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1.
Nurs Outlook ; 70(1): 36-46, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34627615

RESUMO

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.


Assuntos
Consenso , Prova Pericial , Saúde Global , Acessibilidade aos Serviços de Saúde , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Cuidados Paliativos/normas , Enfermagem Baseada em Evidências/tendências , Política de Saúde , Acessibilidade aos Serviços de Saúde/normas , Acessibilidade aos Serviços de Saúde/tendências , Humanos , Sociedades de Enfermagem , Participação dos Interessados , Assistência de Saúde Universal
2.
BMC Womens Health ; 21(1): 376, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34711227

RESUMO

BACKGROUND: Only 8-23% of advanced epithelial ovarian cancer patients survive for 10 years or longer. Given the need for targeted interventions to improve survival, we interviewed this relatively rare survivor population to gain personalized insights into the reasons for their survival. The aim of this study was to characterize subjective attributions of survival and specific coping mechanisms long-term survivors of ovarian cancer. METHODS: Twenty-two semi-structured, qualitative interviews assessing survival attributions and coping strategies were conducted from April to November 2014. Data were analyzed in a multistep process using ATLAS.ti.8: codes were identified during review of the transcripts and refined with literature review; the frequency of codes and code co-occurrence was calculated, and codes were grouped into themes. Resulting themes were checked by a national leader of an ovarian cancer advocacy organization and compared against available literature. RESULTS: Thematic analysis found that participants credited their long-term survival to a variety of factors including medical, social, religious/spiritual, and lifestyle/personal characteristics. Some participants rejected these same attributions, concluding that the reason for survival was due to luck or unknowable. Several of Carver et al.'s theoretical dimensions of coping were evident in our sample: planning, positive reinterpretation, social support, religion and acceptance whereas three relatively new strategies were uncovered: conserving emotional energy, value-based activity coping, and self-care. CONCLUSIONS: Long-term survivors' perspectives were largely consistent with those of newly diagnosed ovarian cancer patients and ovarian cancer survivors of shorter duration. However, the long-term survivors were also willing to reject conventional attributions for survival and recognized the importance of disciplined self-preservational coping strategies.


Assuntos
Sobreviventes de Câncer , Neoplasias Ovarianas , Adaptação Psicológica , Feminino , Humanos , Pesquisa Qualitativa , Sobreviventes
3.
Nurs Outlook ; 69(6): 961-968, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34711419

RESUMO

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.


Assuntos
Consenso , Prova Pericial , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Cuidados Paliativos , Assistência de Saúde Universal , Educação em Enfermagem , Saúde Global , Disparidades em Assistência à Saúde , Humanos , Enfermeiros Administradores , Sociedades de Enfermagem
4.
Nursing ; 51(1): 32-39, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346615

RESUMO

ABSTRACT: Managing pain can be challenging, especially in patients with serious illnesses and a history of substance use disorders. This article discusses the challenges of addressing pain in these patients and offers perspectives regarding their clinical management.


Assuntos
Manejo da Dor/enfermagem , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Humanos
5.
Gynecol Oncol ; 146(1): 101-108, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28527672

RESUMO

PURPOSE: Long-term survival of women with advanced-stage ovarian cancer is relatively rare. Little is known about quality of life (QOL) and survivorship concerns of these women. Here, we describe QOL of women with advanced-stage ovarian cancer surviving for 8.5 years or longer and compare women with 0-1 recurrence to those with multiple recurrences. METHODS: Participants (n=56) recruited from 5 academic medical centers and the Ovarian Cancer Research Fund Alliance completed surveys regarding QOL (FACT-O), mood (CESD), social support (SPS), physical activity (IPAQ-SF), diet, and clinical characteristics. Median survival was 14.0 years (range 8.8-33.3). RESULTS: QOL and psychological adjustment of long-term survivors was relatively good, with mean FACT-G scores (multiple recurrences: 80.81±13.95; 0-1 recurrence: 89.05 ±10.80) above norms for healthy community samples (80.1±18.1). Survivors with multiple recurrences reported more compromised QOL in domains of physical and emotional well-being (p <.05), and endorsed a variety of physical and emotional concerns compared to survivors with 0-1 recurrence. Difficulties in sexual functioning were common in both groups. Almost half (43%) of the survivors reported low levels of physical activity. CONCLUSIONS: Overall, women with advanced-stage ovarian cancer who have survived at least 8.5 years report good QOL and psychological adjustment. QOL of survivors with multiple recurrences is somewhat impaired compared to those with 0-1 recurrence. Limitations include a possible bias towards participation by healthier survivors, thus under-representing the level of compromise in long-term survivors. Health care practitioners should be alert to psychosocial issues faced by these long-term survivors to provide interventions that enhance QOL.


