scholarly journals Research of Psycho-emotional State of Patients, Who Receive Palliative Care in Ambulant Conditions

2021 ◽  
pp. 47-52
Author(s):  
Liudmyla Matviyets ◽  
Larysa Matіukha ◽  
Oleksandra Bratsyunʹ
Keyword(s):  
Palliative Care ◽  
Depressive Disorders ◽  
Moderate Level ◽  
Stress Factors ◽  
Behavioral Reactions ◽  
Incurable Disease ◽  
The Family ◽  
Level Of Difficulty ◽  
High Level ◽  
Palliative Patients

Anxieties, depression, fear, depressive disorders are symptoms, which may be the part of physiological feeling with incurable disease, especially when the diagnosis is informed. Sometimes, the assumption of difficult news, related to worsening of health and even risk to life can lead to fatal consequences. For family physicians and other professionals, who are involved in palliative care, it is important to be able to diagnose the worsening of patients’ psycho-emotional state in time, in order to provide professional psychological support. In this article, the results of research of level of difficulty of depressive disorders in palliative patients depending on different demographic and social data are presented, which can be modified with changing attitudes towards these patients (when ensuring correct communication and managing of the palliative patient by the family physician). The research has shown that socio-demographic indicators significantly affect the forming of state of depression in palliative patients, and require appropriate communication between the family physician and the patient, and the organization of additional measures for managing these patients. Special attention should be given to some results of research when providing palliative care, in particular: depression of different level of difficulty, based on the PHQ-9 scale was found in 81 % of palliative patients; it was set that 90 % of people, aged of 75–90 years had depression of different level of difficulty; it was determined that all patients with high income had depression, among them 16.7 % of light and 58.3 % of moderate level of difficulty, that can be considered as a neurotic reaction of incurable disease. Depression was found in all unmarried patients, among them 35 % of light and 35 % of moderate level of difficulty, and 30 % of patients with high level as well, that significantly predominate over the number of married people (4.1 %) and widows 14 %), that may indicate character traits, which complicate the adaptation of behavioral reactions on stress factors , including to the disease. Depression was found in all unmarried patients, among them 35 % of light and 35 % of moderate level of difficulty, and 30 % of patients with high level as well, that significantly predominate over the number of married people (4.1 %) and widows 14 %), that may indicate character traits, which complicate the adaptation of behavioral reactions on stress factors, including to the disease. Such patients need additional psychological support for reducing their suffering, in particular for preventing of mental genesis pains. According to the indicators of various socio-demographic parameters, the portrait of the most vulnerable palliative patients was determined: they are women of age group 75–89 years, living in the city, by civil state – single (additional depressive factor can be assumed – long-term loneliness), by social status – pensioners with Higher Education and high income, based on a scale of PHQ-9 >20 points, that corresponds to the diagnosis: depressive syndome of heavy level.

scholarly journals The Opinion of General Practitioners, Medical Students, and Other Medical Specialists on Palliative Care in Bulgaria

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
G. Foreva ◽  
R. Asenova ◽  
M. Semerdjieva
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
General Practitioners ◽  
Family Doctor ◽  
Medical Specialists ◽  
Incurable Disease ◽  
The Family ◽  
Care Training ◽  
Level Of Significance ◽  
Structured Questionnaire

In Bulgaria, the patient is entitled to palliative care in case of incurable disease with an unfavourable prognosis. Palliative care is provided by the family doctor/GP and institutions. Literature on palliative care providing is scarce. The objective of the study was to investigate the opinion of general practitioners, medical students, and other medical specialists working in institutions on palliative care. Method. We have developed a structured questionnaire. Descriptive statistics have been calculated for all items. Differences between groups have been compared using u-criterion. Level of significance was P<0.05. Data has been analyzed using SPSS v. 16. Results. A total of 518 respondents completed the survey. Lack of appropriate organisation and financing has been pointed out by all participants. The GP’s role in palliative care providing has been described as a contradictory one. The criteria on the basis of which the patients are eligible for palliative care have been arranged in the same way by all respondents, but GPs chose the longest temporal indicator. Quality assessment has not been applied. 2/3 of respondents demanded palliative care training. Conclusion. On the whole, the investigated groups differed to some extent in their opinion on palliative care both on conceptual and practical levels.

