جستجوی مقالات مرتبط با کلیدواژه « palliative care » در نشریات گروه « پزشکی »

Palliative care is essential for improving the quality of life (QoL) for individuals with dementia, especially in nursing homes. This systematic review aims to recognize, weigh, and appraise different palliative care models specifically designed for people with dementia in nursing homes.

A systematic search was carried out on PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar to find palliative care models or interventions specifically designed for individuals with dementia cared for in nursing homes and studies reporting outcomes related to their characteristics or efficacy. The strengthening the reporting of observational studies in epidemiology (STROBE) checklist and consolidated standards of reporting trials (CONSORT) were used to evaluate the quality of the included articles. The search period spanned from inception until July 2023.

Of 1880 articles retrieved, 5 were deemed eligible in the study. Also, 5 models were identified: The palliative care for older people in Europe (PACE) steps to success program, comfort first, palliative care consultations, Improving palliative care education and training using simulation in dementia (IMPETUS-D), and the compassion model.

By thoroughly examining these different models, we shed light on the achievements and obstacles in improving the quality of care for individuals with dementia in nursing homes. However, more research is needed to ensure the effectiveness of these models, specifically those tailored to dementia patients in nursing homes. Identifying these five models represents a crucial step forward, but further investigation is essential to validate their efficacy and suitability within this population.

Palliative care is an approach designed for critically ill patients, improving their quality of life and alleviating suffering through early detection, proper assessment, and treatment of pain and other problems, whether physical, psychosocial, or spiritual. The purpose of this study was to assess nurses' knowledge of palliative care and attitudes towardcaringfor dyingpatients andtheir relationshipwith evidence-basedpractice.

Methods & Materials:

 A cross-sectional study design was employed to collect data from 565 nurses working in primary healthcare organizations fromJanuary 2022 toMarch 2023. An online questionnaire included four parts: demographic and professional characteristics, PCQN, FATCOD, and EBPQ questionnaires. An independent T-test, One-Way ANOVA, and Kendall tau rank correlation coefficient, hierarchical multiple regression were performed.

Nurses’ palliative care knowledge level was low (mean score: 9.06±2.93). The majority of nurses (93%) have a neutral or negative attitude toward caring for dying patients (94.50±12.41).Theobtainedscore(4.39±1.05) ontheEBPQscale indicates anaverage level of competence in evidence-based practice. Work experience (β=0.534; <0.001) and competencies in evidence-based practice (β=0.136; p=0.001) are statistically significant factors that affect knowledge of palliative care. The aspect ofKnowledge/skills inEBP is the most significant (β=0.122; p=0.005).

An insufficient level of nurses' knowledge about palliative care and a neutral or negative attitude towards caring for dying patientswere revealed. The results also indicate that much attention and resources should be directed toward improving the level of knowledge of nurses in the field of evidence-based practice.

Since family caregivers play an important role in providing care for patients in need of palliative care, it is important to focus on and examine their care ability in fulfilling the expected roles. Therefore, this study aimed to performa psychometric evaluation of the Caring Ability of the Family Caregivers of the Patients in Need of Palliative Care Scale (CAFCPNPCS).

Methods & Materials: 

The present study is methodological research that evaluates the psychometric characteristics of the CAFCPNPCS bymeasuring face validity, content validity, construct validity (confirmatory factor analysis and divergent validity), and internal consistency in 412 family caregivers of the patients in need of palliative care, who were selected through convenient sampling. The datawere analyzed using SPSS 24 andLISREL8.8.

According to the confirmatory factor analysis, the 5-factor model with 31 items was confirmedwiththe valuesRMSEA=0.05,CFI=0.95, andGFI=0.88.The divergent validitywas measured by the estimation of the correlation between the caring ability score with the care burden score (which was measured by Zarit Burden Interview) of the family caregivers of the patients in need of palliative care. Cronbach's alpha (α) was reported to be 0.85 for the whole scale and 0.781-0.852 for other dimensions.

CAFCPNPCSis a valid and reliable tool that can evaluate the caring ability of the family caregivers of patients in need of palliative care. Based on the results, it is recommended to utilize this scale to determine these caregivers’ ability to provide care and to examine the effectiveness of interventions to improve the dimensions of their caring ability.

Comprehensive palliative care for patients with heart failure can be developed by educating cardiac nurses. The current study aimed to design a heart failure palliative care educational program for nurses.

This study was carried out using the multi‑method approach based on two out of four steps of Uys educational program development at Dr. Chamran Hospital, Isfahan, in 2020–2021. In step 1, educational needs were collected through literature review, interviews with 15 patients and 10 nurses, examination of patients’ documents and medical records, and observation. Then, in step 2, the importance and necessity of teaching the proposed topics and the teaching and evaluation method of the items were assessed through two rounds of delphi technique (15 expert panel members). Eventually, the educational program was finalized.

In step 1, the educational needs of nurses were identified in 6 general fields and 26 general learning topics. In step 2, educational needs [specialized knowledge (55% necessity and 55% importance) and social support (33% necessity and 33% importance)], teaching methods (role‑playing, experiential learning, and journal club), and evaluation method (the information analysis method) were removed due to a lack of consensus (11%). Finally, the main parts of the program, including the program mission and vision, general learning topics, general goals, objectives, teaching strategies, and evaluation strategies, were compiled.

