| 1. |
- Beck, Ingela, et al.
(författare)
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Translation and cultural adaptation of the integrated palliative care outcome scale for use in Sweden
- 2016
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patient-reported outcome measurements are important for measuring changes in patients’ health over time, evaluating the quality of care given, and improving the quality of care service. The Integrated Palliative care Outcome Scale (IPOS) is one such measure, capturing clinically important physical, psychological, social, and existential aspects of patients’ palliative care needs. When patients are unable to complete the IPOS questionnaire themselves with or without assistance, a staff version is also available. Aim: To translate and culturally adapt the IPOS Patient and Staff versions for use in the Swedish context. Method: The process comprised forward and backward translations, cultural adaptation, and expert group reviews. To validate the resulting Swedish version of IPOS, cognitive interviews were conducted with 13 patients and 15 staff from various care contexts. Preliminary results: The Swedish expert group changed some words and grammar due to minor discrepancies in the back translation process. The participants in the cognitive interviews responded positively overall to the questionnaire. Deteriorating health and not having Swedish as the native language did not cause problems in completing the questionnaire. After the first round of cognitive interviews, problematic questions and answer options were rephrased, and redundant text was deleted. Conclusion: The Swedish IPOS (Patient and Staff versions) has been validated linguistically and culturally, and is now available for clinical use. The next final step in the validation process will be to test the psychometric performance of the Swedish questionnaires.
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| 2. |
- Brännström, Margareta, et al.
(författare)
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Effectiveness of the Liverpool care pathway for the dying in residential care homes: An exploratory, controlled before-and-after study
- 2016
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 30:1, s. 54-63
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, are lacking. Aim: To compare the effects of the Liverpool Care Pathway for the Dying Patient and usual care on patients' symptom distress and well-being during the last days of life, in residential care homes. Design: Exploratory, controlled before-and-after study. During a 15-month baseline, usual care was carried out in two areas. During the following 15-months, usual care continued in the control area, while residential care home staff implemented Liverpool Care Pathway for the Dying Patient use in the intervention area. The intervention was evaluated by family members completing retrospective symptom assessments after the patient's death, using the Edmonton Symptom Assessment System and Views of Informal Carers - Evaluation of Services. Settings/participants: Patients who died at all 19 residential care homes in one municipality in Sweden. Results: Shortness of breath (estimate=-2.46; 95% confidence interval=-4.43 to -0.49) and nausea (estimate=-1.83; 95% confidence interval=-3.12 to -0.54) were significantly reduced in Edmonton Symptom Assessment System in patients in the intervention compared to the control area. A statistically significant improvement in shortness of breath was also found on the Views of Informal Carers - Evaluation of Services item (estimate=-0.47; 95% confidence interval=-0.85 to -0.08). Conclusion: When implemented with adequate staff training and support, the Liverpool Care Pathway for the Dying Patient may be a useful tool for providing end-of-life care of elderly people at the end of life in non-cancer settings.
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| 3. |
- Böling, Susanna, et al.
(författare)
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Rethinking Consultation - Investigating the Perceived Work Models of a Palliative Consultation Team
- 2018
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Ingår i: Palliative Medicine : A Multiprofessional Journal. Vol. 32, Suppl. 1. Abstract PO38. - : SAGE Publications. - 0269-2163 .- 1477-030X.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Previous research has shown that palliative consultation in hospital contexts sometimes face multifaceted challenges. Possibly creat- ing barriers between the consulting team and patients in need of palliative care. Hence, there is a need to consider how we implement and perform palliative consultation to inform future initiatives. This study is part of an ongoing project with the aim to analyse the discourse around implement- ing palliative care in a hospital context. Aim: The aim of this study was to identify and analyse various work models applied in a hospital context by a palliative consultation team. Method: Repeated focus group discussions with a palliative consultation team and its managers. A total of six focus group discussions were held from April 2016 to June 2017. The focus groups were audio recorded and transcribed verbatim. The data was read and analysed; identifying and categorising different work models. Result: According to what was expressed in the focus groups there were variations in how the consultation team operated in different hospital units and wards. Consulting as a team, consisting of a nurse, social worker and physician, was emphasised. One of the significant features was that they visited several wards on a weekly basis without receiving formal referrals beforehand. Although varying in form, the visits shared the function of being a forum for the wards to raise questions regarding palliative care relating to specific patients with palliative needs. Furthermore, during the introduction of consultation in some of the wards, the consultation team chose to designate time where a nurse from the team were present in the ward and among other things; identified patients with palliative care needs together with the ward staff and paved the way for the weekly palliative consultation.
