Project description:Purpose This descriptive study aimed to explore nursing workplace spirituality, end-of-life care stress, and resilience as factors influencing compassion fatigue among nurses working in hospice and palliative care units. Methods Data were collected using a self-report questionnaire completed by 146 nurses at 14 hospice and palliative care institutions across South Korea who had worked in a hospice and palliative care institution for at least 6 months and had experience providing end-of-life care. Data were collected from February 25, 2019 to April 12, 2019, and analyzed using SPSS for Windows version 18.0. As appropriate, descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and stepwise multiple regression were used. Results The survey results showed that factors influencing compassion fatigue were resilience, subjective health status, current satisfaction with the hospice ward, and end-of-life care stress. Higher levels of resilience, a subjective health status of “healthy”, high levels of current satisfaction with the hospice ward, and lower levels of end-of-life care stress were associated with lower levels of compassion fatigue, explaining 42.9% of the total variance. Conclusion The results of this study suggest that resilience is an important factor mitigating compassion fatigue among nurses at hospice and palliative care institutions. Therefore, intervention programs should be developed to reduce compassion fatigue.
Project description:BackgroundTaiwan's National Health Insurance provides coverage for palliative and hospice care. The following 10 types of diseases have been added to the National Health Insurance reimbursement regulation: end-stage cancer, motor neuron disease, organic psychosis, brain degeneration, heart failure, chronic airway obstruction diseases, other lung diseases, chronic liver disease and cirrhosis, acute renal failure, and chronic renal failure.ObjectiveThis study aimed to determine the association between physicians' palliative education and use of hospice care in hospitalized patients at the end of life.Design and settingA cross-sectional study in a Taipei community hospital.ParticipantsPatients who died between 2014 and 2019 were identified. The deceased had at least 1 of the 10 diseases covered by health insurance were included. Hospice care services included hospice ward care and hospice shared care. This study included 2,661 individuals. In total, 972 (36.5%) patients used hospice care services.ResultsAfter adjusting for age, gender, and comorbidities, physicians' palliative education was found to significantly associated with the use of hospice care (OR: 14.38, 95% CI: 10.90-18.98).ConclusionsPhysicians' palliative education was found to be an independent factor associated with higher use of hospice care. The findings suggest increasing palliative and hospice education among physicians so that they can ensure that their patients have high-quality end-of-life medical care in an aging society.
Project description:OBJECTIVE:The objective of this update, presented at the 2018 Annual Assembly of the American Association of Hospice and Palliative Medicine (AAHPM) and the Hospice and Palliative Nurses Association (HPNA), is to identify, summarize, and critique a sampling of recent research that has the potential for marked impact on hospice and palliative clinical practice. METHODS:In a departure from previous years, we surveyed AAHPM and HPNA members to determine focused topic areas, from which we selected candidate articles. The two topic areas selected by the membership were "Moving into the great beyond: bringing palliative care into the subspecialties" and "Improving the conversation for patients with serious illness." Seven reports of original research published between January 1, 2012 and November 3, 2017 were identified through a systematic search of relevant databases, hand searching of leading journals, and discussion with experts in the field. Candidate articles were scored and ranked independently by four reviewers based on methodological quality, appeal to a breadth of palliative care clinicians across settings, and potential for impact. RESULTS:We summarize the seven articles with the highest ratings.
Project description:Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master’s-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.
Project description:BackgroundHospice and Palliative Care (HPC) is in high demand in China; however, the country is facing the shortage of qualified HPC nurses. A well-suited competence framework is needed to promote HPC human resource development. Nevertheless, existing unstandardized single-structured frameworks may not be sufficient to meet this need. This study aimed at constructing a comprehensive multi-structured HPC competence framework for nurses.MethodsThis study employed a mixed-method approach, including a systematic review and qualitative interview for HPC competence profile extraction, a two-round Delphi survey to determine the competences for the framework, and a cross-sectional study for framework structure exploration. The competence profiles were extracted from publications from academic databases and interviews recruiting nurses working in the HPC field. The research team synthesized profiles and transferred them to competences utilizing existing competence dictionaries. These synthesized competences were then subjected to Delphi expert panels to determine the framework elements. The study analyzed theoretical structure of the framework through exploratory factor analysis (EFA) based on a cross-sectional study receiving 491 valid questionnaires.ResultsThe systematic review involved 30 publications from 10 countries between 1995 and 2021, while 13 nurses from three hospitals were interviewed. In total, 87 and 48 competence profiles were respectively extracted from systematic review and interview and later synthesized into 32 competences. After the Delphi survey, 25 competences were incorporated into the HPC competence framework for nurses. The EFA found a two-factor structure, with factor 1 comprising 18 competences namely Basic Competences; factor 2 concluding 7 competences namely Developmental Competences.ConclusionsThe two-factor HPC competence framework provided valuable insights into the need and directions of Chinese HPC nurses' development.
