scholarly journals Nurses’ required end‐of‐life care competence in health centres inpatient ward – a qualitative descriptive study

2020 ◽  
Author(s):  
Elina Haavisto ◽  
Anu Soikkeli‐Jalonen ◽  
Mia Tonteri ◽  
Maija Hupli
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Descriptive Study ◽  
Life Care ◽  
Inpatient Ward ◽  
Health Centres ◽  
Qualitative Descriptive

scholarly journals Decision making in the end-of-life care of patients who are terminally ill with cancer – a qualitative descriptive study with a phenomenological approach from the experience of healthcare workers.

2021 ◽  
Author(s):  
Angela Luna-Meza ◽  
Natalia Godoy-Casasbuenas ◽  
José Andrés Calvache ◽  
Eduardo Diaz ◽  
Fritz Gempeler ◽  
...  
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
End Of Life Decisions ◽  
Care Plans ◽  
Qualitative Descriptive ◽  
Imminent Death

Abstract Background: In Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients.Methods: Qualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan. Results: When making decisions regarding end-of-life care, professionals consider: 1. Patient’s clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional conditions: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent unclarity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not patients directly for their preferences. Fear of confrontation with family members and lawsuits leads doctors to carrying out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians have access to opioid medications, barriers to their application are largely in delivery by the health system, the requirement of trained personnel for intravenous administration and ambulatory and home care plans which in Colombia are rare.Conclusions: to improve end-of-life decision making, Colombian physicians and patients need to openly discuss wishes, needs and care options and prepare caregivers. Promotion of palliative care education and development of palliative care centres and home care plans is necessary to facilitate access to end-of-life care. Patients and caregivers’ perspectives are needed to complement physicians’ perceptions and practices. Key Message: The results highlight the importance of improving access to end-of-life care in Colombia, and diminish the “denial of imminent death” among patients and caregivers to facilitate end-of-life discussions and shared decisions; interventions to prepare caregivers and promote home care.

scholarly journals Over the Great Wall: A Qualitative Descriptive Study of the Experiences and Preferences of Chinese Immigrant Families when Receiving Hospice Services in New Zealand

2021 ◽  
Author(s):  
◽  
Joanna Clare Hathaway
Keyword(s):  
New Zealand ◽  
End Of Life Care ◽  
Immigrant Families ◽  
Chinese Immigrants ◽  
Descriptive Study ◽  
Sensitive Information ◽  
Chinese Immigrant ◽  
Life Care ◽  
Chinese Immigrant Families ◽  
Qualitative Descriptive

<p>This thesis discusses the background, processes, findings and recommendations of a qualitative descriptive study to explore and describe the experiences and preferences of Chinese immigrant families when receiving hospice services in New Zealand (NZ). The study arose from clinical practice questions about how hospice services were providing end-of-life care to the growing number of Chinese immigrants in NZ. With the assistance of a Cultural Advisor and a team of professional interpreters, eight bereaved Chinese immigrants living in the greater Auckland area who had cared for a terminally ill close family member with hospice service involvement were interviewed using a semi-structured approach. Participants were asked to describe their family support in NZ as well as their experiences of referral to a hospice, the types of care and treatment provided, communication processes between staff and the patient/family, care in the patient's last days of life, comparisons with care provided in their country of origin and suggestions for NZ hospice service improvements. Four key themes emerged: 1) Unfamiliar territory - participants were unfamiliar with the role or services of hospice and staff's lack of awareness of Chinese customs had led to distressing situations; 2) Service experiences and expectations - while some services were deemed useful others were not; participants had expected more medical treatments to manage the patient's symptoms; deaths in in-patient settings were less concerning to families and were preferred to deaths at home; 3) Support to cope - participants wanted more psychological support from hospice and regarded the maintenance of hope as a key component of a good death; 4) Uncovering sensitive information - families wanted to be consulted before sensitive information was discussed with patients and they preferred information to be uncovered slowly and gently to avoid causing the patient psychological harm. Recommendations for hospice service development included: improved access to information for families; greater provision of support services, especially for patients and families at home; education for hospice staff about Chinese culture and customs; options for in-patient admission in the last days of life; and the involvement of families in disclosure decisions. It is hoped that by responding to the experiences and preferences shared by participants, hospice services will be better equipped to address the end-of-life care needs of Chinese immigrant families.</p>

scholarly journals Over the Great Wall: A Qualitative Descriptive Study of the Experiences and Preferences of Chinese Immigrant Families when Receiving Hospice Services in New Zealand

2021 ◽  
Author(s):  
◽  
Joanna Clare Hathaway
Keyword(s):  
New Zealand ◽  
End Of Life Care ◽  
Immigrant Families ◽  
Chinese Immigrants ◽  
Descriptive Study ◽  
Sensitive Information ◽  
Chinese Immigrant ◽  
Life Care ◽  
Chinese Immigrant Families ◽  
Qualitative Descriptive

