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1.
Hepatol Commun ; 6(4): 920-930, 2022 04.
Article in English | MEDLINE | ID: covidwho-1756574

ABSTRACT

Palliative care (PC) benefits patients with serious illness including end-stage liver disease (ESLD). As part of a cluster randomized trial, hepatologists were trained to deliver primary palliative care to patients with ESLD using an online course, Palliative Care Always: Hepatology (PCA:Hep). Here we present a multimethod formative evaluation (feasibility, knowledge acquisition, self-efficacy, and practice patterns) of PCA:Hep. Feasibility was measured by completion of coursework and achieving a course grade of >80%. Knowledge acquisition was measured through assessments before and throughout the course. Pre/post-course surveys were conducted to determine self-efficacy and practice patterns. The hepatologists (n = 39) enrolled in a 12-week online course and spent 1-3 hours on the course weekly. The course was determined to be feasible as 97% successfully completed the course and 100% passed. The course was acceptable to participants; 91.7 % reported a positive course experience and satisfaction with knowledge gained (91.6%). The pre/post knowledge assessment showed an improvement of 6.0% (pre 85.9% to post 91.9%, 95% CI [2.8, 9.2], P = 0.001). Self-efficacy increased significantly (P < 0.001) in psychological symptom management, hospice, and psychosocial support. A year after training, over 80% of the hepatologists reported integrating a variety of PC skills into routine patient care. Conclusion: PCA:Hep is feasible, acceptable, and improves learner knowledge and confidence in palliative care skills. This is a viable method to teach primary PC skills to specialists caring for patients with ESLD.


Subject(s)
End Stage Liver Disease , Gastroenterologists , Gastroenterology , Hospice and Palliative Care Nursing , End Stage Liver Disease/psychology , Humans , Palliative Care/methods
2.
Br J Community Nurs ; 27(2): 96-98, 2022 Feb 02.
Article in English | MEDLINE | ID: covidwho-1687497
3.
Nurs Outlook ; 69(6): 961-968, 2021.
Article in English | MEDLINE | ID: covidwho-1586894

ABSTRACT

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.


Subject(s)
Consensus , Expert Testimony , Hospice and Palliative Care Nursing , Palliative Care , Universal Health Care , Education, Nursing , Global Health , Healthcare Disparities , Humans , Nurse Administrators , Societies, Nursing
4.
Br J Community Nurs ; 26(12): 611, 2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1575184
5.
7.
Br J Community Nurs ; 26(11): 567, 2021 Nov 02.
Article in English | MEDLINE | ID: covidwho-1506535
8.
J Palliat Med ; 24(12): 1867-1871, 2021 12.
Article in English | MEDLINE | ID: covidwho-1493636

ABSTRACT

Background: Nominal group technique (NGT) is a well-established research method for establishing consensus. Owing to the COVID-19 pandemic, research methods need to be adapted to engage with participants online. Objective: To determine the feasibility and acceptability of adapting NGT to an online format. Setting: Palliative care clinicians (n = 31) in Greece, Romania, and Spain. Methods: NGT discussions were used to elicit palliative care clinicians' opinions, and to rank priorities regarding their understanding and needs about clinical research. Preliminary online training of country-based facilitators was followed by content analysis of debriefing reports to capture learning related to the online NGT format. Results/Implementation: Three NGT sessions used online platforms (Zoom/MS Office/Mentimeter) for the meetings. Analysis of the facilitator reports generated three themes: preparation/facilitation/timing; optimizing technology; and interactions. Conclusions: Conducting NGT meetings online is viable and may be advantageous when compared with traditional face-to-face meetings, but requires careful preparation for participants to contribute effectively.


Subject(s)
COVID-19 , Hospice and Palliative Care Nursing , Humans , Palliative Care , Pandemics , SARS-CoV-2
9.
Int J Palliat Nurs ; 27(8): 383-384, 2021 10 02.
Article in English | MEDLINE | ID: covidwho-1485530
10.
Int J Palliat Nurs ; 27(8): 410-416, 2021 Oct 02.
Article in English | MEDLINE | ID: covidwho-1481214

ABSTRACT

BACKGROUND: Mutually respectful and long-term global partnerships are critical to increasing hospice and palliative care access as a key component of universal health coverage. The importance of sustained, transnational palliative care collaboration has become more urgent since the COVID-19 pandemic. AIM: To provide an overview of characteristics for successful global palliative nursing partnerships. METHOD: The authors highlight the need to adapt approaches to meet the challenges and demands of COVID-19 in both clinical and academic spaces. Exemplars of thriving global partnerships are provided, alongside palliative nursing considerations and strategies to advance and sustain them. CONCLUSION: The role of nursing to drive and enhance palliative care partnerships, especially with equitable input from low- and middle-income country stakeholders, must be leveraged to advance shared goals and reduce serious health-related suffering around the world.


