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Mosoiu D, Payne S, Predoiu O, Arantzamendi M, Ling J, Tserkezoglou A, Mitrea N, Dionisi M, Martínez M, Mason S, Ancuta C, Centeno C. Core Palliative Care Research Competencies Framework for Palliative Care Clinicians. J Palliat Med 2024; 27:471-480. [PMID: 38010819 DOI: 10.1089/jpm.2023.0399] [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: 11/29/2023] Open
Abstract
Background: Understanding the principles and practice of research by health care professionals helps to improve the evidence base for palliative care practice and service delivery. Research is a core competency in palliative care that enables the identification and addressing of problems for patients and their families, establishes best practice and improves ways to manage pain, other symptoms, and concerns. This work was undertaken in the research for all palliative care clinicians (RESPACC) Erasmus+ project. Aim: To identify and develop a set of core research competencies within a structured framework for all members of the multidisciplinary palliative team. Design: A multi-method approach was used including rapid review of literature, Nominal Group Technique, and expert consultation. A quiz to self-assess research competencies outlined within the Framework was produced. Results: The Framework includes 17 competencies organized in 7 domains: The clinical context, Scientific thinking and research design, Ethics and regulatory framework for research, Study and site management, Data management and informatics, Communication and relationships, and Research leadership. In the consultation process 6 of the 17 competencies were considered as required by each individual team member, and 3 to be present within the palliative care team. Conclusion: Using a multi-method approach, the first Palliative Care Research Framework identifying core research competencies for palliative care clinicians has been developed. The aim of the framework was not to transform palliative care clinicians into researchers, but to ensure that clinicians understand the important role of research and its integration into clinical practice.
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Affiliation(s)
- Daniela Mosoiu
- Faculty of Medicine, Transilvania University, Brasov, Romania
- HOSPICE Casa Sperantei, Education and National Development Department, Brasov, Romania
| | - Sheila Payne
- International Observatory on End-of-Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Oana Predoiu
- HOSPICE Casa Sperantei, Education and National Development Department, Brasov, Romania
| | - Maria Arantzamendi
- Institute for Culture and Society, ATLANTES Global Observatory of Palliative Care, University of Navarra, Pamplona (Navarra), Spain
- Navarra Medical Research Institute (IdiSNA)
| | - Julie Ling
- European Association for Palliative, Head Office team Department, Vilvoorde, Belgium
| | | | - Nicoleta Mitrea
- Faculty of Medicine, Transilvania University, Brasov, Romania
- HOSPICE Casa Sperantei, Education and National Development Department, Brasov, Romania
| | - Mary Dionisi
- "Galilee" Palliative Care Unit, Senior Management Team, Athens, Greece
| | - Marina Martínez
- Navarra Medical Research Institute (IdiSNA)
- Clinica Universidad de Navarra, Department of Palliative Medicine, Pamplona (Navarra), Spain
| | - Stephen Mason
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Camelia Ancuta
- HOSPICE Casa Sperantei, Education and National Development Department, Brasov, Romania
| | - Carlos Centeno
- Institute for Culture and Society, ATLANTES Global Observatory of Palliative Care, University of Navarra, Pamplona (Navarra), Spain
- Navarra Medical Research Institute (IdiSNA)
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Matthew M, Bainbridge D, Bishop V, Sinding C, Winemaker S, Kilbertus F, Kortes-Miller K, Seow H. Implementing palliative care education into primary care practice: a qualitative case study of the CAPACITI pilot program. BMC Palliat Care 2023; 22:143. [PMID: 37759200 PMCID: PMC10537555 DOI: 10.1186/s12904-023-01265-7] [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] [Received: 06/26/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND CAPACITI is a virtual education program that teaches primary care teams how to provide an early palliative approach to care. After piloting its implementation, we conducted an in-depth qualitative study with CAPACITI participants to assess the effectiveness of the components and to understand the challenges and enablers to virtual palliative care education. METHODS We applied a qualitative case study approach to assess and synthesize three sources of data collected from the teams that participated in CAPACITI: reflection survey data, open text survey data, and focus group transcriptions. We completed a thematic analysis of these responses to gain an understanding of participant experiences with the intervention and its application in practice. RESULTS The CAPACITI program was completed by 22 primary care teams consisting of 159 participants across Ontario, Canada. Qualitative data was obtained from all teams, including 15 teams that participated in focus groups and 21 teams that provided reflection survey data on CAPACITI content and how it translated into practice. Three major themes arose from cross-analysis of the data: changes in practice derived from involvement in CAPACITI, utility of specific elements of the program, and barriers and challenges to enacting CAPACITI in practice. Importantly, participants reported that the multifaceted approach of CAPACITI was helpful to them building their confidence and competence in applying a palliative approach to care. CONCLUSIONS Primary care teams perceived the CAPACITI facilitated program as effective towards incorporating palliative care into their practices. CAPACITI warrants further study on a national scale using a randomized trial methodology. Future iterations of CAPACITI need to help mitigate barriers identified by respondents, including team fragmentation and system-based challenges to encourage interprofessional collaboration and knowledge translation.
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Affiliation(s)
- Midori Matthew
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Daryl Bainbridge
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Valerie Bishop
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | | | | | - Frances Kilbertus
- Northern Ontario School of Medicine University, Thunder Bay, ON, Canada
| | | | - Hsien Seow
- Department of Oncology, McMaster University, Hamilton, ON, Canada.
