International journal of palliative nursing最新文献

Background: Point-of-care ultrasound (PoCUS) is increasingly used in palliative care for bedside assessment and symptom management. Despite their integral role in patient care registered nurses (RNs) rarely receive training or use PoCUS in practice.

Aims: To evaluate the feasibility of training palliative care RNs to perform PoCUS exams and expand access to bedside imaging.

Methods: RNs at a local residential hospice and outpatient clinic were trained in PoCUS for urinary retention, ascites and IV access through didactic and hands-on sessions. Data included scan logs, satisfaction surveys and RN feedback.

Findings: RNs successfully performed PoCUS for bladder and ascites assessments, enabling timely interventions and reducing hospital visits. Patient and family satisfaction was high, and RNs reported increased confidence and interest in further training.

Conclusion: Training RNs in PoCUS is feasible and enhances palliative care delivery by supporting timely, appropriate interventions at the bedside.

Background: While palliative care education has been integrated into the nursing curriculum in Ghana, there remains a scarcity of research that assesses the knowledge and attitudes of undergraduate nursing students toward palliative care and care of the dying.

Aim: This study assessed the knowledge and attitudes of undergraduate nursing students regarding palliative care.

Methods: A cross-sectional study design was used, including a questionnaire-based survey. A total of 272 undergraduate nursing students were selected through convenience sampling.

Results: Most respondents demonstrated poor PC knowledge. Most students exhibited positive attitudes towards palliative care. Factors significantly associated with PC knowledge included being an older student (p=.028) and female gender (p=.038). Positive attitudes towards PC were significantly influenced by experiencing the death of a patient during clinical placement (p=.036), female gender (p=.001), and academic level (fourth year; p=.032).

Conclusions: The study revealed that the nursing students who participated had a positive attitude towards palliative care but poor knowledge.

Background: Many older patients with advanced chronic illnesses have not experienced a peaceful end of life in China.

Aim: To explore the barriers to peaceful end-of-life care for older patients with advanced chronic illnesses from the perspectives of male nurses.

Methods: A qualitative study was used. Ten male nurses in Guiyang City who met the inclusion criteria participated in individual interviews via telephone with audio recording. The interview transcriptions were analysed by using the content analysis method. Trustworthiness was established by following Lincoln and Guba's criteria.

Findings: Barriers to peaceful end-of-life care include not prioritising end-of-life care; not respecting the patient's autonomy to die; not having a comfortable caring environment for dying; family caregivers' lack of knowledge and experience in end-of-life care; and traditional and cultural beliefs regarding death and painkillers.

Conclusion: The findings need to be given due consideration to improve the quality of peaceful end-of-life care for older patients with advanced chronic illnesses.

Background: The extent of involvement of family caregivers in Ghana ranges from giving physical care and emotional support to making medical decisions and liaising with healthcare professionals.

Methods: This study used a descriptive exploratory qualitative methodology grounded in ethnographic theory. Data were collected through observations and interviews with 20 unpaid informal caregivers following a purposeful sampling recruitment. Semi-structured in-depth interviews, lasting 45 to 80 minutes, were conducted at home and on hospital premises, focusing on caregivers' involvement and the support services they received. Data were transcribed, translated and analysed using thematic analysis principles.

Results: The study found that caregivers were predominately female. Male caregivers were typically brothers, spouses or sons. Two primary themes emerged: the extent of caregiver involvement and the reasons for family involvement. Caregivers, despite their central roles in decision-making and extensive physical and emotional support, faced communication challenges with healthcare teams. These challenges, coupled with their moral and family obligations, underscore the complexity of their role.

Conclusion: The findings highlight the critical role of family caregivers in the care of terminally ill patients and the diverse motivations behind their involvement. It is imperative that healthcare professionals, researchers and policymakers, recognise and support the vital contributions of family caregivers. This recognition and support are not only essential for improving palliative care outcomes, but also for ensuring the well-being of these caregivers.

Background: Preparation for the death of a family member is a key part of a transition into a caregiving role for family caregivers.

Aim: To understand the experience of family caregivers preparing for the death of a significant other with a chronic disease.

Methods: Grounded theory was used, and the participants were family caregivers of a person in the process of dying. The sample was obtained by theoretical saturation and an analysis was carried out through open, axial and selective coding.

Findings: Four categories were identified as part of the family caregiver's preparation for the death of their family member: encounter with the disease, the caregiver relationship, the departure and new meanings.

Conclusion: Preparing for the death of a loved one can be described as a roller coaster of emotions with many ups and downs. Preparing for this grief can be helpful for some people, but many participants said that they still felt unprepared.

Background: Continuous education and training is needed for nurses to overcome barriers of accessing palliative care in India.

Methods: An evaluation of baseline knowledge about the basics of palliative care was conducted using a validated questionnaire, Palliative Care Knowledge Questionnaire-Basic (PCKQ-B), as a pretest. A comprehensive 1 day Continuing Nursing Education (CNE) and workshop was conducted for nurses from hospitals across Delhi-NCR. The effectiveness was evaluated using a pre and posttest method with PCKQ-B. PCKQ-B is a 25-question test developed in India and rigorously validated for nurses working in tertiary care hospitals in India. Descriptive analysis was performed for demographics and to summarise the data and paired t-test to compare pre and post data.

Results: A total of 102 nurses participated in the CNE and took pre and post tests. Nurses came from six tertiary care private hospitals across Delhi-NCR. A total of 79% of the participants were females with a mean age of 25.61 years. The mean score of the participants increased from 14.5 in the pre CNE to 18 in the post CNE which was statistically significant (p=0.000). Nurses scoring >60% (16 out of 25) questions correctly increased from 27% in pre-test to 70% in post-test. The question that was correctly answered by the minimum number of participants (13%) in pre-test was 'use of placebos is appropriate in some types of pain' highlighting the common myth and poor clinical practice, which only improved to 35% even in post test. While it was encouraging to find out that more than 88% participants were aware that the 'severity of pain determines the method of pain treatment' and 'prognosis should always be clearly communicated' even in pre-test while the percentage increased to 99% in post test.

Conclusion: Baseline knowledge about palliative care remains dismal, but engaging learning interventions like CNE and workshops can bring significant improvement to palliative care understanding of the nursing staff. However, this must be followed up with regular refresher classes and courses to build a strong framework with a learned workforce.

Background: Nurses and nursing students who have received theoretical and practical training are more likely to provide effective end-of-life care to dying patients and their family members.

Aims: This descriptive study investigated the effect of end-of-life care efficacy on new graduate nurses' attitudes toward death and the care of the dying.

Methods: The study was conducted between July 14, 2021 and May 15, 2022. The sample consisted of 245 nurses who graduated from a nursing school between 2015 and 2020. Participants were contacted through email or phone. Data were collected using a sociodemographic characteristics questionnaire, an end-of-life care characteristics questionnaire, the Death Attitude Profile-Revised and the Frommelt Attitudes Toward Care of the Dying Scale. Numbers and percentages were used for descriptive data. The data were analysed using the Mann-Whitney U Test and Kruskal-Wallis Test.

Findings: More than half of the new graduate nurses believed that they knew enough about end-of-life care (59.3%). New graduate nurses who had not taken a course on end-of-life care before had a higher fear of death than those who had. New graduate nurses noted that nursing educators had not supported or guided them adequately in their student years.

Conclusion: Further research is warranted to better understand new graduate nurses' attitudes toward death and the care of the dying. Universities should integrate end-of-life care into curricula. Nursing educators should better support and guide their students.