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Stennett A, De Souza L, Norris M. A qualitative exploration of physiotherapists' perceptions about exercise and physical activity: reflections on the results from a Delphi Study. Disabil Rehabil 2019; 42:3142-3151. [PMID: 31012331 DOI: 10.1080/09638288.2019.1585969] [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: 10/27/2022]
Abstract
Purpose: This study explored physiotherapists' interpretation of exercise and physical activity, examined physiotherapists' views and opinions about the prioritised physical activity practices of people with multiple sclerosis and its implication for clinical practice.Method: Fourteen physiotherapists (12 females, 2 males) with experience of working with people with multiple sclerosis in the community participated in three focus groups. Physiotherapists commented on the results of a previous Delphi study which highlighted the prioritised exercise and physical activity practices and reasons people with multiple sclerosis engage in exercise and physical activity. The focus groups were audio recorded and transcribed verbatim. Data were analysed using framework analysis.Results: Four themes were developed from the analysis namely, Blurred terminologies, Influencing factors for the meaning of exercise and physical activity, When professional expertise meets experiential expertise and The resolve: resolving professional and experiential tensions.Conclusion: Physiotherapists described exercise and physical activity as movement with a focus on the physiological attributes. Nonetheless they valued and use exercise and physical activity as strategies to manage the symptoms associated with multiple sclerosis. Physiotherapists are strategically placed in the community to initiate discussions, assess, and create opportunities to enhance the physical activity practices of people with multiple sclerosis. However, there is greater scope for the application of physical activity to be embedded in routine clinical practice in the management of multiple sclerosis in the community.Implications for rehabilitationPhysiotherapists should design flexible physical activity programmes which are meaningful, engaging and foster the necessary environment to sustain physical activity participation in people with multiple sclerosis.Health professionals should be aware of and understand the individuals' priorities as these are key drivers to engaging and sustaining physical activity in community dwelling people with multiple sclerosis.Physiotherapists should be aware of their own beliefs and theoretical principles that guide designs and treatment programmes as these might either enhance or restrict physical activity in people with multiple sclerosis.
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Affiliation(s)
- Andrea Stennett
- Department of Clinical Sciences, Brunel University London, London, UK
| | - Lorraine De Souza
- Department of Clinical Sciences, Brunel University London, London, UK
| | - Meriel Norris
- Department of Clinical Sciences, Brunel University London, London, UK
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Higginson IJ, Hart S, Silber E, Burman R, Edmonds P. Symptom Prevalence and Severity in People Severely Affected by Multiple Sclerosis. J Palliat Care 2019. [DOI: 10.1177/082585970602200306] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim This study sought to assess symptom severity and prevalence in people severely affected by multiple sclerosis (MS). Methods We collected data on symptoms and problems of patients as self-reported to trained interviewers on standardized questionnaires (including the Palliative Outcome Scale MS symptom checklist, POS-MSS). Results 52 patients were included, mean age 53 years; 26 had secondary progressive MS, 23 had primary progressive MS, three had other forms; 32/52 were unable to walk independently. Patients reported a mean of nine (median=8.5, mode=12) symptoms. Six symptoms affected more than 50% of patients: problems using legs, problems using arms, fatigue/lack of energy, spasms, pain, and feeling sleepy. Higher levels of disability were correlated with greater symptom severity for nine symptoms (Spearman rho ranged 0.28–0.56, p<0.05). Conclusion Many symptoms in people severely affected by MS are as highly prevalent and severe as those experienced by patients with advanced cancer. Increased disability is associated with increased severity for some symptoms.
