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- Böling, Susanna, et al.
(författare)
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No ordinary consultation : a qualitative inquiry of hospital palliative care consultation services
- 2020
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Ingår i: Journal of Health Organization and Management. - : Emerald Group Publishing Limited. - 1477-7266. ; 34:6, s. 621-638
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – Considering the great need for palliative care in hospitals, it is essential for hospital staff to havepalliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care.However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need forfurther knowledge about the process of palliative consultations. The purpose of this study therefore was toexamine how palliative consultations in hospitals are practised, as perceived by consultants and health careprofessionals on receiving wards.Design/methodology/approach – Focus groups with palliative care consultation services, health carepersonnel from receiving wards and managers of consultation services. Interpretive description and constantcomparative method guided the analysis.No ordinaryconsultationThe authors would like to thank participating colleagues for sharing their knowledge and experiencesabout palliative consultations.Ethics approval and consent to participate: The project received ethical approval from the SwedishEthical Review Authority, No. 809–16. Informed consent preceded participation for all of the participants.Consent for publication: Not applicable.Availability of data and material: The datasets generated and analysed during the current study are notpublicly available due to the inclusion of potentially sensitive individual data about health status. Theethical approval includes a statement that the data will be kept in a private repository but are availablefromthe corresponding author on reasonable request.Funding: Sahlgrenska Academy at the University of Gothenburg.Authors' contributions: JO, HB and JB planned the study. All authors conducted focus group €interviews. Analysis and interpretation of focus group data was performed by SB with support from JO, €HB and JB. SB wrote the first draft of the manuscript, JO, HB and JB commented on the manuscript and €contributed to the final version. The final manuscript was read and approved by all authors.Competing interests: The authors declare that they have no competing interests.The current issue and full text archive of this journal is available on Emerald Insight at:https://www.emerald.com/insight/1477-7266.htmReceived 14 April 2020Revised 24 June 2020Accepted 2 July 2020Journal of Health Organization andManagement© Emerald Publishing Limited1477-7266DOI 10.1108/JHOM-04-2020-0130Findings – Variations were seen in several aspects of practice, including approach to practice and representedprofessions. The palliative consultants were perceived to contribute by creating space for palliative care,adding palliative knowledge and approach, enhancing cooperation and creating opportunity to amelioratetransition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultationservices utilised proactive practices that took the initiative in relation to the receiving wards.Originality/value – A lack of policy and divergent views on how to conceptualise palliative care appeared tobe associated with variations in consultation practices, tentative approaches and a bottom-up drivendevelopment. This study adds knowledge, implying theoretical transferability as to how palliative careconsultations can be practised, which is useful when designing and starting new consultation services.
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| 2. |
- Hamdan Alshehri, Hanan, et al.
(författare)
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Factors influencing the integration of a palliative approach in intensive care units: a systematic mixed-methods review.
- 2020
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Ingår i: BMC Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- While a palliative approach is generally perceived to be an integral part of the intensive care unit (ICU), the provision of palliative care in this setting is challenging. This review aims to identify factors (barriers and facilitators) influencing a palliative approach in intensive care settings, as perceived by health care professionals.A systematic mixed-methods review was conducted. Multiple electronic databases were used, and the following search terms were utilized: implementation, palliative care, and intensive care unit. In total, 1843 articles were screened, of which 24 met the research inclusion/exclusion criteria. A thematic synthesis method was used for both qualitative and quantitative studies.Four key prerequisite factors were identified: (a) organizational structure in facilitating policies, unappropriated resources, multi-disciplinary team involvement, and knowledge and skills; (b) work environment, including physical and psychosocial factors; (c) interpersonal factors/barriers, including family and patients' involvement in communication and participation; and (d) decision-making, e.g., decision and transition, goal conflict, multidisciplinary team communication, and prognostication.Factors hindering the integration of a palliative approach in an intensive care context constitute a complex interplay among organizational structure, the care environment and clinicians' perceptions and attitudes. While patient and family involvement was identified as an important facilitator of palliative care, it was also recognized as a barrier for clinicians due to challenges in shared goal setting and communication.
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| 3. |
- Holm, Maja, et al.
(författare)
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Variations in grief, anxiety, depression, and health among family caregivers before and after the death of a close person in the context of palliative home care
- 2020
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Ingår i: Death Studies. - : Informa UK Limited. - 0748-1187 .- 1091-7683. ; 44:9, s. 531-9
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Tidskriftsartikel (refereegranskat)abstract
- This article investigates longitudinal variations in grief, self-rated health, and symptoms of anxiety and depression among family caregivers in palliative care. Data were taken from a randomized psycho-educational intervention trial and were collected at four time-points; at baseline, upon completion, 2 months later, and 6 months after the patient's death. In total, 117 family caregivers completed all questionnaires. The participants' grief was stable across the measurements, while anxiety, depression, and health varied significantly (p < 0.05). No significant differences were found between the intervention or control group. In conclusion, grief emerged as a constant phenomenon, distinct from symptoms of anxiety and depression.
