1
|
Varay C, Lareyre O, Baeza-Velasco C. Are Palliative Care Volunteers Special People? A Comparative Observational Study Exploring Their Sociodemographic Profile and Psychological Resources. Am J Hosp Palliat Care 2024; 41:754-761. [PMID: 37538050 DOI: 10.1177/10499091231194036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Faced with rising needs for patient support, palliative care is shifting towards a more community-based approach. Yet the profile of volunteers in this field is poorly known. AIM To explore psychosocial characteristics of palliative care volunteers, by comparing them to two groups, volunteers from the health and social sector without contact with palliative patients, and people from the general population without volunteer activity. DESIGN Observational comparative study. Data were analyzed using descriptive statistics and logistic regression analysis. PARTICIPANTS The 3 groups of participants were recruited in France between September 2020 and June 2021. They completed an online survey assessing sociodemographic characteristics and psychological resources (self-efficacy, hope, optimism, resilience, mindfulness, self-compassion, empathy, forgivingness, and gratitude). RESULTS Data from 559 participants were analyzed. Palliative care volunteers had overall significantly higher levels of psychological resources than control groups. Multivariate analysis revealed, among sociodemographic and psychological characteristics that showed differences between groups at the univariate level, the most efficient predictors of group status. The best criteria to distinguish palliative care volunteers from health and social sector volunteers were older age, having received training, and lower levels of self-compassion. To distinguish palliative care volunteers from people with no volunteer activity, older age and non-active professional status were the best criteria. CONCLUSIONS Palliative care volunteers displayed more psychological resources than controls. However, older age and being trained for volunteering, emerged as stronger factors for distinguishing palliative care volunteers from controls. Pursuing research about these volunteers should facilitate recruitment, training, and retention.
Collapse
Affiliation(s)
- Caroline Varay
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne Billancourt, France
| | - Olivier Lareyre
- Universite Paul Valéry Montpellier 3-Epsylon, Montpellier, France
| | - Carolina Baeza-Velasco
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne Billancourt, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
- CNRS, INSERM, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| |
Collapse
|
2
|
Yoong SQ, Wang W, Seah ACW, Gan JON, Schmidt LT, Zhang H. The experiences of nursing students participating in a student death doula service-learning program in palliative care settings: A qualitative study. DEATH STUDIES 2024:1-11. [PMID: 38587973 DOI: 10.1080/07481187.2024.2337205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Nursing students desire more training and experience in palliative care due to a need for more skills and knowledge. This descriptive qualitative study explored nursing students' experiences in participating in a student death doula service-learning program in palliative care settings. Fourteen final-year undergraduate nursing students participated in semi-structured focus group discussions via Zoom. Four focus group discussions were conducted. Six themes with 19 subthemes were developed: (1) initial feelings of fear and uncertainty, (2) death doula training and orientation, (3) palliative wards being a happier place than expected, (4) experience of watching their patients deteriorate over time, (5) benefits of participating in service-learning in palliative care settings, and (6) improving the service-learning experience. The program was well received by the nursing students, who recommended incorporating it into the nursing curriculum to enhance palliative nursing education. Additional refinements were proposed to better support nursing students during service-learning.