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Affiliation(s)
- Irene J. Higginson
- Department of Palliative Care, Policy and Rehabilitation, Kings’ College London, School of Medicine, London
| | - Sam Hart
- Department of Palliative Care, Policy and Rehabilitation, Kings’ College London, School of Medicine, London
| | - Eli Silber
- Department of Neurology, King's College Hospital, Denmark Hill, London
| | - Rachel Burman
- Department of Palliative Care, Policy and Rehabilitation, Kings’ College London, School of Medicine, London, England, UK
| | - Polly Edmonds
- Department of Palliative Care, Policy and Rehabilitation, Kings’ College London, School of Medicine, London, England, UK
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Kristjanson LJ, Aoun SM, Yates P. Are Supportive Services Meeting the Needs of Australians with Neurodegenerative Conditions and Their Families? J Palliat Care 2019. [DOI: 10.1177/082585970602200305] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To identify the needs for supportive care/palliative care services of people in Australia with four neurodegenerative disorders—motor neurone disease, multiple sclerosis, Parkinson's disease, Huntington's disease—and the needs of their families; and to determine the extent to which existing supportive and palliative care services models meet these needs. Design A mailed self-administered questionnaire to individuals with the four neurodegenerative diseases and their carers, in Western Australia, Victoria, and Queensland, using stratified proportional sampling from membership lists of the disease associations. Participants A total of 503 patients and 373 carers responded, representing a response rate of 25.6% and 19.0%, respectively. Exclusion criteria included those who had been recently diagnosed, and those too sick or disabled to participate. Results As patient dependency increased and more support was needed, both patients and carers exhibited higher distress symptoms and a poorer quality of life. Those who received more tailored services and more palliative care services were the most satisfied. The results highlighted the need for tailored and flexible models of care for these groups with unique care requirements. Conclusions This is the first empirical evidence of the needs and services used by these patient groups in Australia, and will form the basis for future developments of palliative and supportive care services for people with these four neurological conditions.
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Affiliation(s)
- Linda J. Kristjanson
- Western Australian Centre for Cancer & Palliative Care, Curtin University, Perth, Western Australia
| | - Samar M. Aoun
- Western Australian Centre for Cancer & Palliative Care, School of Nursing, Midwifery and Postgraduate Medicine, Edith Cowan University, Churchlands, Western Australia
| | - Patsy Yates
- Centre for Health Research - Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Žiaková K, Čáp J, Miertová M, Gurková E. Dimensions of personal dignity of patients with multiple sclerosis: a qualitative narrative review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2019. [DOI: 10.15452/cejnm.2019.10.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Learmonth YC, Adamson BC, Balto JM, Chiu CY, Molina-Guzman IM, Finlayson M, Barstow EA, Motl RW. Investigating the needs and wants of healthcare providers for promoting exercise in persons with multiple sclerosis: a qualitative study. Disabil Rehabil 2017; 40:2172-2180. [DOI: 10.1080/09638288.2017.1327989] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Yvonne C. Learmonth
- Department of Kinesiology and Community Health, University of Illinois at Urbana–Champaign, Champaign, IL, USA
| | - Brynn C. Adamson
- Department of Kinesiology and Community Health, University of Illinois at Urbana–Champaign, Champaign, IL, USA
| | - Julia M. Balto
- Department of Kinesiology and Community Health, University of Illinois at Urbana–Champaign, Champaign, IL, USA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana–Champaign, Champaign, IL, USA
| | - Isabel M. Molina-Guzman
- Departments of Latina/Latino studies, Media & Cinema Studies, University of Illinois at Urbana–Champaign, Champaign, IL, USA
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | - Elizabeth A. Barstow
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert W. Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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Oneschuk D. Progressive Multifocal Leuko-encephalopathy and Sporadic Creutzfeldt-Jakob Disease: A Review and Palliative Management in a Hospice Setting. PROGRESS IN PALLIATIVE CARE 2016. [DOI: 10.1080/09699260.2001.11746932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Methley AM, Chew‐Graham C, Campbell S, Cheraghi‐Sohi S. Experiences of UK health-care services for people with Multiple Sclerosis: a systematic narrative review. Health Expect 2015; 18:1844-55. [PMID: 24990077 PMCID: PMC5810635 DOI: 10.1111/hex.12228] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic, degenerative condition with an estimated UK prevalence of 100 000. Contact with health-care services is frequent and long-term; however, little research has investigated the experiences of health care for MS in the UK. OBJECTIVE The aim of this systematic narrative review was to critically review qualitative studies reporting patients' experiences of health-care services in the UK. SEARCH STRATEGY EMBASE, CINAHL, Medline, psychINFO and MS Society databases were searched with no date restrictions using search terms denoting 'Multiple Sclerosis', 'health-care services', 'patient', 'experience' and 'qualitative research'. Snowballing and hand searching of journals were used. INCLUSION CRITERIA Studies were included if they used qualitative methods of data collection and analysis to investigate adult patient's experiences of health-care services for MS in the UK. DATA EXTRACTION AND SYNTHESIS Data were extracted independently and analysed jointly by two reviewers. Studies were appraised for the quality of evidence described using the Critical Appraisal Skills Programme's qualitative tool. Due to the breadth of areas covered, the data were too heterogeneous for a synthesis and are presented as a narrative review. MAIN RESULTS AND DISCUSSION Five studies were included. Studies primarily investigated diagnosis or palliative care. Themes of importance were the emotional experience of health care, continuity of care and access to services, and support from health-care professionals. Studies were mainly poor quality and focussed on a homogenous sample. CONCLUSIONS This study provides the first review of the UK evidence base of experiences of health care for MS. Future research should investigate experiences of care after diagnosis in a more varied sample of participants.
