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Pamuk Cebeci S, Bilgiç Ş. Perception of Good Death and Level of Perceived Stress in Relatives of Palliative Care Patients. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241237838. [PMID: 38656222 DOI: 10.1177/00302228241237838] [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: 04/26/2024]
Abstract
This study aimed to examine the perception of a good death and the level of perceived stress in relatives of palliative care patients. Relatives of 110 patients hospitalized in a palliative care center constituted the research sample. A personal information form, the "Good Death Scale," and the "Perceived Stress Scale" were used for data collection. The patients' relatives defined good death as being with family members and living this process without suffering. The mean total Good Death Scale score of the relatives of palliative care patients was 54.86 ± 7.78, and their mean total Perceived Stress Scale score was 31.11 ± 10.10. These findings showed that patients' relatives had high perceptions of good death and that their stress levels were above average. To expand the scope of nursing care, it is important to know how patients' relatives are affected by this process. It is recommended that more studies be conducted on this subject.
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Affiliation(s)
- Sevil Pamuk Cebeci
- Fundamentals of Nursing Department, Faculty of Health Sciences, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Şebnem Bilgiç
- Fundamentals of Nursing Department, Faculty of Health Science, Trakya University, Edirne, Turkey
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2
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Ko S, Park S, Kim J, Subramanian SV, Kim R. Spousal multimorbidity and depressive symptoms among older Indian couples: Do one's own health status and sex matter? GeroScience 2024; 46:885-896. [PMID: 37233884 PMCID: PMC10828161 DOI: 10.1007/s11357-023-00822-5] [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: 03/20/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
With the aging population, increases in non-communicable diseases that require chronic management pose a substantial economic and social burden to individuals with multimorbid conditions and their spousal caregivers. However, little is known about the crossover effect of spousal multimorbidity on mental health outcomes in the context of low- and middle-income countries, and whether it depends on one's own health status and sex. We examined the association between spousal multimorbidity and depressive symptoms using data on 6,158 older couples (12,316 individuals aged 60 years or above) from the Longitudinal Aging Study in India (LASI) 2017-18. Overall, 23.4% of the sample were multimorbid and 27.0% reported having depressive symptoms in the past week. Multivariable logistic regression models showed that spousal multimorbidity was associated with depressive symptoms, even after accounting for one's own multimorbidity status (OR: 1.23; 95% CI: 1.06-1.44). However, this association varied by sex. Among males, their own multimorbidity status was associated with 60% higher odds of having depressive symptoms (OR: 1.60; 95% CI: 1.28-2.00), but spousal multimorbidity was not. Furthermore, for males, the association between spousal multimorbidity and depressive symptoms was contingent upon the presence of their own multimorbidity. Among females, spousal multimorbidity was significantly associated with depressive symptoms, regardless of their own multimorbidity status. Our findings indicate that interventions to promote healthy aging should expand the formal caregiving system and consider family-based approaches to minimize the crossover health consequences of chronic morbidity in conjugal relationships, especially for females.
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Affiliation(s)
- Soohyeon Ko
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Sungchul Park
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
- BK21 Four R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Jinho Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
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3
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Dolmans RGF, Robertson FC, Eijkholt M, van Vliet P, Broekman MLD. Palliative Care in Severe Neurotrauma Patients in the Intensive Care Unit. Neurocrit Care 2023; 39:557-564. [PMID: 37173560 PMCID: PMC10689547 DOI: 10.1007/s12028-023-01717-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/17/2023] [Indexed: 05/15/2023]
Abstract
Traumatic brain injury (TBI) is a significant cause of mortality and morbidity worldwide and many patients with TBI require intensive care unit (ICU) management. When facing a life-threatening illness, such as TBI, a palliative care approach that focuses on noncurative aspects of care should always be considered in the ICU. Research shows that neurosurgical patients in the ICU receive palliative care less frequently than the medical patients in the ICU, which is a missed opportunity for these patients. However, providing appropriate palliative care to neurotrauma patients in an ICU can be difficult, particularly for young adult patients. The patients' prognoses are often unclear, the likelihood of advance directives is small, and the bereaved families must act as decision-makers. This article highlights the different aspects of the palliative care approach as well as barriers and challenges that accompany the TBI patient population, with a particular focus on young adult patients with TBI and the role of their family members. The article concludes with recommendations for physicians for effective and adequate communication to successfully implement the palliative care approach into standard ICU care and to improve quality of care for patients with TBI and their families.
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Affiliation(s)
- Rianne G F Dolmans
- Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
| | - Faith C Robertson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Marleen Eijkholt
- Department of Ethics and Law in Healthcare, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter van Vliet
- Department of Intensive Care Medicine, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Marike L D Broekman
- Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Department of Neurosurgery, Haaglanden Medical Centre, The Hague, The Netherlands
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Pankratz L, Gill G, Pirzada S, Papineau K, Reynolds K, Riviere CL, Bolton JM, Hensel JM, Olafson K, Kredentser MS, El-Gabalawy R, Hiebert T, Chochinov HM. "It took so much of the humanness away": Health care professional experiences providing care to dying patients during COVID-19. DEATH STUDIES 2023; 48:706-718. [PMID: 37938174 DOI: 10.1080/07481187.2023.2266639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
COVID-19 has affected healthcare in profound and unprecedented ways, distorting the experiences of patients and healthcare professionals (HCPs) alike. One area that has received little attention is how COVID-19 affected HCPs caring for dying patients. The goal of this study was to examine the experiences of HCPs working with dying patients during the COVID-19 pandemic. Between July 2020-July 2021, we recruited HCPs (N = 25) across Canada. We conducted semi-structured interviews, using a qualitative study design rooted in constructivist grounded theory methodology. The core themes identified were the impact of the pandemic on care utilization, the impact of infection control measures on provision of care, moral distress in the workplace, impact on psychological wellbeing, and adaptive strategies to help HCPs manage emotions and navigate pandemic imposed changes. This is the first Canadian study to qualitatively examine the experiences of HCPs providing care to dying patients during the COVID-19 pandemic. Implications include informing supportive strategies and shaping policies for HCPs providing palliative care.
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Affiliation(s)
- Lily Pankratz
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gagan Gill
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salina Pirzada
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kelsey Papineau
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christian La Riviere
- Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jennifer M Hensel
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kendiss Olafson
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Maia S Kredentser
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Anesthesiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tim Hiebert
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Soriano GP, Calong Calong KA, Martinez RCKP, Ito H, Yasuhara Y, Abalos EA, Tanioka T. Development and psychometric properties of the Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines. BELITUNG NURSING JOURNAL 2023; 9:512-519. [PMID: 37901374 PMCID: PMC10600707 DOI: 10.33546/bnj.2906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/31/2023] Open
Abstract
Background Over the years, a few tools and instruments have been developed to assist in the assessment within a palliative care setting. However, many of these tools and instruments do not reflect a person-centered palliative care model. Objective This study aims to develop a Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines. Methods An exhaustive search of the literature was conducted to develop a pool of items for the instrument. The validity of the instrument was evaluated using the content validity index (CVI), while the factor structure was assessed using exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation. Also, the internal reliability was evaluated using Cronbach's alpha. Results EFA yielded three factors: 1) Caring as maintaining person's dignity (13 items), 2) caring as empowerment of person's autonomy (14 items), and 3) caring as understanding person's momentary concerns (10 items). Whereas the internal consistency reliability of these subscales appeared excellent (i.e., 0.95, 0.96, and 0.93, respectively), the Cronbach's alpha for the overall scale was 0.98. The item-total correlation coefficients were >0.30 for all items, ranging from 0.310 to 0.726. Conclusion Findings support a three-factor, 37-item PPCNI that can be used in clinical practice to ensure that nurses provide palliative care based on patient needs and preferences.
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Affiliation(s)
- Gil P. Soriano
- Graduate School of Health Sciences, Tokushima University, Tokushima, Japan
- College of Allied Health, Department of Nursing, National University Philippines
| | | | | | - Hirokazu Ito
- Department of Nursing, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yuko Yasuhara
- Department of Nursing, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | | | - Tetsuya Tanioka
- Department of Nursing, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
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Ongko E, Philip J, Zomerdijk N. Perspectives in preparedness of family caregivers of patients with cancer providing end-of-life care in the home: A narrative review of qualitative studies. Palliat Support Care 2023:1-11. [PMID: 37496385 DOI: 10.1017/s1478951523001013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Many patients with advanced cancer identify home as being their preferred place of death. A critical component in achieving a home death is the support of family members, who often take on responsibilities for which they feel insufficiently prepared with subsequent impacts upon their health and well-being. OBJECTIVES This study sought to review existing qualitative literature on family carers' experiences in providing end-of-life care at home for patients with advanced cancer, with an emphasis on exploring factors that influence how prepared they feel for their role. METHODS A narrative review was chosen to provide an overview and analysis of qualitative findings. MEDLINE, PubMed, PsychINFO, and EMBASE databases were searched with the following search terms: "Cancer," "Caregiver," "End of Life Care," "Home," and "Qualitative." Inclusion criteria were as follows: English language, empirical studies, adult carers, and articles published between 2011 and 2021. Data were abstracted, and study quality was assessed using the Critical Appraisal Skills Programme checklist for qualitative research. RESULTS Fourteen relevant articles were included. Three overarching themes reflecting the factors influencing family preparedness for their role were identified: "motivations for providing care," "interactions with health-care professionals," and "changes during the caring process." SIGNIFICANCE OF RESULTS Inadequate preparation of family carers is apparent with regard to their role in providing end-of-life care at home for patients with advanced cancer. There is a need for health-care workers to more effectively identify the information and support needs of families, and utilize evidence-based strategies that have emerged to address these needs.