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| 4. |
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| 5. |
- Diffin, Janet, et al.
(författare)
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Person-Centred Care: Principles and Practice Barriers (oral presentation). In: Enabling Person-Centred Care for Palliative Care Patients and Their Informal Carers: Definitions, Models of Practice and Implementation; invited session (Gunn Grande & Gail Ewing, moderators)
- 2019
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Ingår i: 16th Word Congress of the European Association for Palliative Care (EAPC). Berlin, May 23-25, Abstract PS16. Palliative Medicine, vol. 33, issue 1. - : SAGE Publications. - 0269-2163 .- 1477-030X.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: Barriers to the implementation of person-centred care within pal- liative care practice have been identified for patients and family carers. A shared understanding of (i) the principles of person-centred care, and (ii) how to successfully implement person-centred interventions is there- fore required. This paper aims to to define the key principles of person- centred care and identify barriers and enablers to implementation success within palliative care practice. Methods: This paper brings together the international evidence on person-centred care, and reviews the enablers and barriers to imple- mentation within palliative care practice. It will draw on the experi- ences of the development of person-centred care practice and the implementation of the Carer Support Needs Assessment Tool inter- vention, a person-centred process of assessment and support for fam- ily carers. Results: Person-centred care is characterised by practitioners initiat- ing, working through and safeguarding a partnership ‘with’ patients and/or family carers. As such, a change in practice from a practi- tioner-led approach, to one which is led by a patient/family carer is often required. Implementation barriers at the individual level include viewing a person-centred approach as an ‘add-on’ to existing practice, and at the organisational level include a lack of managerial support and protected time. Training is therefore required for the individual practitioner to help them integrate this approach into their everyday practice, and for the organisation to ensure adequate prep- aration, and the establishment of a strategy to support implementa- tion. A team of practitioners within the organisation is needed to drive this implementation planning and ensure organisational readi- ness for change. Conclusions: The evidence presented provides vital lessons learned for implementation of person-centred interventions for patients or family carers within palliative care practice.
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| 6. |
- Groeneveld, E. Iris, et al.
(författare)
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Funding models in palliative care : Lessons from international experience
- 2017
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 31:4, s. 296-305
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Forskningsöversikt (refereegranskat)abstract
- Background: Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. Aim: To assess national models and methods for financing and reimbursing palliative care. Design: Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. Results: Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: • Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision. • Funding is frequently characterised as a mixed system of charitable, public and private payers. • The basis on which providers are paid for services rarely reflects individual care input or patient needs. Conclusion: Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest.
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| 7. |
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| 8. |
- Hamdan Alshehri, Hanan, et al.
(författare)
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Adaptation of a Palliative Care Approach in the Context of Intensive Care: A Systematic Literature Review
- 2019
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Ingår i: 16th Word Congress of the European Association for Palliative Care (EAPC). Berlin, May 23-25, Abstract P02-385. Palliative Medicine, vol. 33, issue 1. - : SAGE Publications.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Palliative care is assumed to be an integral part of care in Intensive Care Units (ICU), yet, research still indicates lack knowledge about how to adapt, integrate and adopt palliative care in curative focused contexts such as in intensive care. Aim To identify factors influencing the integration of a palliative care approach in the context of ICU. Method A systematic review based on quantitative and qualitative studies using a thematic synthesis of the articles was performed. The following search term were used: Implementation, palliative care and ICU. In total 1843 articles were screened, and 25 articles were eligible for this review. Result: The findings show that the influencing factors for integrating a palliative care approach are multifaceted. Themes were identified; facilitators and barriers for implementation and adaptation on organizational level (facilitating policies and environmental support, care pathways, prognostication , multidisciplinary team, training and education) and interpersonal level (communication conflict, emotional and spiritual support, person-centred care and patient and family involvement). Conclusion To adopt a palliative care approach into the ICU setting, the integration process requires adaption of organizational support and personal beliefs and attitudes within the entire multi-professional team including the manager as well as patient and family.
