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Palliative nursing

Marianne Heins, Jolien Hofstede, Mieke Rijken, Joke Korevaar, Gé Donker, Anneke Francke
BACKGROUND: In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. METHODS: Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision...
April 17, 2018: BMC Palliative Care
Keira Lowther, Richard Harding, Victoria Simms, Nancy Gikaara, Aabid Ahmed, Zipporah Ali, Hellen Kariuki, Lorraine Sherr, Irene J Higginson, Lucy Selman
We conducted in Kenya a mixed-methods randomised controlled trial (RCT) of a nurse-led palliative care intervention integrated with anti-retroviral therapy (ART) provision for the management of HIV. Here we report qualitative findings showing increased resistance to HIV-associated stigma among trial participants. A mixed method design was chosen to enable identification of the active ingredients of the intervention and exploration of participants' experiences of receiving the intervention. The RCT was conducted from July 2011 to November 2012 in a community hospital in the city of Mombasa, Kenya, with a sample of 120 adults with HIV on ART...
April 17, 2018: AIDS Care
Amanda Pereira-Salgado, Patrick Mader, Clare O'Callaghan, Leanne Boyd
BACKGROUND: Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations...
April 16, 2018: JMIR Research Protocols
Joan G Carpenter, Patricia H Berry, Mary Ersek
Despite hospital palliative care consultations during which goals of care are discussed in the context of poor prognoses, older adults are admitted to nursing homes for post-acute care where the focus is on rehabilitation. The purpose of this qualitative descriptive study was to describe factors that influence discontinuity between a palliative care consult and nursing home care and explore the potential consequences of this discontinuity. Twelve adults (mean age of 80 years) were enrolled from one community hospital and nursing home in the mid-Atlantic United States...
April 2018: Journal of Hospice and Palliative Nursing: JHPN
Mitsuko Ushikubo
The purpose of this study was to elucidate the circumstances and symptoms of patients with amyotrophic lateral sclerosis (ALS) using noninvasive positive pressure ventilation (NPPV) in whom death was approaching, to understand how to provide palliative care to dying patients with ALS receiving NPPV management. The participants were 6 home visiting nurses who were head or subhead nurses of a home visiting nursing agency. Data were collected data conducting individual semistructured interviews and then group interviews...
April 12, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Tuti Nuraini, Dewi Gayatri, Dewi Irawaty
Indonesia is a developing country and most breast cancer patients present with terminal conditions, including discomfort. Comfort is a crucial component of nursing in palliative care, especially in breast cancer patients. However, this condition is difficult to assess and therefore assign as a diagnosis. Some comfort assessment tools have been developed in other countries are found not appropriate for an Indonesian context. This study is a sequence of prior qualitative research regarding a comfort assessment tool to be developed in Indonesia...
February 2018: Enfermería Clínica
Matthias Vogl, Eva Schildmann, Reiner Leidl, Farina Hodiamont, Helen Kalies, Bernd Oliver Maier, Marcus Schlemmer, Susanne Roller, Claudia Bausewein
BACKGROUND: Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. METHODS: Two-center, standardised micro-costing approach with patient-level cost calculations and analysis of the reimbursement situation for patients receiving palliative care at two German hospitals (7/2012-12/2013)...
April 5, 2018: BMC Palliative Care
Verna L Hendricks-Ferguson, Joan E Haase
BACKGROUND: Parents of children diagnosed with cancer may experience decision regret about cancer treatment decisions and dissatisfaction with the perceived clarity in information received from their child's providers. OBJECTIVE: The aim of this study was to describe parental perspectives about receiving an early palliative care and end-of-life (PC/EOL) communication intervention titled "Communication Plan: Early through End of Life Intervention" (COMPLETE) from an interprofessional team of physician and registered nurse providers...
April 3, 2018: Cancer Nursing
Patricia Hizo-Abes, Lauren Siegel, Gil Schreier
BACKGROUND: On February 6th, 2015, the Supreme Court of Canada ruled that competent adults suffering intolerably from a grievous and irremediable medical condition have the right to the assistance of a physician in ending their own lives, an act known as physician-assisted death, and later defined as medical assistance in dying, allowing for provision by a physician or a nurse practitioner. As of June 6th, 2016, this is no longer illegal across Canada. There is strong support amongst the general population for physician-assisted death, however there is no recent data on the attitudes of terminally ill patients...
April 4, 2018: BMC Palliative Care
Jessica L Spruit, Cynthia J Bell, Valerie B Toly, Maryjo Prince-Paul
The care of pediatric patients with cancer and their families is complex and rapidly evolving. Despite significant advances in outcomes, symptoms of the disease and complications of therapy continue to cause suffering that may improve with the involvement of pediatric palliative care (PPC) services. This descriptive study responds to the observation of great variability in PPC utilization within pediatric oncology. Data collected from 156 health care professionals (nurses, advanced practice professionals, and physicians) from a statewide hematology alliance evaluates the knowledge, beliefs, and perceived barriers to PPC involvement...