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Soundy A, Stubbs B, Freeman P, Coffee P, Roskell C. Factors influencing patients' hope in stroke and spinal cord injury: A narrative review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.5.210] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew Soundy
- Lecturer in Physiotherapy at the University of Birmingham
| | | | - Paul Freeman
- Lecturer in Sport Psychology at University of Exeter
| | - Pete Coffee
- Lecturer in Sports Psychology at the University of Stirling
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Olsman E, Leget C, Onwuteaka-Philipsen B, Willems D. Should palliative care patients' hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals' perspectives on hope of palliative care patients. Palliat Med 2014; 28:59-70. [PMID: 23587737 DOI: 10.1177/0269216313482172] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Healthcare professionals' perspectives on palliative care patients' hope influence communication. However, these perspectives have hardly been examined. AIM To describe healthcare professionals' perspectives on palliative care patients' hope found in the literature. DESIGN The interpretative synthesis consisted of a quality assessment and thematic analysis of included articles. DATA SOURCES Literature search of articles between January 1980 and July 2011 in PubMed, CINAHL, PsycINFO and EMBASE and references of included studies. SEARCH STRATEGY (palliat* or hospice or terminal* in title/abstract or as subject heading) AND (hope* or hoping or desir* or optimis* in title or as subject heading). RESULTS Of the 37 articles, 31 articles were of sufficient quality. The majority of these 31 articles described perspectives of nurses or physicians. Three perspectives on hope of palliative care patients were found: (1) realistic perspective - hope as an expectation should be truthful, and healthcare professionals focused on adjusting hope to truth, (2) functional perspective - hope as coping mechanism should help patients, and professionals focused on fostering hope, and (3) narrative perspective - hope as meaning should be valuable for patients, and healthcare professionals focused on interpreting it. CONCLUSIONS Healthcare professionals who are able to work with three perspectives on hope may improve their communication with their palliative care patients, which leads to a better quality of care.
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Affiliation(s)
- Erik Olsman
- 1Department of General Practice, Section of Medical Ethics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Saleem TZ, Higginson IJ, Chaudhuri KR, Martin A, Burman R, Leigh PN. Symptom prevalence, severity and palliative care needs assessment using the Palliative Outcome Scale: a cross-sectional study of patients with Parkinson's disease and related neurological conditions. Palliat Med 2013. [PMID: 23208011 DOI: 10.1177/0269216312465783] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Palliative care is rarely being offered to patients with Parkinson's disease. AIM To assess symptom prevalence, severity and palliative care needs in advanced stages of Parkinsonism. DESIGN A cross-sectional survey using a palliative care assessment tool, the Palliative Outcome Scale was administered to patients. SETTING/PARTICIPANTS Eight-two patients with a diagnosis of idiopathic Parkinson's disease, multiple systems atrophy or progressive supranuclear palsy were included in the study. RESULTS Their mean age and disease stages 3-5 Hoehn and Yahr were 67 years and 4.1, respectively. Patients reported a mean of 10.7 (standard deviation = 3.9) physical symptoms. Over 80% had pain, fatigue, day time somnolence and problems with mobility. Other symptoms in 50%-80% included constipation, loss of bladder control, swallowing difficulties, drooling, breathlessness and sleep problems. Symptoms rated as causing severe problems were pain, fatigue, constipation and drooling. Assessment of mood revealed 70% of the patients felt anxiety and 60% had felt depressed. Eight-five per cent felt their families were anxious or worried about them. Thirty-eight per cent would have liked more information and 42% had practical problems that still needed to be addressed. There was a positive correlation between number of symptoms and disease severity (r = 0.39, p = 0.01). The total mean Palliative Outcome Scale score was 13.6 (standard deviation = 6.1), suggesting moderate palliative care needs. CONCLUSION This is the first study to describe the care needs of people with Parkinson's disease using the Palliative Outcome Scale tool. The burden of symptoms and concerns was high in advanced stages of disease. It might be appropriate that people severely affected by these conditions should be considered for referral to specialist palliative care services.