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Affiliation(s)
- Emily Ongko
- Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Jennifer Philip
- Parkville Integrated Palliative Care Service, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Parkville, VIC, Australia
- Department of Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Nienke Zomerdijk
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
- Victorian Comprehensive Cancer Centre Alliance, Melbourne, VIC, Australia
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Chochinov HM. Intensive Caring: Reminding Patients They Matter. J Clin Oncol 2023; 41:2884-2887. [PMID: 37075272 PMCID: PMC10414729 DOI: 10.1200/jco.23.00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/05/2023] [Accepted: 03/09/2023] [Indexed: 04/21/2023] Open
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Micklewright K, Farquhar M. Face and content validity of the Carer Support Needs Assessment Tool (CSNAT), and feasibility of the CSNAT intervention, for carers of patients with chronic obstructive pulmonary disease. Chronic Illn 2022; 18:532-548. [PMID: 33761766 PMCID: PMC9397385 DOI: 10.1177/1742395321999433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Informal carers of patients with Chronic Obstructive Pulmonary Disease (COPD) have unmet support needs. Evidence relating to carers' support needs in chronic conditions informed version 3 of the Carer Support Needs Assessment Tool (CSNAT) which forms part of an intervention to identify and address carer support needs. Aim of study: to establish the face and content validity of CSNAT v3 for use with COPD carers and explore their views on delivery of the CSNAT Intervention in practice. METHODS Focus groups conducted September-October 2019 in non-clinical settings recruited eleven COPD carers (two to six participants per group). COPD patients (n = 2) attended one group to facilitate carer attendance, the impact of which is discussed. Most participating carers were female (n = 10); carers' ages ranged 52-79 years. RESULTS CSNAT v3 was easy to understand and complete, and all 15 domains were considered relevant and appropriate, suggesting good face and content validity. The demeanour, relational skills, and knowledge of the CSNAT facilitator appeared more important to carers than being a certain practitioner type. DISCUSSION COPD carers considered the CSNAT Intervention an acceptable way of identifying and responding to their needs. The intervention could potentially be delivered through a range of services.
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Affiliation(s)
- Kerry Micklewright
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK
| | - Morag Farquhar
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK
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Luu KL, Witkamp FE, Nieboer D, Bakker EM, Kranenburg LW, van der Rijt CCD, Lorig K, van der Heide A, Rietjens JAC. Effectiveness of the "Living with Cancer" peer self-management support program for persons with advanced cancer and their relatives: study protocol of a non-randomized stepped wedge study. Palliat Care 2022; 21:107. [PMID: 35692043 PMCID: PMC9188837 DOI: 10.1186/s12904-022-00994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Persons with advanced cancer and their relatives experience physical, emotional, and psychosocial consequences of the illness. Most of the time, they must deal with these themselves. While peer self-management support programs may be helpful, there is little evidence on their value for this population. We present the research protocol of our SMART study that will evaluate the effectiveness of the “Living with Cancer” peer self-management support program, aimed at improving self-management behaviors, self-efficacy, and health-related quality of life of persons with advanced cancer and their relatives. Methods We will conduct a non-randomized stepped wedge study in the Netherlands. We will include 130 persons with advanced cancer and 32 relatives. Participants can choose to either start the program within 4 weeks after inclusion or after eight to 10 weeks. The “Living with Cancer” is a peer self-management support program, based on the Chronic Disease Self-Management Program. It consists of six 1,5 hours video-conferencing group meetings with eight to 12 participants, preceded by two or three preparatory audio clips with supportive text per session. The program has the following core components: the learning of self-management skills (action-planning, problem-solving, effective communication, and decision-making), discussing relevant themes (e.g. dealing with pain and fatigue, living with uncertainty, and future planning), and sharing experiences, knowledge, and best practices. The primary outcome for both persons with advanced cancer and relatives is self-management behavior assessed by the subscale “constructive attitudes and approaches” of the Health Education Impact Questionnaire. Secondary outcomes are other self-management behaviors, self-efficacy, health-related quality of life, symptoms, depression and anxiety, and loneliness. Participants complete an online questionnaire at baseline, and after eight and 16 weeks. After each session, they complete a logbook about their experiences. Group meetings will be video recorded. Discussion SMART aims to evaluate an innovative program building on an evidence-based self-management program. New features are its use for persons with advanced cancer, the inclusion of relatives, and the video-conferencing format for this population. The use of both quantitative and qualitative analyses will provide valuable insight into the effectiveness and value of this program. Trial registration This study was registered in the Dutch Trial Register on October 2021, identifier NL9806. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00994-5.
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Affiliation(s)
- K L Luu
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Center of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - D Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - E M Bakker
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - L W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - K Lorig
- Stanford School of Medicine, CA, Stanford, USA
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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What does it mean to be the main caregiver to a terminally ill family member in Lithuania?: A qualitative study. PLoS One 2022; 17:e0265165. [PMID: 35551302 PMCID: PMC9098011 DOI: 10.1371/journal.pone.0265165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/25/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Family caregivers are a great resource for providing dignified end-of-life care for terminally ill patients. Framed from the perspective of role theory and the relational nature of providing and receiving care, study objectives were as follows: (1) to capture caregivers’ understanding of the process of taking on the role of main caregiver, (2) to conceptualize their understanding of the functions that they assume while being the main caregivers, and (3) to understand how they experienced the consequences they confronted.
Methods
The research team employed the methodological strategy of descriptive thematic analysis using a semi-structured interview guide. The sample consisting of 33 family caregivers was recruited using purposeful and snowball sampling strategies in 2020. Interview data was analyzed using content-driven inductive thematic analysis.
Results
The data analysis revealed four main themes that structure the process of becoming the main care giver of a terminally ill family member and the meaning of the caregiver role: (1) inaccessibility and mistrust of public care services for persons with terminal illness, (2) moral obligations and responsibilities of immediate family and friends, (3) cultural traditions, (4) the caregiver feels responsible for everything. The themes describe the social role of family caregiver in social context, address the process of taking on the role of caregiver and living with systemic corruption.
Conclusions
Recognition of caregiving experiences is essential in planning better systems, in direct practice and in confronting corruption. The study suggests the need for open communication, accessibility of quality services, and the recognition of caregivers as care-team members. The larger implication is that the increasing numbers of distressed caregivers and aging populations can be considered as public health populations, and thus addressable through public health methods.
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Laperle P, Achille M, Ummel D. To Lose a Loved One by Medical Assistance in Dying or by Natural Death with Palliative Care: A Mixed Methods Comparison of Grief Experiences. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221085191. [PMID: 35420908 DOI: 10.1177/00302228221085191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The integration of assisted dying into end-of-life care is raising reflections on bereavement. Patients and families may be faced with a choice between this option and natural death assisted by palliative care; a choice that may affect grief. Therefore, this study describes and compares grief experiences of individuals who have lost a loved one by medical assistance in dying or natural death with palliative care. A mixed design was used. Sixty bereaved individuals completed two grief questionnaires. The qualitative component consisted of 16 individual semi-structured interviews. We found no statistically significant differences between medically assisted and natural deaths, and scores did not suggest grief complications. Qualitative results are nuanced: positive and negative imprints may influence grief in both contexts. Hastened and natural deaths are death circumstances that seem to generally help ease mourning. However, they can still, in interaction with other risk factors, produce difficult experiences for some family caregivers.
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Affiliation(s)
- Philippe Laperle
- Department of Psychology, 141639Université de Montréal, Montreal, Canada
| | - Marie Achille
- Department of Psychology, 141639Université de Montréal, Montreal, Canada
| | - Deborah Ummel
- Department of Psychoeducation, 7321Université de Sherbrooke, Longueuil, Canada
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Kørner H, Guren MG, Larsen IK, Haugen DF, Søreide K, Kørner LR, Søreide JA. Characteristics and fate of patients with rectal cancer not entering a curative-intent treatment pathway: A complete nationwide registry cohort of 3,304 patients. Eur J Surg Oncol 2022; 48:1831-1839. [DOI: 10.1016/j.ejso.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/03/2022] [Accepted: 04/19/2022] [Indexed: 11/11/2022] Open
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Khosravi F, Fereidooni-Moghadam M, Mehrabi T, Moosavizade SR. The Effect of a Spirituality-Based Program on Stress, Anxiety, and Depression of Caregivers of Patients with Mental Disorders in Iran. JOURNAL OF RELIGION AND HEALTH 2022; 61:93-108. [PMID: 34417681 DOI: 10.1007/s10943-021-01372-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
One of the important issues regarding caring for patients with mental disorders is the high prevalence of stress, anxiety, and depression in their caregivers. This study aimed to investigate the effect of a spirituality-based program on stress, anxiety, and depression of caregivers of patients with mental disorders. This clinical-trial study involved 60 family caregivers of patients with mental disorders who were referred to the clinic of Shahid Ayatollah Modarres Psychiatric Hospital in Isfahan, Iran, during 2019-2020. Accordingly, the samples were selected using convenient sampling method and then divided into two groups of experimental and control by simple random allocation. Next, the spirituality-based intervention was performed for the intervention group, and the needed data were collected in both intervention and control groups before, immediately after, and one month after the intervention. The data collection tool used in this study was DASS-21 questionnaire. No significant differences were observed between the two groups in terms of the mean scores of stress, anxiety, and depression (p > 0.05) before the intervention. However, some significant differences were found in terms of the stress, anxiety, and depression scores between the two groups immediately (p < 0.001) and one month after the intervention (p < 0.001). The spirituality-based program seemed to affect stress, anxiety, and depression of caregivers of patients with mental disorders positively. So, it is suggested to perform this intervention as an inexpensive and available supportive method for family caregivers of patients with mental disorders.
