scholarly journals “Swinging Pendulum”: Lives of Family Members Caring for A Dying Relative

2019 ◽  
Author(s):  
Robert Sumaguingsing ◽  
Rudolf Cymorr Kirby Palogan Martinez
Keyword(s):  
Health Care Providers ◽  
Family Members ◽  
Spiritual Support ◽  
Care Providers ◽  
Interpretive Phenomenology ◽  
Home Setting ◽  
Face To Face ◽  
Van Manen ◽  
Informal Carers ◽  
The Individual

Among cultures which place emphasis on the centrality of family in ones lives, the care for the dying patient is more often than not delegated on family members. Given this context, it is interesting to note that few research have been done on the experiences of these individuals who provide care to their dying relatives. This research aims to understand the lives of these informal carers as they provide care to their dying relatives. After securing clearance from an IRB, seven (5) informants, deemed as coresearchers, were recruited and agreed to participate in this study. The co-researchers where selected based on a pre-set criteria and the number were reached based on theoretical saturation. Multiple individual in-depth face-to-face interviews were done to create the individual narratives which was later reflectively analysed. Interpretive phenomenology as espoused by van Manen served as the philosophical underpinning of the study. Consequently, the proposed analytic technique of van Manen was utilized as the process of reflective analysis. After the process of reflective analysis, three (3) themes were gathered, namely: Ambivalence in anticipation, Courage in uncertainty, Meaning in suffering. These themes represent for the co-researchers their lives as they care for their dying relatives. Further, these themes reflects for the co-researchers a phenomenon of living moment-to-moment, unsure of what tomorrow will bring, patiently waiting for their relative to cross over. For them, there seems to be a constant struggle of finding a reason for being and a sense of what has happened, what is happening and what could happen to their dying relative and their family after their death. This essence can be symbolically represented by a swinging pendulum, constantly in motion trying to situate ambivalence in their anticipation, looking for courage amidst uncertainty and finding formeaning in their experience of suffering. The insights suggest that there is a need for constant dialogue among family members and health care providers as they assumed the role of primary caregivers. Further continued emotional, moral and spiritual support is implied during this transition as well as follow-ups when the families are at the home setting.

scholarly journals A Qualitative Study on the Unmet Needs of Cancer Carers in Vietnam

2020 ◽  
Author(s):  
Chris Jenkins ◽  
Hien Thi Ho ◽  
Hoa Le Phuong Nghiem ◽  
Gillian Prue ◽  
Lynne Lohfeld ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Information Needs ◽  
Unmet Needs ◽  
Positive Impact ◽  
Family Members ◽  
Care Providers ◽  
Thematic Content ◽  
Health And Wellbeing ◽  
Cancer Services ◽  
Informal Carers

Abstract Background: Due to limited resources in hospitals and social and cultural norms regarding caregiving in Vietnam, carers provide a range of supportive functions for family members diagnosed with cancer. This paper provides empirical evidence on the self-identified unmet needs of carers of inpatients in national oncology hospitals in Vietnam.Methods: An international, multidisciplinary research team conducted focus group and in-depth interviews with informal carers (n=20) and health care providers (n=22) and collaboratively analysed the results using thematic content analysis.Results: Thematic content analysis highlighted four main areas of needs: (i) material requirements such as accessible and comfortable facilities, accommodation and finance; (ii) information needs about cancer, caring, and nutrition; (iii) emotional support; and (iv) training about how to provide care to their family members during (a) treatment and (b) recovery phases.Conclusions: Carers provide invaluable support in supporting people with a cancer diagnosis, particularly given wider systemic challenges in delivering cancer services in Vietnam. Increasing visibility and formal support is likely to have both a positive impact upon the health and wellbeing of carers, as well as for cancer patients under their care.

scholarly journals The experiences of family members of a person with a head injury

2016 ◽  
Vol 5 (1) ◽  
pp. 24
Author(s):  
Maria Tegelela Iiyambo ◽  
Louis Small ◽  
Agnes Van Dyk ◽  
Esther Kamenye
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Head Injury ◽  
Health Care Providers ◽  
Family Members ◽  
Care Providers ◽  
Face To Face ◽  
The Family ◽  
Rehabilitation Period ◽  
Purposive Sample