Collapse
Affiliation(s)
- Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Alvin Chuen Wei Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joanne Oon Nee Gan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Assisi Hospice, Singapore, Singapore
| | - Laura Tham Schmidt
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hui Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- St. Andrew's Community Hospital, Singapore, Singapore
| |
Collapse
|
3
|
Yildiz B, van der Heide A, Bakan M, Iversen GS, Haugen DF, McGlinchey T, Smeding R, Ellershaw J, Fischer C, Simon J, Vibora-Martin E, Ruiz-Torreras I, Goossensen A. Facilitators and barriers of implementing end-of-life care volunteering in a hospital in five European countries: the iLIVE study. BMC Palliat Care 2024; 23:88. [PMID: 38561727 PMCID: PMC10985898 DOI: 10.1186/s12904-024-01423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND End-of-life (EoL) care volunteers in hospitals are a novel approach to support patients and their close ones. The iLIVE Volunteer Study supported hospital volunteer coordinators from five European countries to design and implement an EoL care volunteer service on general wards in their hospitals. This study aimed to identify and explore barriers and facilitators to the implementation of EoL care volunteer services in the five hospitals. METHODS Volunteer coordinators (VCs) from the Netherlands (NL), Norway (NO), Slovenia (SI), Spain (ES) and United Kingdom (UK) participated in a focus group interview and subsequent in-depth one-to-one interviews. A theory-inspired framework based on the five domains of the Consolidated Framework for Implementation Research (CFIR) was used for data collection and analysis. Results from the focus group were depicted in radar charts per hospital. RESULTS Barriers across all hospitals were the COVID-19 pandemic delaying the implementation process, and the lack of recognition of the added value of EoL care volunteers by hospital staff. Site-specific barriers were struggles with promoting the service in a highly structured setting with many stakeholders (NL), negative views among nurses on hospital volunteering (NL, NO), a lack of support from healthcare professionals and the management (SI, ES), and uncertainty about their role in implementation among VCs (ES). Site-specific facilitators were training of volunteers (NO, SI, NL), involving volunteers in promoting the service (NO), and education and awareness for healthcare professionals about the role and boundaries of volunteers (UK). CONCLUSION Establishing a comprehensive EoL care volunteer service for patients in non-specialist palliative care wards involves multiple considerations including training, creating awareness and ensuring management support. Implementation requires involvement of stakeholders in a way that enables medical EoL care and volunteering to co-exist. Further research is needed to explore how trust and equal partnerships between volunteers and professional staff can be built and sustained. TRIAL REGISTRATION NCT04678310. Registered 21/12/2020.
Collapse
Affiliation(s)
- Berivan Yildiz
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Agnes van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Misa Bakan
- Research Department, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Grethe Skorpen Iversen
- Regional Centre of Excellence for Palliative Care, Western Norway, Haukeland University Hospital, Bergen, Norway
| | - Dagny Faksvåg Haugen
- Regional Centre of Excellence for Palliative Care, Western Norway, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine K1, University of Bergen, Bergen, Norway
| | - Tamsin McGlinchey
- Palliative Care Unit, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Ruthmarijke Smeding
- Palliative Care Unit, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - John Ellershaw
- Palliative Care Unit, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Claudia Fischer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Eva Vibora-Martin
- CUDECA Institute for Training and Research in Palliative Care, CUDECA Hospice Foundation, Malaga, Spain
| | - Inmaculada Ruiz-Torreras
- CUDECA Institute for Training and Research in Palliative Care, CUDECA Hospice Foundation, Malaga, Spain
| | - Anne Goossensen
- Informal Care and Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| |
Collapse
|
4
|
Kramer I, Schubert M. The use of patient sitters at a Swiss hospital: A retrospective observational study. PLoS One 2023; 18:e0287317. [PMID: 37315098 DOI: 10.1371/journal.pone.0287317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/04/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE Patient sitters are frequently used in acute care hospitals to provide one-to-one care for agitated or disorientated patients to assure the safety and well-being of patients. However, there is still a lack of evidence on the use of patient sitters, especially in Switzerland. Therefore, the aim of this study was to describe and explore the use of patient sitters in a Swiss acute care hospital. METHODS In this retrospective, observational study we included all inpatients who were hospitalized between January and December 2018 in a Swiss acute care hospital and required a paid or volunteer patient sitter. Descriptive statistics were used to describe the extent of patient sitter use, patient characteristics, and organizational factors. For the subgroup analysis between internal medicine and surgical patients Mann-Whitney U tests and chi-square tests were used. RESULTS Of the total of 27'855 included inpatients, 631 (2.3%) needed a patient sitter. Of these, 37.5% had a volunteer patient sitter. The median patient sitter duration per patient per stay was 18.0 hours (IQR = 8.4-41.0h). The median age was 78 years (IQR = 65.0-86.0); 76.2% of patients were over the age of 64. Delirium was diagnosed in 41% of patients, and 15% had dementia. Most of the patients showed signs of disorientation (87.3%), inappropriate behavior (84.6%), and risk of falling (86.6%). Patient sitter uses varied during the year and between surgical and internal medicine units. CONCLUSIONS These results add to the limited body of evidence concerning patient sitter use in hospitals, supporting previous findings related to patient sitter use for delirious or geriatric patients. New findings include the subgroup analysis of internal medicine and surgical patients, as well as analysis of patient sitter use distribution throughout the year. These findings may contribute to the development of guidelines and policies regarding patient sitter use.
