scholarly journals Management of pressure ulcers in palliative care patients: nurses' view

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e62774
Author(s):  
Sarah Vieira Figueiredo ◽  
Sherida Karanini Paz de Oliveira ◽  
Anne Kayline Soares Teixeira ◽  
Luciana Catunda Gomes de Menezes ◽  
Ilvana Lima Verde Gomes ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Clinical Improvement ◽  
Pressure Ulcers ◽  
Complete Healing ◽  
Nursing Management ◽  
Structured Interviews ◽  
Categorical Analysis ◽  
Clinical Stabilization ◽  
The Individual

Objective: to understand the management of pressure ulcers in palliative care patients from the perspective of nurses. Methods: qualitative study, in which 17 care nurses participated through semi-structured interviews. Data were submitted to thematic categorical analysis. Results: two categories were listed: Nursing management of pressure ulcers in palliative care patients and Outcome of pressure ulcers in palliative care patients. Their management occurs by means of individualized assistance and may vary according to the different moments in which the individual is and should be malleable. The possibility of three outcomes was also observed: complete healing, clinical improvement and clinical stabilization. Conclusion: despite all the frailty of these patients in palliative care, it was perceived that the clinical improvement of the lesions occurs, although it is a slow path, by means of handling the lesions in an individualized manner and focused on the search for comfort.

A Qualitative Study of Developing Competency in Thyroid Surgery: A Resident’s Perspective With 5 Year Follow Up

2021 ◽  
pp. 000348942199691
Author(s):  
Gabriela DeVries ◽  
Megan Rudolph ◽  
Howard David Reines ◽  
Philip E. Zapanta
Keyword(s):  
Qualitative Study ◽  
Learning Strategies ◽  
Thyroid Surgery ◽  
Washington Dc ◽  
Structured Interviews ◽  
Self Directed Learning ◽  
Surgical Specialty ◽  
Long Term Follow Up ◽  
The Individual

Objectives: The Accreditation Council for Graduate Medical Education has guidelines on assessing surgical qualifications based on experience. Attending surgeons have various assumptions on how their trainees learn and acquire surgical skills. This study primarily investigates the resident’s perspective on gaining experience and achieving competency in thyroid surgical procedures. Methods: A qualitative study using semi-structured interviews was designed to derive themes that discuss the acquisition of competency in thyroid surgery. After IRB approval, data was collected from 2012 to 2014 at 4 academic centers in the Washington, DC area. Fourteen chief residents specializing in either general surgery or otolaryngology were interviewed until saturation was achieved. These semi-structured interviews were transcribed and broken up into codes utilizing Moustakas’ analysis. A comprehensive list of master themes in regards to achieving competency in thyroid surgery was developed. A follow up survey of the surgeons was undertaken at 5 years to determine if the perceptions during residency persisted in practice. Results: Surgical specialty residents experience and learn thyroid surgery in 5 learning themes: 1. Self—directed learning is significant during residency. 2. Repetition with graduated autonomy is key. 3. Effective mentors are competent surgeons who challenge residents and use positive teaching techniques. 4. Residents employ active learning through the “see one, do one, teach one” philosophy. 5. Learning from complexity is of importance to residency training. After several years in practice, the most important theme in learning after residency was repetition of cases. Conclusions: This study demonstrates how residents progress in approaching competency in thyroid surgery. Adult learning strategies are preferred, and programs should incorporate tailored techniques to meet the individual needs of the residents. Perceptions of what is most important shifted in long-term follow up. Further study is needed to assure competency in residency and in practice.

scholarly journals Nurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring

2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Carla Braz Evangelista ◽  
Maria Emília Limeira Lopes ◽  
Solange Fátima Geraldo da Costa ◽  
Patrícia Serpa de Souza Batista ◽  
Marcella Costa Souto Duarte ◽  
...  
Keyword(s):  
Palliative Care ◽  
Content Analysis ◽  
Qualitative Study ◽  
Spiritual Care ◽  
Structured Interviews ◽  
Spiritual Dimension ◽  
Nurses Role ◽  
Theory Of Human Caring ◽  
Process Elements ◽  
Human Caring

