scholarly journals Paramedics’ perceptions and educational needs with respect to palliative care

2015 ◽  
Vol 12 (5) ◽  
Author(s):  
Ian R Rogers ◽  
Freya R Shearer ◽  
Jeremy R Rogers ◽  
Gail Ross-Adjie ◽  
Leanne Monterosso ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Causes Of Death ◽  
Ethical Issues ◽  
Symptom Control ◽  
Educational Needs ◽  
Palliative Approach ◽  
Common Causes ◽  
The Common ◽  
End Of Life Communication

IntroductionTo identify and measure paramedics’ perspectives and educational needs regarding palliative care provision, as well as their understanding of the common causes of death.MethodsAll St John Ambulance Western Australia paramedics were invited to complete a mixed methods qualitative and quantitative survey using a tool previously validated in studies involving other emergency care providers. Quantitative results are reported using descriptive statistics, while Likert-type scales were converted to ordinal variables and expressed as means +/- SD. Qualitative data was analysed using content analysis techniques and reported as themes. ResultsCompleted surveys were returned by 29 paramedics. They considered palliative care to be strongly focussed on end-of-life care, symptom control and holistic care. The dominant educational needs identified were ethical issues, end-of-life communication and the use of structured patient care pathways. Cancer diagnoses were overrepresented as conditions considered most suitable for palliative care, compared with their frequency as a cause of death. Conditions often experienced in ambulance practice, such as heart failure, trauma and cardiac arrhythmias were overestimated in their frequency as causes of death. ConclusionsParamedics have a sound grasp of some important aspects of palliative care including symptom control and the holistic nature of the palliative approach. They did however tend to equate palliative care with that occurring in the terminal phase and saw it as being particularly applied to cancer diagnoses. Paramedic palliative care educational efforts should focus on ethical issues and end-of-life communication, as well as increasing understanding of the common causes of death and those where a palliative approach might be beneficial.

Significant aspects of nursing within the process of end-of-life communication in an oncological context

2018 ◽  
Vol 39 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Annelie Rylander ◽  
Stina Fredriksson ◽  
Ewa Stenwall ◽  
Lena-Karin Gustafsson
Keyword(s):  
Palliative Care ◽  
Content Analysis ◽  
Patient Care ◽  
End Of Life ◽  
Qualitative Content Analysis ◽  
Before And After ◽  
New Situation ◽  
End Of Life Communication ◽  
Depth Interviews ◽  
Insight Into

The complexity of end-of-life communications has previously been described and found to be given late in the patient’s palliative care. There is a need for earlier and more continuous end-of-life-communications throughout the patient’s care to reduce anxiety, confusion, and promote participation. Registered nurses (RNs) have a unique closeness to the patient and the ability to identify early the need for end-of-life communication. The aim of this study was to describe crucial aspects of nursing in end-of-life communication in an oncology context. The study was designed as a qualitative content analysis of in-depth interviews with RNs working in oncology in-patient care units. Two domains were identified: before, and after end-of-life communications, with the categories importance of being well prepared to identify both the patient’s and their family’s needs. Cooperation and interaction between physicians and RNs were crucial to be able to support patients and their relatives around the clock. The presence of RNs encouraged further conversations about the patients’ conditions to gain insight into the new situation. End-of-life communication should not only be medicine oriented and performed by physicians. Involvement of RNs’ expertise enables increased patient/relative participation as well as reduced anxiety and suffering, creating clarity and safety for all involved in care.

