scholarly journals Survey evaluations of University of British Columbia residents’ education and attitudes regarding palliative care and physician assisted death

2017 ◽  
Vol 8 (1) ◽  
pp. e6-21 ◽  
Author(s):  
David Spicer ◽  
Sonia Paul ◽  
Tom Tang ◽  
Charlie Chen ◽  
Jocelyn Chase
Keyword(s):  
British Columbia ◽  
Palliative Care ◽  
Online Survey ◽  
Further Education ◽  
Cross Sectional ◽  
Assisted Death ◽  
Structured Education ◽  
University Of British Columbia ◽  
Resident Physicians ◽  
The Subject

Background: Little prior research has been conducted regarding resident physicians’ opinions on the subject of Physician Assisted Death (PAD), despite past surveys ascertaining the attitudes of practicing physicians towards PAD in Canada. We solicited British Columbia residents’ opinions on the amount of education they receive about palliative care and physician assisted death, and their attitudes towards the implementation of PAD.Methods: We conducted a cross sectional, anonymous online survey with the resident physicians of British Columbia, Canada. Questions included: close-ended questions, graded Likert scale questions, and comments. Results: Among the respondents (n=299, response rate 24%), 44% received ≥5 hours of education in palliative care, 40% received between zero and four hours of education, and 16% reported zero hours. Of all respondents, 75% had received no education about PAD and the majority agreed that there should be more education about palliative care (74%) and PAD (85%). Only 35% of residents felt their program provided them with enough education to make an informed decision about PAD, yet 59% would provide a consenting patient with PAD. Half of the respondents believed PAD would ultimately be provided by palliative care physicians.Interpretation: Residents desire further education about palliative care and PAD. Training programs should consider conducting a thorough needs assessment and implementing structured education to meet this need.

scholarly journals The Changing Nature of Palliative Care: Implications for Allied Health Professionals’ Educational and Training Needs

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 112 ◽  
Author(s):  
Deidre D. Morgan ◽  
Deb Rawlings ◽  
Carly J. Moores ◽  
Lizzie Button ◽  
Jennifer J. Tieman
Keyword(s):  
Professional Development ◽  
Palliative Care ◽  
Clinical Practice ◽  
Health Professionals ◽  
Online Survey ◽  
Allied Health ◽  
Further Education ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Education Access

CareSearch is an Australian Government Department of Health funded repository of evidence-based palliative care information and resources. The CareSearch Allied Health Hub was developed in 2013 to support all allied health professionals working with palliative care clients in all clinical settings. This cross-sectional online survey sought to elicit allied health professionals palliative care experiences and subsequent considerations for educational and clinical practice needs. The survey was disseminated nationally via a range of organisations. Data was collected about palliative care knowledge, experience working with palliative care clients and professional development needs. Data were evaluated by profession, experience and practice setting. In total, 217 respondents answered one or more survey questions (94%). Respondents (65%) reported seeing >15 palliative care clients per month with 84% seen in hospital and community settings. Undergraduate education underprepared or partially prepared allied health professionals to work with these clients (96%) and 67% identified the need for further education. Access to postgraduate professional development was limited by available backfill and funding. Study findings support the importance of free, accessible, relevant educational and professional development resources to support clinical practice. This is particularly relevant for allied health professionals who have limited opportunities to attend formal professional development sessions.

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 Role of attitude in nurses’ responses to requests for assisted dying

2020 ◽  
pp. 096973302096677
Author(s):  
Michael Wilson ◽  
Marie Wilson ◽  
Suzanne Edwards ◽  
Lynette Cusack ◽  
Richard Wiechula
Keyword(s):  
Online Survey ◽  
Rare Event ◽  
Control Beliefs ◽  
Assisted Dying ◽  
Cross Sectional ◽  
Assisted Death ◽  
Institutional Ethics ◽  
The Face ◽  
Generalised Linear Modelling ◽  
And Control

