Integrating Palliative Care Assessment Tools to Enhance Understanding of Illness Trajectory in Post-Acute Care and Long-Term Care.

OBJECTIVES: To determine whether education and integration of the Gold Standard Framework Proactive Identification Guidance (GSF-PIG) and the Palliative Performance Scale (PPS) into care rounds, in post-acute care settings, can facilitate communication between the interprofessional care team to enhance understanding of illness trajectories, identifying those who would benefit from a palliative approach to care. METHODS: Interprofessional care teams received training on the GSF-PIG and PPS which were integrated into weekly care rounds and completed a post-evaluation survey. A chart review was conducted for the 40 patients and residents reviewed with the GSF-PIG and PPS. Data analysis included descriptive statistics and comparisons of characteristics between patients and residents who were grouped as positive or negative on the GFS-PIG surprise question using chi square analyzes and t-tests. RESULTS: The GSF-PIG and PPS were found to enhance communication within care teams and enhance understanding of patient and resident's illness burden. The chart review revealed that patients and residents whom the team would not be surprised if they died within 1 year were older (p = .002), had a lower PPS score (p = .002) and had more indicators of decline (p < .001) compared to patients and residents the team would be surprised if they died within the year. CONCLUSION: Training interprofessional care teams on the utilization and integration of the GSF-PIG and PPS during weekly care rounds helped increase the understanding of patient and resident illness burden and illness trajectory to identify those who may benefit from a palliative approach to care.

Exploring People's Reaction and Perceived Issues of the COVID-19 Pandemic at Its Onset.

The experience of the COVID-19 Pandemic has varied considerably from individual-to-individual. Little is known about the changes in the level of experience general people went through during the first few months after the coronavirus (COVID-19) was declared as a Pandemic. This longitudinal qualitative study explores the general public's reports of their experience with the COVID-19 Pandemic during its early stage. An online survey was conducted using a convenience/snowball sampling technique in March and again in May 2020, where North American adults with at least a college-degree, and female majority, shared their experiences with the COVID-19 Pandemic in response to an open-ended question, apart from completing questionnaires assessing transitional impact and psychological well-being. Open responses were first content analyzed to identify themes most commonly reported, and then, the quantitative analysis examined the reliability of the changes of themes between the two-time points. Text-analysis of the open-responses from the two waves identified seven themes, namely emotional response, social contact, virus-infected, financial impact, impact on plans, disease, and non-disease related concern, as well as social-distance. These themes indicated that, (a) people were distressed and having negative affective thoughts; (b) they spoke more about their plans-and-goals that were affected by the Pandemic than their financial condition; (c) people mostly used digital platforms to maintain contact with their social network, although they preferred face-to-face interactions; (d) they spoke more about the infection experienced by people in general than infection experienced by themselves and individuals they know. Surprisingly, (e) people mentioned more about the way the Pandemic had disrupted their day-to-day activities than the disease-related health concern. Finally, (f) most of the respondents approved of the practice of social distancing while some expressed its negative or neutral effect on their social lives. The quantitative measure determined that as time passed, people's experience with the Pandemic became quite different as people talked more about getting infected, and their affected goals-and-plans. We concluded with a remark that this Pandemic would most likely leave an impression on people's lives and that these online comment-style responses might provide us with insights into people's perspectives as the Pandemic unfolds, helping us in understanding the uniqueness of the Pandemic experience of individuals for an effective tailored intervention to protect their well-being during a health-crisis.