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Lakhani S, Scalzitti DA, Padrone L, Martins-Welch D. From evidence to practice: early integration of palliative care in a comprehensive cancer center. Support Care Cancer 2022; 31:17. [PMID: 36513942 DOI: 10.1007/s00520-022-07510-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The American Society of Clinical Oncology (ASCO) recommends that all patients with a diagnosis of advanced cancer be referred to a palliative care team within 8 weeks of diagnosis. The benefits of early integrated palliative care are well recognized; however, there is a lack of consensus to guide operational aspects of a palliative care service within a comprehensive cancer center. In this study, we explore current palliative care referral patterns at an academic cancer center and provide recommendations for operationalizing palliative care services as a program within comprehensive cancer centers in order to adequately meet the needs of patients with advanced cancer. METHODS A retrospective chart review of patients with newly diagnosed metastatic cancer or advanced hematologic malignancy referred to the palliative care team at a comprehensive cancer center from January 1, 2021, to October 31, 2021, was conducted. Institutional Review Board (IRB) approval was obtained prior to the initiation of the chart review. RESULTS A total of 243 patients with newly diagnosed metastatic cancer or advanced hematologic malignancy were included in this review. Patients with gastrointestinal (26%), gynecologic (19%), and thoracic (21%) malignancies constituted 66% of the total cohort. The most frequent reason for referral was pain (52%). In total, 39% of patients were referred within 8 weeks of an advanced cancer diagnosis. CONCLUSION ASCO recommends that all patients with advanced cancer be referred to a palliative care specialist within 8 weeks of diagnosis. Of the newly referred patients with advanced cancer, only 39% were referred to the palliative care team within 8 weeks of their diagnosis. This considerable gap suggests the need for a consensus with regard to operationalizing the palliative care team.
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Affiliation(s)
- Shamsah Lakhani
- Advanced Clinical Providers, Northwell Health Cancer Institute, Northwell Health, New Hyde Park, NY, USA.
| | - David A Scalzitti
- Department of Health and Human Function and Rehabilitation Sciences, George Washington University, Washington, DC, USA
| | - Laura Padrone
- Northwell Health Cancer Institute, Northwell Health, New York, USA
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Cho MC, Yang PC, Wang YH, Chang HT, Lin MH. Association between the Development of Hospice and Palliative Care and Government-Funded Research Priority: Taiwan-Based Example. Healthcare (Basel) 2022; 10:healthcare10061125. [PMID: 35742174 PMCID: PMC9222240 DOI: 10.3390/healthcare10061125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, hospice and palliative care (HPC) has grown, developed, and changed in response to the humanistic and social needs for supporting those with incurable illnesses. As a relatively new discipline, research is needed in HPC, and the priority setting of research is essential to help direct finite resources to support research. To promote creative research in different fields including HPC, the Taiwan government subsidized institutions to conduct research. In this study, we obtained data from the Government Research Bulletin, an open-source online system containing complete information about government subsidized studies since 1993 to investigate the development of research priority in HPC in Taiwan. In total, 552 studies were recorded during 1993–2021, with a continued upward trend. An association was found between research priority and the promulgation of new HPC regulations. The type of diseases in research extended from cancer to all advanced chronic conditions. The increased diversity in out-of-hospital settings of palliative research was also observed. Numerous studies have focused on education, and the theme gradually shifted from “training and education for healthcare professionals” to “public education”. Here, the results may serve as a basis to understand the commonalities of research and enhance dialog in HPC research.
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Affiliation(s)
- Ming-Chieh Cho
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (M.-C.C.); (Y.-H.W.)
| | - Po-Chin Yang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (P.-C.Y.); (H.-T.C.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yueh-Hsin Wang
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (M.-C.C.); (Y.-H.W.)
| | - Hsiao-Ting Chang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (P.-C.Y.); (H.-T.C.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Ming-Hwai Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (P.-C.Y.); (H.-T.C.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-2-28757460
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Riffin C, Griffin JM, Brody L, Wolff JL, Pillemer KA, Adelman RD, Bangerter LR, Starks SM, Falzarano F, Villanigro-Santiago M, Veney L, Czaja SJ. Engaging and Supporting Care Partners of Persons With Dementia in Health-Care Delivery: Results From a National Consensus Conference. THE PUBLIC POLICY AND AGING REPORT 2022; 32:58-65. [PMID: 35607366 PMCID: PMC9118070 DOI: 10.1093/ppar/prac004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Catherine Riffin
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Joan M Griffin
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Lilla Brody
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Jennifer L Wolff
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Karl A Pillemer
- Department of Psychology, Cornell University, Ithaca, New York, USA
| | - Ronald D Adelman
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Lauren R Bangerter
- Research and Development, UnitedHealth Group, Minnetonka, Minnesota, USA
| | - Steven M Starks
- Department of Clinical Sciences, University of Houston College of Medicine, Houston, Texas, USA
| | | | | | | | - Sara J Czaja
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
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Hopia H, Heikkilä J. Nursing research priorities based on CINAHL database: A scoping review. Nurs Open 2020; 7:483-494. [PMID: 32089844 PMCID: PMC7024619 DOI: 10.1002/nop2.428] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/18/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
Aim To analyse nursing research based on the CINAHL database to identify research priorities for nursing. Design A scoping literature review was conducted. The CINAHL Plus (EBSCO) Full Text was searched between 2012-2018. Methods Out of 1522 original publications, 91 fulfilled the inclusion criteria. The Joanna Briggs Institute critical appraisal tools were applied. Data were analysed by a thematic analysis method. Results A strong emphasis should be put on development and evaluation of nursing theories and, in addition, randomized controlled trial studies, meta-synthesis, experimental and intervention studies are needed in nursing research. Development of competencies and skills in the nursing profession ought to be studied more extensively and research should be focused on variety fields of nursing practice.