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Affiliation(s)
- Tariq Z Saleem
- Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, UK.
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Golla H, Galushko M, Pfaff H, Voltz R. Unmet needs of severely affected multiple sclerosis patients: the health professionals' view. Palliat Med 2012; 26:139-51. [PMID: 21543525 DOI: 10.1177/0269216311401465] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research has only started recently to specifically concentrate on the group of patients severely affected by multiple sclerosis (MS). AIM The aim of this study was to assess the perception on patients' unmet needs by healthcare professionals. METHODS Focus groups and expert interviews were recorded, transcribed verbatim and analysed by qualitative content analysis. RESULTS Unmet needs were identified in four main categories ('support from family/friends'; 'healthcare services'; 'managing everyday life'; 'maintaining biographical continuity'). Whereas physicians assessed most unmet needs in the category 'healthcare services', nurses and social workers focussed on unmet needs in the categories 'support from family/friends' and 'maintaining biographical continuity'. Although the study focused on unmet needs of patients, professionals also voiced their unmet needs when caring for these patients. The group of professionals identified more subcategories than patients and included unmet needs of relatives. CONCLUSION Adding professionals' perspective to that of patients is essential to gain a holistic view on patients' unmet needs and to further optimize their care. The perspective of palliative care might contribute to meet unmet needs of severely affected MS patients.
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Affiliation(s)
- Heidrun Golla
- Department of Palliative Medicine, University Hospital of Cologne, Germany.
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Harmonizing hope: a grounded theory study of the experience of hope of registered nurses who provide palliative care in community settings. Palliat Support Care 2012; 9:281-94. [PMID: 21838949 DOI: 10.1017/s147895151100023x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the hope experience of registered nurses (RNs) who provide palliative care services in community settings. The specific aims of the study were to (1) describe their hope experience, (2) develop a reflexive understanding of the processes of their hope, and (3) construct a substantive theory of hope of palliative care RNs. METHODS Using constructivist grounded theory methodology, purposeful theoretical sampling was used to enroll 14 practicing community palliative care RNs in the study. Twenty-seven open-ended telephone interviews were conducted and nine daily journal entries on hope were copied. Interviews and journals were transcribed verbatim and analyzed using Charmaz's grounded theory approach. RESULTS Participants described their hope as a positive state of being involving a perseverant and realistic understanding of future possibilities. Their hope sustained and motivated them, and helped them to strive to provide high-quality care. The main concern for participants was keeping their hope when faced with work life challenges and contrasting viewpoints (i.e., when their hopes differed from the hopes of others around them). They dealt with this through harmonizing their hope by the processes of "looking both ways," "connecting with others," "seeing the bigger picture," and "trying to make a difference." Their experience of hope was defined within the social context of their work and lives. SIGNIFICANCE OF RESULTS The results of this study suggest that hope is very important to palliative care RNs, in that it helps them to persevere and sustains them when faced with work life challenges in their practice. This study also highlights the need for continued research in this area as there appears to be a lack of evidence on the meaning of hope for healthcare professionals, and, in particular, understanding hope in the context of palliative and end-of-life care delivery.
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Hogden A, Greenfield D, Nugus P, Kiernan MC. Engaging in patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis: the views of health professionals. Patient Prefer Adherence 2012; 6:691-701. [PMID: 23055703 PMCID: PMC3468167 DOI: 10.2147/ppa.s36759] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to explore clinician perspectives on patient decision-making in multidisciplinary care for amyotrophic lateral sclerosis (ALS), in an attempt to identify factors influencing decision-making. METHODS Thirty-two health professionals from two specialized multidisciplinary ALS clinics participated in individual and group interviews. Participants came from allied health, medical, and nursing backgrounds. Interviews were audio recorded, and the transcripts were analyzed thematically. RESULTS Respondents identified barriers and facilitators to optimal timing and quality of decision-making. Barriers related to the patient and the health system. Patient barriers included difficulties accepting the diagnosis, information sources, and the patient-carer relationship. System barriers were timing of diagnosis and symptom management services, access to ALS-specific resources, and interprofessional communication. Facilitators were teamwork approaches, supported by effective communication and evidence-based information. CONCLUSION Patient-centered and collaborative decision-making is influenced by a range of factors that inhibit the delivery of optimal care. Decision-making relies on a fine balance between timing of information and service provision, and the readiness of patients to receive them. Health system restrictions impacted on optimal timing, and patients coming to terms with their condition. Clinicians valued proactive decision-making to prepare patients and families for inevitable change. The findings indicate disparity between patient choices and clinician perceptions of evidence, knowledge, and experience. To improve multidisciplinary ALS practice, and ultimately patient care, further work is required to bridge this gap in perspectives.
