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Taheri-Ezbarami Z, Jafaraghaee F, Sighlani AK, Mousavi SK. Core components of end-of-life care in nursing education programs: a scoping review. BMC Palliat Care 2024; 23:82. [PMID: 38549106 PMCID: PMC10976691 DOI: 10.1186/s12904-024-01398-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND So far, there have been many studies on end-of-life nursing care education around the world, and in many cases, according to the cultural, social, and spiritual contexts of each country, the results have been different. The present study intends to gain general insight into the main components of end-of-life care in nursing education programs by reviewing scientific texts and the results of investigations. METHODS This study was a scoping review conducted with the Arksey and O'Malley methodology updated by Peters et al. First, a search was made in Wos, ProQuest, Scopus, PubMed, Science Direct, Research Gate, and Google Scholar databases to find studies about end-of-life care education programs. Then, the screening of the found studies was done in four stages, and the final articles were selected based on the inclusion and exclusion criteria of the studies. Due to the nature of the research, editorials, letters, and commentaries were excluded. The screening steps are shown in the PRISMA-ScR diagram. RESULTS 23 articles related to end-of-life care education programs were reviewed. The studies included eleven descriptive and cross-sectional studies, two qualitative studies, eight interventional studies, one concept analysis article, and one longitudinal study. By summarizing the data from the studies, six themes were obtained as the main components of end-of-life care education: principles of end-of-life care, communication skills, physical considerations, psychosocial and spiritual considerations, ethical considerations, and after-death care. CONCLUSION End-of-life care is one of the most challenging nursing care in the world. Since many nurses are not prepared to provide such care, the information obtained from this review can help nursing education and treatment managers develop more comprehensive training programs to improve the quality of end-of-life care.
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Affiliation(s)
- Zahra Taheri-Ezbarami
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Fateme Jafaraghaee
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Seyed Kazem Mousavi
- Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran.
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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2
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Haaksman M, Ham L, Brom L, Baars A, van Basten JP, van den Borne BEEM, Hendriks MP, de Jong WK, van Laarhoven HWM, van Lindert ASR, Mandigers CMPW, van der Padt-Pruijsten A, Smilde TJ, van Zuylen LC, van Vliet LM, Raijmakers NJH. Open communication between patients and relatives about illness & death in advanced cancer-results of the eQuiPe Study. Support Care Cancer 2024; 32:214. [PMID: 38446248 PMCID: PMC10917842 DOI: 10.1007/s00520-024-08379-5] [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: 12/19/2023] [Accepted: 02/12/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To assess the degree of openness of communication about illness and death between patients with advanced cancer and their relatives during the last three months of the patient's life, and its association with relatives' characteristics and bereavement distress. METHODS We used data from bereaved relatives of patients with advanced cancer from the prospective, longitudinal, multicenter, observational eQuipe study. Univariate and multivariable linear regression analyses were used to assess the association between the degree of openness of communication (measured using the validated Caregivers' Communication with patients about Illness and Death scale), the a priori defined characteristics of the relatives, and the degree of bereavement distress (measured using the Impact of Event Scale). RESULTS A total of 160 bereaved relatives were included in the analysis. The average degree of open communication about illness and death between patients with advanced cancer and their relatives was 3.86 on a scale of 1 to 5 (SE=0.08). A higher degree of open communication was associated with a lower degree of bereavement distress (p=0.003). No associations were found between the degree of open communication and the relatives' age (p=0.745), gender (p=0.196), level of education (p>0.773), (religious) worldview (p=0.435), type of relationship with the patient (p>0.548), or level of emotional functioning before the patient's death (p=0.075). CONCLUSIONS Open communication about illness and death between patients and relatives seems to be important, as it is associated with a lower degree of bereavement distress. Healthcare professionals can play an important role in encouraging the dialogue. However, it is important to keep in mind that some people not feel comfortable talking about illness and death.
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Affiliation(s)
- Michelle Haaksman
- Department of Health, Medical and Neuropsychology, University of Leiden, Leiden, the Netherlands.