Differences in end-of-life communication for children with advanced cancer who were referred to a palliative care team

2015 ◽  
Vol 62 (8) ◽  
pp. 1409-1413 ◽  
Author(s):  
Alisha Kassam ◽  
Julia Skiadaresis ◽  
Sarah Alexander ◽  
Joanne Wolfe
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Advanced Cancer ◽  
Palliative Care Team ◽  
Care Team ◽  
End Of Life Communication

scholarly journals The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review

2018 ◽  
Vol 35 (8) ◽  
pp. 1140-1154 ◽  
Author(s):  
Madison B. Smith ◽  
Tamara G. R. Macieira ◽  
Michael D. Bumbach ◽  
Susan J. Garbutt ◽  
Sandra W. Citty ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Nursing Students ◽  
End Of Life ◽  
Communication Skills ◽  
End Of Life Care ◽  
Learning Experiences ◽  
Life Care ◽  
Simulation Based ◽  
End Of Life Communication

Objectives: To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. Background: Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills. Methods: Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role. Results: Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices. Conclusion: While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.

Palliative Care and End-of-Life Communication

2021 ◽  
pp. 119-135
Author(s):  
Elaine Wittenberg ◽  
Joy V. Goldsmith
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Communication

A communication training perspective on AND versus DNR directives

2014 ◽  
Vol 13 (2) ◽  
pp. 385-387 ◽  
Author(s):  
Tomer T. Levin ◽  
Nessa Coyle
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Communication Training ◽  
Do Not Resuscitate ◽  
Natural Death ◽  
Goals Of Care ◽  
Advantages And Disadvantages ◽  
Randomized Controlled ◽  
Unnatural Death ◽  
End Of Life Communication

AbstractBackground:From a communication perspective, the term “do not resuscitate” (DNR) is challenging to use in end-of-life discussions because it omits the goals of care. An alternative, “Allow Natural Death” (AND), has been proposed as a better way of framing this palliative care discussion.Case:We present a case where a nurse unsuccessfully discusses end-of-life goals of care using the term DNR. Subsequently, with the aid of a communication trainer, he is coached to successfully use the term “AND” to facilitate this discussion and advance his goal of palliative care communication and planning.Discussion:We contrast the advantages and disadvantages of the term AND from the communication training perspective and suggest that AND-framing language replace DNR as a better way to facilitate meaningful end-of-life communication. One well-designed, randomized, controlled simulation study supports this practice. We also consider the communication implications of “natural” versus “unnatural” death.

Quality of Communication Questionnaire for Hospitalized Patients Hospitalized in Intensive and Palliative Care Unit: Validity Evidence for Use in Brazil

2021 ◽  
pp. 104990912110413
Author(s):  
Flávia Del Castanhel ◽  
Luciana Burg ◽  
Leonardo Maia Nogueira ◽  
Getúlio Rodrigues de Oliveira Filho ◽  
Suely Grosseman
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Validity Evidence ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Brazilian Version ◽  
Fit Index ◽  
End Of Life Communication ◽  
General Communication

The Quality of Communication Questionnaire (QoC) was culturally adapted for Brazil due to its importance and use in several studies and different scenarios. The objective of this study was to evaluate the validity evidence of the Brazilian version of the QoC. A validation study was carried out involving 253 patients admitted to five public hospitals in Southern Brazil. Data were analyzed using descriptive analysis, Cronbach's alpha (α) to assess internal consistency, exploratory factor analysis, and goodness-of-fit index. One hundred and three patients were in intensive care (IC), and 150 were in palliative care (PC). The participants’ mean age was 51 years (SD = 14.2). QoC,and its general communication subscale, and end-of-life communication subscale means were 5.5 (SD = 1.6), 8.8 (SD = 1.5), and 5.5 (SD = 1.6) respectively. Among patients in IC, QoC Cronbach’s alpha was .75, and .84 in the general communication subscale and .51 in the end-of-life communication subscale. Among patients in PC, QoC Cronbach’s alpha was .83, and .88 in the general communication subscale, and .71 in the end-of-life communication subscale. The root mean square error of approximation was .07 (90% CI: .04 – .08); Tucker-Lewis index was .97 (95% CI: .95 – .98); comparative fit index was .98 (95% CI: .97 – .99), and χ2/df ratio was 1.33 (χ2[53] = 70.858, p = .05). The authors conclude that the general communication subscale of QoC Brazilian version has good validity evidence for patients in IC and PC, whereas the end-of-life communication subscale is only valid for patient in PC.

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