International Journal of Palliative Nursing最新文献

Background: Understanding the needs of cancer patients and planning to meet these needs is a major concern of the health system.

Aim: The present study aimed to design and conduct a psychometric evaluation of supportive-care needs scale in patients with cancer.

Methods: This study was conducted in both qualitative and quantitative stages. In the qualitative phase, the questionnaire items were generated by analysing the data from 16 interviews, after which, face, content and construct validity were tested. To construct the validity, the questionnaire was completed by 229 cancer patients. The reliability of the questionnaire was assessed by internal consistency. Data were analysed using SPSS (version 18).

Findings: In this study, 4 factors were extracted from 29 items through exploratory factor analysis: 'Need to be understood by the spouse and family' (10 items), 'Need to manage existential and psychological challenges' (7 items), 'Need to manage lack of knowledge about the disease' (7 items), 'Need organisational-therapeutic support '(5 items). These factors accounted for 50.1%. of the total variance. Internal consistency was 0.88, and also the Cronbach's alpha coefficient was also 0.89 after construct validity for the scale items'. The Cronbach's alpha was 0.91 after the construct validity.

Conclusion: The findings of the present study showed that this supportive care needs scale is a valid and reliable scale for identifying the supportive care needs of patients with cancer.

Synopses of a selection of recently published research articles of relevance to palliative care.

Aim: There have been significant advancements in palliative nursing in health services, but less so in intensive care units (ICUs). The purpose of this literature review was to examine palliative nursing care in ICUs and consider how a nursing strategy could improve communication and support for patients and their families.

Method: An exploratory literature review was conducted to evaluate and compare ICU care strategies with palliative support. The search was conducted using CINAHL Plus and Medline All databases and was limited to a 6-year period. Eight publications were selected for review and a full text review was undertaken using the Critical Appraisal Skills Programme systematic review checklist.

Results: Two themes emerged around the use of palliative nursing strategies. These were: improving communication between health professionals and patients; and providing support for patients and families.

Conclusions: Palliative nursing has the potential to improve the quality of communication in ICU settings and support for patients and families. Further training and preparation of nurses in palliative care would improve the patient and family experience during a critical and emotional period of health service provision.

Background: The palliative care provided to cancer patients should also contemplate the psychological and spiritual dimensions of care.

Aims: This study aimed to compare religiosity and spiritual/religious coping (SRC) of cancer patients in palliative care with a group of healthy volunteers and determine whether sociodemographic characteristics affected this association.

Methods: This was a case-control study conducted with 86 patients living with cancer from an outpatient palliative care clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil and 86 healthy volunteers. The brief Spiritual/Religious Coping Scale (SRCOPE) and the Duke University Religion (DUREL) Index were used as a brief measure of 'religiosity'.

Results: All 172 participants reported to be religious and, overall, made very little use of SRC strategies. DUREL scores were negatively associated with religious practice (P<0.01) and positive SRC (P<0.01). Age was associated with non-organisational religious activities and intrinsic religiosity (P<0.01); and income was associated with intrinsic religiosity (P<0.04). Positive SRC was negatively associated with the palliative group (P=0.03) and DUREL index (P<0.01). Negative SRC was positively associated with the palliative group (P=0.04) and negatively associated with education level (P=0.03) and practice of religion (P<0.01).

Conclusion: All participants reported to be religious; however, their use of SRC strategies was very low. Positive religious coping was the most prevalent score. Negative religious coping was more common in the palliative care group compared to healthy volunteers. There is an association between religious coping and religiosity in palliative cancer care patients.

Background: Spiritual uncertainty is a new construct for end-of-life care that focuses on the questions, worries and doubts people have with end-of-life spirituality. Spiritual uncertainty can contribute to spiritual distress for patients and families dealing with the end of life, as well as lead healthcare providers to avoid spiritual care methods.

Aims: This article reports on the item construction of a new survey design to measure the spiritual uncertainty of healthcare providers.

Methods: Items were constructed from qualitative data gathered from five focus groups (with a total of 23 interdisciplinary hospice and palliative care providers being surveyed). Data were developed through three rounds of item construction, selection/refinement and assessment.

Findings: A final pool of 42 items was constructed to measure the spiritual uncertainty of healthcare providers. Expert validity was obtained by 16 interdisciplinary hospice and palliative care providers.

Conclusion: This survey is the first to measure spiritual uncertainty of healthcare providers. Additional research is needed to assess the psychometric properties of survey items.

Background: Community-based palliative out-of-hours services operate outside normal working hours. However, little is known about the provision and delivery of such care.

Aim: The aim of this study was to describe types of provision and delivery of out-of-hours palliative care services provided by UK hospices.

Methods: Survey questionnaires were emailed to 150 adult hospices in the UK. Quantitative data were analysed using SPSS and qualitative data subjected to thematic analysis.

Findings: Responding hospices (n=57) provided the following types of support: telephone advice 72% (n=41); care at home 70% (n=40); and rapid response 35% (n=20). There were variations between services regarding referral mechanisms, availability and workforce, and integration with statutory services was limited.

Conclusion: Variation in the type of provision and delivery of out-of-hours palliative care services alongside limited integration with statutory care have contributed to inequity of access to community-based palliative care, and potentially suboptimal patient and informal caregiver outcomes.

Background: Integration of care between palliative care and oncology can improve patient outcomes and is increasingly recommended. Enhanced supportive care (ESC), led and delivered by palliative care clinical nurse specialists, is a potential model to achieve this but evidence about it is lacking.

Aim: This research aimed to evaluate a nurse-led integrated ESC model within hepatopancreatobiliary cancer care.

Method: Some 101 patients with hepatopancreatobiliary cancer were supported by integrated ESC delivered in a co-located clinic. Data on symptoms and quality of life were collected prospectively. Survival data and chemotherapy use were retrospectively analysed following minimum follow-up, using a matched control technique.

Results: Patients receiving ESC exhibited less severe symptoms and better mood over time. They also had less aggressive treatment towards the end of life, receiving 31% less chemotherapy than controls with comparable survival.

Conclusion: An integrated, nurse-led ESC model can be effective in improving outcomes for patients with hepatopancreatobiliary cancer.

Background: Palliative care is one of the most important areas of practice because it includes caring for vulnerable people who are mostly in their last stage of life. Palliative care is a relatively new specialty in the Middle East and little is known about student nurses' knowledge of and attitudes towards it.

Aim: The aim of this study was to explore students' knowledge of and attitudes towards palliative care in the Middle East, and to use the findings to make recommendations to higher education institutions about its importance.

Design: An integrative review following an established framework was used. Hawker's Assessment Tool was employed to evaluate the quality of the research articles.

Results: The search found seven quantitative studies from four countries in the Middle East. Their focus was on students' knowledge (n=5) and attitudes (n=2). The number of participants ranged from 110 to 452, with knowledge scores ranging from 5.23 to 8.0 out of 20 on all or part of the Palliative Care Quiz for Nursing. Students' attitudes were marginally positive toward palliative care and dying patients.

Conclusion: There are few studies in the Middle East investigating student nurses' knowledge of and attitude toward palliative care; consequently, more attention needs to be given to this area of practice.