International journal of palliative nursing最新文献

Background: With growing reliance on family caregivers to support people with advanced heart failure and to help them die at home, family caregivers need the relevant information to support this. However, evidence has shown that families continue to have deficits in their knowledge of heart failure and what to expect as the disease advances. This can lead to a high level of uncertainty and stress for family.

Aim: To explore family caregivers experiences of accessing information from healthcare professionals when caring for someone with heart failure.

Method: A qualitative exploratory study design was adopted using a critical realist approach. The study was conducted in one large urban area of Aotearoa New Zealand. Participants were family caregivers of people who had died between April and November 2019. Data was collected using semi-structured telephone interviews.

Results: A total of 15 family caregivers participated. A thematic analysis identified three themes related to accessing information from healthcare professionals: 1) gaining access to healthcare professionals 2) developing, understanding and translating information and 3) receiving information in a timely manner.

Conclusions: Findings highlight the difficulites that family carers of people with heart failure experience in accessing, receiving and understanding the information they require. Further research is needed on supporting healthcare professionals to develop skills in appearing accessible within an environment of 'busyness'. Furthermore, investigating strategies which will enable healthcare settings to be more responsive and flexible to the needs of family caregivers is needed.

Background: As nurses care for patients at the end of life, they face situations that affect not only their jobs, but other aspects of their lives. However, there is very little research on the psychological impact of caring for terminally ill patients, the challenges that nurses face and their specific coping strategies have not been the subject of much research.

Aim: To synthesise the psychological behaviour of nurses working with terminally ill patients and identify their concept of death after caring for terminally ill patients.

Method: An integrative review.

Results: A total of 17 articles were deemed eligible, wherein 6 themes were generated: (1) the highs and lows of terminal illness care, (2) challenges faced by nurses caring for the terminally ill, (3) the role of nurses in terminal illness care, (4) coping with the effects, (5) coming face to face with one's mortality, and (6) continuing education in terminal illness care. Coping with the effects has two subthemes: (a) coping strategies used by nurses and (b) the role of professional relationships in coping.

Conclusion: Nurses need to have a sound mind and body in order for them to be effective when caring for people at the end of life.

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

Background: Spirituality is a core dimension of palliative care. However, Portuguese palliative care teams do not have many spiritual care resources.

Methods: Cross-sectional and observational survey studies were used to characterise spiritual care resources in Portuguese palliative care teams based on a non-probabilistic convenience sampling. An electronic questionnaire was used for data collection.

Results: A total of 150 responses were obtained. In 68.7% of the teams, there was no specific professional dedicated to spiritual care, although 68% of the participants considered that a spiritual assessment or intervention was a part of their role; 47.3% considered that their colleagues were reasonably prepared to develop a spiritual assessment or follow-up; for a patient, and 54.7% were considered to be reasonably involved. However, 50.0% did not consider themseleves to be competent at providing spiritual care. Most referred to not using any specific assessment tool or document (67.3%); 49.3% dedicated less than 10% of their time to specific education or training about spirituality.

Conclusion: This study involved different professionals from multidisciplinary teams. Most recognised the importance of attending to the patient's spirituality and spiritual care. Results suggest that there is a need for specific training, resources and techniques to meet a patient's spiritual care needs at the end of life. This need may be similar in all teams, not just palliative care teams, to facilitate comparing indicators and promote the implementation of holistic care in palliative care.

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

Background: Community nurses (CN), both generalist and palliative care-specific, are key to supporting the carer with their experience of grief.

Aim: To identify the grief-related needs of carers and the capacity of CNs to provide for those needs.

Methods: A convergent parallel mixed-methods study which employed i) a needs questionnaire among carers of palliative care patients who had recently died; ii) a qualitative interview study among carers and iii) a questionnaire among CNs which canvassed their confidence and skills in working with carer grief.

Findings: In the carer survey, just one-third of carers reported engagement with CNs regarding prolonged and anticipatory grief. In the CN survey, low confidence and skill regarding supporting carers with their grief was reported. CNs with palliative care training were more confident and knowledgeable than generalist CNs.

Conclusions: Despite offering high ratings for CN compassion and overall quality of support during the dying process, grief support was reported by carers to be missing from their experience of CN care. The role of CNs in providing for the grief-related needs of carers is yet to be established.

Background: This state-of-the-art (SOTA) review aimed to understand the historical, current and future of rural community palliative care services (PCS) with a primary focus in rural southern Minnesota communities and the United States.

Methods: This review followed the six step SOTA systematic review process described by Barry et al (2022) and examined articles from 2010-2023 regarding rural PCS.

Results: Historical and current research consistently supported the benefits of PCS and reported the top facilitators as a clear definition of palliative care and PCS. The top barriers included a lack service provision, funding/resources, national policies/regulation, and shortages of trained providers in rural communities.

Conclusions: Barriers to the provision of PCS have not improved based on this review in rural areas and must be addressed to reduce healthcare disparities for rural populations.

Background: Healthcare at home is considered a partial substitute for institutional long-term care, because patients and families with known poor prognoses prefer to stay home with their loved ones and are unable to pay for hospital care at the end of life in some countries.

Purpose: To explore patients' and family members' perspectives and experiences of receiving home-based palliative care services.

Method: This was a qualitative exploratory study conducted in Karachi, targeting patients and family members receiving home-based palliative care services. The data collection was done via interviews, and simultaneously, the interviewer recorded field notes, which were all carried out within the confines of the participants' homes. Moreover, the subjects were recruited through purposive sampling, resulting in a total of six patients and six family members. The final number of participants was determined based on data saturation. The inclusion criteria encompassed individuals of all genders, aged 18 and above, and residents of Karachi, Pakistan. Those who were not able to provide information, due to any reason, were excluded from the study. The study adhered strictly to ethical considerations.

Findings: The study uncovered several significant themes that provide valuable insights, including caregivers' availability, patients' inclusiveness, improved dietary pattern, psychological wellbeing, and rapid recovery in home-based care. Furthermore, the study identified themes on providing home-based palliative care, like family members' education and keeping back-ups for unforeseen situations. In contrast, the themes identified as home-based care preference over hospital care were: experienced compromised care, hospital anxiety, restricted to the available resources and higher hospital living expenses for patients and family members.

Conclusion: The study underscored the importance of adopting a patient-centric approach. It has become evident that the comfort and familiarity of one's home environment provide a conducive backdrop for holistic healing and wellbeing.