scholarly journals Missing in Action: Reports of Interdisciplinary Integration in Canadian Palliative Care

2021 ◽  
Vol 28 (4) ◽  
pp. 2699-2707
Author(s):  
Maggie C. Robinson ◽  
Maryam Qureshi ◽  
Aynharan Sinnarajah ◽  
Srini Chary ◽  
Janet M. de Groot ◽  
...  
Keyword(s):  
Palliative Care ◽  
Social Work ◽  
Spiritual Care ◽  
Psychosocial Care ◽  
Research And Practice ◽  
Barriers And Enablers ◽  
Special Concern ◽  
Missing In Action ◽  
Interdisciplinary Integration

Palliative care has an interdisciplinary tradition and Canada is a leader in its research and practice. Yet even in Canada, a full interdisciplinary complement is often lacking, with psychosocial presence ranging from 0–67.4% depending on the discipline and region. We sought to examine the most notable gaps in care from the perspective of Canadian palliative professionals. Canadian directors of palliative care programs were surveyed with respect to interdisciplinary integration. Participants responded in writing or by phone interview. We operationalized reports of interdisciplinary professions as either “present” or “under/not-represented”. The Vaismoradi, Turunen, and Bondas’ procedure was used for content analysis. Our 14 participants consisted of physicians (85.7%), nurses (14.3%), and a social worker (7.1%) from Ontario (35.7%), British Columbia (14.3%), Alberta (14.3%), Quebec (14.3%), Nova Scotia (14.3%), and New Brunswick (7.1%). Psychology and social work were equally and most frequently reported as “under/not represented” (5/14, each). All participants reported the presence of medical professionals (physicians and nurses) and these groups were not reported as under/not represented. Spiritual care and others (e.g., rehabilitation and volunteers) were infrequently reported as “under/not represented”. Qualitative themes included Commonly Represented Disciplines, Quality of Multidisciplinary Collaboration, Commonly Under-Represented Disciplines, and Special Concern: Psychosocial Care. Similar to previous reports, we found that (1) psychology was under-represented yet highly valued and (2) despite social work’s relative high presence in care, our participants reported a higher need for more. These finding highlight those psychosocial gaps in care are most frequently noted by palliative care professionals, especially psychology and social work. We speculate on barriers and enablers to addressing this need.

What information do patients need about their disease or treatments and what they want for end of life?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20656-e20656
Author(s):  
Gaston Martin Reinas ◽  
Ernesto Gil Deza ◽  
Eduardo L. Morgenfeld ◽  
Daniela Gercovich ◽  
Flavio Tognelli ◽  
...  
Keyword(s):  
High School ◽  
Palliative Care ◽  
End Of Life ◽  
Spiritual Care ◽  
Educational Level ◽  
Clinical Investigation ◽  
Psychological Support ◽  
Chi Square ◽  
Stage Of Disease

e20656 Background: As it is very important for Doctors, Patients (Pt) and Family to know everything related to end of life we thought it was unavoidable to develop a survey for that purpose. Methods: Between Oct 15th and Nov 15th, 2012, 1003 Pt out of 3795 Pt that were assisted at the IOHM were given the option to participate in an anonymous survey about diagnosis, prognosis, efficacy and toxicity of treatments, as well as interest in palliative care (PC), clinical investigation (CI), psychological support (PS), spiritual care (SC) for an eventual situation of coping with the end of life dilemma. Results: A total of 845 out of 1,003 (84%) Pt elected to participate. Population: Sex: fem: 332, male: 207, left blank (LB): 306. Mean age 58y (range 18 – 94). Married: 355, unmarried: 211, LB: 279. Children Yes 460 No/LB: 385. Highest educational level achieved: primary Studies:186, high School: 348, universitary:216. LB: 98. Employed:382, retired: 240, unemployed: 112, LB 111. Disclosed diagnostic and stage of disease: 470 (56%). The following results are expressed as a percentage of 845 pt: Are aware of the diagnostic (82%); Pt interested in knowing everythingabout their prognosis (85%) or their treatment’s efficacy (67%) or toxicity (52%). Pt interested in: PC (85%), CI (80%), PS (74%), SC (58%). If they were to choose a place for dying: 40% chose to die in the hospital, 30% at home, 29% did not answer and 1% was indifferent. It was possible to detect a marked increase in the amount of answers with regards to last wishes as the stage of the disease worsened (Chi square= 0.011). Pt were asked to rate the survey: 95% considered it good or very Good, 56% found it useful, 36% thought it necessary, while 23% would recommend it. Conclusions: 1) Most of the pt know their diagnosis, would like to know their prognosis and need to know everything about efficacy and toxicity of treatments. 2) 40% of the pt would prefer to die in the hospital, but analyzing this choice at earlier stages of disease may be inappropriate. 3) PC and CI are of interest to both sexes but women are more likely to request PS and SC. 4) Although the survey was considered good by 95% of pt and more than 50% found it useful, only 23% would recommend it, which speaks about the sensitive quality of these topics.

