International journal of palliative nursing最新文献

Background: Most Australians say they wish to die at home, but many are admitted to inpatient facilities for symptom management. Caring@home resources can be used to support informal carers to manage breakthrough symptoms safely using subcutaneous medicines. Nurses require education about how to teach informal carers to use these resources.

Aim: To evaluate the effectiveness and relevance of an online education programme for registered nurses (RNs) about using the caring@home resources.

Methods: Nurses must complete an online survey prior to the commencement of the online education programme and again upon completion to assess their change in skills, knowledge, confidence and attitudes of the RNs. T-tests were conducted to compare average pre- and post-education scores.

Findings: The knowledge, skills and confidence of RNs to teach carers improved significantly following the completion of an education programme. There was a significant change in attitude, meaning that the perceived benefit of teaching informal carers to give subcutaneous medicines improved. All reported they would use the resources in their clinical practice.

Conclusion: The online education programme is an effective and cost-efficient strategy to educate nurses to support informal carers to help manage breakthrough symptoms using subcutaneous medicines.

Background: Providing end-of-life care in a patient's home is challenging, especially if the nurse is from a different ethnic background from the patient. Evidence shows that people from an ethnic minority background often experience poorer end-of-life care due to care providers not understanding their care needs.

Aim: To explore the experiences of community nursing staff caring for patients with an ethnic minority background at the end of their life.

Method: Using a qualitative descriptive approach, 16 semi-structured interviews were conducted and the data was thematically analysed.

Finding: Participants dealt with large tight-knit families, paternalism and controlling behaviours. There was a mistrust of Western palliative medicine. Language barriers and challenges were faced by the nursing staff, resulting in difficult conversations with the families. Different levels of the nursing staff's spiritual/cultural competencies were also identified. The COVID-19 pandemic intensified the challenges.

Conclusion: This research has shed light on the challenges of individualising end-of-life care in a culturally diverse community in the UK. The nursing staff's cultural/spiritual competencies were challenged.

This monocentric pilot study aimed to assess whether there are significant changes in hair cortisol levels and cognitive functioning at baseline and after 3 weeks of hospitalisation in older palliative care patients, and to ascertain whether hair cortisol can be used as a pertinent stress biomarker in this population. Hair cortisol concentration levels were measured with the use of an enzyme-linked immunosorbent assay (ELISA), while cognitive functions were assessed by using 16-point Mini-Mental State Examination 2 (MMSE-2): brief version. A statistically significant difference in mean hair cortisol levels at the start of the hospitalisation was found when compared to the 3-week follow-up (p=0.007). No statistically significant differences were observed regarding MMSE-2 scores using the same time points. These results have direct clinical implications and set the stage for further research endeavours in the field.

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

Background: People in Thailand receiving palliative care at home can have complex needs and this means that the family caregiver can have a high burden of care.

Aim: To assess the impact of a nursing care activities for a home-based palliative care programme (NHBPC) on the care burden among family caregivers and the care quality in older people at the palliative care stage.

Methods: This quasi-experimental repeated measure study was used to investigate the effects of the nursing care activities for a NHBPC programme.

Results: The mean caregiving burden and care quality scores in the experimental and control groups at post-test and 2-weeks follow-up showed significant differences (p<.05). In addition, improvement was not seen in the control group.

Conclusion: The NHBPC programme significantly improved caregiving burden and quality of care in Thai older people and their family caregiver. This confirms that the NHBPC programme plays a crucial role in helping them to improve quality of life.

The economic challenges for researchers in palliative care is an emerging and challenging topic. Knowing where, how and how much is spent is fundamental for palliative care (PC) provision to be increasingly efficient and with lower costs. To accomplish this, there are three important factors to consider: early access to PC; specialised PC using standardised procedures and informal and home-based PC. Beyond costs, ethical aspects should always be present when this care is being provided in its different forms, locations and contexts. For those who want to study the economic challenges in PC, they need to comprehend the complexity of them, since they will always come from a careful articulation between ethics, the person´s needs, the cost of the care and who these costs are charged to.

Background: Undergraduate nursing students spend a significant amount of time in clinical placements where they are involved in care at the end of a person's life and care after death. While their role is to provide compassionate care, some students feel wholly unprepared.

Aims: The aim of this qualitative study was to explore student nurses' experiences of care in death, dying and post death care, and to explore how students can be better prepared to provide such care.

Methods: This is a qualitative descriptive study that is concerned with the subjective reality of participant's experiences.

Findings: Six themes were developed from the analysis: first encounters with death and dying; preparedness; mentoring and support received; the caring role; striving to cope; working with families and working through COVID-19.

Conclusion: Students described their experience of placements in end-of-life care as challenging, yet were also able to adopt ways to develop as compassionate practitioners.

Background: Nurses have a crucial role in identifying spiritual needs and providing spiritual care to patients living with cancer.

Aim: This study evaluated Iranian oncology nurses' spiritual care competence and its relationship with job satisfaction and moral distress.

Method: This cross-sectional study was conducted on 280 Iranian oncology nurses in 2020 using four questionnaires: demographic questionnaires, the Spiritual Care Competence Questionnaire (SCCQ), the Minnesota Job Satisfaction Questionnaire (MSQ) and the nurses' Moral Distress Questionnaire (MDS-R).

Findings: The mean scores indicated a medium to high Spiritual Care Competence (SCC), mild to moderate moral distress and high job satisfaction. There was a positive correlation between SCC and external job satisfaction (r=184, p<0.05) and a negative correlation between SCC and moral distress (r=-0.356, p<0.05).

Conclusions: SCC diminishes with decreasing external job satisfaction and increasing moral distress. To improve the SCC of nurses working with patients living with cancer, it is recommended that nursing managers and policymakers revise the organisational policies to tackle the obstacles and consider the related factors to provide an ethical climate, implement quality spiritual care and increase job satisfaction.