Subject(s)
COVID-19 , Global Health , Hospice and Palliative Care Nursing/methods , Stakeholder Participation , Hospice and Palliative Care Nursing/trends , Humans , Internationality , Pandemics , SARS-CoV-2
11.
J Pain Symptom Manage ; 60(2): 449-459.e21, 2020 08.
Article in English | MEDLINE | ID: covidwho-1454318

ABSTRACT

CONTEXT: Supplementary support services in palliative care for older people are increasingly common, but with neither recommended tools to measure outcomes nor reviews synthesizing anticipated outcomes. Common clinically focused tools may be less appropriate. OBJECTIVES: To identify stakeholder perceptions of key outcomes from supplementary palliative care support services, then map these onto outcome measurement tools to assess relevance and item redundancy. METHODS: A scoping review using the design by Arksey and O'Malley. EMBASE, CINAHL, MEDLINE, and PSYCHinfo searched using terms relating to palliative care, qualitative research, and supplementary support interventions. Articles were imported into Endnote™, and Covidence™ was used by two reviewers to assess against inclusion criteria. Included articles were imported into NVivo™ and thematically coded to identify key concepts underpinning outcomes. Each item within contender outcome measurement tools was assessed against each concept. RESULTS: Sixty included articles focused on advance care planning, guided conversations, and volunteer befriending services. Four concepts were identified: enriching relationships; greater autonomy and perceived control; knowing more; and improved mental health. Mapping concepts to contender tool items revealed issues of relevance and redundancy. Some tools had no redundant items but mapped only to two of four outcome themes; others mapped to all concepts, but with many redundant questions. Tools such as ICECAP-Supportive Care Measure and McGill Quality of Life had high relevance and low redundancy. CONCLUSION: Pertinent outcome concepts for these services and population are not well represented in commonly used outcome measurement tools, and this may have implications in appropriately measuring outcomes. This review and mapping method may have utility in fields where selecting appropriate outcome tools can be challenging.


Subject(s)
Advance Care Planning , Hospice and Palliative Care Nursing , Aged , Humans , Mental Health , Palliative Care , Quality of Life
12.
J Pain Symptom Manage ; 62(3): 471-481, 2021 09.
Article in English | MEDLINE | ID: covidwho-1397515

ABSTRACT

CONTEXT: Research priority guidelines highlight the need for examining the "dose" components of palliative care (PC) interventions, such as intervention adherence and completion rates, that contribute to optimal outcomes. OBJECTIVES: Examine the "dose" effect of PC intervention completion vs. noncompletion on quality of life (QoL) and healthcare use in patients with advanced heart failure (HF) over 32 weeks. METHODS: Secondary analysis of the ENABLE CHF-PC intervention trial for patients with New York Heart Association (NYHA) Class III/IV HF. "Completers" defined as completing a single, in-person outpatient palliative care consultation (OPCC) plus 6 weekly, PC nurse coach-led telehealth sessions. "Non-completers" were defined as either not attending the OPCC or completing <6 telehealth sessions. Outcome variables were QoL and healthcare resource use (hospital days; emergency department visits). Mixed models were used to model dose effects for "completers" vs "noncompleters" over 32 weeks. RESULTS: Of 208 intervention group participants, 81 (38.9%) were classified as "completers" with a mean age of 64.6 years; 72.8% were urban-dwelling; 92.5% had NYHA Class III HF. 'Completers' vs. "non-completers"" groups were well-balanced at baseline; however "noncompleters" did report higher anxiety (6.0 vs 7.0, P < 0.05, d = 0.28). Moderate, clinically significant, improved QoL differences were found at 16 weeks in "completers" vs. "non-completers" (between-group difference: -9.71 (3.18), d = 0.47, P = 0.002) but not healthcare use. CONCLUSION: Higher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF. Future work should focus on identifying the most efficacious "dose" of intervention components and increasing adherence to them. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02505425.