Collapse
Affiliation(s)
- Iris Kramer
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Maria Schubert
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| |
Collapse
|
5
|
No One Dies Alone: A Unique Volunteer Program. J Christ Nurs 2023; 40:59-61. [PMID: 36469879 DOI: 10.1097/cnj.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT No One Dies Alone is a hospital-based volunteer program that provides a caring human presence at the end of life for patients when nurses cannot remain at the bedside. No One Dies Alone volunteers offer peace of mind for families who can know their loved ones will not die alone. Volunteers live out the second greatest commandment of loving your neighbor as yourself by providing a calming presence, voice, touch, support, and validation of feelings. A case study illustrates the value of a volunteer's presence.
Collapse
|
6
|
Former à l’accompagnement du deuil : méthodes, publics, résultats. Intérêt de l’approche psychanalytique du groupe en formation. MÉDECINE PALLIATIVE 2022. [DOI: 10.1016/j.medpal.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
7
|
Tierney S, Mahtani KR, Wong G, Todd J, Roberts N, Akinyemi O, Howes S, Turk A. The role of volunteering in supporting well-being - What might this mean for social prescribing? A best-fit framework synthesis of qualitative research. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e325-e346. [PMID: 34337817 DOI: 10.1111/hsc.13516] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/27/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
Volunteering for an organisation, charity or group enables people to make connections with others and to be involved in interesting, worthwhile and/or enjoyable pursuits. Engaging in volunteering can form part of a social prescribing action plan developed between a patient and link worker. Greater understanding of the processes through which volunteering can improve people's well-being as part of social prescribing will help to support link workers in their role. We conducted a best-fit framework synthesis of qualitative literature on volunteering and well-being. Our search of eight electronic databases, complemented by a Google search, conducted in June 2020, resulted in the location of 2210 potentially relevant references. After screening, 335 papers were read in full and 54 drawn upon within the review. They were published between 1993 and 2020. We used the New Economics Foundation's Five Ways to Well-Being model to guide data extraction and synthesis. From this, we developed a conceptual framework that highlights how volunteering can contribute to identity validation and modification leading to the establishment of an acceptable sense of self. Our findings have implications for: (a) the use of volunteering as part of a link worker's toolkit as they seek to support people with varying psychosocial needs and (b) requirements of organisations accepting referrals to volunteering as part of social prescribing.
