scholarly journals Perception of health professionals about neonatal palliative care

2019 ◽  
Vol 72 (6) ◽  
pp. 1707-1714
Author(s):  
Ernestina Maria Batoca Silva ◽  
Maria José Machado Silva ◽  
Daniel Marques Silva
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Neonatal Intensive Care ◽  
Ethical Decisions ◽  
Palliative Care Teams ◽  
Pain And Suffering ◽  
Probabilistic Sample ◽  
Perception Of Health ◽  
Relational Difficulties

ABSTRACT Objective: To identify the perception of health professionals about neonatal palliative care. Method: A phenomenological qualitative study, a non-probabilistic sample, of 15 health professionals from a neonatal intensive care unit in northern Portugal. Content analysis was performed. Results: Despite their lack of training in palliative care, the health professionals showed concern for the dignity, quality of life and comfort of the newborn and family. They expressed emotional and relational difficulties in following the trajectories of serious illness and death and in the ethical decisions regarding the end-of-life. Conclusion: It is emphasized that professionals are sensitive to pain and suffering and reveal dedicated and committed in the care of the newborn and family. They are available to train and embrace the current challenges posed by the constitution of pediatric palliative care teams and to help achieve an organizational culture that advances in such care.

scholarly journals Palliative care in the pre-hospital service in Brazil: experiences of health professionals

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacqueline Resende Boaventura ◽  
Juliana Dias Reis Pessalacia ◽  
Aridiane Alves Ribeiro ◽  
Fabiana Bolela de Souza ◽  
Priscila Kelly da Silva Neto ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Professional Training ◽  
Family Care ◽  
Levels Of Care ◽  
Care Services ◽  
Primary Care Services ◽  
Home Context ◽  
Perception Of Health

Abstract Background An integrated care network between emergency, specialized and primary care services can prevent repeated hospitalizations and the institutionalized death of terminally ill patients in palliative care (PC). To identify the perception of health professionals regarding the concept of PC and their care experiences with this type of patient in a pre-hospital care (PHC) service in Brazil. Methods Study with a qualitative approach, of interpretative nature, based on the perspective of Ricoeur’s Dialectical Hermeneutics. Results Three central themes emerged out of the professionals’ speeches: (1) unpreparedness of the team, (2) decision making, and (3) dysthanasia. Conclusions It is necessary to invest in professional training associated with PC in the home context and its principles, such as: affirming life and considering death as a normal process not rushing or postponing death; integrating the psychological and spiritual aspects of patient and family care, including grief counseling and improved quality of life, adopting a specific policy for PC that involves all levels of care, including PHC, and adopt a unified information system, as well as more effective procedures that favor the respect for the patients’ will, without generating dissatisfaction to the team and the family.

scholarly journals Investigation of ill-defined causes of death: assessment of a program's performance in a State from the Northeastern region of Brazil

2014 ◽  
Vol 17 (1) ◽  
pp. 119-134 ◽  
Author(s):  
Elisabeth Barboza França ◽  
Carolina Cândida da Cunha ◽  
Ana Maria Nogales Vasconcelos ◽  
Juan José Cortez Escalante ◽  
Daisy Xavier de Abreu ◽  
...  
Keyword(s):  
Health Professionals ◽  
Causes Of Death ◽  
Family Health ◽  
Completion Rate ◽  
Epidemiological Surveillance ◽  
Mortality Data ◽  
Hospital Records ◽  
Brazilian Government ◽  
Probabilistic Sample

OBJECTIVE: The proportion of ill-defined causes of death (IDCD) was persistently high in some regions of Brazil in 2004. In 2005, the Brazilian government implemented a project in order to decrease this proportion, especially in higher priority states and municipalities. This study aimed to evaluate the performance of this project in Alagoas - a state from the Northeast region of Brazil. METHOD: We selected a probabilistic sample of 18 municipalities. For all IDCD identified in 2010, we collected the verbal autopsy (VA) questionnaires used for home investigation, and the Ministry of Health (MoH) form, which contains information about the final disease and cause of death taken from hospital records, autopsies, family health teams, and civil registry office records. The completion rate of the MoH form and VA was calculated using the number of deaths with specific causes assigned among investigated deaths. RESULTS: A total of 681 IDCD were recorded in 2010 in the sample, of which 26% had a MoH and/or VA3 forms completed. Although the majority of cases were attended by health professionals during the terminal disease, the completion rate was 45% using the MoH form and 80% when VA was performed. CONCLUSIONS: Our findings provide evidence that the training of the epidemiological surveillance teams in the investigation and certification of causes of death could contribute to improve the quality of mortality data.