This program provides nurses with up‑to‑date information on various aspects of the physical, psychological, social, spiritual, and educational needs of heart failure patients and ensures the provision of better services to them.

Nursing practice must include palliative care (PC) as an essential component. The main obstacles to quality PC are nurses’ lack of knowledge, negative attitudes, and gaps in evidence-based practice (EBP). Accordingly, the present study aims to evaluate nurses’ knowledge of PC, their attitude towards caring for dying patients, and its relationship with EBP (knowledge/skills, attitude, and performance) in primary health care (PHC) organizations in Astana City, Kazakhstan.

The data were collected through a cross-sectional study design from 565 nurses working in primary health care organizations in Astana, Kazakhstan, from January 2022 to March 2023. The subjects were recruited by convenience sampling. The study data were collected using an online questionnaire with four parts: Demographic and professional characteristics, the palliative care quiz for nurses (PCQN), the Frommelt attitudes towards care of the dying (FATCOD), and the evidence-based practice questionnaire (EBPQ). The independent t-test, a one-way ANOVA, and Kendall tau rank correlation coefficient were employed to analyze data. Hierarchical multiple regression was also developed to identify variables influencing nurses’ PC knowledge. SPSS software, version 24, was used for data analysis. The significance level was set at 0.05.

The nurses’ PC knowledge level was low (mean score=9.06±2.93). Most nurses (93%) had a neutral or negative attitude towards caring for dying patients (mean score=94.50±12.41). The obtained score (4.39±1.05) on the EBPQ indicated a moderate level of competence in EBP. Work experience (β=0.534; P=0.000) and competencies in EBP (β=0.136, P=0.001) were associated with knowledge of PC. The aspect of knowledge/skills in EBP had the most significant impact on nurses’ competence level in the PC field (β=0.122, P=0.005).

An insufficient level of nurses’ knowledge about PC and a neutral or negative attitude towards caring for dying patients were revealed. The results also indicated that much attention and resources should be directed to improving nurses’ knowledge level in the field of EBP because this aspect significantly affects the level of knowledge on PC.

Demographic development and continuing improvements in supportive and antineoplastic therapies are reasonable predictors of increasing travel activities carried out by patients with malignant diseases. There is a lack of data on travel habits of patients with end-stage oncological diseases. We performed a multi-phased cross-sectional study to gain insights into the intersection of travel medicine and oncology. A total of 82 patients with 21 different cancer entities at a median age of 63 years completed the final questionnaire. 90.2% of all participants rated travelling as an important or very important aspect in their lives, of whom 73.2% had participated in a short- or holiday trip after the cancer diagnosis. All but one (98.8%) participant were about to plan a short- or holiday trip in the near future. Germany (home country) was the most important travel destination, ‘Relaxing’ and ‘enjoying nature’ were the most important travel motives. Fatigue and overall (medical) insecurities were major obstacles to carry out travel plans. In conclusion, a high proportion of patients enjoy travelling. Physicians and patients are encouraged to openly discuss holiday-taking in accordance with available guidelines. More research is needed to fully understand needs and obstacles at the crossroads of travel medicine and oncology.

The proactive activities of professional organizations have significantly contributed to improving nurses’ knowledge related-specialty in order to improve health care services quality offered by nurses. Since the palliative care improvement and development in Indonesia remain still in their infancy, and the organization of palliative care for Indonesian nurses has not been established yet, it is imperative to investigate the Indonesian nurses’ viewpoints concerning the importance of establishing a palliative nursing organization in fostering palliative care services in Indonesia. This study aimed to identify what kind of palliative care related activities are carried out by Indonesian nurses and what are the perspectives of nurses regarding the importance of establishing palliative nursing organizations in Indonesia. A national study was conducted using an embedded mixed-methods design, for which the quantitative and qualitative data were collected and analyzed in the same time period from October – December 2020. There were a total of 552 (92%) respondents who participated through WhatsApp, and Telegram platforms, and completed our online survey. There were four themes and nine sub themes found in this study: namely, services improvement (quality improvement, and literacy improvement sub themes), human resource development (knowledge development, individual nurse development, and professional development sub-themes), boarding and information source (boarding, and information source sub themes), and policy and legality (policy, and legality sub themes). While barriers exist, respondents confirmed the importance of establishing an Indonesian palliative nursing organization. Establishing a palliative nursing organization could be an important step in developing palliative care in Indonesia.

Death in the place that the patient has selected and feels comfortable remaining in for the remainder of their life is one of the main objectives of palliative care for terminally ill cancer patients. Nevertheless, this problem is constantly disregarded. The goal of the present study was to look at variables that affected cancer patients' decisions about their place of death.   