scholarly journals FAMILY NEEDS OF INCURABLE ILL CHILDREN IN THE CONTEXT OF SPECIAL EDUCATION

2019 ◽  
Vol 7 ◽  
Author(s):  
Kristína Nagyová ◽  
Terézia Harčaríková
Keyword(s):  
Palliative Care ◽  
Structured Interview ◽  
Research Data ◽  
Family Needs ◽  
Special Educator ◽  
Transdisciplinary Approach ◽  
Incurable Disease ◽  
Incurable Illness ◽  
The Family ◽  
New Challenges

Incurable disease of children is one of the most difficult periods in the life of a family. The family must adapt to the new challenges that bring the illness and everything adapts to the needs of the child. However, we often don´t realize and even don´t know that the family needs must also be fulfilled. The paper presents partial results of the research aimed at identifying the needs of the family with an incurable ill child in a special pedagogical context. For the collection of research data a semi-structured interview with assistants working in the area of child palliative care was conducted. The obtained data were processed by qualitative analysis. The results point to the necessity of a transdisciplinary approach to children with incurable illness and their families – psychologist, social worker, clergymen, and special educator.

scholarly journals Comparing the Perspectives of Professionals and Relatives Toward the Quality of Palliative Care: A Qualitative Study

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Emily Reeves ◽  
Brigitte Liebig ◽  
Eveline Degen Jermann ◽  
◽  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Qualitative Study ◽  
Family Members ◽  
Care Services ◽  
The Family ◽  
Palliative Care Services ◽  
Specialized Palliative Care ◽  
Palliative Patients

High-quality care is an important aim of palliative care services. However, the quality of care is a complex phenomenon and is subjectively perceived by those who are closest to the services and are often evaluated poorly. Prior research has highlighted the difficulties in evaluating the quality of care because of different perspectives, and still, only a little is understood about the perception of the quality of care in palliative care services. Investigating the perspectives of key individuals involved in palliative care, such as palliative professionals and relatives of palliative patients, can provide invaluable insight to understand the quality of care. To identify the perceptions of palliative professionals and relatives of the patients toward the quality of palliative care along with identifying the similarities and divergences in the perceptions, as well as highlighting the complexity of quality in palliative care settings while indicating their areas of improvement. This was a qualitative study that involved semi-structured interviews for the evaluation of palliative care guided by the proposed system approach model [1]. The interviews were conducted with a total number of 38 professionals working in palliative care along with 26 relatives of palliative patients across four Swiss cantons (Ticino, Basel, Vaud, and Lucerne). These professionals worked in primary palliative care (PPC) and specialized palliative care (SPC), where 11 general practitioners (GP’s) and 12 nurses were from primary palliative care services. Additionally, 15 interviews were conducted with 9 specialized medical doctors (e.g., oncologists) and 6 specialized palliative care nurses from different hospitals, hospices, mobile palliative care teams (MPCT’s), and specialist private practice. The results revealed considerable differences between the perspectives of professionals and relatives regarding the following aspects of care: 1) the availability, 2) client-centeredness (including respect for patient’s wishes and relative’s involvement in care, 3) satisfaction (including physical and psychosocial), and 4) communication and information transfer. Mainly, the family members felt that care was not being always readily available and coordinated poorly, the patient’s needs were overlooked because of the lack of time. Also, some professionals were perceived to be incompetent with a lack of communication and negligence toward the psychosocial needs of the patient. On the other hand, professionals indicated that relatives may be too involved in the patient care and might have expressed concern due to the high risk of burn out caused by extreme stress and emotionally taxing circumstances of palliative care. The different perspectives uncovered both the similarities and discrepancies, representing a demand for addressing the shortcomings of palliative care services. Specifically, findings indicated that professionals may overestimate the quality of palliative care. Also, future initiatives were needed to ensure that the family members of palliative patients were adequately supported, both psycho-socially and financially, justifying the investment. These findings would help in informing the health policy about the aspects of care that require specific attention to improve the overall quality of care and urge future research to explore the best ways to support these aspects of care.

