scholarly journals Evaluation of Care Providers’ Attitude toward Perinatal Palliative Care and its Challenges in the Selected Teaching Hospitals of Tehran in 2019

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Arman Mohammadi ◽  
Mamak Tahmasebi ◽  
Leila Khanali Mojen ◽  
Maryam Rassouli ◽  
Hadis Ashrafizadeh
Keyword(s):  
Palliative Care ◽  
Neonatal Intensive Care ◽  
Teaching Hospitals ◽  
Care Providers ◽  
Health Authorities ◽  
Positive Attitudes ◽  
Treatment Type ◽  
Research Population ◽  
Perinatal Palliative Care ◽  
Evaluation Of Care

Objectives: The present study aims to determine the attitudes of care providers including obstetricians, paediatricians and midwives working in perinatal, obstetric and neonatal intensive care unit (NICU) wards of the selected teaching hospitals in Tehran in 2019. In addition, the challenges of providing palliative care from the perspective of these individuals have been examined. Materials and Methods: In this descriptive study, the research population was selected through convenience sampling based on the inclusion criteria. To assess care providers’ attitude toward the perinatal palliative care and the challenges of its implementation, in addition to the questionnaire of demographic characteristics, a researcher-made questionnaire was also used. Results: Most of the care providers (90.5%) believed that parents should be involved in decision-making to select the treatment type. Most of the care providers (90%) believed that the lack of prepared infrastructures is one of the major challenges in providing these types of care. Conclusion: Care providers have almost positive attitudes toward the various dimensions of providing perinatal palliative care, but it has not been properly implemented yet due to the insufficient knowledge of this type of care, the lack of required infrastructures (appropriate conditions in NICUs to provide this type of care, the sufficient number of staff and experts in this field), as well as the health authorities’ neglecting this type of care.

scholarly journals Summary of the Key Concepts on How to Develop a Perinatal Palliative Care Program

2020 ◽  
Vol 8 ◽  
Author(s):  
Paola Lago ◽  
Maria Elena Cavicchiolo ◽  
Francesca Rusalen ◽  
Franca Benini
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Newborn Care ◽  
Care Program ◽  
Spiritual Support ◽  
Care Providers ◽  
Perinatal Palliative Care

Purpose of review: The aim of this study is to assess the most significant Perinatal Palliative Care (PnPC) development projects in the literature and summarize the shared key principles.Recent findings: PnPC is a new concept in neonatal intensive care approach. Advancements in perinatal diagnostics and medical technology have changed the landscape of the perinatal world. The threshold of viability continues to decrease, and diagnostic information is available earlier in pregnancy and more rapidly at the bedside; overall outcomes continue to improve. This rapid technological improvement brings ethical debates on the quality of life of patients with life-limiting and life-threatening conditions and the need to involve the family in the decision-making process, according to their wishes and cultural beliefs. Although the Perinatal Hospice concept was developed in the 1980s in the US, the first recommendations on how to develop a PnPC pathway were published in the early 2000s. We considered the most relevant position statements or guidelines on PnPC published in the last two decades. Some of them were more pertinent to pediatrics but still useful for the fundamental concepts and PnPC project's development.Summary: Health care providers and institutions are encouraged to develop PnPC programs, which have the goal of maximizing the quality of life of infants with non-curable conditions. These may generally include the following: a formal prenatal consultation; development of a coordinated birth plan between obstetrician, newborn care, and family; access to other neonatal and pediatric specialties, as needed; comfort palliative care during the prenatal, birth, and postnatal periods; and psychosocial and spiritual support for families, siblings, and staff.

scholarly journals Factors Related to Nurses and Physicians’ Knowledge of and Attitudes Towards Palliative Care

2021 ◽  
Author(s):  
Hadis Ashrafizadeh ◽  
Leila Khanali-Mojen ◽  
Salman Barasteh ◽  
Samira Beiranvand ◽  
Azam Shirinabadi Farahani ◽  
...  
Keyword(s):  
Palliative Care ◽  
Work Experience ◽  
General Medicine ◽  
Teaching Hospitals ◽  
P Value ◽  
Practical Training ◽  
Care Providers ◽  
The Mean ◽  
Nurses And Physicians ◽  
Knowledge And Attitude