Collapse
Affiliation(s)
- Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Geoffrey Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Joy Todd
- Gardens, Libraries and Museums (GLAM), University of Oxford, Oxford, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Oluwafunmi Akinyemi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Seth Howes
- Worcester College, University of Oxford, Oxford, UK
| | - Amadea Turk
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
8
|
Helping hands, healing hearts: A qualitative descriptive study on nurses’ perceptions on the use of volunteers in an inpatient hospital setting. Collegian 2022. [DOI: 10.1016/j.colegn.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
9
|
Kaur A, Sharma MP, Chaturvedi SK. Felt Needs of Cancer Palliative Care Professionals Working in India: A Qualitative Study. Indian J Palliat Care 2021; 27:544-551. [PMID: 34898950 PMCID: PMC8655635 DOI: 10.25259/ijpc_125_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/02/2021] [Indexed: 12/04/2022] Open
Abstract
Objectives: Cancer palliative care professionals face a plethora of challenges related to death, dying and suffering apart from limited workforce and other resources in India. However, the grief held by them is underappreciated and psychological needs are under explored. The aim of the present study was to explore felt needs of cancer palliative care professionals working in India. Materials and Methods: The study was cross-sectional, qualitative and in-depth in nature. It was conducted across four cancer palliative care centers in Bengaluru city of India. sample consisted of 15 professionals (mean age = 42 years and standard deviation = 8.41) with at least six months of experience, involved in direct patient care who gave an additional consent for audio-recording. The tools used were sociodemographic and professional datasheet and semi-structured interview guide, which were developed for the present study and validated from five experts. Thematic analysis was used to generate and analyze patterns within the qualitative data. Results: Five themes were identified, namely, death and grief; challenges in practice; strategies for self-care; positive professional experiences; and vision for palliative care. Conclusion: The cancer palliative care professionals need regular support in coping with death and grief, regular trainings and supervision across workplace to deal with occupational challenges, and to address their self-care and spiritual needs. The study highlights need to introduce more specialized training courses in handling pediatric patients, increase palliative care workforce, and hospice units. This can have implications in future research and training with development of innovative interventions to address these needs and challenges.
Collapse
Affiliation(s)
- Amanpreet Kaur
- Research Fellow, The George Institute for Global Health, New Delhi, India
| | - Mahendra P Sharma
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Santosh K Chaturvedi
- Consultant Psychiatrist, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| |
Collapse
|
10
|
Abstract
BACKGROUND Health science students in Spain should be trained to manage the process of death and dying. AIM To compare the perceptions, attitudes and fears of death from a sample of these students. METHODS This descriptive, cross-sectional and multi-centre study comprised 411 students studying degrees in medicine, nursing and physiotherapy. The variables used were the hospice-related death self-efficacy scale by Robbins and the Collet-Lester fear of death scale. FINDINGS The total score obtained on the death self-efficacy scale was 74.43/110, which is considered moderate to high self-efficacy for facing death. Facing the death of a friend at a young age obtained the lowest score (3.85±2.809). Regarding the Collet-Lester scale, the lowest score was 'fear of one's own death' (3.58±0.983) with a value of p=0.81. CONCLUSION The health science students who participated in this study displayed high levels of fear and anxiety towards death.
Collapse
|
11
|
Novaes LMS, Paiva EMDC, O'Mahony A, Garcia ACM. Roleplay as an Educational Strategy in Palliative Care: A Systematic Integrative Review. Am J Hosp Palliat Care 2021; 39:570-580. [PMID: 34350773 DOI: 10.1177/10499091211036703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Simulation activities, such as roleplay, have become established in undergraduate and graduate education in several subjects of healthcare. The objective of this study was to synthesize the evidence available in the literature on the use of roleplay as an educational strategy in palliative care. METHODS Using the method proposed by Whittemore and Knafl, this integrative systematic review was carried out based on the following guiding question: "What is the available evidence in the literature on the use of roleplay as an educational strategy in the teaching of palliative care?" The databases used for the selection of articles were the following: Web of Science, Scopus, Cochrane Library, PubMed, CINAHL, EMBASE, and LILACS. There were no limitations regarding the year of publication or language. RESULTS The articles (n = 34) were grouped into 3 categories, according to the purpose of roleplay use: 1) Use of roleplay as an educational strategy to teach communication in palliative care; 2) Use of roleplay as an educational strategy to teach the communication of bad news, and 3) Use of roleplay as an educational strategy to teach end-of-life care. CONCLUSION Roleplay has been employed in the teaching of palliative care in order to develop skills related to communication and to the provision of end-of-life care. These educational activities have mainly been directed to healthcare students and professionals. Future investigations should further evaluate the efficacy of this teaching strategy, based on studies with more robust designs that allow the establishment of cause-and-effect relationships.