Assuntos
Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/psicologia , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Epiteliais e Glandulares/psicologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/psicologia , Idoso , Carcinoma Epitelial do Ovário , Estudos Transversais , Intervalo Livre de Doença , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Psicometria , Qualidade de Vida , Apoio Social , Sobreviventes
6.
J Contin Educ Nurs ; 46(2): 65-73; quiz 74-5, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25633303

RESUMO

Catastrophic mass casualty events (MCEs), such as pandemic influenza outbreaks, earthquakes, or large-scale terrorism-related events, quickly and suddenly yield thousands of victims whose needs overwhelm local and regional health care systems, personnel, and resources. Such conditions require deploying scarce resources in a manner that is different from the more common multiple casualty event. This article presents issues associated with providing nursing care under MCE circumstances of scarce resources and the educational needs of nurses to prepare them to effectively respond in these emergencies.


Assuntos
Planejamento em Desastres/métodos , Recursos Humanos de Enfermagem/educação , Cruz Vermelha , Desenvolvimento de Pessoal/métodos , Educação Continuada em Enfermagem , Humanos , Estados Unidos
7.
Am J Nurs ; 121(3): 60-63, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33625014

RESUMO

This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; https://advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.


Assuntos
Administração Oral , Analgésicos Opioides/uso terapêutico , Infusões Parenterais , Morfina/uso terapêutico , Oxicodona/uso terapêutico , Medição da Dor , Relação Dose-Resposta a Droga , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Humanos , Papel do Profissional de Enfermagem , Cuidados Paliativos
8.
Palliat Support Care ; 7(4): 487-93, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19939311

RESUMO

American's experiences with dying and death have changed throughout the course of our history. As an agrarian society death, was seen first-hand on, often, a daily basis. Industrialization brought with it removal of the dying process to the hospital and burial became the responsibility of the undertaker. This separation of dying and death from society resulted in not only a physical barrier but a psychological one as well. Technology in health care once again raised issues of the dying process by asking people to make decisions about their health care in the realm of resuscitation, respirators, and the use of artificial food and fluids.One way that Americans have been known handle the difficult times in their lives is through humor. When it becomes difficult to cope, tears and laughter are both cathartic. This study analyzes cartoons from The New Yorker in an effort to categorize contemporary notions of death as well as establish the correlation between societal events related to dying and death and the overall percent of death-related cartoons in this media.


Assuntos
Atitude Frente a Morte , Desenhos Animados como Assunto , Senso de Humor e Humor como Assunto , Bibliometria , Humanos , Publicações Periódicas como Assunto , Pesquisa Qualitativa
9.
J Holist Nurs ; 37(1): 100-106, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29669454

RESUMO

The fields of palliative and holistic nursing both maintain a commitment to the care of the whole person, including a focus on spiritual care. Advanced serious illness may pose a plethora of challenges to patients seeking to create meaning and purpose in their lives. The purpose of this article is to introduce scholarly dialogue on the integration of entheogens, medicines that engender an experience of the sacred, into the spiritual and holistic care of patients experiencing advanced serious illness. A brief history of the global use of entheogens as well as a case study are provided. Clinical trials show impressive preliminary findings regarding the healing potential of these medicinal agents. While other professions, such as psychology, pharmacy, and medicine, are disseminating data related to patient outcomes secondary to entheogen administration, the nursing literature has not been involved in raising awareness of such advancements. Research is illustrating their effectiveness in achieving integrative experiences for patients confronting advanced serious illness and their ability to promote presence, introspection, decreased fear, and increased joy and acceptance. Evidence-based knowledge surrounding this potentially sensitive topic is necessary to invite understanding, promote scientific knowledge development, and create healing environments for patients, nurses, and researchers alike.


Assuntos
Medicina Tradicional/métodos , Cuidados Paliativos/métodos , Terapias Espirituais/métodos , Banisteriopsis , Canfanos , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Humanos , Mescalina/uso terapêutico , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/psicologia , Cuidados Paliativos/tendências , Panax notoginseng , Psilocibina/uso terapêutico , Salvia miltiorrhiza , Terapias Espirituais/normas , Tabernaemontana
10.
Am J Nurs ; 119(8): 66-69, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31356337

RESUMO

: This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; https://advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.