scholarly journals Burnout Determinants among Nurses Working in Palliative Care during the Coronavirus Disease 2019 Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3358
Author(s):  
José Vítor Gonçalves ◽  
Luísa Castro ◽  
Guilhermina Rêgo ◽  
Rui Nunes
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Online Survey ◽  
Three Dimensions ◽  
Linear Regression Models ◽  
Perceived Health Status ◽  
Cross Sectional ◽  
National Network ◽  
Work Related ◽  
High Level

Nurses working in palliative care are at risk of burnout. The Copenhagen Burnout Inventory was used to determine burnout levels of nurses working in the Portuguese national network of palliative care. We evaluated the contribution of personal, work, and COVID-19 variables in three burnout subclasses: personal, work, and patient-related. A cross-sectional, exploratory, and quantitative design was employed and participants were sampled using convenience and snowball technique. An online survey was conducted and 153 nurses participated in our study. Socio-demographic characterization was conducted, levels of burnout and determinants were explored through multiple linear regression models for its three dimensions. High levels of personal, working, and patient burnout were present in 71 (46%), 68 (44%), and 33 nurses (22%), respectively. Most of them agreed that COVID-19 had an impact on their activities. Significant personal and work related burnout factors found were specialization in palliative care, self-perceived health status, unit type, weekly hours of work, and allocation to COVID-19 units. Gender was found to be a significant factor in patient-related burnout. There is a high level of burnout among nurses working in the Portuguese national network of palliative care. Measures for identification and mitigation of burnout are necessary to protect health care professionals.

scholarly journals “It’s Always Been a Second Class Cancer”: An Exploration of the Experiences and Journeys of Bereaved Family Carers of People with Sarcoma

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2670
Author(s):  
Moira O’Connor ◽  
Greta Smith ◽  
Ashleigh Pantaleo ◽  
Darren Haywood ◽  
Rhys Weaver ◽  
...  
Keyword(s):  
Palliative Care ◽  
Family Member ◽  
The Body ◽  
Social Constructionist ◽  
Family Carers ◽  
Writing Therapy ◽  
The Family ◽  
Qualitative Descriptive ◽  
Bereaved Family ◽  
Delays In Diagnosis

Sarcomas are a group of rare and aggressive cancers, which develop in bones and connective tissue throughout the body. Sarcomas account for only 1–2% of all cancers worldwide; however, mortality rates for sarcoma are high with approximately two in four sarcoma patients dying following a diagnosis. Delays in diagnosis, poor management of symptoms, patients’ high symptom loads and high carer burden are all associated with carer distress, which may lead to complications after bereavement. The experience of having a family member referred for palliative care is also distressing for carers, with the realisation that their family member is dying. This study aimed to explore the experiences of bereaved family carers of people diagnosed with sarcoma. A qualitative descriptive design using a social constructionist framework was adopted. Interviews were conducted with sixteen participants, and thematic analysis was used to identify patterns in the data. Four overarching themes emerged: beginning the journey; moving through treatment; transitioning to palliative care; and experiencing bereavement. The narratives were coherent and potent, and people reflected on their journeys. Interventions and supports for bereaved carers could include opportunities for counselling to support reflections, supports for developing a narrative such as writing therapy, and preparation for the death of the family member.

scholarly journals Effects of dignity therapy on palliative patients’ family members: A systematic review

