 Subjects -> OCCUPATIONS AND CAREERS (Total: 33 journals)
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- COPD patients’ accessibility to palliative care: Current challenges and
opportunities for improvement-
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Authors: Gonçalves; Barbara, Harkess-Murphy, Eileen, Cund, Audrey, Sime, Caroline, Lusher, Joanne
Pages: 429 - 431
PubDate: 2024-01-24
DOI: 10.1017/S1478951524000063
- Complexity of needs in amyotrophic lateral sclerosis (ALS) patients using
the ENP-E scale in the north-eastern region of Spain-
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Authors: Castro-Rodriguez; Emilia, Azagra-Ledesma, Rafael, Gómez-Batiste, Xavier, Aguyé-Batista, Amada, Clemente-Azagra, Carlos, Díaz-Herrera, Miguel Angel
Pages: 460 - 469
Abstract: ObjectivesThis study aimed to explore the clinical characteristics of amyotrophic lateral sclerosis (ALS) patients in Spain’s north-eastern region, their inclusion in chronic care programmes, and their psychosocial and spiritual needs (PSNs).MethodsA longitudinal descriptive study in adult patients with ALS. We analyzed clinical variables and participation in chronicity and PSNs assessment using the tool Psychosocial and Spiritual Needs Evaluation scale in end-of-life patients (ENP-E scale).Results81 patients (average age 65.6 ± 11.7) were studied. At the study’s outset, 29.7% employed non-invasive ventilation (NIV), increasing to 51.9% by its conclusion. Initial percutaneous endoscopic gastrostomy (PEG) utilization was 14.8%, rising to 35.85%. Chronic care programme participation was as follows: home care (24.7% initially, 50.6% end), palliative care (16% initially, 40.7% end), case management (13.6% initially, 50.6% end), and advance care planning registration (6.2% initially, 35.8% end). At study start, 47.8% of patients (n = 46) showed moderate-to-severe complexity in PSNs assessment using the ENP-E scale, without showing differences in age, sex, and time of evolution; whereas, on the evolutionary analysis, it was 75% (n = 24). A higher evolutionary complexity was observed in males 70 years, with no PEG and evolution of ALS of
PubDate: 2024-01-31
DOI: 10.1017/S1478951523001773
- Caregivers’ concerns through health professionals’ eyes
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Authors: Oliveira; Carolina, Lourenço, Daniela, Sotero, Luciana, Relvas, Ana Paula
Pages: 499 - 510
Abstract: ObjectivesAdvancements in medicine and science have enabled more and more people to live longer with a chronic medical condition, namely cancer. Nevertheless, the palliative care (PC) approach continues to be introduced and incorporated later in the lives of patients and families dealing with such conditions. Thus, the need for individuals to care for this population in our society is increasing, giving rise to the so-called “informal caregivers.” The present study intends to examine the main obstacles faced by informal caregivers taking care of a cancer patient receiving PC based on what health professionals working in these settings perceive and write down. To achieve this goal, the written files of 2 Portuguese palliative care institutions were analyzed.MethodsAn inductive thematic analysis was conducted, focusing on the contact between health professionals and family caregivers and based on the notes taken by health professionals.ResultsThree main overarching themes were identified: (1) burden, (2) intra-family impact of the illness, and (3) network vulnerabilities. Included in this are the emphasis on the role of the family and social support, the high levels of psychological morbidity and caregiver burden present over this period, and a great need for information about the illness.Significance of resultsThis study provided a broader awareness regarding the daily struggle experienced by family caregivers, particularly those who juggle between “roles.” It is vital to understand the scope of the obstacles experienced by caregivers during the terminal phase of their loved one’s illness, given how important it is to address the family’s needs. Future studies and practitioners should consider these observations and topics when considering new approaches for this population, as they ought to be quite focused and short in time in order to meet people’s needs.