Assuntos
Neoplasias Encefálicas/enfermagem , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/normas , Família Militar/psicologia , Medicina Militar/normas , Pediatria/normas , Guias de Prática Clínica como Assunto , Criança , Evolução Fatal , Humanos , Masculino , Estados Unidos
11.
J Hosp Palliat Nurs ; 21(4): E17-E23, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31166302

RESUMO

Building on the strong work of previous research agendas (2009-2012, 2012-2015, 2015-2018), the Hospice and Palliative Nurses Association Research Advisory Council developed the 2019-2022 Research Agenda in consultation with Hospice and Palliative Nurses Association (HPNA) membership and assessment of major trends in palliative nursing. The HPNA Research Advisory Council identified 5 priority areas and asked subject experts in each area to summarize the state of the science, identify critical gaps, and provide recommendations for future research. This document expands the executive summary published on the HPNA website (www.advancingexpertcare.org/hpna/) and provides supporting evidence for the 2019-2022 recommendations. The 5 priority areas are as follows: (1) pediatric hospice and palliative nursing research; (2) family caregiving; (3) interprofessional education and collaborative practice; (4) big data science, precision health, and nursing informatics; and (5) implementation science.


Assuntos
Congressos como Assunto , Guias como Assunto , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/métodos , Educação Continuada em Enfermagem/métodos , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/tendências , Humanos
12.
J Gerontol Nurs ; 34(2): 21-6, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18286789

RESUMO

This study sought to document older Oklahomans' knowledge, attitudes, and behaviors regarding the decision to write an advance directive. In Oklahoma, 67% of individuals older than age 18 do not have an advance directive; 76% say the reason is that they "have not gotten around to it." The findings from this study also indicate that some groups in Oklahoma, because of their age and race, need nurses to initiate this conversation. The discussion about advance directives should be part of the health promotion teaching provided by nurses and presented to the general public as a normal part of health care, with the focus on planning for a comfortable and peaceful death.


Assuntos
Diretivas Antecipadas , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Fatores Etários , Idoso , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oklahoma
13.
Am J Nurs ; 118(10): 30-38, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30211703

RESUMO

: Medication-assisted treatment for opioid use disorder (OUD), which incorporates methadone, buprenorphine, or naltrexone, has been shown to reduce all-cause mortality rates in patients with this disease-and the numbers of patients receiving such treatment is substantial. In 2016, among U.S. patients with OUD, nearly 350,000 were treated with methadone, more than 60,000 were treated with buprenorphine, and more than 10,000 were treated with naltrexone. Managing acute pain in patients receiving this treatment can be a significant nursing challenge. The authors discuss the attributes of the three medications used to treat OUD and, through a composite patient case, review how to manage acute pain effectively in patients receiving this type of treatment.This article is one in a series on palliative care developed in collaboration with the Hospice and Palliative Nurses Association (https://advancingexpertcare.org), which offers education, certification, advocacy, leadership, and research on palliative care.


Assuntos
Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/enfermagem , Manejo da Dor/enfermagem , Síndrome de Abstinência a Substâncias/enfermagem , Analgésicos Opioides/farmacologia , Analgésicos Opioides/uso terapêutico , Buprenorfina/farmacologia , Buprenorfina/uso terapêutico , Feminino , Humanos , Metadona/farmacologia , Metadona/uso terapêutico , Pessoa de Meia-Idade , Naltrexona/farmacologia , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/farmacologia , Antagonistas de Entorpecentes/uso terapêutico , Papel do Profissional de Enfermagem , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Manejo da Dor/métodos , Cuidados Paliativos , Síndrome de Abstinência a Substâncias/prevenção & controle
14.
J Hosp Palliat Nurs ; 20(1): 6-14, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30063608

RESUMO

The Hospice and Palliative Nurses Association, in conjunction with the Hospice and Palliative Credentialing Center and the Hospice and Palliative Nurses Foundation, organized a Palliative Nursing Summit in Washington, DC, on May 12, 2017. The goal of the summit was to convene leaders from various nursing specialty organizations to develop a collaborative nursing agenda for primary palliative nursing. The work of the summit focused on 3 aspects of palliative nursing: communication/advance care planning, coordination/transitions of care, and pain and symptom management. The meeting objectives were to identify the current state of primary palliative nursing and to identify the greatest opportunities to advance primary palliative nursing within the 3 focus areas. Twenty-six nursing specialty organizations participated in the summit. This article describes the basis for the summit, the data and resources that informed the meeting's participants, the outcomes in each of the 3 categories, and next steps.