The aim of this study was to understand what the family members of a person with a head injury go through during the pre-hospitalization, hospitalization and rehabilitation period. The objective set for this study was to explore and describe the experiences of family members of a person with a head injury.A purposive sample was selected from the records of the Intensive Care Unit at the Intermediate Hospital Oshakati where the addresses of the head injury patients were identified. A qualitative explorative, descriptive and contextual research design was conducted utilizing individual in-depth face-to-face interview to gather data from family members of a person with a head injury. Data was analyzed using Tech’s method for content analysis.The results of this study showed that family members of a person with head injury had varied and different experiences varying from different feelings, challenges and support to them.Recommendations based on the findings were made for both health care providers and family members of a person with a head injury.

scholarly journals Clinical Practice of Palliative Care: Current Concepts and Future Perspectives

2019 ◽  
Vol 55 (02) ◽  
pp. 084-091
Author(s):  
Ashok Kumar Saxena ◽  
Anupriya Saxena ◽  
Anand Kumar Chopra ◽  
Hazel Talwar ◽  
Megha Bajaj ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Care Providers ◽  
Family Members ◽  
Multimodal Analgesia ◽  
Social Consequences ◽  
Spiritual Support ◽  
Care Providers ◽  
Complex Needs ◽  
Realistic Option ◽  
Advanced Stages

AbstractPain is a distressing symptom having biological, psychological, and social consequences. A large number of cancer patients are in advanced stages of the disease and for these patients the only positive and realistic option is pain management and palliative care. These patients have complex needs that have to be taken care of in order to improve the quality of life of such patients and their family members. Surgical treatment along with chemotherapy and radiotherapy is the mainstay for the treatment of cancer, but these modalities also have limitations. The main aim behind palliative care is to allay the sufferings of a terminally ill patient by responding to pain using multimodal analgesia including opioids. According to WHO step ladder, other symptoms like breathlessness, fatigue, delirium etc., are also needed to be managed adequately along with psychosocial and spiritual support. Along with it patients and his family members should be well explained that palliative care is a multidimensional approach directed to the best possible care for that stage of their illness, which may not be curative in nature. There are multiple obstacles in the growth of palliative care in India. Nonetheless we have overcome many such hurdles and there has been a noticeable change regarding palliative care in the mindset of health care providers in the last 2 decades.

scholarly journals The Role of Rehabilitation in Reducing Resource Use and Lowering Hospital Readmission Through Discharge Planning

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 804-804
Author(s):  
Kenneth Miller
Keyword(s):  
Health Care Providers ◽  
Resource Use ◽  
Hospital Readmission ◽  
Discharge Planning ◽  
Care Transitions ◽  
Healthcare Team ◽  
Transition Management ◽  
Care Providers ◽  
Initial Examination ◽  
The Individual

Abstract The transitions between medical settings, the community and back again is a complex and intimidating process for patients, families and caregivers. These transitions are vulnerable points where planning is key and must begin at the initial examination with rehabilitation providers (PTs/OTs,SLPs). These providers are key members of the healthcare team to facilitate effective transition management. In this session, attendees will learn the critical factors rehabilitation providers use to evaluate patients in order to facilitate successful care transitions. An overview of the indications for rehabilitation referral will be presented, as well as evidence for effective rehabilitation strategies. The speaker will present tools from the American Physical Therapy Association Home Health Toolbox and outline a decision-making process for care transitions based on the individual, caregivers, and health care providers to achieve successful transitions that reduce resource use and hospital readmission rates. Attendees will learn strategies to facilitate inter-professional collaboration, communication, and advocacy.

scholarly journals Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Family Members ◽  
Expected Improvement ◽  
Transition Of Care ◽  
Care Providers ◽  
Icu Discharge ◽  
Family Perceptions

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.

scholarly journals Experiences of Patients With COVID-19 Admitted to the Intensive Care Units: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Reza Norouzadeh ◽  
Mohammad Abbasinia ◽  
Zahra Tayebi ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Spiritual Support ◽  
Care Providers ◽  
Structured Interviews ◽  
Icu Patients ◽  
Life Challenges ◽  
Care Models ◽  
The Face

This study aimed to describe the experiences of patients with COVID-19 admitted to the intensive care units (ICU). The data were analyzed by content analysis on 16 ICU patients with COVID-19. Data were collected by semi-structured interviews. Three categories were identified: (a) captured by a challenging incident with subcategories: perceived sudden and challenging death, fear of carelessness in overcrowding, worry about the family, and frustration with stigmatizing; (b) the flourishing of life with subcategories: spiritual-awakening, resilience in the face of life challenges, promoting health behaviors, and striving for recovery; and (c) honoring the blessings with subcategories: understanding the importance of nurses, realizing the value of family, and realizing the value of altruism. COVID-19 survivors experienced both positive and negative experiences. The results of this study could help health care providers identify the needs of ICU patients with COVID-19, including psychological, social, and spiritual support and design care models.