National survey of oncology fellows on palliative care education

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9541-9541
Author(s):  
M. K. Buss ◽  
D. S. Lessen ◽  
J. Von Roenn ◽  
A. M. Sullivan ◽  
R. M. Arnold ◽  
...  
Keyword(s):  
Palliative Care ◽  
Multiple Testing ◽  
Psychosocial Care ◽  
Cord Compression ◽  
Type I ◽  
Bone Marrow Biopsies ◽  
Opioid Rotation ◽  
Palliative Care Education ◽  
Hospice Referral

9541 Background: Palliative care (PC) is recognized as an integral part of the practice of oncology, yet many oncologists report inadequate training in critical PC domains, such as symptom management, psychosocial care and communication skills. We sought to assess the quantity and quality of PC education within oncology fellowships. Methods: Second year fellows enrolled in US oncology fellowships were invited to complete a 104 item survey that was modified from a national telephone survey of medical students and residents. Topics included: 1) quality and quantity of teaching and education, 2) observation and feedback, 3) knowledge, 4) attitudes and preparation. Items were designed to allow comparison between PC and non-PC topics. To reduce Type I errors from multiple testing, an alpha level of 0.01 was considered statistically significant. Results : Of 402 eligible fellows, 63.5% responded (n=254). Respondents were: 52% male, 62% White, 27% Asian and 64% US medical school graduates. One-quarter (26%) had completed a PC rotation and 68% reported exposure to palliative care during their fellowship. On a 5-point Likert Scale, fellows rated teaching on PC less highly than the overall quality of fellowship teaching (3.0 v 3.7; p<0.001). Fellows rated attending oncologists less favorably in performing PC skills compared to other oncology skills: managing pain in the terminally ill versus managing spinal cord compression (3.9 v. 4.5; p < 0.001); discussing the decision to stop chemotherapy versus discussing chemotherapy side effects (3.8 v. 4.2; p < 0.001). Fellows were less likely to be observed (81% v 93%; p =0.005) or receive feedback (80 v 93%; p= 0.02) on end-of-life (EOL) discussions than bone marrow biopsies. Many fellows reported not receiving explicit education on PC topics: managing depression at the EOL (68%), opioid rotation (67%), telling a patient she is dying (42%) and hospice referral (37%). Fellows who completed a PC rotation were more likely to report explicit teaching on opioid rotation (p =0.005) and hospice referral (p = 0.002). Conclusions: Our study reveals opportunities for improving the PC training of oncology fellows. No significant financial relationships to disclose.

Effect of a spiritual care training program on patient quality of life and spiritual well-being.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 235-235
Author(s):  
Grace Meijuan Yang ◽  
Yung Ying Tan ◽  
Yin Bun Cheung ◽  
Dennis Dignadice ◽  
Amy Lim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Training Program ◽  
Spiritual Care ◽  
Training Session ◽  
Palliative Care Service ◽  
Well Being ◽  
Spiritual Assessment ◽  
Spiritual Well Being

