scholarly journals Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review

2021 ◽  
Author(s):  
Anu Soikkeli‐Jalonen ◽  
Kaisa Mishina ◽  
Heli Virtanen ◽  
Andreas Charalambous ◽  
Elina Haavisto
Keyword(s):  
Systematic Review ◽  
Inpatient Care ◽  
Family Members ◽  
Supportive Interventions ◽  
Seriously Ill Patients ◽  
Seriously Ill

scholarly journals The “surprise question” for predicting death in seriously ill patients: a systematic review and meta-analysis

2017 ◽  
Vol 189 (13) ◽  
pp. E484-E493 ◽  
Author(s):  
James Downar ◽  
Russell Goldman ◽  
Ruxandra Pinto ◽  
Marina Englesakis ◽  
Neill K.J. Adhikari
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Seriously Ill Patients ◽  
Surprise Question ◽  
Seriously Ill

scholarly journals Smiles behind the masks: A systematic review and narrative synthesis exploring how family members of seriously ill or dying patients are supported during infectious disease outbreaks

2021 ◽  
pp. 026921632110295
Author(s):  
Melissa J Bloomer ◽  
Catherine Walshe
Keyword(s):  
Infectious Disease ◽  
Systematic Review ◽  
Family Members ◽  
Disease Outbreaks ◽  
Control Measures ◽  
Narrative Synthesis ◽  
Infectious Disease Outbreaks ◽  
Dying Patients ◽  
The Impact ◽  
Seriously Ill

Background: Infection control measures during infectious disease outbreaks can have significant impacts on seriously ill and dying patients, their family, the patient-family connection, coping, grief and bereavement. Aim: To explore how family members of patients who are seriously ill or who die during infectious disease outbreaks are supported and cared for during serious illness, before and after patient death and the factors that influence family presence around the time of death. Design: Systematic review and narrative synthesis. Data sources: CINAHL, Medline, APA PsycInfo and Embase were searched from inception to June 2020. Forward and backward searching of included papers were also undertaken. Records were independently assessed against inclusion criteria. Included papers were assessed for quality, but none were excluded. Findings: Key findings from 14 papers include the importance of communication and information sharing, as well as new ways of using virtual communication. Restrictive visiting practices were understood, but the impact of these restrictions on family experience cannot be underestimated, causing distress and suffering. Consistent advice and information were critical, such as explaining personal protective equipment, which family found constraining and staff experienced as affecting interpersonal communication. Cultural expectations of family caregiving were challenged during infectious disease outbreaks. Conclusion: Learning from previous infectious disease outbreaks about how family are supported can be translated to the current COVID-19 pandemic and future infectious disease outbreaks. Consistent, culturally sensitive and tailored plans should be clearly communicated to family members, including when any restrictions may be amended or additional supports provided when someone is dying.

scholarly journals Partnering with frail or seriously ill patients in research: a systematic review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Claire Ludwig ◽  
Ian D. Graham ◽  
Wendy Gifford ◽  
Josee Lavoie ◽  
Dawn Stacey
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Lived Experience ◽  
Narrative Analysis ◽  
Mixed Methods Research ◽  
Well Being ◽  
Research Partnerships ◽  
Research Teams ◽  
Seriously Ill Patients ◽  
Seriously Ill

Abstract Background The expectation to include patients as partners in research has steadily gained momentum. The vulnerability of frail and/or seriously ill patients provides additional complexity and may deter researchers from welcoming individuals from this patient population onto their teams. The aim was to synthesize the evidence on the engagement of frail and/or seriously ill patients as research partners across the research cycle. Methods A systematic review was conducted using PRISMA guidelines. A search strategy included MEDLINE®, EMBASE®, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO from database inception to April, 2019. Eligible studies were peer-reviewed qualitative, quantitative, and mixed methods research reporting on the engagement of frail and/or seriously ill patients as partners on research teams. The Mixed Methods Appraisal Tool was used to appraise study quality. Narrative analysis was conducted. Results Of 8763 citations, 30 were included. Most studies included individuals with cancer on the research team (60%). Barriers included: lack of time and resources (50%), discontinuity in contribution (37%), and concerns for well-being (33%). Facilitators included: trust and mutual respect (60%), structural accessibility (57%), flexibility in timing and methods of engagement (43%), and attention to care and comfort, (33%). Perceived impacts for patients included: renewed personal sense of agency (37%) and emotional/peer support (37%). Impacts for researchers included sensitization to the lived experience of disease (57%) and an increased appreciation of the benefits of patient engagement (23%). Research design, execution, and outcomes, developed with patients, were deemed more suitable, relevant and reflective of patients’ priorities. Conclusions There is emerging evidence to suggest that research partnerships with frail and/or seriously ill patients can be achieved successfully. Patients mostly report benefit from partnering with research teams. Frailty and/or serious illness do present legitimate concerns for their well-being but appear to be successfully mitigated when researchers ensure that the purpose of engagement is well-defined, the timing and methods of engagement are flexible, and the practical and emotional needs of patient partners are addressed throughout the process. Systematic review registration The systematic review protocol was registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).