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Affiliation(s)
- Anne Hogden
- Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, New South Wales, Australia
- Correspondence: Anne Vaughan Hogden, Centre for Clinical Governance Research, Australian Institute of Health Innovation, Faculty of Medicine, Level 1, AGSM, Building, University of New South Wales, Sydney, NSW 2052, Australia, Tel +612 9385 3071, Fax +612 9663 4926, Email
| | - David Greenfield
- Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, New South Wales, Australia
| | - Peter Nugus
- Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, New South Wales, Australia
| | - Matthew C Kiernan
- Prince of Wales Clinical School, University of New South Wales, and Neuroscience Research Australia, Sydney, New South Wales, Australia
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O'Connor M, Harris R, Lee S. Non-malignant disease: a pathway for quality care at the end of life. ACTA ACUST UNITED AC 2011. [DOI: 10.12968/bjnn.2011.7.2.470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Margaret O'Connor
- Palliative Care Nursing, palliative care research team, School of Nursing & Midwifery, Monash University, Australia
| | - Rodney Harris
- Motor Neurone Disease Association of Victoria, Australia
| | - Susan Lee
- School of Nursing & Midwifery, Monash University. Australia
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Moro TT, Kavanaugh K, Savage TA, Reyes MR, Kimura RE, Bhat R. Parent decision making for life support for extremely premature infants: from the prenatal through end-of-life period. J Perinat Neonatal Nurs 2011; 25:52-60. [PMID: 21311270 PMCID: PMC3085847 DOI: 10.1097/jpn.0b013e31820377e5] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Most deaths of extremely premature infants occur in the perinatal period. Yet, little is known about how parents make life support decisions in such a short period of time. In the paper, how parents make life support decisions for extremely premature infants from the prenatal period through death from the perspectives of parents, nurses, and physicians is described. Five cases, comprised of five mothers, four neonatologists, three nurses, and one neonatal nurse practitioner, are drawn from a larger collective case study. Prenatal, postnatal and end-of-life interviews were conducted, and medical record data were obtained. In an analysis by two research team members, mothers were found to exhibit these characteristics: desire for and actual involvement in life support decisions, weighing pain, suffering and hope in decision making, and wanting everything done for their infants. All mothers received decision making help and support from partners and family, but relationships with providers were also important. Finally, external resources impacted parental decision making in several of the cases. By understanding what factors contribute to parents' decision making, providers may be better equipped to prepare and assist parents when making life support decisions for their extremely premature infants.
