scholarly journals A New Approach to the Identification of Palliative Care Needs and Advanced Chronic Patients among Nursing Home Residents

Author(s):  
Ana A. Esteban-Burgos ◽  
María José Lozano-Terrón ◽  
Daniel Puente-Fernandez ◽  
César Hueso-Montoro ◽  
Rafael Montoya-Juárez ◽  
...  

Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident’s advanced chronic condition. Methods: Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05. Results: More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups. Conclusions: Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents.

2016 ◽  
Vol 16 (6) ◽  
pp. 356
Author(s):  
Carles Constante Beitia ◽  
Carles Blay Pueyo ◽  
Marisa Martínez-Muñoz ◽  
Anna Schiaffino Rubinat ◽  
Albert Ledesma Castelltort

2016 ◽  
Vol 17 (10) ◽  
pp. 1501-1507 ◽  
Author(s):  
Kirsten Hermans ◽  
Joachim Cohen ◽  
Nele Spruytte ◽  
Chantal Van Audenhove ◽  
Anja Declercq

2021 ◽  
Author(s):  
Jenny T. van der Steen ◽  
Esmée Jongen ◽  
Natashe Lemos Dekker ◽  
Lotje Bagchus ◽  
H. Roeline W. Pasman ◽  
...  

Objective: To assess experiences of medical practitioners who are on the staff of nursing homes with communication with nursing staff about identifying emerging and changing (palliative) care needs of residents of nursing homes in the Netherlands. Design: Qualitative interview study. Setting and Participants: Fifteen physicians and two nurse practitioners employed by eight care organizations in the western urbanized region of the Netherlands. Methods: We conducted individual semi-structured interviews in 2018 informed by a topic list that was based on a qualitative dataset about facilitators to palliative care in dementia reported by elderly care physicians. The interviews were recorded, transcribed verbatim and analysed with Atlas.ti. We used both deductive and inductive coding adding refined codes related to communication. Results: All interviewees expressed appreciation for nursing staff on whom they relied to communicate palliative care needs, yet they reported a variety of communication challenges around important changes in the condition of the residents which were covered by two themes. (1) Teamwork was facilitated or impeded by team size and structure, quality of relationships and clarity in hierarchical relationships. (2) Continuity of information was affected by (in)effective routes of consultation and (lack of) detail in communicating observations. Conclusions and Implications: Also in the case of on-staff physicians, functioning of the multidisciplinary team and accurate sharing of observed changes in the condition of nursing home residents are crucial for physicians to be able to address palliative care needs. The expressions of the physicians of how they would favor nursing staff to communicate can inspire interprofessional training, such as reporting objective observations and phrasing a clear request for help while avoiding overly demanding appeals.


Author(s):  
Elena Chover-Sierra ◽  
Antonio Martínez-Sabater ◽  
Yolanda Lapeña-Moñux

Resume Objective: to determine the level of knowledge in palliative care of nursing staff at a Spanish tertiary care hospital. Method: descriptive, cross-sectional study. Data were collected about the results of the Spanish version of the Palliative Care Quiz for Nurses (PCQN), sociodemographic aspects, education level and experience in the field of palliative care. Univariate and bivariate descriptive analysis was applied. Statistical significance was set at p < 0.05 in all cases. Results: 159 professionals participated (mean age 39.51 years ± 10.25, with 13.96 years ± 10.79 of professional experience) 54.7% possessed experience in palliative care and 64.2% educational background (mainly basic education). The mean percentage of hits on the quiz was 54%, with statistically significant differences in function of the participants’ education and experience in palliative care. Conclusions: although the participants show sufficient knowledge on palliative care, they would benefit from a specific training program, in function of the mistaken concepts identified through the quiz, which showed to be a useful tool to diagnose professionals’ educational needs in palliative care.


2020 ◽  
Vol 19 (3) ◽  
pp. 322-344
Author(s):  
Antonio Valenzuela Vidal ◽  
Ana Folch Ayora ◽  
Joan Bou Esteller ◽  
Zaira Fernández Yañez ◽  
Sebastian Eroles Tena ◽  
...  

La implementación de los cuidados paliativos en las universidades ha sido paulatina. Su reciente implantación requiere de su evaluación para la mejora en la formación de nuestros futuros profesionales. Por tanto, el objetivo de este trabajo es valorar el conocimiento en paliativos, en estudiantes de enfermería de la Universidad Jaume I, tras la implementación de un plan de estudios de enseñanza transversal y evaluación mediante una asignatura de carácter obligatorio. Método: Estudio observacional, de corte transversal, durante el curso académico 2017/2018 mediante la escala Palliative Care Quiz for Nursing. Análisis descriptivo, comparativo de las variables cuantitativas y cualitativas global y según aciertos/errores, significación estadística p-value <0,05.Resultados: La muestra de n=155, edad 22,21±6,61 años, con predominio del sexo femenino en el 80% (n=124). La esfera con mayor número de aciertos fue la relacionada con el control de dolor y los síntomas 69,1% y la esfera con más fallos la relacionada con la filosofía y los principios 46,9%. El conocimiento en paliativos viene explicado en un 16% por el curso académico y con la experiencia previa en paliativos. Conclusiones: Mediante nuestros resultados observamos, que la educación en paliativos desarrollada de forma transversal con la culminación de una asignatura obligatoria en cuarto curso, resulta ser efectiva en estudiantes de enfermería, donde el 63% ostentó una buena tasa de aciertos en conocimientos de paliativos.   The inclusion of palliative care content in university curricula has been gradual. Due to the recent incorporation of palliative care as a subject, an evaluation is necessary in order improve the education of our future health professionals. The objective of this study was thus to assess palliative care knowledge in nursing students at Jaume I University after the transversal inclusion of palliative care content throughout the program, culminating in a subject of an obligatory nature. Method: This observational cross-sectional study was undertaken over the 2017/2018 academic year using the Palliative Care Quiz for Nursing. A descriptive and comparative analysis of the quantitative and qualitative global variables was performed with respect to correct/incorrect responses. Statistical significance was set at p <0.05.Results: The sample included 155 participants, with a mean age of 22.21±6.61 years. Females (n=124) were predominant in the sample (80%). The domain which received the highest number of correct responses was related to the control of pain and symptoms (69.1%) and the domain which received the highest number of incorrect responses was related to philosophy and principles (46.9%). Academic year and prior palliative care experience explained 16% of the variance in knowledge. Conclusions: Through our results, we observed that palliative care education, implemented in a transversal manner and with the completion of compulsory subject in the fourth year, was effective in nursing students, with 63% achieving good scores with respect to palliative care knowledge.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Raes ◽  
Sophie Vandepitte ◽  
Delphine De Smedt ◽  
Herlinde Wynendaele ◽  
Yannai DeJonghe ◽  
...  

Abstract Background Knowledge about the relationship between the residents’ Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes. Methods The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question. Results The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P <  0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes. Conclusion Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.


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