1
|
Lourenço M, Gomes T, Araujo F, Ventura F, Silva R. Challenges for palliative care in times of COVID-19: a scoping review. Front Public Health 2024; 12:1330370. [PMID: 38596518 PMCID: PMC11002222 DOI: 10.3389/fpubh.2024.1330370] [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: 10/31/2023] [Accepted: 03/06/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Many of the essential practices in palliative care (PC) had to be adapted to the COVID-19 pandemic. This global spread of the infectious respiratory disease, caused by SARS-CoV-2, created unprecedented obstacles. The aim of this research was to comprehensively assess the experiences and perceptions of healthcare professionals, individuals, and families in palliative and end-of-life situations during the COVID-19 pandemic. Methods A scoping review was conducted using the databases CINAHL Complete, MEDLINE, Scopus, SciELO, Cochrane Central Register of Controlled Trials, Psychology and Behavioral Sciences, MEDIClatina, and Portugal's Open Access Scientific Repository. The review followed the JBI® methodological approach for scoping reviews. Results Out of the initially identified 999 articles, 22 studies were included for analysis. The deprivation of relationships due to the safety protocols required to control the spread of COVID-19 was a universally perceived experience by healthcare professionals, individuals in PC, and their families. Social isolation, with significant psychological impact, including depersonalization and despair, was among the most frequently reported experiences by individuals in palliative situation. Despite healthcare professionals' efforts to mitigate the lack of relationships, the families of these individuals emphasized the irreplaceability of in-person bedside contact. Systematic review registration https://osf.io/xmpf2/.
Collapse
Affiliation(s)
- Marisa Lourenço
- Nursing School of Porto, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Tânia Gomes
- Urology Department - Santo António University Hospital Center, Porto, Portugal
| | - Fátima Araujo
- Nursing School of Porto, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Filipa Ventura
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Coimbra, Portugal
| | - Rosa Silva
- Nursing School of Porto, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), Coimbra, Portugal
| |
Collapse
|
2
|
Velasco Yanez R, Frota Goyanna N, Carvalho Fernandes A, Moura Barbosa Castro R, Holanda da Cunha G, Silva Ferreira I, Miranda Mattos S, Magalhães Moreira T. Palliative Care in Breast Cancer During the COVID-19 Pandemic: A Scoping Review. Am J Hosp Palliat Care 2023; 40:351-364. [PMID: 35581537 PMCID: PMC9127630 DOI: 10.1177/10499091221101879] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has harmed the provision of palliative care (PC) services for women with breast cancer due to all the restrictions that came along with the virus. OBJECTIVE To map the available evidence on the situation of PC in breast cancer during the COVID-19 pandemic. METHODS A scoping review was carried out based on the methodology proposed by the Joanna Briggs Institute. The search was conducted in nine databases, one electronic repository, and one library, using controlled vocabularies. RESULTS Twenty-nine articles and seven documents were included. The majority (11.4% each) were published in the United Kingdom, Italy, and the United States, 38.9% addressed palliative radiotherapy (RT), and 47.2% consisted of recommendations. From the content analysis, five categories were obtained focused on the recommendations on changes in palliative treatment guidelines and the response of PC teams to the evolving crisis. CONCLUSIONS The evidence pointed to the management of general PC, palliative RT, palliative chemotherapy, management of metastatic breast cancer, and use of technologies in palliative care. No recommendations were found to manage frequent symptoms in PC, indicating the need to develop primary studies that investigate these aspects in detail in this vulnerable group. IMPLICATIONS The results contained in this document can provide professionals working in this field of care with a global view of how other teams have dealt with the pandemic, thereby identifying the best guidelines to apply in their reality, taking into account the clinical and social situation of each patient.
Collapse
Affiliation(s)
- Romel Velasco Yanez
- Universidade Federal do Ceará, Fortaleza, Brazil,Romel Velasco Yanez, Department of Nursing, Universidade Federal do Ceará, 1115 Alexandre Baraúna St, Rodolfo Teófilo, Fortaleza 60020-181, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Parekh de Campos A, Levoy K, Pandey S, Wisniewski R, DiMauro P, Ferrell BR, Rosa WE. Integrating Palliative Care into Nursing Care. Am J Nurs 2022; 122:40-45. [PMID: 36261904 PMCID: PMC9889110 DOI: 10.1097/01.naj.0000897124.77291.7d] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACT The need for palliative care in our health care system has exponentially increased in the past few years as a result of the COVID-19 pandemic, the aging population, and the increasing number of people living with serious illnesses. While nurses play a critical role in delivering palliative care, many lack confidence and knowledge, causing practice gaps in the clinical and psychological management of seriously ill patients. The collective burden of the pandemic has demonstrated the importance of palliative care education and training, specifically in communication, symptom management, and continuing education. All nurses, including nursing students, transitioning nurses, and practicing nurses, should be trained to offer generalist (or primary) palliative care, in accordance with the American Association of Colleges of Nursing Essentials: Core Competencies for Professional Nursing Education. Provision of holistic, relationship-based, and integrated palliative care for patients and their families is an ethical obligation for all nurses.