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Affiliation(s)
- Teresa T. Moro
- Project Director, University of Illinois at Chicago, Department of Women, Children, and Family Health Science (MC802), College of Nursing, 845 S. Damen Avenue, Room 843, Chicago, IL 60612-7350, Phone: (312) 355-0210, Fax: (312) 996-8871
| | - Karen Kavanaugh
- Professor, University of Illinois at Chicago, Department of Women, Children, and Family Health Science (MC802), College of Nursing, 845 S. Damen Avenue, Room 848, Chicago, IL 60612-7350, Phone: (312) 996-6828
| | - Teresa A. Savage
- University of Illinois at Chicago, Research Assistant Professor, Department of Women, Children, and Family Health Science (MC802), College of Nursing, 845 S. Damen Avenue, Room 843, Chicago, IL 60612-7350, Phone: (312) 355-0210
| | - Maria R. Reyes
- Rush University Medical Center, Perinatal / Women's HC Nurse Practitioner, Clinical Coordinator, Rush Fetal & Neonatal Medicine Program, 407 Pro Building, Office: (312)942-9823, Fax:(312) 942-9198
| | - Robert E. Kimura
- Rush University Medical Center, Director of the Section of Neonatology and Department of Pediatrics, Rush University Medical Center, 1653 West Congress Parkway, ste. 622 Murdoch, Chicago, IL 60612-3833, Office: (312) 942-6640
| | - Rama Bhat
- University of Illinois Medical Center, Professor Emeritus of Pediatrics, University of Illinois at Medical Center, Chicago, IL-60612
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Soundy A, Smith B, Butler M, Lowe CM, Helen D, Winward CH. A qualitative study in neurological physiotherapy and hope: Beyond physical improvement. Physiother Theory Pract 2010; 26:79-88. [DOI: 10.3109/09593980802634466] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Penz K. Theories of hope: are they relevant for palliative care nurses and their practice? Int J Palliat Nurs 2009; 14:408-12. [PMID: 19023958 DOI: 10.12968/ijpn.2008.14.8.30779] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hope is a multidimensional construct that is gaining recognition in nursing theory, research and practice. It is evident that there are few hope theories that are specific to the work and lives of palliative care nurses. As such, little attention has been paid to analyzing the relevance of specific theories to palliative nursing practice. To address these issues, the objectives of this article are: 1) to introduce and critique selected theories of hope with evaluation of their relevance to palliative care nurses; and 2) to identify the conceptual gaps in knowledge that emerged through the critique process, and suggest future research directions for the development of hope theory in palliative nursing practice. An exploration into the dimensions of palliative care nurses' hope and the potential influence of their hope on the care they provide may have future implications for their quality of life and the quality of life of their patients.
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Affiliation(s)
- Kelly Penz
- College of Nursing, University of Saskatchewan, Saskatoon, Canada.
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McCabe MP, Roberts C, Firth L. Satisfaction with services among people with progressive neurological illnesses and their carers in Australia. Nurs Health Sci 2008; 10:209-15. [DOI: 10.1111/j.1442-2018.2008.00399.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brown J, Addington-Hall J. How people with motor neurone disease talk about living with their illness: a narrative study. J Adv Nurs 2008; 62:200-8. [PMID: 18394032 DOI: 10.1111/j.1365-2648.2007.04588.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a study which explores patients' experiences and how they talk about living and coping with motor neurone disease. BACKGROUND Living with motor neurone disease is challenging, frightening and disabling. It leads to progressive physical decline, normally with a prognosis of 3-5 years. Patients have to deal with many problems, including loss of mobility and the inability to communicate. There is little evidence about how people manage these problems or live with this illness. METHOD Narrative case studies were used, the unit of analysis being a patient living in their own home or a care home. Thirteen adults were recruited through purposeful sampling. Longitudinal narrative interviews were conducted at three-monthly intervals over an 18-month period in 2005-06. Interviews were analysed focusing on the form and content of the patients' narratives. FINDINGS Four types of narrative, or storyline were identified. The sustaining storyline is about living life as well as possible through keeping active and engaged in life. In contrast, the enduring storyline concerns living in an insurmountable situation leaving the person feeling disempowered, unable to fight for life or against death. Survival is the essence of the preserving storyline, while the fracturing storyline concerns loss and fear of what is to come. CONCLUSION Storylines help make sense of complex narratives by encouraging closer attention and active listening to the stories and serve as organizing threads to help patients, families and healthcare professionals better understand living with motor neurone disease.
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Affiliation(s)
- Janice Brown
- Cancer, Palliative Care and End of Life Research Group, School of Nursing and Midwifery, University of Southampton, Southampton, UK.
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White CP, White M, Russell CS. Multiple sclerosis patients talking with healthcare providers about emotions. J Neurosci Nurs 2007; 39:89-101. [PMID: 17477223 DOI: 10.1097/01376517-200704000-00005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to consider multiple sclerosis (MS) patients' experiences of talking with healthcare professionals about emotions and their emotional well-being both at the time of diagnosis and while they are living with the illness. Relationships between talking about emotions and positive outcomes were examined. The 145 respondents completed a paper-and-pencil survey, an Internet survey, or a telephone interview. Forty-four percent of respondents indicated that a healthcare provider had discussed their emotional well-being at the time of their diagnosis. Fifty-six percent of respondents reported that their healthcare professional had talked with them about their fears, sadness, and anger related to living with their illness. For those respondents who wanted to talk with their healthcare professional, doing so appeared to be associated with several positive outcomes. The small number (N = 22) of respondents who did not want to talk with a healthcare professional about emotions were also doing well on several measures. Nurses can help MS patients deal with their uncertainty and emotional challenges by being willing to inquire about emotions and emotional well-being.
