Does Informational and Relational Continuity Improve Outcomes for People Receiving Palliative Care? A Mixed Methods Rapid Review

2019 ◽  
Author(s):  
Briony Hudson
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Rapid Review ◽  
Relational Continuity

scholarly journals Impact of informational and relational continuity for people with palliative care needs: a mixed methods rapid review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027323 ◽  
Author(s):  
Briony F Hudson ◽  
Sabine Best ◽  
Patrick Stone ◽  
Thomas (Bill) Noble
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Continuity Of Care ◽  
Hospital Admissions ◽  
Place Of Death ◽  
Rapid Review ◽  
Synthesis Methods ◽  
Relational Continuity ◽  
Meta Analyses ◽  
The Impact

ObjectiveTo identify and synthesise existing literature exploring the impact of relational and informational continuity of care on preferred place of death, hospital admissions and satisfaction for palliative care patients in qualitative, quantitative and mixed methods literature.DesignA mixed methods rapid review.MethodsPUBMED, PsychINFO, CINAHL were searched from June 2008 to June 2018 in order to identify original peer reviewed, primary qualitative, quantitative or mixed methods research exploring the impact of continuity of care for people receiving palliative care. Synthesis methods as outlined by the Cochrane Qualitative and Implementation Methods Group were applied to qualitative studies while meta-analyses for quantitative data were planned.OutcomesThe impact of interventions designed to promote continuity of care for people receiving palliative care on the following outcomes was explored: achieving preferred place of death, satisfaction with care and avoidable hospital admissions.Results18 eligible papers were identified (11 qualitative, 6 quantitative and 1 mixed methods papers). In all, 1951 patients and 190 family caregivers were recruited across included studies. Meta-analyses were not possible due to heterogeneity in outcome measures and tools used. Two studies described positive impact on facilitating preferred place of death. Four described a reduction in avoidable hospital admissions. No negative impacts of interventions designed to promote continuity were reported. Patient satisfaction was not assessed in quantitative studies. Participants described a significant impact on their experiences as a result of the lack of informational and relational continuity.ConclusionsThis rapid review highlights the impact that continuity of care can have on the experiences of patients receiving palliative care. The evidence for the impact of continuity on place of death and hospital admissions is limited. Methods for enhancing, and recording continuity should be considered in the design and development of future healthcare interventions to support people receiving palliative care.

scholarly journals Implementing person-centred outcome measures (PCOMs) into routine palliative care: A protocol for a mixed-methods process evaluation of The RESOLVE PCOM Implementation Strategy

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051904
Author(s):  
Andy Bradshaw ◽  
Martina Santarelli ◽  
Assem M Khamis ◽  
Kathryn Sartain ◽  
Miriam Johnson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Outcome Measures ◽  
Implementation Strategy ◽  
Public Involvement ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Care Practice ◽  
Ethical Approval

IntroductionPerson-centred outcome measures improve quality of care and patient outcomes but are used inconsistently in palliative care practice. To address this implementation gap, we developed the ‘RESOLVE Implementation Strategy’. This protocol describes a process evaluation to explore mechanisms through which this strategy does, or does not, support the implementation of outcome measures in routine palliative care practice.Methods and analysisMultistrand, mixed-methods process evaluation. Strand one will collect routine outcomes data (palliative Phase of Illness, Integrated Palliative care Outcomes Scale, Australia-modified Karnofsky Performance Status) to map the changes in use of outcome measures over 12 months (July 2021–July 2022). Strand two will collect survey data over the same 12-month period to explore how professionals’ understandings of, skills in using and ability to build organisational practices around, outcome measures change over time. Strand three will collect interview data to understand the mechanisms underpinning/affecting our implementation strategy. Thematic framework analysis and descriptive statistics will be used to analyse qualitative and quantitative data, respectively.Ethics and disseminationFor strand one, ethical approval has been obtained (Cambridge REC, REF: 20/EE/0188). For strands two and three, ethical approval has been obtained from Hull York Medical School ethics committee (2105). Tailored feedback of study findings will be provided to participating sites. Abstracts and papers will be submitted to national/international conferences and peer-reviewed journals. Lay and policy briefings and newsletters will be shared through patient and public involvement and project networks, plus via the project website.