Project description:BackgroundPharmacists contribute to medication safety by providing their services in various settings. However, standardized definitions of the role of pharmacists in hospice and palliative care (HPC) are lacking.AimThe purpose of this scoping review was to provide an overview of the evidence on the role of pharmacists and to map clinical activities in inpatient HPC.MethodWe performed a scoping review according to the PRISMA-ScR extension in CINAHL, Embase, and PubMed. We used the American Society of Hospital Pharmacists (ASHP) Guidelines on the Pharmacist's Role in Palliative and Hospice Care as a framework for standardized categorization of the identified roles and clinical activities.ResultsAfter screening 635 records (published after January 1st, 2000), the scoping review yielded 23 publications reporting various pharmacy services in HPC. The articles addressed the five main categories in the following descending order: 'Medication order review and reconciliation', 'Medication counseling, education and training', 'Administrative Roles', 'Direct patient care', and 'Education and scholarship'. A total of 172 entries were mapped to the subcategories that were added to the main categories.ConclusionThis scoping review identified a variety of pharmacists' roles and clinical activities. The gathered evidence will help to establish and define the role of pharmacists in inpatient hospice and palliative care.
Project description:BackgroundPharmacists contribute to medication safety by providing their services in various settings. However, standardized definitions of the role of pharmacists in hospice and palliative care (HPC) are lacking.AimThe purpose of this scoping review was to provide an overview of the evidence on the role of pharmacists and to map clinical activities in inpatient HPC.MethodWe performed a scoping review according to the PRISMA-ScR extension in CINAHL, Embase, and PubMed. We used the American Society of Hospital Pharmacists (ASHP) Guidelines on the Pharmacist's Role in Palliative and Hospice Care as a framework for standardized categorization of the identified roles and clinical activities.ResultsAfter screening 635 records (published after January 1st, 2000), the scoping review yielded 23 publications reporting various pharmacy services in HPC. The articles addressed the five main categories in the following descending order: 'Medication order review and reconciliation', 'Medication counseling, education and training', 'Administrative Roles', 'Direct patient care', and 'Education and scholarship'. A total of 172 entries were mapped to the subcategories that were added to the main categories.ConclusionThis scoping review identified a variety of pharmacists' roles and clinical activities. The gathered evidence will help to establish and define the role of pharmacists in inpatient hospice and palliative care.
Project description:ObjectivesTo explore the experiences and perceptions of oncology nurses providing hospice care in Chinese mainland.MethodsA descriptive phenomenological research method was utilized to describe experience of hospice care among oncology nurses. Eighteen oncology nurses were selected for interviews using purposive sampling from four grade A tertiary hospitals in Wuhan, Hubei province, China. The face-to-face semi-structured interviews were used to collect data. Data were recorded using NVivo 12.0 and analyzed using the Colaizzi's 7-step phenomenological data analysis method.ResultsThe interview data generated five major themes: (1) end-of-life care for oncology patients, (2) support and care for family members, (3) self-limitation and psychological distress, (4) culture and external environment constraints, and (5) self-coping and gains.ConclusionsIn Chinese mainland, oncology nurses encountered barriers and negative emotions in conducting hospice care, but have also made strides in the promotion of hospice care. In the future, the use of different traditional Chinese medicine technology to facilitate symptom management in end-of-life patients should be explored, and more tools to assist in providing psychological care and communication should be developed.
Project description:The '2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines' are authored by a Task Force of experts in feline hospice and palliative care convened by the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care. They emphasize the specialized communication skills and ethical considerations that are associated with feline hospice and palliative care, with references to other feline practice guidelines for a more complete discussion of specific diseases, feline pain management best practices and cat friendly interactions. A comprehensive, multi-step hospice consultation allows for tailoring the approach to both the cat and the family involved in the care. The consultation includes establishing 'budgets of care', a concept that greatly influences what can be done for the individual cat. The Guidelines acknowledge that each cat and caregiver will be different in this regard; and establishing what is reasonable, practical and ethical for the individual cat and caregiver is important. A further concept of the 'care unit' is introduced, which is extrapolated from human hospice and palliative care, and encourages and empowers the caregiver to become a part of the cat's care every step of the way. Ethical considerations include a decision-making framework. The importance of comfort care is emphasized, and the latest information available about how to assess the quality of a cat's life is reviewed. Emotional health is as equally important as physical health. Hence, it is fundamental to recognize that compromised physical health, with pain and/or illness, impairs emotional health. A limited discussion on euthanasia is included, referring to the AAFP's End of Life Educational Toolkit for recommendations to help the caregiver and the veterinary professional ensure a peaceful passing and transition - one that reflects the best interests of the individual cat and caregiver.