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Affiliation(s)
- Hanna Hopia
- School of Health and Social StudiesJAMK University of Applied SciencesJyvaskylaFinland
| | - Johanna Heikkilä
- School of Health and Social StudiesJAMK University of Applied Sciences, Research and DevelopmentJyvaskylaFinland
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Weaver RH, Naar JJ, Jarrott SE. Using Contact Theory to Assess Staff Perspectives on Training Initiatives of an Intergenerational Programming Intervention. THE GERONTOLOGIST 2020; 59:770-779. [PMID: 29294005 DOI: 10.1093/geront/gnx194] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Project TRIP (Transforming Relationships through Intergenerational Programs) was developed as a sustainable intergenerational community project involving child care participants and elders attending an elder care program or volunteering at the children's program. The project focused on staff development of evidence-based intergenerational practices. To enhance available intervention research, contact theory provided a theoretical framework to explore how staff members' and administrators' perceptions of the intervention influenced their ability to implement programming in social care settings. RESEARCH DESIGN AND METHODS We used a directed content analysis approach to analyze small group and individual interviews with 32 participants from 6 program sites over 5 years. RESULTS Participants highlighted inherent challenges and subsequent benefits of academic-community partnerships. Greater on-site presence, open communication, and relationship-building proved critical to improve community partnerships, project fidelity, and program sustainability. When interactions reflected contact theory tenets, collaborators reported positive attitudes toward and interactions with research partners. DISCUSSION AND IMPLICATIONS Contact theory provided a useful framework to understand the researcher-practitioner partnership. Researchers should plan for partnerships that: (a) are supported by authority figures, including staff and participants, (b) utilize a shared expertise approach where partners have equal group status, (c) involve close cooperation; (d) align research and program goals, and (e) foster positive communication through frequent contact using practitioners' preferred methods and including in-person contact. We recommend future intergenerational programming interventions build on a foundation of both theory and practice.
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Affiliation(s)
- Raven H Weaver
- Department of Human Development, Washington State University, Pullman
| | - Jill J Naar
- Department of Human Development and Family Science, Virginia Tech, Blacksburg
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Hasson F, Nicholson E, Muldrew D, Bamidele O, Payne S, McIlfatrick S. International palliative care research priorities: A systematic review. BMC Palliat Care 2020; 19:16. [PMID: 32013949 PMCID: PMC6998205 DOI: 10.1186/s12904-020-0520-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been increasing evidence and debate on palliative care research priorities and the international research agenda. To date, however, there is a lack of synthesis of this evidence, examining commonalities, differences, and gaps. To identify and synthesize literature on international palliative care research priorities originating from Western countries mapped to a quality assessment framework. METHODS A systematic review of several academic and grey databases were searched from January 2008-June 2019 for studies eliciting research priorities in palliative care in English. Two researchers independently reviewed, critically appraised, and conducted data extraction and synthesis. RESULTS The search yielded 10,235 articles (academic databases, n = 4108; grey literature, n = 6127), of which ten were included for appraisal and review. Priority areas were identified: service models; continuity of care; training and education; inequality; communication; living well and independently; and recognising family/carer needs and the importance of families. Methodological approaches and process of reporting varied. There was little representation of patient and caregiver driven agendas. The priorities were mapped to the Donabedian framework for assessing quality reflecting structure, process and outcomes and key priority areas. CONCLUSIONS Limited evidence exists pertaining to research priorities across palliative care. Whilst a broad range of topics were elicited, approaches and samples varied questioning the credibility of findings. The voice of the care provider dominated, calling for more inclusive means to capture the patient and family voice. The findings of this study may serve as a template to understand the commonalities of research, identify gaps, and extend the palliative care research agenda.
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Affiliation(s)
- Felicity Hasson
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland.