Background: Legal assisted dying is a rare event, but as legalisation expands, requests for it will likely increase, and the nurse most often receives the informal, initial request. Objectives: To assess the effects of attitude in interaction with normative and control beliefs on an intention to respond to a request for legal assisted dying. Ethical considerations: The study had the lead author’s institutional ethics approval, and participants were informed that participation was both anonymous and voluntary. Methodology: This was a cross-sectional correlational study of 377 Australian registered nurses who completed an online survey. Generalised linear modelling assessed the effects of independent variables against intended responses to requests for legal assisted dying. Results: Compared to nurses who did not support legal assisted dying, nurses who did had stronger beliefs in patient rights, perceived social expectations to refer the request and stronger control in that intention. Nurses who did not support legal assisted dying had stronger beliefs in ethics of duty to the patient and often held dual intentions to discuss the request with the patient but also held an intention to deflect the request to consideration of alternatives. Discussion: This study advances the international literature by developing quantified models explaining the complexity of nurses’ experiences with requests for an assisted death. Attitude was operationalised in interaction with other beliefs and was identified as the strongest influence on intentions, but significantly moderated by ethical norms. Conclusion: The complex of determinants of those intentions to respond to requests for an assisted death suggests they are not isolated from each other. Nurses might have distinct intentions, but they can also hold multiple intentions even when they prioritise one. These findings present opportunities to prepare nurses in a way that enhances moral resilience in the face of complex moral encounters.

scholarly journals Factors influencing resilience and burnout among resident physicians - a National Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cristina Nituica ◽  
Oana Alina Bota ◽  
John Blebea ◽  
Chin-I Cheng ◽  
Gus J. Slotman
Keyword(s):  
Training Program ◽  
Online Survey ◽  
High Stress ◽  
Institutional Support ◽  
Maslach Burnout Inventory ◽  
Demographic Characteristics ◽  
Burnout Syndrome ◽  
Cross Sectional ◽  
Resident Physicians ◽  
Factors Influencing

Abstract Background Residency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.S. resident physicians. Methods A cross-sectional study was conducted through an online survey, which was distributed to all accredited residency programs by Accreditation Council of Graduate Medical Education (ACGME). The survey included the Connor-Davidson Resilience Scale (CD-RISC 25), Abbreviated Maslach Burnout Inventory, and socio-demographic characteristics questions. The association between burnout, resilience, and socio-demographic characteristics were examined. Results The 682 respondents had a mean CD-RISC score of 72.41 (Standard Deviation = 12.1), which was equivalent to the bottom 25th percentile of the general population. Males and upper-level trainees were more resilient than females and junior residents. No significant differences in resilience were found associated with age, race, marital status, or training program type. Resilience positively correlated with personal achievement, family, and institutional support (p <  0.001) and negatively associated with emotional exhaustion and depersonalization (p <   0.001). Conclusions High resilience, family, and institutional support were associated with a lower risk of burnout, supporting the need for developing a resilience training program to promote a lifetime of mental wellness for future physicians.

scholarly journals Evaluation of Pharmacists' Knowledge of Centers for Medicare and Medicaid Services Medication Drug Plan Star Ratings

2017 ◽  
Vol 8 (4) ◽  
pp. 8
Author(s):  
Alyson O'Leary ◽  
Bella Mehta ◽  
Brianne Porter ◽  
Amy Lehman ◽  
Jennifer L. Rodis
Keyword(s):  
Online Survey ◽  
Community Setting ◽  
Further Education ◽  
Self Assessment ◽  
Chi Square ◽  
Cross Sectional ◽  
Actual Knowledge ◽  
Drug Plan ◽  
Knowledge Based ◽  
High Knowledge

Objectives: 1) Evaluate Ohio pharmacists’ awareness about Centers for Medicare and Medicaid Service’s (CMS) Medication Drug Plan (MDP) Star Ratings, 2) identify gaps in knowledge about CMS MDP Star Ratings, and 3) determine interest in continuing education (CE) opportunities with CMS PDP Star Ratings. Methods: A cross-sectional, online survey was conducted in February 2015. The 16-question, pilot-tested survey targeted licensed pharmacists in Ohio practicing in the ambulatory care or community setting. Respondents were surveyed on their self-assessed and actual knowledge on CMS MDP Star Ratings. Respondent’s interest in and preferred source and delivery of CE were evaluated. Data were collected in aggregate; descriptive statistics, ANOVA and chi-square tests were used to characterize and evaluate data. Responses were summarized for all 16 questions using frequencies and percentages. Results: Of 13,235 licensed Ohio pharmacists, 913 pharmacists completed the survey (6.9% response rate). 454 (49.7%) respondents were eligible to complete the survey based on practice setting and of those, 390 (85.9%) were aware of CMS’s MDP Star Ratings. Respondents’ self-assessment of their knowledge regarding CMS Star Ratings aligned with their actual knowledge as defined by performance on three multi-statement knowledge-based assessments. Significant differences existed between self-assessed knowledge groups in their ability to answer greater than 50% of questions correctly (p < .001). The majority of respondents (81.2%) indicated interest in receiving further education on CMS Star Ratings. Conclusions: Survey respondents are aware of CMS MDP Star Ratings, yet few indicated high knowledge levels on the topic. Gaps in knowledge were identified in development and utilization of the rating system, identifying quality measures, and sources utilized to measure achievement of ratings. Respondents indicated interest in opportunities to improve knowledge on the subject and would prefer education provided by their employer with a live presentation.   Type: Student Project