April 1, 2018: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
Ulrika Hilding, Renée Allvin, Karin Blomberg
BACKGROUND: The transition from life-prolonging to palliative care (PC) can be challenging often characterized by psychical, physiological, social and existential changes. Knowledge of how to support the patient and family in this specific care phase is lacking, and this area needs to be further explored. The aim of this study was to investigate strategies that registered nurses (RNs) use to ease the transition from life-prolonging care to PC for patients with incurable disease. METHODS: The study has a descriptive design...
April 3, 2018: BMC Palliative Care
Gisèle Chvetzoff, Géraldine Thevenet
Nurses play a strategic role alongside patients and their families in the process leading to the decision to limit cancer treatments in the advanced phase of the disease. This stage of the patient's care requires support and guidance as part of the palliative approach, which, in addition to the patient and the family, also concerns the oncologist.
April 2018: Revue de L'infirmière
Dion Smyth
Dion Smyth's review of palliative nursing on the internet.
March 2, 2018: International Journal of Palliative Nursing
Pnina Sela-Katz, Perla Werner
BACKGROUND: Several instruments are available to assess knowledge about hospice care, but none specifically address knowledge about home hospice for persons with Alzheimer's disease (AD). AIM: To develop and validate the Alzheimer's Disease Home Hospice Knowledge Scale (AD-HHK-S). METHODS: A total of 107 Israeli family caregivers of persons with dementia (mean age=71.2; 73% female) participated in the study. RESULTS: The AD-HHK-S included 28 true/false items assessing 3 areas of knowledge: knowledge about hospice, knowledge about home hospice, and knowledge about home hospice for AD...
March 2, 2018: International Journal of Palliative Nursing
Mitsuru Shiokawa, Kazumi Kawamura
 The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences was held at Act City Hamamatsu, Japan, with a total of 2634 participants in attendance. The theme of the meeting was realized through a number of new concepts, such as a debate symposium, information sessions, nurses' workshops, and so on. The results obtained from the participation questionnaire (n=438), which were aggregated up to 1 month following the end of this year's meeting, revealed that 89% of the participants at considered it to have been appealing...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Lourdes Zubieta, Réjean Hébert, Michel Raîche
INTRODUCTION: To determine the palliative care pathways of older patients in Sherbrooke, Qc by examining their transfers to other facilities. METHODS: This analysis was conducted by linking 3 databases: emergency department, hospitalizations and nursing homes. The study period ranged from January 2011 to December 2015. SPSS was used for statistical analysis. The study only included palliative care patients. RESULTS: 25% of patients waited less than 7 days for transfer, and 74% waited less than 3 weeks...
January 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Annicka Gm van der Plas, H Roeline W Pasman, Bart Schweitzer, Bregje D Onwuteaka-Philipsen
BACKGROUND: In PaTz (PAlliatieve Thuis Zorg, palliative care at home), modelled after the Gold Standards Framework, GPs and community nurses meet on a regular basis to identify patients with palliative care needs (the PaTz register), and to discuss care for these patients. AIM: To study the effects of the implementation of PaTz, and provide additional analyses on two important elements: the PaTz register and patient discussions. DESIGN AND SETTING: A pre- and post-evaluation among Dutch GPs ( n = 195 before the start of PaTz; n = 166, 1 year after the start of PaTz)...
March 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
M E Lokker, S J Swart, J A C Rietjens, L van Zuylen, R S G M Perez, A van der Heide
BACKGROUND: Clinical nursing practice may involve moral distress, which has been reported to occur frequently when nurses care for dying patients. Palliative sedation is a practice that is used to alleviate unbearable and refractory suffering in the last phase of life and has been linked to distress in nurses. AIM: The aim of this study was to explore nurses' reports on the practice of palliative sedation focusing on their experiences with pressure, dilemmas and morally distressing situations...
April 2018: Applied Nursing Research: ANR
Charlotte Benoot, Paul Enzlin, Lieve Peremans, Johan Bilsen
AIM: To explore palliative care nurses' attitudes, roles and concrete experience with regard to addressing sexual issues in their daily practice. BACKGROUND: Patients and their partners in palliative care might experience dramatic changes in their sexuality and want nurses to provide the opportunity to address them. Moreover, it is argued that the holistic philosophy of palliative care encourages nurses working in this area to include sexual issues in their daily care...
March 25, 2018: Journal of Advanced Nursing
David Kenneth Wright, Susan Brajtman, Mary Ellen Macdonald
Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end-of-life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end-of-life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients' comfort and dignity were deemed most at stake and therefore commanded nurses' primary attention...
March 24, 2018: Nursing Inquiry
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