scholarly journals Attitudes of Nonpalliative Care Nurses towards Palliative Care

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Victoria Tait ◽  
Megan Higgs ◽  
Linda Magann ◽  
Joanne Dixon ◽  
Jan Maree Davis ◽  
...  

The quality of palliative care given to terminally ill patients and their family members can be directly impacted by the attitudes that nurses hold towards palliative care. This study aimed to investigate the attitudes of nonpalliative care nurses towards death and dying in the context of palliative care. Nurses working within the medical aged care, cardiology and respiratory wards at two metropolitan teaching hospitals in Sydney completed the Frommelt Attitudes Towards Care of the Dying (FATCOD) scale, an anonymous self-administered questionnaire, and a twelve-item demographic questionnaire. A total of 95 completed surveys were used in the final analysis. The total FATCOD score was 119.8±11.1, patient FATCOD was 79.6±8.6, and family FATCOD was 40.2±4.4. Of significance, the professional variables designation and role were associated with attitudes in the total FATCOD and country of birth, designation, highest level of education, and role were associated with attitudes towards the patient FATCOD. Scores for communication between the nurse and the terminally ill patient were poor. Health care facilities should focus on developing strategies to improve the communication skills among nonpalliative care nurses in order to optimize patient outcomes.

2021 ◽  
Vol 5 (1) ◽  
pp. 9-16
Author(s):  
Titih Huriah ◽  
Nurul Hidayah ◽  
Akichika Mikami

Background: The increment of terminal health problems causes the demand for palliative care to increase. Nurses’ attitudes toward palliative care have critical implications on the quality of care for terminally ill patients. This study aimed to investigate non-palliative care nurses’ attitudes towards death and dying patients in palliative care in Indonesia.Method: A cross-sectional design was performed in four general hospitals, five primary health centers, and three nursing homes in Yogyakarta. Systematic random sampling was the method employed. The research instrument used Frommelt Attitudes towards Care of the Dying (FATCOD). FATCOD is a 30-item tool using a five-point Likert scale to indicate respondents' attitudes toward caring for dying patients. Attitudes had two categories, namely favorable (≥ mean score of the total score of (FATCOD) Scale) and unfavorable ( mean score of the total score of (FATCOD) Scale). Two hundred seventeen (217) non-palliative care nurses completed the FATCOD and a ten-item demographic questionnaire. The data analysis used descriptive statistics, chi-square, and linear regression.Results: The total FATCOD score achieved in this study was 111.29±9.44 (range 30–150). Concerning nurses’ attitudes towards the family members of terminally ill dying patients, the score was 39.85 (±4.12) out of a possible 50. Besides attitudes towards patient care provision, the score was 71.43 (±6.39) out of a possible 100. The nurses' attitudes towards the dying patients showed that the favorable and unfavorable attitudes had almost the same percentage. Of significance, working experience variables were associated with attitudes in the total FATCOD and patient FATCOD. Working experience and level of education were related to attitudes towards the family FATCOD.Conclusion: Non-palliative care nurses had a favorable attitude towards palliative care. The ministry of health should give awareness by providing various training, workshop, formal and informal education about PC for nurses.


2015 ◽  
Vol 33 (4) ◽  
pp. 357-363 ◽  
Author(s):  
Hiroya Kinoshita ◽  
Isseki Maeda ◽  
Tatsuya Morita ◽  
Mitsunori Miyashita ◽  
Akemi Yamagishi ◽  
...  

Purpose To explore the associations between place of death and quality of death and dying and caregiver burden in terminally ill patients with cancer and their families. Methods Two bereavement surveys were conducted in October 2008 and October 2011. A total of 2,247 family caregivers of patients with cancer who were deceased responded to the mail surveys (response rate, 67%). Family members reported patient quality of death and dying and caregiver burden by using the Good Death Inventory and Caregiving Consequences Inventory. Results Patient quality of death and dying was significantly higher at home relative to other places of dying after adjustment for patient and/or family characteristics (adjusted means): 5.0 (95% CI, 4.9 to 5.2) for home, 4.6 (95% CI, 4.5 to 4.7) for palliative care units, and 4.3 (95% CI, 4.2 to 4.4) for hospitals. For all combinations, pairwise P < .001; the size of the difference between home and hospital was moderate (Hedges' g, 0.45). Home was superior to palliative care units or hospitals with respect to “dying in a favorite place,” “good relationships with medical staff,” “good relationships with family,” and “maintaining hope and pleasure” (P < .001 for all combinations of home v palliative care units and home v hospitals). Home death was significantly associated with a lower overall (P = .03) and financial caregiver burden (P = .004) relative to hospital death. Conclusion Dying at home may contribute to achieving good death in terminally ill patients with cancer without causing remarkably increased caregiver burden. Place of death should be regarded as an essential goal in end-of-life care.