PubDate: 2024-01-05
DOI: 10.1017/S1478951523001864
- Effects of Dignity Therapy on individuals with amyotrophic lateral
sclerosis: Case studies-
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Authors: Meira; Mariana do Valle, Silva, Rudval Souza da, Chochinov, Harvey Max, Medeiros, Maria Olivia Sobral Fraga de, Ferreira, Marilaine Matos de Menezes, de Góes Salvetti, Marina
Pages: 517 - 525
Abstract: ObjectivesTo analyze the effects of Dignity Therapy (DT) on the physical, existential, and psychosocial symptoms of individuals with amyotrophic lateral sclerosis (ALS).MethodsThis is a mixed-methods case study research that used the concurrent triangulation strategy to analyze the effects of DT on 3 individuals with ALS. Data collection included 3 instances of administering validated scales to assess multiple physical symptoms, anxiety, depression, spiritual well-being, and the Patient Dignity Inventory (PDI), followed by the implementation of DT and a semi-structured interview.ResultsThe scale results indicate that DT led to an improvement in the assessment of physical, social, emotional, spiritual, and existential symptoms according to the score results. It is worth noting that the patient with a recent diagnosis showed higher scores for anxiety and depression after DT. Regarding the PDI, the scores indicate improvements in the sense of dignity in all 3 cases, which aligns with the positive verbal reports after the implementation of DT.Significance of resultsThis study allowed us to analyze the effects of DT on the physical, existential, and psychosocial symptoms of individuals with ALS, suggesting the potential benefits of this approach for this group of patients. Participants reported positive effects regarding pain and fatigue, could reflect on their life trajectories, and regained their value and meaning.
PubDate: 2024-01-05
DOI: 10.1017/S1478951523001888
- End-of-life conversations about death and dying from volunteer
perspectives: A qualitative study-
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Authors: Rodríguez-Prat; Andrea, Wilson, Donna M.
Pages: 526 - 534
Abstract: ObjectivesAlthough often unrecognized, volunteers fulfill many essential roles in hospices and other end-of-life care settings. Volunteers complement the actions of professionals in fulfilling many extra care needs, such as delivering newspapers and tidying bedsides. We explored end-of-life conversations about death and dying between hospice volunteers and terminally ill people, with a particular emphasis on any expressed desire to die. Our 2 research questions were as follows: (1) What is the nature of end-of-life conversations between hospice patients and hospice volunteers' and (2) How do hospice volunteers experience conversations about death and dying with patients who are at the end-of-life'MethodsWe conducted semi-structured interviews using an interpretive phenomenological analysis. We recruited hospice volunteers from 4 hospices in Calgary, Edmonton, and Red Deer; 3 larger cities in the province of Alberta, Canada.ResultsWe interviewed 12 participants to saturation. Four themes emerged: (1) trusting conversations about death and dying in the context of a safe place; (2) normalcy of conversations about death and dying; (3) building meaningful relationships; and (4) end-of-life conversations as a transformative experience. Our results emphasize the importance of preparing volunteers for conversations about death and dying, including the desire to die.Significance of resultsThe safe environment of the hospice, the commitment to patient confidentiality, and the ability of volunteers to meet the basic and emotional needs of dying people or simply just be present without having formal care duties that need to be completed contribute to volunteers being able to participate in timely and needed conversations about death and dying, including the desire to die. In turn, hospice experiences and end-of-life conversations provide a transformative experience for volunteers.
PubDate: 2024-01-22
DOI: 10.1017/S147895152300189X
- Communicating with families of young people with hard-to-treat cancers:
Healthcare professionals’ perspectives on challenges, skills, and
training-
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Authors: Kelada; Lauren, Robertson, Eden G., McKay, Skye, McGill, Brittany C., Daly, Rebecca, Mazariego, Carolyn, Taylor, Natalie, Tyedmers, Elijah, Armitage, Nicole, Evans, Holly E., Wakefield, Claire E., Ziegler, David S.
Pages: 539 - 545
Abstract: ObjectivesHard-to-treat childhood cancers are those where standard treatment options do not exist and the prognosis is poor. Healthcare professionals (HCPs) are responsible for communicating with families about prognosis and complex experimental treatments. We aimed to identify HCPs’ key challenges and skills required when communicating with families about hard-to-treat cancers and their perceptions of communication-related training.MethodsWe interviewed Australian HCPs who had direct responsibilities in managing children/adolescents with hard-to-treat cancer within the past 24 months. Interviews were analyzed using qualitative content analysis.ResultsWe interviewed 10 oncologists, 7 nurses, and 3 social workers. HCPs identified several challenges for communication with families including: balancing information provision while maintaining realistic hope; managing their own uncertainty; and nurses and social workers being underutilized during conversations with families, despite widespread preferences for multidisciplinary teamwork. HCPs perceived that making themselves available to families, empowering them to ask questions, and repeating information helped to establish and maintain trusting relationships with families. Half the HCPs reported receiving no formal training for communicating prognosis and treatment options with families of children with hard-to-treat cancers. Nurses, social workers, and less experienced oncologists supported the development of communication training resources, more so than more experienced oncologists.Significance of resultsResources are needed which support HCPs to communicate with families of children with hard-to-treat cancers. Such resources may be particularly beneficial for junior oncologists and other HCPs during their training, and they should aim to prepare them for common challenges and foster greater multidisciplinary collaboration.