How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals

2021 ◽  
pp. 026921632110265
Author(s):  
Hannah Seipp ◽  
Jörg Haasenritter ◽  
Michaela Hach ◽  
Dorothée Becker ◽  
Lisa-R Ulrich ◽  
...  
Keyword(s):  
Home Care ◽  
Focus Groups ◽  
Health Professionals ◽  
Care Delivery ◽  
Death And Dying ◽  
Theory Approach ◽  
Palliative Home Care ◽  
Palliative Care Teams ◽  
Key Issues

Background: Specialised palliative home-care supports patients with life-limiting diseases in their familiar surroundings. The number of palliative care teams and patients being cared for is increasing worldwide. To assess and improve quality, it is needed to understand, how specialised palliative home-care can be provided successfully. For this purpose we examined the views of all involved stakeholders. Aim: To identify the issues that patients, their relatives and involved health professionals view as important in ensuring the success of specialised palliative home-care. Design: We used a qualitative design based on participant observations, interviews and focus groups following the principles of a Grounded Theory approach. Setting/participants: All specialised palliative home-care teams ( n = 22) caring for adults in Hesse, Germany, participated. We conducted participant observations ( n = 5), and interviewed patients ( n = 14), relatives ( n = 14) and health professionals working in or collaborating with specialised palliative home-care ( n = 30). We also conducted focus groups ( n = 4) with health professionals including a member check. Results: Successful specialised palliative home-care needs to treat complex symptoms, and provide comprehensive care including organisation of care, involving relatives and addressing issues of death and dying. Sense of security for patients and relatives is key to enable care at home. Care delivery preferences include a focus on the quality of relationships, respect for individuality and the facilitation of self-determination. Conclusions: Consideration of the identified key issues can help to ensure successful specialised palliative home-care. Knowledge of these should also be considered when researching and assessing quality of care. Trial registration: German Clinical Trials Register DRKS-ID: DRKS00012421; http://www.germanctr.de .

Retrospective review of end-of-life care in the last month of life in older patients with multiple myeloma: what collaboration between haematologists and palliative care teams?

2020 ◽  
pp. bmjspcare-2020-002293
Author(s):  
Thomas Chalopin ◽  
Nicolas Vallet ◽  
Lotfi Benboubker ◽  
Marlène Ochmann ◽  
Emmanuel Gyan ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Palliative Care ◽  
End Of Life ◽  
Older Patients ◽  
High Rate ◽  
Palliative Care Teams ◽  
Care Family ◽  
Eol Care

ObjectivesPatients with haematological malignancies (HM) receive more aggressive treatments near the end-of-life (EOL) than patients with solid tumours. Palliative care (PC) needs are less widely acknowledged in patients with multiple myeloma (MM) than in other HM. The main objective of our study was to describe EOL care and PC referral in a population of older patients with MM.MethodsWe retrospectively included deceased inpatients and outpatients with an MM previously diagnosed at the age of 70 and over in two tertiary centres in France. We reported EOL characteristics regarding treatments considered to be aggressive—antimyeloma therapies, hospitalisations, blood product transfusions, intensive care units (ICUs) or emergency admissions—and PC referral.ResultsWe included 119 patients. In their last month of life, 75 (63%) were hospitalised for fever, pain, asthenia, anaemia or bleeding, 49 (41%) were admitted in the emergency department and 12 (10%) in ICU, 76 (64%) still received antimyeloma therapy and 45 (38%) had at least two transfusions. Only 24 (20%) received PC intervention for pain, global care, family support, anxiety, social care or confusion. Median follow-up until death was 20 days.ConclusionsOur study found a high rate of hospitalisations and antimyeloma therapies in the last month of life. The PC referral rate was low, often once specific treatments were stopped. Our results suggest the need for more effective collaboration between PC teams and haematologists in order to respond to the specific needs of these patients and to improve their quality of care at EOL.