Abstract Background With the increase of the elderly population, the need for palliative care has increased, which is one of the requirements of effective palliative care services, sufficient knowledge and positive attitude of nurses and physicians towards this care approach. The aim of this study was to determine the factors related to the knowledge and attitudes of nurses and physicians about palliative care. Methods This descriptive correlational study was performed in 2021 on 277 nurses and physicians working in selected teaching hospitals in Iran who were selected by convenience sampling method. The data collection tool was an online and researcher-made questionnaire consisting of three sections: demographics and occupation, knowledge (30 items) and attitude (37 items) that were designed and validated in the present study. To analyze the data, spss-v24 software was used for descriptive statistics tests (means and frequency tables) and inferential tests (correlation and univariate regression). Results The mean scores of knowledge and attitude of care providers were 19.36 ± 2.73 and 140.90 11 11.56, respectively. There was a positive relationship between knowledge and attitude variables (P-value = 0.000, r = 0.378). Meaning of relationship between the mean score of attitude and knowledge with age ranges of 31-60 and 60-51 years, level of education, workplace, work experience in palliative care, need for formal education in palliative care and need to pass palliative care course there was. Conclusion Based on the results of this study, the level of knowledge and attitude of palliative care providers was moderate. Therefore, in order to further promote the knowledge and attitude of nurses and physicians, it is recommended to hold theoretical and practical training courses in the form of skill and retraining courses, reviewing the curricula of general medicine and bachelor's degree in nursing.

Perinatal palliative care: Parent perceptions of caring in interactions surrounding counseling for risk of delivering an extremely premature infant

2013 ◽  
Vol 13 (2) ◽  
pp. 145-155 ◽  
Author(s):  
Karen Kavanaugh ◽  
Cecelia I. Roscigno ◽  
Kristen M. Swanson ◽  
Teresa A. Savage ◽  
Robert E. Kimura ◽  
...  
Keyword(s):  
At Risk ◽  
Palliative Care ◽  
Life Support ◽  
Healthcare Providers ◽  
Secondary Analysis ◽  
Family Care ◽  
Care Providers ◽  
Therapeutic Environment ◽  
Perinatal Palliative Care

AbstractObjective:When infants are at risk of being born at a very premature gestation (22–25 weeks), parents face important life-support decisions because of the high mortality for such infants. Concurrently, providers are challenged with providing parents a supportive environment within which to make these decisions. Practice guidelines for medical care of these infants and the principles of perinatal palliative care for families can be resources for providers, but there is limited research to bridge these medical and humanistic approaches to infant and family care. The purpose of this article is to describe how parents at risk of delivering their infant prior to 26 weeks gestation interpreted the quality of their interpersonal interactions with healthcare providers.Methods:Directed content analysis was employed to perform secondary analysis of data from 54 parents (40 mothers and 14 fathers) from the previously coded theme “Quality of Interactions.” These categorized data described parents' encounters, expectations, and experiences of interactions that occurred prenatally with care providers. For this analysis, Swanson's theory of caring was selected to guide analysis and to delineate parents' descriptions of caring and uncaring interactions.Results:Parents' expectations for caring included: (a) respecting parents and believing in their capacity to make the best decisions for their family (maintaining belief); (b) understanding parents' experiences and their continued need to protect their infant (knowing); (c) physically and emotionally engaging with the parents (being with); (d) providing unbiased information describing all possibilities (enabling); and (e) helping parents navigate the system and creating a therapeutic environment for them in which to make decisions (doing for).Significance of Results:Understanding parents' prenatal caring expectations through Swanson's theory gives deeper insights, aligning their expectations with the palliative care movement.

scholarly journals Who Receives Home-Based Perinatal Palliative Care: Experience from Poland

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Aleksandra Korzeniewska-Eksterowicz ◽  
Łukasz Przysło ◽  
Bogna Kędzierska ◽  
Małgorzata Stolarska ◽  
Wojciech Młynarski
Keyword(s):  
Palliative Care ◽  
Neonatal Intensive Care ◽  
Hospice Care ◽  
Feeding Tube ◽  
Cardiac Insufficiency ◽  
Congenital Diseases ◽  
Care Experience ◽  
Home Based ◽  
Perinatal Palliative Care ◽  
Neonates And Infants