PubDate: 2024-01-24
DOI: 10.1017/S1478951523001992
- Effectiveness of a palliative care education program for caregivers of
cancer patients receiving chemotherapy in Port Said City: A pre-post
quasi-experimental study-
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Authors: Ibrahim; Ateya Megahed, Elnaghy, Sara Fawzy, Abo Elmatty, Gehad Mohamed, Mohamed Ghida, Nglaa Ibrahim, Mohamed, Magda Ali
Pages: 546 - 562
Abstract: BackgroundEmphasizing the pivotal role of caregivers in the cancer care continuum, a program designed to educate caregivers of cancer patients undergoing chemotherapy underscores their significance. The palliative care education initiative strives to cultivate a compassionate and effective care environment, benefiting both patients and caregivers. By imparting education, fostering positive attitudes, offering support, encouraging appropriate behaviors, and providing essential resources, the program aims to enhance the overall caregiving experience and contribute to the well-being of those navigating the challenges of cancer treatment.ObjectivesTo evaluate the effectiveness of a palliative care education program for caregivers of cancer patients receiving chemotherapy.MethodsThe research employed a purposive sample comprising 155 caregivers who were actively present with their cancer patients throughout the pre- and post-test phases within a quasi-experimental research design. The study took place at the outpatient oncology center of Al-Shifa Medical Complex in Port Said City, Egypt. To gather comprehensive data, 4 instruments were utilized: a demographic questionnaire, a nurse knowledge questionnaire, a scale measuring attitudes toward palliative care, and an assessment of reported practices in palliative care. This methodological approach allowed for a thorough exploration of caregiver perspectives, knowledge, attitudes, and practices within the context of a palliative care education program.ResultsBefore the palliative care education program, only 1.3% of caregivers had a good overall level of knowledge about cancer and palliative care; this increased to 40.6% after the program. Similarly, before the palliative care education program, 32.9% of caregivers had a positive overall attitude, which increased to 72.3% after the program. Similarly, 27.1% of caregivers had an overall appropriate palliative care practice during the pre-test phase, which increased to 93.5% after the palliative care education program.Significance of the resultsThe palliative care education program significantly improved caregivers’ knowledge, attitudes, and practice scores. It is strongly recommended that caregivers of cancer patients receive continuing education in palliative care. In addition, it is crucial to conduct further research with a larger sample size in different situations in Egypt.
PubDate: 2024-01-30
DOI: 10.1017/S1478951523002067
- Hemichorea–hemiballismus associated with a case of cerebral
toxoplasmosis in a hematopoietic stem cell transplant recipient-
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Authors: Rocha-Cadman; Xiomara, Revilla, Amanda R., Cadman, Karla, Root, James C.
Pages: 623 - 625
Abstract: Due to their immunocompromised state, recipients of hematopoietic stem cell transplants (HSCTs) are at a higher risk of opportunistic infections, such as that of toxoplasmosis. Toxoplasmosis is a rare but mortal infection that can cause severe neurological symptoms, including confusion. In immunosuppressed individuals, such as those with acquired immunodeficiency syndrome (AIDS), toxoplasmosis can cause movement disorders, including hemichorea–hemiballismus. We present the case of a 54-year-old Caucasian male with a history of hypertension and JAK-2-negative primary myelofibrosis who underwent an allogeneic peripheral blood stem cell transplant from a related donor. After the development of acute changes in mental status, left-sided weakness, and left-sided hemichorea–hemiballismus post-transplant, the patient was readmitted to the hospital. Subsequent testing included an magnetic resonance imaging (MRI) of the brain, which revealed multiple ring-enhancing lesions around the thalami and basal ganglia, as well as a cerebrospinal fluid tap that tested positive for toxoplasmosis. The patient was initially treated with intravenous clindamycin and oral pyrimethamine with leucovorin. The completion of treatment improved the patient’s mental status but did not improve his hemichorea–hemiballismus. This case illustrates an uncommon complication associated with central nervous system (CNS) toxoplasmosis in stem cell transplant recipients. Due to its rarity, cerebral toxoplasmosis in immunocompromised patients often remains undetected, particularly in HSCT patients who are immunosuppressed to improve engraftment. Neurological and neuropsychiatric symptoms due to toxoplasmosis may be misidentified as psychiatric morbidities, delaying appropriate treatment. Polymerase chain reaction (PCR) assays offer methods that are sensitive and specific to detecting toxoplasmosis and provide opportunities for early intervention.