scholarly journals Ethical considerations for engaging frail and seriously ill patients as partners in research: sub-analysis of a systematic review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Claire Ludwig ◽  
Ian D. Graham ◽  
Josee Lavoie ◽  
Wendy Gifford ◽  
Dawn Stacey
Keyword(s):  
Systematic Review ◽  
Ethical Issues ◽  
Financial Burden ◽  
Value Added ◽  
Analysis Data ◽  
Biomedical Ethics ◽  
Ethical Considerations ◽  
Ethical Implications ◽  
Seriously Ill Patients ◽  
Seriously Ill

Abstract Background The commitment to engage patients as partners in research has been described as a political, moral and ethical imperative. Researchers feel ill-equipped to deal with potential ethical implications of engaging patients as partners. The aim of this study is to identify the ethical considerations related to engaging frail and seriously ill (FSI) patients as partners in research. Methods We conducted a sub-analysis of a prior systematic review of 30 studies that engaged FSI patients as partners in research. Studies were included if they reported ethical considerations associated with partnering. We performed deductive content analysis, data were categorized according to Beauchamp and Childress’ Principles of Biomedical Ethics (2019): autonomy, non-maleficence, beneficence, and justice. Results Twenty-five studies were included. Common ethical considerations reported in relation to the principles were: autonomy – promoting desired level of involvement, addressing relational and intellectual power, facilitating knowledge and understanding of research; non-maleficence – protection from financial burden, physical and emotional suffering; beneficence – putting things right for others, showing value-added, and supporting patient-partners; and, justice – achieving appropriate representation, mutual respect for contributions, and distributing risks and benefits. Conclusions When partnering with FSI patients, research teams need to establish shared values and ensure processes are in place to identify and address ethical issues. Researchers and patients should work together to clarify the intent and outcomes of the partnership, actively address power differentials, recognize and minimize the potential for unintended harm, and strive to maximize the benefits of partnership. Systematic review registration The protocol for the original systematic review has been registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).

Principles of care for seriously ill patients in palliative office

2020 ◽  
pp. 15-18
Author(s):  
Nina Tishchenko
Keyword(s):  
Palliative Care ◽  
The State ◽  
State Budget ◽  
Oncological Patients ◽  
Seriously Ill Patients ◽  
Seriously Ill

The article reflects the importance and importance of the work of nurses of the Department of Palliative Care for Oncological Patients of the State Budget Health Establishment «Samara Regional Clinical Oncological Clinic». Important stages and features of care when dealing with seriously ill patients.

Home Health Agencies: Empirical Evidence on the Patient-Driven Groupings Model’s Expected Effects on Agency Reimbursements

2021 ◽  
pp. 108482232199038
Author(s):  
Elizabeth Plummer ◽  
William F. Wempe
Keyword(s):  
Ordinary Least Squares ◽  
Process Quality ◽  
Home Health ◽  
Least Squares Regression ◽  
Residual Variation ◽  
Health Agencies ◽  
Dual Eligible ◽  
Home Health Agencies ◽  
Seriously Ill Patients ◽  
Seriously Ill

Beginning January 1, 2020, Medicare’s Patient-Driven Groupings Model (PDGM) eliminated therapy as a direct determinant of Home Health Agencies’ (HHAs’) reimbursements. Instead, PDGM advances Medicare’s shift toward value-based payment models by directly linking HHAs’ reimbursements to patients’ medical conditions. We use 3 publicly-available datasets and ordered logistic regression to examine the associations between HHAs’ pre-PDGM provision of therapy and their other agency, patient, and quality characteristics. Our study therefore provides evidence on PDGM’s likely effects on HHA reimbursements assuming current patient populations and service levels do not change. We find that PDGM will likely increase payments to rural and facility-based HHAs, as well as HHAs serving greater proportions of non-white, dual-eligible, and seriously ill patients. Payments will also increase for HHAs scoring higher on quality surveys, but decrease for HHAs with higher outcome and process quality scores. We also use ordinary least squares regression to examine residual variation in HHAs’ expected reimbursement changes under PDGM, after accounting for any expected changes related to their pre-PDGM levels of therapy provision. We find that larger and rural HHAs will likely experience residual payment increases under PDGM, as will HHAs with greater numbers of seriously ill, younger, and non-white patients. HHAs with higher process quality, but lower outcome quality, will similarly benefit from PDGM. Understanding how PDGM affects HHAs is crucial as policymakers seek ways to increase equitable access to safe and affordable non-facility-provided healthcare that provides appropriate levels of therapy, nursing, and other care.

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