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| 9. |
- Henoch, Ingela, 1956, et al.
(författare)
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Nursing Students’ Attitudes toward Caring for Dying Persons - Development during Nurse Education.
- 2016
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Ingår i: Palliative Medicine : A Multiprofessional Journal. - : SAGE Publications. - 0269-2163 .- 1477-030X.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background and aim: Most nurses will care for dying patients in their work and nursing education need to prepare students for this task. The attitudes toward dying and death, and communication with patients and families are important issues in palliative care education. The aim was to describe nursing students’ attitudes toward caring for dying patients during undergraduate education, factors influencing changes in attitudes, and how prepared students feel to perform end of life care. Design and methods: This is a longitudinal study exploring the development of nursing students’ attitudes to care for dying patients with the questionnaire Frommelt Attitude Toward Care of the Dying Scale (FATCOD) first, at the beginning of their education (T1), second, at the beginning of the second year (T2) and finally, at the end of the third year of education (T3). FATCOD is a 30 item questionnaire exploring attitudes to care for dying patients; items are rated on a five-point Likert scale. Total FATCOD score, all items summated ranging from 30 to 150, for T1, T2 and T3 was analyzed with ANOVA. Length of theoretical and presence of practical palliative care education were hypothesized to influence changes in attitudes. Students also evaluated support and preparation from education. At all three occasions, 117 nursing students from six universities in Sweden participated. Results and interpretation: The total FATCOD increased from 126 to 132 from T1 to T3. Theoretical palliative care education became significant predictor of changes in attitudes towards caring for dying patients in that five weeks education better predicted changes in attitudes than three weeks. Students with five weeks theoretical palliative care education also felt more prepared and supported by the education to take care of a dying patients. Students did not feel prepared to take care of a dead body or meet families. Although nursing students’ attitudes increased, they need more preparation in palliative care.
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| 10. |
- Henoch, Ingela, 1956, et al.
(författare)
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The 6S Dialogue Tool to Facilitate Person-centered Palliative Care
- 2019
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Ingår i: Palliative Medicine : A Multiprofessional Journal. - : SAGE Publications. - 0269-2163 .- 1477-030X.
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Konferensbidrag (refereegranskat)abstract
- Background: Palliative care must be planned in accordance with patients’ needs, beliefs and preferences. The 6S person-centered palliative care model aims to co-create care together with patient and family in order to achieve good quality palliative care and a peaceful death for patients. The model includes six concepts that will facilitate to plan a person-centered care for patients in palliative care. The concepts are Self-image, Symptom relief, Self-determination, Social relationships, Synthesis, and Strategies. The 6S Dialogue Tool was elaborated to concretize the concepts. Aim: To explore if the 6S Dialogue Tool covers the meaning of the S-concepts in the 6S person-centered palliative care model. Methods: This is a qualitative study where data was collected with structured questions and patients responded in an open-ended format to the 15 questions in the 6S Dialogue Tool. Forty-six patients in palliative care services in Sweden responded to the 6S Dialogue Tool from May 2015 to August 2016. Responses were analyzed with qualitative content analysis. Results: Six categories related to the 6S concepts were formulated: Selfimage was illustrated of Maintaining everyday life, Symptom relief was related to Challenges in everyday life, Self-determination concerned Maintaining control, Social relations was illustrated by Maintaining selected relations, Synthesis was related to Appraisal of life, and Strategies was illustrated by Appraisal of future. Conclusion: The responses to the 6S Dialogue Tool questions illuminated the intent and meaning of the 6S-concepts. The 6S Dialogue Tool questions are suitable for obtaining patients’ preferences and could be used as an approach in palliative care. Nurses should integrate both 6S-concepts and questions in their approach to obtain the patient’s own view of the situation and make it possible to co-create palliative care in dialogue with the patient and improve the possibilities for patients to have an appropriate death.
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