PubDate: 2024-02-05
DOI: 10.1017/S1478951524000105
- Silent melodies
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Authors: Yaghy; Antonio
Pages: 629 - 629
PubDate: 2024-01-05
DOI: 10.1017/S1478951523001979
- Evaluating a novel hospital-based online health community to address
palliative and psychosocial care factors for chronically ill adolescent
and young adult patients-
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Authors: LeBeau; Kelsea, Collins, Sarah, Zori, Gaia, Walker, Drew, Marchi, Emily, Pomeranz, Jamie L., Hart, Mark
Pages: 432 - 443
Abstract: ObjectivesChronically ill adolescent and young adult (AYA) patients experience barriers to accessing psychosocial care. AYAs who receive palliative and psychosocial care experience numerous benefits from these services. However, we still lack research investigating age-appropriate programs targeting AYAs’ psychosocial needs that are delivered virtually and extend beyond the hospital setting. Streetlight is a palliative care program designed for chronically ill AYAs that offers the Streetlight Gaming League (SGL), an online health community (OHC) combining peer-based support, online gaming, and community events. We evaluated the usefulness, acceptability, and potential effectiveness of SGL through an assessment of chronically ill AYAs’ lived experiences.MethodsWe used a qualitative evaluation approach grounded in hermeneutic phenomenology. Questionnaires and interviews were conducted with 9 chronically ill AYAs to elicit in-depth accounts of their lived experiences of using SGL. Descriptive statistical analysis was performed on questionnaire data. Phenomenological data analysis, informed by hermeneutic analysis, was used to analyze interviews.ResultsAYAs reported positive experiences with SGL and valued the ability to engage in various content while having few participation expectations. They also described psychosocial benefits, including reprieve from illness, sense of community, and solidarity through mutual understandings and shared experiences.Significance of the resultsFindings highlight the usefulness and acceptability of a virtual palliative psychosocial care program for chronically ill AYAs. Findings also suggest the effectiveness of SGL and support using an OHC to meet the psychosocial needs of AYAs. This study can guide future programming and implementation of online palliative psychosocial care programs in other hospital settings, resulting in similar beneficial and meaningful experiences.
PubDate: 2023-02-27
DOI: 10.1017/S1478951523000147
- Deathbed experiences and meaning-making: Perspectives of family caregivers
of patients who received cancer palliative care-
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Authors: Teo; Irene, Paramasivam, Keerthana, Chee, Wai Yee, Ng, Carolyn, Neo, Patricia Soek Hui, Lee, Geok Ling
Pages: 444 - 450
Abstract: ObjectivesThe deathbed symbolizes a time when the patient is dangerously ill and where death is imminent. The memories of family caregivers during this time can potentially shape their meaning-making of the patient’s death and bereavement adjustment. We aimed to understand the experiences of family caregivers at the deathbed of patients receiving palliative care. We also examined caregiver’s meaning-making that occurred after the patient’s death.MethodsIn this retrospective qualitative study, family caregivers of cancer patients who received palliative care in Singapore were recruited through purposive sampling. In-person, semi-structured interviews were individually conducted with study participants to understand their experiences from a caregiver’s perspective before and after the death of the patient. Thematic content analysis method was conducted.ResultsA total of 25 bereaved family caregivers were interviewed, with spouses, adult children, and others comprising one-third each of the sample. Six themes emerged from caregivers’ recollected experiences around the patient deathbed: Lasting image of the patient, A time of intense emotions, Healthcare providers prepare caregivers, A time for saying goodbye, Rituals provide comfort, and Impact on family ties. Four themes emerged surrounding post-loss meaning-making: An end to the pain and suffering, “Have I done enough',” Significance in the timing of events, and Gaining strength and personal growth.Significance of resultsThe deathbed is a salient time for family caregivers as they prepare for patient’s death. There are opportunities to provide support to the family based on the study findings.
