• Title/Summary/Keyword: palliative care

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Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19

  • Kim, Yejin;Yoo, Shin Hye;Shin, Jeong Mi;Han, Hyoung Suk;Hong, Jinui;Kim, Hyun Jee;Choi, Wonho;Kim, Min Sun;Park, Hye Yoon;Keam, Bhumsuk
    • Journal of Hospice and Palliative Care
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    • v.24 no.2
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    • pp.130-134
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    • 2021
  • In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.

Relationship Among Nurses' Knowledge, Attitude Towards Palliative Care and Perception of Death in Neonatal Intensive Care Units (신생아중환자실 간호사의 완화간호에 대한 지식과 태도 및 죽음에 대한 인식 간의 관계)

  • Wi, Da Hee;Kang, Sook Jung
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.257-264
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    • 2016
  • Purpose: The purpose of this study was to investigate the relationship among knowledge and attitude toward palliative care and perception of death for Neonatal Intensive Care Unit (NICU) nurses. Methods: A cross-sectional descriptive study was conducted with 110 nurses who work in NICUs in South Korea. The participants filled out a questionnaire regarding their knowledge, attitude towards palliative care and perception of death. The attitude scale was divided into 3 subscales: comfort level, nurses' role and nurses' involvement with family. Results: Comfort level regarding attitude towards palliative care was positively correlated with knowledge (r=.220, p=.016) and the perception of death (r=.194, p=.042). Nurses' role showed a positive correlation with perception of death (r=.395, p=.001). Conclusion: NICU nurses' knowledge of palliative care was below standard across the board, implying that there is a definite need for palliative care education for nurses. The education program for palliative care should include a section that focuses on fostering a positive perception of death as well as defining and delineating the role of nurses.

The Use of Antibiotics in Hospice and Palliative Care Settings

  • Shekhar, Aditya C.
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.50-54
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    • 2022
  • Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

Effect of palliative care practical training on nursing students' attitudes toward death, end-of-life care nursing attitude, and spiritual nursing competency (말기 환자간호 실습교육이 간호대학생의 죽음에 대한 태도, 임종간호 태도, 영적간호역량에 미치는 효과)

  • Kim, Kyung Ah
    • Journal of Home Health Care Nursing
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    • v.30 no.3
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    • pp.276-286
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    • 2023
  • Purpose: This study aimed to assess the effect of palliative care practical training for nursing students. Methods: This quasi-experimental study included 38 third-grade nursing students form one university. Practical training, develooed by experts, was provided for 2 weeks (90 h) in a palliative care hospital. Participants received education on palliative care but no clinical practical experience. Collected data were analyzed using independent t-test, χ2 test and paired t-test using the WIN SPSS 23.0 program. Results: Students showed significant pretest-posttest differences in attitude toward death (t=-2.43, p=.021), end-of-life nursing attitude (t=3.90, p=<.001) and spiritual nursing competency (t=3.82, p=.001). Conclusion: The study results revealed that palliative care practical training was an effective learning method to improve nursing attitude, toward death, end-of-life nursing attitude and spiritual nursing competency. Further studied are needed to assess the effects of various education programs of palliative care.

Screening and Assessment Tools for Measuring Delirium in Patients with Cancer in Hospice and Palliative Care: A Systematic Review

  • Yang, Eun Jung;Hahm, Bong-Jin;Shim, Eun-Jung
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.214-225
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    • 2021
  • Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.