| | - Emma Nicholson
- UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Deborah Muldrew
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland
| | - Olufikayo Bamidele
- Academcy of Primary Care, Hull York Medical School, Allam Medical Building, University of Hull, Hull, HU6 7RZ, England
| | - Sheila Payne
- International Observatory on End of Life Care, Lancaster University, LA14YX, Lancaster, UK
| | - Sonja McIlfatrick
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland
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Trevino KM, Healy C, Martin P, Canin B, Pillemer K, Sirey JA, Reid MC. Improving implementation of psychological interventions to older adult patients with cancer: Convening older adults, caregivers, providers, researchers. J Geriatr Oncol 2019; 9:423-429. [PMID: 29759913 DOI: 10.1016/j.jgo.2018.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/23/2018] [Accepted: 04/25/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Older adults with cancer (OACs) are a large and growing population. Psychological distress is prevalent in this population yet few OACs receive evidence-based psychological care. The purpose of this project was to identify barriers and strategies for the implementation of psychological interventions to OACs from the perspective of OACs, OAC caregivers, researchers, clinicians, and advocacy organization members. METHODS The Cornell Research-to-Practice (RTP) Consensus Workshop Model was used to organize and convene a consensus conference. The one-day conference consisted of small and large group discussions regarding barriers, facilitators, and strategies for the implementation of psychological interventions targeting OACs. A half-day roundtable meeting was subsequently conducted to organize data generated at the conference. De-identified transcriptions of the small group discussions were uploaded into NVivo 11 software and qualitatively analyzed using standard methods. RESULTS Thirty-five participants attended the consensus conference from across stakeholder groups. Three themes related to implementation barriers were identified: lack of knowledge about psychological interventions in patients and providers; personal and social factors associated with being an OAC; and institutional-level factors. Themes related to implementation strategies focused on increasing awareness, tailoring interventions for older adults, and modifying institutional-level factors. DISCUSSION Effective implementation of psychological interventions to OACs is complex and barriers exist across multiple levels of care. However, this project indicates that implementation can be improved in various ways that include all members of the healthcare system. Further clarification of implementation strategies and rigorous evaluation of their effectiveness is vital to improving care and care outcomes of OACs.
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Affiliation(s)
- Kelly M Trevino
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States.
| | - Charlotte Healy
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
| | - Peter Martin
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
| | | | - Karl Pillemer
- Cornell University, 144 East Ave., Ithaca, NY 14853, United States
| | - Jo Anne Sirey
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
| | - M Cary Reid
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
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10
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Pereira A, Ferreira A, Martins J. Healthcare Received in the Last Months of Life in Portugal: A Systematic Review. Healthcare (Basel) 2019; 7:healthcare7040122. [PMID: 31652935 PMCID: PMC6955763 DOI: 10.3390/healthcare7040122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 11/16/2022] Open
Abstract
Background: While evidence demonstrates that end-of-life care practices vary across countries, there is still a lack of evidence regarding the healthcare that is received by adult individuals in the last months of life in Portugal. Methods: This is a systematic review that aims to examine the evidence published until 2019 regarding the healthcare received by adult individuals in the last months of life in Portugal. Results: Nine studies were included in this review. All of these were quantitative and retrospective studies, used patient records as the source of information, and were conducted in hospital settings. The time frame analysis before death ranged from 48 h to 3 months. The majority of the studies focused on the physical aspects of care, such as physical needs assessment and symptom management, prescribed medication, and invasive interventions. No evidence was found regarding spiritual, psychological, social or cultural needs. Conclusion: Although using patient records as a source of information may introduce a bias, this study indicates that there is a greater emphasis on the physical aspects of care and less on the psychological, spiritual or social aspects of care received by adult individuals in their last months of life in Portugal.
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Affiliation(s)
- Alexandra Pereira
- Community Care Unit of Lousada, Rua de Santo Tirso 70, Meinedo, Lousada, 4620-848 Porto, Portugal.
- Abel Salazar Biomedical Institute, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Amélia Ferreira
- Community Care Unit of Lousada, Rua de Santo Tirso 70, Meinedo, Lousada, 4620-848 Porto, Portugal.
- Abel Salazar Biomedical Institute, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - José Martins
- Medical-Surgical Nursing Department, Nursing School of Coimbra, 3046-841 Coimbra, Portugal.
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Trivedi N, Peterson EB, Ellis EM, Ferrer RA, Kent EE, Chou WYS. Awareness of Palliative Care among a Nationally Representative Sample of U.S. Adults. J Palliat Med 2019; 22:1578-1582. [PMID: 31038384 DOI: 10.1089/jpm.2018.0656] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Palliative care can alleviate symptom burden, reduce psychosocial distress, and improve quality of life for patients suffering from serious or life-threatening illnesses. However, the extent to which U.S. adults are aware of or understand the goals and benefits of palliative care is not well understood. Public awareness of palliative care is necessary to change norms and create demand, and as such, limited awareness may be a significant barrier to palliative care uptake. An assessment of current palliative care awareness in the United States is needed to inform the health care sector's improving palliative care communication and delivery. Objective: To examine the prevalence of palliative care awareness among a nationally-representative sample of U.S. adults and to identify sociodemographic and health-related characteristics associated with palliative care awareness. Design: Weighted data from the Health Information National Trends Survey (HINTS 5, Cycle 2 [2018], N = 3445) were used to produce frequencies of the characteristics, and associations with palliative care awareness were determined through multiple logistic regression. Results: An estimated 71% of U.S. adults reported having never heard of palliative care. Older individuals, those with higher educational attainment, women, and whites (vs. nonwhites) had greater odds of palliative care awareness. Conclusions: These data suggest there is limited awareness of palliative care in the United States, despite its documented benefits. Addressing this awareness gap is a priority to change norms around using palliative care services. Community- and population-based interventions are necessary to raise awareness and inform the public about palliative care.