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands.
| | - Laurien Ham
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Linda Brom
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands
| | - Arnold Baars
- Department of Internal Medicine, Hospital Gelderse Vallei, Ede, the Netherlands
| | | | | | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, The Netherlands
| | - Wouter K de Jong
- Department of Pulmonology, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam University Medical Center, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Anne S R van Lindert
- Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Tineke J Smilde
- Department of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Lia C van Zuylen
- Department of Medical Oncology, Amsterdam University Medical Center, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Liesbeth M van Vliet
- Department of Health, Medical and Neuropsychology, University of Leiden, Leiden, the Netherlands
| | - Natasja J H Raijmakers
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501, DB, Utrecht, the Netherlands
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Murray SA, Boyd K, Moine S, Kendall M, Macpherson S, Mitchell G, Amblàs-Novellas J. Using illness trajectories to inform person centred, advance care planning. BMJ 2024; 384:e067896. [PMID: 38428953 DOI: 10.1136/bmj-2021-067896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Scott A Murray
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Kirsty Boyd
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Sebastien Moine
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
- Health Education and Practices Laboratory, University of Paris 13, Bobigny, France
| | - Marilyn Kendall
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Stella Macpherson
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
- patient author, UK
| | | | - Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group, Faculty of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain
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Walker W, Jones J, Astley M. In-hospital end-of-life care: an appreciative analysis of bereaved family feedback. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:126-131. [PMID: 38335107 DOI: 10.12968/bjon.2024.33.3.126] [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: 02/12/2024]
Abstract
Experience feedback data is increasingly recognised as being helpful in improving healthcare services, and in meeting patient and family needs. This end-of-life care project, based on the principles of appreciative inquiry, sought to learn from the experiences of bereaved people whose relative had died in an acute hospital setting. Informal feedback, offered during a routine telephone call, was thematically analysed and interpreted in an appreciative manner. Confirmatory representations of caring practices and behaviours were identified, categorised and disseminated in a way that enabled staff to come to know and understand end-of-life care at its best, rather than as a set of problematised events. The findings served as a benchmark for individuals and teams to assess and progress their practice reflectively. The authors conclude that staff receptiveness to informal bereaved family feedback may be enhanced by focusing on the positive qualities of end-of-life care within existing practices.
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Affiliation(s)
- Wendy Walker
- Reader in Nursing (End-of-life Care and Bereavement), The Royal Wolverhampton NHS Trust
| | - Jennifer Jones
- Specialist Nurse-Bereavement/Lead Medical Examiner Officer, The Royal Wolverhampton NHS Trust
| | - Melanie Astley
- Clinical Nurse Specialist-Palliative Care, The Royal Wolverhampton NHS Trust
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5
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Wu Y, Zhang X. Examining Conversation Analysis in Palliative Care: A Systematic Review. HEALTH COMMUNICATION 2024:1-12. [PMID: 38166606 DOI: 10.1080/10410236.2023.2301202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Communication is an integral component in palliative care. A number of studies have used conversation analysis (CA) to examine communication between healthcare professionals (HCPs) and patients/companions in palliative care. To the best of our knowledge, however, no work has been done to synthesize these studies. Thus, the review aimed to synthesize these conversation analytic studies in the setting of palliative care. The review included peer-reviewed studies that focused on communication between HCPs and patients/companions and that were published in English before September 10 2022. The database and manual search produced 16 eligible studies. The thematic analysis generated five themes: (1) promoting patient agency and autonomy; (2) practices for gathering pain-related information and navigating pain concerns (practices for gathering pain-related information and practices for navigating patients' pain concerns); (3) initiating and managing end-of-life discussions; (4) facilitating shared decision making in palliative care; and (5) navigating sensitive topics and uncertainty in prognostic talk. The review highlighted the potential of CA for research in palliative care and had implications for communication practice.