Evaluation of an Interdisciplinary Training Program in Palliative Care: Addressing the Needs of Rural and Northern Communities

1997 ◽  
Vol 13 (3) ◽  
pp. 5-12 ◽  
Author(s):  
Linda Kristjanson ◽  
Deborah Dudgeon ◽  
Fred Nelson ◽  
Paul Henteleff ◽  
Lynda Balneaves
Keyword(s):  
Palliative Care ◽  
Training Program ◽  
Health Professionals ◽  
Repeated Measures ◽  
Family Care ◽  
Interdisciplinary Training ◽  
Repeated Measures Design ◽  
Care Training ◽  
Care Of The Dying

Our study was a pilot test of an interdisciplinary training program in palliative care to improve the quality of care to terminally ill cancer and AIDS patients in rural and northern communities in Manitoba. The program involved two weeks of intense palliative care training for nurses, social workers, physicians, and volunteers. Four teams were trained during a six-month period. A repeated measures design was used to assess the effectiveness of the program. Results indicated that health professionals’ knowledge about care of the dying, care of individuals with HIV/AIDS, and attitudes toward care of the dying improved upon completion of the training program and remained improved three months following the program. Improvements in use of medications, increased attention to family care, increased discussion of DNR orders, and increased consultation related to symptom management were evident following the training program. The parallel training program for volunteers was also judged to be effective.

Human relationship: The forgotten dynamic in palliative care

2003 ◽  
Vol 1 (3) ◽  
pp. 261-265 ◽  
Author(s):  
DENISE L. HAWTHORNE ◽  
NANCY J. YURKOVICH
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
World View ◽  
Human Relationship ◽  
Scientific Process ◽  
Incurable Disease ◽  
Shared Humanity ◽  
Dynamics Of Science ◽  
Current Emphasis

Objective: Palliative care is a philosophy of care for individuals experiencing progressive, incurable disease. It encompasses two dynamics, science-based practice and relationship between patient, family, and health professional. Each dynamic is essential for quality palliative care, yet the requisites for each are different.Methods: The scientific process of observation and measurement requires differentiation, distance, and detachment to fulfill its demands for objectivity, whereas relationship, unobservable and immeasurable, requires sameness, closeness, and connection of a shared humanity. It is science, however, the prevailing world-view, that shapes our thinking and consequently, influences the education and practice of health professionals.Results: We explore the dynamics of science and relationship and the incongruities between them. We examine the prominence of science in palliative care and its impact on relationship.Significance of results: We contend that questioning the current emphasis of science in palliative care and discovering the joy and rewards of shared human experience will enrich the quality of life for patients, families, and health professionals.

scholarly journals Do Palliative Care Teams in Nursing Homes Improve the Quality of End-of-Life Care for Nursing Home Residents?

2019 ◽  
Author(s):  
Helena Temkin-Greener Helena Temkin-Greener ◽  
Dana Mukamel ◽  
Susan Ladwig ◽  
Thomas , Caprio ◽  
Sally Norton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Life Care ◽  
Palliative Care Teams

Journeys to the centre of empathy

2017 ◽  
Author(s):  
Renee Lim ◽  
Stewart Dunn
Keyword(s):  
Palliative Care ◽  
Physical Health ◽  
Health Professionals ◽  
Professional Communication ◽  
Professional Burnout ◽  
Patient Complaints ◽  
Effective Training ◽  
Empathic Communication ◽  
Training Programmes

As a species, we appear to be programmed to respond to the situations and emotions of others. However, there is wide variation in the ways doctors and other health professionals experience and express this capacity, and there is a need for effective training to enhance these skills. Unfortunately, systematic reviews suggest that many of our current training programmes do not improve the quality of communication in cancer and palliative care so as to limit the burden of professional burnout, and to improve patients’ mental or physical health and satisfaction. Our attempts to produce a generation of empathic clinical communicators are inconsistent and reviews of patient complaints reveal an increasing discontent with professional communication. So what is missing? How do we develop, sustain, and teach empathic communication? The answer, according to Lim and Dunn, is to shift the focus from empathy to authenticity.

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