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1.
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
2.
JCO Oncol Pract ; 17(1): e26-e35, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33434451

RESUMO

PURPOSE: Approximately 20% of caregivers (CGs) live > 1 hour away from the patient and are considered distance caregivers (DCGs) who often report higher distress and anxiety than local CGs. The purpose of this study was to test the effectiveness of an intervention aimed at reducing anxiety and distress in DCGs of patients with cancer. METHODS: This randomized controlled trial enrolled DCGs of patients with all cancer types who were being seen monthly by oncologists in outpatient clinics. There were three arms of the intervention delivered over a 4-month period: arm 1 (a) received 4 monthly videoconference-tailored coaching sessions with an advanced practice nurse or social worker focused on information and support, (b) participated in patient's appointments with the oncologist via videoconference over the 4-month study period, and (c) had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other two components, and arm 3 received access to the DCG website only. RESULTS: There were 302 DCGs who provided pre- and postintervention data. There were significant anxiety by group (P = .028 and r = 0.16) and distress by group interactions (P = .014 and r = 0.17). Arm 1 had the greatest percentage of DCGs who demonstrated improvement in anxiety (18.6%) and distress (25.2%). CONCLUSION: Coaching and use of videoconference technology (to join the DCG into the patient-oncologist office visit) were effective in reducing both anxiety and distress for DCGs. These components could be considered for local CGs who-with COVID-19-are unable to accompany the patient to oncologist visits.


Assuntos
Transtornos de Ansiedade/psicologia , COVID-19/psicologia , Cuidadores/psicologia , Neoplasias/psicologia , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/patologia , Transtornos de Ansiedade/terapia , COVID-19/complicações , COVID-19/patologia , COVID-19/terapia , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/patologia , Neoplasias/terapia , Oncologistas , Qualidade de Vida , SARS-CoV-2/patogenicidade , Inquéritos e Questionários , Comunicação por Videoconferência/normas
3.
J Pain Symptom Manage ; 55(2S): S140-S145, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28800999

RESUMO

In February 2000, nine nursing educators, practitioners, and researchers met in Nashville, Tennessee, to develop a palliative care curriculum specifically for nurses. The following month, 22 advisors from nursing organizations across the United States convened in Washington, DC to review the recommended curriculum development and dissemination plans for end-of-life care throughout nursing schools, hospitals, hospices, home care, and geriatric settings. The Robert Wood Johnson Foundation provided funding for curriculum and competency development and for six national train-the-trainer courses to be held from 2001 to 2003. The curriculum entitled the End-of-Life Nursing Education Consortium was designed to meet the needs of nurses caring for patients with serious and complex illnesses at the end of their lives. This work, beginning in 2000 with the development of the End-of-Life Nursing Education Consortium curriculum, has been taught in every state across America and in 91 countries around the world and has been translated into eight languages. Over 21,400 trainers have returned to their institutions and educated over 642,000 colleagues.


Assuntos
Currículo , Educação em Enfermagem , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/educação , Liderança , Cuidados Paliativos , Assistência Terminal , Promoção da Saúde , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/métodos , Humanos , Internacionalidade , Cuidados Paliativos/métodos , Defesa do Paciente , Assistência Terminal/métodos , Estados Unidos
4.
Semin Oncol Nurs ; 30(4): 203-11, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25361872

RESUMO

OBJECTIVES: To describe the evidence that palliative care, provided concurrently with disease-modifying treatment early in the course of a cancer diagnosis, can improve quality of life, length of survival, symptom burden, mood, and utilization of health services. DATA SOURCES: Current research, the National Consensus Guidelines for Quality Palliative Care, and the American Society of Clinical Oncology Provisional Opinion on Integrating Palliative Care into Standard Oncology Care. CONCLUSION: Despite recommendations and evidence, only a subset of cancer centers and community-based oncology clinics currently implement palliative care into ambulatory disease-focused cancer care. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses can improve access by becoming knowledgeable about generalist palliative care and by advocating for local and national practice change.


Assuntos
Assistência Ambulatorial/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Neoplasias/terapia , Cuidados Paliativos/normas , Qualidade de Vida , Medicina Baseada em Evidências , Feminino , Reforma dos Serviços de Saúde , Humanos , Masculino , Neoplasias/enfermagem , Papel do Profissional de Enfermagem , Enfermagem Oncológica/organização & administração , Cuidados Paliativos/tendências , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Resultado do Tratamento , Estados Unidos
5.
Oncol Nurs Forum ; 38(3): 307-13, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21531681

RESUMO

PURPOSE/OBJECTIVES: To explore the new and complex phenomenon of distance caregiving in the advanced cancer population. RESEARCH APPROACH: Qualitative. SETTING: A large comprehensive cancer center in the midwestern region of the United States. PARTICIPANTS: 14 distance caregivers of parents with advanced cancer. METHODOLOGIC APPROACH: Patients with advanced lung, gastrointestinal, and gynecologic malignancies consented to have their distance caregiving adult children contacted to participate in the study. Responses to three open-ended questions guided the tape-recorded telephone interviews with the distance caregivers. Following transcription, content analysis with inductive coding was performed. FINDINGS: Two major themes, communication and control, and five subthemes, benefits and burdens of distance caregiving, dealing with uncertainty, direct action through information seeking, protecting, and staying connected, emerged from the data. CONCLUSIONS: Distance caregivers experience some of the same stressors that local caregivers of patients with cancer experience. In addition, they have unique psychosocial needs related to the burden of geographic distance. INTERPRETATION: Distance caregivers could benefit from nursing interventions targeted at their unique needs. Innovative interventions using Web-based computer technology for improved communication, as well as supportive care interventions, may be helpful.


Assuntos
Cuidadores/psicologia , Comunicação , Neoplasias/psicologia , Poder Psicológico , Apoio Social , Adulto , Efeitos Psicossociais da Doença , Feminino , Geografia , Humanos , Internet , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neoplasias/enfermagem , Enfermagem Oncológica/métodos , Estados Unidos , Adulto Jovem
6.
Am J Hosp Palliat Care ; 27(8): 560-6, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21071435

RESUMO

Multiple, complex factors influence end-of-life (EOL) decisions for all persons. In the African American population, these factors include history of disparities and discrimination in health care, which may affect the individual and the family, family system beliefs, values, and practices, and health care system issues. Family dynamics have an especially important role in treatment decisions for loved ones with advanced disease. A family systems framework can guide the clinicians in appreciating care needs and preferences at EOL. Understanding why so many African Americans choose aggressive and often burdensome care, even at the expense of suffering, is important for communication about options at the EOL and the delivery of quality care at the EOL.


Assuntos
Negro ou Afro-Americano , Competência Cultural , Tomada de Decisões , Hospitais para Doentes Terminais/estatística & dados numéricos , Relações Profissional-Família , Assistência Terminal , Atitude Frente a Saúde/etnologia , Disparidades em Assistência à Saúde , Humanos , Modelos Psicológicos , Confiança , Estados Unidos
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