ABSTRACT Objectives: to analyze nurses’ role in assisting patients in palliative care, with emphasis on the spiritual dimension, in the light of Theory of Human Caring. Methods: this is an exploratory, qualitative study, carried out in a hospital in João Pessoa, Paraíba, between August and December 2019, with 10 nurses. For data collection, semi-structured interviews were used. For analysis, we opted for content analysis. Results: the spiritual dimension of care is contemplated by several religious and spiritual practices. These are respected and encouraged by nurses, although there is difficulty in providing care for the spiritual dimension. Final Considerations: nurses have attitudes consistent with Jean Watson’s Theory and apply the Caritas Process elements during assistance to patients’ spiritual dimension in palliative care.

scholarly journals “How Long Can I Carry On?” The Need for Palliative Care in Parkinson’s Disease: A Qualitative Study from the Perspective of Bereaved Family Caregivers

2020 ◽  
Vol 10 (4) ◽  
pp. 1631-1642
Author(s):  
Herma Lennaerts-Kats ◽  
Anne Ebenau ◽  
Maxime Steppe ◽  
Jenny T. van der Steen ◽  
Marjan J. Meinders ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Palliative Care ◽  
Parkinson's Disease ◽  
Qualitative Study ◽  
Family Caregivers ◽  
Interpretative Phenomenological Analysis ◽  
Healthcare Professionals ◽  
Structured Interviews ◽  
Practice Nurses ◽  
Bereaved Family

Background: Family caregivers provide the majority of care for people with Parkinson’s disease (PD) in the palliative care phase. For many this is a demanding experience, affecting their quality of life. Objective: We set out to map the experiences of bereaved family caregivers during the period of informal care in the palliative care phase as well as after the death of their loved one with PD. Methods: Ten bereaved family caregivers participated in this qualitative study. Semi-structured interviews were conducted and interpretative phenomenological analysis was used executed. Results: We identified four main themes. 1) Feeling like a professional caregiver: while caring for a person with PD, the family caregivers took over many roles and tasks of the person with PD. 2) Healthcare professionals do not always know what PD really means: most interviewees had negative experiences with knowledge and understanding of PD of, especially, (practice) nurses. 3) Being on your own: many respondents had felt highly responsible for their loved one’s care and lacked time and space for themselves. Grief and feelings of guilt were present during the caregiving period and after death. 4) Being behind the times: to provide palliative care in line with patients’ preferences and to feel prepared for the palliative care phase of PD, proactive palliative care planning was considered important. However, the interviewees told that this was most often not provided. Conclusion: These findings indicate that caring for a person with PD in the palliative care phase is a demanding experience for family caregivers. They experience psychological problems for many years before and after the death of the person with PD. Increasing healthcare professionals’ awareness of family and bereaved caregivers’ needs may mitigate these long-term detrimental effects.

scholarly journals Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study

2020 ◽  
Vol 17 (11) ◽  
pp. 3906 ◽  
Author(s):  
Viviana Dávalos-Batallas ◽  
Vinita Mahtani-Chugani ◽  
Carla López-Núñez ◽  
Víctor Duque ◽  
Fatima Leon-Larios ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Policy ◽  
Qualitative Study ◽  
Health Services ◽  
Human Resources ◽  
Thematic Analysis ◽  
Medical Professional ◽  
Structured Interviews ◽  
Unequal Distribution

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals’ activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.

scholarly journals ‘…you just put up with it for the sake of humanity.’: an exploratory qualitative study on causes of stress in palliative care nursing during the COVID-19 pandemic in Germany

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051550
Author(s):  
Susann May ◽  
Kerstin Stahlhut ◽  
Matthew Allsop ◽  
Martin Heinze ◽  
Felix Mühlensiepen
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Infection Control ◽  
Hospice Care ◽  
Qualitative Content Analysis ◽  
Daily Basis ◽  
Control Measures ◽  
Infection Control Measures ◽  
The Individual ◽  
Care Nursing

