International journal of palliative nursing最新文献

Background: There is a lack of theoretically sound, scientifically-tested interventions for bereaved parents.

Aims: To describe the acceptability and feasibility testing of an online grief-support-resource platform for bereaved parents.

Methods: Participants included 20 parents of children who had died from a disease. The study involved a quasi-experimental treatment-only two-site design.

Findings: The study was not able to recruit the intended number of participants. The website designed to support parents during grieving was found to be helpful by participants (43% enrolment rate), though not feasible. Lessons learned from this trial include: to use a well-defined eligibility criteria; follow a model for behavioural intervention development in a stepwise fashion, not exceed the individual stage's purpose; cautiously approach bereaved parents less than 6 months after a child's death; and comprehensive parent orientation to the grief-support-resource platform.

Conclusion: Transparent sharing of lessons learned provide opportunities for investigators who are planning studies to learn from this team's experience.

Background: Palliative care provision is a serious challenge for nursing staff as it involves end-of-life care decisions, as well as a very close relationship with the grief and pain of the patient and their relatives. Their beliefs and attitudes regarding palliative care affect the quality of care, and can potentially influence whether a nurse experiences burnout in their career.

Aims: To investigate the attitudes and beliefs of nursing staff about palliative care and correlation with various demographic factors.

Methods: The study used a cross-sectional design and included nurses and nursing assistants who worked at Intensive Care Units and High Dependency Units. The authors assessed the attitudes on palliative care using the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD) scale.

Findings: A total of 150 nurses/nursing assistants. Their satisfaction with care and the months since the patient's initial diagnosis were positively associated with a more positive quality of life. Participants' beliefs about end-of-life care are positively and sometimes negatively influenced by demographic factors, such as their gender and previous work experience.

Conclusion: The findings of the study may prove valuable in understanding the challenges faced by nurses caring for patients in the final stretch of the patient's life and may be the starting basis for initiating educational programmes on palliative care.

Background: Making healthcare decisions on behalf of loved ones can be highly stressful for family members to act as surrogate decision makers, especially when decisions are relevant to terminal care.

Aim: To understand the challenges that caregivers face when making decisions for family members at the end of life.

Methods: A descriptive phenomenological approach using semi-structured interviews with seven family caregivers recruited from two palliative care institutions in Amman.

Results: Family caregivers mentioned several reasons to avoid participating in decisions near their relative's end-of-life, such as holding on to hope that their family member would recover and fearing loss. Others expressed that they felt their relationship to the patient impaired their ability to make reliable judgments and they found it hard to know what the right decisions were. They were worried about being held responsible for the result of decisions and were concerned about felling guilty.

Conclusion: To conclude, caregivers do not feel prepared to make decisions about their relative's care and feel that they are too emotional and attached to the patient, or are afraid of the consequences of their decisions.

Background: Palliative care (PC) is recognised by the United Nations as a crucial element of universal health coverage. This article explores the cultural beliefs around the acceptability and accessibility of PC in Tanzania, East Africa.

Aim: To provide insight into barriers for the provision of culturally safe PC in this region.

Method: Qualitative studies researching adult perspectives on PC in Tanzania between 2010 and 2022 were critically appraised.

Findings: Of 153 studies identified in the initial search, seven met the inclusion criteria. Four key themes were identified: acceptability of PC for recipients; acceptability of PC for providers; accessibility of PC for recipients and accessibility of PC for providers.

Conclusion: Cultural beliefs around the acceptability of PC included shared values for individuals at the end of life and challenges around breaking bad news. Barriers to the accessibility of PC included training opportunities and opioid availability. Further research prioritising 'cultural safety' is necessary to improve PC provision in Tanzania.

Background: Specialised outpatient paediatric palliative care (SOPPC) is vital for young people with life-limiting conditions and telehealth integration might improve this care.

Aim: Evaluate the acceptance and challenges of implementing teleconsultations among SOPPC healthcare professionals.

Methods: A questionnaire, tailored to various professions in SOPPC, was developed. After pilot testing, it was distributed to all healthcare professionals in SOPPC in the county of Lower Saxony, Northern Germany. Statistical analyses, using descriptive methods, ensured the reliability of the findings.

Findings: The survey involved 96 participants from SOPPC teams. Teleconsultations were perceived as time-saving (physicians (80%), nursing (68%), psychosocial varied), facilitating patient-centred discussions (physicians (87%), nursing staff (72%), psychosocial had varied responses) and maintaining intensive contact during restrictions (85% agreement). Improved team communication (91%) and patient-family communication (physicians (80%), nursing (68%), psychosocial (62%) were perceived benefits. Concerns included language barriers (84%) and technical readiness (80%). While physicians and nursing professionals saw telehealth enhancing patient safety (64-95%), psychosocial professionals were more skeptical (38-62%).

Conclusion: This study highlights telehealth's potential in SOPPC, stressing the need for tailored strategies. While nursing staff and physicians generally accept telehealth, psychosocial professionals express reservations. Overcoming barriers like language and technical readiness is crucial for maximising telehealth benefits.

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.