Addressing Mistreatment of Providers by Patients and Family Members as a Patient Safety Event

2021 ◽  
Author(s):  
Marianne Hatfield ◽  
Rebecca Ciaburri ◽  
Henna Shaikh ◽  
Kirsten M. Wilkins ◽  
Kurt Bjorkman ◽  
...  
Keyword(s):  
Patient Safety ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Tertiary Care ◽  
Family Members ◽  
Incident Reporting ◽  
Care Providers ◽  
Cross Sectional ◽  
Offensive Behavior ◽  
Safety Incident

OBJECTIVE: Mistreatment of health care providers (HCPs) is associated with burnout and lower-quality patient care, but mistreatment by patients and family members is underreported. We hypothesized that an organizational strategy that includes training, safety incident reporting, and a response protocol would increase HCP knowledge, self-efficacy, and reporting of mistreatment. METHODS: In this single-center, serial, cross-sectional study, we sent an anonymous survey to HCPs before and after the intervention at a 213-bed tertiary care university children’s hospital between 2018 and 2019. We used multivariable logistic regression to examine the effect of training on the outcomes of interest and whether this association was moderated by staff role. RESULTS: We received 309 baseline surveys from 72 faculty, 191 nurses, and 46 residents, representing 39.1%, 27.1%, and 59.7%, respectively, of eligible HCPs. Verbal threats from patients or family members were reported by 214 (69.5%) HCPs. Offensive behavior was most commonly based on provider age (85, 28.5%), gender (85, 28.5%), ethnicity or race (55, 18.5%), and appearance (43, 14.6%) but varied by role. HCPs who received training had a higher odds of reporting knowledge, self-efficacy, and experiencing offensive behavior. Incident reporting of mistreatment increased threefold after the intervention. CONCLUSIONS: We report an effective organizational approach to address mistreatment of HCPs by patients and family members. Our approach capitalizes on existing patient safety culture and systems that can be adopted by other institutions to address all forms of mistreatment, including those committed by other HCPs.

scholarly journals Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide

2020 ◽  
Vol 16 (1) ◽  
pp. 79-87
Author(s):  
Meaghan Lunney ◽  
Aminu K. Bello ◽  
Adeera Levin ◽  
Helen Tam-Tham ◽  
Chandra Thomas ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Kidney Failure ◽  
Low Income Countries ◽  
Multidisciplinary Teams ◽  
Spiritual Support ◽  
Care Providers ◽  
The Status ◽  
Kidney Health

Background and objectivesPeople with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality.Design, setting, participants, & measurementsThe Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management.ResultsRespondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery.ConclusionsOverall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.

scholarly journals Withdrawing Versus not Offering Cardiopulmonary Resuscitation: Is There a Difference?

2015 ◽  
Vol 22 (1) ◽  
pp. 20-22 ◽  
Author(s):  
Simon JW Oczkowski ◽  
Bram Rochwerg ◽  
Corey Sawchuk
Keyword(s):  
Mechanical Ventilation ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Case Law ◽  
Decision Makers ◽  
Court Decisions ◽  
Medical Team ◽  
Care Providers ◽  
Substitute Decision Makers ◽  
The Individual

Conflict between substitute decision makers (SDMs) and health care providers in the intensive care unit is commonly related to goals of treatment at the end of life. Based on recent court decisions, even medical consensus that ongoing treatment is not clinically indicated cannot justify withdrawal of mechanical ventilation without consent from the SDM. Cardiopulmonary resuscitation (CPR), similar to mechanical ventilation, is a life-sustaining therapy that can result in disagreement between SDMs and clinicians. In contrast to mechanical ventilation, in cases for which CPR is judged by the medical team to not be clinically indicated, there is no explicit or case law in Canada that dictates that withholding/not offering of CPR requires the consent of SDMs. In such cases, physicians can ethically and legally not offer CPR, even against SDM or patient wishes. To ensure that nonclinically indicated CPR is not inappropriately performed, hospitals should consider developing ‘scope of treatment’ forms that make it clear that even if CPR is desired, the individual components of resuscitation to be offered, if any, will be dictated by the medical team’s clinical assessment.

scholarly journals Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Research Question ◽  
Chronic Musculoskeletal Pain ◽  
Self Management ◽  
Care Providers ◽  
The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

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