Collapse
Affiliation(s)
| | | | - Aoife O'Mahony
- School of Psychology, 2112Cardiff University, Cardiff, Wales, United Kingdom
| | | |
Collapse
|
12
|
Bloomer MJ, Walshe C. 'It's not what they were expecting': A systematic review and narrative synthesis of the role and experience of the hospital palliative care volunteer. Palliat Med 2020; 34:589-604. [PMID: 32063159 PMCID: PMC7222697 DOI: 10.1177/0269216319899025] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Volunteers make a major contribution to palliative care but little is known specifically about hospital palliative care volunteers. AIM The aim of this study was to understand the role and experience of hospital palliative care volunteers. DESIGN Systematic review and narrative synthesis. DATA SOURCES CINAHL, Embase, Medline, PsycINFO, PubMed and three dissertation databases were searched from inception to June 2019. A forward and backward search of included papers in key journals was also undertaken. Records were independently assessed against inclusion criteria by authors. Included papers were assessed for quality, but none were excluded. RESULTS In total, 14 papers were included. Hospital palliative care volunteers were mostly female, aged above 40 years, and training varied considerably. Volunteers faced unique challenges in supporting dying patients due to the nature of hospital care, rapid patient turnover and the once-off nature of support. Volunteer roles were diverse, with some providing hands-on care, but most focused on 'being with' the dying patient. Volunteers were appreciated for providing psychosocial support, seen as complementary to, rather than replacing the work of health professionals. Given volunteers were often required to work across multiple wards, establishing positive work relationships with health professionals was challenging. Divergent views about whether the volunteer was part of or external to the team impacted volunteers' experience and perceptions of the value of their contribution. CONCLUSION Hospital palliative care volunteers face unique challenges in supporting terminally ill patients. Volunteer support in hospital settings is possible and appropriate, if sufficient support is available to mitigate the challenges associated with complex, high-acuity care.
Collapse
Affiliation(s)
- Melissa J Bloomer
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research, Deakin University, Geelong, VIC, Australia
| | - Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| |
Collapse
|
13
|
Shulman C, Hudson BF, Kennedy P, Brophy N, Stone P. Evaluation of training on palliative care for staff working within a homeless hostel. NURSE EDUCATION TODAY 2018; 71:135-144. [PMID: 30286371 DOI: 10.1016/j.nedt.2018.09.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/19/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In the UK, many people experiencing homelessness whose health is deteriorating remain in homeless hostels due to few suitable alternative places of care. Hostel staff struggle to support residents with deteriorating health and palliative care services are rarely involved. There is recognition of the need for multiagency working to support this group. OBJECTIVES To pilot and evaluate the impact of a two-day training course for hostel staff around supporting clients with palliative care needs, and increasing multiagency working. DESIGN Mixed methods evaluation using pre-and-post training data collection. SETTINGS AND PARTICIPANTS Frontline staff from two London homeless hostels. METHODS Staff from two hostels attended a two day training course. Self-perceived confidence in supporting residents with deteriorating health, knowledge of palliative care, openness to discussing deteriorating health and work related stress were assessed at baseline and immediately after training using a novel questionnaire. Qualitative data was collected via focus groups immediately after and three months post-training. RESULTS Twenty four participants attended at least one day of training, 21 (87%) completed the course. Training was reported to be useful and relevant. Modest improvements in self-perceived work related stress, knowledge, confidence and openness were observed following training. At three months, qualitative data indicated the beginnings of a shift in how palliative care was conceptualised and an increase in knowledge and confidence around supporting residents. Anxiety regarding the role of the hostel in palliative care, the recovery focused ethos of homelessness services and fragmented systems and services presented challenges to establishing changes. CONCLUSIONS Training can be useful for improving knowledge, confidence, openness and work related stress. Recommendations for implementing changes in how people experiencing homelessness are supported include embedding training into routine practice, promoting multidisciplinary working, incorporating flexibility within the recovery focused approach of services and recognising the need for emotional support for staff.
