International journal of palliative nursing最新文献

Background: Knowledge of and understanding the palliative care approach should be a core competency in all healthcare settings. E-learning offers the potential to deliver palliative care education and meet this challenge.

Aim: To examine hospice educator's perspectives of e-learning in palliative care education.

Methods: Semi-structured interviews were conducted with a purposeful sample of hospice educators on the island of Ireland (Republic of Ireland and Northern Ireland). These were transcribed and the data was analysed thematically.

Findings: Many factors were considered when using e-learning: objectives of the programme, learner's characteristics, topic suitability (as palliative care is very emotive) and organisational factors. Barriers to using e-learnning were the preparation time required and developing expertise in e-learning. Support mechanisms for hospice educators to share knowledge would be beneficial.

Conclusions: Educators were keen to adopt a blended approach in their teaching. While acknowledging the challenges and limitations of e-learning, educators felt that e-learning has a positive role in palliative care education.

Background: Avoiding futile treatment for patients at the end of life is among one of the care challenges of nurses in intensive care units (ICUs).

Aims: This study aimed to determine the attitude of intensive care unit nurses toward futile treatment and its relationship with missed care for patients at the end of life.

Method: This cross-sectional study was conducted on 307 ICU nurses. Eleven teaching hospitals were selected from three Iranian provinces, Zanjan Province, East Azerbaijan and West Azerbaijan, in 2021. The data were collected using The Attitudes Toward Futile Treatment Scale (ATFTS) and The Missed Nursing Care Survey (MISSCARE Survey) as self-reports.

Results: According to the obtained results, 94.8% of the nurses agreed that futile treatment should not be performed. However, 97.7% of the nurses reported that missed care occurs less for patients at the end of life. The correlation between the MISSCARE Survey's total scale and the ATFTS's total scale was positive and statistically significant (r =.11).

Conclusion: This research contributes to understanding nurses' attitudes toward futile treatment. Nurses oppose futile treatment, so obstacles to avoiding it should be eliminated. This attitude does not have a significant impact on nursing care quality or missed care for patients at the end of life, but it can lead to enduring distress for nurses. It is recommended to study the reasons for futile treatment, and its link to nurses' mental and physical health.

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

Aim: This study aimed to determine which factors improve the quality of dying and death from the point of view of patients with cancer who are nearing the end of their lives. The goal was to find out what they think are necessary conditions for a good death and how they would like to be cared for and supported at the end of their lives.

Methods: This study used an exploratory research approach. Purposive sampling was used to select 21 participants from two hospices in Bengaluru and Hyderabad (Karunashraya and Sparsh), and Karnataka Cancer Hospital in Bangalore, India. Semi-structured interviews were undertaken to obtain data from the patients. Thematic analysis was used to examine the data.

Results: Four themes were identified: 1) Spirituality and religiosity, 2) socioemotional support, 3) Breaking silence about the stage of the disease and 4) Preparation for and embracing death. There were distinct sub-themes within some of these that were highlighted using quotes from the participants.

Conclusions: The study provided a comprehensive understanding of end-of-life care, the criteria for a high-quality end of life, strategies for achieving it, and the quality of the dying process and death in advanced cancer patients. Studying patients' experiences will help inform a more robust intervention strategy and action plan to improve the quality of end-of-life care in the Indian community.

Background: Advance care planning (ACP) is an integral part of good quality end-of-life care. This study aimed to explore the role and practice of ACP among health and social care professionals (HSCPs) in a community long-term care facility.

Methods: This was a mixed-methods study. The study purposefully sampled 12 HSCPs from one community long-term care facility in Macao, China. All data were collected in November 2022.

Results: Some participants had discussed with terminally ill residents or with families in terms of end-of-life care preferences, the average correct rate of ACP knowledge was 67.4%. Interview data showed that HSCPs were primarily concerned with information-giving. The responsibility of decision-making was found to have been placed predominantly on family members of the residents.

Conclusion: Study findings raised awareness in that the execution of ACP has remained in discord with the expectations in practicing ACP. The study illuminated that the perceived sense of responsibility among HSCPs was influenced by the potential legal risks involved and consequentially impacted on the adherence to individual's decisions.

Background: The transfer of end-of-life patients to hospital via admission to an emergency service mainly happens because of a lack of community support nearby and a lack of resources in palliative care.

Aims: This study aimed to define the concept of avoidable admission to an emergency department for palliative patients.

Methods: An integrative literature review was performed. The results of this were put to a panel of palliative care experts via a Delphi process to determine their consensus and agreement with the statements.

Findings: The results of the two-step Delphi process reached a high level of consensus and agreement that patients with palliative needs accompanied by home palliative care teams should not go to the emergency department. There was a low level of consensus and agreement about the appropriate admission of a patient in pain in the absence of any information about previous community support.

Conclusion: The findings allowed the definition of an 'avoidable emergency admission', which is an emergency admission for any symptom or condition that could be supported in a home context or primary health care, or any emergency admission that does not require immediate nursing or medical intervention, nor leads to greater comfort or quality of life for the patient.

Background: Breast cancer is the most common malignancy among women. Women with breast cancer need to adapt all aspects of their life following their diagnosis.

Aim: To investigate how women with breast cancer make adaptations in their lives to cope with the condition.

Methods: A directed content analysis was used for this study and 23 participants were interviewed. The participants included women undergoing a mastectomy and their husbands, oncologists, oncology ward nurses and psychologists. Questions were asked regarding the participants' experiences of their adaptation to a mastectomy and cancer.

Results: Data analysis led to the emergence of four dimensions; the physical dimension, self-concept, role-playing and interdependence. These four dimensions consisted of 21 main categories, 59 subcategories and 111 codes.

Conclusion: The present study showed that despite the emergence of different coping approaches, women undergoing mastectomy have had various physical and mental problems that lead to role disruption. It is recommended that solutions be adopted to increase the adaptation of these patients.