Nurses experience of communication with palliative patients in critical care unit: Saudi experience

2016 ◽  
Vol 5 (2) ◽  
pp. 102 ◽  
Author(s):  
Hanan Alshehri ◽  
Samantha Ismaile
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
Do Not Resuscitate ◽  
Cross Sectional ◽  
Advanced Directives ◽  
Critical Care Units ◽  
Feeding Tubes ◽  
Common Causes ◽  
Cross Sectional Design ◽  
Palliative Patients

Communication is crucial regardless of a patient's condition in Critical Care Units (CCU). However; communication barriers are common in CCU. In recent years there has been a rapid growth within hospital settings in the provision of palliative care according to patient needs. The purpose of the research study was to investigate nurses’ experiences of communication with palliative patients in CCU. A cross sectional design was conducted using questionnaire. The study sample included nurses who were working in CCU. The total number of completed and submitted questionnaires were 61. The majority of respondents were females. The results show that 49% of respondents have experienced difficulties in palliative care tasks while 41% respondents have complications with communication in palliative care. Also, nurses who took part in this study reported difficultly in discussing decisions such as advanced directives, do not resuscitate orders, and feeding tubes. In conclusion, nurses experience difficulty with communication whilst carrying out palliative care tasks in critical care units. The common causes of communication difficulty are because of the complexity of palliative care tasks, language barriers, shortage of staff and feeling un-empowered. Moreover, there is a lack of education programs centered around enhancing communication difficulties between nurses and palliative patients.

The significance of fatigue in relatives of palliative patients

2010 ◽  
Vol 8 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Maria E. Carlsson
Keyword(s):  
Palliative Care ◽  
Pilot Study ◽  
Psychosocial Support ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Study Population ◽  
Cross Sectional Design ◽  
Palliative Phase ◽  
Close Family ◽  
Palliative Patients

AbstractObjective:The aim of this study was to explore the significance of fatigue among relatives of palliative patients.Method:This pilot study has a descriptive and cross-sectional design and is the report of four open-ended questions focusing on the relatives' experiences of fatigue. The study population consisted of relatives of patients who were cared for in palliative care settings either at home or in an institution in Uppsala County during a specific day.Results:The relatives were very tired and identified worries, uncertainty, the patient's suffering, and many demands as the causes for the fatigue. The most obvious consequences of the tiredness were a lack of motivation, feelings of insufficiency and apathy, and putting their own interests aside. Many relatives expressed that having the company of close family members, taking exercise and spending time outdoors gave them strength to carry on. The health care system could make the situation easier for relatives of patients in palliative care by providing good care for the patient, and psychosocial support and respite care for the relatives.Significance of results:The result of the pilot study is only preliminary, but it showed that relatives caring for patients in a late palliative phase suffer from great fatigue and require more attention, both scientifically and in the clinical settings.

Factors associated with feelings of reward during ongoing family palliative caregiving

2014 ◽  
Vol 13 (3) ◽  
pp. 505-512 ◽  
Author(s):  
Anette Henriksson ◽  
Ida Carlander ◽  
Kristofer Årestedt
Keyword(s):  
Palliative Care ◽  
Family Caregivers ◽  
Influential Factors ◽  
Cross Sectional ◽  
Spousal Relationship ◽  
Factors Associated ◽  
Specialized Palliative Care ◽  
Cross Sectional Design ◽  
Bereaved Family ◽  
Demographic Background

AbstractObjective:Of the few studies that have paid attention to feelings of reward in family palliative caregiving, most are retrospective and examine the experiences of bereaved family caregivers. Although feeling rewarded has been described as an influence that may facilitate the way family caregivers handle the caregiving situation, no study has sought to identify the factors associated with feelings of reward while providing ongoing family palliative care. The aim of this study, therefore, was to identify influential factors in feelings of reward experienced by family palliative caregivers.Method:Our study had a correlational cross-sectional design. Family caregivers (n = 125) of patients receiving specialized palliative care were consecutively recruited from four settings. These caregivers answered a questionnaire that included the Rewards of Caregiving Scale (RCS). This questionnaire included questions about demographic background and scales to measure preparedness for caregiving, feelings of hope, perceived health, and symptoms of anxiety and depression. Correlation and regression analyses were conducted to identify factors associated with rewards.Results:The results demonstrated that the more prepared caregivers with higher levels of hope felt more rewarded, while caregivers with higher levels of anxiety and those in a spousal relationship with the patient felt less rewarded by caregiving.Significance of results:It seems reasonable that feeling rewarded can be a significant contributor to the overall experience of providing ongoing palliative care. The situation of family caregivers has been shown to be multifaceted and complex, and such covariant factors as preparedness, anxiety, hope, and being in a spousal relationship with the patient to influence this experience.