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Affiliation(s)
- Fateme Khosravi
- Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Malek Fereidooni-Moghadam
- Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Tayebe Mehrabi
- Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Informal caregivers of older Muslims diagnosed with cancer: A portrait of depression, social support, and faith. Palliat Support Care 2021; 19:598-604. [PMID: 34676809 DOI: 10.1017/s147895152100081x] [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: 12/15/2022]
Abstract
OBJECTIVE Islamic population constitute more than 20% of the world population and is growing rapidly. Nevertheless, data concerning informal caregiving to older Muslim patients diagnosed with cancer are scarce. Improving the well-being of caregivers is a vital step to optimal care for the patients themselves throughout the Muslim community and the world. This study focuses on a sample of Palestinian caregivers of older Muslim patients diagnosed with cancer living in East Jerusalem, the West Bank, and Gaza. The study aims to describe the socio-demographic characteristics of the caregivers and to understand their social support, and identify predictors of caregivers' depression. METHODS A cross-sectional study of a convenience sample of 99 dyads of Palestinian patients (age ≥65) and their informal caregivers. Depression and social support were measured using the five items of the Geriatric Depression Scale and the Cancer Perceived Agents of Social Support questionnaire. RESULTS Caregivers were most frequently adult children (52%) or spouses (32%), with male patients cared for by spouses (47.5%) or sons (32%), and female patients by daughters (50%). Clinical levels of depression were reported by 76% of the caregivers and 85% of patients. The significant predictors of caregiver depression were female gender, lower education, lower perceived social support from spouse and family, and higher perceived support from faith. SIGNIFICANCE OF RESULTS Healthcare providers serving the study population should determine the position and role of the caregiver within the social and family structure surrounding the patients' families. This understanding may facilitate overcoming barriers to effective and meaningful social support.
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Laperle P, Achille M, Ummel D. The relational landscape of bereavement after anticipated death: An interpretive model. DEATH STUDIES 2021; 46:2485-2497. [PMID: 34520318 DOI: 10.1080/07481187.2021.1975177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
To complement existing literature and better capture the diversity of factors influencing grief, a more interpersonal understanding is required. Thus, we used the relational landscape's concept and empirical investigation to clarify the roles of individuals surrounding the bereaved. Sixteen interviews with bereaved individuals by euthanasia or natural death were analyzed using Interpretive Description. We present a model describing five types of actors in the environment of the bereaved and their ways of "being with" or giving space. We also include four lived landscapes in our model, with the purpose of describing how bereavement can be experienced within the social environment.
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Affiliation(s)
- Philippe Laperle
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Marie Achille
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Deborah Ummel
- Department of Psychoeducation, Université de Sherbrooke, Longueuil, Canada
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Gawinski L, Stiel S, Schneider N, Herbst FA. Communication in dyads of adult children at the end of life with their parents and parents at the end of life with their adult children: Findings from a mixed-methods study. Psychooncology 2021; 30:1535-1543. [PMID: 33982826 DOI: 10.1002/pon.5728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/30/2021] [Accepted: 05/10/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Patient-family member communication plays a decisive role in coping with an end-of-life situation and is strongly influenced by the dyadic relationship. There is a lack of research exploring and comparing the specifics of communication between (1) terminally ill adult children and their parents and (2) terminally ill parents and their adult children. The present study aimed at describing and comparing communication specifics within these two dyads. METHODS As part of the research project Dy@EoL on parent-adult child interactions, this mixed-methods study combined qualitative interviews and the Berlin Social Support Scales self-report questionnaire. Participants in both dyads were recruited via 12 inpatient and ambulatory palliative/hospice care providers between February 2018 and September 2019. RESULTS Participants included 65 patients (dyad 1: 19; dyad 2: 46) and 42 family members (dyad 1: 13; dyad 2: 29). Qualitative interviews revealed communication changes in the terminal illness situation and provided insight into each dyad partner's perception of openness and avoidance in the dyadic communication. The quantitative results showed that patients in both dyads provided significantly less informational support relative to family members. A strong similarity present in both dyads was the central motivation for limiting information sharing. CONCLUSIONS Individual preferences for information sharing suggest that the divergent needs of dyad partners must be carefully negotiated to ensure that patients are able to address important topics without putting too great an emotional burden on their family members. Tailored psychosocial support measures are needed to achieve this goal. The study was registered prospectively in the German Clinical Trials Register (registration N° DRKS00013206).
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Affiliation(s)
- Laura Gawinski
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Stephanie Stiel
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Nils Schneider
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Franziska A Herbst
- Institute for General Practice, Hannover Medical School, Hannover, Germany
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Butola S, Bhatnagar S, Rawlinson F. Caring and Conflict-Palliative Care in the Armed Forces: The Challenges for Caregivers. Indian J Palliat Care 2021; 27:405-418. [PMID: 34898934 PMCID: PMC8655645 DOI: 10.25259/ijpc_393_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES In India, Palliative care remains inaccessible, especially in remote areas. This study aimed at exploring the experience of caregivers related to arranging palliative care at home, for personnel and family members of an armed force. MATERIALS AND METHODS Qualitative study based on thematic analysis of semi-structured interviews with adult caregivers - either serving personnel or their dependent family members. RESULTS Lack of palliative care in rural areas makes arranging home care challenging for Indian caregivers, especially in armed forces. The families stay alone and personnel cannot be there to look after loved ones. Constraints of leave, financial and legal problems, frequent movement and social isolation disrupt care as well as family and community support systems, leading to psycho-social problems and stress for the serving personnel as well as families. Educating staff, integrating palliative care into existing medical services, coordinating with other agencies to increase awareness and provide care at home, access to opioids, timely leave, reimbursement of expenses, increased family accommodation, guidance about benefits, and considerate implementation of transfer policy can help mitigate some of their problems. CONCLUSION These caregivers face physical exhaustion, psycho-social, financial, legal, and spiritual issues- some common to all rural Indians and others unique to the armed forces. Understanding their experiences will help the providers find solutions, especially in relation to the unique needs of the men in uniform.
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Affiliation(s)
- Savita Butola
- Border Security Force, Gwalior, Madhya Pradesh, India
| | - Sushma Bhatnagar
- Department of Oncoanaesthesia and Palliative Medicine, Dr. B.R.A IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Fiona Rawlinson
- Centre for Medical Education, Cardiff university, Wales, United kingdom
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18
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The validity and reliability of the Turkish version of the Family Inventory of Needs. Palliat Support Care 2021; 20:255-263. [PMID: 34158143 DOI: 10.1017/s1478951521000833] [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: 11/07/2022]
Abstract
OBJECTIVE The aim of this methodological study was to test the validity and reliability of the Turkish version of the Family Inventory of Needs. METHODS The universe of the study consisted of 300 family members of inpatients hospitalized in the palliative care units of four hospitals in northern Turkey between April 12, 2019 and December 30, 2019. The translation process was performed in multiple stages using the forward-backward translation model. The reliability of the Family Inventory of Needs was evaluated using the Cronbach α reliability coefficient and item-total score correlations. Exploratory factor analyses were applied to examine the factor structure of the scale and its construct validity. To test the time invariance of the scale, the relationships between the scores obtained from the first and second applications were examined using the intraclass correlation coefficient (ICC). RESULTS The Kaiser-Meyer-Olkin value of the Family Inventory of Needs was found to be 0.893. The items of the Family Inventory of Needs were found to explain 45.23% of the total variance in scores. The Turkish form of the scale consisted of the importance and fulfillment subdimensions, and had 19 items. The ICCs of the test-retest scores of the importance and fulfillment subdimensions of the Family Inventory of Needs were found to be, respectively, ICC = 1.000 and ICC = 0.730 with a positive, linear, and highly significant relationship between the scores. The item-total score correlation coefficients of the scale were found to vary between 0.920 and 0.908 in the importance subdimension, and between 0.930 and 0.922 in the fulfillment subdimension. SIGNIFICANCE OF RESULTS The Turkish version of the Family Inventory of Needs was found to be a valid and reliable measurement tool that can be safely used with the family members of Turkish inpatients.
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Aghaie B, Anoosheh M, Foroughan M, Mohammadi E, Kazemnejad A. A Whirlpool of Stress in Families of Intensive Care Unit Patients: A Qualitative Multicenter Study. Crit Care Nurse 2021; 41:55-64. [PMID: 34061191 DOI: 10.4037/ccn2021322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family members of patients admitted to the intensive care unit must tolerate high levels of stress, making them emotionally and physically vulnerable. However, little is known about the kinds of stress family members may experience. OBJECTIVE To explore perceived stress in the families of patients admitted to the intensive care unit. METHODS This qualitative content analysis study involved 23 family members of patients admitted to intensive care units. Participants were drawn from family members of patients hospitalized in intensive care units of 3 public and 2 private hospitals. Data were collected through semistructured interviews. RESULTS Three themes emerged from the data: "distrust," "repeated stress exposure," and "a whirlpool of persistent negative emotional-physical state." The first theme had 2 categories: "fearful mindset" and "negative beliefs about professional caregivers." The second theme also had 2 categories: "fear of the future" and "sustained accumulation of tensions." The third theme had 3 categories: "impaired mental health," "impaired physical health," and "impaired family function." CONCLUSIONS The findings of this study may help critical care nurses better understand the nature and sources of family stresses during a patient's intensive care unit stay. Supervisory nurses should alert their staff to these issues so that family care programs can address them, thereby reducing family members' risk of posttraumatic stress disorder and post-intensive care syndrome-family.