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Affiliation(s)
- Neha Trivedi
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Emily B Peterson
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Erin M Ellis
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Rebecca A Ferrer
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Wen-Ying Sylvia Chou
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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Sullivan R, Ugalde A, Sinclair C, Breen LJ. Developing a Research Agenda for Adult Palliative Care: A Modified Delphi Study. J Palliat Med 2018; 22:480-488. [PMID: 30461347 DOI: 10.1089/jpm.2018.0462] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Little is known about research priorities in adult palliative care. Identifying research priorities for adult palliative care will help in increasing research quality and translation. Objective: The aim was to identify the views of health professionals' research priorities in adult palliative care that lead to development of a palliative care research agenda in Australia. Design: A modified three-round Delphi survey. Setting/Subjects: Palliative care researchers and clinicians in Australia were invited to participate. Results: A total of 25 panelists completed round 1, 14 completed round 2, and 13 completed round 3. Round 1 resulted in 90 research priorities in 13 categories. Round 2 showed consensus agreement on 19/90 research priorities. Round 3 resulted in the top 10 research priorities of the 19 achieving consensus in round 2. Panelists agreed that research is needed on the transition to palliative care; improving communication about prognosis; increasing access to palliative care for indigenous communities, people who wish to remain at home, and people in aged care; addressing family caregivers' needs; promoting patients' and families' decision making; improving cross-cultural aspects of palliative care; determining the effects of assisted dying legislation; and improving bereavement care in rural, remote, and Aboriginal populations. Conclusions: The expert panelists identified the top 10 research priorities for adult palliative care. These identified research priorities are the most urgent topics requiring attention to increase the quality of life of patients requiring palliative care and their family members.
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Affiliation(s)
| | - Anna Ugalde
- 2 School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Craig Sinclair
- 3 Rural Clinical School of Western Australia, University of Western Australia (Albany Centre), Albany, Australia
| | - Lauren J Breen
- 1 School of Psychology, Curtin University, Perth, Australia
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13
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Pereira A, Ferreira A, Martins J. Academic Palliative Care Research in Portugal: Are We on the Right Track? Healthcare (Basel) 2018; 6:healthcare6030097. [PMID: 30103530 PMCID: PMC6163737 DOI: 10.3390/healthcare6030097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The narrow link between practice, education, and research is essential to palliative care development. In Portugal, academic postgraduate publications are the main booster for palliative care research. METHODS This is a bibliometric study that aims to identify Portuguese palliative care postgraduate academic work published in electronic academic repositories between 2000 and 2015. RESULTS 488 publications were identified. The number of publications has increased, especially in the last five years. The most frequently used method was quantitative, healthcare professionals were the most studied participants, and psychological and psychiatric aspects of care comprised the most current theme. Practice-based priorities are financial costs and benefits of palliative care, awareness and understanding of palliative care, underserved populations, best practices, communication, and palliative care in nonhospital settings. CONCLUSION The number of palliative care postgraduate academic publications has increased in Portugal in the past few years. There is academic production in the eight domains of quality palliative care and on the three levels of recommendation for practice-based research priorities. The major research gaps in Portugal are at the system and societal context levels.
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Affiliation(s)
- Alexandra Pereira
- Community Care Unit of Lousada, Rua de Santo Tirso 70, Meinedo, Lousada, 4620-848 Porto, Portugal.
- Abel Salazar Biomedical Institute, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Amélia Ferreira
- Community Care Unit of Lousada, Rua de Santo Tirso 70, Meinedo, Lousada, 4620-848 Porto, Portugal.
- Abel Salazar Biomedical Institute, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - José Martins
- Nursing School of Coimbra, 3046-841 Coimbra, Portugal.
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Trevino KM, Canin B, Healy C, Moran S, Trochim WM, Martin P, Pillemer K, Sirey JA, Reid MC. Bridging the Gap Between Aging Research and Practice: A New Strategy for Enhancing the Consensus Workshop Model. J Appl Gerontol 2018; 39:677-680. [PMID: 30058433 DOI: 10.1177/0733464818791433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: The Cornell Research-to-Practice (RTP) Consensus Workshop Model is a strategy for bridging the gap between aging research and practice but lacks a technique for evaluating the relative importance of ideas. This project assessed the feasibility of adding a quantitative survey to the RTP model to address this gap. Method: Older adults with cancer (OACs), OAC caregivers, researchers, clinicians, and advocacy organization representatives participated in a RTP workshop on implementing psychological interventions for OACs. Following an in-person workshop, participants completed surveys assessing the relative importance of barriers and strategies for psychological intervention implementation. Results: Seventeen of 35 participants completed the survey, the majority of which were likely clinicians. Barriers and strategies to implementation rated as having the greatest impact were associated with the care team and institutional factors. Conclusion: Quantitative ratings add novel information to the RTP model that could potentially enhance the model's impact on aging research and practice.