Subject(s)
Heart Failure , Hospice and Palliative Care Nursing , Telemedicine , Heart Failure/therapy , Humans , Middle Aged , Palliative Care , Quality of Life
14.
Palliat Med ; 35(10): 1975-1984, 2021 12.
Article in English | MEDLINE | ID: covidwho-1370928

ABSTRACT

BACKGROUND: Understanding patterns of mortality and place of death during the COVID-19 pandemic is important to help provide appropriate services and resources. AIMS: To analyse patterns of mortality including place of death in the United Kingdom (UK) (England, Wales, Scotland and Northern Ireland) during the COVID-19 pandemic to date. DESIGN: Descriptive analysis of UK mortality data between March 2020 and March 2021. Weekly number of deaths was described by place of death, using the following definitions: (1) expected deaths: average expected deaths estimated using historical data (2015-19); (2) COVID-19 deaths: where COVID-19 is mentioned on the death certificate; (3) additional non-COVID-19 deaths: above expected but not attributed to COVID-19; (4) baseline deaths: up to and including expected deaths but excluding COVID-19 deaths. RESULTS: During the analysis period, 798,643 deaths were registered in the UK, of which 147,282 were COVID-19 deaths and 17,672 were additional non-COVID-19 deaths. While numbers of people who died in care homes and hospitals increased above expected only during the pandemic waves, the numbers of people who died at home remained above expected both during and between the pandemic waves, with an overall increase of 41%. CONCLUSIONS: Where people died changed during the COVID-19 pandemic, with an increase in deaths at home during and between pandemic waves. This has implications for planning and organisation of palliative care and community services. The extent to which these changes will persist longer term remains unclear. Further research could investigate whether this is reflected in other countries with high COVID-19 mortality.


Subject(s)
COVID-19 , Hospice and Palliative Care Nursing , Humans , Pandemics , SARS-CoV-2 , United Kingdom
15.
J Palliat Med ; 24(8): 1253-1254, 2021 08.
Article in English | MEDLINE | ID: covidwho-1343603
16.
J Pain Symptom Manage ; 63(2): e224-e236, 2022 02.
Article in English | MEDLINE | ID: covidwho-1330996

ABSTRACT

CONTEXT: Palliative care access is fundamental to the highest attainable standard of health and a core component of universal health coverage. Forging universal palliative care access is insurmountable without strategically optimizing the nursing workforce and integrating palliative nursing into health systems at all levels. The COVID-19 pandemic has underscored both the critical need for accessible palliative care to alleviate serious health-related suffering and the key role of nurses to achieve this goal. OBJECTIVES: 1) Summarize palliative nursing contributions to the expansion of palliative care access; 2) identify emerging nursing roles in alignment with global palliative care recommendations and policy agendas; 3) promote nursing leadership development to enhance universal access to palliative care services. METHODS: Empirical and policy literature review; best practice models; recommendations to optimize the palliative nursing workforce. RESULTS: Nurses working across settings provide a considerable untapped resource that can be leveraged to advance palliative care access and palliative care program development. Best practice models demonstrate promising approaches and outcomes related to education and training, policy and advocacy, and academic-practice partnerships. CONCLUSION: An estimated 28 million nurses account for 59% of the international healthcare workforce and deliver up to 90% of primary health services. It has been well-documented that nurses are often the first or only healthcare provider available in many parts of the world. Strategic investments in international and interdisciplinary collaboration, as well as policy changes and the safe expansion of high-quality nursing care, can optimize the efforts of the global nursing workforce to mitigate serious health-related suffering.


Subject(s)
COVID-19 , Hospice and Palliative Care Nursing , Humans , Palliative Care , Pandemics , SARS-CoV-2 , Workforce
17.
Br J Community Nurs ; 26(7): 360, 2021 Jul 02.
Article in English | MEDLINE | ID: covidwho-1304883
18.
Br J Community Nurs ; 26(6): 307, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1278732
19.
Soins ; 66(855): 44-45, 2021 May.
Article in French | MEDLINE | ID: covidwho-1261966

ABSTRACT

Patients with cancer are more at risk of quickly developing lethal forms of covid-19. Hospitals have therefore had to organise themselves to continue to receive patients while respecting the health measures. It was necessary to think about the best way of maintaining visits, as well as a means of adapting a specific space for palliative care and team thinking for patients cared for in identified palliative care beds.


Subject(s)
COVID-19 , Hospice and Palliative Care Nursing , Humans , Palliative Care , SARS-CoV-2
20.
Soins ; 66(855): 39-40, 2021 May.
Article in French | MEDLINE | ID: covidwho-1261964

ABSTRACT

What risks does coronavirus pose to people not infected with covid in palliative care? Between certain death and uncertain covid, how can caregivers support what helps patients live while protecting them from what could make them die? It is important to be aware of what is vital to protect, but also examine the advantages and limitations of the digitalisation of care.


Subject(s)
COVID-19 , Hospice and Palliative Care Nursing , Humans , Palliative Care , SARS-CoV-2
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