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Affiliation(s)
- Bahman Aghaie
- Bahman Aghaie is an assistant professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Monireh Anoosheh
- Monireh Anoosheh is an associate professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahshid Foroughan
- Mahshid Foroughan is an associate professor, Research Center on Aging, Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Esa Mohammadi
- Esa Mohammadi is a professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University
| | - Anoshirvan Kazemnejad
- Anoshirvan Kazemnejad is a professor, Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University
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Micklewright K, Farquhar M. Does the carer support needs assessment tool cover the established support needs of carers of patients with chronic obstructive pulmonary disease? A systematic literature search and narrative review. Palliat Med 2020; 34:1305-1315. [PMID: 32669040 PMCID: PMC7543023 DOI: 10.1177/0269216320939243] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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 Informal carers play a key supportive role for patients with chronic obstructive pulmonary disease. However, caring can have a considerable impact on health and wellbeing. Carers may have unidentified support needs that could be a target for intervention. Literature on the support needs of informal carers has not been fully synthesised, and our knowledge of the comprehensiveness of the Carer Support Needs Assessment Tool for these individuals is limited. AIM To explore whether the Carer Support Needs Assessment Tool covers the support needs of carers of patients with chronic obstructive pulmonary disease identified in published literature. DESIGN English language studies were identified against predetermined inclusion/exclusion criteria through database searching. Further studies were identified through searching reference lists and citations of included papers. Papers were critically appraised and data extracted and synthesised by two reviewers. Identified needs were mapped to Carer Support Needs Assessment Tool questions. DATA SOURCES MEDLINE, CINAHL, EMBASE, CDSR, ASSIA, PsycINFO and Scopus databases (Jan 1997-Dec 2017). RESULTS Twenty-four studies were included. Results suggest that carers have support needs in a range of domains including physical, social, psychological and spiritual. Many of these needs are unmet. Particular areas of concern relate to prolonged social isolation, accessing services, emotional support and information needs. Findings also suggest amendment of the Carer Support Needs Assessment Tool may be required relating to difficulties within relationship management. CONCLUSION Evidence suggests that carers of patients with chronic obstructive pulmonary disease would benefit from identification and response to their support needs by healthcare professionals but to enable this, the Carer Support Needs Assessment Tool requires an additional question. Future planned work will explore this with carers of patients with chronic obstructive pulmonary disease.
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Affiliation(s)
| | - Morag Farquhar
- School of Health Sciences, University of East Anglia, Norwich, UK
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Miller LM, Utz RL, Supiano K, Lund D, Caserta MS. Health profiles of spouse caregivers: The role of active coping and the risk for developing prolonged grief symptoms. Soc Sci Med 2020; 266:113455. [PMID: 33126099 PMCID: PMC7669721 DOI: 10.1016/j.socscimed.2020.113455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/23/2020] [Accepted: 10/14/2020] [Indexed: 12/27/2022]
Abstract
STUDY AIMS 1) To characterize distinct profiles of cancer caregivers' physical and mental health during the end-of-life caregiving period; 2) to identify the background and antecedent factors associated with the distinct profiles of caregivers; 3) to determine the relevance of caregiver profiles to the risk for developing prolonged grief symptoms. DESIGN & METHODS This study was a secondary analysis of spouses/partners (n = 198) who participated in the Cancer Caregiver Study. Latent profile mixture modeling was used to characterize caregiver health profiles from data collected prior to their spouse's death. Regression analyses were used to determine the impact of caregiver health profiles on the risk of developing prolonged grief symptoms (PG-13 scale). RESULTS Two health profiles were identified, one of which was comprised of a minority of caregivers (n = 49; 25%) who exhibited higher anxiety and depressive symptoms, greater health impact from caregiving, more self-reported health problems, and greater difficulty meeting physical demands of daily activities. Caregivers who were observed in this poorer health profile had significantly lower levels of active coping (p < 0.001) in adjusted models. Additionally, according to subsequent bereavement data, caregivers' preloss health profile was a significant predictor of developing prolonged grief symptoms (p = 0.018), controlling for caregivers' age (p = 0.040) and amount of active coping (p = 0.049), and there was a mediating effect of caregiver health on the relationship between active coping and prolonged grief symptoms. CONCLUSIONS Caregiving and bereavement should not be considered separately; caregivers adapt to bereavement with the resources and coping attained throughout the life course, culminating in the experience of providing end-of-life care. Interventions aimed at supporting caregivers and bereaved persons should focus on maintaining physical and mental health during stressful life transitions, and especially during the period in which they are providing care to a spouse at end-of-life.
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Affiliation(s)
| | | | | | - Dale Lund
- California State University San Bernardino, Department of Sociology, USA
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Lund L, Ross L, Petersen MA, Blach A, Rosted E, Bollig G, Juhl GI, Farholt HB, Winther H, Laursen L, Hasse M, Weensgaard S, Guldin MB, Ewing G, Grande G, Groenvold M. Effect of the Carer Support Needs Assessment Tool intervention (CSNAT-I) in the Danish specialised palliative care setting: a stepped-wedge cluster randomised controlled trial. BMJ Support Palliat Care 2020:bmjspcare-2020-002467. [PMID: 33115831 DOI: 10.1136/bmjspcare-2020-002467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND The Carer Support Needs Assessment Tool intervention (CSNAT-I) has been shown to improve end-of-life care support for informal caregivers. This study investigated the impact of the CSNAT-I on caregivers of patients recently enrolled in specialised palliative care (SPC) at home in Denmark. METHODS A stepped-wedge cluster randomised controlled trial with nine clusters (ie, SPC teams). Outcome measures were collected using caregiver questionnaires at baseline (T0) and 2-week (T1) and 4-week (T2) follow-up. RESULTS A total of 437 caregivers were enrolled (control group, n=255; intervention group, n=182). No intervention effect was found on the primary outcome, caregiver strain at T1 (p=0.1865). However, positive effects were found at T1 and T2 on attention to caregivers' well-being (p<0.0001), quality of information and communication (p<0.0001), amount of information (T1: p=0.0002; T2: p<0.0001), involvement (T1: p=0.0045; T2: p<0.0001), talking about greatest burdens (p<0.0001) and assistance in managing greatest burdens (p<0.0001). The effect sizes of these differences were medium or large and seemed to increase from T1 to T2. At T1, positive effects were found on distress (p=0.0178) and home care responsibility (p=0.0024). No effect was found on the remaining outcomes. CONCLUSION Although no effect was found on caregiver strain, the CSNAT-I showed positive effects on caregiver distress, home care responsibility and key outcomes regarding caregivers' experience of the interaction with healthcare professionals. TRIAL REGISTRATION NUMBER NCT03466580.
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Affiliation(s)
- Line Lund
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lone Ross
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Morten Aagaard Petersen
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Elizabeth Rosted
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
| | - Georg Bollig
- Palliative Care Team, Medical Department Soenderborg/Toender, South Jutland Hospital, Soenderborg, Denmark
- Medical Research Unit, Institute of Regional Health Research, University of Southern Denmark, Aabenraa, Denmark
| | - Gitte Irene Juhl
- Palliative Care Unit, Department of Oncology and Palliative Care, North Zealand Hospital, Frederikssund, Denmark
| | - Hanne Bollerup Farholt
- Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Helen Winther
- Palliative Care Unit, Odense University Hospital, Odense, Denmark
| | - Louise Laursen
- Department of Palliative Care, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Mai-Britt Guldin
- Palliative Care Team, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Gail Ewing
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Gunn Grande
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Mogens Groenvold
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Section of Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Boyko RM, Sodhi S, Herman DJ. Evaluation of an Online Home Caregiver Support Program for Non-Professional Caregivers of Patients With Palliative Care Needs. Am J Hosp Palliat Care 2020; 38:1099-1105. [PMID: 33078620 DOI: 10.1177/1049909120968257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Caring for loved ones with palliative needs can be very stressful for carers'. To address this growing issue, an online Home Caregiver Support Program course was created to provide information to non-professional home caregivers about end-of-life care. OBJECTIVES To measure non-professional caregivers' perceived level of competence in addressing physical, psychological, social, and spiritual needs before and after completing online training modules. METHODS Learners rated their competence before and after completing online modules addressing 4 key dimensions relevant to palliative caregivers. Self-ratings of competence were assessed through surveys, completed before and after the online modules. Scores from before and after each module were compared to determine if the online course had increased participant competence. The Wilcoxon signed rank test was used to analyze participant responses to the pre- and post-survey questions. RESULTS A total of 176 participants who completed one or more of the online modules between July 2017-December 2018, 70 (40%) of the participants completed at least one pre- and post-module survey and did not declare themselves as a professional caregiver. Participating in the online Home Caregiver Support Program increased participants' ratings of perceived competence in all domains (p < .01). This significance was maintained when professional caregivers were added to our analysis. CONCLUSION After the completing the modules, participants' self-ratings of perceived competence increased suggesting that participants completing the online program had improved knowledge in addressing the physical, psychological, social, and spiritual challenges faced by non-professional caregivers.
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Affiliation(s)
- Robert M Boyko
- 12366Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sukhmani Sodhi
- 12366Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dakoda J Herman
- 12366Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Gott M, Morgan T, Williams L. Gender and palliative care: a call to arms. Palliat Care Soc Pract 2020; 14:2632352420957997. [PMID: 33134926 PMCID: PMC7576896 DOI: 10.1177/2632352420957997] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/17/2020] [Indexed: 12/11/2022] Open
Abstract
There has been a systematic and largely unconscious neglect of gender in
palliative care research, practice and policy. This is despite significant,
although previously uncollated, evidence that gender influences almost all
aspects of end-of-life preferences, experiences and care. The social situations
of women, transgender people and men often differ from one another while also
intersecting in complex ways with sex differences rooted in biology. If
palliative care is to meet its aspiration of providing universal benefit, it
urgently needs to address a range of gender inequalities currently (re)produced
at the level of the laboratory all the way through to government departments. In
this call to arms, we spotlight specific instances where gender inequalities
have been documented, for example, regarding end-of-life caregiving, end-of-life
intervention and palliative care access and benefit. We highlight how gender
inequalities intersect with other social determinants of health including
ethnicity and economic status to exacerbate situations of marginality. We
conclude by offering some practical steps that can be taken to support the
discipline to adopt a more critical gender lens to support more equitable
research, policy and practice.