Context. The current literature suggests that perinatal palliative care (PPC) programs should be comprehensive, initiated early, and integrative. So far there have been very few publications on the subject of home-based PC of newborns and neonates. Most publications focus on hospital-based care, mainly in the neonatal intensive care units.Objective. To describe the neonates and infants who received home-based palliative care in Lodz Region between 2005 and 2011.Methods. A retrospective review of medical records.Results. 53 neonates and infants were admitted to a home hospice in Lodz Region between 2005 and 2011. In general, they are a growing group of patients referred to palliative care. Congenital diseases (41%) were the primary diagnoses; out of 53 patients 16 died, 20 were discharged home, and 17 stayed under hospice care until 2011. The most common cause of death (56%) was cardiac insufficiency. Neurological symptoms (72%) and dysphagia (58%) were the most common clinical problems. The majority of children (45%) had a feeding tube inserted and were oxygen dependent (45%); 39 families received psychological care and 31 social supports.Conclusions. For terminally ill neonates and infants, perinatal palliative care is an option which improves the quality of their lives and provides the family with an opportunity to say goodbye.

scholarly journals Evaluating Barriers and Opportunities in Delivering High-Quality Oncology Care in a Resource-Limited Setting Using a Comprehensive Needs Assessment Tool

2018 ◽  
pp. 1-9
Author(s):  
Chika R. Nwachukwu ◽  
Omobola Mudasiru ◽  
Lynn Million ◽  
Shruti Sheth ◽  
Hope Qamoos ◽  
...  
Keyword(s):  
Palliative Care ◽  
Needs Assessment ◽  
Cancer Care ◽  
Assessment Tool ◽  
Hospital Staff ◽  
Teaching Hospitals ◽  
High Quality ◽  
Middle Income ◽  
Quality Cancer Care ◽  
Oncology Care

Purpose Despite recognition of both the growing cancer burden in low- and middle-income countries and the disproportionately high mortality rates in these settings, delivery of high-quality cancer care remains a challenge. The disparities in cancer care outcomes for many geographic regions result from barriers that are likely complex and understudied. This study describes the development and use of a streamlined needs assessment questionnaire (NAQ) to understand the barriers to providing quality cancer care, identifies areas for improvement, and formulates recommendations for implementation. Methods Using a comprehensive NAQ, in-depth interviews were conducted with 17 hospital staff involved in cancer care at two teaching hospitals in Nigeria. Data were analyzed using content analysis and organized into a framework with preset codes and emergent codes, where applicable. Results Data from the interviews were organized into six broad themes: staff, stuff, system, space, lack of palliative care, and provider bias, with key barriers within themes including: financial, infrastructural, lack of awareness, limited human capacity resources, lack of palliative care, and provider perspective on patient-related barriers to cancer care. Specific solutions based on ability to reasonably implement were subcategorized into short-, medium-, and long-term goals. Conclusion This study provides a framework for a streamlined initial needs assessment and a unique discussion on the barriers to high-quality oncology care that are prevalent in resource-constrained settings. We report the feasibility of collecting and organizing data using a streamlined NAQ and provide a thorough and in-depth understanding of the challenges in this setting. Knowledge gained from the assessments will inform steps to improve oncology cancer in these settings.

scholarly journals What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Connie Swenson ◽  
John I. MacArtney ◽  
Rachel Perry ◽  
Hazel Lamberton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Psychological Needs ◽  
Care Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Complex Needs ◽  
Sequential Explanatory ◽  
Palliative Care Needs

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.

scholarly journals Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

2019 ◽  
Vol 15 (10) ◽  
pp. 531-538 ◽  
Author(s):  
Vinita Singh ◽  
Ali J. Zarrabi ◽  
Kimberly A. Curseen ◽  
Roman Sniecinski ◽  
Justine W. Welsh ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Medical Marijuana ◽  
Survey Study ◽  
Care Practice ◽  
Care Providers ◽  
Patients With Cancer ◽  
Medical Marijuana Laws ◽  
Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

Barriers of Palliative Care in Neonatal Intensive Care Units

2016 ◽  
Vol 34 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Mansooreh Azzizadeh Forouzi ◽  
Marjan Banazadeh ◽  
Jila Soltan Ahmadi ◽  
Farideh Razban
Keyword(s):  
Palliative Care ◽  
Organizational Culture ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Attitude Scale ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Eol Care

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.

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