A descriptive cross-sectional study was conducted from May to August 2018. Using a continuous sampling method, 631 patients who had passed away between 2011 and 2017 were selected among the patients with a history of cancer and hospitalization at the Firoozgar Hospital in Tehran. A self-made 3-section questionnaire with 21 questions was completed by phone calls made to the families who confirmed their patients’ deaths due to cancer. Data were managed by SPSS software Version 13, and descriptive statistics were used in data analysis.  

Based on the results, among 631 deceased patients, only 157 (24.9%) chose their place of death, and 474 (75.1%) had not spoken about it during their lifetime. Among the examined variables, age, sex, education, insurance status, duration of disease, activities of daily living, awareness of disease progression, and receiving home care had a significant association with this choice in people who died of cancer.   

Despite the importance of the choice of place of death by the patient in the final days of life, the possibility of having an option is not provided for most cancer patients. Patients who understand how their disease is progressing at this point are probably going to want to select where they pass away. Consequently, the healthcare system must be ready to grant cancer patients the option to choose their final resting place and ensure a comfortable and respectable passing. Future research can be built upon the results of this study.

Chronic diseases like hypertension have become a global burden in the older population and are associated with high mortality rates and poor quality of life. The tenacity of these diseases could increase the comorbidities and impact older patients who need palliative care (PC) services to manage the symptoms and improve their quality of life. This study aims to determine the characteristics and determinants of PC needs of older Indonesian adult patients with chronic hypertension. 

This cross-sectional study applied a quantitative research design. The study was conducted in a primary healthcare facility in Kolaka Regency, Southeast Sulawesi, Indonesia, from July to October 2022. The study subjects were 142 elderlies with chronic hypertension who were recruited by the census method. The data were collected using a demographic questionnaire and the Indonesian version of the supportive and PC indicators tool (SPICT 2019 version). The data were analyzed with the Pearson chi-square test at a significant level P<0.05 in IBM SPSS software, version 25. 

According to the findings, 47.2% of the respondents were in the age group of 55 to 64 years, most were women (55.6%), and living in rural areas (54.9%). Also, most had comorbidities (77.5%), at least one comorbidity (66.9%), and 26.8% needed palliative care. The bivariate analysis showed that comorbidities are associated with PC needs among older adults with chronic hypertension (P<0.05). 

This study showed that comorbidity has a significant relationship with PC needs in older patients with chronic hypertension. This condition demands the treatment team members’ attention to comorbidities in patients with chronic hypertension. To enhance the results’ generalizability and provide stronger evidence, it is advisable to conduct research with a larger sample size.

Instruction : 

Palliative care units aim to improve the quality of life and alleviate symptoms in patients with serious illnesses. Dyspnea, a distressing symptom, can significantly impact patients' quality of life. While various methods are used to manage dyspnea in palliative patients, surgical interventions may be overlooked or underutilized due to patient-specific considerations. This study investigates the effects of pleural interventions on quality of life, dyspnea, and pain scores in palliative care patients.

This retrospective case series analyzed data from 213 patients treated in a palliative care service between May 2022 and May 2023. Patients who underwent pleural interventions for dyspnea control were included. Data on patient characteristics, pleural pathologies, type of intervention (thoracentesis, indwelling pleural catheter or tube thoracostomy), complications, modified Borg dyspnea scale, Karnofsky Performance Scale (KPS), and visual analog scale (VAS) scores were collected.

A total of 21 patients met the inclusion criteria. Thoracentesis was the most commonly performed intervention. After pleural intervention, Borg dyspnea scale scores significantly decreased (5.9-3.2, p<0.001), while KPS scores significantly increased (32.4-40.9, p<0.001). No significant difference was observed in VAS scores (3.1-3.4, p:0.25). Complications were minimal, with a small number of patients experiencing iatrogenic pneumothorax or catheter infection.

This study highlights the importance of pleural interventions in managing dyspnea and improving symptom control-related performance in palliative care patients. Therapeutic thoracentesis, pleural catheter insertion, and chest tube placement have demonstrated effectiveness in alleviating dyspnea. Therefore, pleural interventions should not be avoided if indicated in palliative care patients accompanied by dyspnea. However, potential complications and limitations must be considered, and patient-specific factors should guide decision-making.

 The concept of demoralization is used to describe situations of existential distress and self-perceived inability to effectively deal with stressors. The Demoralization Scale-II (DS-II) is a short and modified version of the original DS that measures the level of demoralization in patients. The purpose of this study is to evaluate the psychometric properties of the Greek version of the Greek Demoralisation Scale-II (DS-II GR) in the population of patients with cancer.

 The main tool used in this cross-sectional study is the DS-II GR translated and evaluated for its psychometric properties in a sample of 150 Greek patients with cancer. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), convergent validity, known groups’ validity, cut-off points, internal consistency reliability and test-retest reliability were done.

 According to the CFA, a two-factor model emerged with a different conceptual content and grouping than the original. The correlation coefficients between DS-II GR and Hospital Anxiety and Depression Scale-Greek (HADS-GR) The internal consistency of DS-II GR for factor 1, factor 2, and total score were measured with Cronbach’s alpha and calculated to be 0.906, 0.810, and 0.913.

 The Greek version of the demoralization scale is reliable and valid for assessing demoralization in Greek patients with cancer.