ObjectiveTo explore and analyse causes of stress among nurses in palliative and inpatient hospice care settings in Germany during the COVID-19 pandemic.DesignExplorative, qualitative study using problem-centred interviews. Interview data were analysed using structured qualitative content analysis.SettingTelephone interviews with nurses of different settings of palliative and inpatient hospice care.Participants16 nurses from inpatient hospice, palliative care units and specialised palliative home care were recruited.ResultsCOVID-19 infection control measures placed both physical and psychological strain on palliative care nurses. Due to changes in infection control information, workflows were being readjusted on a daily basis, preventing everyday routines and hindering relief from stress. There are reduced and limited opportunities for sharing and reflecting on daily working routines with team colleagues. Specific causes of stress in the individual settings of palliative and inpatient hospice care were identified. Overall, there is a tension between the nurses’ perceptions of proper palliative care nursing, in terms of closeness, psychosocial and emotional support and compliance with infection control measures.ConclusionsPalliative care nurses have been exposed to high levels of both physical and psychological stress during the COVID-19 pandemic. This requires rapid relief and support, with a need to ensure continuity of professional supervision and peer-support, which may be facilitated via digital technologies. The unique role of nurses in inpatient hospice and palliative care during COVID-19 ought to be recognised and valorised.

scholarly journals A Qualitative Study Using Semi-Structured Interviews: Comparing the Views of Palliative Care Unit Patients and Clinicians on Corneal Donation Discussions

2022 ◽  
Author(s):  
Chirag Patel ◽  
Gregory B Crawford
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
South Australia ◽  
Corneal Opacity ◽  
Structured Interview ◽  
Palliative Care Unit ◽  
Attitudes And Beliefs ◽  
Structured Interviews ◽  
Face To Face ◽  
Corneal Donation

Abstract Background: Blindness from corneal opacity accounts for 12% of cases of blindness worldwide. There is a severe shortage of corneas for donation worldwide for transplantation and research purposes. One group of individuals who could potentially be donors are those who die within the inpatient palliative care unit. The aims of the study were to 1. determine the frequency of corneal donation discussion; 2. determine whether inpatient palliative care unit patients and clinicians were aware of the potential for corneal donation discussions and 3. explore the attitudes and beliefs of inpatient palliative care unit patients and clinicians about corneal donation. Methods: An exploratory qualitative study was designed where inpatient palliative care unit patients and clinicians were invited to a semi-structured interview. A total of 46 face to face interviews were undertaken involving inpatient palliative care unit patients (20) and clinicians (26) in three major inpatient palliative care units in South Australia. Results: Very few patient participants were asked about corneal donations during their time in palliative care. Most inpatient palliative care unit clinicians did not bring up the topic as they felt other areas of care took precedence. Inpatient palliative care unit patients thought if inpatient palliative care unit clinicians did not raise the topic, then it was not important. Conclusions: Findings suggest that patients are receptive to discussing corneal donations, but few discussions are occurring. There were some differences between patient and clinician views, such as preference about who raises the possibility of donation and when the discussion might occur.

scholarly journals Hospital patients’ perspectives on what is essential to enable optimal palliative care: A qualitative study

2020 ◽  
Vol 34 (10) ◽  
pp. 1402-1415 ◽  
Author(s):  
Claudia Virdun ◽  
Tim Luckett ◽  
Karl Lorenz ◽  
Patricia M Davidson ◽  
Jane Phillips
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Family Involvement ◽  
Inpatient Care ◽  
Sense Of Self ◽  
The Body ◽  
Structured Interviews ◽  
Care Needs ◽  
Number Of Patients ◽  
Palliative Care Needs

Background: The majority of expected deaths in high income countries occur in hospital where optimal palliative care cannot be assured. In addition, a large number of patients with palliative care needs receive inpatient care in their last year of life. International research has identified domains of inpatient care that patients and carers perceive to be important, but concrete examples of how these might be operationalised are scarce, and few studies conducted in the southern hemisphere. Aim: To seek the perspectives of Australian patients living with palliative care needs about their recent hospitalisation experiences to determine the relevance of domains noted internationally to be important for optimal inpatient palliative care and how these can be operationalised. Design: An exploratory qualitative study using semi-structured interviews. Setting/participants: Participants were recruited through five hospitals in New South Wales, Australia. Results: Twenty-one participants took part. Results confirmed and added depth of understanding to domains previously identified as important for optimal hospital palliative care, including: Effective communication and shared decision making; Expert care; Adequate environment for care; Family involvement in care provision; Financial affairs; Maintenance of sense of self/identity; Minimising burden; Respectful and compassionate care; Trust and confidence in clinicians and Maintenance of patient safety. Two additional domains were noted to be important: Nutritional needs; and Access to medical and nursing specialists. Conclusions: Taking a person-centred focus has provided a deeper understanding of how to strengthen inpatient palliative care practices. Future work is needed to translate the body of evidence on patient priorities into policy reforms and practice points.

Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study

2019 ◽  
Vol 33 (4) ◽  
pp. 430-444 ◽  
Author(s):  
Nicole Heneka ◽  
Priyanka Bhattarai ◽  
Tim Shaw ◽  
Debra Rowett ◽  
Samuel Lapkin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
System Level ◽  
Quality And Safety ◽  
Specialist Palliative Care ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Care Services ◽  
Palliative Care Services

Background: Opioid errors are a leading cause of patient harm and adversely impact palliative care inpatients’ pain and symptom management. Yet, the factors contributing to opioid errors in palliative care are poorly understood. Identifying and better understanding the individual and system factors contributing to these errors is required to inform targeted strategies. Objectives: To explore palliative care clinicians’ perceptions of the factors contributing to opioid errors in Australian inpatient palliative care services. Design: A qualitative study using focus groups or semi-structured interviews. Settings: Three specialist palliative care inpatient services in New South Wales, Australia. Participants: Inpatient palliative care clinicians who are involved with, and/or have oversight of, the services’ opioid delivery or quality and safety processes. Methods: Deductive thematic content analysis of the qualitative data. The Yorkshire Contributory Factors Framework was applied to identify error-contributing factors. Findings: A total of 58 clinicians participated in eight focus groups and 20 semi-structured interviews. Nine key error contributory factor domains were identified, including: active failures; task characteristics of opioid preparation; clinician inexperience; sub-optimal skill mix; gaps in support from central functions; the drug preparation environment; and sub-optimal clinical communication. Conclusion: This study identified multiple system-level factors contributing to opioid errors in inpatient palliative care services. Any quality and safety initiatives targeting safe opioid delivery in specialist palliative care services needs to consider the full range of contributing factors, from individual to systems/latent factors, which promote error-causing conditions.

scholarly journals Living with pain: the experience of children and adolescents in palliative care

2014 ◽  
Vol 48 (spe) ◽  
pp. 67-73 ◽  
Author(s):  
Camila Amaral Borghi ◽  
Lisabelle Mariano Rossato ◽  
Elaine Buchhorn Cintra Damião ◽  
Danila Maria Batista Guedes ◽  
Ellen Maria Reimberg da Silva ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Children And Adolescents ◽  
Oral History ◽  
Pain Control ◽  
Limiting Factor ◽  
Methodological Framework ◽  
Effective Management ◽  
Structured Interviews ◽  
Daily Pain

A qualitative study was conducted with semi-structured interviews with the aim of understanding the experience of children and adolescents under palliative care when managing pain daily and how they describe the intensity, quality and location of pain. We used Piaget’s theory of cognitive development as a theoretical framework and oral history as a methodological framework. We found four themes: describing pain; seeking a life closer to normality, despite pain and disease; using a variety of alternatives for pain control; and living with damaged physical appearance. Although pain is a limiting factor in the lives of children and adolescents, we found that they faced their daily pain and still had a life beyond pain and illness. In addition, we highlight the relevance of nurses’ understanding that effective management of pain in children is essential for a normal life and less suffering.

scholarly journals Patients’ experiences of discontentment one year after total knee arthroplasty- a qualitative study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Aamir Mahdi ◽  
Mia Svantesson ◽  
Per Wretenberg ◽  
Maria Hälleberg-Nyman
Keyword(s):  
Total Knee Arthroplasty ◽  
Qualitative Study ◽  
Knee Arthroplasty ◽  
Qualitative Content Analysis ◽  
Organizational Level ◽  
Structured Interviews ◽  
Common Procedure ◽  
Replacement Surgery ◽  
Total Knee ◽  
The Individual

Abstract Background Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are dissatisfied without known explanation. Satisfaction and dissatisfaction have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients’ experiences. Qualitative knowledge might be useful in creating strategies to decrease the dissatisfaction rate. Methods Of the 348 patients who responded to a letter asking if they were satisfied or dissatisfied with their surgery, 61 (18%) reported discontent. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients’ experiences of discontentment 1 year after total knee arthroplasty. Results The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and lacking of relational supports. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a lack of relational supports, and a lack of respect and continuity, support from health care, and information adapted to their needs. Conclusion Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient satisfaction after surgery.

Sign in / Sign up

Export Citation Format

Share Document