scholarly journals EXPERIENCE OF LGBT PATIENTS AND FAMILY WITH HOSPICE AND PALLIATIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Palliative Care ◽  
Staff Training ◽  
Online Survey ◽  
Research Policy ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Future Research ◽  
Policy And Practice ◽  
Cross Sectional ◽  
Hospice And Palliative Care

Abstract This study examines the degree to which hospice and palliative care staff observe or perceive inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely to experience discrimination at their institution than non-LGB patients; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Findings reported also include: institutional non-discrimination policy, staff training, intake procedures, and comfort in assessing LGBT status. Implications for future research, policy, and practice will be presented.

PP26  Knowledge, attitudes and practices of UK paramedics regarding pharmacology and the legal, management and administration aspects of medicines: a cross-sectional online quantitative survey

2020 ◽  
Vol 37 (10) ◽  
pp. e12.2-e12
Author(s):  
Samantha Laws ◽  
Mary Halter ◽  
Chao Wang
Keyword(s):  
Online Survey ◽  
Care Quality ◽  
Further Education ◽  
Medicines Management ◽  
Cross Sectional Survey ◽  
Perceived Knowledge ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
The Impact ◽  
Knowledge Attitudes And Practices

BackgroundChanges in the paramedic profession have seen an increased range of medicines available within UK ambulances services. However, poor practice in medicines management has been identified by the Care Quality Commission. Literature in this area is sparse. This study aimed to determine the perceived knowledge, attitudes and practices of paramedics regarding pharmacology and the legal and regulatory issues of medicines management and administration.MethodsThe study utilised a cross-sectional survey design, administering an anonymous online survey to all (approximately 1000) paramedics within one UK NHS ambulance trust. The survey focused on paramedic knowledge on pharmacology, legal supply and administration; self-assessment of knowledge and confidence related to medicine management and administration; and personal characteristics. The primary outcome was percentage of (pre-determined) correct answers.Results251 responses were received. The mean percentage of correct answers was 79.0% (SD 10.0), with variation by question observed, from 34.7 to 97.2% correct responses. A higher correct knowledge was associated with: higher self-rated confidence, lower self-reported knowledge, being less likely to report errors and higher education-based initial route into the paramedic profession.ConclusionThis single-site UK-based survey highlighted variation in medicines knowledge amongst self-selecting paramedic respondents. The results indicate a need for medicines-specific further education for all paramedics, particularly those who have not experienced longer formal education entry routes, integrating a focus on confidence and self-perceived knowledge, and enhancing and embedding integrated improvement strategies. Further research is required with larger, multi-site samples, and to evaluate the impact of education packages developed.

scholarly journals Caring for depression in the dying is complex and challenging – survey of palliative physicians

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Lee ◽  
Sungwon Chang ◽  
Michelle DiGiacomo ◽  
Brian Draper ◽  
Meera R. Agar ◽  
...  
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Online Survey ◽  
Symptom Assessment ◽  
Depression Care ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Training And Research ◽  
Screening Assessment ◽  
Patient Burden