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Affiliation(s)
- Carmel Parker White
- Department of Child Development and Family Relations at East Carolina University, Greenville, NC, USA.
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22
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Smith LN. Setting the agenda for neurological nursing: strategic directions. Int J Nurs Stud 2006; 43:1063-72. [PMID: 16386254 DOI: 10.1016/j.ijnurstu.2005.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 11/09/2005] [Accepted: 11/13/2005] [Indexed: 11/26/2022]
Abstract
This paper explores a range of issues related to neurological care. The scope and scale of neurological conditions is described in order to illustrate disparities in research funding and care delivery as compared with cancer and cardiovascular disease. Financial implications, ethical issues and health service development are outlined as a context for the state of the art of neurological nursing. Areas for potential neurological nursing research are identified. Finally, it is argued that policy and research must be linked if neurological care, research and education are to receive greater resource allocation.
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Kristjanson LJ, Aoun SM, Oldham L. Palliative care and support for people with neurodegenerative conditions and their carers. Int J Palliat Nurs 2006; 12:368-77. [PMID: 17077795 DOI: 10.12968/ijpn.2006.12.8.368] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM to identify and compare the needs for supportive care/palliative care services of people in Australia with Motor Neurone Disease (MND), Multiple Sclerosis (MS), Huntington's Disease (HD) and Parkinson's Disease (PD) and the needs of their carers. DESIGN national, descriptive survey of service use and support needs for 503 patients and 373 carers. Patients and carers were recruited from the databases of the disease associations in three Australian states. Patients were excluded if recently diagnosed or too sick or disabled to complete the survey. This was a specification of the ethics committee overseeing this project. FINDINGS the MND and HD groups had the greatest needs for support and appeared most receptive to a palliative approach. The MS group was least likely to have a carer and more likely to live alone. HD and PD groups had the highest rates of anxiety and HD groups had the highest rate of depression. CONCLUSIONS patients and carers who received more tailored services and more palliative care services were the most satisfied. Therefore, results highlight the need for tailored and flexible models of care for these groups with unique care requirements.
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Affiliation(s)
- Linda J Kristjanson
- Western Australian Centre for Cancer and Palliative Care, School of Nursing, Midwifery and Postgraduate Medicine, Edith Cowan University, Churchlands, Western Australia 6018.
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Hughes RA, Sinha A, Higginson I, Down K, Leigh PN. Living with motor neurone disease: lives, experiences of services and suggestions for change. HEALTH & SOCIAL CARE IN THE COMMUNITY 2005; 13:64-74. [PMID: 15717908 DOI: 10.1111/j.1365-2524.2005.00530.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Palliative care involves the complete, holistic care of people with progressive illness and their families. People living with motor neurone disease (MND) require a range of multidisciplinary palliative care services. However, there are significant gaps in our understanding of these people's lives, experiences of services and their suggestions for service change. The present study addressed the following questions: (1) What are the lived experiences of people living with MND? (2) What are people's experiences of services? and (3) Can improvements to care be identified? A qualitative research design was adopted using semi-structured interviews. The topic guide was developed from existing literature. The study was based in three boroughs in London, UK. People living with MND and professionals were drawn from a database at King's College Hospital, and additionally, through 'snowball' sampling. Nine people with MND, five carers/family members and 15 professionals took part in the interviews. These interviews were audio-taped, transcribed and checked for accuracy against the original recordings. Themes within the interviews were coded and grouped. The analysis was facilitated with the NVIVO computer software package. The findings are presented within three substantive groups: (1) the impact of MND on people's lives (the physical impacts of the illness, including increasing disability; social issues, including restrictions on social activities; and adjustments to people's lives, including methods of coping with the illness); (2) experiences of services (accessing service entitlements, information sources, professionals' attitudes and approaches, and professionals' knowledge and understanding of MND); and (3) suggestions for service change (better information and communication, including information on service entitlements; improved knowledge amongst professionals about MND; and some suggestions for service restructuring). This study brings a fresh approach to understanding the impacts of MND and the ways in which services can be improved to meet people's needs. The paper concludes with methodological considerations, the implications of the findings for practitioners and policy makers, and suggestions for further research.
