International Journal of Palliative Nursing最新文献

Background: Patients with metastatic non-small cell lung cancer (NSCLC) often experience severe eating disorders and other problems because of rapid disease progression and various therapies, which significantly affect their quality of life (QoL).

Aims: This study aimed to assess the nutritional status and QoL of patients with NSCLC at the start of immunotherapy and 3 months later.

Methods: This study used a prospective, observational, consecutive sampling approach and was carried out between July 2018 and August 2019. The convenience sample comprised 60 patients treated in the oncology ward and the day care department of a public hospital in Greece. Their nutritional status was assessed using the Mini Nutritional Assessment questionnaire and their QoL using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire and its QLQ-LC13 module. They were evaluated at the start of immunotherapy (phase I) and 3 months later (phase II).

Findings: Of the initial 60 patients, 25% had died and 23.3% declined to participate by phase II. Of the 31 patients (51.7%) who completed the study, 64.5% had been assessed as malnourished at phase I; at phase II, this had decreased to 32.3%, so nutritional status appeared to have significantly improved. There were also significant improvements between phases I and II in global health status/QoL, as well as in the physical, roles, emotional and social dimensions. Additionally, all nine symptoms of QLQ-C30 significantly decreased, while the QLQ-LC13 showed significant improvements in dyspnoea, alopecia and pain in parts of the body other than the chest, arm or shoulder.

Conclusion: Metastatic NSCLC patients' QoL and nutritional status significantly improved after 3 months' immunotherapy.

Background: Nursing is at the forefront of palliative care. Games are an innovative strategy in palliative care training. Aims: This study aimed to examine the usefulness of games for nurses in palliative care. Methods: A scoping review was conducted using the following databases: CINAHL and PUBMED (which includes MEDLINE, PsycINFO, SCOPUS and SciELO). The steps outlined by the Joanna Briggs Institute were followed. Findings: Of the 685 articles initially identified, 17 were included for analysis. Games used were role-play (n=12), card games (n=1), digital games (n=1), board games (n=1), reflection games (n=1) and experimental games (n=1). Games were aimed at nurses (n=6) and nursing students (n= 1 1). Game advantages included: improved palliative care knowledge, increased communication skills, reduced negative emotions and increased multidisciplinary team skills. Conclusions: Effective and innovative pedagogical techniques are required training techniques for nurses and nursing students who provide palliative care, as they can reduce negative emotions such as fear, anguish and guilt.

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

Background: Among healthcare professionals, hospice and palliative nurses have a high risk of experiencing work stress. However, little attention has been paid to protective factors that could mitigate the impact of daily stressors on hospice and palliative nurses. Aim: This study aimed to determine whether resourcefulness and positive thinking have a negative association with perceived stress among hospice and palliative nurses, and whether positive thinking moderates or mediates the link between resourcefulness and stress among hospice and palliative nurses. Method: A cross-sectional, correlational design was used to address these two aims. Results: A convenience sample of 86 hospice and palliative nurses (95% female) in the US completed an online survey. The results demonstrated that positive thinking and resourcefulness are useful predictors of stress reduction and help mitigate the effects of stress. Positive thinking did not mediate the relationship between resourcefulness and stress. Conclusion: Moderation analysis suggests that social resourcefulness may be especially helpful in reducing stress among hospice and palliative nurses with a low level of positive thinking.

Background: Without objective screening for risk of death, the palliative care needs of older patients near the end of life may be unrecognised and unmet. Aim: This study aimed to estimate the usefulness of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool in determining older patients' risk of death within 3-months after initial hospital admission. Methods: A prospective cohort study of 235 patients aged 70+ years, who presented to two rural emergency departments in two adjacent Australian states, was utilised. The 'risk of death' of each patient was screened with the CriSTAL prognostic tool. Their 3-month follow-up outcomes were assessed through telephone interviews and a clinical record review. Findings: A CriSTAL cut-off score of more than 7 yielded a sensitivity of 80.7% and specificity of 70.81% for a 3-month risk of death. Palliative care services were only used by 31% of the deceased in their last trimester of life. Conclusion: Prognostic tools provide a viable means of identifying individuals with a poor prognosis. Identification can trigger an earlier referral to palliative care, which will benefit the patient's wellbeing and quality of life.

Background: Despite the low quality of life (QoL) of children with leukaemia, there is a lack of well-designed and culture-oriented care programmes to improve it. The Partnership Care Model (PCM), which was developed based on the Iranian culture, seems to be effective in improving the QoL in children living with chronic diseases. Aim: This study aimed to evaluate the effect of a care programme based on the PCM on the QoL of children with leukaemia. Methods: This controlled clinical trial encompassed 60 school-age children with leukaemia and their mothers. In the experimental group (n=30), a 2-month care programme was implemented based on the PCM, including the four stages of motivation, preparation, involvement and evaluation. Only standard care was provided to the control group (n=30). Children's QoL was assessed using the Paediatric Quality of Life Inventory 3.0 Cancer Module in the pre-test phase and 2 months after the intervention. Findings: The total score of QoL and all its subscales were significantly higher in the experimental group than the control group in the post-test phase (p<0.001). Moreover, a significant difference was observed between pre-test and post-test scores in all domains in the experimental group (p<0.001); however, no significant difference was noticed between the scores in the control group. Conclusion: The partnership care programme seems to improve the QoL in children with leukaemia. Future investigations are recommended to shed further light on the findings of this study.

Background: There is a paucity of evidence regarding the contribution of generalist community nursing to palliative care. Aim: The aim of this study was to identity the proportion of patients referred to a generalist community nursing service who meet the criteria for palliative care need and explore key aspects of their management. Methods: A retrospective case note review of people known to a generalist community nursing service was undertaken to identify people with palliative care needs. Results: Of the 1284 people enrolled in the community nursing service, 21.1% (n=271) were identified as having palliative care needs, of which most (82.7%; n=224) had a non-cancer illness. However, palliative care need was largely unrecognised in the referrals to community nursing and there was little evidence of a palliative approach being integrated into nursing care. Conclusions: Nursing has a significant role in the provision of generalist palliative care in the community. However, research is needed to identify the barriers community nurses experience identifying needs and providing palliative care. A focus on education and support in implementing screening tools, which may assist community nurses in recognising needs and delivering palliative in the generalist setting, is urgently needed.

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