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Affiliation(s)
- Yijin Wu
- Center for Geriatric Healthcare Services and Health Education, Qufu Normal University
| | - Xin Zhang
- Center for Geriatric Healthcare Services and Health Education, Qufu Normal University
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Thomas Hebdon MC, Cloyes KG, Vega M, Rosenkranz SJ, Reblin M, Tay D, Mooney K, Ellington L. Hospice Family Caregivers' Uncertainty, Burden, and Unmet Needs in Prospective Audio Diaries. J Hosp Palliat Nurs 2023; 25:321-329. [PMID: 37851960 PMCID: PMC10843703 DOI: 10.1097/njh.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Hospice cancer caregivers' (HCCs') burden and unmet needs are well documented in the literature through retrospective, standardized self-report surveys. Hospice cancer caregiver daily experiences of burden and unmet needs are rarely captured within a real-time context. The purpose of this secondary data analysis was to characterize HCCs' day-to-day burden and unmet needs with prospective HCC (N = 50) audio diary data between hospice enrollment and patient death. Uncertainty theory provided a framework for analysis. Diaries were transcribed, analyzed deductively and inductively, and organized thematically. Uncertainty in day-to-day experiences was an important driver of HCC burden and unmet needs. Unmet needs included unclear/unmet expectations regarding hospice care team support; not understanding the extent of HCC role and involvement; and communication challenges with hospice team members. Sources of HCCs' burden were dissonance between how they "should" feel and how they actually felt; feeling alone/having no outlet to express feelings; concerns about their own health and subsequent patient impact; and feeling helpless/occupying a liminal space. Uncertainty surrounding HCCs' experiences encompassed interactions with hospice care teams and the nature of end-of-life caregiving with symptom management, the dying process, and the HCC role. Hospice care teams can respond to uncertainty through assessment, understanding, and recognition of the daily context of HCCs.
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Affiliation(s)
| | | | | | | | | | - Djin Tay
- University of Utah, College of Nursing
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Bennett-Day S, Nice C. Clinical helpline: communicating and improving inpatient experience and safety using digital health records. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:890-896. [PMID: 37830864 DOI: 10.12968/bjon.2023.32.18.890] [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: 10/14/2023]
Abstract
The clinical telephone helpline discussed here is a communication channel for family members and caregivers whose loved ones are in hospital. It makes full use of the effect families can have on the care experience and complements standard visiting as well as when hospital visits are restricted. The helpline helps to meet family members' health information and emotional wellbeing needs and is a reciprocal patient safety communication channel. Three main benefits have been identified. Flrst, communication between patients, relatives, communities and staff is enhanced. The helpline provides comprehensive patient clinical updates to relatives and caregivers using live digital healthcare records, and person-centred care is facilitated by patient-specific information being obtained by helpline clinicians from relatives. Second, it releases time to care. The helpline runs remotely, away from wards, enabling ward-based clinicians to prioritise direct patient care. Finally, clinical staff who are unable to work directly within wards maintain their active engagement in care provision, supporting relatives, patients and their ward-based colleagues.
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Affiliation(s)
- Sarah Bennett-Day
- Antenatal and Newborn Screening Lead Midwife, Maternity Department, West Suffolk Hospital, West Suffolk NHS Foundation Trust, Bury St Edmunds
| | - Cassia Nice
- Head of Patient Experience and Engagement, Department of Nursing and Governance, West Suffolk Hospital, West Suffolk NHS Foundation Trust, Bury St Edmunds
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Atallah FC, Caruso P, Nassar Junior AP, Torelly AP, Amendola CP, Salluh JIF, Romano TG. High-value care for critically ill oncohematological patients: what do we know thus far? CRITICAL CARE SCIENCE 2023; 35:84-96. [PMID: 37712733 PMCID: PMC10275311 DOI: 10.5935/2965-2774.20230405-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/26/2023] [Indexed: 09/16/2023]
Abstract
The number of patients with cancer requiring intensive care unit admission is increasing around the world. The improvement in the pathophysiological understanding of this group of patients, as well as the increasingly better and more targeted treatment options for their underlying disease, has led to a significant increase in their survival over the past three decades. Within the organizational concepts, it is necessary to know what adds value in the care of critical oncohematological patients. Practices in medicine that do not benefit patients and possibly cause harm are called low-value practices, while high-value practices are defined as high-quality care at relatively low cost. In this article, we discuss ten domains with high-value evidence in the care of cancer patients: (1) intensive care unit admission policies; (2) intensive care unit organization; (3) etiological investigation of hypoxemia; (4) management of acute respiratory failure; (5) management of febrile neutropenia; (6) urgent chemotherapy treatment in critically ill patients; (7) patient and family experience; (8) palliative care; (9) care of intensive care unit staff; and (10) long-term impact of critical disease on the cancer population. The disclosure of such policies is expected to have the potential to change health care standards. We understand that it is a lengthy process, and initiatives such as this paper are one of the first steps in raising awareness and beginning a discussion about high-value care in various health scenarios.