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| 5. |
- Nilsson, Stefan, 1972, et al.
(författare)
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Paediatric palliative care: a systematic review.
- 2020
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Ingår i: BMJ Supportive & Palliative Care. - : BMJ. - 2045-4368 .- 2045-435X. ; 10:2
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Forskningsöversikt (refereegranskat)abstract
- To review literature relating to evidence, context and facilitation to describe knowledge translation in paediatric palliative care. Paediatric palliative care requires competences including both paediatric specialists as well as services that are developed for this purpose, and there is a need to facilitate paediatric palliative care knowledge translation. Promoting Action on Research Implementation in the Health Services (PARiHS) is a framework for knowledge translation, which highlights the relationships between evidence, context and facilitation. PARiHS framework has been revised and updated in a new version called i-PARiHS.The electronic databases AgeLine, CINAHL, The Cochrane Library, PsycINFO, PubMed and Scopus were searched. Papers included were limited to English and Swedish publications and restricted to publications dated between 1993 and August 2019. All types of observational and experimental studies using any research design were included.Thirty-eight articles were included and there was a common vision about how and when palliative care should be offered to children. The i-PARiHS was used as a lens to describe the knowledge translation in paediatric palliative care. Symptom relief was the most commonly described evidence-based strategy, and the hospital environment was the most commonly described context. Different types of education were the most commonly used strategies to facilitate knowledge translation. The results mainly focused on increasing knowledge of palliative care in paediatric care. To sum up, the results report strategies to achieve knowledge translation of paediatric palliative care, and these can be interpreted as a guideline for how this process can be facilitated.CRD42018100663.
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| 6. |
- Tønnessen, Siri, et al.
(författare)
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Visibility of nursing in policy documents related to healthcare priorities.
- 2020
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 28:8, s. 2081-2090
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Tidskriftsartikel (refereegranskat)abstract
- To explore the visibility of nursing in policy documents concerning healthcare priorities in the Nordic countries.Nurses at all levels in healthcare organizations set priorities on a daily basis. Such prioritization entails allocation of scarce public resources with implications for patients, nurses, and society. Although prioritizations in healthcare has been on the political agenda for many years, prioritization in nursing seems to be obscure in policy documents.Each author searched for relevant documents from their own country. Text analyses were conducted of the included documents concerning nursing visibility.All the Nordic countries have published documents articulating values and criteria relating to healthcare priorities. Nursing is seldom explicitly mentioned but rather is included and implicit in discussions of healthcare prioritization in general.There is a need to make priorities in nursing visible to prevent missed nursing care and ensure fair allocation of limited resources.To highlight nursing priorities, we suggest that the fundamental need for nursing care and what this implies for patient care in different organizational settings be clarified and that policymakers explicitly include this information in national policy documents.
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| 7. |
- Öhlén, Joakim, 1958
(författare)
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Lidande
- 2020
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Ingår i: Andershed B &N Ternestedt B-M, red. Palliativ vård: begrepp och perspektiv i teori och praktik (2:a omarb.uppl.). Lund: Studentlitteratur. - Lund : Studentlitteratur. - 9789144070964 ; , s. 249-266
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Idag förs personcentrering alltmer fram som ideal och arbetssätt inom vården. Inom palliativ vård finns det en lång tradition av att möta patient och närstående som personer med de utmaningar behov av palliativ vård kan medföra. Att lindra lidande anges som det centrala målet i de flesta definitioner av palliativ vård. Trots detta är det vanligt att lidandet och möjlighet att lindra det inte uppmärksammas vid vård i livets slutskede. Ibland är det nästan som om vi tar för givet att patienters och närståendes lidande kan vändas till förtröstan och lindras genom stödjande, livskvalitetshöjande eller symtomlindrande insatser. Är det så självklart? Och vilket ansvar har vården för att lindra lidande? I det här kapitlet kommer innebörder av lidande att belysas ur olika perspektiv – och kanske utmana invanda föreställningar knutna till palliativ vård. Avsikten med kapitlet är därför i första hand att med utgångspunkt i etik öppna för olika perspektiv på lidande inom palliativ vård. Förhoppningsvis väcker kapitlet i större utsträckning frågor än ger enkla svar. De perspektiv på lidande som presenteras kan förenklat beskrivas som den lidande personen, den lidandes beroende av andra samt kulturella och samhälleliga inramningar av lidande.
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