<p>This thesis discusses the background, processes, findings and recommendations of a qualitative descriptive study to explore and describe the experiences and preferences of Chinese immigrant families when receiving hospice services in New Zealand (NZ). The study arose from clinical practice questions about how hospice services were providing end-of-life care to the growing number of Chinese immigrants in NZ. With the assistance of a Cultural Advisor and a team of professional interpreters, eight bereaved Chinese immigrants living in the greater Auckland area who had cared for a terminally ill close family member with hospice service involvement were interviewed using a semi-structured approach. Participants were asked to describe their family support in NZ as well as their experiences of referral to a hospice, the types of care and treatment provided, communication processes between staff and the patient/family, care in the patient's last days of life, comparisons with care provided in their country of origin and suggestions for NZ hospice service improvements. Four key themes emerged: 1) Unfamiliar territory - participants were unfamiliar with the role or services of hospice and staff's lack of awareness of Chinese customs had led to distressing situations; 2) Service experiences and expectations - while some services were deemed useful others were not; participants had expected more medical treatments to manage the patient's symptoms; deaths in in-patient settings were less concerning to families and were preferred to deaths at home; 3) Support to cope - participants wanted more psychological support from hospice and regarded the maintenance of hope as a key component of a good death; 4) Uncovering sensitive information - families wanted to be consulted before sensitive information was discussed with patients and they preferred information to be uncovered slowly and gently to avoid causing the patient psychological harm. Recommendations for hospice service development included: improved access to information for families; greater provision of support services, especially for patients and families at home; education for hospice staff about Chinese culture and customs; options for in-patient admission in the last days of life; and the involvement of families in disclosure decisions. It is hoped that by responding to the experiences and preferences shared by participants, hospice services will be better equipped to address the end-of-life care needs of Chinese immigrant families.</p>

Building organizational compassion among teams delivering end-of-life care in the intensive care unit: The 3 Wishes Project

2020 ◽  
Vol 34 (9) ◽  
pp. 1263-1273 ◽  
Author(s):  
Meredith Vanstone ◽  
Marina Sadik ◽  
Orla Smith ◽  
Thanh H Neville ◽  
Allana LeBlanc ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Life Care ◽  
Dying Patients ◽  
Qualitative Descriptive

Background: The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians. Aim: To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit. Design: Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework. Setting/participants: Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders. Results: The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians. Conclusions: Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.

scholarly journals At the Grave We Make Our Song: A Palliative Care Study in Rural Guatemala

2016 ◽  
Vol 29 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Erin Traister ◽  
Kim L. Larson ◽  
Dell Hagwood
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Family Involvement ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
The Family ◽  
Qualitative Descriptive ◽  
Training Opportunities

Purpose: We sought to understand decision making, family involvement, and cultural factors that influence palliative care for Guatemalans. Design: A qualitative descriptive study was conducted in Guatemala to explore palliative care experiences among seven participants. Findings: The overarching theme was Relief from Suffering, reinforced by three support systems: the family, community rezadora, and priest. The family made decisions and provided physical care. The rezadora sang prayers and prepared the home altar. The priest provided traditional sacraments. Discussion: The role of the rezadora should be considered in providing palliative care to Guatemalans. Some Guatemalans are unfamiliar with or have difficulty understanding the role of the nurse in palliative and end-of-life care. Implications: We suggest training opportunities using international resources to enhance the role for Guatemalan nurses in end-of-life care. Palliative care nurses in the United States may benefit from incorporating the rezadora into strategies that extend these services to Guatemalans.

scholarly journals Transition to exclusive palliative care for women with breast cancer

2021 ◽  
Vol 74 (5) ◽  
Author(s):  
Audrei Castro Telles ◽  
Paulo Alexandre de Souza São Bento ◽  
Marléa Crescêncio Chagas ◽  
Ana Beatriz Azevedo de Queiroz ◽  
Nair Caroline Cavalcanti de Mendonça Bittencourt ◽  
...  
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Palliative Care ◽  
Human Resources ◽  
Health Professionals ◽  
End Of Life Care ◽  
Descriptive Study ◽  
Physical Structure ◽  
Life Care ◽  
Qualitative Descriptive

ABSTRACT Objective: to analyze the perspectives that affect the transition to exclusive palliative care for women with breast cancer. Methods: qualitative, descriptive study, carried out in a public health institution in Rio de Janeiro, Brazil, between December 2018 and May 2019. 28 health professionals were interviewed. Content analysis was used in the thematic modality. Results: the operational difficulties were linked to the fragmented physical structure, the late and unplanned nature of the referral, the ineffective communication, and the deficit of human resources. In general, women and family members resist referral because they do not know palliative care. There is no consensus among oncologists on the most appropriate time to stop systemic therapy for disease control. Final considerations: the perceived difficulties configure an abrupt referral, accompanied by false hopes and, often, limited to end-of-life care.

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