scholarly journals PERCEPTION OF NURSES IN DECISION-MAKING PROCESS IN PALLIATIVE CARE FOR PATIENTS WITH CANCER IN PUBLIC HEALTH CENTERS

2019 ◽  
Vol 5 (4) ◽  
pp. 169-175
Author(s):  
Atsarina Fauzan ◽  
Sri Setiyarini ◽  
Christantie Effendy ◽  
Martina Sinta Kristanti
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Palliative Care ◽  
Health Care Providers ◽  
Physiological Condition ◽  
Health Centers ◽  
Decision Making Process ◽  
Care Providers ◽  
Snowball Sampling ◽  
Patients With Cancer

Background: Nurses have a key role in promoting patients’ involvement in decision-making process of palliative care to improve their dignity and satisfaction. However, there is a dearth of studies exploring this involvement, especially in public health centers in Indonesia.Objective: This study aimed to explore the perception of nurses in decision-making process and to understand what type of decision-making made by health care providers in palliative care.Methods: This was a descriptive explorative study with qualitative approach. Participants were selected using purposive and snowball sampling. Data were collected using Focus Group Discussion (FGD) and in-depth interview. Content analysis method by inductive approach was used for data analysis. Consolidated criteria for reporting qualitative research (COREQ) was also used.Results: Eight themes emerged in this study, namely: (1) Collecting information about patients’ current physiological condition, (2) Creating alternative strategies according to the patients’ current physiological condition, (3) Establishing implementation type to be performed, (4) Providing information to the patients, (5) Discussing decision-making between patients and family, (6) Choosing/rejecting an action by patients,  (7) Performing selected actions, and (8) Evaluating action. Three points that are different from the existing theory were: (i) there was a discussion between patients and family, (ii) the absence of the process of collecting information after a patient rejects to act, and (iii) there were three types of decision-making: paternalistic, shared, and informed decision-making.Conclusion: This study serves as an input for nurses to pay more attention in decision-making process in palliative care in patients with cancer, and to encourage patients to give contribution in decision-making as part of shared decision-making.

scholarly journals Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

2019 ◽  
Vol 15 (10) ◽  
pp. 531-538 ◽  
Author(s):  
Vinita Singh ◽  
Ali J. Zarrabi ◽  
Kimberly A. Curseen ◽  
Roman Sniecinski ◽  
Justine W. Welsh ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Medical Marijuana ◽  
Survey Study ◽  
Care Practice ◽  
Care Providers ◽  
Patients With Cancer ◽  
Medical Marijuana Laws ◽  
Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

Knowledge, Beliefs, and Behaviors Related to Palliative Care Delivery Among Pediatric Oncology Health Care Providers

2018 ◽  
Vol 35 (4) ◽  
pp. 247-256 ◽  
Author(s):  
Jessica L. Spruit ◽  
Cynthia J. Bell ◽  
Valerie B. Toly ◽  
Maryjo Prince-Paul
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Pediatric Oncology ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Advanced Practice ◽  
Care Providers ◽  
The Public ◽  
Patients With Cancer

The care of pediatric patients with cancer and their families is complex and rapidly evolving. Despite significant advances in outcomes, symptoms of the disease and complications of therapy continue to cause suffering that may improve with the involvement of pediatric palliative care (PPC) services. This descriptive study responds to the observation of great variability in PPC utilization within pediatric oncology. Data collected from 156 health care professionals (nurses, advanced practice professionals, and physicians) from a statewide hematology alliance evaluates the knowledge, beliefs, and perceived barriers to PPC involvement. Data analysis reveals significant variability when comparing respondents from professional roles and practice environments. Despite progress in PPC availability, care delivery remains incongruent with current recommendations. Knowledge gained from this study emphasizes the important role for all health care providers in advocating for support of PPC programs, educating the public, and committing to intentional involvement of PPC services while caring for pediatric oncology patients.

scholarly journals Leveraging Smart Health Technology to Empower Patients and Family Caregivers in Managing Cancer Pain: Protocol for a Feasibility Study

10.2196/16178 ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. e16178 ◽  
Author(s):  
Virginia LeBaron ◽  
James Hayes ◽  
Kate Gordon ◽  
Ridwan Alam ◽  
Nutta Homdee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Pain ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Care Providers ◽  
Patients With Cancer ◽  
Smart Watch ◽  
Smart Health

