Ilaria de Barbieri, Veronica Strini, Helen Noble, Stefano Amatori, Davide Sisti
{"title":"护士感知的促进因素和障碍在肾脏疾病患者姑息治疗:欧洲德尔菲调查。","authors":"Ilaria de Barbieri, Veronica Strini, Helen Noble, Stefano Amatori, Davide Sisti","doi":"10.1111/jorc.12371","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The palliative care phenomenon is increasingly invested in all medicine and nursing fields, as care for people with kidney disease who do not wish to embark on dialysis: it encompasses a palliative approach to shared decision-making. To deliver patient-centred optimal care, nephrology healthcare staff should be knowledgeable about palliative care and the appropriate conservative management approach.</p><p><strong>Objective: </strong>This paper aimed to explore, using a Delphi survey, the barriers and facilitators to palliative care in patients with kidney disease.</p><p><strong>Design: </strong>An e-Delphi technique with three questionnaire rounds was performed; statements were generated using Likert scales.</p><p><strong>Participants and measurements: </strong>A list of 80 statements related to palliative care in patients with kidney disease was divided into facilitators and barriers. Questionnaires were administered to 13 nephrology nurse experts in some European countries.</p><p><strong>Results: </strong>Seven items were removed from the list of 80 statements after the first round of the Delphi study; eight items achieved a significant change of the mean between round two and three, whereas internal stability emerged in all the remaining items.</p><p><strong>Conclusions: </strong>Specific training and education in palliative care emerged as a facilitator, as well as the role of spiritual and beliefs and the role of family and caregiver. The main barriers were represented by the differences in cultures, beliefs, and practices and by the lack of experience in the role of the staff in palliative care. These statements provide a platform for future research to improve palliative care practice in patients with kidney disease.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jorc.12371","citationCount":"4","resultStr":"{\"title\":\"Nurse-perceived facilitators and barriers to palliative care in patients with kidney disease: A European Delphi survey.\",\"authors\":\"Ilaria de Barbieri, Veronica Strini, Helen Noble, Stefano Amatori, Davide Sisti\",\"doi\":\"10.1111/jorc.12371\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The palliative care phenomenon is increasingly invested in all medicine and nursing fields, as care for people with kidney disease who do not wish to embark on dialysis: it encompasses a palliative approach to shared decision-making. To deliver patient-centred optimal care, nephrology healthcare staff should be knowledgeable about palliative care and the appropriate conservative management approach.</p><p><strong>Objective: </strong>This paper aimed to explore, using a Delphi survey, the barriers and facilitators to palliative care in patients with kidney disease.</p><p><strong>Design: </strong>An e-Delphi technique with three questionnaire rounds was performed; statements were generated using Likert scales.</p><p><strong>Participants and measurements: </strong>A list of 80 statements related to palliative care in patients with kidney disease was divided into facilitators and barriers. Questionnaires were administered to 13 nephrology nurse experts in some European countries.</p><p><strong>Results: </strong>Seven items were removed from the list of 80 statements after the first round of the Delphi study; eight items achieved a significant change of the mean between round two and three, whereas internal stability emerged in all the remaining items.</p><p><strong>Conclusions: </strong>Specific training and education in palliative care emerged as a facilitator, as well as the role of spiritual and beliefs and the role of family and caregiver. The main barriers were represented by the differences in cultures, beliefs, and practices and by the lack of experience in the role of the staff in palliative care. These statements provide a platform for future research to improve palliative care practice in patients with kidney disease.</p>\",\"PeriodicalId\":16947,\"journal\":{\"name\":\"Journal of renal care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2022-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1111/jorc.12371\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of renal care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jorc.12371\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/3/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of renal care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jorc.12371","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/3/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
Nurse-perceived facilitators and barriers to palliative care in patients with kidney disease: A European Delphi survey.
Background: The palliative care phenomenon is increasingly invested in all medicine and nursing fields, as care for people with kidney disease who do not wish to embark on dialysis: it encompasses a palliative approach to shared decision-making. To deliver patient-centred optimal care, nephrology healthcare staff should be knowledgeable about palliative care and the appropriate conservative management approach.
Objective: This paper aimed to explore, using a Delphi survey, the barriers and facilitators to palliative care in patients with kidney disease.
Design: An e-Delphi technique with three questionnaire rounds was performed; statements were generated using Likert scales.
Participants and measurements: A list of 80 statements related to palliative care in patients with kidney disease was divided into facilitators and barriers. Questionnaires were administered to 13 nephrology nurse experts in some European countries.
Results: Seven items were removed from the list of 80 statements after the first round of the Delphi study; eight items achieved a significant change of the mean between round two and three, whereas internal stability emerged in all the remaining items.
Conclusions: Specific training and education in palliative care emerged as a facilitator, as well as the role of spiritual and beliefs and the role of family and caregiver. The main barriers were represented by the differences in cultures, beliefs, and practices and by the lack of experience in the role of the staff in palliative care. These statements provide a platform for future research to improve palliative care practice in patients with kidney disease.
期刊介绍:
The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA).
The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given.
The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.