Collapse
Affiliation(s)
- Amisha Parekh de Campos
- Amisha Parekh de Campos is an assistant clinical professor at the University of Connecticut School of Nursing in Storrs; Kristen Levoy is an assistant professor at the Indiana University School of Nursing and a research scientist at the university's Regenstrief Institute for Aging Research in Indianapolis; Shila Pandey and Renee Wisniewski are NPs in supportive care services at Memorial Sloan Kettering Cancer Center in New York City; Pierce DiMauro is a nurse researcher at the Columbia University Irving Medical Center School of Nursing in New York City; Betty R. Ferrell is a nurse scientist in the Division of Nursing Research and Education at City of Hope Medical Center in Duarte, CA; and William E. Rosa is chief research fellow at Memorial Sloan Kettering Cancer Center in New York City. Contact author: Amisha Parekh de Campos, . The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | | | |
Collapse
|
4
|
Shih KK, Anderson AE, Brown J, Schuren N, Lyles MY, Williams J, Ross Y, Hampton M, Chen M, Cruz VDL, Nelson C, Stanton P, Shelal Z, Bruera E. Stay Home, Work Safe: Attitudes and Beliefs of Members of a Department of Palliative Care, Rehabilitation, and Integrative Medicine Regarding Remote Work during the COVID-19 Pandemic. J Palliat Med 2021; 25:757-767. [PMID: 34847735 DOI: 10.1089/jpm.2021.0343] [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: 11/13/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic compelled rapid transition to work from home for the University of Texas MD Anderson Cancer Center Palliative, Rehabilitation, and Integrative Medicine (PRIM) department to ensure social distancing and prevention of transmission. Objectives: To survey the attitudes and beliefs of personnel toward remote work during the COVID-19 pandemic. Methods: One hundred forty-eight clinical, research, and administrative PRIM department employees were invited to participate in an anonymous voluntary survey in May 2020, two months after the beginning of the COVID-19 pandemic and transition to work from home in the geographic location of Houston, Texas. The survey comprised 25 questions, including employee demographics and attitudes and beliefs toward working from home and the COVID-19 pandemic. Results: Ninety-four percent (139) of employees responded, with high response rates among all three employee arms. The majority of respondents were female (74%), between the ages of 30 and 59 years (87%), had broadband Internet (93%), and shared office space before working from home (59%). There were overall positive reports of experience (87%) and emotional response (79%) toward working from home, especially for those more concerned about COVID-19 illness and spread, shared office space, and those reporting adequate resources and equipment for remote work. Clinical role, however, was associated with a less positive response (80%), less productivity (29%), and higher levels of stress (62%). Most of the department also reported increased emotional exhaustion (68%). When surveyed about permanently working from home, most of the department responded favorably (69%). Conclusions: The PRIM rapid transition to remote work was associated with positive perceptions by most members of the clinical, research, and administrative teams. Insight from this survey can serve as a model for future rapid transitions in remote work and merits follow-up studies to prepare us for a postpandemic work environment. Clinical Trial Registration number NCI-2021-01265.
Collapse
Affiliation(s)
- Kaoswi Karina Shih
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aimee E Anderson
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Natalie Schuren
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marilyn Y Lyles
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Yvette Ross
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marie Hampton
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Vera De La Cruz
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Christina Nelson
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Penny Stanton
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zeena Shelal
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
5
|
Bakitas M, Cheville AL, Mulvey TM, Peppercorn J, Watts K, Dionne-Odom JN. Telehealth Strategies to Support Patients and Families Across the Cancer Trajectory. Am Soc Clin Oncol Educ Book 2021; 41:413-422. [PMID: 34010046 DOI: 10.1200/edbk_320979] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Effective delivery of cancer care via telehealth requires a planned care system that accounts for myriad patient, provider, and practice/cancer center resources before, during, and after the care episode. Telehealth is broadly defined as a method to have virtual, bidirectional communication between patients and providers. Telehealth can include methods such as audio-only, video-consultation, and tele-monitoring, which can occur in a synchronous, asynchronous, or blended format. The purpose of this review is to present common foundational principles for providing clinical cancer care via telehealth, followed by an overview of three distinct examples of comprehensive telehealth programs that have been developed to meet the needs of patients and families across the cancer trajectory, including survivorship, rehabilitation, and palliative care phases. The programs described are exemplars that were developed and implemented prior to the coronavirus pandemic, so they reflect many years of planning and evidence. Lessons learned include the need for ongoing patient support, clinician training, and cancer health system/practice programmatic considerations such as billing, scheduling, reimbursement, software, and hardware/platform security. Although the COVID-19 pandemic produced an explosive shift in regulations and implementation, sustainability of these changes may not be long-term. Nevertheless, a permanent shift in cancer care to include telehealth is likely here to stay.
Collapse
Affiliation(s)
- Marie Bakitas
- School of Nursing, Center for Palliative and Supportive Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | | | - J Nicholas Dionne-Odom
- School of Nursing, Center for Palliative and Supportive Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| |
Collapse
|
6
|
Abstract
This issue of the Clinical Journal of Oncology Nursing presents foundational content about clinical oncology care in the environment of a virulent pandemic, particularly the COVID-19 pandemic, which continues to overwhelm global health and healthcare delivery systems.
Collapse
Affiliation(s)
- Ellen Carr
- University of California San Diego Moores Cancer Center
| |
Collapse
|