Background An estimated 60%-90% of patients with cancer experience moderate to severe pain. Poorly managed cancer pain negatively affects the quality of life for both patients and their family caregivers and can be a particularly challenging symptom to manage at home. Mobile and wireless technology (“Smart Health”) has significant potential to support patients with cancer and their family caregivers and empower them to safely and effectively manage cancer pain. Objective This study will deploy a package of sensing technologies, known as Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C), and evaluate its feasibility and acceptability among patients with cancer-family caregiver dyads. Our primary aims are to explore the ability of BESI-C to reliably measure and describe variables relevant to cancer pain in the home setting and to better understand the dyadic effect of pain between patients and family caregivers. A secondary objective is to explore how to best share collected data among key stakeholders (patients, caregivers, and health care providers). Methods This descriptive two-year pilot study will include dyads of patients with advanced cancer and their primary family caregivers recruited from an academic medical center outpatient palliative care clinic. Physiological (eg, heart rate, activity) and room-level environmental variables (ambient temperature, humidity, barometric pressure, light, and noise) will be continuously monitored and collected. Behavioral and experiential variables will be actively collected when the caregiver or patient interacts with the custom BESI-C app on their respective smart watch to mark and describe pain events and answer brief, daily ecological momentary assessment surveys. Preliminary analysis will explore the ability of the sensing modalities to infer and detect pain events. Feasibility will be assessed by logistic barriers related to in-home deployment, technical failures related to data capture and fidelity, smart watch wearability issues, and patient recruitment and attrition rates. Acceptability will be measured by dyad perceptions and receptivity to BESI-C through a brief, structured interview and surveys conducted at deployment completion. We will also review summaries of dyad data with participants and health care providers to seek their input regarding data display and content. Results Recruitment began in July 2019 and is in progress. We anticipate the preliminary results to be available by summer 2021. Conclusions BESI-C has significant potential to monitor and predict pain while concurrently enhancing communication, self-efficacy, safety, and quality of life for patients and family caregivers coping with serious illness such as cancer. This exploratory research offers a novel approach to deliver personalized symptom management strategies, improve patient and caregiver outcomes, and reduce disparities in access to pain management and palliative care services. International Registered Report Identifier (IRRID) DERR1-10.2196/16178

scholarly journals Ethical and Social Issues for Health Care Providers in the Intensive Care Unit during the Early Stages of the COVID-19 Pandemic in Japan: a Questionnaire Survey

2021 ◽  
Author(s):  
Yusuke Seino ◽  
Yayoi Aizawa ◽  
Atsushi Kogetsu ◽  
Kazuto Kato
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Intensive Care ◽  
Medical Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Social Issues ◽  
Free Text ◽  
Care Providers

AbstractThis questionnaire-based observational study was conducted in July 2020 with the aim of understanding the ethical and social issues faced by health care providers (HCPs) registered with the Japanese Society of Intensive Care Medicine in intensive care units (ICUs) during the coronavirus disease (COVID-19) pandemic. There were 200 questionnaire respondents, and we analyzed the responses of 189 members who had been involved in COVID-19 treatment in ICUs. The ethical and social issues that HCPs recognized during the pandemic were difficulties in the decision-making process with patients’ families, limitations of life-sustaining treatment, lack of palliative care, and inadequate mental support for patients’ families and HCPs. Regarding decision-making on issues of clinical ethics during the pandemic, more than half of the respondents thought they had failed to provide sufficient palliative care to patients and responded that they experienced moral distress. The free-text responses on moral distress revealed issues such as unusual treatment and care, restricted visits, challenging situations for HCPs, and psychological burden. Additionally, 38.1% of respondents experienced episodes of social prejudice or discrimination and 4.7% experienced a shortage of medical resources. Our study result shows that the moral distress of HCPs was caused by difficulties in patient-centered decision-making and insufficient medical care to patients and their families. These were caused mainly by a lack of communication due to the stronger implementation of infection control measures. We believe that it is important to address ethical and social issues during a pandemic in order to provide appropriate medical care and prevent burnout among HCPs.

scholarly journals Patients' Decision Making Preferences and Perceived Participation in Care: A Case Study in Selected Educational Hospitals of Yazd

2021 ◽  
Author(s):  
Mohamad Amin Bahrami ◽  
Hasan Jafari ◽  
Sara Jambarsang ◽  
Samane Entezarian Ardakani
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Decision Making Process ◽  
Shared Decision ◽  
Willingness To Participate ◽  
Care Providers ◽  
The Mean ◽  
The Difference