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Affiliation(s)
- Kelly M Trevino
- Weill Cornell Medicine, NewYork Presbyterian Hospital, New York, NY, USA
| | | | - Charlotte Healy
- Weill Cornell Medicine, NewYork Presbyterian Hospital, New York, NY, USA
| | | | | | - Peter Martin
- Weill Cornell Medicine, NewYork Presbyterian Hospital, New York, NY, USA
| | | | - Jo Anne Sirey
- Weill Cornell Medicine, NewYork Presbyterian Hospital, New York, NY, USA
| | - M Cary Reid
- Weill Cornell Medicine, NewYork Presbyterian Hospital, New York, NY, USA
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15
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Wethington E, Eccleston C, Gay G, Gooberman-Hill R, Schofield P, Bacon E, Dombrowski W, Jamison R, Rothman M, Meador L, Kenien C, Pillemer K, Löckenhoff C, Reid MC. Establishing a Research Agenda on Mobile Health Technologies and Later-Life Pain Using an Evidence-Based Consensus Workshop Approach. THE JOURNAL OF PAIN 2018; 19:1416-1423. [PMID: 29969726 DOI: 10.1016/j.jpain.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/07/2018] [Accepted: 06/21/2018] [Indexed: 01/13/2023]
Abstract
The rapid growth of mobile health (mHealth) devices holds substantial potential for improving care and care outcomes in all patient populations, including older adults with pain. However, existing research reflects a substantial gap in knowledge about how to design, evaluate, and disseminate devices to optimally address the many challenges associated with managing pain in older persons. Given these knowledge gaps, we sought to develop a set of practice-based research priorities to facilitate innovation in this field. We employed the Cornell Research-Practice Consensus Workshop Model, an evidence-based approach to generating research priorities. Sixty participants attended the conference, where stakeholder groups included older adults with pain and their caregivers, behavioral and social scientists, healthcare providers, pain experts, and specialists in mHealth and health policy. Participants generated 13 recommendations classified into 2 categories: 1) implications for designing research on mHealth among older adults (eg, conduct research on ways to enhance accessibility of mHealth tools among diverse groups of older adults with pain, expand research on mHealth sensing applications), and 2) implementation of mHealth technology into practice and associated regulatory issues (eg, promote research on ways to initiate/sustain patient behavior change, expand research on mHealth cybersecurity and privacy issues). PERSPECTIVE: This report highlights a set of research priorities in the area of mHealth and later-life pain derived from the joint perspectives of researchers and key stakeholder groups. Addressing these priorities could help to improve the quality of care delivered to older adults with pain.
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Affiliation(s)
- Elaine Wethington
- Department of Human Development, Cornell University, Ithaca, New York
| | | | - Geri Gay
- Departments of Information Science & Communication, Cornell University, Ithaca, New York
| | - Rachael Gooberman-Hill
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Patricia Schofield
- Department of Research and Income Generation, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Elizabeth Bacon
- Department of Computing and Information Systems, University of Greenwich, Greenwich, United Kingdom
| | | | - Robert Jamison
- Departments of Anesthesia and Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Max Rothman
- Department of Human Development, Cornell University, Ithaca, New York
| | - Lauren Meador
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Cara Kenien
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Karl Pillemer
- Department of Human Development, Cornell University, Ithaca, New York
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16
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Martins Pereira S, Araújo J, Hernández-Marrero P. Towards a public health approach for palliative care: an action-research study focused on engaging a local community and educating teenagers. BMC Palliat Care 2018; 17:89. [PMID: 29958534 PMCID: PMC6025723 DOI: 10.1186/s12904-018-0344-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/20/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Education sessions about palliative care among teenagers are uncommon in developed countries. However, very little is known either about the impact of this type of intervention or about how this age-group perceives its impact. The purpose of this study was therefore to (i) implement an education program about palliative care among teenagers and (ii) to investigate the impact of the program on the participants. METHODS An action-research study was conducted at a local community parish in Portugal in November 2015. An education programme was purposively built about palliative care, using active educational strategies adapted for teenagers. Quantitative and qualitative techniques and instruments were used for data collection: questionnaire; reflective diaries; interviews and written testimony. The program had three stages: preparation; intervention; and evaluation. Qualitative data were analysed using thematic content analysis; quantitative data were analysed descriptively. RESULTS 69 people (47 teenagers) participated in the education program. Findings show that the education program contributed to creating awareness about palliative care. Both the teenagers and other participants assessed the education program positively. At the end of the program, teenagers had a constructive message about palliative care. CONCLUSIONS The education-intervention contributed to create awareness about palliative care among the participant teenagers, who ended the program with a positive message about palliative care. Based on our findings, the following policy implications can be drawn: (1) Further research is needed to evaluate the effect of education programs about palliative care among younger age groups (teenagers and children), particularly in relation to the changing of attitudes toward palliative care. (2) Education about palliative care should be promoted to local communities, involving all age groups, to foster involvement, participation and empowerment. (3) Compassionate communities should be promoted to enhance the health and wellbeing of all citizens at the end of their life.