2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.


Author(s):  
William S. Breitbart

Anxiety is common in palliative care patients and may significantly impact patients’ quality of life. Anxiety can have many etiologies resulting in different anxiety syndromes, ranging from adjustment disorder, anxiety resulting from general medical condition, to medication-induced anxiety disorders. Pre-existing anxiety disorders should also be taken into consideration in palliative care settings. Different screening and assessment tools have been used to improve recognition and assessment of anxiety in the terminally ill. Treatment of anxiety in this patient population includes use of a variety of pharmacological agents to relieve severe anxiety symptoms and use of psychotherapy interventions that have been shown to be safe and effective in the terminally ill. This chapter includes an overview of the prevalence, assessment, and management of anxiety disorders in palliative care settings.


Author(s):  
Lesley K Bowker ◽  
James D Price ◽  
Sarah C Smith

Breaking bad news 638 HOW TO . . . Break bad news 639 Bereavement 640 HOW TO . . . Promote a ‘healthy bereavement’ 641 Palliative care 642 Symptom control in the terminally ill 644 HOW TO . . . Prescribe a subcutaneous infusion for palliative care 646 Documentation after death 648 Other issues after death ...


2013 ◽  
Vol 21 (3) ◽  
Author(s):  
Cornelia Meffert ◽  
Gerhild Becker

SummaryRecent statistics reveal a substantial and even growing need for palliative care in present-day society. Providing adequate pain therapy remains a largely unsolved problem, mainly because of the small number of clinical studies in palliative medicine. Hence, clinical research is urgently needed – and therefore suitable tools to measure outcomes must be developed. Contrary to typical clinical studies, the usual outcome parameters such as decreased mortality and/or morbidity are unsuitable. Future research should focus on developing an instrument which allows to measure quality of life as the central outcome criterion of clinical studies in palliative medicine.


2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 70-70
Author(s):  
Pedro Emilio Perez-Cruz ◽  
Oslando Padilla Pérez ◽  
Pilar Bonati ◽  
Oliva Thomsen Parisi ◽  
Laura Tupper Satt ◽  
...  

70 Background: Improving quality of death (QOD) is a key goal in palliative care. No instruments to measure QOD have been validated in Spanish. The goal of this study was to validate the Spanish version of the quality of death and dying questionnaire (QODD) and to develop a shortened version of this instrument suitable to be completed by phone interview. Methods: Translation/back-translation and adaptation of the QODD was performed following established standards. One question was removed due to cultural inadequacy. We enrolled caregivers (CGs) of consecutive deceased cancer patients from a single palliative care clinic in Santiago, Chile. CGs were contacted by phone between 4 and 12 weeks after patients’ death. Participating CGs completed the adapted QODD (QODD-ESP) by phone interview. A global rating question assessing quality of life (QOL) during the last week of life was included. A shortened version of the QODD (QODD-ESP-12) based on the model by Downey et al. (J Pain Sympt Manage 2010;39) was created. Measures of reliability (Cronbach-alpha), convergent validity (correlation with global rating question) and construct validity (factorial analysis [FA]) were estimated for both versions of the instrument. Results: 150 (50%) out of 302 CGs completed the QODD-ESP. Patients mean (standard deviation [SD]) age was 67 (14), 71 (47%) female and 131 (87%) died at home. CGs mean (SD) age was 51 (13), 128 (85%) female. Mean QODD-ESP score was 69 (range 35-96) with an alpha = .829. Correlation with last week QOL was .434 (p < .01). Kaiser-Meyer-Olkin measure of sampling adequacy was .585, not supporting the existence of a unique underlying construct. Mean QODD-ESP-12 score was 69 (range 31-97) with a alpha = .728. Correlation with last week QOL was .306 (p < .01). Confirmatory FA of QODD-ESP-12 showed that data fitted well Downey’s model (Chi2 4.85 (60), p = .311 Comparative Fit ndex = .98; Tuker-Lewis Index = .977 and root mean square error of approximation (RMSEA) = .023 (CI: 0-.056). Conclusions: QODD-ESP-12 is a reliable and valid instrument with good psychometric properties and can be used to assess QOD in a Spanish speaking cancer palliative care population by phone interview.


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