235 Background: Spiritual care (SC) is a vital part of palliative care (PC) but its provision is still not routine. We studied the effect of a SC training program for staff on patient quality of life (QOL) and spiritual wellbeing (SPS), as measured by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp). Methods: This study was conducted at two sites: a PC consultative service in an acute hospital and a home PC service. The program comprised a 30 min training session for nurses and doctors on using the FICA tool for spiritual assessment and subsequent referral to a medical social worker (MSW) if needed, and a 60min training session with the MSWs on how to manage spiritual problems. A prospective cluster-controlled trial was done across 7 clusters. FACIT-Sp comprises 27 items for QOL (FACT-G) in the 4 domains and 12 items for SPS. This was administered at T1: upon referral to the palliative care service and T2: after 3 clinical visits by the PC team (doctor, nurse or MSW visits). Results: QOL data from 142 participants (69 intervention and 73 control) were analyzed. There appeared to be some benefit of the program on all domains of QOL as well as SPS, although only the FACT-G score achieved statistical significance. After further statistical adjustment for scores at T1 (to account for any regression to the mean), FACT-G score remained practically significant (p value 0.076). Conclusions: A brief SC training program for staff (30 min for nurses and doctors, 60 min for MSWs) appeared to result in some improved QOL and SPS for patients. However, a larger sample size will be needed to estimate the degree of benefit more accurately. [Table: see text]

A psychosocial and pshycoeducational intervention for cancer patients integrated into routine care: A study from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19518-e19518 ◽  
Author(s):  
Anita Chandra
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Professionals ◽  
Psychosocial Intervention ◽  
Psychological Intervention ◽  
Symptom Control ◽  
Psychosocial Care ◽  
Patients With Cancer ◽  
Oncology Care

e19518 Background: Patients with cancer experience significant distress and access to effective psychosocial care is limited by lack of systematic approach. This paper presents results of a study to evaluate the effectiveness of a brief tailored psychosocial intervention delivered by health professionals in cancer care in developing countries. Methods: Health professionals deliver the multicomponent, psychoeducational and psychosocial intervention focusing on core concepts of quality of life, supportive-expressive, cognitive, social functioning, symptom scale and dignity-conserving care. A total of 100 patients recruited across all tumour sites, from July 2011 to December 2011, in a University Hospital in India. Eligible patients received 2 sessions, each for 30 minutes in length, delivered face-to-face at baseline and 12 week follow-up. Results: Quality of life was measured by using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire .In this study the functional scales were high, whereas in the symptom scales fatigue (48.9%) and financial difficulties (45.53%) were noted. Percentages of families who evaluated by the palliative care team voted as useful or very useful were: 80% (symptom control), 85% (emotional support), 86% (family support), and 87% (care coordination). Compared with participants receiving usual oncology care, those receiving a palliative care-focused intervention addressing psychosocial care provided concurrently with oncology care had higher scores for quality of life and mood. Conclusions: This study will provide important information about the effectiveness of a brief tailored psychological intervention for patients with cancer in a developing country. This model of care should be a systematic implementation in routine clinical practice cancer settings in resource restraints countries. [Table: see text]

scholarly journals Global Palliative Care: Improving the Quality of Spiritual Care in Global Palliative Care (SA525)

2018 ◽  
Vol 55 (2) ◽  
pp. 652
Author(s):  
Christina Puchalski ◽  
Betty Ferrell ◽  
Kathleen Foley ◽  
Katherine Pettus ◽  
Anke Flohr
Keyword(s):  
Palliative Care ◽  
Spiritual Care

Effect of a spiritual care training program for staff on patient outcomes

2016 ◽  
Vol 15 (4) ◽  
pp. 434-443 ◽  
Author(s):  
Grace Meijuan Yang ◽  
Yung Ying Tan ◽  
Yin Bun Cheung ◽  
Weng Kit Lye ◽  
Sock Hui Amy Lim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Training Program ◽  
Spiritual Care ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Spiritual Well Being ◽  
Care Training