Collapse
Affiliation(s)
- Caroline Shulman
- Pathway, 5th Floor East, 250 Euston Road, London NW1 2PG, UK; Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, 6th Floor, Wing B, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK; Kings Health Partners, Kings College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Briony F Hudson
- Pathway, 5th Floor East, 250 Euston Road, London NW1 2PG, UK; Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, 6th Floor, Wing B, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
| | - Peter Kennedy
- St Mungos, 3 Thomas More Square, Tower Hill, London E1W 1YW, UK
| | - Niamh Brophy
- St Mungos, 3 Thomas More Square, Tower Hill, London E1W 1YW, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, 6th Floor, Wing B, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| |
Collapse
|
14
|
Somes E, Dukes J, Brungardt A, Jordan S, DeSanto K, Jones CD, Sanghvi UJ, Breathett K, Jones J, Lum HD. Perceptions of trained laypersons in end-of-life or advance care planning conversations: a qualitative meta-synthesis. BMC Palliat Care 2018; 17:98. [PMID: 30081957 PMCID: PMC6080535 DOI: 10.1186/s12904-018-0354-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/31/2018] [Indexed: 12/03/2022] Open
Abstract
Background Laypersons including volunteers, community health navigators, or peer educators provide important support to individuals with serious illnesses in community or healthcare settings. The experiences of laypersons in communication with seriously ill peers is unknown. Methods We performed an ENTREQ-guided qualitative meta-synthesis. We conducted a systematic search of MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED to include qualitative studies with data regarding communication and laypersons in advance care planning, palliative care, or end-of-life settings. Study quality was appraised using a standardized tool. The analysis identified key domains and associated themes relating specifically to laypersons’ perspectives on communication. Results Of 877 articles, nine studies provided layperson quotations related to layperson-to-peer communication associated with advance care planning (n = 4) or end-of-life conversations (n = 5). The studies were conducted in United Kingdom (n = 4) or United States settings (n = 5). The synthesis of layperson perspectives yielded five main domains: 1) layperson-to-peer communication, focusing on the experience of talking with peers, 2) layperson-to-peer interpersonal interactions, focusing on the entire interaction between the layperson and peers, excluding communication-related issues, 3) personal impact on the layperson, 4) layperson contributions, and 5) layperson training. Laypersons described using specific communication skills including the ability to build rapport, discuss sensitive issues, listen and allow silence, and respond to emotions. Conclusions Published studies described experiences of trained laypersons in conversations with peers related to advance care planning or end-of-life situations. Based on these layperson perspectives related to communication, programs should next evaluate the potential impact of laypersons in meaningful conversations.
Collapse
Affiliation(s)
- Elizabeth Somes
- Internal Medicine Residency, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joanna Dukes
- University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Adreanne Brungardt
- Division of Geriatric Medicine, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Mail Stop B179, Aurora, CO, 80045, USA
| | - Sarah Jordan
- Division of Geriatric Medicine, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Mail Stop B179, Aurora, CO, 80045, USA
| | - Kristen DeSanto
- Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christine D Jones
- Division of Hospital Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Urvi Jhaveri Sanghvi
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Khadijah Breathett
- Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona, Tucson, AZ, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Hillary D Lum
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA. .,Division of Geriatric Medicine, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Mail Stop B179, Aurora, CO, 80045, USA.
| |
Collapse
|
15
|
Dean A, Willis S. ‘A strange kind of balance’: Inpatient hospice volunteers’ views on role preparation and training. PROGRESS IN PALLIATIVE CARE 2017. [DOI: 10.1080/09699260.2017.1396018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|