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Affiliation(s)
- Sandra Martins Pereira
- Instituto de Bioética, Universidade Católica Portuguesa, Rua Diogo Botelho, 1327 4169-005 Porto, Portugal
- UNESCO Chair in Bioethics Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal
- CEGE: Centro de Estudos em Gestão e Economia [Research Centre in Management and Economics Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal
| | - Joana Araújo
- Instituto de Bioética, Universidade Católica Portuguesa, Rua Diogo Botelho, 1327 4169-005 Porto, Portugal
- UNESCO Chair in Bioethics Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal
- CEGE: Centro de Estudos em Gestão e Economia [Research Centre in Management and Economics Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal
| | - Pablo Hernández-Marrero
- Instituto de Bioética, Universidade Católica Portuguesa, Rua Diogo Botelho, 1327 4169-005 Porto, Portugal
- UNESCO Chair in Bioethics Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal
- CEGE: Centro de Estudos em Gestão e Economia [Research Centre in Management and Economics Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal
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Scherrens AL, Beernaert K, Robijn L, Deliens L, Pauwels NS, Cohen J, Deforche B. The use of behavioural theories in end-of-life care research: A systematic review. Palliat Med 2018; 32:1055-1077. [PMID: 29569998 DOI: 10.1177/0269216318758212] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: It is necessary to understand behaviours that contribute to improvement in the quality of end-of-life care; use of behavioural theories allows identification of factors underlying end-of-life care behaviour, but little is known about the extent to which, and in what manner, these theories are used in an end-of-life care research context. Aim: To assess the number of end-of-life care studies that have used behavioural theories, which theories were used, to what extent main constructs were explored/measured and which behavioural outcomes were examined. Design: We conducted a systematic review. The protocol was registered on PROSPERO (CRD42016036009). Data sources: The MEDLINE (PubMed), PsycINFO, EMBASE, Web of Science and CINAHL databases were searched from inception to June 2017. We included studies aimed at understanding or changing end-of-life care behaviours and that explicitly referred to individual behavioural theories. Results: We screened 2231 records by title and abstract, retrieved 43 full-text articles and included 31 studies – 27 quantitative (of which four (quasi-)randomised controlled trials) and four qualitative – for data extraction. More than half used the Theory of Planned Behaviour (9), the Theory of Reasoned Action (4) or the Transtheoretical Model (8). In 9 of 31 studies, the theory was fully used, and 16 of the 31 studies focussed on behaviours in advance care planning. Conclusion: In end-of-life care research, the use of behavioural theories is limited. As many behaviours can determine the quality of care, their more extensive use may be warranted if we want to better understand and influence behaviours and improve end-of-life care.
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Affiliation(s)
- Anne-Lore Scherrens
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,2 Health Education and Promotion Research Group, Department of Public Health, Ghent University, Ghent, Belgium
| | - Kim Beernaert
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,3 Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Lenzo Robijn
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,3 Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Luc Deliens
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,3 Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Nele S Pauwels
- 4 Knowledge Centre for Health Ghent, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- 2 Health Education and Promotion Research Group, Department of Public Health, Ghent University, Ghent, Belgium
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18
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Kozlov E, Niknejad B, Reid MC. Palliative Care Gaps in Providing Psychological Treatment: A Review of the Current State of Research in Multidisciplinary Palliative Care. Am J Hosp Palliat Care 2018; 35:505-510. [PMID: 28783958 PMCID: PMC5873550 DOI: 10.1177/1049909117723860] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients with advanced illness often have high rates of psychological symptoms. Many multicomponent palliative care intervention studies have investigated the efficacy of overall symptom reduction; however, little research has focused explicitly on how interventions address psychological symptoms associated with serious illness. METHODS The current study reviewed 59 multicomponent palliative care intervention articles and analyzed the mental health components of palliative care interventions and their outcomes in order to better understand the current state of psychological care in palliative care. RESULTS The majority of articles (69.5%) did not provide any details regarding the psychological component delivered as part of the palliative care intervention. Most (54.2%) studies did not specify which provider on the team was responsible for providing the psychological intervention. Studies varied regarding the type of outcome measure utilized; multi-symptom assessment scales were used in 54.2% of studies, mental health scales were employed in 25.4%, quality of life and distress scales were used in 16.9%, and no psychological scales were reported in 28.8%. Fewer than half the studies (42.4%) documented a change in a psychological outcome. DISCUSSION AND CONCLUSION The majority of analyzed studies failed to describe how psychological symptoms were identified and treated, which discipline on the team provided the treatment, and whether psychological symptoms improved as a result of the intervention. Future research evaluating the effects of palliative care interventions on psychological symptoms will benefit from using reliable and valid psychological outcome measures and providing specificity regarding the psychological components of the intervention and who provides it.
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Affiliation(s)
- Elissa Kozlov
- Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA
| | - Bahar Niknejad
- Cornell University Joan and Sanford I Weill Medical College, New York, NY, USA
| | - M. C. Reid
- Weill Cornell Medical College, New York, NY, USA
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19
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Dowling TB. Reflection on curative treatment versus palliation of symptoms in end of life care. Nurs Stand 2018; 32:46-51. [PMID: 29341551 DOI: 10.7748/ns.2018.e10644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2016] [Indexed: 06/07/2023]
Abstract
The conflicting tasks of treating or managing disease and preparing patients and their families for the end of life are well documented in haematology and palliative care settings. This article is a reflection on practice by a nursing student who was in the fourth year of an internship, and discusses a case study involving a woman at the end of life. It considers the approach to palliative and end of life care adopted in an oncology and haematology ward where there was a reluctance to be realistic about the limitations of treatments among some healthcare practitioners, who did not want to dispel unrealistic expectations of the patient's recovery as a result of continuing treatment. This reflection focuses on the care of a patient at the end of life and the frustration experienced by the nursing student at their inability to alter the direction of treatment from curative treatment to the palliation of symptoms.