scholarly journals MEASURING KNOWLEDGE OF JORDANIAN NURSES WORKING IN CRITICAL CARE UNITS TOWARD STROKE PATIENTS

World Science ◽  
2020 ◽  
Author(s):  
Eslam Abd Alkreem Allsassmah
Keyword(s):  
Critical Care ◽  
Negative Relationship ◽  
Signs And Symptoms ◽  
Public Hospitals ◽  
Stroke Management ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Critical Care Units ◽  
Jordanian Nurses ◽  
The Impact

Background. Stroke is a devastating disease. It is a major cause for the neurological admission to hospitals all over the world. Limited knowledge among the critical care nurses about stroke in general and specifically about the risk factors, signs, and symptoms of stroke usually is a main source of delayed prompt stroke management and non-compliance with follow-up rehabilitation. Therefore, there is a need for a study that examines the impact of these factors in order to promote stroke management and improve nursing care outcomes.Aim. This study aimed at measuring the knowledge of Jordanian nurses working in critical care units toward stroke patients.Methods. This cross-sectional study used the descriptive approach in order to measure the knowledge of the Jordanian nurses working in critical care units regarding stroke patients in the Jordanian hospitals. Data were collected from Jordanian critical care units' nurses from seven hospitals; five private and two public hospitals. Critical care units’ nurses were selected conveniently based on specific inclusion criteria. Eligible participants were required to complete self–reported questionnaires about knowledge in addition to completing demographic questionnaires. The descriptive and inferential statistics were conducted using the SPSS software. Results. A total of (200) Critical care units’ nurses from public and private hospitals participated in the study. The nurses in this study exhibited poor knowledge on the study scales. There were statistically significant differences among nurses according to the type of hospital on the one scales (P< .05). There is a negative relationship between the knowledge and years of nursing practice in ER or ICU (P= .013).Conclusions. The measures of knowledge among the nurses in critical care units in the Jordanian hospitals towards stroke patients seem to be highly poor. Nurses in critical care units seem to have acceptable information, but inadequate to correctly enhance stroke awareness. There is a gap that should be stuffed via planning and implementation of educational and instructional programs focused on hospital nurses as well as community sectors in order to improve the stoke focus and experience and avoid the delay in accessing the medical help which would, in return, improve stroke management and reduce its effect in Jordan.

scholarly journals Predictors of moral harassment in nursing work in critical care units

2021 ◽  
Vol 74 (3) ◽  
Author(s):  
Luana Silva de Sousa ◽  
Roberta Meneses Oliveira ◽  
Jênifa Cavalcante dos Santos Santiago ◽  
Érika da Silva Bandeira ◽  
Yane Carmem Ferreira Brito ◽  
...  
Keyword(s):  
Critical Care ◽  
Public Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Critical Care Units ◽  
Young Professionals ◽  
Work Related ◽  
Emergency Units ◽  
Nursing Professionals ◽  
Negative Acts

ABSTRACT Objectives: to analyze the predictors of moral harassment in nursing work in critical care units. Methods: a cross-sectional study conducted in a public hospital in Fortaleza, Ceará, with 167 nursing professionals in 2016. Sociodemographic/occupational questionnaire and Negative Acts Questionnaire Revised were applied. The analysis included descriptive statistics, measures of central tendency and dispersion, as well as Mann-Whitney, Kruskal-Wallis and Conover Inman U-tests for multiple comparisons. Results: there was a 33% prevalence of self-perception of moral harassment, highlighting personal/professional disqualification and work-related harassment. The predictors of moral harassment included age, time working in the job and time in the unit, employment relationship and sector. Conclusions: young professionals (< 30 years), cooperative, crowded in intensive care or emergency units, with less time working in the job (< 5 years) or greater time in the unit (above 10 years) are the biggest victims of moral harassment in the work of nursing in critical environments.