2021 ◽  
pp. 1-10
Author(s):  
Leonor Grijó ◽  
Carolina Tojal ◽  
Francisca Rego
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
End Of Life ◽  
Meaning In Life ◽  
Family Members ◽  
Cochrane Library ◽  
Publication Date ◽  
Dignity Therapy ◽  
Bibliographic Search ◽  
Palliative Patients

Abstract Objective Dignity therapy (DT) is a kind of psychotherapy that identifies the main concerns of end-of-life patients that affect their perception of dignity and helps them to find a new meaning in life. Most prior studies on DT analyze outcomes for palliative care patients. The aim of this systematic review is to explore the outcomes of DT in palliative care patients’ family members. Method In June 2020, a bibliographic search was performed using the terms “Dignity Therapy” and “Palliative Care” in the following databases: Cochrane library, TRIP database, PUBMED, Scopus, and Web of Knowledge. Of the 294 articles found, 8 met the selection criteria and were considered in the present study. No articles were excluded based on their publication date. Results Family members generally believe that DT helps them to better prepare the patient's end-of-life and overcome the bereavement phase. The legacy document was considered a source of comfort, and most would recommend DT to other people in their situation. DT is generally considered as important as any other aspect of the patient's treatment. Significance of results There is evidence of the benefits of DT for palliative patients’ family members. However, there are still few studies that evaluate these outcomes. The existing evidence is poorly generalized, and thus, further studies are needed to deeply explore the benefits of this therapy both for patients and their families.

scholarly journals Implementation of the Family HELP Protocol: A Feasibility Project for a West Texas ICU

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 146
Author(s):  
Rebecca McClay
Keyword(s):  
Strong Support ◽  
Family Intervention ◽  
Successful Implementation ◽  
Positive Perception ◽  
Family Presence ◽  
West Texas ◽  
The Family ◽  
Control And Prevention ◽  
High Level ◽  
Near Future

The purpose of this project was to determine if bedside intensive care unit (ICU) nurse buy-in to the Family Hospital Elder Life Program (HELP) protocol was sufficient to make implementation feasible at one county hospital in West Texas. Surveys were anonymous with ballot box collection being available to the bedside ICU nurses for one week each. Questions were based on literature findings of expected outcomes, identified barriers and facilitators, Calgary Family Intervention Method framework domains, and the Centers for Disease Control and Prevention Framework for program evaluation. Outcome measures were taken from the stated aims of the project and evaluated from paired baseline and summative survey questions. Survey participation was approximately half of nurses employed in the studied ICU. Analysis of the surveys showed a positive perception of family presence decreasing patient delirium symptoms, and a positive perception of the Family HELP protocol. The results described a high perception of family members as partners in care and high intention to implement the Family HELP protocol, indicating strong support of a full implementation of the protocol. The high level of bedside nurse buy-in present in this study has large implications for successful implementation of the Family HELP protocol in the near future, with sustainability and continued use supported by potential inclusion of the task in the electronic health record charting.

scholarly journals Staff Burnout in Care Institutions for Juvenile Delinquents in Jordan

2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Khaled Sulaiman Shhadeh Alsloot
Keyword(s):  
Marital Status ◽  
Emotional Exhaustion ◽  
Juvenile Delinquents ◽  
Moderate Level ◽  
Years Of Experience ◽  
Staff Burnout ◽  
High Level ◽  
Academic Qualifications

The current study aimed to identify the levels of burnout among staff in care institutions for juvenile delinquents in Jordan, and how different these levels, based on the variables of academic qualifications, years of experience, and marital status. The sample consisted of (107) staff. Maslach Burnout Scale used in this study. The results showed high level of emotional exhaustion and depersonalization, and moderate level of lack of sense of accomplishment among participants.Level of emotional exhaustion varied according to academic qualifications: holders of secondary or below and university qualification holders, the results were in favor of holders of secondary or below, while no statistically significant differences shown in apathy and lack of sense of accomplishment and the total degreeBurnout Scale. The results indicated no differences in the three main levels and the total degreeofBurnout Scale based on the various levels of years of experience and marital status.

