ABSTRACT
<p>Purpose: We investigated the benefits and problem of the palliative care provided by long-term care unit through a survey of staff in palliative care units (PCU) and long-term care units. Methods: Self-reported questionnaires were administered to staff who engaged in PCU and long-term care units. Questions included: awareness of WHO palliative care definition, and, the general idea on palliative care, possibility of cooperation with PCU, advantages / disadvantages, and idea for non-cancer palliative care in long-term care unit. Results: We got responses from 248 medical and nursing-care staff. The percentage of “knowing” the WHO definition was 76.5% in medical staff / 32.3% in care worker, 87.6% in PCU experience / 46.5% in non-experience. Categories of responses are good, advantageous, problematic, difficult requirement, difficulty, etc. The main answers were the difficulty of care, problems of knowledge and technique, and points of problems related to personnel shortage. Medical staff or PCU experienced staff pointed out needs of palliative care and improvement of knowledge and skills. Conclusion: Opinions acknowledging the benefits and necessities for palliative care of long-term care units and a number of problems were revealed.</p>
ABSTRACT
<p>Objective: The aim of this study was to investigate the current status of the palliative care provided by long-term care unit that was established together with palliative care unit (PCU). Methods: Self-reported questionnaires were administered to long-term care unit administrators at 24 facilities that was established together with PCU. Questions included: managing the use of narcotic drugs, situation about receiving cancer patients, situation about cooperation with PCU, and difficulty with palliative care. Results: Eighteen (75%) facilities responded to the questionnaire. Fourteen facilities of respondents reported that narcotic drugs were available and usable in long-term care unit, and ten facilities reported that the narcotic drugs could be used in the same way as PCU could. Ten facilities reported that they had doctor(s) knowledgeable about palliative care or prescribing narcotic drugs, and 11 facilities reported that they had nurse(s) experienced about palliative care. Cancer patients were accepted in all 18 long-term care units. Transferring from long-term care unit to PCU due to medical condition changes after hospitalization had been carried out in 17 facilities. Unit administrator’s perceived difficulty lack of staffing, lack of staff expertise and education, and issues surrounding narcotic drug management. Conclusion: These long-term care units were providing palliative care for cancer patients in cooperation with PCU. The survey results indicated the need for solving human resource, educational, and administrative problems.</p>
ABSTRACT
Objective: The aim of this study was to investigate the palliative care for cancer patients provided by a long-term care unit. Methods: We retrospectively investigated the medical records of 194 patients who hospitalized in our long-term care unit between April 2010 and December 2014. The patients shared with a group of two, narcotic drugs non-use period (previous group; until March 2012) and narcotics use period (later group; in April 2012 or later), and it was compared with a background, hospitalization period, result on discharge, narcotic drug administration, symptom relief. And it was surveyed hospitalization dynamics of our palliative care unit for comparison. Result: Cancer patients were 16 (22%) in previous group of 74 patients and were 79 (66%) in later group of 120. The proportion of cancer patients in later group increased to three times (p<0.001). In later group, the average hospital stay was shortened to half (144 days, p<0.01) and the mortality discharge rates increased (78%, p<0.05). Narcotic drugs were administered to more than half (57%) of cancer patients in later group, and pain relief was significantly better. In the period of later group, number of hospitalized patients in palliative care unit was also increased. Conclusion: It was suggested that the long-term unit can perform palliative care for cancer patients in cooperation with the palliative care unit.
ABSTRACT
<b>Background:</b> The authors, in collaboration with a nursing college and healthcare organizations, initiated a project, "Tama District (a suburban area in Tokyo) End-of-life Care Networking" for nurses, in order to provide networking opportunities for nurses who would like to work together in their local community. A survey was conducted to identify those nurses' needs before initiating this project. <b>Result:</b> The first networking meeting was held based upon the survey results, and 39 nurses participated. The participants were from 14 hospitals, six home-visit nursing stations, and one home care support office in a northern area of Tama District and its surrounding areas in Tokyo. After having this meeting, it was identified that these nurses were highly motivated in providing better end-of-life care, and they had strong desires to network together and to exchange information about challenges and opportunities in their practice. <b>Conclusion:</b> Future issues and implications included the following: (1) Providing continuous opportunities for nurses with such meetings, and refining and updating programs to meet their needs; (2) Facilitating face-to-face relationships among individual nurses in this local community in order to facilitate better collaboration; (3) Initiating local activities that may improve and enhance nursing practice for patients and families who have health issues in their daily life.