the high adaptability of social work, which is to be as flexible as possible to the needs of its clients. However, significant patterns, similarities, and differences emerge. The present study may, therefore, serve as a basis for further in-depth studies.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S134-S134
Author(s):  
Catherine Carrico ◽  
Andrea Slosser ◽  
Robin A Barry ◽  
Christine McKibbin

Abstract Background: Palliative Care (PC) is a valuable tool for improving the lives of people living with chronic illness. However, access to PC is limited in rural areas. The purpose of this study is to describe the current PC needs and barriers to care in a rural state. Methods: An online survey was disseminated through professional organizations, licensing boards, and the University of Wyoming. Rurality of counties was classified using Rural Urban Continuum Codes (RUCC). Descriptive statistics were calculated using SPSS. Results: Responses were received from 336 individuals across 20 of 23 counties (i.e., RUCC range 3 - 9; 1=most metropolitan, 9=most rural). The majority worked in healthcare or social service sectors (n = 265, 78.8%). Approximately one-half (n = 119, 50.6%) of these individuals endorsed providing PC (i.e., typically symptom management, supportive resources, and family support). Over one-half of respondents (n = 173, 51.5%) rated availability of PC services in their communities as “poor” or “somewhat good.” Key barriers to providing PC were lack of patient information and knowledge (n = 215), access to PC specialists (n = 183), and funding and reimbursement (n = 181). Approximately one third of healthcare professionals (n = 78, 32.8%) had received formal training in PC. A majority of healthcare and social service respondents (n = 139, 59.1%) endorsed interest in PC continuing education. Conclusions: This study provides insight into the state of PC across a rural state. Results highlight the need to design accessible education and implement system transformation to improve PC access.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Gary L Stein ◽  
Cathy Berkman

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.


2018 ◽  
Vol 8 (3) ◽  
pp. 362.3-363
Author(s):  
Natasha Bradley ◽  
Mari Lloyd-Williams ◽  
Chris Dowrick

IntroductionSocial isolation is increasing with negative consequences for both physical and mental health. People with life-limiting illness and their carers are at risk of inadequate social support and loneliness.Hospices support social wellbeing with services including traditional day care support groups befriending multi-component interventions and community activities. Existing research suggests that access to social support is highly valued. However models of support used in practice are poorly documented and outcomes difficult to ascertain. The significance of social support in palliative care is under-researched.AimTo establish an overview of hospice service models that facilitate social support for adults living in the community with life-limiting illness.MethodAn online survey was developed piloted and disseminated to adult hospices in the UK and ROI. Questions include hospice characteristics provision of services facilitating social support access issues use of patient outcomes and availability of cost data.Results107 hospices responded to the survey (>50% of eligible hospices). A diverse range of service models were identified. Preliminary results presented include: descriptive statistics of the sample categories and aims of services and salient access issues. Implications of findings for research and economic evaluation are discussed.ConclusionThis survey demonstrates hospices to be interested and active in facilitating social support. It is possible that increasingly diverse approaches used in practice may improve issues regarding access to and awareness of hospice care. More work is needed to share best practice document outcomes and consider cost-effectiveness.Reference. Bradley N, Lloyd-Williams M, Dowrick C. Effectiveness of palliative care interventions offering social support to people with life-limiting illness – A systematic review. Eur J Cancer Care2018. doi:10.1111/ecc.12837


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