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Affiliation(s)
- Merryn Gott
- Professor, School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Tessa Morgan
- Department of Public Health and Primary Care and Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Gregory C, Gellis Z. Problem Solving Therapy for Home-Hospice Caregivers: A Pilot Study. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2020; 16:297-312. [PMID: 32865148 DOI: 10.1080/15524256.2020.1800554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This pilot study examined the effects of Brief Problem-Solving Therapy on caregiver quality of life, depression, and problem-solving in family caregivers of hospice patients. Thirty-seven family caregivers to home-based hospice patients (mean age 62.8 [SD = 12.32]) were randomized to the study group (PST-Hospice), for a 45 minute per week/5 week intervention or comparison group of usual care plus caregiver education (UC + CE). The severity of depressive symptoms, caregiver quality of life and problem-solving functioning were assessed at baseline and follow-up. At post-test, the PST-Hospice condition had significantly higher scores on caregiver quality of life compared to UC + CE. On the Social Problem Solving Inventory-Revised Short Form (SPSI-R) measure, PST-Hospice scores clinically improved as compared to UC + CE on Positive Problem Orientation and Rational Problem-Solving subscales. In addition, this pilot study found that brief problem-solving treatment delivered by a hospice social worker appears to be an acceptable and feasible tool for routine use in the home-hospice setting.
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Affiliation(s)
- Christin Gregory
- Center for Mental Health and Aging, School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Zvi Gellis
- Center for Mental Health and Aging, School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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26
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Kaur P, Tan WS, Gunapal PPG, Ding YY, Ong R, Wu HY, Hum A. Deaths in dementia: a scoping review of prognostic variables. BMJ Support Palliat Care 2020; 11:242-252. [PMID: 32561548 DOI: 10.1136/bmjspcare-2020-002217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/17/2020] [Accepted: 05/12/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To identify the types of factors included in research examining mortality in patients with dementia, and to stratify the identified factors by care settings. DESIGN We systematically searched PubMed, Embase, PsycINFO and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, and identified grey literature from the Networked Digital Library of Theses and Dissertations, Open Grey and Grey Literature Report. Two authors independently screened for eligibility of studies. Independent reviewers extracted relevant study information. We conducted a narrative synthesis of the data. RESULTS We identified 8254 articles, of which 94 met the inclusion criteria. More than half (n=53) were published between 2009 and 2018 with half from Europe. Studies were conducted across hospices/nursing homes (n=25), hospital (n=23), outpatient clinics (n=21), mixed settings (n=15) and in the community (n=10). Nearly 60% adopted a prospective cohort study design with 87% performing multivariable analysis. Overall, 239 variables were identified and classified into six themes-individual factors, health status, functional ability, cognition and mental health, treatments and health system factors. Although a general set of factors were common across all studies, when stratified by care settings, variations were seen in the specific variables included. CONCLUSION Identifying prognostic variables relevant to the dementia population in each setting is key to facilitate appropriate care plans and to ensure timely access to palliative care options. Future research should also focus on ensuring the replicability of prognostic models and to generate a better understanding of the direct and interacting influence of the identified factors on mortality.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Woan Shin Tan
- Health Services and Outcomes Research, National Healthcare Group, Singapore.,Palliative Care Centre for Excellence in Research and Education, Singapore
| | | | - Yew Yoong Ding
- Geriatric Education and Research Institute, Singapore.,Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - Reuben Ong
- Health Services and Outcomes Research, National Healthcare Group, Singapore
| | - Huei Yaw Wu
- Palliative Care Centre for Excellence in Research and Education, Singapore.,Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore
| | - Allyn Hum
- Palliative Care Centre for Excellence in Research and Education, Singapore .,Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore
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Challenges, Coping Strategies, and Social Support among Breast Cancer Patients in Ghana. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/4817932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background. Despite the high incidence and mortality rate of breast cancer (BC) in Ghana, little attention has been given to the issue of how adult women cope with having BC. The aim of this study was to explore the challenges, coping strategies, and support systems among women diagnosed with BC in Ghana. Methods. A descriptive cross-sectional study was conducted from February to August 2017 at the Komfo Anokye Teaching Hospital (KATH), Ghana. A systematic random sampling technique was used to select 202 women with a confirmed diagnosis of BC. Coping strategies of women with BC were assessed using the Brief-COPE. The associations between sociodemographic characteristics, social network/support, and coping strategies were assessed using linear regression models. Results. The most and least adopted active coping strategies were religious coping and humors, respectively. Self-distraction and substance use were the most and least adopted avoidant coping strategies, respectively. Spouses and children offered the most support to women with BC; having support from 5 or more sources was associated with higher mean active coping (beta [β] 1.14; 95% CI 0.66 to 1.62) and avoidant coping (β 1.46; 95% CI 0.98 to 1.94), as compared with having <2 sources of social support. Conclusion. This study demonstrates that women diagnosed with BC in Ghana adopt varied coping strategies to deal with these challenges. The forms of coping strategies adopted by women diagnosed with BC are influenced by the extent of social support received. Psychosocial counseling and support should be an integral part of BC management. Exploring and including social networks could play an important role in the management of BC in Ghana.
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DURAN SONGÜL, Kaynak S, Karadas A. Palyatif bakım hastasına bakım verenlerde depresyon, anksiyete ve stres düzeyi: tanımlayıcı-kesitsel tipte bir çalışma. FAMILY PRACTICE AND PALLIATIVE CARE 2019. [DOI: 10.22391/fppc.532571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Krawczyk M. Organizing end of life in hospital palliative care: A Canadian example. Soc Sci Med 2019; 291:112493. [DOI: 10.1016/j.socscimed.2019.112493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 08/04/2019] [Accepted: 08/12/2019] [Indexed: 10/26/2022]
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Asadi P, Fereidooni-Moghadam M, Dashtbozorgi B, Masoudi R. Relationship Between Care Burden and Religious Beliefs Among Family Caregivers of Mentally Ill Patients. JOURNAL OF RELIGION AND HEALTH 2019; 58:1125-1134. [PMID: 29936675 DOI: 10.1007/s10943-018-0660-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Families are considered as primary sources of care for individuals suffering from mental disorders. However, one of the major stresses in families is the infliction of a family member with mental illnesses causing dysfunction in health dimensions or generally their quality of life. Currently, most experts believe that religion can affect physical health and other aspects of human life. So, the aim of this study was to investigate "the relationship between care burden and religious beliefs among family caregivers of mentally ill patients." This cross-sectional study was carried out in Iran on 152 families with mentally ill patients who were hospitalized in psychiatric wards. The sampling method was nonprobability and consecutive sampling method. The data collection instruments included a demographic characteristic questionnaire, Religious Beliefs, and Zarit Care Burden Questionnaires. The mean score for care burden was 30.99 (SD = 16.45). 5.9% of the participants reported a low level, and 39.5% experienced a moderate level of care burden. Moreover, the mean score for religious beliefs was 115.5 (SD = 13.49), and majority of the participants (70.4%) were endowed with strong religious beliefs. There were no significant associations between care burden and intensity of religious beliefs among the study samples (P = 0.483). Considering the results of this study indicating experience of moderate-to-high levels of care burden in families with mentally ill patients, it is recommended to consider such families and their religious beliefs as contributing factors in coping with challenges of mental disorders.
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Affiliation(s)
- Parisa Asadi
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Malek Fereidooni-Moghadam
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Bahman Dashtbozorgi
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Masoudi
- Community-oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Norouzadeh R, Anoosheh M, Ahmadi F. Contingency Help: The Main Strategy of Iranian Nurses in Dealing With the Family of the End-of-Life Patients. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:426-445. [PMID: 31188718 DOI: 10.1177/0030222819854909] [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: 11/15/2022]
Abstract
Families are struggling with many challenges in the final stages of patient life. It is important to understand what actions nurses do for the family of the end-of-life (EOL) patients. This study aimed to explain the main strategy of nurses' dealing with the family of the EOL patients. Data were analyzed using conventional content analysis. Semistructured interviews were conducted on 32 nurses from hospitals in Tehran. Nurses used six measures of explaining the bitter reality, effective communication, management of violence, referral, consolation, and reinforcement. "Contingency help" was conceptualized as the main strategy. Nurses through "contingency help" were involved in solving the emotional, physical, financial, and spiritual needs of the family. Nurses will be able to apply the results of this study to the development of care policies for the family of the EOL patients.
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Affiliation(s)
- Reza Norouzadeh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Monireh Anoosheh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
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Waldrop DP, Meeker MA. Crisis in Caregiving: When Home-Based End-Of-Life Care is No Longer Possible. J Palliat Care 2018. [DOI: 10.1177/082585971102700207] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Understanding the factors that precipitate caregiving crises that cannot be resolved at home is central to improving options for care at life's end. The purpose of this study was to explore caregivers’ perceptions of the crises that preceded and were resolved by relocation during end-of-life care. In-depth interviews were conducted with 36 caregivers of people who died in a hospice house. The results illuminate a conceptual model of the caregiving crisis, which has three stages: a) precipitating factors — the interrelationship between illness trajectory and reciprocal suffering (physical, psychological, emotional and social distress), b) crisis, and c) resolution (settled or unsettled). Relocation presents an opportunity for families to relinquish the burden of end-stage care so that they can resume and complete a lifelong relationship. Careful recognition of and attention to the intimate dynamics that accompany suffering and dying are essential elements of palliative care, which aims to uphold the dignity of the dying person and the integrity of the family in both caregiving and bereavement.
