Nurses’ experiences of managing vulnerability when working with seriously ill children

The article reflects the importance and importance of the work of nurses of the Department of Palliative Care for Oncological Patients of the State Budget Health Establishment «Samara Regional Clinical Oncological Clinic». Important stages and features of care when dealing with seriously ill patients.

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Optimism

The Oxford Handbook of Positive Psychology ◽

10.1093/oxfordhb/9780195187243.013.0028 ◽

2009 ◽

pp. 302-312 ◽

Cited By ~ 20

Author(s):

Charles S. Carver ◽

Michael F. Scheier ◽

Daniel Fulford

Keyword(s):

Disease Progression ◽

Health Risks ◽

Well Being ◽

Problem Solution ◽

Subjective Well Being ◽

Negative Effects ◽

Negative Feelings ◽

Seriously Ill

Optimism is expecting good things to occur in one's life. Such positive expectations are associated with higher subjective well-being, even under conditions of stress or adversity. In contrast, pessimists respond to adversity with more intense negative feelings. There are also differences in the manner in which optimists and pessimists try to cope with adversity. Optimists tend to put the best face on the adversity, but they acknowledge its existence and its importance, and they try to do as much as possible to resolve whatever problems can be resolved. Pessimists are more likely to distance themselves from the problem and put off doing anything about it as long as possible. They are also more likely to give up trying, if things remain difficult. Some kinds of problem solution is proactive, engaged in before the problem arises. Optimists also tend to engage in such proactive efforts, including taking actions to minimize various kinds of health risks. Perhaps, as a consequence of these preventive steps, optimists also tend to have better health than pessimists. They seem to heal faster from wounds, and there is some evidence that when they are seriously ill they experience slower disease progression. It has been suggested that optimists sometimes are no better off than pessimists, and sometimes are worse off: that their confidence can get them into situations where it is difficult to cope effectively. Evidence of such negative effects of optimism does exist, but it is relatively sparse.

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Home Health Agencies: Empirical Evidence on the Patient-Driven Groupings Model’s Expected Effects on Agency Reimbursements

Home Health Care Management & Practice ◽

10.1177/1084822321990382 ◽

2021 ◽

pp. 108482232199038

Author(s):

Elizabeth Plummer ◽

William F. Wempe

Keyword(s):

Ordinary Least Squares ◽

Process Quality ◽

Home Health ◽

Least Squares Regression ◽

Residual Variation ◽

Health Agencies ◽

Dual Eligible ◽

Home Health Agencies ◽

Seriously Ill Patients ◽

Seriously Ill

Beginning January 1, 2020, Medicare’s Patient-Driven Groupings Model (PDGM) eliminated therapy as a direct determinant of Home Health Agencies’ (HHAs’) reimbursements. Instead, PDGM advances Medicare’s shift toward value-based payment models by directly linking HHAs’ reimbursements to patients’ medical conditions. We use 3 publicly-available datasets and ordered logistic regression to examine the associations between HHAs’ pre-PDGM provision of therapy and their other agency, patient, and quality characteristics. Our study therefore provides evidence on PDGM’s likely effects on HHA reimbursements assuming current patient populations and service levels do not change. We find that PDGM will likely increase payments to rural and facility-based HHAs, as well as HHAs serving greater proportions of non-white, dual-eligible, and seriously ill patients. Payments will also increase for HHAs scoring higher on quality surveys, but decrease for HHAs with higher outcome and process quality scores. We also use ordinary least squares regression to examine residual variation in HHAs’ expected reimbursement changes under PDGM, after accounting for any expected changes related to their pre-PDGM levels of therapy provision. We find that larger and rural HHAs will likely experience residual payment increases under PDGM, as will HHAs with greater numbers of seriously ill, younger, and non-white patients. HHAs with higher process quality, but lower outcome quality, will similarly benefit from PDGM. Understanding how PDGM affects HHAs is crucial as policymakers seek ways to increase equitable access to safe and affordable non-facility-provided healthcare that provides appropriate levels of therapy, nursing, and other care.

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Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

Palliative & Supportive Care ◽

10.1017/s1478951520001200 ◽

2020 ◽

pp. 1-9

Author(s):

Hyunjin Noh ◽

Lewis H. Lee ◽

Chorong Won

Keyword(s):

Older Adults ◽

Palliative Care ◽

Cognitive Impairment ◽

Educational Intervention ◽

Test Scores ◽

Informal Caregivers ◽

Cognitively Impaired ◽

Significant Difference ◽

Post Test ◽

Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

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