Background: Patient's preferences in decision-making procedure are defined as the patient's willingness to participate in self-care management and decision-making. The aim of present study was to assess patients' preferences in decision-making procedure and perceived participation in care and their relationship with demographic in selected educational hospitals of Yazd in 2019. Methods: The study was conducted on 195 inpatients of the gynecology, internal medicine and surgery wards of teaching hospitals in Yazd of Iran. The inpatients were selected through stratified sampling method. The data was collected by 2 questionnaires: Degner and Sloan's control preferences scale and patients' perceived involvement in care scale of Lerman et al. parametric and non-parametric tests used to analyze the data. Results: In general, 49.20 % of patients preferred a relatively passive role in the decision-making process, and 36.40 % of them had high level of willingness to participate in their medical care decisions. The difference between the types of patients 'decision-making preferences was significant for education level, type of hospital and type of inpatient ward, type of basic insurance (p ≤ 0.05). The mean score of Patients' perceived participation was 62.08 ± 14.92. The difference observed in the mean score of patients' perceived participation in care for gender, type of disease, type of hospital, history of hospitalization, type of basic insurance was significant (p < 0.05). Conclusion: A large percentage of patients in the present study preferred a relatively passive role in decision-making, so it is best for health care providers to provide patients with understandable information about available treatment options and the benefits / risks associated with those choices. Also, the necessary interventions to promote shared decision-making, especially to help female patients and patients with more acute illnesses, as well as to support health care providers to participate in the shared decision-making process with patients, are of particular importance.

Assessment of Indian Public Health Standards in the Primary Health Centers in a District of Uttar Pradesh, India

2017 ◽  
Vol 2 (2) ◽  
pp. 53-60
Author(s):  
Arshiya Masood ◽  
Anil K Singh ◽  
DS Martolia ◽  
Tanu Midha
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Rural Areas ◽  
Uttar Pradesh ◽  
Health Centers ◽  
Care Providers ◽  
Cross Sectional ◽  
Primary Health ◽  
Health Standards

ABSTRACT Introduction Primary health center (PHC) is a first port of call to a qualified doctor of the public sector in rural areas. Standards are the main driver for continuous improvement in quality. The performance of PHCs can be assessed against the Indian Public Health Standards (IPHS) recommended for PHCs in early 2007. The overall objective of IPHS for PHCs is to provide health care, i.e., quality oriented and sensitive to the needs of the community. These standards would also help monitor and improve the functioning of the PHCs. Aims and objectives This study was carried out to assess (1) the infrastructure, equipments, instruments, staffing, and other facilities; (2) the services being provided at PHCs; (3) to find out the reasons for nonutilization of health services and suggest remedial measures for the same. Material and methods This was a cross-sectional study at two PHCs, namely Thatiya and Umerda of Tirwa block of Kannauj District selected randomly for assessment. Health care providers, mainly medical officers, were interviewed using pretested, precoded pro forma. Descriptive analysis was used as per study requirements. Results It has been found that only outpatient department services were being provided with many missing components, such as one of the most important ones like maternal and child health and family planning. Physical infrastructure and facilities were inadequate at both the PHCs. Both of them were grossly underequipped and understaffed. Medical officers face their own problems; even basic amenities of life like water, electricity, canteen, etc., are lacking there. Conclusion Both the PHCs were not performing up to the expectations and standards of the Indian Public Health. How to cite this article Masood A, Singh AK, Martolia DS, Midha T. Assessment of Indian Public Health Standards in the Primary Health Centers in a District of Uttar Pradesh, India. Int J Adv Integ Med Sci 2017;2(2):53-60.

Symptom burden and distress in patients with cancer in Africa.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 255-255
Author(s):  
John K. Weru
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Symptom Burden ◽  
Public Health Problem ◽  
Symptom Assessment ◽  
University Hospital ◽  
Care Providers ◽  
Patients With Cancer ◽  
Edmonton Symptom Assessment Scale

255 Background: Cancer has become a significant public health problem in Africa but still most diagnoses are made late, Sitas et al (2006). The need for palliative care is significant due to the late contact with health care providers and the many symptoms they present with. No study has been undertaken to assess symptomatology for these patients in Africa. Objective: To study the prevalence of symptoms in patients with cancer in an African setting. Methods: Symptom studies from records of patients with cancer referred to the Palliative Care Services at the Aga Khan University Hospital, Nairobi in 6 months. Symptoms charted on Edmonton Symptom Assessment Scale. Results: 42 patients were referred to the service in this period. All the patients reported > 3 symptoms which cut across the physical, social, psychological and spiritual concerns. The most common symptoms were pain in the physical dimension (90%) as reported by the patient. Fatigue was reported by (93%).Family wellbeing was the main worry in psychological dimension (95%). 94 % reported social disconnect due to the diagnosis, job losses and huge cost of health care. 96% suffered from the existential question of why me and worry about the future. Conclusions: Cancer has become a major burden to patients, families, societies and nations in Africa. Patients suffering from this illness experience a myriad of symptoms which require holistic approach to care. Social wellbeing remains a major concern for patients with cancer in Africa.

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