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Affiliation(s)
- Fernanda Chohfi Atallah
- Discipline of Anaesthesiology, Pain and Intensive Care, Escola
Paulista de Medicina, Universidade Federal de São Paulo - São Paulo
(SP), Brazil
| | - Pedro Caruso
- AC Camargo Cancer Center - São Paulo (SP), Brazil
| | | | - Andre Peretti Torelly
- Hospital Santa Rita - Santa Casa de Misericórdia de Porto
Alegre - Porto Alegre (RS), Brazil
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9
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Lv T, Li L, Wang H, Zhao H, Chen F, He X, Zhang H. Relationship between Death Coping and Death Cognition and Meaning in Life among Nurses: A Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231158911. [PMID: 36803151 DOI: 10.1177/00302228231158911] [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: 02/22/2023]
Abstract
To explore nurses' ability to cope with death and its relationship with death cognition and meaning in life in the context of Chinese traditional culture. 1146 nurses from six tertiary hospitals were recruited. Participants completed the Coping with Death Scale, the Meaning in Life Questionnaire, and the self-made Death Cognition Questionnaire. Multiple regression analysis revealed that the search for meaning, the understanding of "good death", receiving education related to life-and-death, cultural aspect, the presence of meaning, and the number of patient deaths experienced in career explained 20.3% of the variance in the ability to cope with death. Lacking a correct understanding of death, nurses are not sufficiently prepared to deal with death and their ability to cope with death is influenced by the unique cognition of death and the sense of the meaning in life in the context of Chinese traditional culture.
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Affiliation(s)
- Tingting Lv
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Lezhi Li
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Huiping Wang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Hong Zhao
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Fengzhi Chen
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiachan He
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
| | - Huilin Zhang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, China
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Lewis ET, Hammill K, Culbert R, van der Merwe M, Sahay A, Turner R, Cardona M. Delivering Prognostic News to Older People with Chronic Disease: What Format Preference and Level of Involvement in Decision Making? A Hospital Survey. Healthcare (Basel) 2023; 11:healthcare11030444. [PMID: 36767019 PMCID: PMC9913994 DOI: 10.3390/healthcare11030444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Shared decision making near end of life is a balancing act of communicating prognosis to patients and their surrogates/families and engaging them in considering value-concordant management choices. This cross-sectional survey aimed to determine the format in which older patients with chronic illnesses would prefer to receive prognostic information on their treatment options and disease progression, and their desired level of engagement in decision making. With a 60% participation rate, 139 inpatients in two hospitals and five surrogates were presented with six hypothetical scenarios with a randomly assigned sequence: verbal and written summary, graph, table, photo, video, and pamphlet. The majority (76%) of respondents chose the traditional verbal communication of prognosis by their doctor with a written summary as a reference and to share with family; the second choice was a condition-specific pamphlet (63%). Many found the graph and photo to be distressing (36% and 42%, respectively). Most (71%) wanted to know everything about their condition trajectory, and 63% chose shared decision making rather than completely autonomous or full delegation to clinicians or family. There were no gender differentials between wanting to know it all, supporting shared decision making or the preferred format for breaking news (p > 0.05). Older hospitalized patients with chronic conditions are willing to discuss end-of-life issues, learn about their prognosis, and be involved in shared decision making. Innovative formats such as graphs, videos, or photos were not welcome as part of the prognostic discussion.