PubDate: 2023-12-06
DOI: 10.1017/S1478951523001670
- Emotion dysregulation and family functioning moderate family caregiving
burden during the pandemic-
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Authors: Kim; Dahee, Russell, Beth S., Park, Crystal L., Fendrich, Michael
Pages: 451 - 459
Abstract: ObjectivesSince the onset of COVID-19 pandemic, additional risk factors affecting family caregivers’ mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers’ mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated.MethodsThis study analyzed data collected in April 2021 from 154 family caregivers (Mage = 38.79, SDage = 9.36, range = 22–64) recruited through Amazon’s Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated.ResultsBoth COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors.Significance of resultsThe current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic.
PubDate: 2023-11-24
DOI: 10.1017/S1478951523001712
- Spirituality moderates the relationship between cancer caregiver burden
and depression-
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Authors: La; In Seo, Johantgen, Meg, Storr, Carla L., Zhu, Shijun, Cagle, John G., Ross, Alyson
Pages: 470 - 481
Abstract: ObjectivesCancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers’ burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer.MethodsThis secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates.ResultsSpirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers’ spirituality on the relationship between depression and caregiver burden over time (b = −1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support.Significance of resultsSpirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients’ health.
PubDate: 2023-12-22
DOI: 10.1017/S1478951523001785
- Distress, demoralization, and fulfillment among palliative care providers
during the COVID-19 pandemic-
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Authors: Tang; Michael, Ann-Yi, Sujin, Zhukovsky, Donna S., Fellman, Bryan, Bruera, Eduardo
Pages: 482 - 486
Abstract: ObjectivesProlonged distress is a risk factor for burnout among health-care providers (HCP) and may contribute to demoralization. We examined sources of distress during the COVID-19 pandemic and associations with demoralization.MethodsThis prospective cross-sectional survey of HCP was conducted among palliative care providers of an academic medical center. Participants completed a survey evaluating sources of distress and the Demoralization Scale-II (DS-II) to measure the intensity of demoralization.ResultsOf 106 eligible participants, 74 (70%) completed the survey. DS-II median (range) score was 2 (0–19). There were no statistically significant associations with demographic characteristics. Participants reported high rates of distress for multiple reasons and high rates of sense of fulfillment (90%) and satisfaction (89%) with their profession.Significance of resultsOur study identified high levels of distress but low demoralization rates. Further study to evaluate fulfillment and satisfaction as protective factors against demoralization and burnout is indicated.
PubDate: 2023-12-01
DOI: 10.1017/S1478951523001803
- Adjustment to “new normal” after cancer among non–small cell lung
cancer survivors: A qualitative study-
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Authors: Lee; Genehee, Kim, Soo Yeon, Ahn, Alice, Kong, Sunga, Nam, Heesu, Kang, Danbee, Kim, Hong Kwan, Shim, Young Mog, Jeong, Ansuk, Shin, Dong Wook, Cho, Juhee
Pages: 487 - 492
Abstract: ObjectivesCancer is a life-changing experience, and side effects from treatment can make it difficult for survivors to return to their pre-cancer “normal life.” We explored the “new normal” and barriers to achieving it among lung cancer survivors who underwent surgery.MethodsSemi-structured interviews were conducted with 32 recurrence-free non–small cell lung cancer survivors. We asked survivors how life had changed; how they defined the “new normal”; barriers that prevent them from achieving a “normal” life; and unmet needs or support for normalcy. Thematic analysis was performed.ResultsDefining “new normal” subjectively depends on an individual’s expectation of recovery: (1) being able to do what they want without pain or discomfort; (2) being able to do activities they could accomplish before their surgery; and (3) being able to work, earn money, and support their family. We found that (1) persistent symptoms, (2) fear of cancer recurrence, (3) high expectations in recovery, and (4) psychosocial stress and guilty feelings were barriers to achieving a “new normal.” The needs and support for normalcy were information on expected trajectories, postoperative management, and support from family and society.Significance of resultsSurvivors defined the “new normal” differently, depending on their expectations for recovery. Informing survivors about the “new normal” so they could expect possible changes and set realistic goals for their life after cancer. Health professionals need to communicate with survivors about expectations for “normality” from the beginning of treatment, and it should be included in comprehensive survivorship care.