Abstract Background Depression is prevalent in people with very poor prognoses (days to weeks). Clinical practices and perceptions of palliative physicians towards depression care have not been characterised in this setting. The objective of this study was to characterise current palliative clinicians’ reported practices and perceptions in depression screening, assessment and management in the very poor prognosis setting. Methods In this cross-sectional cohort study, 72 palliative physicians and 32 psychiatrists were recruited from Australian and New Zealand Society of Palliative Medicine and Royal Australian and New Zealand College of Psychiatrists between February and July 2020 using a 23-item anonymous online survey. Results Only palliative physicians results were reported due to poor psychiatry representation. Palliative physicians perceived depression care in this setting to be complex and challenging. 40.0% reported screening for depression. All experienced uncertainty when assessing depression aetiology. Approaches to somatic symptom assessment varied. Physicians were generally less likely to intervene for depression than in the better prognosis setting. Most reported barriers to care included the perceived lack of rapidly effective therapeutic options (77.3%), concerns of patient burden and intolerance (71.2%), and the complexity in diagnostic differentiation (53.0%). 66.7% desired better collaboration between palliative care and psychiatry. Conclusions Palliative physicians perceived depression care in patients with very poor prognoses to be complex and challenging. The lack of screening, variations in assessment approaches, and the reduced likelihood of intervening in comparison to the better prognosis setting necessitate better collaboration between palliative care and psychiatry in service delivery, training and research.

scholarly journals The impact of the COVID-19 pandemic on resident physicians: A cross-sectional study

Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Anja Barac ◽  
Paola Krnjaic ◽  
Nikola Vujnovic ◽  
Nino Matas ◽  
Edita Runjic ◽  
...  
Keyword(s):  
Online Survey ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Personal Lives ◽  
Resident Physicians ◽  
Negative Effect ◽  
Stress At Work ◽  
The Impact

BACKGROUND: COVID-19 presents a threat to the mental health of the medical staff working with COVID-19 patients. OBJECTIVE: To investigate the impact of working during the COVID-19 pandemic on resident physicians. METHODS: The study was conducted via anonymous online survey and included resident physicians. The survey contained questions about sociodemographic information, general job satisfaction during the COVID-19 pandemic, and the impact of the COVID-19 pandemic on their personal lives. RESULTS: This study included a response from 728 resident physicians. The majority of residents rated that the COVID-19 pandemic had a mostly negative impact on their satisfaction with professional life (59.9%) and quality of work (62.8%), their personal lives (44.7%) and quality of life (57.1%). Half of all residents indicated that they did not have enough personal protective equipment (PPE). About one-third of residents indicated that the level of stress at work during the COVID-19 pandemic was higher. CONCLUSIONS: Working as resident physicians during COVID-19 pandemic had a negative effect on participants’ professional and personal lives. Residents did not have all the necessary PPE nor felt safe working with patients with suspected or proven COVID-19. Further action is needed to provide support for physician residents working during the COVID-19 pandemic.

scholarly journals The current clinical use of adjuvant analgesics for refractory cancer pain in Japan: a nationwide cross-sectional survey

2020 ◽  
Vol 50 (12) ◽  
pp. 1434-1441
Author(s):  
Keita Tagami ◽  
Hiromichi Matsuoka ◽  
Keisuke Ariyoshi ◽  
Shunsuke Oyamada ◽  
Yusuke Hiratsuka ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Online Survey ◽  
Cord Compression ◽  
Dose Titration ◽  
Pathophysiological Mechanism ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
First Response ◽  
Starting Dose

Abstract Background Although adjuvant analgesics are used to treat opioid-refractory cancer pain, there is insufficient evidence to support this practice and limited data to guide the choice depending on cancer pain pathophysiology, dose titration and starting dose. This survey aimed to clarify the current use of adjuvant analgesics for treating opioid-refractory cancer pain. Methods In this cross-sectional study, we sent an online survey questionnaire to 208 certified palliative care specialists. Primary outcomes were (i) effective pathophysiological mechanism of cancer pain and (ii) initiating doses and time period to the first response to each adjuvant analgesic therapy. Results In total, 87 (42%) palliative care specialists responded. Of all patients with cancer pain, 40% of patients (median) with refractory cancer pain were prescribed adjuvant analgesics. Additionally, 94.3, 93.1 and 86.2% of palliative care specialists found dexamethasone/betamethasone effective for neuropathic pain caused by tumor-related spinal cord compression, pregabalin effective for malignant painful radiculopathy and dexamethasone/betamethasone effective for brain tumor or leptomeningeal metastases-related headache, respectively. The median starting dose of pregabalin, dexamethasone/betamethasone, lidocaine and ketamine were 75, 4, 200, and 50 mg/day, respectively, and the median time to the first response of those medications were 5, 3, 2 and 3 days, respectively. Conclusions Many palliative care specialists select adjuvant analgesics depending on the pathophysiological mechanism of cancer pain in each case. They used such adjuvant analgesics in low doses for cancer pain with short first-response periods.

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