International journal of palliative nursing最新文献

Background: This study aimed to identify barriers to paediatric palliative care provision at one Palestinian paediatric hospital, elucidate reasons for the barriers, provide recommendations for enhancing care and identify topics for future research in other low-to middle-income countries.

Methods: A mixed-method cross-sectional study, employing both quantitative and qualitative methods was conducted, involving 61 healthcare professionals at a paediatric hospital in Palestine. Data collection consisted of 58 participants completing an electronic survey, while three healthcare professionals participated in semi-structured interviews. Ethical approval was obtained prior to data collection.

Results: The study identified significant barriers to paediatric palliative care, categorised into patient-family, healthcare professional and organisational domains. Quantitative data from 58 healthcare professionals revealed family resistance to a palliative prognosis and inadequate training for healthcare professionals, with mean barrier scores ranging from 3.09 to 4.00 (maximum=5.00). Qualitative insights from interviews and open-ended survey questions complemented these findings, highlighting the need for effective communication, educational enhancement and organisational support to improve the quality of care.

Conclusion: The study identified barriers to the implementation of effective paediatric palliative care, underscoring the need for emotional support, better clinical guidance, more education and training and stronger interdisciplinary collaboration.

Background: Art therapy offers a creative outlet for patients in palliative and hospice care to express emotions, manage distress and enhance wellbeing by addressing physical, emotional and spiritual challenges.

Aims: This review evaluates the effectiveness, challenges and outcomes of art therapy in improving the quality of life for patients in palliative and hospice care.

Methods: An integrative review.

Findings: The review of 27 studies identified four key themes: (1) the effects of art therapy on the quality of life of patients, (2) intervention and patient outcomes, (3) improved wellbeing through self-expression, and (4) challenges in care delivery. Art therapy significantly reduced emotional distress, including anxiety, depression and psychological fatigue, while alleviating physical symptoms, like pain and exhaustion. It fostered emotional expression, personal growth and coping skills, helping patients manage their conditions more effectively. Participants also reported enhanced self-awareness, stronger interpersonal connection and a greater sense of control over their lives, leading to improved emotional and physical wellbeing.

Conclusion: Art therapy provides significant benefits by alleviating emotional and physical distress and enhancing wellbeing. Integrating art therapy into palliative and hospice care supports holistic, patient-centered care, though further research is needed to address access barriers and ensure consistent delivery.

Background: Patients with cancer are referred late to palliative care services (PCS).

Aim: To analyse the time of referral to PCSs and the characteristics of patients that are referred.

Methods: A retrospective cohort. All patients admitted in a single tertiary care institution were evaluated by the PCSs from February 1, 2018 to January 31, 2019.

Findings: Among the 642 patients (557 patients with cancer) referred to PCSs: 7.47% died before evaluation, 13.08% died before transfer, and 15.6% died within 8 days after transfer. Out of all the patients with cancer included in the study, 85.28% had less than 2 months of PCS follow-up during their disease. In the last 30 days of life, 96.26% had were readmitted to hospital. A total of 94.09% of patients with cancer died in a hospital.

Conclusion: These findings suggest that patients with cancer in Brazil are not referred early enough to PCSs. Early integration with PCS must be sought to improve the accuracy of referral.

Background: Nurses experience high levels of stress while providing end-of-life care, which puts them under emotional pressure, stress and conflict. Therefore, this study aimed to explain the experiences of nurses during the provision of end-of-life care in Iran.

Methods: A qualitative descriptive study conducted using a conventional content analysis approach in Gorgan in 2023. A total of 11 nurses participated in this study, who were selected purposefully with maximum variation. Data were collected using semi-structured interviews and analysed using the five-step conventional content analysis method of Graneheim and Lundman (2004).

Results: From the data analysis, three categories and seven subcategories emerged. The categories include: 'caring nature', 'structural challenges of the care system' and 'communication challenges'.

Conclusion: Generally speaking, different types of stresses influence the performance of nurses that are involved in end-of-life care. By identifying some of these stressors, nurses, nursing managers and health policymakers can adopt supportive strategies to reduce the perceived stress and, consequently, improve the quality of end-of-life care by reducing the consequences of stress, such as burnout, moral distress and high job turnover.

Background: With burnout rates highly prevalent in palliative care nurses, it is important to have a holistic understanding of the causes of burnout and strategies both to prevent burnout and to cope with burnout.

Aim: To understand the causes of burnout and strategies used to prevent and cope with burnout in palliative care nurses. This would allow the implementation of strategies on a personal level and organisational level to mitigate the effects of burnout.

Methods: A thematic analysis to explore palliative care nurses' experiences and their interpretations. In total, 11 in-depth interviews and one focus group discussion with 19 nurses were conducted. The study participants were recruited from three palliative care units within a health cluster in Singapore and had at least 1 year of experience working in palliative care.

Results: Five themes were identified: (a) description of burnout and its attributes; (b) factors that contribute to burnout; (c) triggers that initiate burnout; (d) coping with burnout; and (e) resilience to burnout. The nurses were competent in recognising signs of burnout and understood the use of coping strategies to manage burnout. They were also able to develop resilience to burnout through meaning-making and personal experiences.

Significance of results: Helping palliative nurses find a deep purpose in their work builds resilience. Managers, organisation leaders, researchers and peers should look into ways to increase resilience in this group of nurses.

Background: Effective training of health professionals is essential to end-of-life care.

Aims: To explore the level of knowledge on paediatric palliative care (PPC) of nurses in a children's monographic hospital.

Methods: Cross-sectional observational analytical study. A sample of 53 nurses were selected. The translated and validated Spanish version of the Palliative Care Quiz for Nurses was used.

Findings: Statistically significant differences (Mann-Whitney U; p=0.0346) were found between the knowledge of nurses in non-PPC-specific wards and nurses working in PPC, with the latter having a higher level of training in PPC (Chi-square; p=0.042).

Conclusion: Professional experience with children with palliative needs and training seems to be related to increased knowledge of palliative care.

Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative condition. This report presents the largest published case series on the condition. The palliative care symptom burden and management of these patients is considered. Early advanced care planning and goals of care discussions are necessary.

Background: Hope is important to patients with a life-limiting illness. Identifying factors that influence hope is important. However, little research has been undertaken to understand patient-reported hope in malignant and non-malignant chronic disease.

Aim: This research aimed to determine hope level and its influencing factors in patients with malignant and non-malignant illness in advanced stages.

Methods: A total of 155 patients with malignant and non-malignant illness participated in this cross-sectional study. Data was collected on sociodemographic, disease characteristics and measures of hope. Hope was assessed using the validated Herth Hope Index (HHI). Multiple linear regression models were used to determine associations of identified factors with the patient's level of hope. This paper adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Findings: A total of 155 patients were enrolled (mean age=54.4±10.97 years, 60% female and 54.8.% were diagnosed with chronic kidney disease and the mean duration of illness was 35.61±3.192 months. Patients had an average HHI score of 35.52 (range 26-46), were in the medium range of the HHI as specified by Herth to be 24-35. Patients who were younger and had completed higher education had a higher level of hope. These variables explained a total of 11.6% of the variation in hope.

Conclusions: The level of hope was not optimal, and still needs to be improved further. Thus, nurses and other healthcare professionals should pay special attention to older patients, patients with a low-education level and support them to have a positive attitude.