PubDate: 2023-12-22
DOI: 10.1017/S1478951523001815
- Reiki intervention for supporting healthcare professional care behaviors
in pediatric palliative care: A pilot study-
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Authors: Zucchetti; Giulia, Ciappina, Sabrina, Bottigelli, Cristina, Campione, Gabriela, Parrinello, Annalisa, Piu, Paola, Lijoi, Stefano, Quarello, Paola, Fagioli, Franca
Pages: 493 - 498
Abstract: ObjectivesPediatric healthcare professionals (HCPs) working in a palliative setting may experience challenges during their clinical practice in addressing the complex end-of-life phase of children and their families. Nurses, especially, have a frontline role in providing assistance, thereby becoming at risk of physical and psychological burden. Pediatric psychologists have an ethical responsibility to help colleagues by proposing self-care interventions that will improve their well-being and, indirectly, the work climate. This study investigated the impact of a complementary therapy, delivered by a pediatric psychologist and a nurse, on physical and psychological variables among nurses at the Paediatric Hospice of the Regina Margherita Children’s Hospital in Italy.MethodsThirty-five nurses participated in 5 weeks of Reiki sessions for an overall total of 175 sessions. The effect of the sessions was analyzed through a paired t-test analysis comparing the values of heart rate, oxygen saturation, and systolic and diastolic pressure collected before and after each session. The same test was conducted comparing the values of the 3 burnout subscales for each of the 35 nurses collected before the beginning of the first session with those collected at the end of the last session 2 months later.ResultsResults underlined a positive short-term effect with a significant decrease in heart rate before and after each session (t = 11.5, p < .001) and in systolic pressure (t = 2, p < .05). In addition, a decrease in emotional exhaustion symptoms was found (t = 2.3, p < .05) at the end of the intervention.Significance of resultsReiki could be a valid strategy to complement traditional pediatric psychology clinical practice designed to protect HCPs from emotional and physical demands and to create a more supportive workplace for staff and patients alike.
PubDate: 2023-12-22
DOI: 10.1017/S1478951523001852
- Discussion of the do-not-resuscitate (DNR) orders with the family
caregivers of cancer patients: An example from a major cancer center in
Saudi Arabia-
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Authors: Al-Shahri; Mohammad Z., Sroor, Mahmoud, Ghareeb, Wael Ali Said, Alhassanin, Suzan, Ateya, Heba Aly
Pages: 511 - 516
Abstract: ObjectivesTo explore the views of the family caregivers (FCGs) about the “do-not-resuscitate” (DNR) discussions and decision-making processes that occurred during hospitalization in a Saudi cancer center.MethodsIn this cross-sectional survey, the FCGs of inpatients with advanced cancer completed a self-administered questionnaire soon after giving the patients a DNR status designation by their oncologists.ResultsEighty-two FCGs participated in the study, with a median age of 36.5 years and male preponderance (70.7%). The FCGs were mostly sons (41.5%), daughters (14%), or brothers (11%) of patients. Only 13.4% of mentally competent patients had the chance to listen to the DNR discussion. The discussion mainly occurred in the ward corridor (48.8%) or another room away from the patients’ rooms (35.4%). In 36.6% of cases, the discussion took ≤5 minutes. Half of the FCGs stated that the oncologists’ justifications for the DNR decision were unconvincing. The majority (84.2%) of the FCGs felt that the healthcare providers should share the DNR decision-making with patients (1.2%), families (69.5%), or both (13.4%). FCGs ≤ 30 years of age were more supportive of giving patients’ families a chance to participate in the DNR decision-making process (p = 0.012).Significance of resultsThere is considerable room for improving the current practice of DNR discussions and decision-making processes in the studied setting. A readily feasible rectifying measure is to ensure the adequacy of time and privacy when planning for DNR discussions. We expect our findings to draw the attention of stakeholders to a compelling need for reviewing the current policies and processes, aiming to improve the experience of cancer patients and their FCGs.