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Affiliation(s)
- Ebony T. Lewis
- School of Population Health, University of New South Wales, Sydney 2052, Australia
- School of Psychology, The University of New South Wales, Sydney 2052, Australia
- Correspondence:
| | - Kathrine Hammill
- School of Science and Health, Western Sydney University, Campbelltown 2560, Australia
| | - Rebekah Culbert
- Occupational Therapy Services, Camden and Campbelltown Hospitals, Campbelltown 2560, Australia
| | | | - Ashlyn Sahay
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Mackay 4740, Australia
| | - Robin Turner
- Biostatistics Unit, Otago Medical School, University of Otago, Dunedin 9054, New Zealand
| | - Magnolia Cardona
- Institute for Evidence-Based Healthcare, Bond University, Robina 4226, Australia
- EBP Professorial Unit, Gold Coast University Hospital, Southport 4215, Australia
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Gonella S, Di Giulio P, Berchialla P, Bo M, Cotogni P, Macchi G, Campagna S, Dimonte V. The Impact of Health and Social Care Professionals' Education on the Quality of Serious Illness Conversations in Nursing Homes: Study Protocol of a Quality Improvement Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:725. [PMID: 36613049 PMCID: PMC9819581 DOI: 10.3390/ijerph20010725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Health and social care professionals (HCPs) who work in nursing homes (NHs) are increasingly required to sustain serious illness conversations about care goals and preferences. Although these conversations may also be challenging for experienced HCPs and the literature recognizes high-quality communication as key to providing patient-centered care, so far, no specific educational program has been developed for the NH setting to improve HCPs' communication skills. Our study aims to test the feasibility and potential effectiveness of an innovative, blended communication skills training program (Teach-to-Communicate) targeting the HCPs who work in NHs. This program includes classroom-based theory, experiential learning, and e-learning, and relies on interdisciplinary contexts and several didactic methods. The study consists of two phases: phase I is the development of written resources that employ focus group discussion involving field experts and external feedback from key stakeholders. Phase II consists of a multicenter, pilot, pre-post study with nested qualitative study. The Teach-to-Communicate training program is expected to enhance the quality of communication in NH and HCPs' confidence in sustaining serious illness conversations, reduce family carers' psycho-emotional burden and improve their satisfaction with the care received, and increase advance care planning documentation. Our protocol will provide insight for future researchers, healthcare providers, and policymakers and pave the way for blended educational approaches in the field of communication skills training.
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Affiliation(s)
- Silvia Gonella
- Direction of Health Professions, City of Health and Science University Hospital of Torino, Corso Bramante 88-90, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Torino, via Santena 5 bis, 10126 Turin, Italy
| | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Torino, via Santena 5 bis, 10126 Turin, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, via Santena 5 bis, 10126 Torino, Italy
| | - Mario Bo
- Section of Geriatrics, Department of Medical Sciences, University of Torino, City of Health and Science University Hospital of Turin, Corso Bramante 88-90, 10126 Turin, Italy
| | - Paolo Cotogni
- Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, University of Torino, City of Health and Science University Hospital of Turin, Corso Bramante 88-90, 10126 Turin, Italy
| | - Giorgia Macchi
- Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, University of Torino, City of Health and Science University Hospital of Turin, Corso Bramante 88-90, 10126 Turin, Italy
| | - Sara Campagna
- Department of Public Health and Pediatrics, University of Torino, via Santena 5 bis, 10126 Turin, Italy
| | - Valerio Dimonte
- Direction of Health Professions, City of Health and Science University Hospital of Torino, Corso Bramante 88-90, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Torino, via Santena 5 bis, 10126 Turin, Italy
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12
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Etkind SN. Uncertainty in multimorbidity: a shared experience we should recognise, acknowledge and communicate. Br J Community Nurs 2022; 27:540-544. [PMID: 36327210 DOI: 10.12968/bjcn.2022.27.11.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Multimorbidity is increasingly common and inevitably results in uncertainties about health, care and the future. Such uncertainties may be experienced by patients, carers and health professionals. Given the ubiquitous presence of uncertainty, all professionals should be prepared to approach and address it in clinical practice. Uncertainty in multimorbidity can rarely be eliminated, and so, must be carefully addressed and communicated; however, there is little evidence on how to approach it. Key areas are: recognising the existence of uncertainty, acknowledging it, and communicating to achieve a shared understanding. Evaluation of what has been discussed, and preparedness to repeat such conversations are also important. Future research should explore optimal communication of uncertainty in multimorbidity.
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Affiliation(s)
- Simon Noah Etkind
- Academic Clinical Lecturer, Department of Public Health and Primary Care, University of Cambridge
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