Assuntos
Congressos como Assunto/tendências , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/tendências , Planejamento Antecipado de Cuidados , Comunicação , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/organização & administração , Humanos
15.
Am J Nurs ; 117(11): 52-56, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29076857

RESUMO

: This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, competence, advocacy, leadership, and research.


Assuntos
Atenção à Saúde , Cuidados Paliativos , Imigrantes Indocumentados , Gastos em Saúde , Humanos , Patient Protection and Affordable Care Act , Estados Unidos
16.
Am J Nurs ; 117(9): 64-67, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28837496

RESUMO

This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.


Assuntos
Cuidados Críticos/métodos , Cuidados Paliativos/métodos , Relações Profissional-Paciente , Assistência Terminal/métodos , Diretivas Antecipadas , Idoso de 80 Anos ou mais , Doença de Alzheimer/enfermagem , Doença de Alzheimer/psicologia , Atitude do Pessoal de Saúde , Família , Humanos , Masculino , Equipe de Assistência ao Paciente , Conforto do Paciente
17.
J Pain Symptom Manage ; 54(5): 766-771, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28751078

RESUMO

CONTEXT: The American Academy of Hospice and Palliative Medicine (AAHPM) and Hospice and Palliative Nurses Association (HPNA) convened the Measuring What Matters (MWM) initiative in 2013, which recommended 10 quality performance measures; yet, little is known about the quality improvement (QI) environment and implementation of the MWM among hospices and palliative care services. OBJECTIVES: The objective of this study was to describe the findings of the 2016 AAHPM/HPNA Needs Assessment survey exploring the QI environment among hospice and palliative care services. METHODS: An online survey was distributed to approximately 16,500 AAHPM and HPNA members, and other hospice and palliative care organizations were invited to respond. Summary data and individual write-in responses were collated and analyzed. Data analysis included generating descriptive statistics and analyzing individual write-in responses for additional information and themes. RESULTS: More than 1000 responses were received. Most organizations had a designated QI leader and used an electronic medical record. Less than 50% of systems had fields for palliative care information. The top three MWM measures collected through an electronic medical record were pain treatment (66%), screening for physical symptoms (55%), and comprehensive assessment (54%). The most common barrier to implementing QI was time constraint. Most respondents had received no training and education in how to implement QI. CONCLUSIONS: The 2016 AAHPM/HPNA Needs Assessment Survey provided important information about the QI systems and measurement environment within hospice and palliative care services. Survey insights can aid AAHPM/HPNA in developing resources to empower hospice and palliative care clinicians to make QIs that matter for their patients and families.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Cuidados Paliativos , Melhoria de Qualidade , Adulto , Idoso , Registros Eletrônicos de Saúde , Meio Ambiente , Feminino , Pessoal de Saúde , Cuidados Paliativos na Terminalidade da Vida/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Inquéritos e Questionários
18.
Am J Nurs ; 116(6): 59-62, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27227867

RESUMO

This article is the first in a series on palliative care developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , Cuidados Paliativos , Medicina Baseada em Evidências , Humanos , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente
19.
Am J Nurs ; 116(10): 50-3, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27684772

RESUMO

This article is the second in a series on palliative care developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; http://hpna.advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.


Assuntos
Neoplasias/terapia , Cuidados Paliativos , Humanos , Sociedades de Enfermagem
20.
J Contin Educ Nurs ; : 1-9, 2015 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-25646952

RESUMO

Catastrophic mass casualty events (MCEs), such as pandemic influenza outbreaks, earthquakes, or large-scale terrorism-related events, quickly and suddenly yield thousands of victims whose needs overwhelm local and regional health care systems, personnel, and resources. Such conditions require deploying scarce resources in a manner that is different from the more common multiple casualty event. This article presents issues associated with providing nursing care under MCE circumstances of scarce resources and the educational needs of nurses to prepare them to effectively respond in these emergencies. J Contin Educ Nurs. 2015;46(x):xxx-xxx.

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