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Affiliation(s)
- Rhidian A Hughes
- Centre for Health and Social Care, School for Policy Studies, University of Bristol, Bristol, UK.
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Gantert TW, McWilliam CL. Interdisciplinary Team Processes Within an In-Home Service Delivery Organization. Home Health Care Serv Q 2004; 23:1-17. [PMID: 15451713 DOI: 10.1300/j027v23n03_01] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Interdisciplinary teamwork is particularly difficult to achieve in the community context where geographical separateness and solo practices impede face to face contact and collaborative practice. Understanding the processes that occur within interdisciplinary teams is imperative, since client outcomes are influenced by interdisciplinary teamwork. The purpose of this exploratory study was to describe the processes that occur within interdisciplinary teams that deliver in-home care. Applying grounded theory methodology, the researcher conducted unstructured in-depth interviews with a purposeful sample of healthcare providers and used constant comparative analysis to elicit the findings. Findings revealed three key team processes: networking, navigating, and aligning. The descriptions afford several insights that are applicable to in-home healthcare agencies attempting to achieve effective interdisciplinary team functioning.
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Affiliation(s)
- Thomas W Gantert
- School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, Canada.
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26
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Thorne S, Con A, McGuinness L, McPherson G, Harris SR. Health care communication issues in multiple sclerosis: an interpretive description. QUALITATIVE HEALTH RESEARCH 2004; 14:5-22. [PMID: 14725173 DOI: 10.1177/1049732303259618] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Communication between persons with chronic illness and their professional health care providers is a critical element of appropriate health care. As the field of health care communication evolves, it becomes apparent that aspects of the illness experience shared by those affected by specific diseases might be a source of particular insight into what constitutes effective or appropriate communications. This interpretive description of health care communication issues in multiple sclerosis was based on qualitative secondary analysis of a set of in-depth interviews and focus groups conducted with 12 persons with longstanding MS experience. Analysis of their accounts illustrates an intricate interplay between common features within the disease trajectory and the communications that are perceived as helpful or unhelpful to living well with this chronic illness. From the analysis of these findings, the authors draw interpretations regarding what might be considered communication competencies for those who care for patients with this disease.
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Affiliation(s)
- Sally Thorne
- University of British Columbia School of Nursing, Vancouver, Canada
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Abstract
This paper discusses the findings of a critical study that examined the communication patterns between nurses and general practitioners (GPs) providing palliative care in Australia. Interviews and focus groups involved 40 palliative care nurses who worked in the three settings of care: community, hospice and hospital. Issues that impeded effective communication strategies between palliative care nurses and GPs were networking, case management, multiple service providers, lack of standardized documentation and formal tracking of clients, along with difficulties in transmission of relevant practice knowledge. Supporting strategies for effective formal modes of communicating and reporting are described.
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Affiliation(s)
- A Street
- School of Nursing, La Trobe University, Bundoora, Victoria, Australia.
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Blackford J, Street A. The role of the palliative care nurse consultant in promoting continuity of end-of-life care. Int J Palliat Nurs 2001; 7:273-8. [PMID: 12066021 DOI: 10.12968/ijpn.2001.7.6.9024] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The provision of end-of-life care through a multidisciplinary integrated palliative-care approach is dependent on effective communication between professional groups and services. We did a qualitative study, using semi-structured individual and focus group interviews, in Melbourne, Australia. The research aim was to explore the experiences and strategies used by palliative care nurses to communicate with general practitioners. We found that palliative care nurse consultants in acute hospitals not only provided inpatient consultation, but also played an important part in facilitating continuity of care across healthcare services by improving existing communication strategies and establishing further communication networks. However, there were several issues that had the potential to disrupt communication, and this article reports on the role of the palliative care nurse consultant in addressing these issues.
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Affiliation(s)
- J Blackford
- School of Nursing, La Trobe University, Bundoora, Victoria, Australia
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Macleod R, Carter H. Health professionals' perception of hope: Understanding its significance in the care of people who are dying. ACTA ACUST UNITED AC 1999. [DOI: 10.1080/713685980] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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