scholarly journals Palliative care in paediatric oncology: perceptions, expertise and practices from the perspective of the multidisciplinary team

2015 ◽  
Vol 36 (2) ◽  
pp. 56-62 ◽  
Author(s):  
Adriana Ferreira da Silva ◽  
Helena Becker Issi ◽  
Maria da Graça Corso da Motta ◽  
Daisy Zanchi de Abreu Botene
Keyword(s):  
Palliative Care ◽  
Multidisciplinary Team ◽  
Structured Interview ◽  
Paediatric Oncology ◽  
Lessons Learned ◽  
Team Members ◽  
Descriptive Research ◽  
The Family ◽  
Research Questions ◽  
Oncology Unit

OBJECTIVE: To reveal the perceptions, expertise and practices of multi-professional teams providing palliative care to children in a paediatric oncology unit. The research questions were based on everyday care, facilitations and difficulties, essential aspects of professional approaches, and the inter-disciplinary focus of care for children in palliative care and their families. METHOD: Qualitative, exploratory and descriptive research. Data were collected from June to October 2013 from nine professional multidisciplinary team members by means of a semi-structured interview submitted to thematic analysis. RESULTS: The following four themes emerged from analysis: palliative care: conceptions of the multi-professional team; the construction of singular care; the facilitations and difficulties experienced by the team and significant lessons learned. CONCLUSIONS: The subjects revealed that the team also suffers with the death of a child and, like the family, moves toward the construction of coping mechanisms for the elaboration of mourning. Paradoxically, the team shares knowledge to determine the foundations of a singular therapeutic project and inserts the family in this process so that it can be the protagonist of the child's care.

scholarly journals Job Stress and Burnout among Social Workers in the VUCA World of COVID-19 Pandemic

2021 ◽  
Vol 13 (13) ◽  
pp. 7109
Author(s):  
Gabriela Dima ◽  
Luiza Meseșan Schmitz ◽  
Marinela-Cristina Șimon
Keyword(s):  
Social Workers ◽  
Job Stress ◽  
Job Demands ◽  
Stress Factors ◽  
Care Plan ◽  
Average Score ◽  
Supervisory Support ◽  
Work Related ◽  
Study Results ◽  
High Level

This paper aimed to explore the changes posed by the new COVID-19 pandemic to the field of social work and its impact on social workers in terms of job stress and burnout in Romania. Two conceptual models were used to frame the discussion: the theoretical framework of VUCA (volatility, uncertainty, complexity, and ambiguity) to discuss the challenges that the unprecedented context of the COVID-19 pandemic has created for social workers; and the Job Demands and Resources model (JD-R) to understand job demands perceived as stressors and burnout. Based on convergent mixed methods, the study sample consisted of 83 social workers employed in statutory and private social services in Romania, from different areas of intervention. Results showed that social workers perceived a high level of job stress related to work during the pandemic, which was associated with higher levels of burnout in the areas of personal burnout (average score 55.9) and work-related burnout (average score 52.5). Client-related burnout was lower (average score 38.4), indicating that stress was generated mainly by organisational factors and work-related factors (workload, aligning to new legislative rules and decisions, inconsistency, instability, ambiguity of managerial decisions, and lack of clarity of working procedures) and less by client-related stressors (lack of direct contact with clients, risk of contamination, managing beneficiaries’ fears, and difficulties related to technology). High job demands and limited job resources (managerial and supervisory support, financial resources, and recognition and reward) led to a high to very high level of work-related burnout for 15.7% and an upper-medium level for 44.2% of respondents. A group of 27.7% reported lower to medium levels of work-related burnout, while 14.5% had very low levels, managing to handle stress factors in a healthy manner. Study results pointed to the importance of organisational support and the development of a self-care plan that help to protect against job stress and burnout. Recommendations were made, putting forward the voice of fieldworkers and managers fostering initiatives and the application of sustainability-based measures and activities designed to deal with the challenges of the VUCA environment.

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