The ACS-TQIP palliative care guidelines at two level I trauma centres: a prospective study of patient and caregiver satisfaction

2020 ◽  
pp. bmjspcare-2020-002229
Author(s):  
Rebecca Vogel ◽  
Constance McGraw ◽  
Diane Redmond ◽  
Pamela Bourg (retired) ◽  
Chester Dreiman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Patient Satisfaction ◽  
Family Satisfaction ◽  
Trauma Patients ◽  
Do Not Resuscitate ◽  
Advanced Directives ◽  
Trauma Centres ◽  
Caregiver Satisfaction ◽  
Information Giving ◽  
Level I

ObjectivesTo measure trauma patient and caregiver satisfaction before and after implementation of standardised palliative care (PC) guidelines.MethodsProspective pre–post study at two level-I trauma centres. PC satisfaction surveys were administered prior to discharge for consented trauma patients (Family Satisfaction with Advanced Cancer Scale, Patient (FAMCARE-P13) survey)≥55 years, and their caregivers (FAMCARE survey), from 1 November 2016 to 30 November 2018. Standardised PC guidelines were implemented January 2018 and included consultations, prognostication assessments, identification of proxies, review of advanced directives and do not resuscitate orders within 24 hours of admission, while advanced goals of care, formal family meetings and spiritual care support were recommended within 72 hours of admission. Generalised linear models were used to determine whether differences in patient or caregiver satisfaction existed pre versus post implementation.ResultsThere were 572 patients (299 pre; 273 post) and 595 caregivers (334 pre; 261 post) included. Overall patient satisfaction significantly increased post implementation (82.0 vs 86.0, p=0.001). After adjustment, the implementation of the guidelines was an independent predictor of higher overall patient satisfaction (least squares mean (LSM= (83.8% (95%CI 81.2%-86.5%) vs 80.3% (77.7%-82.9%), p=0.003)). Compared with preimplementation, patient satisfaction was significantly higher post implementation in the following domains: information giving (80.9 vs 85.5, p=0.001), followed by physical care (82.2 vs 86.0, p=0.002), availability of care (83.4 vs 86.8, p=0.007) and psychosocial care (84.7 vs 87.6, p=0.04). No significant differences in caregiver satisfaction were found before or after adjustment (LSMpre: 83.1% (95%CI 80.9%-85.3%) vs. post: 82.4% (80.3%-84.5%), p=0.56))ConclusionsOur data suggest that the implementation of PC guidelines significantly improved patient satisfaction following traumatic injury, while maintaining robust caregiver satisfaction.

The Short Demoralization Scale (SDS): A new tool to appraise demoralization in palliative care patients

2017 ◽  
Vol 15 (5) ◽  
pp. 516-523 ◽  
Author(s):  
Laura Galiana ◽  
David Rudilla ◽  
Amparo Oliver ◽  
Pilar Barreto
Keyword(s):  
Palliative Care ◽  
Depression Scale ◽  
Cost Effective ◽  
Assessment Tools ◽  
Cross Sectional ◽  
Brief Assessment ◽  
Palliative Care Setting ◽  
Cross Sectional Design ◽  
The One ◽  
Demoralization Scale

ABSTRACTObjective:The Demoralization Scale (DS) is the most widely used measure for assessing demoralization. Following the recent clamor for brief assessment tools, and taking into account that demoralization has proved to be a symptom that needs to be controlled and treated in the palliative care setting, a shorter scale is needed. The aim of the present research is to introduce and evaluate the Short Demoralization Scale (SDS).Method:We employed a cross-sectional design that included a survey of 226 Spanish palliative care patients from the Hospital General Universitario de Valencia. We employed the SDS, the DS, and the Hospital Anxiety and Depression Scale (HADS).Results:The confirmatory factor analysis supported the one-factor structure of the SDS (χ2(5) = 12.915; p = 0.024; CFI = 0.999; RMSEA = 0.084; CI95% = [0.028, 0.141]). The reliability was found to be appropriate, with a value of Cronbach's alpha (α) equal to 0.920. A cutoff criterion of 10 was established, which favored the interpretability of the instrument.Significance of results:The SDS corrects previous limitations, has a simple scoring system, is cost-effective, and is widely and fully available. In addition, our findings demonstrate that the SDS can be employed effectively in the clinical context.

Structured outpatient palliative care family conferences to enhance early integration of palliative care in advanced cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 36-36
Author(s):  
Cheruppolil R. Santhosh-Kumar ◽  
Deborah Gray ◽  
Stephanie Struve ◽  
Carol Huibregtse
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Direct Result ◽  
Do Not Resuscitate ◽  
Advanced Directives ◽  
Early Integration ◽  
Early Palliative Care ◽  
Family Conference ◽  
Nurse Navigator ◽  
Care Family