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Affiliation(s)
- Deborah P. Waldrop
- DP Waldrop (corresponding author) University at Buffalo School of Social Work, 685 Baldy Hall, Buffalo, New York, USA 14260
| | - Mary Ann Meeker
- University at Buffalo School of Nursing, Buffalo, New York, USA
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Challenges in supporting lay carers of patients at the end of life: results from focus group discussions with primary healthcare providers. BMC FAMILY PRACTICE 2018; 19:112. [PMID: 30001698 PMCID: PMC6044065 DOI: 10.1186/s12875-018-0816-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 07/02/2018] [Indexed: 11/10/2022]
Abstract
Background Family caregivers (FCGs) of patients at the end of life (EoL) cared for at home receive support from professional and non-professional care providers. Healthcare providers in general practice play an important role as they coordinate care and establish contacts between the parties concerned. To identify potential intervention targets, this study deals with the challenges healthcare providers in general practice face in EoL care situations including patients, caregivers and networks. Methods Focus group discussions with general practice teams in Germany were conducted to identify barriers to and enablers of an optimal support for family caregivers. Focus group discussions were analysed using content analysis. Results Nineteen providers from 11 general practices took part in 4 focus group discussions. Participants identified challenges in communication with patients, caregivers and within the professional network. Communication with patients and caregivers focused on non-verbal messages, communicating at an appropriate time and perceiving patient and caregiver as a unit of care. Practice teams perceive themselves as an important part of the healthcare network, but also report difficulties in communication and cooperation with other healthcare providers. Conclusion Healthcare providers in general practice identified relational challenges in daily primary palliative care with potential implications for EoL care. Communication and collaboration with patients, caregivers and among healthcare providers give opportunities for improving palliative care with a focus on the patient-caregiver dyad. It is insufficient to demand a (professional) support network; existing structures need to be recognized and included into the care.
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How family caregivers of cancer patients manage symptoms at home: A systematic review. Int J Nurs Stud 2018; 85:68-79. [PMID: 29857223 DOI: 10.1016/j.ijnurstu.2018.05.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Cancer affects not only the patient, but also the whole family, especially when a member of the family assumes the role of the family caregiver. This puts an additional emotional, social and financial strain on the family caregivers. Family caregivers of cancer patients are actively involved in the care provided at the home setting through various ways including practical tasks, symptom management and care coordination. The focus of preceding studies on family caregivers and symptom management was either on pain or the patients' and family caregivers' experience of symptom management and coping. The aim of this review was to provide evidence on how family caregivers manage symptoms and side effects at home, in adult cancer patients throughout the disease trajectory. METHODS A systematic literature review was performed in PubMed, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials with a combination of keywords and MeSH terms for family caregivers, cancer, symptoms, side effects and management. Based on predetermined inclusion and exclusion criteria, a total of 1270 articles were screened and 20 studies were included in the analysis. A descriptive analysis was performed due to the heterogeneity of the findings. RESULTS The results showed that only a limited number of studies (3/20) explored how and what family caregivers do in symptom management as a primary outcome. Family caregivers provided psychosocial support, such as supporting and motivating the patient and maintaining social engagement. Caregivers provided physical support such as with the administration of medicine and tube feeding. As an integral part of managing the symptoms, family caregivers actively monitored and assessed symptoms to timely recognize any treatment related side effects, assess the response to therapeutic interventions and recognize possible deterioration in physical status. Furthermore, family caregivers were often the decision maker - being alert, watching and waiting and decided when to act and when not to act. CONCLUSIONS Family caregivers are doing work similar to healthcare professionals, when managing symptoms and side effects at home in patients with cancer. Advanced tasks such as assessing, monitoring and deciding when and how to act are included in the daily routine of family caregivers.
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Bader F, Atallah B, Brennan LF, Rimawi RH, Khalil ME. Heart failure in the elderly: ten peculiar management considerations. Heart Fail Rev 2018; 22:219-228. [PMID: 28164253 DOI: 10.1007/s10741-017-9598-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chronic heart failure (HF) is a disease with significantly higher prevalence in the elderly or patients older than 65 years old. Typically, older patients have more risk factors for HF, more comorbidities, and are more likely to have recurrent admissions for acute decompensations. With HF burden on health care systems primarily related to hospital and nursing home costs, it is critical that elderly patients are approached with a clear understanding of certain unique clinical, laboratory, imaging, and pharmacokinetic differences that can alter their management and outcomes. Psychosocial factors have major implications on adherence to therapy as well as decisions on advanced care for elderly HF patients. In this article, we highlight ten peculiar management considerations when approaching older patients with HF. We discuss issues related to epidemiology, diagnostic challenges, pharmacotherapy, and palliative care; all of which can impact this unique population and, more importantly, the disease burden as a whole.
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Affiliation(s)
- Feras Bader
- Cleveland Clinic Abu Dhabi, United Arab Emirates, Heart and Vascular Institute, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE.
| | - Bassam Atallah
- Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, United Arab Emirates, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE
| | - Lisa F Brennan
- Levine College of Health Sciences, Wingate University School of Pharmacy, 515 N. Main Street, Wingate, NC, 28174, USA
| | - Rola H Rimawi
- , 34522 N. Scottsdale road, Suite 120, PMB 489, Scottsdale, Arizona, 85266, USA
| | - Mohammed E Khalil
- Cleveland Clinic Abu Dhabi, United Arab Emirates, Heart and Vascular Institute, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE
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Ateş G, Ebenau AF, Busa C, Csikos Á, Hasselaar J, Jaspers B, Menten J, Payne S, Van Beek K, Varey S, Groot M, Radbruch L. "Never at ease" - family carers within integrated palliative care: a multinational, mixed method study. BMC Palliat Care 2018; 17:39. [PMID: 29490657 PMCID: PMC5831577 DOI: 10.1186/s12904-018-0291-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 02/20/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Family carers manage a wide range of responsibilities in the lives and care of patients receiving palliative care. They fulfil multiple roles and perform activities within different settings. This has immediate consequences on family carers' every-day lives. According to literature, family carers in palliative care are both part of the formal and informal care network, but also persons in need of support. This article aims to investigate 1) burdens and rewards associated with family caregiving and 2) what family carers find helpful in their contact with professionals from integrated palliative care initiatives (IPC-i) and other services. METHODS Family carers looking after patients with cancer, chronic obstructive pulmonary disease or chronic heart failure were purposefully recruited at 22 IPC-i in Belgium, Germany, Hungary, the Netherlands and the United Kingdom in the course of the project "Patient-centred palliative care pathways in advanced cancer and chronic disease" (InSup-C). Semi-structured interviews (n = 156) and 87 quantitative questionnaires (CRA, POS, CANHELP Lite) were conducted with family carers. Interviews were analysed with transnationally agreed thematic codes (MAXQDA or NVivo). Statistical tests (SPSS) were carried out in accordance with the characteristic value of the items and distributions. RESULTS On average, quantitative data showed moderate burden, but the qualitative findings indicated that this burden might be underrated. There is some evidence that IPC-i with well-developed professional care networks and communication systems relieved family carers' burden by direct and indirect interventions; e.g. provision of night shift nurses or psychological support. Needs of family carers were similar in all participating countries. However, in all countries IPC-i mostly offered one-off events for family carers, lacking systematic or institutionalised support structures. CONCLUSIONS Data suggest that, most IPC-i did not pay enough attention to the needs of most family carers, and did not offer proactive care and access to supportive resources to them (e.g. training, respite care, access to resources). We recommend recognizing family carers as part of the 'unit of care' and partner in caregiving, to improve their knowledge about, and access to, and the support available.
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Affiliation(s)
- Gülay Ateş
- Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
| | - Anne Frederieke Ebenau
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, P.O. Box 9101 (internal code 549), 6500 Nijmegen, HB Netherlands
| | - Csilla Busa
- Department of Hospice and Palliative Care, Institution of Primary Health Care, University of Pecs Medical School, Szigeti str 12, Pécs, H-7624 Hungary
| | - Ágnes Csikos
- Department of Hospice and Palliative Care, Institution of Primary Health Care, University of Pecs Medical School, Szigeti str 12, Pécs, H-7624 Hungary
| | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, P.O. Box 9101 (internal code 549), 6500 Nijmegen, HB Netherlands
| | - Birgit Jaspers
- Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
- Center of Palliative Care, Malteser Hospital Seliger Gerhard Bonn/Rhein-Sieg, Von-Hompesch-Straße 1, Bonn, 53123 Germany
| | - Johan Menten
- Radiation Oncology Department and Palliative Care, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sheila Payne
- Division of Health Research, International Observatory on End of Life Care, Lancaster University, Furness Building, Lancaster, LA1 4YG UK
| | - Karen Van Beek
- Radiation Oncology Department and Palliative Care, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sandra Varey
- Division of Health Research, International Observatory on End of Life Care, Lancaster University, Furness Building, Lancaster, LA1 4YG UK
| | - Marieke Groot
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, P.O. Box 9101 (internal code 549), 6500 Nijmegen, HB Netherlands
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
- Center of Palliative Care, Malteser Hospital Seliger Gerhard Bonn/Rhein-Sieg, Von-Hompesch-Straße 1, Bonn, 53123 Germany
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Farquhar M. Assessing carer needs in chronic obstructive pulmonary disease. Chron Respir Dis 2018; 15:26-35. [PMID: 28685601 PMCID: PMC5802659 DOI: 10.1177/1479972317719086] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 05/21/2017] [Indexed: 12/31/2022] Open
Abstract
Informal carers play a key role in supporting patients with chronic obstructive pulmonary disease (COPD), particularly when disease is advanced. They also enable delivery of healthcare professional advice. There is a well-established impact of the caring role on carers in both the generic and COPD-specific literature. The needs of carers of patients with COPD are both generic to the caring role and disease specific. Healthcare professionals and health systems supporting patients with COPD need to actively identify and support carers. Carer assessment enables unmet needs to be identified and appropriately addressed. Assessments should consider carers' support needs, their caring capacity and practices, and carers own clinical needs. This narrative review outlines considerations for the assessment process including what should be assessed, who should conduct assessment and what should happen as a result of assessment.
