International journal of palliative nursing最新文献

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.

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: 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.

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.

Background: Patients with cancer require emotional support in addition to specialised medical treatments for their physical ailments. The quality of nursing care, resilience and hope can influence a person's cancer trajectory, and understanding these factors and their relationship can be influential in improving the process for these patients.

Aim: This study examined the relationship between the quality of oncology nursing care and resilience and hope in patients with cancer.

Methods: The present study is a descriptive analytics study conducted on 160 patients with cancer from April-August 2023. The data collection tools included four questionnaires: a demographic information questionnaire, the Connor-Davidson Resilience Scale (CD-RSC), the Snyder Hope Scale, and the Oncology Nursing Care Quality Scale. The data were analysed using SPSS version 22 statistical software.

Results: In examining the relationship between demographic 'variables' and 'resilience', marital status and place of residence had statistically significant correlations (P<0.05). Place of residence, education level, job and first cancer treatment (P=0.004) had statistically significant correlations with hope (P<0.05). There was no statistically significant relationship between the quality of oncology nursing (QON) and its domain with two variables: 'resilience' (P=0.76) and 'hope' (P=0.37). However, a statistically significant relationship existed between the variables 'resilience' and 'hope' (P<0.001). The linear regression model results showed that among the entered demographic variables, only the variable 'hope' predicted resilience (P<0.001; R=27%). Additionally, the 'resilience' variables (P<0.001) and the 'first cancer treated' variable (P=0.001; R=34%) were predictors of 'hope'.

Conclusion: Given the interrelationship between 'resilience' and 'hope' for patients with cancer, it is necessary to focus on the factors that impact these qualities. In addition, paying attention to the concept of resilience can improve the level of hope in patients with cancer. Based on the results, it is recommended that interventions to increase QON in patients with cancer be planned and implemented.

Background: In a pandemic, existing palliative care units may be inadequate and palliative care may need to be provided in other hospital units.

Aims: To review and improve the palliative care approach applied during a pandemic.

Methods: Studies published between 2019 and 2020 were examined using the keywords 'fighting against COVID-19 'and 'organisation' in the PubMed, Ebsco, ScienceDirect and Web of Science databases.

Findings: It was determined that the US Mass Critical Care Task Force created a framework for organising palliative care in the fight against the pandemic. It was determined that institutions and organisations implemented practices aligned with this framework during the pandemic. However, due to the evaluation, this framework was limited, and its scope should be expanded.

Conclusions: The recommendations in this review and indicated in italics will improve the palliative care approach to be applied during the pandemic.