36 Background: Integrating early palliative care with cancer treatment improves quality of life and survival. Effective communication among physicians, patients and their loved ones is crucial to end-of-life, hospice and palliative care discussions. To address the inherent challenges in these discussions, we implemented a structured outpatient palliative care family conference (OFC) program at our community cancer clinic. Methods: A team comprising a hematologist/oncologist, cancer nurse navigator and social worker developed a toolkit for conducting an OFC, recognizing that each family conference is a unique adaptive challenge. New patients with advanced malignancies and limited life expectancy (<12 months) were offered a 90-minute structured OFC attended by the care team, patient and family members and or friends. Pre and post-conference patient satisfaction surveys and other data were collected prospectively. Results: From March 2014 through May 2015, fortyOFC were conducted (16 female and 24 male patients, median age: 67 years). Diagnoses were advanced gastrointestinal (14), lung (12), hematologic (6) and other (8) malignancies. As a direct result of the OFC program, 18 patients ordered do-not-resuscitate bracelets, 15 completed advanced directives, 7 submitted paperwork for disabled parking permits, 7 were referred to hospice and 4 for rehabilitation therapy. Further results are shown in the table. Conclusions: Structured outpatient palliative care family conferences improve satisfaction of end-of-life discussions and facilitate integration of palliative care options. Enhanced communication between providers, patients and loved ones eases the challenges of such discussions. The OFC approach could be a model for integrating palliative care in community cancer clinics. [Table: see text]

scholarly journals Perception of Nurses on Needs of Family Members of Patient Admitted to Critical Care Units of Teaching Hospital, Chitwan Nepal: A Cross-Sectional Institutional Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ishwori Khatri Chhetri ◽  
Bedantakala Thulung
Keyword(s):  
Critical Care ◽  
Teaching Hospital ◽  
Family Members ◽  
College Teaching ◽  
Patient Treatment ◽  
Family Needs ◽  
Cross Sectional ◽  
Critical Care Units ◽  
Medical College ◽  
Significant Difference

Background. Critical care units’ nurses should seek to develop collaborative relationships with patients’ family members based on their needs and help them to cope with their distress. The objective of this study was to find out the perception of nurses on needs of family members of patients admitted to critical care units.Methods. A descriptive cross-sectional study was conducted in Chitwan Medical College Teaching Hospital among all 65 nurses working in critical care units. Ethical clearance was obtained from Chitwan Medical College Institutional Review Committee. Data were collected from March 27 to April 25, 2016, using Critical Care Family Needs Inventory (CCFNI). Obtained data were analyzed using descriptive and inferential statistics.Results. This study found that mean age of the nurses was 23.98 ± 4.05 years. More than half of the nurses had completed PCL in nursing (52.3%) and had 1-5 years of experience in critical care units (58.5%). Nurses ranked the needs for assurance as most important needs with mean percent (86.25%) followed by needs for information (78.58%), need for comfort (69.59%), needs for closeness (69%), and needs for support (64.13%). Out of 45 family needs, 81.5% of nurses perceived that knowing about patient treatment is very important for family members. Married nurses perceived the needs for support to be more important than unmarried nurses (p=0.04) whereas unmarried nurses perceived the needs for information to be more important than married (p=<0.01). There was significant difference on perception of nurses on needs of assurance with ethnicity (p=0.009) and critical care experience (p=0.04).

scholarly journals Does heavy mental workload affect moral sensitivity among critical care unit nursing professionals? a cross-sectional study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hosein Zahednezhad ◽  
Nasrin shokrollahi ◽  
Reza Ghanei Gheshlagh ◽  
Pouya Farokhnezhad Afshar
Keyword(s):  
Critical Care ◽  
Regression Analysis ◽  
Mental Workload ◽  
Critical Care Nursing ◽  
Moral Sensitivity ◽  
Cross Sectional ◽  
Experienced Nurses ◽  
Critical Care Units ◽  
Nursing Professionals ◽  
Care Nursing

Abstract Background Moral sensitivity creates the basic attitude in providing effective ethical care to patients. Heavy mental workload is a major concern of critical care nursing professionals, which could adversely affect nursing staff and patients. The present study aimed to investigate the effects of mental workload and some demographic variables on the moral sensitivity of critical care nursing professionals. Methods This cross-sectional, descriptive-correlational study was performed on 181 nursing professionals working in the critical care units of Shahid Rajaei Cardiovascular Medical and Research Center in Tehran, Iran. Data were collected using a demographic questionnaire, the moral sensitivity questionnaire, and the NASA-task load index to assess mental workload. Data analysis was performed in SPSS version 22 using descriptive statistics, independent t-test, Pearson’s correlation-coefficient, and regression analysis. Results The results of regression analysis yielded no statistical significant relationship between heavy mental workload and moral sensitivity of the critical care nursing professionals, while clinical experience had a positive, significant association with moral sensitivity. Conclusions Although care nursing professionals experience a heavy mental workload in critical care units, it does not decrease their moral sensitivity. In addition, experienced nurses have higher moral sensitivity and lower mental workload. Therefore, it seems that nursing managers should pay special attention to the importance of employing experienced nurses along with younger nurses.

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