ABSTRACTObjective:Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative care for patients with an advanced serious illness. The aim of our study was to determine whether a training program for healthcare professionals on spirituality and the taking of a spiritual history would result in improved patient quality of life (QoL) and spiritual well-being.Method:This was a cluster-controlled trial of a spiritual care training program for palliative care doctors and nurses. Three of seven clinical teams (clusters) received the intervention, while the other four served as controls. Included patients were newly referred to the palliative care service, had an estimated survival of more than one month, and were aware of their diagnosis and prognosis. The primary outcome measure was the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT–Sp) patient-reported questionnaire, which patients completed at two timepoints. Total FACIT–Sp score includes the Functional Assessment of Cancer Therapy–General (FACT–G) questionnaire, which measures overall quality of life, as well as a spiritual well-being score.Results:Some 144 patients completed the FACIT–Sp at both timepoints—74 in the control group and 70 in the intervention group. The change in overall quality of life, measured by change in FACT–G scores, was 3.89 points (95% confidence interval [CI95%] = –0.42 to 8.19, p = 0.076) higher in the intervention group than in the control group. The difference between the intervention and control groups in terms of change in spiritual well-being was 0.32 (CI95% = –2.23 to 2.88, p = 0.804).Significance of results:A brief spiritual care training program can possibly help bring about enhanced improvement of global patient QoL, but the effect on patients' spiritual well-being was not as evident in our participants. Further study with larger sample sizes is needed to allow for more definite conclusions to be drawn.

Addressing Spirituality in Pediatric Hospice and Palliative Care

2002 ◽  
Vol 18 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Betty Davies ◽  
Paul Brenner ◽  
Stacy Orloff ◽  
Liz Sumner ◽  
William Worden
Keyword(s):  
Palliative Care ◽  
Spiritual Care ◽  
Psychosocial Care ◽  
Pediatric Palliative Care ◽  
Children And Families ◽  
Personal Experiences ◽  
Total Care ◽  
Organization Committee ◽  
Spiritual Issues ◽  
Hospice And Palliative Care

Hospice and palliative care principles mandate clinicians to provide “total” care to patients and their families. Such care incorporates not only physical, emotional, and psychosocial care, but spiritual care as well. Even though considerable attention has been directed to spiritual issues for adult patients in hospice and palliative care, spirituality in pediatric palliative care has been virtually neglected. The need for guidelines to assess spirituality in this population was identified as a priority issue by members of a subcommittee of the Children's International Project on Children's Palliative/Hospice Services, created under the auspices of the National Hospice Organization. Committee members, based on their clinical, research, and personal experiences, identified several aspects relevant to spirituality in general, and to spirituality in pediatric palliative care in particular, and developed guidelines for clinicians in pediatric palliative care. The purpose of this paper is to share the results of this committee's work and, in particular, to present their guidelines for addressing spiritual issues in children and families in pediatric hospice and palliative care.

scholarly journals Post-disaster social work research: A scoping review of the evidence for practice

2020 ◽  
pp. 002087282090413
Author(s):  
Louise Harms ◽  
Jennifer Boddy ◽  
Lyndal Hickey ◽  
Kathryn Hay ◽  
Melinda Alexander ◽  
...  
Keyword(s):  
Social Work ◽  
Natural Disasters ◽  
Scoping Review ◽  
Social Work Education ◽  
Psychosocial Care ◽  
Future Research ◽  
Research Activity ◽  
Research And Practice ◽  
Social Work Research ◽  
Work Education

The aim of this study was to understand the extent, range and nature of social work research activity after natural disasters and to identify the implications for future research and practice. A Scoping review methodology framework was used search of three databases: Web of Science, ProQuest and Informit was conducted to identify relevant studies between 2000 and 2018. Selection of studies was based on empirical research about social work and natural disasters and/or authored by social workers. Study selection found a total of 38 relevant articles. Charting the data was conducted and the following areas of focus were summarised: (1) interventions relating to psychosocial care, aid work and community work; (2) the effects of disasters on people and mediators of these effects; (3) social work education and challenges in disaster relief; and (4) measuring mental health outcomes of people who have experienced a disaster event. This scoping review has established that there is a range of social work literature focused on natural disasters that primarily examines social work interventions, the effects of disasters and social work education. Future social work research and practice needs to focus on the types and timing of interventions that promote positive recovery following natural disasters.

Abstract PA-15: Consensus Project and Pilot Demonstration Projects to Improve the Quality of Spiritual Care in Palliative Care

2010 ◽  
Vol 8 (5) ◽  
pp. A11
Author(s):  
Betty R. Ferrell ◽  
Tami Borneman ◽  
Shirley Otis-Green ◽  
Gwen Uman ◽  
Christina Puchalski ◽  
...  
Keyword(s):  
Palliative Care ◽  
Spiritual Care
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