A Palliative Care Program for Volunteers in a Community Setting: A Mixed-Methods Pilot Study

2019 ◽  
Vol 37 (6) ◽  
pp. 455-464 ◽  
Author(s):  
Jiwon Lee ◽  
Jong-Eun Lee
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Pilot Study ◽  
Meaning In Life ◽  
Palliative Care Service ◽  
Care Program ◽  
Palliative Care Program ◽  
Community Based ◽  
Volunteer Program ◽  
Coping With Death

Background: The objective of community-based palliative care is to improve the quality of life of patients and their families and to share the responsibility of caregiving. However, the evidence of the efficacy of volunteer services in community-based palliative care is insufficient. Purpose: This pilot study sought to uncover the feasibility and efficacy of a volunteer program in palliative care. Methods: The study used a sequential mixed-methods design. A total of 19 volunteers participated in the training program, and 6 trained volunteers provided services for a period of 10 weeks to 5 families. Quantitative data were collected on death anxiety, coping with death, and meaning in life for volunteers before and after the training and after completing their services. Qualitative data were collected about volunteering experiences. Results: Significant increases in coping with death and meaning in life after training and in meaning in life after providing services were observed among volunteers. Three categories (“Volunteer’s growing influence at home,” “Discovering meaning-in-life through volunteering,” and “Death as the final journey in life”) emerged from the qualitative findings. The caregivers’ satisfaction score was high. Conclusions: A palliative care program was found to be useful for volunteers in finding meaning in life, motivating continued volunteering. Moreover, caregivers were satisfied with the palliative care service of volunteers.

scholarly journals ‘. . . and then no more kisses!’ Exploring patients’ experiences on multidrug-resistant bacterial microorganisms and hygiene measures in end-of-life care A mixed-methods study

2019 ◽  
Vol 34 (2) ◽  
pp. 219-230 ◽  
Author(s):  
Maria Heckel ◽  
Alexander Sturm ◽  
Stephanie Stiel ◽  
Christoph Ostgathe ◽  
Franziska A Herbst ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Mixed Methods ◽  
End Of Life ◽  
End Of Life Care ◽  
Multidrug Resistant ◽  
Life Care ◽  
Hygiene Measures ◽  
Patients Wishes

Background: In end-of-life care hygiene, measures concerning multidrug-resistant bacterial microorganisms may contradict the palliative care approach of social inclusion and be burdensome for patients. Objectives: To integrate patients’ perspectives on handling multidrug-resistant bacterial microorganisms at their end of life, their quality of life, the impact of positive multidrug-resistant bacterial microorganisms’ diagnosis, protection and isolation measures on their well-being and patients’ wishes and needs regarding their care. Design: A mixed-methods convergent parallel design embedded quantitative data on the patients’ multidrug-resistant bacterial microorganisms’ trajectory and quality of life assessed by the Schedule for the Evaluation of Individual Quality of Life in qualitative data collection via interviews and focus groups. Data analysis was performed according to Grounded Theory and qualitative and quantitative results were interrelated. Setting/participants: Between March 2014 and September 2015 at two hospitals adult patients diagnosed with multidrug-resistant bacterial microorganisms and treated in a palliative care department or a geriatric ward were included in the sample group. Results: Patients in end-of-life and geriatric care reported emotional and social impact through multidrug-resistant bacterial microorganisms’ diagnosis itself, hygiene measures and lack of information. This impact affects aspects relevant to the patients’ quality of life. Patients’ wishes for comprehensive communication/information and reduction of social strain were identified from the focus group discussion. Conclusion: Patients would benefit from comprehensible information on multidrug-resistant bacterial microorganisms. Strategies minimizing social exclusion and emotional impact of multidrug-resistant bacterial microorganisms’ diagnosis in end-of-life care are needed as well as adaption or supplementation of standard multidrug-resistant bacterial microorganisms’ policies of hospitals.

scholarly journals Characterizing the Role of U.S. Surgeons in the Provision of Palliative Care: A Systematic Review and Mixed-Methods Meta-Synthesis

2018 ◽  
Vol 55 (4) ◽  
pp. 1196-1215.e5 ◽  
Author(s):  
Pasithorn A. Suwanabol ◽  
Arielle E. Kanters ◽  
Ari C. Reichstein ◽  
Lauren M. Wancata ◽  
Lesly A. Dossett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Mixed Methods
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