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Affiliation(s)
- Morag Farquhar
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK
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Rakic M, Escher M, Elger BS, Eckstein S, Pacurari N, Zwahlen S, Wienand I. Feelings of Burden in Palliative Care: A Qualitative Analysis of Medical Records. J Palliat Care 2018; 33:32-38. [PMID: 29301449 DOI: 10.1177/0825859717750522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Care for palliative care patients is often provided by unpaid caregivers (eg, family members) who take care of the patient's daily needs (eg, bathing, dressing). Family members of palliative care patients are involved in numerous ways. These tasks and responsibilities can make them feel burdened and even overburdened. AIM We specifically looked at patients' medical records to determine what is being reported about burden and overburden and who seems to be mostly affected. Burden was understood as a weight or task that is difficult to accept or carry, whereas overburden indicates that this weight or task cannot be carried anymore. METHODS We looked at 300 medical records of palliative care patients written by health-care professionals. Written notes were analyzed using latent content analysis as it helps to analyze large amounts of textual data qualitatively and to understand the underlying concepts of what was said. RESULTS Most (73.5%) patients had a cancer diagnosis. Mean age was 67.6 years (range, 22-98 years). Burden and overburden were identified as main categories and further divided into the following subcategories: for patients and families. According to the written notes, patients often felt burdened by their disease, financial problems, situation at home, and families' reactions to their disease. By and large, patients felt overburdened by their own disease. Families often felt burdened because of issues related to patients' medical condition, providing home care, or financial and social aspects. Families mentioned home care and the decision-making process as being overburdening. CONCLUSION Findings in the palliative care patients' medical records are inasmuch important, as they point at the health-care staff's awareness of possible weights and tasks that might be burdensome for patients and their families. Attention should be drawn to the documentation of medical records in order to identify recurrent difficulties and to help discuss these.
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Affiliation(s)
- Milenko Rakic
- 1 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Monica Escher
- 2 Division of Clinical Pharmacology and Toxicology, Pain and Palliative Care Consultation, Geneva University Hospitals, Geneva, Switzerland
| | - Bernice S Elger
- 1 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Sandra Eckstein
- 3 Palliative Care, University Hospital Basel, Basel, Switzerland
| | - Nadia Pacurari
- 1 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Susanne Zwahlen
- 4 Centre for Palliative Care, University Hospital Bern, Bern, Switzerland
| | - Isabelle Wienand
- 1 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Abstract
The health of family carers may affect not only their own lives but also the lives of the people for whom they provide care. This article describes how the caring role can affect the health and well-being of a carer of a person who has a mental or physical disorder. Suggestions are made about how to recognise and ameliorate some of the detrimental effects of the caring role on the carer's own health.
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Guo Q, Chochinov HM, McClement S, Thompson G, Hack T. Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study. Palliat Med 2018; 32:195-205. [PMID: 29130367 PMCID: PMC5758936 DOI: 10.1177/0269216317734696] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Effective patient-family communication can reduce patients' psychosocial distress and relieve family members' current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. AIM To develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk, explore anticipated benefits and challenges of using Dignity Talk, and solicit suggestions for protocol improvement. DESIGN A convergent parallel mixed-methods design. Dignity Talk, a self-administered question list, was designed to prompt end-of-life conversations, adapted from the Dignity Therapy question framework. Participants were surveyed to evaluate the Dignity Talk question framework. Data were analyzed using qualitative and quantitative methods. SETTING/PARTICIPANTS A total of 20 palliative patients, 20 family members, and 34 healthcare providers were recruited from two inpatient palliative care units in Winnipeg, Canada. RESULTS Most Dignity Talk questions were endorsed by the majority of patients and families (>70%). Dignity Talk was revised to be convenient and flexible to use, broadly accessible, clearly stated, and sensitively worded. Participants felt Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business. Participants suggested that patients and family members be given latitude to respond only to questions that are meaningful to them and within their emotional capacity to broach. CONCLUSION Dignity Talk may provide a gentle means of facilitating important end-of-life conversations.
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Affiliation(s)
- Qiaohong Guo
- 1 School of Nursing, Capital Medical University, Beijing, China.,2 Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada.,3 Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Harvey Max Chochinov
- 2 Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada.,3 Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Susan McClement
- 2 Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada.,4 Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Genevieve Thompson
- 2 Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada.,4 Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Tom Hack
- 4 Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.,5 University of Central Lancashire, Preston, UK
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Bidwell JT, Higgins MK, Reilly CM, Clark PC, Dunbar SB. Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads. Heart Lung 2018; 47:32-39. [PMID: 29153759 PMCID: PMC5722704 DOI: 10.1016/j.hrtlng.2017.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patient's knowledge about heart failure (HF) contributes to successful HF self-care, but less is known about shared patient-caregiver knowledge. OBJECTIVES The purpose of this analysis was to: 1) identify configurations of shared HF knowledge in patient-caregiver dyads; 2) characterize dyads within each configuration by comparing sociodemographic factors, HF characteristics, and psychosocial factors; and 3) quantify the relationship between configurations and patient self-care adherence to managing dietary sodium and HF medications. METHODS This was a secondary analysis of cross-sectional data (N = 114 dyads, 53% spousal). Patient and caregiver HF knowledge was measured with the Atlanta Heart Failure Knowledge Test. Patient dietary sodium intake was measured by 3-day food record and 24 h urine sodium. Medication adherence was measured by Medication Events Monitoring System caps. Patient HF-related quality of life was measured by the Minnesota Heart Failure Questionnaire; caregiver health-related quality of life was measured by the Short Form-12 Physical Component Summary. Patient and caregiver depression were measured with the Beck Depression Inventory-II. Patient and caregiver perceptions of caregiver-provided autonomy support to succeed in heart failure self-care were measured by the Family Care Climate Questionnaire. Multilevel and latent class modeling were used to identify dyadic knowledge configurations. T-tests and chi-square tests were used to characterize differences in sociodemographic, clinical, and psychosocial characteristics by configuration. Logistic/linear regression were used to quantify relationships between configurations and patient dietary sodium and medication adherence. RESULTS Two dyadic knowledge configurations were identified: "Knowledgeable Together" (higher dyad knowledge, less incongruence; N = 85, 75%) and "Knowledge Gap" (lower dyad knowledge, greater incongruence; N = 29, 25%). Dyads were more likely to be in the "Knowledgeable Together" group if they were White and more highly educated, if the patient had a higher ejection fraction, fewer depressive symptoms, and better autonomy support, and if the caregiver had better quality of life. In unadjusted comparisons, patients in the "Knowledge Gap" group were less likely to adhere to HF medication and diet. In adjusted models, significance was retained for dietary sodium only. CONCLUSIONS Dyads with higher shared HF knowledge are likely more successful with select self-care adherence behaviors.
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Affiliation(s)
- Julie T Bidwell
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, United States.
| | - Melinda K Higgins
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, United States.
| | - Carolyn M Reilly
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, United States.
| | - Patricia C Clark
- Georgia State University, Byrdine F. Lewis College of Nursing and Health Professions, P.O. Box 3995, Atlanta, GA, 30302, United States.
| | - Sandra B Dunbar
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, United States.
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Hoerger M, Cullen BD. Early Integrated Palliative Care and Reduced Emotional Distress in Cancer Caregivers: Reaching the "Hidden Patients". Oncologist 2017; 22:1419-1420. [PMID: 28982800 PMCID: PMC5728035 DOI: 10.1634/theoncologist.2017-0432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022] Open
Abstract
Caregivers of patients with advanced cancer are affected physically and emotionally by the patient's illness and are too often overlooked by health care systems. This commentary considers recent findings that early integrated palliative care is beneficial for reducing emotional distress in both patients and caregivers.