PubDate: 2023-12-21
DOI: 10.1017/S1478951523001876
- Subcutaneous administration of drugs and hydration in acute palliative
care units: Physician attitudes and beliefs in the United States and
Canada-
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Authors: Tang; Michael, Khan, Rida, Ruiz Buenrostro, Alejandra, Andersen, Clark R., Lau, Jenny, Hui, David, Zimmermann, Camilla, Bruera, Eduardo
Pages: 535 - 538
Abstract: ObjectivesThe objective of this study was to compare the attitudes and beliefs of PCU physicians leaders in the United States versus Canada regarding the subcutaneous method in the administration of medications and hydration in order to gain a better understanding as to why variations in practice exist.MethodsThis survey trial took place from November 2022 to May 2023. The MD Anderson Cancer Center institutional review board in Houston, Texas, approved this study. The participants were the physician leaders of the acute palliative care units (PCUs) in the United States and Canada. The survey comprised questions formulated by the study investigators regarding the perceived comfort, efficiency, and preference of using the subcutaneous versus the intravenous method. The consent form and survey links were emailed to the participants.ResultsSixteen PCUs were identified in the United States and 15 PCUs in Canada. Nine US and 8 Canadian physicians completed the survey. Physicians in Canada were more likely to use the subcutaneous route for administering opioids, antiemetics, neuroleptics, and hydration. They preferred subcutaneous over intravenous or intramuscular routes (p = 0.017). Canadian physicians felt their nursing staff was more comfortable with subcutaneous administration (p = 0.022) and that it was easier to administer (p = 0.02). US physicians felt the intravenous route was more efficient (p = 0.013).Significance of resultsThe study results suggest that exposure to the subcutaneous route influences a physician’s perception. Further research is needed to explore ways to incorporate its use to a greater degree in the US healthcare system.
PubDate: 2023-12-21
DOI: 10.1017/S1478951523001943
- Positive psychology interventions in palliative care: Cui bono'
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Authors: Stiefel; Friedrich, Bourquin, Céline, Michaud, Laurent
Pages: 588 - 591
PubDate: 2023-12-21
DOI: 10.1017/S1478951523001682
- Palliative care in the treatment of women with breast cancer: A scoping
review-
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Authors: Velasco Yanez; Romel Jonathan, Carvalho Fernandes, Ana Fátima, de Freitas Corpes, Erilaine, Moura Barbosa Castro, Régia Christina, Sixsmith, Judith, Lopes-Júnior, Luís Carlos
Pages: 592 - 609
Abstract: ObjectivesRecent studies on the quality of life in women with breast cancer show a high prevalence of signs and symptoms that should be the focus of palliative care (PC), leading us to question the current role they play in addressing breast cancer. Therefore, the objective of this review is to map the scope of available literature on the role of PC in the treatment of women with breast cancer.MethodsThis is a methodologically guided scoping review by the Joanna Briggs Institute and adapted to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist for report writing. Systematic searches were conducted in 8 databases, an electronic repository, and gray literature. The searches were conducted with the support of a librarian. The study selection was managed through the RAYYAN software in a blind and independent manner by 2 reviewers. The extracted data were analyzed using the qualitative thematic analysis technique and discussed through textual categories.ResultsA total of 9,812 studies were identified, of which only 136 articles and 3 sources of gray literature are included in this review. In terms of general characteristics, the majority were published in the USA (35.7%), had a cross-sectional design (44.8%), and were abstracts presented at scientific events (19.6%). The majority of interventions focused on palliative radiotherapy (13.6%). Thematic analysis identified 14 themes and 12 subthemes.Significance of resultsOur findings offer a comprehensive view of the evidence on PC in the treatment of breast cancer. Although a methodological quality assessment was not conducted, these results could guide professionals interested in the topic to position themselves in the current context. Additionally, a quick synthesis of recommendations on different palliative therapies is provided, which should be critically observed. Finally, multiple knowledge gaps are highlighted, which could be used for the development of future studies in this field.
PubDate: 2023-12-07
DOI: 10.1017/S1478951523001840
- Healing across cultures
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Authors: Zieneldien; Tarek
Pages: 626 - 626
PubDate: 2023-11-16
DOI: 10.1017/S1478951523001694
- The sonographer’s explorations
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Authors: Zieneldien; Tarek
Pages: 627 - 627
PubDate: 2023-11-16
DOI: 10.1017/S1478951523001700
- Snowmelt
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Authors: Gandhi; Malini M.
Pages: 628 - 628
PubDate: 2023-11-17
DOI: 10.1017/S1478951523001724
- A commentary on “Spirituality is ‘sometimes just a hug’: A
conceptual analysis from the perspective of nursing students” (Piret
Paal et al, 2023)-
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Authors: Sitefane; Sara, Afonso, Ana, Shapira, Revital, Rabiais, Isabel, Caldeira, Sílvia
Pages: 630 - 631
PubDate: 2023-12-21
DOI: 10.1017/S1478951523002006
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