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20
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Kozlov E, Reid MC, Carpenter BD. Improving patient knowledge of palliative care: A randomized controlled intervention study. PATIENT EDUCATION AND COUNSELING 2017; 100:1007-1011. [PMID: 28034612 PMCID: PMC5879772 DOI: 10.1016/j.pec.2016.12.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/14/2016] [Accepted: 12/20/2016] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To determine if laypersons' knowledge about palliative care can improve with a brief education intervention. METHODS 152 adults were recruited to participate in a web-based randomized intervention trial that followed a 2 (content)×2 (format) between-subjects design. Groups received either a video intervention, an information page intervention, a video control, or an information page control. An ANCOVA with contrast coding of two factors was utilized to assess if knowledge, as measured by the Palliative Care Knowledge Scale (PaCKS), increased post intervention. RESULTS There was a significant difference between intervention group means and control group means on PaCKS scores from T1 to T2 F(1, 139)=11.10, p=0.00, ηp2=0.074. There was no significant difference in PaCKS change scores between the video intervention and information page intervention. CONCLUSIONS This study demonstrates that an information page and a brief video can improve knowledge of palliative care in laypersons. PRACTICE IMPLICATIONS Self-administered educational interventions could be made available in diverse settings in order to reach patients and their families who may benefit from but are unaware of palliative care. Interventions more intensive than the one tested in this study might result in even more significant improvements in knowledge.
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Affiliation(s)
- Elissa Kozlov
- Weill Cornell Medical College, Department of Medicine, New York, NY, United States.
| | - M Carrington Reid
- Weill Cornell Medical College, Department of Medicine, New York, NY, United States
| | - Brian D Carpenter
- Washington University in St. Louis, Department of Psychological & Brain Sciences, St. Louis, MO, United States
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21
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Reid MC, Ghesquiere A, Kenien C, Capezuti E, Gardner D. Expanding palliative care's reach in the community via the elder service agency network. ANNALS OF PALLIATIVE MEDICINE 2017; 6:S104-S107. [PMID: 28595429 DOI: 10.21037/apm.2017.03.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/06/2017] [Indexed: 11/06/2022]
Abstract
Over the past two decades, palliative care has established itself as a promising approach to address the complex needs of individuals with advanced illness. Palliative care is well-established in US hospitals and has recently begun to expand outside of the hospital setting to meet the needs of non-hospitalized individuals. Experts have called for the development of innovative community-based models that facilitate delivery of palliative care to this target population. Elder service agencies are important partners that researchers should collaborate with to develop new and promising models. Millions of older adults receive aging network services in the U.S., highlighting the potential reach of these models. Recent health care reform efforts provide support for community-based initiatives, where coordination of care and services, delivered via health and social service agencies, is highly prioritized. This article describes the rationale for developing such approaches, including efforts to educate elder service agency clients about palliative care; training agency staff in palliative care principles; building capacity for elder services providers to screen individuals for palliative care needs; embedding palliative care "champions" in agencies to educate staff and clients and coordinate access to services among those with palliative care needs; and leveraging telehealth resources to conduct comprehensive assessments by hospital palliative care teams for elder service clients who have palliative care needs. We maintain that leveraging the resources of elder service agencies could measurably expand the reach of palliative care in the community.
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Affiliation(s)
- M Carrington Reid
- Department of Medicine, Weill Cornell Medical Center, New York, NY, USA.
| | - Angela Ghesquiere
- Brookdale Center for Healthy Aging, Hunter College of CUNY, New York, NY, USA
| | - Cara Kenien
- Department of Medicine, Weill Cornell Medical Center, New York, NY, USA
| | - Elizabeth Capezuti
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, NY, USA
| | - Daniel Gardner
- Brookdale Center for Healthy Aging, Hunter College of CUNY, New York, NY, USA
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22
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Riffin C, Kenien C, Ghesquiere A, Dorime A, Villanueva C, Gardner D, Callahan J, Capezuti E, Reid MC. Community-based participatory research: understanding a promising approach to addressing knowledge gaps in palliative care. ANNALS OF PALLIATIVE MEDICINE 2017; 5:218-24. [PMID: 27481321 DOI: 10.21037/apm.2016.05.03] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 04/22/2016] [Indexed: 11/06/2022]
Abstract
Concern over the need for effective and accessible healthcare for individuals with advanced chronic illness has drawn attention to the significant gaps in our knowledge of palliative medicine. To advance our understanding of this field, community-based participatory research (CBPR) is proposed as a tool for future research initiatives. This paper offers a rationale for how CBPR may be employed to address specific gaps in palliative care research. Several examples where this approach has been used previously are described, and potential obstacles to implementing this research method are delineated. Despite challenges to incorporating CBPR to palliative care research, this approach holds substantial potential to advance our current understanding of the field and promote sensitivity for future programs, practices and policies.
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Affiliation(s)
- Catherine Riffin
- Department of Human Development, College of Human Ecology, Ithaca, NY, USA.
| | - Cara Kenien
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Angela Ghesquiere
- Brookdale Center for Healthy Aging, Hunter College of the City University of New York, New York, NY, USA
| | - Ashley Dorime
- Northeast Business Group on Health, New York, NY, USA
| | | | - Daniel Gardner
- Brookdale Center for Healthy Aging, Hunter College of the City University of New York, New York, NY, USA
| | - Jean Callahan
- Legal Aid Society, Brooklyn Neighborhood Office, New York, NY, USA
| | - Elizabeth Capezuti
- Hunter College School of Nursing of the City University of New York, New York, NY, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
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