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Affiliation(s)
- Michael Hoerger
- Psycho-Oncology Research Program, Tulane Cancer Center, New Orleans, Louisiana, USA
| | - Brittany D Cullen
- Psycho-Oncology Research Program, Tulane Cancer Center, New Orleans, Louisiana, USA
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Aparicio M, Centeno C, Carrasco JM, Barbosa A, Arantzamendi M. What are families most grateful for after receiving palliative care? Content analysis of written documents received: a chance to improve the quality of care. BMC Palliat Care 2017; 16:47. [PMID: 28874150 PMCID: PMC5586049 DOI: 10.1186/s12904-017-0229-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family members are involved in the care of palliative patients at home and therefore, should be viewed as important sources of information to help clinicians better understand the quality palliative care service patients receive. The objective of the study was to analyse what is valued most by family carers undergoing bereavement of a palliative care home service in order to identify factors of quality of care. METHODS Qualitative exploratory study based on documentary analysis. Content analysis of 77 gratitude documents received over 8 years by a palliative home service in Odivelas, near Lisbon (Portugal) was undertaken, through an inductive approach and using investigator triangulation. Frequency of distinct categories was quantitatively defined. RESULTS Three different content categories emerged from the analysis: a) Recognition of the care received and the value of particular aspects of care within recognised difficult situations included aspects such as kindness, listening, attention to the family, empathy, closeness, affection and the therapeutic relationships established (63/77 documents); b) Family recognition of the achievements of the palliative care team (29/77) indicated as relief from suffering for the patient and family, opportunity of dying at home, help in facing difficult situations, improvement in quality of life and wellbeing, and feeling of serenity during bereavement; c) Messages of support (45/77) related to the need of resources provided. The relational component emerges as an underlying key aspect of family carers' experience with palliative care home service. CONCLUSION Family carers show spontaneous gratitude for the professionalism and humanity found in palliative care. The relational component of care emerges as key to achieve a high quality care experience of palliative care homes service, and could be one indicator of quality of palliative care.
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Affiliation(s)
- María Aparicio
- St John’s Hospice, London, UK
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
| | - Carlos Centeno
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
- Clínica Universidad de Navarra, Departamento de Medicina Paliativa, Avenidad Pío XII, 31080 Pamplona, España
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Grupo: Medicina paliativa, Pamplona, España
| | - José Miguel Carrasco
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Grupo: Medicina paliativa, Pamplona, España
| | - Antonio Barbosa
- Centre for Bioethics, Faculty of Medicine, University of Lisboa, Lisbon, Portugal
| | - María Arantzamendi
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Grupo: Medicina paliativa, Pamplona, España
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Caswell G, Hardy B, Ewing G, Kennedy S, Seymour J. Supporting family carers in home-based end-of-life care: using participatory action research to develop a training programme for support workers and volunteers. BMJ Support Palliat Care 2017; 9:e4. [PMID: 28768679 PMCID: PMC6579492 DOI: 10.1136/bmjspcare-2017-001317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 11/09/2022]
Abstract
Background Family carers are crucial in enabling dying people to stay at home, but are often not prepared for their caring role, receiving little support from formal health and social care services. It is increasingly likely that any help or support family carers receive will be provided by a third sector organisation on either a voluntary basis or by untrained carer support workers. Objectives To produce a training programme designed to equip carer support workers and volunteers with the basic skills and knowledge needed to support family carers. Process of development Participatory action research, a collaborative form of working in which those who are affected by an issue take a lead role in the research, was used. Bereaved carers acting as research partners, support workers and representatives of third sector organisations took an active part in designing, developing, piloting and refining the programme in a number of interlinked stages. During development, the programme was piloted on four occasions and evaluated by 36 trainees and 3 trainers. Final training programme The outcome of the project is an innovative, 1-day training programme, offering an introduction to supporting family carers who are looking after someone approaching the end of life. The use of participatory action research methods enabled the development of a programme that addresses support needs identified by bereaved carers and training needs identified by carer support workers. The finished programme includes all the materials necessary to run a training day for support workers and volunteers: facilitator’s notes, trainee workbook, slides, promotional poster and pre-course reading for trainees. Knowledge of issues involved in end-of-life and palliative care is not required, although some experience in delivering training is advisable. Conclusion The programme evaluated well during development, but further research is required to examine the transfer of learning into the workplace.
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Affiliation(s)
- Glenys Caswell
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Beth Hardy
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Gail Ewing
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Sheila Kennedy
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jane Seymour
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
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Perceptions of the care received from Australian palliative care services: A caregiver perspective. Palliat Support Care 2017; 16:198-208. [PMID: 28357973 DOI: 10.1017/s1478951517000177] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACTBackground:Caregiver satisfaction and experience surveys help health professionals to understand, measure, and improve the quality of care provided for patients and their families. OBJECTIVE Our aim was to explore caregiver perceptions of the care received from Australian specialist palliative care services. METHOD Caregivers of patients receiving palliative care in services registered with Australia's Palliative Care Outcomes Collaboration were invited to participate in a caregiver survey. The survey included the FAMCARE-2 and four items from the Ongoing Needs Identification: Caregiver Profile questionnaire. RESULTS Surveys were completed by 1,592 caregivers from 49 services. Most respondents reported high satisfaction and positive experiences. Caregivers receiving care from community-based palliative care teams were less satisfied with the management of physical symptoms and comfort (odds ratio [OR] = 0.29; 95% confidence interval [CI95%] = 0.14, 0.59), with patient psychological care (OR = 0.56; CI95% = 0.32, 0.98), and with family support (OR = 0.52; CI95% = 0.35, 0.77) than caregivers of patients in an inpatient setting. If aged over 60 years, caregivers were less likely to have their information needs met regarding available support services (OR = 0.98; CI95% = 0.97, 0.98) and carer payments (OR = 0.99; CI95% = 0.98, 1.00). Also, caregivers were less likely to receive adequate information about carer payments if located in an outer regional area (OR = 0.41; CI95% = 0.25, 0.64). With practical training, caregivers receiving care from community services reported inadequate information provision to support them in caring for patients (OR = 0.60; CI95% = 0.45, 0.81). SIGNIFICANCE OF RESULTS While our study identified caregivers as having positive and satisfactory experiences across all domains of care, there is room for improvement in the delivery of palliative care across symptom management, as well as patient and caregiver support, especially in community settings. Caregiver surveys can facilitate the identification and evaluation of both patients' and caregivers' experiences, satisfaction, distress, and unmet needs.
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Abstract
The purpose of this review was to investigate and review the concept of "peace" and the role it plays in the spiritual well-being and care of people with a chronic or terminal illness. Our objectives were, first, to examine the importance of peace in palliative care as a measure of acceptance and in chronic illness settings as a predictor of improved survival. Second, we explored the dimensions of peace and their relationships with spiritual well-being. We further examined how the constructs of peace are assessed both within valid spiritual well-being measures and as individual items related solely to peace. Finally, we examined therapies aimed at promoting peace and emotional well-being in palliative and chronic illness settings. Despite much being written about different constructs of peace and the positive effects of being at peace during times of illness, the effects of therapies on the feeling of peace are not well-studied.
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Martín JM, Olano-Lizarraga M, Saracíbar-Razquin M. The experience of family caregivers caring for a terminal patient at home: A research review. Int J Nurs Stud 2016; 64:1-12. [DOI: 10.1016/j.ijnurstu.2016.09.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/25/2022]
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Chattat R, Ottoboni G, Zeneli A, Berardi MA, Cossu V, Maltoni M. The Italian version of the FAMCARE scale: a validation study. Support Care Cancer 2016; 24:3821-30. [PMID: 27067593 DOI: 10.1007/s00520-016-3187-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Evaluation of the quality of care is a key element that healthcare providers now take into consideration to meet patients' needs, expectations, and values. The FAMCARE scale is one of the most important instruments available to assess the level of satisfaction about care received by patients and families. We describe the validation process used to develop an Italian version (IF) of the original FAMCARE scale for caregivers. METHODS The IF was prepared according to standard guidelines for translation and transcultural adaptation of self-reported measures. The scale was self-administered to 132 informal caregivers of patients with cancer treated with curative and/or palliative care in a hospice, outpatient, or inpatient setting for at least 1 month. The participant group was composed of spouses (47.73 %), children (31.82 %), siblings (3.03 %), or other relatives (17.42 %). All participants simultaneously completed the EuroQol-5D (EQ-5D) questionnaire to test the construct validity. Twenty-two percent of randomly chosen participants re-completed the test after 1 month to evaluate IF test-retest stability. RESULTS The IF showed a strong reliability with internal consistency [α = 0.93, confidence intervals (CI) = 0.91-0.95] and test-retest stability (Pearson r = 0.38; Kendall's tau-b = 0,25; Spearman's rho =0.34). Factor analysis identified four factors capable of explaining the 63 % total variance which did not change after the Varimax normalized rotation. Notwithstanding the lack of correlation with the VAS component of the EQ-5D questionnaire, our results highlighted robust psychometric properties of the IF. CONCLUSIONS IF is a valid translation of the FAMCARE scale and can be used to assess caregiver satisfaction within the Italian context of cancer palliative care.
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Affiliation(s)
- Rabih Chattat
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Giovanni Ottoboni
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Anita Zeneli
- Nursing Service, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014, Meldola, Italy
| | - Maria Alejandra Berardi
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014, Meldola, Italy
| | - Veronica Cossu
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Marco Maltoni
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014, Meldola, Italy.
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Turriziani A, Attanasio G, Scarcella F, Sangalli L, Scopa A, Genualdo A, Quici S, Nazzicone G, Ricciotti MA, La Commare F. The importance of measuring customer satisfaction in palliative care. Future Oncol 2016; 12:807-13. [PMID: 26837318 DOI: 10.2217/fon.15.359] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In the last decades, palliative care has been more and more focused on the evaluation of patients' and families' satisfaction with care. However, the evaluation of customer satisfaction in palliative care presents a number of issues such as the presence of both patients and their families, the frail condition of the patients and the complexity of their needs, and the lack of standard quality indicators and appropriate measurement tools. In this manuscript, we critically review existing evidence and literature on the evaluation of satisfaction in the palliative care context. Moreover, we provide - as a practical example - the preliminary results of our experience in this setting with the development of a dedicated tool for the measurement of satisfaction.
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Affiliation(s)
- Adriana Turriziani
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gennaro Attanasio
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Francesco Scarcella
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Luisa Sangalli
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Anna Scopa
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Alessandra Genualdo
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Stefano Quici
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giulia Nazzicone
- Hospice Villa Speranza, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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